Welcome to Long-Term Care

Care lives here, and all are welcome.

We understand that you have many questions about your new home. This information will guide you around some of the important procedures we have in place to benefit and support all who live, work, and visit.

This video is for families who have a loved one living as a resident in one of the City of Toronto long-term care homes.

The fundamental principle to be applied in the interpretation of Fixing Long-Term Care Act, 2021 and anything required or permitted under this Act is that a long-term care home is primarily the home of its residents and is to be operated so that it is a place where they may live with dignity and in security, safety and comfort and have their physical, psychological, social, spiritual and cultural needs adequately met.

Seniors Services and Long-Term Care (SSLTC) fully respects that the following rights of residents are fully respected and promoted:

Right to be treated with respect

  1. Every resident has the right to be treated with courtesy and respect and in a way that fully recognizes the resident’s inherent dignity, worth and individuality, regardless of their race, ancestry, place of origin, colour, ethnic origin, citizenship, creed, sex, sexual orientation, gender identity, gender expression, age, marital status, family status or disability.
  2. Every resident has the right to have their lifestyle and choices respected.
  3. Every resident has the right to have their participation in decision-making respected.

Right to freedom from abuse and neglect

  1. Every resident has the right to freedom from abuse.
  2. Every resident has the right to freedom from neglect by the licensee and staff.

Right to an optimal quality of life

  1. Every resident has the right to communicate in confidence, receive visitors of their choice and consult in private with any person without interference.
  2. Every resident has the right to form friendships and relationships and to participate in the life of the long-term care home.
  3. Every resident has the right to share a room with another resident according to their mutual wishes, if appropriate accommodation is available.
  4. Every resident has the right to meet privately with their spouse or another person in a room that assures privacy.
  5. Every resident has the right to pursue social, cultural, religious, spiritual and other interests, to develop their potential and to be given reasonable assistance by the licensee to pursue these interests and to develop their potential.
  6. Every resident has the right to live in a safe and clean environment.
  7. Every resident has the right to be given access to protected outdoor areas in order to enjoy outdoor activity unless the physical setting makes this impossible.
  8. Every resident has the right to keep and display personal possessions, pictures and furnishings in their room subject to safety requirements and the rights of other residents.
  9. Every resident has the right to manage their own financial affairs unless the resident lacks the legal capacity to do so.
  10. Every resident has the right to exercise the rights of a citizen.

Right to quality care and self-determination

  1. Every resident has the right to proper accommodation, nutrition, care and services consistent with their needs.
  2. Every resident has the right to be told both who is responsible for and who is providing the resident’s direct care.
  3. Every resident has the right to be afforded privacy in treatment and in caring for their personal needs.
  4. Every resident has the right to,
      1. participate fully in the development, implementation, review and revision of their plan of care,
      2. give or refuse consent to any treatment, care or services for which their consent is required by law and to be informed of the consequences of giving or refusing consent,
      3. participate fully in making any decision concerning any aspect of their care, including any decision concerning their admission, discharge or transfer to or from a long-term care home and to obtain an independent opinion with regard to any of those matters, and
      4. have their personal health information within the meaning of the Personal Health Information Protection Act, 2004  kept confidential in accordance with that Act, and to have access to their records of personal health information, including their plan of care, in accordance with that Act.
  5. Every resident has a right to ongoing and safe support from their caregivers to support their physical, mental, social and emotional wellbeing and their quality of life and to assistance in contacting a caregiver or other person to support their needs.
  6. Every resident has the right to have any friend, family member, caregiver or other person of importance to the resident attend any meeting with the licensee or the staff of the home.
  7. Every resident has the right to designate a person to receive information concerning any transfer or any hospitalization of the resident and to have that person receive that information immediately.
  8. Every resident has the right to receive care and assistance towards independence based on a restorative care philosophy to maximize independence to the greatest extent possible.
  9. Every resident has the right not to be restrained, except in the limited circumstances provided for under this Act and subject to the requirements provided for under this Act.
  10. Every resident has the right to be provided with care and services based on a palliative care philosophy.
  11. Every resident who is dying or who is very ill has the right to have family and friends present 24 hours per day.

Right to be informed, participate, and make a complaint

  1. Every resident has the right to be informed in writing of any law, rule or policy affecting services provided to the resident and of the procedures for initiating complaints.
  2. Every resident has the right to participate in the Residents’ Council.
  3. Every resident has the right to raise concerns or recommend changes in policies and services on behalf of themself or others to the following persons and organizations without interference and without fear of coercion, discrimination or reprisal, [Watch SSLTC No Reprisal video on You Tube] whether directed at the resident or anyone else:
      1. the Residents’ Council.
      2. the Family Council.
      3. the licensee, and, if the licensee is a corporation, the directors and officers of the corporation, and, in the case of a home approved under Part IX, a member of the committee of management for the home under section 135 or of the board of management for the home under section 128 or 132.
      4. staff members
      5. government officials.
      6. any other person inside or outside the long-term care home.

We are committed to providing exemplary care and service. If we do not meet your expectations, we want to know about it so that we can quickly make it right. Our priority is to accomplish this in a supportive and transparent way that ensures there is no fear of reprisal.

If you have a question, concern or complaint:

  1. You are welcome to speak with any member of our front-line staff as they may be able to quickly answer your question or address your concern. If additional time or assistance is needed, staff will explain what steps will be taken which may include speaking to the Registered Nurse or Registered Nurse in Charge.
  2. If you are not satisfied with the outcome, please speak to the appropriate Manager within your resident home area.
  3. If you still have an unresolved question or concern, you are welcome to speak to the Director of Nursing or the Assistant Administrator.
  4. If after following the above steps your question or concern has not been resolved to your satisfaction, please speak directly to the Administrator of your home.
  5. We expect your concern or complaint to be resolved here in the LTC home, but if it is not, please contact the Director, Long-Term Care Homes, City of Toronto 416-392-3299.
  6. If you cannot resolve your issue, concern or complaint with the Director, Long-Term Care Homes, you may escalate to the General Manager, Seniors Services and Long-Term Care, City of Toronto 416-392-8896.
  7. Concerns or complaints not addressed to your satisfaction by the General Manager and not covered by the Ministry of Long-Term Care, may also be directed to the: City of Toronto Ombudsman 416-392-7062.

In line with Ministry guidance, caregivers /essential visitors may visit, even if the long-term care (LTC) home is in outbreak, to provide essential support for a resident to maintain good health and well-being.

Caregivers / essential visitors:

  • receive added training on IPAC and PPE
  • be provided with and a wear mask and PPE as required, depending on the condition of the resident they are visiting.

All general visitors are welcome to visit.

Sometimes there may be a need to limit the number of visitors at a time, depending on the physical structure of the LTC home and based on Toronto Public Health direction, please follow staff guidance.

In some circumstances, general visitors may need to wear a mask and PPE for indoor visits. If required, these items will be provided.

In line with the CARE values, the presence of family, friends, and the community support a home-like environment and contribute to a high quality of life for those residing in long-term care.

There are four types of essential visitors:

  • people visiting very ill or palliative residents who are receiving end-of-life care for compassionate reasons, hospice services, etc.
  • government inspectors with a statutory right of entry
  • support workers provide support to the critical operations of the home or to provide essential services to residents
  • caregivers provide direct care to meet the essential needs of a particular resident
  • caregivers must be at least 16 years of age and must be designated by the resident or their substitute decision-maker.

Tips when visiting a long-term care home operated by the City of Toronto:

  • There is no requirement to schedule your visit and there are no limitations on the length or frequency of visits, you are welcome at any time
  • Provide required information in the Visitor Log
  • Adhere to all posted Ministry and City of Toronto guidelines and policies
  • Stay out of non-resident areas such as the nursing station, staff rooms, storage rooms, utility rooms, etc.
  • Non-family members need to be expressly invited into a resident room by the resident or family
  • Children are always to be supervised by a responsible adult
  • Pets must be leashed, well-mannered and have updated rabies vaccination.

Maintaining a healthy and safe environment for all:

  • Please do not visit the long-term care home if you feel ill, unwell or have symptoms that are not related to pre-existing health conditions
  • Please clean your hands frequently, cover coughs or sneezes with tissue or crook of arm, refrain from touching your face
  • Participate in training on infection prevention and control (IPAC) practices and adhere to use of personal protective equipment (PPE), as required
  • Please refrain from wearing scented products
  • Visitors who are legally prohibited from contacting a resident are not permitted to visit
  • If Infection Control Precaution signage is posted, please check with the nursing staff for further direction prior to entering the resident room
  • During an outbreak, visitors are expected to adhere to any restrictions put into effect by Toronto Public Health, including wearing a mask and required PPE
  • Follow staff instruction in the event of an emergency
  • Visitors will refrain from providing personal care to residents for which knowledge, education, and certification may be required. Do not bring in medications and leave in resident room, always give to the nurse
  • During winter months, visitors are asked to take care to ensure they have removed excess snow from clothing and footwear; resulting puddles could become a hazard.

Health Information and Privacy:

  • Staff are only able to provide updates on a resident’s specific condition to a documented designated person
  • Visitors, including family, may not take pictures or video recordings of any other visitors, staff or residents without the express consent of the individuals involved
  • Visitors may be requested to leave a resident’s room when care is being provided.

Other:

  • Food and fluids are available for resident consumption only. Meal tickets can be purchased from the Administration Office for visitors
  • Supplies and equipment re not available for use by visitors without the express permission from management
  • Smoking is prohibited in the long-term care home and nine meters surrounding any entrance/exit. Smoking is only permitted in designated areas on the grounds
  • The consumption of alcohol is prohibited by visitors
  • Possession and use of street drugs and/or weapons is prohibited.

Unacceptable behaviour on the part of a visitor such as loud and disruptive behaviour, verbal abuse, physical abuse, violence, interference with the care of a resident, and infringement of the guidelines for visitors will not be tolerated and may result in visiting restrictions or visiting prohibition.

Please do your part to prevent infections and help keep everyone safe by adhering to these infection, prevention and control (IPAC) tips:

  • Screen yourself before visiting
  • Stay home if you are unwell
  • Stay up-to-date with vaccinations
  • Clean your hands often
  • Follow additional IPAC instructions given by staff members and adhere to all posted guidelines
  • Practice good respiratory hygiene
  • Properly wear supplied personal protective equipment.

Each long-term care home has an Infection, Prevention & Control (IPAC) Manager to lead, plan and oversee infection monitoring programs, identify and mitigate risk factors, prevent disease outbreaks, and improve resident outcomes.

In line with Ministry direction, the City will support, monitor and record all resident non-emergency absences from the home, without requiring discharge.

Absences from the home include:

  • Medical absence where the length of the medical absence does not exceed 30 days.
  • Psychiatric absence where the length of absence does not exceed 60 days.
  • Casual absence during the period between midnight on a Saturday and midnight on the following Saturday and that the total length of the resident’s casual absences during the period does not exceed 48 hours.
  • Vacation absence, where the total length of the resident’s vacation absences during the calendar year does not exceed 21 days.

To ensure the safety and security of all residents, policies for private sitters, hired to provide companionship for the resident, include the requirement for a police reference check to be completed and submitted prior to the resumption of duties.

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:

  • Uphold the right of the residents of Long-Term Care Homes to be treated with dignity and respect within those homes, and to live free from abuse and neglect.
  • Neither abuse, nor allow the abuse of any resident in the Operator’s Long-Term Care Home by Staff or volunteers, nor condone the abuse of any resident by any other person(s) at the home.
  • Provide information and education regarding abuse and the prevention of abuse.
  • Treat every allegation of abuse as a serious matter.
  • Investigate every allegation of abuse.
  • Take corrective action, including sanctions or penalties against those who have committed abuse against a resident.
  • Report to the Ministry of Health and Long-Term Care every suspected or confirmed incident of abuse.
  • Make every effort to eliminate abuse through the quality and risk management programs.

For the purpose of this policy, staff includes any permanent, part-time and contracted:

  • Employees
  • Physicians
  • Agency staff
  • Contracted health-care professionals
  • Paid trainees
  • Students under clinical placements
  • Paid companions (paid by the resident, family member or substitute decision-maker).

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:

  • Physical Abuse
  • Sexual Abuse and Sexual Assault
  • Emotional Abuse
  • Verbal Abuse
  • Financial Abuse
  • Exploitation or a Resident’s Property or Person
  • Neglect
  • Prohibited Use of Restraints
  • Measures Used to Discipline a Resident

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.