Carefree Lodge

Opened in 1967 as a retirement home, the City of Toronto purchased the building from the Vint Foundation, renovated the site and opened Carefree Lodge in 1991, featuring:

• private and semi-private accommodations with ensuite washrooms on three levels (127 total beds)
• all resident bedrooms have air conditioning
• resident lounges
• a library, gift shop, and hair salon
• activity room with a full kitchen
• auditorium
• therapeutic garden and outdoor patio
• unique octagonal formal dining room that overlooks a ravine.

• As recognized leaders in behavioural support programs, we have a long history of demonstrated knowledge of dementia, delirium and mental health in the delivery of care.
• Staff and medical professionals are knowledgeable in the most prevalent types and related causes of behavioural issues, understand disease processes, stages and progression, diagnostic and assessment process, cognitive or neurological symptoms, treatment interventions, appropriate communication to address resident needs, strategies to promote optimal quality of life and experience of the behaviour(s) from the perspective of the resident, family members and other partners in care.
• Residents with severe cognitive impairment live on the Garden Level which includes its own dining room, lounge area with fireplace and secure outdoor patio.  Beautiful murals adorn the walls and life panels depicting the lives of each residents are installed outside the rooms
• Recreation programs are developed to meet the specific needs of the residents and are held during the day, evenings and on weekends
• We offer a range of inter-denominational faith services and based on the resident population we also offer specific cultural activities such as Jewish and Korean recreational activities.

Toronto Emergency Management leads and facilitates activities related to the City’s ability to mitigate, prepare for, respond to, and recover from major emergencies.

We have incorporated the City’s Business Continuity Management and Toronto’s Emergency Plan into an Emergency Management Plan for the City’s directly operated long-term care homes.

Carefree Lodge has a structured emergency management process of risk identification, mitigation, preparedness, response and recovery.

The scope of emergency management planning includes a variety of hazardous situations that may occur inside or outside of the long-term care home, such as:

• fire
• natural disaster
• biochemical and bomb threats
• chemical spills
• radiation exposure
• threats of personal violence
• power failure
• utilities and telecommunications failure

All staff members are trained to respond to these universal codes for emergencies:

• Code Red: Fire
• Code Black: Bomb Threat
• Code Yellow: Missing Resident
• Code Green: Evacuation
• Code Orange: External Disaster
• Code White: Violent Behaviour
• Code Blue: Cardiac Arrest
• Code Brown: Hazardous Spill
• Code Grey: Infrastructure Failure

In addition, we follow the Incident Management System (ISM) and have a robust Crisis/Disaster Communication Protocol.

For further information, please contact Cornel Baptista, Manager Environmental Services

Quality Improvement Report

Tenzin Nyima, Administrator, Designated Quality Improvement Lead and Chair of Site Continuous Quality Improvement Committee

Elizabeth Juraschka, Divisional Quality Improvement Advisor and Chair of Divisional Quality Council

Overview

The team at Carefree Lodge is dedicated to continuously improving the care and services provided. The quality improvement plan (QIP) for 2024/25 reflects our commitment to enhancing equity, improving resident and family experience, fostering innovation integrating palliative care and aligning with external partners to improve care outcomes.

Quality Improvement Priority Selection Process

The quality improvement priority selection process reflects the collaboration and analysis of statistical data trends, program evaluation outcomes, inspection guidelines, audit results, Ministry of Long-Term Care reports, results from the Resident and Family experience survey “Your Opinion Counts”, Ontario Health system level priority areas, collaborations with healthcare partners and opportunities for improvement submitted to Site Continuous Quality Improvement Committee.  The selection process is a balance between the many opportunities, resources available to support quality improvement work and the significant impact on the quality of care and service that can be achieved. The Quality Improvement Plan is developed through consultation and approved by the Site Continuous Quality Improvement Committee.

Priority Areas for 2024-25

The full Quality Improvement Plan 2024/25 and Narrative are posted in the home, on the Quality Improvement board, provided to Residents’ Council, Family Council, and staff.

Policies, Procedures and Protocols that Guide Continuous Quality Improvement

Quality Improvement policy:

• Establishes our commitment to continuous quality improvement in the provisions of care and service through the application of a quality improvement methodology to achieve positive resident outcomes.

Quality Improvement Project Idea Submission Form:

• An informal and formal mechanism that provides employee(s), residents, families, caregivers, Residents’ Council, Family Council and clients with an avenue for submitting quality improvement ideas for consideration by Quality Councils.

Quality Improvement Project Selection Matrix:

• The Quality Improvement Project Selection Matrix form assists in the prioritizing and approval of quality improvement submission ideas.

Quality Improvement Reporting:

• Quality Improvement reports are prepared and submitted at minimum quarterly to identify quality improvement priorities, current activities, success to date and future quality improvement work.

Quality Improvement Charters:

• The Quality Improvement Charter is a documentation tool that supports teams through the plan do study act (PDSA) problem-solving model. The PDSA problem-solving model provides a common framework for different teams to speak the same language and work together to improve a process or care outcome. The charter serves as a communication tool for the team and Quality Committee to track the progress of QI projects/initiatives.

Problem-Solving Cycle Model – Plan-Do-Study- Act (QI Model for Improvement)®:

• Quality improvement work within the home is grounded in QI science which outlines the tools and processes to support, assess achievements and spread QI results. Teams apply QI tools aligned within the Model for Improvement – plan do study act (PDSA), Six Sigma and Lean, enabling them to achieve incremental changes.

Divisional Quality Council, Site Continuous Quality Improvement Committee and Divisional Committee Structures

Structures and accountability are in place to support the commitment to quality improvement which includes, authorization to the General Manager from City Council to certify and approve on behalf of the City, the home’s annual Quality Improvement Plan(s) (QIPs) for submission to Ontario Health, as required under the Fixing Long-Term Care Act, 2021 and Excellent Care for All Act, 2010. The General Manager has responsibility and authority for the quality of care and service and the management of risks.

Seniors Services and Long-Term Care’s integrated quality management framework overseen by the divisional Quality Improvement Advisor considers and acts on opportunities to improve in areas related to strategic direction, quality improvement, risk management, safety culture, positive customer experience, resource allocation, just culture (including positive work life culture) and an ethical culture.

Accountability:

At a divisional level, the General Manager, with the leadership of Quality Improvement Advisor and support of the Divisional Quality Council directs, co-ordinates and provides for the ongoing development of the division’s Integrated Quality Management framework.

At a site level, the General Manager has delegated day-to-day operational accountability for quality improvement and risk management outcomes and innovation to the Administrator of each home.

The terms of reference of each committee reflects legislative requirements of membership and accountability.

Resident and Family Survey

The advice of Residents’ Council and Family Council was sought in developing and carrying out the annual Your Opinion Counts Survey which was administered in September 2023.  The survey consists of 13 standard questions with additional 1-2 questions from Residents’ Council and Family Council. The results of the survey are integrated into the QIP, as priority areas.

The results were presented to Residents’ Council in January 2024, and Family Council in March 2024, and advice was sought in the development of the Quality Improvement Plan. Updates on the plan and projects will be provided throughout the year as requested by the chairs of these committees and documented in the minutes.  Residents and families have been invited to participate in quality improvement work, including providing feedback through surveys. Resident and family members are part of the home’s Site Continuous Quality Improvement Committee terms of reference and committee.

Communication and Record of Quality Improvement Work

A comprehensive communication strategy supports quality improvement work within the long-term care home and at the division level.  The actions enable the home to broadly communicate annual Quality Improvement Plans, the results of quality improvement activities to senior management, residents/clients, caregivers, families, staff and volunteers.  A central part of the communication strategy is to seek advice if any from Residents’ Council and Family Council and make improvements as appropriate to care and services. Quality Improvement teams encourage and facilitate opportunities for input if any from Residents’ Council and Family Council into the annual Quality Improvement Plan and utilize feedback from residents/clients and families to improve the quality improvement system and communication methods.

• smoke-free environment
• diverse resident and staff population
• 2SLGBTQI+ friendly home accepting all residents regardless of religion, language, or cultural background.

Families are an integral part in helping make the best decisions for their family member. We offer many opportunities for families to be involved:

• Resident care conferences
• Quality Improvement, Innovation and Risk Management Committee
• Family Council
• Satisfaction surveys
• Volunteer services.

• Volunteers, including family members, adult and youth members of the community along with college and university placement students, all play a pivotal role in improving the quality of life of the residents
• Carefree Lodge has excellent partnerships with the North York General Hospital’s Psychogeriatric Mental Health Outreach Team, Nurse Practitioner-led Outreach Team (HRRH & NYGH) to work with our team to support resident care. The Regional Geriatric Program provides educational support to the team in management of resident care.