Toronto has an aging population, with the number of seniors 75+ expected to triple by 2041. Residents in City operated long-term care (LTC) homes have an average of eight co-morbidities and 87 per cent are dependent upon or require extensive assistance with daily activities.

CareTO, the City’s Emotion-Centred approach, adopted by City Council in 2019 (EC10.8), is a multi-year program to improve quality of life for residents and to invest in professional development for staff who provide care and services. Lakeshore Lodge (150 residents) is the CareTO pilot site with the remaining nine LTC sites, home to more than 2,400 residents, to be brought on in 2023.

Current Status

The pandemic highlighted existing vulnerabilities within the long-term care sector:

  • Adding more care requires more staff resources. Senior Services and Long-Term Care (SSLTC) is mandated by legislation to meet Ministry of Long-Term Care staffing requirements.
  • The LTC and health human services sector faces significant resource gaps, exacerbated by COVID-19.
  • To support direct resident care and service delivery, investments and focus on standardized recruitment, workforce planning, and retention and performance management of a skilled workforce is required to sustain the changes required for excellence.

The overall cost of the multi-year CareTO program (2021-2025) is $60.4 million gross or $7.8 million net. The City’s annual budget processes have since included considerations for base funding and enhancements for direct care nursing hours and to train additional staff.

Background & Context

  • Toronto Seniors Strategy outlines Council’s mandate to improve equity, respect, inclusion, and quality of life for seniors.
  • COVID-19 exacerbated systemic under-funding and staffing challenges. In response, the Province is moving to increase the number of direct care hours for LTC residents to four by 2024/25
  • Experts have reviewed Dementia Care Models and recommended increasing staffing levels to maintain current quality and address the complex care needs of residents.
  • Council adopted recommendations to increase hours of care for LTC residents, adding both staff and educational supports to guide the transition to a social model of living.

Truth, Justice & Reconciliation

SSLTC is engaging with Toronto Public Health and Indigenous service providers to determine the feasibility of developing an Indigenous specific long-term care home. Concurrently, SSLTC is exploring adapting existing programs, services and spaces to support Indigenous cultural practices provide training for staff members in Indigenous healing and wellness practices and create culturally-specific supports for Indigenous community members choosing to age in place.

Equity, Diversity & Inclusion

Toronto is diverse and the residents in City LTC homes come from 55 countries of origin, speak 50 languages/dialects and practice 34 faiths. CareTO enhances resident autonomy by incorporating their personal preferences and lived experiences to attend to their emotional and social needs. Furthermore, increasing equitable care for seniors aligns with the Toronto Seniors Strategy, Poverty Reduction Strategy, Action Plan to Confront Anti-Black Racism and HousingTO Action Plan. In 2022, SSLTC released Leading & Learning with Pride: A Revitalized Tool Kit on Supporting 2SLGBTQI+ Seniors, co-developed with the community. To support its implementation, managers and staff are receiving education in diversity, equity and inclusion, emotional literacy, collaborative teamwork, relational care and advancing initiatives through the City’s Confronting Anti-Black Racism unit, including a staff mentoring program.

Key Contact

Jennifer Dockery
General Manager, 416-392-8896

Soo Ching Kikuta
Director, Resident Care & Services,416-292-8488

Daniela Sabitini
Director, Management Services, 416-392-9061

Additional Resources