The guiding principle of the Retirement Homes Act is that a retirement home should be a place where residents live with dignity, respect, privacy and autonomy, in security, safety and comfort and can make informed choices about their care options. As part of its mandate to protect retirement home residents, the RHRA inspects more than 700 homes across the province, oversees compliance with the regulations and care standards and enforces the Act on behalf of the provincial government.
The following examples highlight the success we had over the past year, helping to ensure Ontarians have choice and the protection they need to live with confidence and dignity in retirement homes.
Avoiding Disruption for Residents
In rare cases, the RHRA must protect the interests of residents by exercising its power to revoke a retirement home’s licence to operate. This was the case with a retirement home in Southern Ontario, after the owner pleaded guilty in court to defrauding investors, in previous years, to generate money to build the facility.
The RHRA worked with several parties, including counsel for the creditors and a new owner for the property, to navigate the sale and the transition so there was no disruption to the residents.
This required flexibility to orchestrate a smooth transition of ownership and licensing status for the residence.
Preventing Risk of Harm
The RHRA carried out a Mandatory Report Inspection at a home after a resident with dementia was in an altercation with another resident, who also had dementia. RHRA staff determined the licensee had failed to establish protective protocols to address chronic aggressive behaviour by the resident.
RHRA action including a Compliance Order resulted in the retirement home taking steps to come into compliance.
Enforcing Licencing Rules
A retirement home is defined by the Retirement Homes Act as a home that is occupied or intended to be occupied by six or more persons (unrelated to the operator), the majority of whom are 65 years of age or older, and provides at least two care services, such as administering medication or serving meals.
More than 55,000 Ontario seniors live in the province’s 733 licenced retirement homes, which range in capacity from six to more than 250 residents.
In its role as a regulator and consumer protector, one of the RHRA’s key responsibilities is making sure that homes are properly licensed and following the rules.
Last year, RHRA staff became aware of a home that was operating as a retirement home without a licence.
The RHRA worked with the Local Health Integration Network (LHIN) and Community Care Access Centre (CCAC) to ensure that one of the residents, who was hospitalized, was discharged to a long- term care facility, which met the residents’ needs, but also meant that the Home was no longer defined as a retirement home.
The RHRA and its community partners — the CCAC and LHIN — continue to monitor the situation to ensure the Home does not operate as a Retirement Home.
The RHRA conducts Mandatory Report Inspections when it receives reports of harm or risk of harm to residents.
RHRA staff carried out a total of nine of these inspections at a retirement residence in Southwestern Ontario within six months. Several issues related to neglect, behavioural management and plans of care and assessment were cited in their findings. Following warning letters and compliance orders issued by the RHRA, the licensee hired additional
expertise. The RHRA followed up with a series of conference calls with the licensee. The home advised of additional compliance measures it took relating to plans of care, holding daily huddles to monitor resident behaviours, and implementing a tracking tool to allow for analysis of trends. The licensee also partnered with an external consultant to provide additional education to staff.
Intervention and close monitoring by the RHRA delivered results and improved protection for residents at the home. There were no findings of non-compliance during a series of follow-up inspections.
Improving Resident Safety
Protecting the safety of retirement home residents takes many forms, including ensuring their physical surroundings don’t present any potential risks of injury or harm and making sure retirement home staff are prepared for emergencies.
The RHRA became concerned about two homes managed by same operator which did not have adequate emergency plans or training procedures regarding evactuations and fire safety.
We issued Compliance Orders for both properties related to emergency plans and training, and also imposed conditions on both licences that require the operator to advise the RHRA of any fire service inspection orders or charges.
Our subsequent inspection determined both homes are now in compliance, meeting care standards and regulations for the protection of residents.
Providing Guidence and Education
RHRA staff provide targeted assistance to help licensees achieve and maintain compliance in particular areas. Individualized guidance and education help ensure more homes are in compliance with regulations and safeguard more residents.
We used this approach to better protect seniors living at a retirement residence in Niagara Falls. Our inspectors found the home to be in non-compliance in various areas, including emergency and safety plans, dementia care and staff training. This was deemed to present a heightened risk because the home has many residents with dementia.
After issuing an initial Compliance Order and a warning letter regarding breach of the Compliance Order, RHRA enforcement staff began working with the residence on an individualized compliance plan. With our guidance and training, the residence was able to comply fully with all regulations during a follow-up inspection.