Community Handbook Victoria Manor
Contents 1
Welcome from our Director Long Term Care, Administrator
39 Spousal Reunification 40 Leaves of Absence
3
Our Purpose, Values and Vision
4
Our Approach to Living
6
Diversity, Equity and Inclusion Statement
55 Safety and Security
7
Our Shared Commitment
58 Infection Prevention and Control
42 Clinical Care 51 Privacy
11 Residents’ Bill of Rights
61 Emergency Procedures
15 Communication
62 Financial/Service Agreements
17 Your Voice
72 Long-Term Care Governance
19 Our Team
73 Support Resources for Residents and
21 Partners in Care/Essential Caregivers
23 Volunteer Services 26 Accommodations/Life at the Community
Families
76 Glossary of Terminology Content written by Sienna and adapted by the City of Kawartha Lakes
Greetings, This booklet has been prepared as a resource to help you get to know your community. If you have any questions that are not answered in this guide, please ask any of our team members for assistance. Our Purpose is Cultivating Happiness in Daily Life. This means your happiness is equally as important as your comfort and safety. This community is your home, where you can thrive in an environment that fosters friendships, stimulating activities, and a sense of belonging. Our Circle approach to living puts you at the centre of everything we do. With a strong foundation of service excellence and quality clinical care, Circle goes even further to elevate quality of life. Whether it is settling into your new home, savouring delicious meals, enjoying stimulating activities, or socializing with your neighbours, family, and friends, our Circle approach will surround you with the means to live your life to the fullest. As partners in care, our team is here to provide you with care and services that are tailored just for you. We value your ongoing feedback and encourage you and your loved ones to participate in care conferences, surveys where we will seek your opinions on your experience, Residents’ and Family Council meetings, and in everyday conversations with our team. We believe it is a privilege to care for and serve people living in our community. Our commitment is to ensure that you live with utmost comfort, dignity, and respect.
Sincerely,
Kyle Cotton Director Long Term Care, Administrator Victoria Manor
1 | Victoria Manor Community Handbook
Our Purpose:
Cultivating happiness 2 | Victoria Manor Community Handbook
in daily life.
Our Values: Act Positively We inspire happiness and hope in the people around us.
Be Accountable We do what we say we will and work as a team to get things done.
Create Community We foster strong relationships and celebrate diversity.
Demonstrate Caring We are passionate about what we do, and engage with empathy and understanding.
Our Vision:
Most Loved and Most Trusted Long-Term Care Home in Kawartha Lakes.
3 | Victoria Manor Community Handbook
Our approach to living:
Surrounding you with the care and support needed to live life to the fullest. 4 | Victoria Manor Community Handbook
It starts from the moment you move in, where we welcome you with a warm, caring, and tailored experience. We put you at the centre of everything we do, helping you to live with utmost dignity, respect and comfort. We call this our Circle approach, where we surround you with the care and support needed to live life to the fullest. Built on a strong foundation of service excellence and quality clinical care, Circle goes even further to elevate your quality of life. Whether it’s settling into your new home, savouring delicious meals, enjoying stimulating activities, or socializing with your neighbours, family, and friends, Circle delivers a person-centred experience for every member of our community. Our Circle approach is guided by our Purpose to cultivate happiness in daily life.
Settle-in Creates a caring, positive move-in experience, and helps you smoothly transition into your new home and life.
Savour it Elevates the culinary experience with hospitality and service, with focus on food quality, flexibility, and diverse menu options that reflect the community.
Stimulate Enhances your experience based on individual preference, while encompassing all domains of health: physical, social, intellectual, emotional, and spiritual.
Socialize Facilitates meaningful visits and social connections by expanding our sense of community, widening the circle outside our walls to welcome our neighbours and partners.
5 | Victoria Manor Community Handbook
Diversity, Equity, and Inclusion Differences in race, ethnicity, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, cognitive ability, and age are acknowledged, celebrated, and welcome in all those living, visiting, and working in this community. Please note: when we talk about “Family” in this guide, we mean any person of importance in your life, including legal/biological family, chosen or found family, and friends.
6 | Victoria Manor Community Handbook
Our Shared Commitment Each and every day, we strive to cultivate happiness in daily life by enabling our team to put their passion for their work into action. We are committed to helping you discover happiness through personalization, choice and community engagement in a comfortable, home-like setting. Everyone living, working, and visiting here plays an important role in achieving this goal. You help us create a safe, respectful and comfortable home for all who live here, and where team members can thrive and feel encouraged to do their best for you. Here, we highlight our shared commitment to ensuring you live with the utmost comfort, dignity and respect.
Living our Values We believe that how we do our work is just as important as what we do. We have four core Values that guide our work and our actions every day. Act Positively – We inspire happiness and hope in the people around us Be Accountable – We do what we say we will and work as a team to get things done Create Community – We foster strong relationships and celebrate diversity Demonstrate Caring – We are passionate about what we do, and engage with empathy and understanding 7 | Victoria Manor Community Handbook
What we commit to: • Our entire team is engaged in demonstrating these Values consistently. • We recognize team members for putting these Values into practice in meaningful ways. What we ask of you: • As an important part of our community, we ask you to join us in the responsibility to uphold these Values so that together, we foster an environment where everyone can thrive. • We know you value the effort and compassion of the team members in your community. Please take the opportunity to recognize their behaviours as they put our Values into practice.
Health, Safety, and Support What we commit to: The health and safety of all who live, work, and visit here is our number one priority. • Our team always strives to provide high-quality and compassionate care and services based on your individual needs. • Our experts will ensure we are always implementing best practices for infection prevention and control. • We strive to adhere to all regulatory requirements at all times. What we ask of you: We need your help to support the health and safety of everyone in our community, including all who live, work, and visit here. • Follow all infection prevention and control protocols as per team member instructions. • Visitors: Help us ensure the community is free from illness by not visiting when sick or feeling ill. Sign in and out of the kiosk/visitor logbook at each visit so we know who is in the building. Remember to take care of yourself.
8 | Victoria Manor Community Handbook
Fairness and Respect What we commit to: Respect, kindness and compassion go hand in hand with excellent care and quality of life. We believe that if we all work together, focused on bringing happiness to daily life, we will have harmony for everyone who lives, works and visits here. • We encourage respectful and supportive interactions focused on productive solution-building. • The rights of every individual are equally respected at all times and we will act upon any inappropriate behaviours. What we ask of you: Help us to promote an environment that is respectful to everyone – people living here, team members, family members and visitors – at all times. We accept nothing less. If you are a witness to any inappropriate behaviour, please report it immediately to a manager or the nurse in charge.
Communication What we commit to: We strive to be open and transparent with regular communication to ensure you know what is happening at the community. This means: • We provide timely updates across multiple channels, including email, phone calls, town hall meetings, and newsletters. We will always look for new and better ways to communicate. • We will ensure that you/your Substitute Decision Maker (as applicable) are aware of and involved in the development of your Plan of Care to assess, evaluate, and deliver your healthcare and social care needs in accordance with all applicable provincial regulations. What we ask of you: Stay informed of what is happening at the community and get involved. • Be familiar with the Move-in Guide and Community Handbook, which provides useful information about how things work at the community. • Make sure we have your current email address and other contact information so we can reach you. Check that you are receiving the regular e-newsletters, as well as receiving invitations and attending town halls where we share information about life at our community. 9 | Victoria Manor Community Handbook
• There are many volunteer opportunities in our community. Consider joining the Residents’ Council or Family Council, or ask the Manager of Resident and Family Services about other ways you can get involved.
Concerns, Compliments and Understanding What we commit to: We know that questions may come up and from time to time, difficult situations may arise that need to be addressed in a timely and sensitive way. Whatever the circumstances, we want to work with you in overcoming any issues or obstacles, and to hear about things that are working well. • We offer various mechanisms for you to provide your input and ask questions, both through regular communication and in our satisfaction surveys. • We are committed to acknowledging and responding to you in a timely manner. What we ask of you: • • • • •
We invite you to tell us how we’re doing, anytime Ask questions at our town halls Share your feedback through our satisfaction surveys Speak to your Residents’ Council/Family Council Give us a call
Connect with your Residents’ Council/Family Council if there are topics or ideas you would like them to explore with leadership at the community. Please rely on us for the facts. If you have questions or concerns, or have heard something you want to clarify, please ask us. You can speak to the Administrator at the community or reach out to them by phone or email.
10 | Victoria Manor Community Handbook
Residents’ Bill of Rights 3 (1) Every licensee of a long-term care home shall ensure that the following rights of residents are fully respected and promoted:
Right to be Treated With Respect 1.
2. 3.
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. Every resident has the right to have their lifestyle and choices respected. Every resident has the right to have their participation in decision-making respected.
Right to Freedom from Abuse and Neglect 4. 5.
Every resident has the right to freedom from abuse. Every resident has the right to freedom from neglect by the licensee and staff.
Right to an Optimal Quality Of Life 6. 7. 8. 9. 10.
11.
Every resident has the right to communicate in confidence, receive visitors of their choice and consult in private with any person without interference. Every resident has the right to form friendships and relationships and to participate in the life of the long-term care home. Every resident has the right to share a room with another resident according to their mutual wishes, if appropriate accommodation is available. Every resident has the right to meet privately with their spouse or another person in a room that assures privacy. 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. Every resident has the right to live in a safe and clean environment.
11 | Victoria Manor Community Handbook
12.
13.
14. 15.
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. 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. Every resident has the right to manage their own financial affairs unless the resident lacks the legal capacity to do so. Every resident has the right to exercise the rights of a citizen.
Right To Quality Care and Self-Determination 16. Every resident has the right to proper accommodation, nutrition, care and services consistent with their needs. 17. Every resident has the right to be told both who is responsible for and who is providing the resident’s direct care. 18. Every resident has the right to be afforded privacy in treatment and in caring for their personal needs. 19. Every resident has the right to, i. participate fully in the development, implement. participate fully in the development, implementation, review and revision of their plan of care ii. 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, iii. 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 iv. 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. 20. 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.
12 | Victoria Manor Community Handbook
21. 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. 22. 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. 23. 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. 24. 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. Note: On a day to be named by proclamation of the Lieutenant Governor, paragraph 24 of subsection 3 (1) of the Act is amended by striking out “restrained” and substituting “restrained or confined”. (See: 2021, c. 39, Sched. 1, s. 203 (3)) 25. Every resident has the right to be provided with care and services based on a palliative care philosophy. 26. 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 27. 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. 28. Every resident has the right to participate in the Residents’ Council. 29. 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, whether directed at the resident or anyone else: i. the Residents’ Council. ii. the Family Council. iii. 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 iv. committee of management for the home under section 135 or of the board of management for the home under section 128 or 132. 13 | Victoria Manor Community Handbook
v. staff members. vi. government officials. vii.any other person inside or outside the long- term care home.
Further Guide to Interpretation (2) Without restricting the generality of the fundamental principle, the following are to be interpreted so as to advance the objective that a resident’s rights set out in subsection (1) are respected: 1. 2. 3.
This Act and the regulations. Any agreement entered into between a licensee and the Crown or an agent of the Crown. Any agreement entered into between a licensee and a resident or the resident’s substitute decision-maker.
Enforcement by the resident (3) A resident may enforce the Residents’ Bill of Rights against the licensee as though the resident and the licensee had entered into a contract under which the licensee had agreed to fully respect and promote all of the rights set out in the Residents’ Bill of Rights.
Regulations (4) The Lieutenant Governor in Council may make regulations governing how rights set out in the Residents’ Bill of Rights shall be respected and promoted by the licensee.
14 | Victoria Manor Community Handbook
Communication Your care team will keep you updated regularly about events and activities. We have a number of ways to keep you informed. We encourage you to let us know the best ways to communicate with you and provide information. We welcome you to reach out to our team any time you have a question, concern, compliment, or anything else you wish to share. If you/your loved one require supports for interpretation, translation, and/or augmentative and alternative communication, please speak to a member of our team and we will do our best to assist you.
15 | Victoria Manor Community Handbook
We welcome you to reach out to our team any time you have a question, concern, compliment, or anything else you wish to share. Some of the ways we regularly communicate with you and your loved ones include, but are not limited to: • Community Town Halls – conducted virtually and/or in person to provide updates on the community and offer opportunity for questions and answers with the leadership team. • Bulletin Boards – information is posted on upcoming activities, general interest, and any other items you may want to be aware of. • Connections Newsletter – distributed to you and your loved ones in person and via email. It includes updates on the community, messages from the Administrator and other leaders, any safety protocols in place, and sharing of special moments at the community. Please be sure we have your email address and the email addresses of any family members who would like to receive this newsletter. • Satisfaction Surveys • Daily Menu Boards • Residents’ and Family Council Meetings • Community Handbook – your go to reference guide on life at our community • Email Updates or Phone Calls as Needed • City of Kawartha Lakes Website (www.kawarthalakes.ca) • Sienna Senior Living, our partner in care (www.siennaliving.ca)
16 | Victoria Manor Community Handbook
Your Voice Your feedback is always important to us. Compliments, comments, suggestions or concerns may be brought forward to any manager. In addition to participating in some of our formal feedback forums, we offer other formal opportunities to have your voice heard.
Let’s Connect Our “Let’s Connect” feedback program encourages open and ongoing dialogue about any of our programs or services. There are many ways for you and your loved ones to share your thoughts with us: • Fill out a Let’s Connect comment card at any time and submit it to any one of our confidential Let’s Connect boxes. • Speak directly with the Administrator or with any manager on duty. • Submit your feedback to the City of Kawartha Lakes at www.kawarthalakes.ca/ComplimentsComplaints or call 705-324-9411 • For emergencies or urgent concerns, please contact the nurse or manager on duty to request immediate assistance. There is also a poster from the Ministry Long-Term Care (MLTC), providing direction on how to contact the Ministry should you wish to bring a concern to their attention. 17 | Victoria Manor Community Handbook
Satisfaction Surveys Your feedback through this survey is incredibly meaningful to help us determine both what we are doing well and what we can improve. At least once a year, we will reach out to you and your loved ones to participate in a Satisfaction Survey to understand your level of satisfaction with our care and services. Your feedback through this survey is incredibly meaningful to help us determine both what we are doing well and what we can improve. We review all the feedback you provide and use it to inform quality improvement efforts both at our community and across our organization. We are happy to facilitate any assistance you need to be able to participate, including translation of the survey in multiple languages. We may also contact you to request your response to other surveys, such as how we supported your move-in experience, or to understand how we are doing on specific quality improvement projects. We thank you in advance for your valuable time in providing your feedback and commit to doing all we can to be responsive and inclusive of your responses in our action planning.
18 | Victoria Manor Community Handbook
Our Team We believe that what makes our community so special is our people – team members who know that the fullness of life comes cultivating happiness – from being surrounded by people who come when you call, who listen and understand, who help you to be your best. Our team members undergo a rigorous screening and orientation upon hire. While training addresses the specifics of each team member’s new role, they must also review and understand our Code of Conduct (including ethical and legal compliance), and commitment to service excellence, privacy, and confidentiality.
Gifts Please be aware that in accordance with our policy, team members cannot accept money or gifts from you, your family/visitors, or others. We encourage you to convey your compliments or satisfaction with service to us by filling out a Let’s Connect card or by speaking with a member of our management team.
19 | Victoria Manor Community Handbook
Personal Support Workers provide direct care to you every day, including assistance at whatever level is required with activities such as bathing, personal hygiene, using the washroom and/or incontinence products, mobility, and meals. Nurses (RNs, RPNs) are responsible for the day-to-day functioning of the neighbourhood/home area, as well as for distributing medications, completing clinical assessments, supporting you in the development of your plan of care, and administering treatments. Physicians are available to serve your medical needs, visiting regularly and providing emergency coverage. They also order any consultations with specialists and hospital examination visits. You may choose to retain your own physician while living at the community; please connect with us if this is your preference so we can support whatever requirements may be needed to ensure continuity of care. Therapy services may be arranged as needed following an assessment and referral by the care team. Services are provided within the community by a variety of healthcare providers, such as a Physiotherapist, Occupational Therapist, or SpeechLanguage, Pathologist, based on individual need. The community’s Dietary Manager works closely with a Registered Dietitian to ensure your meal preferences and nutritional needs are met. You may also meet Dietary Aides who support with meal preparation, service, and cleanup. The Life Enrichment Supervisor and Assistants will support you to participate in high quality and varied recreation and leisure offerings designed to meet individual needs and preferences. Our valued Building Services team includes Housekeeping and Laundry teams that keep our community clean and welcoming, caring for common areas, resident rooms, and community and personal laundry. It also includes our Maintenance team that oversees repairs and maintenance of the building and fixtures. Our Office Manager and Reception team look after keeping records, invoicing services, and financial aspects of the community. Our Manager of Resident and Family Services can provide or facilitate social work/social services work services as needed, and supports you and your loved ones as the ‘go to’ person for questions, comments, concerns, and suggestions.
20 | Victoria Manor Community Handbook
Partners in Care and Essential Caregivers You and/or your substitute decision maker(s) may designate Caregivers as ‘essential’ visitors – individuals who provide one or more forms of support or assistance, including providing direct physical support with daily functions, and social, spiritual, and/or emotional support. When Caregivers are designated as essential, they may be permitted to visit even during situations such as an outbreak when general visits may be limited in order to support infection prevention and control and community safety. We believe that Caregivers are essential partners in care. Anyone you designate as a Caregiver is welcome in our community to provide whatever supports you may need from them, and we commit to doing our best to support them as they support you. As partners in care, our team will seek your input to learn about your/your loved one’s unique needs and preferences to ensure care and services that are individually tailored.
21 | Victoria Manor Community Handbook
We recognize that caring for someone can at times feel overwhelming, and we want to make the following commitment to Caregivers: • We will treat you with empathy and respect, as a partner and contributor in decision making and care planning. • We will help you however we can in navigating the healthcare system – please reach out to our team with your questions and concerns. • We want to provide you with the right information, at the right time. If we are overloading you or if you are not feeling like you’re getting enough information, please let us know so we can adjust and course correct as needed. • We can help you get training and education you might need to best support your loved one. Reach out to us if you would like to learn more about things like supporting an individual with dementia, responding to personal expressions or behaviours that might be difficult for you to deal with, infection prevention and control, etc. We can provide or point you in the right direction to find the information and training you need. • We can help you find support or respite. If you need a break or even just someone to talk to, please reach out to our team – we would love to help.
Private Caregivers and Companion Services Should you and/or your substitute decision maker(s) wish to hire a private caregiver or companion, please speak to our Director of Care for more information. Any care provided by private caregivers and/or companions hired by your/your loved ones must be consistent with the operations of the community. Services provided by private caregivers/ companions will not diminish or impact upon the obligations of the community and its employees to ensure health and safety standards are maintained and care is provided in accordance with legislation, regulatory bodies, and your individual care needs. You are not required to purchase additional care, services, programs, or goods from the community. You may purchase such things from other providers, and we ask that you please discuss this with our Director of Care.
22 | Victoria Manor Community Handbook
Volunteer Services If you, a family member, or friend would like to volunteer, please contact our Life Enrichment Supervisor for more information. We will work with you to develop a volunteer schedule that meets your needs, including facilitating any support you may require for accessibility. If you are looking to volunteer monthly, weekly, or for just special events, we can accommodate you.
Residents’ Council The Residents’ Council is made up of people living here who have volunteered to sit on the Council in the community to provide a strong line of communication between administration and those living here. Council meetings provide the opportunity for you to participate actively in matters that affect your daily life and where you can exercise decision-making autonomy. Councils attempt to cultivate a safe environment that encourages unity, partnership, and mutual support to contribute to increased quality of living for all who live here. Only people who live here may be members of the Residents’ Council. The Residents’ Council may advise people living here with respect to their rights and obligations and those of the community. They sponsor and plan activities, advise the community of any concerns, and make recommendations regarding the operation of the community and improvements to care and quality of life. In addition, the Council reviews specific documentation relating to the community (like Ministry of Long-Term 23 | Victoria Manor Community Handbook
Care Quality Inspection Reports), and they advocate for protecting residents’ rights and for shared concerns to be resolved, thereby contributing to their own welfare and that of their peers. The community will appoint a Residents’ Council assistant who is acceptable to the Council; however, employees or community volunteers who work with the Residents’ Council are not members of the Council. Minutes of the meetings are posted in the community for all who live here to review.
Family Council Families play a significant role as partners in the care of their family members and loved ones, and we value their contributions and involvement as active participants with the Family Council. Family Council is an organized, self-led, self-determining, democratic group composed of family and friends, providing assistance, information and advice to people living in the community and their loved ones. Similar to the Residents’ Council, the Family Council may advise people living here, their families, and other loved ones with respect to their rights and obligations, and those of the community. The Council sponsors and plans activities, advises the community of any concerns, reviews specific documentation relating to the community, and makes recommendations regarding the operation of the community. Minutes of Family Council meetings are posted within the community for you to review. Please reach out to your Family Council representatives or Manager of Resident and Family Services for more information on how you can participate.
24 | Victoria Manor Community Handbook
Additional Volunteer Opportunities Volunteers provide an invaluable service to the community. We offer both in-person and virtual volunteer opportunities. Once it is established they are a good fit, volunteers are provided with an orientation to the community and to our purpose, values, and vision. There are a variety of activities that volunteers can support at our community. Whether it is engaging with people who live here or supporting our team with everyday tasks, we have something for you. Here are some examples of volunteer roles: • Supporting with outings: picnics, local animal sanctuaries, restaurants, etc. • Friendly visits: discussing current events, playing cards, painting, reminiscing, reading, etc. • Helping recreation team members with programs: Bingo, monthly birthday parties, manicures, etc. • Helping in the dining room: eating assistance, supporting people to get to and from mealtimes • Decorating the community seasonally and/or helping to plant gardens and beautify outdoor spaces • Clerical tasks: filing, photocopying, creating posters for special events • Supporting technology: Virtual Reality programs, teaching people how to navigate the internet and use technology • Pastoral care: visiting, supporting with religious/spiritual programming • Family Peer Support Network: families supporting new families with the transition to long-term care • Resident Welcoming Committee: current community members supporting new people moving in with the transition to long-term care • People living here may also volunteer to help in different areas around the community. For example: delivering mail, watering plants, leading a program on the recreation calendar, etc.
25 | Victoria Manor Community Handbook
Accommodations/Life at the Community Community Living A long-term care community is home to a number of individuals with a variety of social, spiritual, cultural, and healthcare needs. It is different from a hospital, which generally provides short-term care, whereas our community is your home. Some people living in long-term care experience difficulty with verbal communication and may use behaviours to communicate. These behaviours may include things like making unexpected and/or loud noises, agitation or aggression, wandering or restlessness, paranoia, and others. We call these responsive behaviours or personal expressions, and our teams are educated to support and respond to people expressing their needs in this way. We understand that both you and your loved ones may experience many different feelings when faced with such behaviours and in general about entering a community living setting. We are here to help you in any way we can, and we welcome you to reach out to us with any questions or concerns.
Respectful, Inclusive, and Affirming Community Our community is firmly committed to fostering an inclusive living and working environment for all who live, work, and visit here. We are committed to anti-racism and will work with all those living, working, and visiting here to identify and eliminate racism and racial discrimination as a fundamental to our environment. 26 | Victoria Manor Community Handbook
If you feel that you have been discriminated against or harassed, that your safety is at issue, or that you have not been treated equally and with the respect and dignity that is your right, please reach out to one of our team, contact the City of Kawartha Lakes through our “Let’s Connect” program at www.kawarthalakes.ca/ComplimentsComplaints or call 705-324-9411, or reach out to the Ministry of Long-Term Care at www.ontario.ca/page/ministry-long-term-care or call 1-866-876-7658. At our community, differences in race, ethnicity, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, cognitive ability, and age are acknowledged, celebrated, and welcome in all those living, visiting, and working here. We commit to making every effort to supporting your physical, psychological, emotional, social, and spiritual needs. If you identify as Two-Spirit, Lesbian, Gay, Bisexual, Trans, Queer, Intersex, and/or additional gender and sexual minorities, we commit to supporting your identification and individual needs. You have the right to be treated with respect and dignity, including honouring your preference to dress in accordance with and to be identified by and referred to as your self-identified or expressed gender. Please be welcome to communicate your pronouns, preferred name and forms of address, and any other information you wish to share with us, and reach out to our team for any accommodations or supports you may require, including through transitioning, rooming that affirms your gender identity, washroom access, etc. Every person living, working, and visiting here has the right to equal treatment, without discrimination or harassment because of one or more of the following prohibited grounds: age, ancestry, citizenship, colour, creed, disability, ethnic origin, family status, gender expression, gender identity, level of literacy, marital status, place of origin, political affiliation, race, sex, or sexual orientation. We affirm the fundamental principle of equality of all peoples and recognize the inherent dignity and worth of every person. We are committed to identifying, dismantling, and eliminating racism in all its forms. We acknowledge that: Racism and racial discrimination continue to exist and affect the lives of not only racialized persons, but also all persons in Canada. ii. “Race” is a socially constructed way of judging, categorizing and creating hierarchies among people based on perceptions, real or imagined, about their places of origin, physical traits, name, manner of speech, etc. i.
27 | Victoria Manor Community Handbook
iii. “Racism” operates at several levels, including individual, systemic or institutional,
and societal. Racism plays a major role in fostering racial discrimination and is an ideology that either directly or indirectly asserts that one group is inherently superior to others. Racism can be openly displayed in racial jokes and slurs or hate crimes, but it can be more deeply rooted in attitudes, values and stereotypical beliefs. Racism is tied to the aspect of power – or the authority or ability to influence, make decisions, and access resources – and includes social, political, economic and institutional power that is held by the dominant group in society. iv. “Racial discrimination” is an expression of racism. It includes any action, intentional or not, that has the effect of singling out persons based on their race, and imposing burdens on them and not on others, or withholding or limiting access to benefits available to other members of society, in areas covered by the Human Rights Code. Racial discrimination can occur through stereotyping and overt prejudice or in more subconscious, subtle and subversive ways. Racial discrimination can also occur on a systemic or institutional level.
Neighbourhood and Shared Spaces Designed to promote friendship and wellbeing, our community has been divided into small neighbourhoods or home areas where you’ll get to know familiar faces of those living and working nearby. We also share communal dining and living spaces such as lounges, activity rooms, outdoor courtyards or balconies, and more.
Individual Rooms and Personal Belongings Each person’s room is furnished with a bed, mattress, bedside table, chair, and wardrobe/closet. We also provide pillows, bed linens, washcloths, towels, and selected toiletries/personal hygiene supplies. Mechanical lifts are provided as required. We welcome you to personalize your space with furniture, decorations, and other items as you wish, while noting for safety reasons that the room cannot be overcrowded; large furniture items may not be accommodated. Please speak to our team for support; we can help you with choosing and arranging items as needed. We will test any electrical items you may wish to bring for safety before they go in the room to ensure they meet Fire and Public Health Department regulations. Furniture and electrical cords may not obstruct movement in the room or the ability to carry out care, and will be checked for safety and appropriateness. 28 | Victoria Manor Community Handbook
You and your family/substitute decision maker(s) are responsible for the care, protection, and wellbeing of any valuables, personal effects, prosthetic devices, or cash. We are unable to accept responsibility for loss or damage to personal belongings and encourage you not to keep articles of value in your room. For security, money may be deposited into a trust account.
Living with a Roommate Our community includes shared common spaces for all who live here, and our semiprivate rooms provide a shared bathroom and accommodation for two people. We understand that living alongside a new person can take time to get used to. Here are some things you may consider as you get to know your new roommate and how to be respectful of their needs while still maintaining your own comfort. • Communicate openly • Reach out to our team if you need help or have concerns • Be ready for certain differences, and understand that your roommate may be experiencing cognitive impairment or other disease processes that may affect their actions and words (as you may be also) • Be respectful, and work together to make a compromise where needed (or reach out to your loved ones or our team to help) • Respect your roommate’s privacy and belongings as you would like them to respect yours Your room and belongings will be cared for upon transfer, move out, or death. The community is required to notify the local health authority within 24 hours of a vacancy and prepare to welcome a new person to move in. In consideration of this, we respectfully request that personal belongings be removed within 24 hours of transfer, move out, or death, or at an agreed upon timeframe with community designate. Please note that if you wish to donate any items, you can contact community organizations directly to facilitate this.
29 | Victoria Manor Community Handbook
For safety reasons, the following items are prohibited: • • • • • •
• • •
Personal medications Valuable jewelry/expensive art/antiques, etc. Scissors, nail clippers, pocket knives, straight razors, or other sharp objects Weapons, including collectible or spiritual in nature (possession/ storage of any weapon is prohibited) Hand tools, power tools, gardening equipment Electrical appliances (toaster, microwave, kettle, iron, humidifier, portable air conditioner, heater, heating pads, heated blankets, etc.) Bedrails or rail attachments Electric scooters Cleaning chemicals Area rugs
Aids and Equipment Please bring eyeglasses, hearing aids, dentures, and assistive devices such as wheelchair, walker, or cane as needed. These items are not provided by the community. Please label these items before moving in. We cannot be responsible for lost or damaged items, and we strongly recommend purchasing insurance for aids and equipment should they go missing or become damaged given the nature of community living with multiple complex care needs. Our Occupational Therapist or Physiotherapist will assess you for the appropriateness of additional assistive devices as need arises, and can support you and your family/substitute decision maker(s) with sourcing equipment.
Television, Computers, Telephones, and Radios Televisions are provided in the common areas for your use. All rooms have the capability for television and private phone lines, which can also be used for computers. You are welcome to arrange personal cable, telephone, and/or Internet in your room if you choose. You (or your designate) will be responsible for billing and setup of these services. We can provide you with any information you need to arrange accounts and setup, to be billed directly to you/your designate via the provider(s) you choose. 30 | Victoria Manor Community Handbook
If you have chosen to place a television or radio in your room, when appropriate and practical, we encourage the use of earphones in order to keep noise down for others. In the interest of safety, all lamps, radios and other electrical items are required to be Canadian Standards Association (CSA) approved and checked by our maintenance team prior to use in the community. Please speak to our team before bringing a wall-mounted television to ensure it can be accommodated in the room.
Clothing and Laundry Services Please bring an adequate supply of clothing. To ensure we can identify what belongs to you, we require all clothing to be labelled. We will advise you prior to moving in if we can assist you with labelling your clothing or request that you label your clothing before arrival. We also request that any time you bring in or purchase new items that you label them or let our team know so we can ensure they are labelled. The community provides laundry services, or a family member/friend can care for your laundry – whichever you prefer. The community provides your bed linens, pillows, washcloths, and towels, including laundry service for these. You are welcome to have your own bedspread, blanket, and/or pillow, which must be labelled (please note, these may need to be laundered by family depending on their size/ garment care requirements). Bring clothing that is comfortable and suits your needs (please note – items that require dry cleaning or that will shrink in commercial laundry machines (e.g. wool, 100% cotton) are not recommended unless your family member/friend will be providing laundry care for these items). Please report any personal clothing items that are missing to our team and complete a Missing Clothing and Items Form that our team will provide to you. Every effort will be made to locate any clothing/items noted as missing. Ensuring items are labelled on move-in and when any new clothing or items are brought in will support identification and belonging to the correct person, which we sincerely appreciate in our community living environment. You may find it helpful to access adaptive clothing to make dressing and hygiene more comfortable. The nurse or Occupational Therapist can assist in assessing for this based on need.
31 | Victoria Manor Community Handbook
Call Bells Call bells are available for you to signal to team members that you would like assistance. Visitors may also use the call bell while visiting if you require assistance during the visit. If you would like more information on how to use the call bell, our team will be happy to show you.
Toiletries You are welcome to bring your own preferred toiletries, and if needed the community can provide personal hygiene items such as shampoo, soap, and other products used for bathing. The community also provides briefs/ incontinence products; the care team will assist you in choosing products that will best meet your needs.
Housekeeping Services Housekeeping services are offered seven (7) days per week with routine schedules in place to ensure community spaces are cleaned regularly, with enhanced cleaning practices implemented during outbreak. Your room will be cleaned daily, including cleaning and sanitizing of the washroom, surfaces, and floors, and waste removal.
Maintenance Our maintenance team supports maintenance of the building and can be available to assist you as needed with hanging pictures, room repairs, etc. We may advise you on room setup as required to ensure safety, including where we may not be able to accommodate large items of furniture or wall-mounted televisions, and to ensure items are stored safely; for example, we request that no large items are stored on top of wardrobes. Our team will also conduct an inspection of all electrical items brought in, in accordance with regulatory requirements.
Hair Care Hair care services are provided through the Hair Salon on a fee-for-service basis. Rates and times are posted in the salon. You/your designate may make an appointment directly with the hairdresser, or you can speak with the Office Manager or designate for assistance. 32 | Victoria Manor Community Handbook
Mail Your mail will be delivered to you daily, and outgoing mail (with postage affixed) can be collected and sent out by the community. We commit to respecting your privacy related to written communications, including promptly sending and receiving unopened mail. You or your designate are welcome to make arrangements for delivery of newspapers or magazines to your room. Should you request it, we are happy to open and read your mail to you, and to assist you as needed with sending mail or writing letters. All information will be treated as confidential. Please note that we cannot screen, forward, or redirect your mail to other individuals except under conditions established by provincial or federal law, which may include: • • • •
Your Written Request Guardianship Power of Attorney Executor (if name and legal documentation is provided to the community)
Because of this, we strongly recommend that you arrange for any business/financial mail that will not or cannot be managed by you to be sent directly to your family member/power of attorney/substitute decision maker or other individual that you designate; you/your designate can arrange for this with external providers as applicable i.e. bank, cable company, Service Canada, etc. You may also advise our team if you would like your business mail to be held in our business office for pickup by your family/designated person.
Parking Please park only in designated areas. Please watch for and comply with “Fire Route-No Parking” areas.
Dining All meals, snacks, and beverages are provided by the community, including therapeutic diets, dietary supplements, diabetic-friendly choices, and other as needed. Menus are posted and are rotated weekly. You will have a choice of selections for three nutritious and appetizing meals daily (breakfast, lunch, and dinner), along with a variety of hot and cold beverages, and snacks. These are planned by our culinary experts, including our Executive Chef, in collaboration with people living here. 33 | Victoria Manor Community Handbook
If you require a therapeutic diet (such as a minced or pureed texture, or specific foods to suit your needs), our Registered Dietitian will work with you to create a meal plan, including any dietary supplements and assistive devices you may need. We will also work with you to accommodate any dietary needs you may have such as kosher, halal, vegetarian, allergies, food sensitivities, or other. You are welcome to participate in meal planning discussions through the Residents’ Council and Food Committee. Additionally, the menu planning process includes multiple touch points for your input through menu planning programs. These events include Menu Fest, Food Fairs, and special events that occur throughout the year. We are always open to feedback about your dining experience. Our goal is that you savour your meals and that they meet your preferences and needs.
Guests at Meals You are welcome to invite your family and friends to dine with you in the community. Meal tickets can be arranged for a fee. Please note that infection prevention and control measures may at times prohibit guests joining you for communal dining. Please speak to one of our team for more information.
The Gathering Place Our community includes a café space which we encourage you to use at your leisure with friends and family. The Gathering Place is a place of connection, memorable moments, and a meeting place within the community where everyone can share a warm beverage or a frozen treat together.
Bringing Food into the Community You and your family/friends may wish to bring your own food into the community and you are welcome to do so. If you plan on bringing food into the community, we ask you to speak with the Dietary Manager and follow a few simple steps to ensure everyone’s safety. Ensure that the food was prepared using safe food handling practices. Label all food with the date and individual’s name, and cover the container before placing it in the fridge and informing a team member about the food items. Disposable containers are preferred to support infection prevention and control practices. Please note that team members are assigned to clean the fridge and will discard any food that has been in there longer than 48 hours. 34 | Victoria Manor Community Handbook
If you have any questions regarding food safety or appropriate use of the family-friendly area, please contact the Dietary Manager.
Recreational Substances Should you wish to engage in the use of recreational substances, we ask that you follow the community’s protocols and applicable legislation to ensure the health, safety, and comfort of others. You must be able to engage in consuming them independently, including managing access to designated areas for smoking and returning them to the community for safe keeping when not in use. Recreational substances include, but are not limited to: • • • •
Cigarettes, cigars, and any tobacco products Electronic cigarettes or vapour cigarette devices Alcoholic beverages Recreational cannabis (all formats)
Please reach out to our team to understand the protocols we have in place around provision, purchase, delivery, and storage of recreational substances. To ensure safety, recreational substances must be kept secured by the community and cannot be kept in your room.
Community Experiences The Life Enrichment Team strives to provide high quality recreation offerings to meet your unique needs and to create a personalized experience for you through programs that are dedicated to improving your experience by supporting the mind, body, and spirit. Recreation experiences are offered on a regular basis at times when it is convenient for you to participate. Experiences come in many different forms, from individual to large group programs, both within the home and in the broader community. Our focus is to enhance quality of life and wellbeing by offering personalization and choice. Friends and family members are welcome to participate with you. A monthly calendar of events is posted in the community, and you are encouraged to attend monthly calendar planning meetings to be involved in the creation of programs being offered.
35 | Victoria Manor Community Handbook
Spiritual Support At our community, we support your right to practice and continue a relationship with your own spirituality. How this is accomplished is by learning about you and your needs. As you settle-in to your new home, we will discuss all domains of health, and in considering spirituality we will seek to learn and understand what brings meaning and purpose to your life. This may include questions such as: • Do you have a history with a faith (religious) community and if so, where? • Do you practice any particular means of connection such as yoga, massage, nature walks, music, meditation, or art? • What is sacred to you? For example: books, people, practices? Please see the Recreation Calendar for times and locations of various spiritual programs or visits from multi-faith leaders. Should you want one-to-one visiting to aid in spiritual wellness, please reach out to a Recreation team member. We welcome and encourage you to maintain your spiritual connections and will support you with this. We recognize that not all spiritual opportunities are religious. Opportunities to support spiritual connection may also include meditation, nature, gratitude, art, and more. All requests will be honoured, as we know that meaning and purpose in life contribute to wholeness and happiness.
Guests This is your home, where family and friends are welcome to visit as often as you would like. We have no set visiting hours and you are welcome to host visitors as you please. We do lock our main doors in the evening to ensure safety and security; if you expect guests later in the evening, please just let our team know. All visitors are required to sign in and out of the kiosk or visitor log book located at the front entrance. Visitors who are unwell are asked not to visit until they are feeling better.
Virtual Visits If visiting in person is not possible, talk to our team about how you and family members/friends can participate in virtual visits.
36 | Victoria Manor Community Handbook
Essential Caregivers We believe that caregivers are essential partners in care and can play a critical role in providing physical, emotional, and cognitive supports. Anyone designated as an essential caregiver is welcome in our community, and may be permitted to visit even during situations such as an outbreak when general visits may be limited in order to support infection prevention and control and community safety.
Visiting Pets Furry friends are welcome to visit the community – we ask that immunization records are brought to the front desk on initial visit and annually thereafter to make sure immunizations are up to date. Pets must be supervised/not left unattended on their visit, and must remain on leash at all times.
Tips for Visiting Visiting is a great way for you to stay connected with your loved ones. You may visit in person or virtually. Some ways you and your family might prepare to get the most out of visits include: • Making visits a continuation of lifelong routines, such as scheduling a visit around an activity like sharing a meal. • Making visits a social experience – consider timing visits to participate together in a group activity such as a musical event. You can look at the monthly calendar for upcoming events or speak to one of our team for suggestions. • Making visits a chance for personal time – simply sitting quietly together, reading aloud, talking or reminiscing. • Making visits an opportunity for connection – welcoming other family members, friends, and children. • Making a visit an outing to a family or friend’s home, a local museum or garden, shopping, etc. Check with our team to understand how we can support you to make this happen.
37 | Victoria Manor Community Handbook
Some additional ideas for spending time together: • • • • • • • • • • • • • • • • • •
Look at pictures or a photo album Go for a walk Listen to music Hold hands Work on self-care together: hair brushing, hand or foot massage, manicure or pedicure Talk about your early life: how did you spend holidays? What was your favourite toy? How did you spend the summer holidays? Rummage through interesting items that have meaning for you. For example, a variety of fabrics for someone who sews, or baseball memorabilia for a sports fan Enjoy painting or creating something Share a snack Read aloud from the newspaper or from a favourite book Visit a garden Do tasks, like folding laundry Walk around the community and meet your neighbours Watch a television series Read aloud letters or emails from friends or listen to a recorded message or voicemail Pre-arrange to call a friend or family member Sit where you can see activities like at a window overlooking a busy street or a garden with a bird feeder Reminisce about knickknacks that hold shared memories. Talk about how or when they were acquired and your memories of that time in your life
38 | Victoria Manor Community Handbook
Spousal Reunification Spousal Reunification is a special provision that allows your spouse or partner to come and live with you in your long-term care home. If this is something you are interested in, please speak to our Manager of Resident and Family Services for more information and to find out if you may be eligible.
39 | Victoria Manor Community Handbook
Leaves of Absence Leaving the Community — When and for How Long? Living in a long-term care community means that Ontario Health atHome has determined that you require care services 24 hours a day. We recognize, however, that there are times you may wish to leave, or must leave, the community for social or medical reasons. The Fixing Long-Term Care Act, 2021 and its regulation O. Reg. 246/22 has defined rules about how long and for what purposes you can leave the community. Here are some of the rules applicable to leaves of absence: Casual Absence You can leave for up to 48 hours (two days) per week and continue to have the Ministry of Long-Term Care subsidize a portion of your stay — this is called a “Casual Absence”. For the purposes of calculation, the week is considered to begin on a Sunday. Where possible, two days’ notice should be given to our team to allow time to secure a physician’s order, prepare medications, and provide healthcare information.
40 | Victoria Manor Community Handbook
Vacation Absence You can take what is called a “Vacation Absence” of up to 21 days within a calendar year. Medical Absence A medical absence refers to a leave of absence for a maximum 30-day period for the purpose of receiving medical care (other than psychiatric care) or for the purpose of undergoing medical assessment (other than psychiatric assessment). If, for medical reasons, you cannot return within the 30-day period, we are required by the Ministry of Long-Term Care to discharge you. You, or your substitute decision maker(s), may, at any point within the 30 days of the medical leave, make the decision to be discharged from our community and move out permanently. We will request that these wishes are confirmed in writing, to ensure that all financial and legal obligations are met. Psychiatric Absence A Psychiatric absence is a leave of absence for up to a 60-day period for the purpose of receiving psychiatric care or undergoing psychiatric assessment. Release of Responsibility When you are away on Casual or Vacation Absence, a Leave of Absence Record must be completed and signed by you/the responsible person accompanying you, upon leaving and returning to our community, including a contact name and telephone number. Completion of a Leave of Absence with Medication form is required when you require medications while you are away from our community. Please ask the Nurse to help you with this form. Our community cannot take responsibility for your care, safety, and wellbeing during a casual or vacation absence. Full responsibility is yours or your substitute decision maker(s)’s. We will provide you or your substitute decision maker(s) with a written outline of the care which you require during your absence. You or your substitute decision maker(s) will need to take all reasonable steps to ensure that you receive the required care during your absence. Should you be hospitalized while out on a vacation or casual leave, or if the date of your return to the community changes, please have your family member/substitute decision maker(s) notify our Administrator as soon as possible. During a medical, psychiatric, vacation, or casual leave of absence, you are responsible for paying the maximum amounts that may be charged by our community for the type of accommodation that was provided to you immediately before your leave of absence. 41 | Victoria Manor Community Handbook
Clinical Care Palliative Care Palliative care is an approach that improves the quality of life of persons and their families facing the challenges associated with life-limiting illness, through the prevention and relief of suffering by means of early identification, assessment, and treatment of pain and other problems, physical, psychosocial and spiritual. Palliative care: • • • • • •
Provides relief from pain and other distressing symptoms; Affirms life and regards dying as a normal process; Intends neither to hasten nor postpone death; Integrates the psychological and spiritual aspects of care; Offers a support system to help persons live as actively as possible until death; Offers a support system to help the family cope during the person’s illness and in their own bereavement; • Uses a team approach to address the needs of persons and their families, including bereavement counselling, if indicated; • Will enhance quality of life, and may also positively influence the • course of illness; 42 | Victoria Manor Community Handbook
• Is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life, such as chemotherapy or radiation therapy, and includes those investigations needed to better understand and manage distressing clinical complications. Our community’s palliative approach to care begins at move-in, with an interprofessional team that works together to support your needs and continuously engages with you and your loved ones at key touchpoints such as care conferences, health status updates, and changes in health conditions to ensure your physical, psychological, social, linguistic, cultural, ethical, and spiritual needs are met. The interprofessional team will have early conversations with you and your family around optimizing quality of life, consent decisions, and goals of care to assist in the development of a comprehensive plan of care. You and your loved ones will be supported throughout your journey with us, through proactive palliative and symptom management focused on quality of life, to comfort care needs at the end-of-life.
Who Makes Decisions About Your Care? Ontario’s law called the Health Care Consent Act sets out the rules related to consent, capacity, and substitute decision making about treatment decisions. A person is considered “incapable” of making a treatment decision if they do not have both the ability to understand information related to the decision, and the ability to appreciate the effects of receiving or not receiving the treatment. The person proposing the treatment is responsible for evaluating capacity. You are able to make your own treatment decisions so long as you are considered capable to do so. If you have been found incapable of making a treatment decision and you do not agree with this assessment, you can appeal the finding by completing what is called a “Form A” with Ontario’s Consent and Capacity Board; you can ask your physician or our team to help you complete the form. It is important for you and your family/substitute decision maker(s) to understand that capacity is both decision-specific and time-specific. This means that even if you are incapable of making one decision, you might still be capable of making a different decision, and that you might be capable of making a particular decision at one time, and not another. Even if you are not capable of making all treatment decisions at all times, you have the right to make whichever decisions you are capable of making whenever you are capable of making them. This means that our team will not
43 | Victoria Manor Community Handbook
automatically turn to your substitute decision maker(s) or Power of Attorney for Care for all treatment decisions. Signing a Power of Attorney for Personal Care does not make you incapable, and it does not give the person you name the automatic right to make your treatment decisions for you. In the event that you are incapable of making a treatment decision, the Health Care Consent Act includes a list of people we will turn to in the following hierarchy: 1. Guardian 2. Power of Attorney for Personal Care 3. Representative 4. Spouse or Partner 5. Child or Parent 6. Parent with right of access only 7. Any other relative 8. Public Guardian and Trustee
The first person or people on the list will be your “substitute decision maker(s)”, as long as they are capable, willing, and available to make the decision. You can designate a specific person or specific people to make treatment decisions for you if you become incapable by completing a Power of Attorney for Personal Care document. You can also discuss your values, beliefs, and wishes with your Power of Attorney for Personal Care and/or Substitute Decision Maker(s), so that should they need to make decisions on your behalf, they may act in your best interests by considering your values, wishes, and beliefs. You may also wish to put your values and beliefs in writing, and/or ask that they be documented in your health record. The above explanation is adapted from the PoET Project Resource: Who Makes Decisions About Your Treatment? Information for Residents of Ontario Long-Term Care Homes. Visit www.poetproject.ca/resident-resources/ for the full booklet, where it is also available in various languages, as well as additional information on consent, capacity, and substitute decision making.
44 | Victoria Manor Community Handbook
You can find more information about capacity, treatment decisions, and expressing your wishes by visiting: • • • •
The PoET Project Website – www.poetproject.ca Advance Care Planning Ontario – www.advancecareplanningontario.ca Consent and Capacity Board of Ontario – www.ccboard.on.ca Ministry of Long-Term Care – www.ontario.ca/page/ministry-long-term-care
Plan of Care Upon move-in, a plan of care will be developed and maintained that reflects your individual needs based on your choices. Your current care and service needs, goals, and approaches will be reviewed and updated in response to changes in care and service needs, wishes, preferences, and goals. Your plan of care will be developed in collaboration with you and/or your Substitute Decision Maker(s) (as applicable) and the interprofessional care team. Your plan of care is how your care and service needs and preferences will be communicated to our team members. This plan will outline any assistance you might need with mobility or equipment, your dietary preferences and needs, your daily routine preferences, bathing preferences, leisure and spiritual preferences and needs, medications, continence care and other treatment needs, and more.
Care Conferences Care Conferences occur when our care team meets with you and/or your Power of Attorney (POA)/Substitute Decision Maker (SDM) to discuss the care and services that have been provided, and to discuss progress and set goals for future care. This is also a chance for you and/or your POA/SDM to meet the various caregivers who look after your needs and wants. A Care Conference coordinated by the community will take place within six (6) weeks after you move in, and annually thereafter. This meeting may take place more frequently should issues arise that require greater attention, such as a significant change your health. They will usually run for approximately 20 to 30 minutes.
45 | Victoria Manor Community Handbook
In addition to you and/or your POA/SDM, the following people may contribute to the Care Conference: • • • • • • •
Attending Physician/NP or the Director of Care Charge Nurse Manager of Resident and Family Services Personal Support Worker Dietary Manager Recreation Professional Restorative/Rehabilitation Professional
If you are unable to attend the Care Conference, your POA/SDM is asked to provide information about you, such as how things have been going in terms of your comfort and care needs. This is also an opportunity to ask any questions or raise any concerns regarding the care and services that are being provided. In order to honour your wishes, Advance Care Planning is discussed at all Care Conferences. At this time, you, along with your POA/SDM, can advise us of what treatment decisions you would like to make in the event of a life-threatening or emergency situation. Your wishes will be documented and can be revised at any time. If at any time there is a significant change in health or other condition, the team will review your plan of care. You and/your POA/SDM can also contact the Manager of Resident and Family Services to request a Care Conference.
Medical Services While you may wish to retain your own physician while living at the community, you are encouraged to use the services of the community’s Attending Physicians as they are an integral part of the care team. Our Medical Director and Attending Physicians are available to serve your medical needs, visiting regularly and providing emergency coverage. They also order any consultations with specialists and hospital examination visits. It is recommended that, whenever possible, a family member accompanies you to appointments outside of the community. In collaboration with the Medical Director and Attending Physician, your health care needs may also be provided by an attending Nurse Practitioner (NP) who is an advanced RN. Nurse Practitioners can diagnose and treat illnesses, prescribe medications, order and interpret tests, and perform medical procedures. 46 | Victoria Manor Community Handbook
Nursing Services Registered nursing professionals are available 24 hours per day, 7 days a week for your comfort and security. A registered team member who is a Registered Nurse (RN) or a Registered Practical Nurse (RPN) oversees each neighbourhood/home area. An RN or RPN is responsible for the day-to-day functioning of the neighbourhood as well as distributing medications and administering treatments. A Personal Support Worker (PSW) provides direct care, such as bathing, personal hygiene, using the washroom and/or incontinence products, mobility, and meal assistance. Please contact the Associate Director of Care or the Director of Care if there are any questions regarding nursing support and/or care needed.
Medical Emergencies In the event that you experience an unanticipated medical emergency, you will be assessed by the nurse on duty/physician or nurse practitioner to determine if your care needs can be met in the community to align with your goals of care and treatment plan in place. A transfer to hospital may be required based on the assessment and consultation with you/your substitute decision maker(s).
Pharmacy Services Required medications are prescribed by the Attending Physician/NP, and are administered by a qualified team member. For safety reasons, you cannot keep medications in your room. Upon arrival to the community, all medications, including over the counter, herbal, vitamins, creams, and topical ointments, should be given to the Charge Nurse. The nurses will review all medications to establish a medication profile, verified by the Attending Physician/NP. Your medications are also reviewed by a clinical pharmacist, who may make recommendations to your Physician or NP. To avoid drug interactions and for the safety of all, additional medications cannot be brought into the community. Prescription drugs may only be obtained from or through the community’s approved pharmacy service provider.
47 | Victoria Manor Community Handbook
Diagnostic Services For your convenience, in most cases, diagnostic services such as blood work are provided at the community.
Nutrition Care Nutritious, attractive, and appetizing meals are an essential part of wellbeing. The community’s Director of Dietary Services works closely with a Registered Dietitian to meet your meal preferences and nutritional needs in consideration of your personal preferences and any religious and cultural preferences you may have.
Chewing and Swallowing Care Chewing and swallowing ability can be affected by many factors such as poor dentition and various disease diagnoses. In the event chewing and/or swallowing difficulties are identified, the appropriate assessments can be completed by the Registered Dietitian or Speech Language Pathologist. Our menu planning program provides a variety of texture modified diets and altered fluid consistencies to support safe swallowing and to ensure your meal preferences and nutritional needs are met.
Dementia Care Dementia is a term used to describe a group of symptoms that affect memory, thinking, and social abilities. Many people living in our community experience these symptoms, which may include delusions, hallucinations, restlessness, wandering, depression, anxiety, compulsive or repetitive behaviours, sleep disturbances, and other personal expressions. We recognize the personal expressions or behaviours associated with dementia as a form of communication and/or coping strategy. We seek to understand the meaning of expressions, behaviours, and psychological symptoms that are unique to each individual to identify triggers and risks to enable us to provide supportive interventions where needed. These interventions become part of your plan of care, which is developed in collaboration with you and/or your substitute decision maker(s).
48 | Victoria Manor Community Handbook
Restorative Care/Rehabilitation Restorative care/rehabilitation approaches are integrated into your care. Working with you, we strive to restore functional status to maximum potential. Components of the program include ambulation, restorative dining, sensory stimulation, and physiotherapy and occupational therapy programs developed on an individual basis by qualified team members. Therapy services may be arranged or provided as a result of assessment by the care team. Services are provided within the community by a variety of healthcare providers, such as a physiotherapist, occupational therapist, speech-language pathologist, and restorative care aid. The primary focus of restorative care is to maximize your independence while maintaining safety.
Incontinence Care You have the right to maintain your dignity, comfort, and independence. You will be assessed for continence status and, if required, supplied at no additional cost with an appropriate product that meets your needs. If you/your substitute decision maker prefer not to use the assessed product, the Director of Care will meet with you and/or your substitute decision maker to discuss options. If a product is preferred that is not within the selection of products provided by the community or not clinically indicated, there will be a fee related to the provision of this product. This request needs to be discussed with the Director of Care, and all options fully explored.
Foot Care Regular foot care can reduce the risk of infections and preventable foot conditions, as well as lessen foot discomfort and improve mobility. Foot care is provided by a qualified professional such as a Foot Care Nurse or a Podiatrist. The cost of specialized foot care visit is directly billed to you or your substitute decision maker.
Social Work Services Registered Social Workers or Registered Social Services Workers are available to you and your loved ones. They can assist by identifying appropriate internal and external resources and social supports. They can also support with counselling to assist you and/or your family through any challenges you may be experiencing, including with transitioning to the community. Please ask your care team to be connected to the Social Worker/Social Services Worker if you would like this support. 49 | Victoria Manor Community Handbook
Dental Services We recommend that you be examined annually by a dentist, and arrangements can be made in the community regarding this service. The cost of this service is the responsibility of you/your substitute decision maker. If you require the services of a Denturist, in most cases, arrangements to have dentures made, relined, or adjusted may be made by contacting the community’s contracted Denturist. Alternately, you can contact a Denturist of your choice. The cost of these services is the responsibility of you/your substitute decision maker. We also recommend that you have your dentures labelled by a Denturist.
Ophthalmology and Audiology Services Arrangements for eye examinations or glasses assessments and hearing assessments can be made through a consultation or referral. The cost of these services is the responsibility of you/your substitute decision maker.
Auxiliary Services Additional services such as massage therapy, music therapy, art therapy, peer support groups, and others may be offered at the community. For more information, please connect with the Director of Resident Programs.
50 | Victoria Manor Community Handbook
Privacy Our Commitment to Privacy We are committed to protecting the privacy of your personal health information, and will maintain the security and confidentiality of your personal health information. Our community operates in keeping with the requirements of two important pieces of privacy legislation: the federal law called Personal Information Protection and Electronic Documents Act, and the provincial law called Personal Health Information Protection Act.
51 | Victoria Manor Community Handbook
Collection of Personal Health Information We collect personal health information from you, or from other persons acting on your behalf, to enable us to provide you with the care, programs, and services you require. Occasionally, we collect personal health information about you from other sources, such as other members of the healthcare community, if we have your consent to do so, or if the law permits. In accordance with applicable privacy legislation, we must get your consent for the collection, use and disclosure of your personal information, subject to limited exceptions. We only share this information with people and organizations who need to know this information. In order to provide services and meet your needs, we need to know personal information about you. Examples of the type of information we collect include: • your name and address; • your health card number; • facts about your health, healthcare history, and the healthcare services you have received, as well as payment and eligibility for your healthcare service; and • the identity of your healthcare providers and substitute decision-makers.
Use and Disclosure of Personal Health Information We collect and use information about you for the following purposes: • to help plan and provide you with the type and amount of care, programs, and services you need; • to get payment for your treatment and care (from OHIP or your private insurer or others); • to educate the care team; • to communicate with other service providers; • to plan, administer, and manage our internal operations; • to monitor the way we provide care and services through our quality management program; • to conduct risk management activities; • to evaluate your response to the services we provide, and to allow us to verify that we are meeting our commitments to you; 52 | Victoria Manor Community Handbook
• to serve as a record of the services provided to you, including who provided the services and when they were provided; • to conduct research, when it is approved by the research review team and you/your designate; • to compile statistics; • for strategic planning, decision-making, and allocating of resources; • as a legal document made in the normal course of business; • to comply with legal and regulatory requirements; and • to fulfill other purposes permitted or required by law.
Your Right to Limit the Use and Disclosure of Personal Health Information If you have specific concerns, or would like to limit the use or disclosure of personal health information about you, please contact the Administrator. We do not release any confidential information about you without written consent from you or your POA/SDM, subject to limited exceptions permitted by law. You have the right to: • ask for and receive a copy of your health record and any personal information we have in our custody; • ask us to correct your records; • make a complaint to our Privacy Officer about access or correction to your personal information, or about how it is collected, stored, used or disclosed to others; and • rely on our assurance that we cannot and will not give out any of your personal information without your consent, subject to limited exceptions permitted by law.
53 | Victoria Manor Community Handbook
Privacy – Video Cameras and Recording Devices The privacy and dignity of people living and working here relating to the installation and use of video cameras and similar recording devices (each a “Video Camera”) will be protected at all times. Our community offers shared living accommodations. Different individuals, including people living here, visitors, and team members, will enter your room to offer care/services, support, and/or to visit. As such, our community has a responsibility to respect and protect the privacy and dignity of all who live and work here. The community will not tolerate privacy or other breaches by team members, people living here, substitute decision-makers (“SDM”), family, or visitors, including instances of unauthorized video or audio surveillance or tampering with an authorized Video Camera. The community may be required to report such breaches to the police, the Ministry of Health, the Ministry of Long-Term Care, or other public authorities. The community is in no way responsible for any Video Camera installed in your room by you or your SDM and is not responsible for protecting the Video Camera or its recordings against damage, theft, loss, or unauthorized use or disclosure of its recordings. If you/your family member/SDM wish to install or utilize a video camera or similar recording device within your room, please request a copy of our Video Camera Specifications from the Executive Director or other manager prior to installing or utilizing the Video Camera to ensure privacy requirements are maintained.
54 | Victoria Manor Community Handbook
Safety and Security Identification Upon move-in, and regularly thereafter, we will request permission to take your photograph. This photo is included in your health care record for identification purposes. In addition, and with your prior consent, we may request permission to use other photographs, as may be taken from time to time, for any of the following purposes, which include but are not limited to: newsletters, annual reports, posters, marketing brochures, displays, newspapers, corporate website, educational and teaching materials, and social media platforms.
Security To ensure safety, all exit doors are secured 24 hours a day, 7 days a week.
55 | Victoria Manor Community Handbook
Whistle Blower Protection If a complaint is brought forward to the Ministry of Long-Term Care (MLTC), the Fixing Long-Term Care Act, 2021 offers protection against retaliation to any person who discloses information to an inspector or to the Director of the Ministry, or who gives evidence in legal proceedings. This protection is known as “whistle-blowing” protection. Specifically, whistle-blowing protection requires that the community and its employees will not retaliate against any person, whether by action or omission, or threaten to do so because anything has been disclosed to an inspector or to the Director at MLTC. The community or its employees will not do anything that discourages, is aimed at discouraging, or that has the effect of discouraging a person from doing anything mentioned above. Nor will the community or its employees do anything to encourage a person to fail to do anything mentioned above. For the purpose of whistle-blowing protection, “retaliation” includes, but is not limited to, disciplining or dismissing an employee, imposing a penalty upon any person, or intimidating, coercing, or harassing any person. You shall not be discharged from the community, threatened with discharge, or in any way be subjected to discriminatory treatment (e.g. any change or discontinuation of any service to or care of or the threat of any such change or discontinuation) because of anything mentioned above, even if you or another person acted maliciously or in bad faith. Further, no family member, Power of Attorney or Substitute Decision Maker, or person of importance to you shall be threatened with the possibility of any of those actions being done to you.
Zero Tolerance for Abuse Our policy regarding abuse is zero tolerance, and it applies to everyone living here, family members, visitors, volunteers, and team members. All team members have an obligation to report any incident or suspected incident of abuse. We will investigate and respond to all such concerns or complaints. Every person living here will be treated with courtesy and respect and in a way that fully recognizes the person’s dignity and individuality, and to be cared for free from all forms of abuse. The full policy is posted and was included in your Move-In package.
56 | Victoria Manor Community Handbook
Minimizing Restraints/Bed Safety We support a “least-restraint” philosophy, and believe that you should live in a caring, safe, and least restrictive environment as possible. You have the right to be fully informed about the procedures and consequences of receiving or refusing a restraint. Any restraining measure deemed necessary must be kept to an absolute minimum, and must allow as much freedom of movement and expression as possible. There are provincial recommendations in place to continually review bed safety to reduce the safety risk that can be posed by the inappropriate use of bed rails. Our Bed Safety Program includes regular assessments of your sleep environment to reduce entrapment risks and to encourage other bed safety strategies while promoting a restful sleep environment. There are many safe alternatives to bed rails. Should you currently have a bed rail in place, the interprofessional care team may determine that the rail should be removed. In that case, the care team will consult with you/your family to discuss the many other bed safety strategies available. We have written policies about our Bed Safety Program as well as minimizing restraints. Please ask any manager for copies of these policies.
Smoking/Candles We permit smoking only according to legislated regulations. If you are a smoker, internal policies will be reviewed with you on an annual basis, or as required, and must be adhered to. No one is permitted to light candles and/or sparklers within the community, as they present a fire hazard and may set off the smoke alarms in small areas. The use of battery operated “candles” as an alternative is recommended.
Traditional Ceremony/Healing Practices If you wish to engage in traditional Aboriginal healing practices such as smudging or cleansing smoke, we are committed to supporting this. We want to honour your values and beliefs. Please connect with the Manager of Resident and Family Services so we can accommodate your traditional ceremony.
57 | Victoria Manor Community Handbook
Infection Prevention and Control Infection Prevention and Control practices and vaccines provide protection from disease spreading germs. Infection Prevention and Control principles are included into all aspects of providing care and services in the community. Hand washing is the most powerful way to stop the spread of germs. To protect against the spread of germs, team members sanitize their hands often, using either alcohol-based hand rub or washing hands with soap and water. We encourage you and your visitors to do the same. When washing hands with soap and water, a paper towel to turn off the taps keeps hands clean.
What to Expect During an Outbreak There are times when a number of people living here may become ill and an outbreak may be declared by the Public Health Department. We will work with our local Public Health Department during such a situation to decrease the risk of spread of the disease. During outbreaks, we may be required to limit visitor traffic and timing to support safety for all. In these cases, signage will be posted at the entrance of the building with instructions for all visitors to follow. Family members and visitors should not visit if they have cold, fever, vomiting, diarrhea, or any other symptoms of illness. Children exposed to chickenpox are advised not to visit. 58 | Victoria Manor Community Handbook
Immunization Immunization for Influenza (or Flu) Flu is a common respiratory illness affecting millions of Canadians each year. In Canada, flu season usually runs from November to April. Vaccination is important for everyone. It is especially important for individuals who frequently visit a long-term care community. Health Canada states the most effective way to be protected from the flu is to be vaccinated each year in the fall. The annual seasonal influenza vaccine is changed each year to provide protection from the types of viruses that are predicted to be the most common for that year. Our care team will contact you or your Power of Attorney/Substitute Decision Maker each year to provide education and information regarding flu and vaccination. Once informed consent is received and if there are no known allergies, the annual vaccination will be given. Another form of protection for flu is a type of medication called antivirals, which should not be used in place of yearly flu shot. Unlike vaccines, antivirals do not prevent illness by providing immunity. An antiviral is a medicine taken in the form of a pill that will reduce the chance of getting sick with flu virus. It is usually given to reduce symptoms, shorten the length of illness, and to minimize serious complications. When antivirals are used for preventive purposes, individuals must continue taking them as prescribed by the physician.
Tuberculosis (TB) Screening If you are moving into the community and 65 years or older, a chest X-ray should be taken within 90 days prior to moving into the community. For people under the age of 65 years, it is required to do a two-step TB screening within 14 days of move-in, according to Public Health guidelines. Prior to taking the test, please inform the nurse if you have had a positive reaction to TB testing in the past.
59 | Victoria Manor Community Handbook
Vaccinations against Pneumococcal Pneumonia Pneumonia is a disease of the lungs in which thick fluid builds up in lung spaces that are normally filled with air. Pneumococcus is a type of bacteria (germ) that can cause pneumonia. It normally lives in our mouths and on our skin. It usually does not cause trouble, unless it gets into the chest or other places in the body where it is not supposed to be. Pneumococcus is not the only germ that causes pneumonia, but it does account for nearly one in every four cases of pneumonia. Individuals who have one or more of the risks outlined below should consider taking a vaccine against pneumococcal pneumonia, which is offered free of charge. You are at risk if you: are 65 years or older; have not had a vaccine against pneumococcal pneumonia in the past 10 years; have any kind of chronic disease, especially of the heart, lungs, liver, kidneys or blood; and/or have diabetes mellitus.
Vaccination against Tetanus, Diphtheria and Pertussis (Tdap) Tdap is a combination vaccine that protects against three potentially life-threatening bacterial diseases: tetanus, diphtheria, and pertussis (whooping cough). This vaccine is provided free of charge.
Vaccination against COVID-19 COVID-19 presents an increased risk for severe outcomes in the elderly population due to age and underlying medical conditions, particularly in long-term care homes. Vaccination remains the best defense against COVID-19 and has been shown to be very effective against severe illness and outcomes. Everyone living and visiting here is strongly encouraged to get vaccinated and stay up to date with recommended doses. All vaccines provided by Public Health are safe and effective. In addition, consistent Infection Prevention and Control processes and practices are critical to preventing COVID-19 spread, and we thank you in advance for following protocols in place at our community for the safety of all.
60 | Victoria Manor Community Handbook
Emergency Procedures Our community has an Emergency Management Plan in place to respond in the event of any emergency, promote processes related to the prevention of risk, and ensure that people and property are safeguarded in the event of an emergency. We use a system of colour codes and procedures as follows to ensure common understanding for response to an emergency: • • • • • • • • • • • • •
Code RED – Fire Code BLACK – Bomb Threat Code WHITE – Physical Threat/Violence Code GREEN – Evacuation Code BLUE – Medical Emergency Code ORANGE – External Emergency Code YELLOW – Missing Person Code GREY – Infrastructure Loss/Failure Code BROWN – Spill/Leak/Hazard Code SILVER – Active Shooter Boil Water Advisory Building Lockdown Outbreak/Epidemic/Pandemic
All team members are educated on their role in an emergency, on orientation, and annually or more frequently as required. Each Emergency Code/Procedure is tested annually or more frequently as required; fire drills are conducted monthly on all three shifts. Our fire exits are clearly marked; please take the time to locate the exit closest to your/ your love one’s room. Our Emergency Response practice includes activation of Communication Plan and Agreements with Community Partners, and staff roles in response to any emergency are identified based on an Incident Management Team structure. You may request to see a copy of our full Emergency Management Plan, and you can also find it on our website at www.kawarthalakes.ca/VictoriaManor. Actual Emergency events are always followed by debrief and action planning for improvements as needed, including consultation with Residents’ Council and Family Council.
61 | Victoria Manor Community Handbook
Financial and Service Agreements Financial Responsibility Payment for your accommodation, which is due at the beginning of each month (in advance), is the responsibility of you or your Power of Attorney/Substitute Decision Maker. Even if you have not entered into a written agreement for accommodation, you are responsible for payment of the amounts charged by the community for basic accommodation in accordance with the Fixing Long-Term Care Act, 2021. You are required to enroll in our Pre-Authorized Payment Program (PAP) upon move-in. Refunds are made in accordance with established policy. Please see the Accommodation Agreement upon move-in for the daily rates for accommodation. You agree that if any payment from you is not received by us when due, that we may take any legal means available for collection of such overdue accounts, including without limitation, garnishment of Old Age Security payments, Canada Pension Plan payments, Guaranteed Income supplement payments, or any other source of income, support or maintenance payments as may be permitted by law. You further agree that the community may require you to move to Basic Accommodation and withhold any optional Unfunded Service until all overdue accounts are paid in full.
62 | Victoria Manor Community Handbook
Move-In Agreement We require that you/your representative sign the Accommodation Agreement upon move-in to our community. However, even if you do not sign the Accommodation Agreement, your acceptance of a placement implies that you consent to receiving basic long-term care home services from us, including nursing and personal care, programs and services, and paying for the level of accommodation that you had requested and were provided. Upon move-in, we will ask you/your representative (Power of Attorney or Substitute Decision Maker) to sign an agreement, which contains in part the following responsibilities: LTC Home Accommodation Agreement, outlining: • that your move-in was authorized by Ontario Health atHome; • the type of accommodation and the charge for that accommodation; • your obligation to pay for accommodation charges; • the community’s obligation to provide goods and services included in basic or preferred accommodation; • that the community will provide an itemized monthly statement of accommodation charges; • that the community will provide at least 30 days’ written notice of an increase in accommodation charges; and • interest charges for missed, incomplete, or late payments. Your personal responsibilities include: • provision of personal clothing and effects as needed or desired; • provision for spending money; • responsibility for hospital charges and non-emergency transportation to hospital. It is preferable that a family member or responsible party accompany you. If this is not possible, arrangements can be made for an escort, on a fee-for-service basis. This expense will be billed to you, or your POA/SDM, by the service provider; • responsibility for any extra or applicable physician’s fees, medications and other treatments or aids ordered by the Physician/ NP, which are not covered by existing benefit programs; • first accommodation payment, due upon move-in; • future payments for accommodation, due at the first of each month; and • responsibility for unfunded services, where authorized by you. 63 | Victoria Manor Community Handbook
LTC Home Unfunded Services Acknowledgement, describing: • additional unfunded services which you may purchase and are responsible for payment over and above the accommodation fee; • a description and charges for these additional services; • that the community/service provider will provide at least 30 days’ written notice of an increase in the unfunded service charges; • how to terminate your unfunded services agreement with the community; and • your responsibility for paying unfunded service charges for unfunded services provided to you. In turn, we agree to: • provide a furnished room with basic furniture (including a bed, mattress, bedside table, chair, and wardrobe/closet), linens and bedding; • provide nursing care and those personal services necessary for your health, safety, wellbeing, and basic grooming; • obtain the services of a licensed physician, as well as such medications and treatments covered by the Ontario Drug Benefit Plan and High Intensity Needs; • arrange for your transfer to hospital, when ordered by the Attending Physician/NP, and to notify your POA/SDM; • make refunds in accordance with established policy. Accounts are reconciled for billing each month. When refunds are owing to you, these will be processed as soon as practicable, following the receipt of all your charges and the reconciliation of the account; and • honour and abide by the Residents’ Bill of Rights.
Daily Rates The Fixing Long-Term Care Act, 2021 sets out the maximum amount that you can be charged, and the Ministry of Long-Term Care sets the rates that are charged for private, semi-private, and basic accommodation in a long-term care community. These rates are the same for all regulated long-term care communities in Ontario. The Ministry of Long-Term Care announces new rates annually that are typically effective on July 1st unless otherwise specified by the Ministry. The current rates for all types of accommodation are available in your move-in package.
64 | Victoria Manor Community Handbook
Available Reductions If you are residing in a basic room and your income is not sufficient to afford the full basic rate, there is a special consideration for this situation only. The Fixing Long-Term Care Act, 2021 stipulates that where a long-stay resident of a long-term care home has accessed all sources of income to maximize their annual net income, they may apply for a reduced amount, payable by the resident, for basic accommodation. Our community can provide you with a rate reduction application form to complete. The application must be completed as directed, including any supporting documentation required as well as the Notice of Assessment issued under the Income Tax Act (Canada) for your most recent taxation year. If required, our community will assist you with completing the application. Before such an application will be approved by the Ministry of Long-Term Care, you first have to apply for all of the other forms of government subsidies described under “Government Assistance Programs Available to Seniors” (see: The Guaranteed Annual Income System (GAINS) (A Provincial Pension)). The reduced rate can be retroactively applied to 30 days prior to your application date.
Services Provided at No Extra Charge Services provided at no extra charge include: • nursing and personal care on a 24-hour basis, including care given by or under the supervision of a Registered Nurse or a Registered Practical Nurse, the administration of medication, and assistance with activities of daily living; • medical supplies and nursing equipment necessary for the provision of care, including prevention or care of skin disorders, incontinence care, infection prevention and control, and sterile procedures. Medical devices, such as catheters, colostomy and ileostomy devices, are also included; • supplies for personal hygiene and grooming, including skin care lotions, shampoos, soap, deodorant, toothpaste, toothbrushes, denture cups and cleansers, toilet tissue, facial tissue, hairbrushes, combs, disposable razors, shaving cream, and feminine hygiene products; • meal service and meals, including three meals daily, snacks throughout the day, special and therapeutic diets, dietary supplements, and assistive devices for eating (as required); 65 | Victoria Manor Community Handbook
• social, recreation, and physical activities and programs including related supplies and equipment (some exceptions may apply); • laundry, including machine washing and drying of personal clothing, and provision of bedding/linen, including pillows, wash cloths and towels; • bedroom furnishing such as a bed, bedside table, chair, and a wardrobe/closet; • cleaning and upkeep of accommodation; • suitable space and seating for meetings of the Residents’/Family Councils; and • maintaining any personal funds you have entrusted to the community.
Non-Allowable Charges Our community will not charge a fee to you for anything, except in accordance with the following: • for basic accommodation, you will not be charged more than the amount provided for in the Regulation under the Fixing Long-Term Care Act, 2021 for the accommodation provided; • for preferred accommodation, you will not be charged more than can be charged for basic accommodation, unless the preferred accommodation was provided under an agreement, in which case you will not be charged more than the amount provided for in the Regulation under the Fixing Long-Term Care Act, 2021 for the accommodation provided; • for anything other than accommodation, you will be charged only if it was provided under an agreement, and will not be charged more than the amount provided for in the Regulation under the Fixing Long- Term Care Act, 2021, or, if no amount is provided for, more than a reasonable amount; and • you will not be charged for anything that the Regulation under the Fixing LongTerm Care Act, 2021 states is not to be charged.
66 | Victoria Manor Community Handbook
The following charges are prohibited by the Regulation: • charges for goods and services that the community is required to provide to you using funding that the community receives from Ontario Health (including goods and services funded by Ontario Health under a service accountability agreement), or the Ministry of Long-Term Care; • charges for goods and services paid for by the Government of Canada, the Government of Ontario, including Ontario Health, or a municipal government in Ontario; • charges for goods and services that the community is required to provide to you under any agreement between the community and the Ministry of Long-Term Care or between the community and Ontario Health; • charges for goods and services provided without your consent; • charges, other than the accommodation charge that you are required to pay, to hold a bed for you during a medical absence, psychiatric absence, casual absence, and/or vacation absence, or during the period permitted for you to move into the community once the placement coordinator has authorized admission to the community; • charges for basic or preferred accommodation for you in a short-stay convalescent care program; • transaction fees for deposits to and withdrawals from a trust account required to be established and maintained by the community, or for anything else related to a trust account; and • charges for anything the community must ensure is provided to you pursuant to the Regulation under the Fixing Long-Term Care Act, 2021, unless a charge is expressly permitted.
67 | Victoria Manor Community Handbook
Resources for Financial Support/Government Assistance Programs The Old Age Security Pension (A Federal Pension) The Old Age Security (OAS) Pension is available to you if: • You are aged 65 years or over; AND • You live in Canada and are a Canadian citizen or a legal resident at the time your pension application is approved; AND • You have a minimum of 10 years of residence in Canada after reaching age 18. You must complete an application for the OAS pension. Application forms are available from any Income Security Programs Office.
The Guaranteed Income Supplement (A Federal Pension) The Guaranteed Income Supplement (GIS) is an income-tested, monthly pension or benefit for Old Age Security (OAS) pensioners with limited income apart from the OAS Pension. To qualify for the GIS, you must be receiving the OAS Pension, you must be a resident of Canada, and your income must be at or below the qualifying level. Application for the GIS can be made at the same time that you apply for the OAS pension, or an application will automatically be sent to you at the time your application for the OAS pension is approved. If you did not qualify for GIS in the past and you think that you may be eligible, you should complete a GIS application as soon as possible and return it to an Income Security Programs Office. Since the GIS is based on your income for the previous year, you must complete a renewal form each year. The total of your OAS Pension and GIS are added together and will be on one cheque. If a completed renewal form is not received by the Income Security Programs Office, your cheque will only reflect the OAS portion. Each pensioner of a married couple will receive a little less monthly GIS than a single pensioner. 68 | Victoria Manor Community Handbook
Involuntary Separation If you and your spouse/partner are “living apart involuntarily” (i.e. one of you is confined to a hospital or living in long-term care community) you can be considered as a single person for purposes of GIS benefits. You must notify the Income Security Programs Office if you fall under the above classification so that arrangements can be made to adjust the GIS benefits of the couple involved.
Spouse’s Allowance (A Federal Pension) You may qualify for the Spouse’s Allowance if you have a low income and your spouse/partner receives or is eligible for the Guaranteed Income Supplement. You may also qualify for the Allowance if your spouse/partner has died, and you have not remarried or entered into a new common-law relationship for more than 12 months. In addition, to qualify for the Spouse’s Allowance, you must: • be 60 to 64 years old; • be a Canadian citizen or legal resident when your benefit is approved (or have been one when you last lived in Canada); • have lived in Canada for at least 10 years after turning 18; and • have an annual income below the prescribed limit.
The Guaranteed Annual Income System (GAINS) (A Provincial Pension) Although some persons 65 years of age and over may receive retirement income from a variety of sources, their total income may still be lower than the minimum level guaranteed by the Province of Ontario. The Guaranteed Annual Income System (GAINS) ensures that the income for Ontario’s seniors does not fall below the minimum level. The monthly GAINS payment varies per eligible senior. The GAINS payment is based on the reported income of an individual and may increase or decrease according to any change in income or marital status
69 | Victoria Manor Community Handbook
You are eligible to receive GAINS if: • you receive the full or partial federal Old Age Security (OAS) and the federal Guaranteed Income Supplement (GIS); AND • you are and have been a permanent resident of Ontario for the past twelve months, or you previously lived in Ontario for a total of 20 years after the age of 18; AND • your total income from all sources is below the level guaranteed by the Province. No application is necessary for GAINS. However, you must apply to the Income Security Program for the OAS Pension and the GIS supplement. If you qualify for GIS, your name will be passed to the Ministry of Finance of Ontario to determine if you also qualify for GAINS. If you qualify, a separate GAINS cheque will be mailed monthly or deposited directly to your bank account, depending upon your directive. When you re-apply for your GIS supplement each spring, your eligibility for GAINS will automatically be re-established. Items considered income for federal GIS purposes are also considered income for Ontario’s GAINS program. The following are some of the items that ARE considered income: • • • • • • • •
Canada Pension Plan, Quebec Pension Plan or private pension payments; foreign pension; employment earnings; bank, bond, mortgage and other interests; net dividends, net capital gains; unemployment insurance benefits; net rents from property; and workers’ compensation benefits
The following are some of the items that are NOT considered income for GIS and GAINS purposes: • • • • •
savings and investments; possessions (including home and property); Ontario Tax Grants for Credits; Federal Spouse’s Allowance; Disability, Widow’s or Dependent Parent’s Pension based on War Service;
70 | Victoria Manor Community Handbook
• War Veteran’s Allowance; and • Provincial government property tax rebates, e.g. farm and managed forest rebates. A monthly Personal Needs Allowance is an accepted standard. If you have a limited income and are receiving the OAS pension, the GIS supplement and the GAINS benefit, you will be receiving enough to afford the current minimum standard room rate, and have money left over for personal needs (the Comfort Allowance).
Trust Accounts You can deposit money into a non-interest bearing trust account. Our community has established and will maintain a non-interest bearing trust account at a financial institution in which it will deposit all money entrusted to it on your behalf. At no time will we hold more than $5,000 in the trust account for you. Our community will keep petty cash trust money, composed of money withdrawn from the trust account, which is sufficient to meet your daily cash needs, if you have deposited money in the trust account. You, or a person acting on your behalf, may pay the community for accommodation and other charges with money from your trust account upon providing our community with a written authorization. We have a written policy and procedures for the management of trust accounts and petty cash trust money. The written policy and procedures will be provided to you/person acting on your behalf when you ask to have money deposited into a trust account. The primary purpose of our Trust Accounts Policy is to establish uniform guidelines to protect personal funds managed by our community on your behalf, and to comply with legislative requirements where applicable. For further information regarding our Trust Accounts Policy, please contact the Office Manager.
71 | Victoria Manor Community Handbook
Long-Term Care Governance Ministry of Long-Term Care Long-term care homes are licensed, regulated, and funded by the Ministry of LongTerm Care (MLTC). The MLTC conducts unannounced inspections of all long-term care homes throughout the province, and publishes their reports online. This information is also posted within the community along with a statement of residents’ rights. For detailed information, you can call the Long-Term Care Action Line at 1-866-8767658 or visit www.ontario.ca/page/ministry-long-term-care If you have a concern about the health, safety, or wellbeing of a person living in longterm care that you have brought to the attention of the community and its manager but think that they have not addressed your concerns, you can contact the Ministry of Long-Term Care’s toll-free telephone number for making complaints at 1-866-4340144, with the hours of operation: 8:30am to 7:00pm, 7 days a week. You may also contact the Patient Ombudsman at 1-888-321-0339 or online at www.patientombudsman.ca/Complaints/Make-a-complaint/Submit-Complaint
72 | Victoria Manor Community Handbook
Support Resources for Residents and Families Moving into long-term care can be a significant transition and often feels overwhelming. We encourage you to reach out to people who have already gone through it – to answer questions and make recommendations – or even just to talk about what you are going through. If you would like to speak with a resident and/or family member at our community, please connect with our Manager of Resident and Family Services to arrange a chat. There are also a number of organizations available that can provide support. See following page for listings.
73 | Victoria Manor Community Handbook
Support Resources for Residents and Families Ontario Health atHome
ontariohealthathome.ca
The Ontario Caregiver Organization – Support for Caregivers
ontariocaregiver.ca
Family Councils Ontario
www.fco.ngo
Ontario Association of Residents’ Councils
www.ontarc.com
Alzheimer’s Society
alzheimer.ca/en/helpinformation/im-caring-person-livingdementia/long-term-care
Now What: Managing the Emotional Journey of Long-Term Care for Families, by Deborah Bakti
deborahbakti.com/now-what-book
Power of Attorney and Living Wills
www.ontario.ca/page/make-powerattorney
Advance Care Planning Ontario
www.advancecareplanningontario.ca
PoET Project (Supports long-term care residents, staff, physicians, substitute decision makers with consent, capacity, and substitute decision making in alignment with resident wishes, values, and beliefs)
www.poetproject.ca
Canadian Hospice Palliative Care Association
www.chpca.ca
Virtual Hospice
www.virtualhospice.ca
Canadian Mental Health Association
cmha.ca
74 | Victoria Manor Community Handbook
Behavioural Supports Ontario
www.behaviouralsupportsontario.ca
Developmental Supports Ontario
www.dsontario.ca
Veterans Affairs Canada
www.veterans.gc.ca
March of Dimes
www.marchofdimes.ca
Heart and Stroke Foundation
www.heartandstroke.ca
Diabetes Canada
www.diabetes.ca
Parkinson’s Society
www.parkinson.ca
Multiple Sclerosis (MS) Society
mscanada.ca
Canadian Red Cross
www.redcross.ca/how-wehelp/community-health-services-incanada
211 Ontario
211ontario.ca
Canadian Hearing Services
www.chs.ca
Canadian National Institute for the Blind
www.cnib.ca
Heart to Home Meals
www.hearttohomemeals.ca
Meals on Wheels
www.mealsonwheels.ca
Advocacy Centre for the Elderly
www.acelaw.ca
Seniors for Seniors
spectrumhealthcare.com/services/seni or-care-services
75 | Victoria Manor Community Handbook
Glossary of Terminology Common Terms and Acronyms Used in Long-Term Care Sometimes we use words or acronyms in the community that may not be familiar to everyone. See below for some of the terminology you might hear and an explanation of what it means. This list is not all-inclusive. If we are using what sounds like jargon or technical words and you don’t know what something means, please let us know! Activities of Daily Living (ADLs): Daily functions such as getting dressed, eating, taking a shower or bath, going to the bathroom, getting into a bed or chair, or walking from place to place. Advance Care Plan: A collection of your beliefs, values and health care wishes, which may or may not include a Power of Attorney or health representation agreement. Advance Care Planning: A process by which a capable adult talks over their beliefs, values, and wishes for healthcare with their close family/friend(s) and a healthcare provider in advance of a time when they may be incapable of deciding for themselves. Advance Directive/Healthcare Wishes: A capable adult’s written instructions to inform the healthcare provider about the healthcare treatment the adult consents to or refuses. This is effective when the capable adult becomes incapable and only applies to the healthcare conditions and treatments noted in the advance directive/healthcare wishes. Cardiopulmonary Resuscitation (CPR): An emergency procedure consisting of chest compressions often combined with artificial ventilation in an effort to manually preserve intact brain function until further measures are taken to restore spontaneous blood circulation and breathing in a person who is in cardiac arrest. Care Conference: Meeting held with you and our interprofessional care team to discuss your health and wellbeing, co-develop your plan of care, and address any concerns. You are welcome to invite anyone you would like to participate in your care conference, including family/friend(s), your spouse or partner, your essential caregiver(s), an interpreter – whoever you want to support you.
76 | Victoria Manor Community Handbook
Care Plan/Plan of Care: A detailed written plan that describes what is needed for an individual’s care and provided by a range of health professionals, including nurses, therapists, social workers, and Personal Support Workers. It may also include caregiving activities that family members or essential caregivers are able to do, need help learning how to do, and/or will be doing. Care plans can also describe the risks that an individual is prepared to take in exercising their autonomous self-determination and choice. We work with you to develop your plan of care. Do Not Resuscitate Order (DNR): DNR stands for “Do Not Resuscitate”. It is an order that tells physician(s) and other health-care providers what health care to provide: • • • •
If your heart stops; If you stop breathing; If you are in pain or need comfort care; and If you need medical or critical care treatment.
End-of-Life Care: Provided in the final period of an individual’s illness trajectory; death is expected soon. End-of-life care addresses physical, psychological, and spiritual concerns and focuses on comfort, respect for your decisions, and support for you and your loved ones. Goals of care include pain and symptom management as opposed to life sustaining treatments. Long-Term Care (LTC): A term used to describe the care needed by someone who must depend on others for help with daily needs. LTC is designed to help people with chronic health problems or dementia live as independently as possible. You may know it as Long-Term Care, Extended Care, Nursing Home Care, or Geriatric Care. Palliative Care: An approach that improves the quality of life of persons and their families facing the problems associated with life-limiting illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual. Palliative care: • • • • • •
Provides relief from pain and other distressing symptoms. Affirms life and regards dying as a normal process. Intends neither to hasten or postpone death. Integrates the psychological and spiritual aspects of care. Offers a support system to help persons live as actively as possible until death. Offers a support system to help the family cope during the person’s illness and in their own bereavement.
77 | Victoria Manor Community Handbook
• Uses a team approach to address the needs of persons and their families, including bereavement counselling, if indicated. • Will enhance quality of life, and may also positively influence the course of illness. • Is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life, such as chemotherapy or radiation therapy, and includes those investigations needed to better understand and manage distressing clinical complications Power of Attorney (POA): A Power of Attorney is a legal document that gives someone else the power to act on your behalf. This person is called your “attorney”. In Canada the word “attorney” usually does not mean lawyer, as it does in the USA. You can give someone a Power of Attorney for Personal Care if you want them to make personal care decisions on your behalf if you become mentally incapable of making them yourself. This is sometimes called a “personal power of attorney”. A Continuing Power of Attorney for Property or a General Power of Attorney for Property gives your attorney the power to make decisions about your finances, home, and possessions. A Power of Attorney for Personal Care deals only with personal care decisions. You can name the same person as your attorney for both property and personal care, or you can name different people. Substitute Decision Maker (SDM): a capable person with the authority to make healthcare treatment decisions on behalf of an incapable adult. This may include a personal guardian (committee of the person), representative, and/or temporary substitute decision maker. Trust Account: An optional account you may choose to set up with our business office for your convenience. This provides a safe place for funds to be stored readily available for personal use. Funds in the trust account can be used to pay for uninsured services that are approved by you and/or your authorized representative for things such as hairdressing, tuck shop purchases, special outings, or other optional services. These funds can be added to as needed, with cash or cheque, and your balance and charges can be seen on your monthly invoice. You or your authorized representative must sign for cash withdrawals and no more than $5,000.00 can be in the account at any given time. Funds will be refunded by cheque upon move out or closing of the account to you or your authorized representative. This process can take up to eight (8) weeks. Our Trust Account policy will be provided to anyone wanting to open a trust account at the community. Trust Account hours will be posted by the business office door in your community.
78 | Victoria Manor Community Handbook
Live, laugh and ease into tomorrow.
Victoria Manor 79 | Victoria Manor Community Handbook Community Handbook