The City of Toronto operates 10 long-term care homes. Learn more about the quality care and services we provide as leaders in excellence and groundbreaking services for healthy aging.
We have been Accredited with Commendation for going beyond the requirements of Accreditation Canada’s Qmentum accreditation program and demonstrating an ongoing commitment to quality improvement.
Overall meeting 97 per cent of the 614 standard criteria and met 100 per cent of the required organizational practices (ROPs), which are evidence-based practices that mitigate risk and contribute to improving the quality and safety of health services: Safety Culture, Communication, Medication Use, Worklife/Workforce, Infection Control, and Risk Assessment.
High priority criteria results were impressive, as a percentage of criteria met: Leadership 100 per cent; Long-Term Care Services 94 per cent; Home Support Services 93 per cent; Infection Prevention and Control 92 per cent; and Medication Management 100 per cent.
A survey team of eight healthcare professionals from across Canada, visited all ten Toronto long-term care homes, community programs and head office May 2 – 6, 2016 as part of the Qmentum accreditation program. Organizations that choose to participate in this pursuit of excellence must complete detailed self-assessments, provide evidence of compliance with national standards, and commit to integrated quality management, continuous improvement and intensive peer review.
Accreditation Canada is a not-for-profit, independent organization accredited by the International Society for Quality in Health Care (ISQua).
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.
All City of Toronto long-term care homes have behavioural support programs. Cummer Lodge has a Ministry-designated 16-bed Behavioural Support Unit which receives enhanced funding.
In the Service Plan, we provide a framework to guide budget and resource allocations over the next five years to support how the City will provide, improve and prioritize long-term care services to a diverse, aging population with complex care and social needs.
Aligned with the service principles specified in the Toronto Seniors Strategy – Equity, Respect, Inclusion and Quality of Life – the Service Plan will:
Within the context of a rapidly changing long-term care landscape, the Service Plan captures current service levels, and notes where enhancements can be initiated and identifies opportunities where new services are needed, pending City Council approval and/or funding.
The Service Plan is part of a holistic approach to broader planning initiatives that include the divisional Strategic and Capital Renewal Plans, the City’s Strategic Actions, Toronto Seniors Strategy, other City initiatives and plans, as well as the priorities of provincial and partner organizations.
Preparation was collaborative, involving all stakeholder groups. Throughout the research, consultations, information gathering and sharing exercises, three overall themes and priorities emerged:
Within the Service Plan, further context is provided on what we do in terms of service delivery, who our residents and clients are and how we operate within the broader healthcare sector.
This Service Plan will differentiate between actions that are going to build on or enhance current service (which can be pursued within the existing budget) – and those which we will monitor and would represent “new” activities or programs, which would be subject to funding and Council approval.
Seniors Services and Long-Term Care provides a variety of exemplary, high-quality services along a comprehensive and flexible continuum of care – from enabling vulnerable individuals to continue living in the community to healthy aging and quality end of life care in our homes – to help seniors at different stages of their long-term care journey. The goal is to provide Torontonians in need of long-term care with the right services, at the right time, and in the right place. There is a need for:
To support residents in long-term care homes and clients living in their own homes for as long as possible through enhanced programs and services.
Pursue within the existing budget:
Subject to future approval by City Council:
Seniors Services and Long-Term Care serves a diverse population, from young adults with severe disabilities to seniors with cognitive impairments, medical complexities and behavioural challenges.
Residents and clients represent an increasingly diverse range of spoken languages, cultures and ethnicities, food preferences, faiths, sexual orientations, gender identities and expression. As a municipal service provider, we fills a gap in service for hard-to serve or under-served Torontonians, who may lack family support, struggle with poverty, homelessness, substance abuse or social isolation and lack resources to access long-term care.
At the same time, there is an increase in the complexity of residents’ and clients’ physical and mental health conditions and behaviours, requiring an investment in increased training, specialized services, and new approaches to care. Further, with the growing movement to support Torontonians to age at home for as long as possible and large wait-lists for long-term care homes, many individuals entering the City’s long-term care homes are older, frailer and have more complex needs than in the past. As the challenges of complex care needs, growing poverty and diversity intersect, we will continue to provide exemplary care that is responsive to the emerging needs of Toronto’s diverse and vulnerable adults.
To meet the increasingly complex and diverse needs of those we serve.
Pursue within the existing budget:
Subject to future approval by City Council:
Seniors Services and Long-Term Care strives to be recognized leaders in excellence and ground-breaking services for healthy aging, to make contributions that shape and influence public policy, and to improve the overall long-term care system and better serve the people of Toronto. We will continue to strengthen Toronto’s communities and the wider long-term care sector through a range of research, innovation and leadership initiatives.
The rising complexity of care needs and acuity of clients will require skill and competency training for staff at all levels.
Given the relative size of Toronto’s seniors population and the size and scope of Toronto as a municipal long-term care service provider, the City’s influence and leadership has the potential to have a far-reaching and positive impact on the wider long-term care sector. This could contribute to ‘improved quality of life and care’ for all seniors, enhance the appeal of long-term care as a career choice for future generations, and contribute to a thriving, age-friendly Toronto. It is important that this leadership role be highlighted as a key priority for the next five years.
To be recognized as a leader in the long-term care sector and within the City by supporting seniors.
Pursue within the existing budget:
Subject to future approval by City Council:
In November 2015, Toronto City Council approved the Long-Term Care Homes & Services Capital Renewal Plan. The plan allows the division to proceed with the staged redevelopment of five long-term care homes to meet new design standards, explore affordable housing opportunities and advance the vision to be leaders in excellence and ground-breaking services for healthy aging. The Capital Renewal Plan promotes and preserves partnerships, responds to emerging community needs, serves vulnerable individuals and ensures residents will continue to receive excellent care and services, throughout redevelopment, in City-operated long-term care homes.
The Capital Renewal Plan is an exciting opportunity to modernize and improve the design of homes while advancing our vision to be leaders in excellence and ground-breaking services for healthy aging. The plan keeps beds in service at each site for as long as possible in order to minimize disruption. Residents will continue to receive excellent care and service throughout the redevelopment program.City Council has directed:
Receiving approval of City Council is very encouraging and will allow us to move forward with planning. However, it is important to note that funding still needs to be allocated, so final Council approval of the Capital Renewal Plan is subject to budget approval.
In addition to approving the Capital Renewal Plan, Council adopted the George Street Revitalization plan which will include a long-term care home, emergency shelter, transitional assisted living and affordable housing units to better meet the needs of homeless, vulnerable and elderly individuals.
The Capital Renewal Plan is based on the following Guiding Principles:
The five (5) City of Toronto long-term care homes identified for mandatory redevelopment are:
End of life care is adopted when death is expected within six months. The aim is to provide comfort and quality of life by relieving the symptoms and stresses experienced at the end of life.
Palliative care is a type of specialized care which is administered when a terminal diagnosis is given for an illness or disease. The aim is not to cure, but to provide comfort and maintain the best quality of life, with a focus on providing relief by managing a resident’s pain and symptoms.
Each home has a care team made up of professionals that includes: physicians; nurses; social work counsellors; physiotherapists; dietitians; and, spiritual and religious care coordinators.
An end of life care plan determines how to provide care that reflects the resident’s physical, intellectual, social, emotional, and spiritual needs and preferences. The resident’s values, strengths, and desires will also be considered. End of life care plans are unique to each resident and are created in collaboration with the resident, the substitute decision-makers/family and the care team. The resident’s level of function will be assessed by looking at: how much they walk; their activity level and evidence of disease; their ability to care for self; how much they eat and drink; and their mental alertness. Looking at these factors will help guide a discussion with the resident and their family regarding end of life care.
The care team will take action based on the resident’s needs in order to minimize discomfort and provide relief from symptoms. Some of the symptoms experienced at end of life include: pain; tiredness and fatigue; drowsiness; nausea; changes in appetite; shortness of breath; depression and anxiety. The earlier we identify symptoms, the better we can manage and treat them.Grief and Bereavement Support: Grief is a natural and personal reaction to the death of a loved one. It is important to provide opportunities for expressing feelings and thoughts that are common in grieving. Staff, including a social work counsellor is available to speak with you and your family when needed.
Lesbian, gay, bi, trans, queer and two-spirit (LGBTQ2S) supports are available in all of the City’s long-term care homes.
In 2008, we published the LGBT Tool Kit for Creating Lesbian, Gay, Bisexual and Transgender Culturally Competent Care at Toronto Long-Term Care Homes & Services. At the time, this work was ground-breaking in supporting and caring for LGBT residents in long-term care.
The Tool Kit has been updated and the refresh focused on engagement within the organization given the experience gained since the original Tool Kit was published. In addition to building upon the successes, challenges and understanding further opportunities to deliver LGBTQ2S-inclusive care and services, the LGBT Tool Kit: Creating Lesbian, Gay, Bisexual and Trans Inclusive and Affirming Care and Services (2017) also supports self-reflection and learning for individuals wishing to learn more. While it is meant primarily for City management and staff, the Tool Kit is also available to other organizations as a resource.
The first two sections of the updated Tool Kit, Introduction and Background and Our Journey Continues provide context and set the stage for the following sections: Achieving Social and Cultural Competency and Achieving Organizational Competency which are related to how welcoming, inclusive and affirming environments can be created and supported by individuals and organizations. The Appendices contains resources related to a number of different areas that can be used as references to help support ongoing learning and understanding.
Resources are contained throughout the Tool Kit and include:
Self-study which provide links to resources throughout the Tool Kit
Self-reflection guide users through a series of questions to support thinking and understanding
Best practices provide readers with an opportunity to learn about a promising practice, process or initiative within Seniors Services and Long-Term Care as well as other organizations.
The appendices provide additional information in a variety of areas such as LGBTQ2S affirming religious and spiritual groups, LGBTQ2S activity protocols, community and educational resources.
End notes also provide links to resources referenced throughout the Tool Kit.
To request an electronic copy of the Tool Kit, please email ltc-ho@toronto.ca
Quality Improvement Plans (QIPs) are required to be developed by all long-term care homes for annual submission to Ontario Health by April 1. QIPs are intended to be organization and community-specific while integrating system and provincial priorities.
Visit HQO to access City of Toronto long-term care home QIPs including narratives, detailed summary of achievements, and QIP targets for the upcoming year.
Thank you for your interest in research at Seniors Services and Long-Term Care. We welcome opportunities to enhance our knowledge in pursuit of excellence in the services that we provide. We know that research is an integral component of knowledge building in pursuit of that excellence.
To that end, we have developed formalized processes related to the submission of research proposals these are based on our ethics statement and ethics decision-making principles. This framework guides us to ensure that any research that is approved to be conducted within our division meets the highest standards for health care research and also meets the more specific criteria established by Seniors Services and Long-Term Care.
All research proposals must have prior ethical approval from an accredited university, teaching hospital or national granting agency before the proposal will be submitted to the division’s own Ethics and Research Committee for consideration. All approved research must be conducted in a way that ensures minimal disruption to residents, clients, families and staff and provides learning and potential future benefit related to the enhancement of long-term care. All approved research must comply with the requirements of the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA) and the Personal Health Information Protection Act (PHIPA).
If you are interested in collaborating with us in research that would build knowledge in the pursuit of excellence in long-term care, email ltc-ho@toronto.ca subject line Research for more details about the application process.
A Guide for Planning and Providing Francophone Long-Term Care Services is for those involved in planning, advocating for, and providing Francophone health services. The guide provides an optimal model for providing long-term care in French and features the Pavillon Omer Deslauriers and Bendale Acres. Full report including resources available online in English and French
Seniors Services and Long-Term Care fully respects and promotes the following rights of residents:
Service Accountability Agreements outline the responsibilities of local health service providers and the Local Health Integration Network (LHIN) with each of the City’s ten long-term care homes and community programs situated across the boundaries of five LHINs:
The M-SAA is a multi-year agreement that supports a collaborative relationship between the LHIN and the health service provider to improve the health of Ontarians through better access to high-quality health services, to co-ordinate health care in local health systems and to manage the health system at the local level effectively and efficiently. Stated as a matter of record for public viewing, the following is a copy of the M-SAA between City of Toronto:
The City’s long-term care homes provide spiritual and religious care as part of its inter-disciplinary approach to resident care and service.
The Long-Term Care Homes Act, 2007 section 14 states: Every licensee of a long-term care home shall ensure that there is an organized program for the home to ensure that residents are given reasonable opportunity to practice their religious and spiritual beliefs, and to observe the requirements of those beliefs.
Within each of our homes there is a contracted Coordinator of Spiritual and Religious Care available to support residents and families in meeting their spiritual and religious care needs. The Coordinators work with multi-faith community leaders to ensure that residents’ traditions and beliefs are respected. Homes have regularly scheduled worship services for residents and it is possible to make additional arrangements for spiritual and religious care for another community faith leader or a lay visitor.
Zero Tolerance for Abuse applies to any person who has contact with a resident or client, including staff, agents, volunteers, family members, substitute decision makers (SDMs), visitors, paid trainees and paid companions. Seniors Services and Long-Term Care adheres to and enforces zero tolerance of abuse by any person.
Seniors Services and Long-Term Care strictly adheres to and enforces zero tolerance of abuse of residents and clients by any person.The policy Zero Tolerance for Abuse applies to any person who has contact with a resident or client, including staff, agents, volunteers, family members, substitute decision makers (SDMs), visitors, paid trainees and paid companions.The definition of zero tolerance for abuse is defined by the Ministry of Health and Long-Term Care as:
“Zero tolerance” means within this policy, that the Long-Term Care Home Operator shall:
For the purpose of this policy, staff includes any permanent, part-time and contracted:
This definition does not imply or create an employer/employee relationship where none exists, and it is used solely in the context of this policy to clarify that abuse will not be tolerated from any source.
Abuse can take many forms. Seniors Services and Long-Term Care will not condone any resident abuse. The Standards of Employee Conduct, Standard Respect for Others, 6.1 Resident Abuse, clearly defines staff expectations regarding resident abuse.
Abuse is defined as:
“Abuse” of a resident means any action or inaction, misuse of power and/or betrayal of trust or respect by any person against a resident, that the person knew or ought to have known, would cause (or could reasonably be expected to cause) harm to the resident’s health, safety or well-being.
Abuse includes, but is not limited to:
Residents have the right to dignity, respect and freedom from abuse and neglect. Seniors Services and Long-Term Care has a zero tolerance for abuse; therefore, abuse will not be tolerated by any person entering the Home and corrective action will be taken in all instances of resident abuse.