Long-term care

Long Term Care Homes

• Carleton Lodge
• Centre d'accueil Champlain
• Garry J. Armstrong
• Peter D. Clark

Subject:  Visiting Long-Term Care Homes
Division:  Administration
P & P no:  750.122
Approval date:  August 2022
Approval authority:  Long Term Care Management Team
Revision/review date:
References:  

• Fixing Long-Term Care Act, 2021
• O. Reg. 246/22
• Residents’ Bill of Rights
• Minister’s Directive: COVID-19 response measures for long-term care homes

Form #:  Designated Caregiver Form

Practice

The City of Ottawa’s Long-Term Care Homes adhere to the visiting requirements in the Fixing Long-Term Care Act, 2021, O. Regulation 246/22.

During the COVID-19 pandemic, the homes also follow the Ministry of Long-Term Care’s (MLTC) Minister’s Directive: Covid-19 response measures for long-term care homes.

The practice and procedure on visiting long-term care homes incorporates the following important principles:

• Safety
• Emotional well-being
• Equitable access
• Flexibility
• Equality

Procedure

Please consult the information below for current visiting guidelines. It is important that all visitors abide by these guidelines, to ensure the safety of residents, staff and other visitors. If you require clarification on any of the instructions below, please ask a member of the screening team, or contact the home prior to your visit.

City of Ottawa Long-Term Care Homes are committed to upholding these guidelines to ensure the highest level of safety and protection for residents, visitors and staff. Visitors who do not follow the guidelines of this document may be asked to speak with a member of management, undergo additional training, or leave the building, in accordance with Appendix A: Visitor Non-Adherence.

Types of visitors

Essential visitors include:

• Support workers, who perform an essential support service for the home or for a resident of the home
• Caregivers, who provide support or assistance to meet the needs of the resident, including providing direct physical support with activities of daily living, or social, spiritual or emotional support.
• People visiting residents who are palliative or very ill
• Government inspectors with a statutory right to enter a long-term care home to carry out their duties

General visitors include people who are visiting for social reasons or who are providing non-essential services. During outbreaks, there may be some restrictions on general visitors.

Designating caregivers

Designated caregivers must be designated by the resident or their substitute decision maker. Individuals under 16 years of age must have approval from a parent or legal guardian to be designated as a caregiver.

To designate an individual as a caregiver, residents or their substitute decision makers must complete the Designated Caregiver Form and return it to reception.

Limitation on visits

Residents may have up to four visitors at a time inside the home, with no restrictions on frequency of visits or length of time.

One caregiver at a time may visit residents during outbreaks. General visitors are not permitted to visit residents who are isolating or areas of the home that are on outbreak.

Limits on number of visitors may change based on current guidance from the Ministry of Long-Term Care. 

The reception desk in the home can provide information on regular visiting hours and building access.

Infection prevention and control information

During the COVID-19 pandemic, all visitors, both essential visitors and general visitors, must complete the following before entering the home:

• Review training material
• Attest that they have read the home’s visiting practice and procedure prior to first visit and monthly thereafter
• Attest that they have reviewed the Infection Prevention and Control package prior to entering the home, receive training on putting on and taking off Personal Protective Equipment (PPE) and hand hygiene with retraining as required

Active screening and surveillance testing

All visitors must be actively screened for symptoms and exposure to COVID-19 and undergo rapid antigen testing as required. The frequency of testing will depend on the visitor’s role and vaccination status. Visitors must receive a negative result from the rapid antigen test prior to entering the home.

Visitors of residents who are very ill or imminently palliative will be permitted to enter in accordance with the Minister’s Directive, unless they are currently required to quarantine under federal quarantine requirements.

Personal protective equipment

All visitors must wear a surgical/procedure mask at all times if visiting indoors, including in the resident’s room, regardless of their immunization status. Caregivers who are visiting a resident who is on isolation must wear full personal protective equipment (PPE) for droplet-contact precautions, including mask, gown, gloves and eye protection. N95 respirators will be available for caregivers who are visiting residents who are confirmed or suspected as positive for COVID-19.

Outdoor visitors must complete active screening prior to their visit. Visitors are encouraged to wear masks during outdoor visits.

Permitted activities

Regardless of immunization status, visitors may briefly hug a resident during both indoor and outdoor visits, including if the visit is with a resident who is very ill or imminently palliative.

Visitors who accompany a resident for meals are unable to eat with the resident, however they may assist the resident with eating. Visitors must remain masked for the duration of their visit, including when in the resident’s room or when assisting at mealtimes.

Palliative and emergency situations

The requirements for support workers, caregivers and general visitors do not need to be followed in an emergency or palliative situation, subject to any restrictions or requirements contained in the Minister’s Directive: COVID-19 response measures for long-term care homes.

Visitors of residents who are very ill or imminently are allowed in the home at any time, including during outbreaks, subject to direction from Ottawa Public Health. There are no restrictions on the length or frequency of their visits, however, there may be some limits on the number of visitors at a time.

Private care providers (sitters)

Private care providers (PCPs) (Sitters) are required to adhere to the guidelines above. If the PCP is a documented designated caregiver, they should follow those criteria, if not, they should follow criteria for general visitors.  

Visitors requiring a support person

Visitors who require a support person are permitted to visit with their support person. The support person must follow all screening and PPE requirements. Visitors requiring a support person should inform the home in advance.

Responsibilities of the home

Staff undertake the following responsibilities to ensure visits take place as safely as possibly:

• Supporting residents in receiving visitors while mitigating risk of exposure to COVID-19
• Obtaining and documenting information from residents/substitute decision makers regarding designated caregivers
• Reception staff to obtain the signed Designated Caregiver Form from the resident/substitute decision maker and enter the names of designated caregivers as ’Approved Visitor’ under ’Resident Contact/Associations’
• Maintaining a list of visitors that is available for staff to access in MED e-care
• Reception staff will run a report for ’Resident Contact/Associations Full' in MED e-care and deliver to the screening desk at the end of each day
• Completing active screening and attestations
• Providing training to visitors 
• Providing the following PPE:
  • Surgical/procedure masks, gloves and gowns, for essential visitors as required
  • Surgical/procedure masks for general visitors for indoor visits
• Supervision of visits is not required, but the home has discretion to supervise as needed to manage health and safety while respecting resident’s rights

Outbreaks

There may be changes to visiting during outbreaks

• Essential visitors and support workers are the only types of visitors allowed in the home when the home is on outbreak, or if the resident being visited is on isolation or has symptoms of COVID-19
• Maximum of one designated caregiver is permitted per resident at a time during outbreaks
• Ottawa Public Health may provide additional direction on visiting guidelines when a home is in outbreak

Visitor log

The home shall maintain a visitor log for a minimum of 30 days, which includes the:

• Name and contact information of the visitor
• Time and date of the visit
• Name of the resident visited