Item - 2019.EC3.4

Tracking Status

EC3.4 - Review of Dementia Care Based Models

Decision Type:
ACTION
Status:
Amended
Wards:
All

City Council Decision

City Council on April 16 and 17, 2019, adopted the following:

 

1.  City Council request the Interim General Manager, Long-Term Care Homes and Services to report to the Economic and Community Development Committee in the third quarter of 2019 on:

 

a.  a business case for a multi-year hiring and staffing plan, and technological enhancements, to address the rising acuity and complex care needs of long-term care home residents, such plan to be phased in through the 2020 and future years' budgets;

 

b.  an implementation strategy to ensure that all 10 Long-Term Care Homes provide emotion-centred approaches to care, along with a specific accountability process to measure the plan’s outcomes against stated goals, and report to the Economic and Community Development Committee in the fourth quarter of 2019; and

 

c.  a budget impact assessment for the implementation strategy.

 

2.  City Council forward a copy of the report (March 15, 2019) from the Interim General Manager, Long-Term Care Homes and Services on Review of Dementia Care Based Models to the Ontario Minister of Health and Long-Term Care, and the Ontario Minister of Seniors and Accessibility.

Background Information (Committee)

(March 15, 2019) Revised Report from the Interim General Manager, Long-Term Care Homes and Services on Review of Dementia Care Based Models - posted on April 15, 2019
https://www.toronto.ca/legdocs/mmis/2019/ec/bgrd/backgroundfile-131530.pdf
Revised Appendix A - Models for Long-Term Residential Care: A Summary of the Consultants' Report to Long-Term Care Homes and Services, City of Toronto - posted on April 15, 2019
https://www.toronto.ca/legdocs/mmis/2019/ec/bgrd/backgroundfile-130891.pdf
Appendix B - LTCHS Commitment to Care
https://www.toronto.ca/legdocs/mmis/2019/ec/bgrd/backgroundfile-130892.pdf
Revised Appendix C - LTCHS Dementia Care Journey, 2004 - 2019 - posted on April 15, 2019
https://www.toronto.ca/legdocs/mmis/2019/ec/bgrd/backgroundfile-130893.pdf
Presentation from York University on Models for Long-term Residential Care: A Summary of the Consultantsí Report to Long-Term Care Homes and Services, City of Toronto
https://www.toronto.ca/legdocs/mmis/2019/ec/bgrd/backgroundfile-131571.pdf
Annual Report from the Chair Advisory Committee on Long-Term Care Homes and Services and the General Manager Long-Term Care Homes and Services on Long-Term Care Homes and Services Annual Report 2018
https://www.toronto.ca/legdocs/mmis/2019/ec/bgrd/backgroundfile-131639.pdf
Notice of Revised Documents - posted on April 15, 2019
https://www.toronto.ca/legdocs/mmis/2019/ec/bgrd/backgroundfile-132070.pdf

Communications (Committee)

(April 1, 2019) Submission from Teresa Gaito (EC.New.EC3.4.1)
https://www.toronto.ca/legdocs/mmis/2019/ec/comm/communicationfile-93208.pdf
(April 2, 2019) Letter from David Mitchell, Canadian Union of Public Employees CUPE Local 79 (EC.New.EC3.4.2)
https://www.toronto.ca/legdocs/mmis/2019/ec/comm/communicationfile-93213.pdf
(April 3, 2019) Letter from Councillor Josh Matlow (EC.New.EC3.4.3)
https://www.toronto.ca/legdocs/mmis/2019/ec/comm/communicationfile-93287.pdf

Motions (City Council)

1 - Motion to Amend Item moved by Councillor Josh Matlow (Carried)

That City Council delete Economic and Community Development Committee Recommendation 1.b.

 

Recommendation to be deleted

 

b.  an implementation strategy to strengthen the provision of emotion-centred approaches to care, along with a specific accountability process to measure the plan’s outcomes against stated goals; and

 

and adopt instead the following new recommendation 1.b.

 

b.  an implementation strategy to ensure that all 10 Long-Term Care Homes provide emotion-centred approaches to care, along with a specific accountability process to measure the plan’s outcomes against stated goals, and report to the Economic and Community Development Committee in the fourth quarter of 2019; and

Vote (Amend Item) Apr-16-2019 12:04 PM

Result: Carried Majority Required - EC3.4 - Matlow - motion 1
Total members that voted Yes: 23 Members that voted Yes are Paul Ainslie, Ana Bail„o, Brad Bradford, Mike Colle, Gary Crawford, Joe Cressy, John Filion, Paula Fletcher, Mark Grimes, Stephen Holyday, Jim Karygiannis, Cynthia Lai, Mike Layton, Josh Matlow, Jennifer McKelvie, Denzil Minnan-Wong, Frances Nunziata (Chair), James Pasternak, Gord Perks, Anthony Perruzza, Jaye Robinson, John Tory, Kristyn Wong-Tam
Total members that voted No: 0 Members that voted No are
Total members that were Absent: 3 Members that were absent are Shelley Carroll, Michael Ford, Michael Thompson

Motion to Adopt Item as Amended (Carried)

EC3.4 - Review of Dementia Care Based Models

Decision Type:
ACTION
Status:
Amended
Wards:
All

Committee Recommendations

The Economic and Community Development Committee recommends that:

 

1.  City Council request the Interim General Manager, Long-Term Care Homes and Services to report to the Economic and Community Development Committee in the third quarter of 2019 on:

 

a.  a business case for a multi-year hiring and staffing plan, and technological enhancements, to address the rising acuity and complex care needs of long-term care home residents, such plan to be phased in through the 2020 and future years' budgets.

 

b.  an implementation strategy to strengthen the provision of emotion-centred approaches to care, along with a specific accountability process to measure the plan’s outcomes against stated goals; and

 

c.  a budget impact assessment for the implementation strategy.

 

2.  City Council forward a copy of the report (March 15, 2019) from the Interim General Manager, Long-Term Care Homes and Services on Review of Dementia Care Based Models to the Ontario Minister of Health and Long-Term Care, and the Ontario Minister of Seniors and Accessibility.

Decision Advice and Other Information

Dr. Pat Armstrong, Project Lead, Research Team, York University and the Interim General Manager, Long-Term Care Homes and Services gave a presentation on Models for Long-term Residential Care: A Summary of the Consultants' Report to Long-Term Care Homes and Services, City of Toronto; and presented a video entitled: "Commitment to Care".

Origin

(March 15, 2019) Report from the Interim General Manager, Long-Term Care Homes and Services

Summary

This report responds to Council's request of the General Manager, Long-Term Care Homes and Services (LTCHS) for a report on the potential for a pilot project in one of the City's ten long-term care homes, inspired by care-based programs (such as the Butterfly and Greenhouse project models), to better support seniors living with dementia.

 

LTCHS completed a number of activities and reviews in order to provide a thorough and informed response to the motion.

 

LTCHS engaged Dr. Pat Armstrong, Distinguished Research Professor of Sociology at York University, as an external consultant and researcher to assist in investigating leading models and approaches to dementia care. For almost a decade, Dr. Pat Armstrong and her international, interdisciplinary team of researchers have been reimagining long-term care. They have conducted 27 ethnographic studies of nursing homes in Canada, Germany, Norway, Sweden, the US and the UK. In addition, they have been involved in related studies that have taken them to another 20 homes and have seen examples of the Butterfly Household® Model and the Eden Alternative®, among others.

 

Attached as Appendix A to this report is the report from Dr. Pat Armstrong titled "Models for Long-Term Residential Care: A Summary of the Consultants' Report to Long-Term Care Homes and Services, City of Toronto".

 

As recommended by the consultants, LTCHS will investigate opportunities for enhanced direct care staffing levels.

 

LTCHS agrees with the conclusion provided by Dr. Pat Armstrong and her team regarding the need to have a flexible model of care, to not implement a specific pilot model for LTCHS but to continue its current practice of using the best aspects and learning from all models, adapting them into our own person centred model to best suit the individual resident.

Background Information

(March 15, 2019) Revised Report from the Interim General Manager, Long-Term Care Homes and Services on Review of Dementia Care Based Models - posted on April 15, 2019
https://www.toronto.ca/legdocs/mmis/2019/ec/bgrd/backgroundfile-131530.pdf
Revised Appendix A - Models for Long-Term Residential Care: A Summary of the Consultants' Report to Long-Term Care Homes and Services, City of Toronto - posted on April 15, 2019
https://www.toronto.ca/legdocs/mmis/2019/ec/bgrd/backgroundfile-130891.pdf
Appendix B - LTCHS Commitment to Care
https://www.toronto.ca/legdocs/mmis/2019/ec/bgrd/backgroundfile-130892.pdf
Revised Appendix C - LTCHS Dementia Care Journey, 2004 - 2019 - posted on April 15, 2019
https://www.toronto.ca/legdocs/mmis/2019/ec/bgrd/backgroundfile-130893.pdf
Presentation from York University on Models for Long-term Residential Care: A Summary of the Consultantsí Report to Long-Term Care Homes and Services, City of Toronto
https://www.toronto.ca/legdocs/mmis/2019/ec/bgrd/backgroundfile-131571.pdf
Annual Report from the Chair Advisory Committee on Long-Term Care Homes and Services and the General Manager Long-Term Care Homes and Services on Long-Term Care Homes and Services Annual Report 2018
https://www.toronto.ca/legdocs/mmis/2019/ec/bgrd/backgroundfile-131639.pdf
Notice of Revised Documents - posted on April 15, 2019
https://www.toronto.ca/legdocs/mmis/2019/ec/bgrd/backgroundfile-132070.pdf

Communications

(April 1, 2019) Submission from Teresa Gaito (EC.New.EC3.4.1)
https://www.toronto.ca/legdocs/mmis/2019/ec/comm/communicationfile-93208.pdf
(April 2, 2019) Letter from David Mitchell, Canadian Union of Public Employees CUPE Local 79 (EC.New.EC3.4.2)
https://www.toronto.ca/legdocs/mmis/2019/ec/comm/communicationfile-93213.pdf
(April 3, 2019) Letter from Councillor Josh Matlow (EC.New.EC3.4.3)
https://www.toronto.ca/legdocs/mmis/2019/ec/comm/communicationfile-93287.pdf

Speakers

Greg Shaw, International Federation on Ageing (IFA)
Jeannette Rowan
Tamar Fernandes
Mark Smith, Toronto Seniors Forum

Motions

1 - Motion to Amend Item moved by Councillor Michael Thompson (Carried)

That:

 

1.  City Council request the Interim General Manager, Long-Term Care Homes and Services to report to the Economic and Community Development Committee in the third quarter of 2019 on:

 

a.  A business case for a multi-year hiring and staffing plan, and technological enhancements, to address the rising acuity and complex care needs of long-term care home residents, such plan to be phased in through the 2020 and future years' budgets.

 

b.  An implementation strategy to strengthen the provision of emotion-centred approaches to care, along with a specific accountability process to measure the plan’s outcomes against stated goals; and

 

c.  A budget impact assessment for the implementation strategy.


2 - Motion to Amend Item moved by Councillor Cynthia Lai (Carried)

That:

 

1.  City Council forward a copy of the report (March 15, 2019) from the Interim General Manager, Long-Term Care Homes and Services on Review of Dementia Care Based Models to the Ontario Minister of Health and Long-Term Care, and the Ontario Minister of Seniors and Accessibility.

Source: Toronto City Clerk at www.toronto.ca/council