In response to COVID-19, there are screening requirements and some restrictions when visiting residents in long-term care homes.
Carefree Lodge provides individualized care to each of its 127 residents within a safe and friendly environment. Guided by the CARE values – Compassion | Accountability | Respect | Excellence, we are committed to improving quality of life and support for healthy aging.
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:
Toronto’s Office of Emergency Management (OEM) 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.
Beds for pandemic-related isolation purposes are available.
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:
All staff members are trained to respond to these universal codes for emergencies:
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 Quality Improvement, Risk Management and Innovation Committee
Elizabeth Juraschka, Divisional Quality Improvement Advisor and Chair of Divisional Quality Improvement, Risk Management and Innovation Committee
Overview
Carefree Lodge is a City of Toronto directly-operated long-term care home dedicated to continuously improving care and service provision. The quality improvement plan for 2023-24 reflects our commitment to engage with all stakeholders – residents, families, staff and external partners to collaboratively advance innovative care and services leading to improved outcomes. The commitment to quality improvement is grounded in Seniors Services and Long-Term Care’s mission, vision and values.
Identified strategic priorities provide a roadmap to address the many challenges long-term care operators will continue to face over the next few years and guide our approach to respond to sector-wide staffing shortages, an aging demographic, and the high acuity care needs and multiple health co-morbidities and complexities of the resident population. All of our work encourages innovation, research, effective, efficient service pathways and emotion-centered resident care.
Our commitment to quality improvement has over 20 years of history and we have been able to foster a culture of improvement where staff are committed to continuously enhancing the quality of care and services for residents, caregivers and families. Quality improvement is everyone’s responsibility and it is more than a project or initiative, it is about how we provide care and services, how we pivot, reflect, adapt, adopt and abandon practices when they no longer meet or achieve the desired outcomes. It is aligned with the experience responses received from the annual experience survey, Residents’ Council, Family Council and Home Advisory Committee. Quality Improvement is about doing something when you hear that change is needed, when data illustrates an area for improvement is required, and when service and care pathways no longer achieve positive outcomes. Quality Improvement is fluid, and empowers all stakeholders to collaborate to achieve an ideal state.
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 2023-24
Carefree Lodge will focus on improving:
The long-term care home has diligently worked on improving healthcare outcomes over the year(s) and is below the provincial average in several areas which will be monitored and were not included in the Quality Improvement Plan.
The full Quality Improvement Plan 2023/24 and Narrative are posted in the home, on the Quality Improvement board, provided to Residents’ Council, Family Council, staff and can be accessed on Ontario Health – Health Quality Ontario website.
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 2022. The survey consists of 14 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 will be presented to Residents’ Council and Family Council in April 2023 and advice will be received in the further 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.
Partnerships and Achievements 2022/23
In 2022/23 Carefree Lodge engaged with Alzheimer’s Society, Infection Prevention and Control partners at North York General Hospital and Home and Community Care Support Services, and Behavioural Supports Ontario.
The future of excellent care and services is linked to strong partnerships with many organizations and individuals such as researchers, hospitals, institutions of quality improvement, residents, families, and caregivers in order to build infrastructures, align resources, and create care models that reflect population healthcare needs, ensuring equitable access to care and services.
The team continues to foster a relationship of trust, collaboration and partnership with our residents, families and partners. These partnerships continue to support many quality improvement projects.
In 2022, Family Council was re-established with a new chair, and transitioned from virtual meetings to in-person. Family Council is very engaged and involved in organizing fundraising initiatives for residents, and actively involved in staff recognition.
Carefree Lodge implemented weekly falls rounds and weekly Care plan review with the staff on the unit to continue to focus on an interprofessional approach to care and remained a restraint free home, with zero restraints for all residents. This was done in collaboration with ongoing education to families, and staff in the benefits and risk associated with restraints.
In collaboration with Healthcare Excellence Canada the team assessed, tested and implemented processes that improved care planning with a focus on person-centred care plans related to falls. The home was invited to share their project at a national event held by Healthcare Excellence Canada.
The home’s commitment to quality improvement was acknowledged by Accreditation Canada, Institute for Safe Medication Practices and Healthcare Excellence Canada.
Policies, Procedures and Protocols that Guide Continuous Quality Improvement:
Quality Improvement policy:
Quality Improvement Project Idea Submission Form:
Quality Improvement Project Selection Matrix:
Quality Improvement Reporting:
Quality Improvement Charters:
Problem-Solving Cycle Model – Plan-Do-Study- Act (QI Model for Improvement)®:
Divisional Quality Improvement, Risk Management and Innovation Council Site Continuous Quality Improvement Committee and Divisional Committee Structures:
Seniors Service 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 Improvement, Risk Management and Innovation Council directs, co-ordinates and provides for the ongoing development of the division’s Integrated Quality Management framework.
Divisional Program leads and committee members are accountable to support the long-term care homes’ achieve positive outcomes through quality improvement work, audits, program evaluations, action plan development, risk management, innovation, education, and implementation of policies and procedures which reflect best practices.
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.
Communication 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.
Communication strategies are in place and include the following:
Families are an integral part in helping make the best decisions for their family member. We offer many opportunities for families to be involved:
For further information or to schedule a personal tour, please call 416-397-1500.