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COVID-19 at our long term care centres

Protecting the health of our residents and staff at Peel Region’s 5 long term care centres is our top priority.

Peel Long Term Care is dedicated to protecting residents and staff from COVID-19 while maintaining their safety and emotional wellbeing.

As of March 14:

Vaccines continue to be our best defense against the COVID-19 Omicron variant and reducing the risk of infection and serious illness.

Emerging evidence suggests that those who have received 2 doses of vaccine have a significantly higher risk of infection with Omicron compared to those that receive a third or booster dose. All staff, students, volunteers, support workers, and caregivers who are eligible to receive the booster dose after 3 months (84 days) of receiving the second dose, will need to show proof of their third dose to come into or work within the home, unless they have a valid medical exemption.

Staff, students, volunteers, support workers, and caregivers:

Regardless of vaccination status, any person who has travelled outside of Canada, other than the United States, within the past 14 days:

This includes persons intending to visit palliative residents. Learn more about travel, testing, and borders.

All staff, essential caregivers, support workers, and general visitors follow infection control measures, screening measures, indoor and outdoor visitor restrictions, and testing requirements as directed by the Ontario government.

Other information

A maximum of 4 caregivers, including general visitors, can visit a resident indoors at a time.

A general visitor is someone who is not an essential visitor. They are visiting:

  • To provide non-essential services, who may or may not be hired by the centre or the resident and/or their substitute decision maker.
  • For social reasons that the resident or their substitute decision maker assess as different from direct care. This includes care related to cognitive stimulation, meaningful connection, and relational continuity.

Examples of general visitors include entertainers, hairdressers, sales representatives, families, and friends.

General visitors under the age of 5 are allowed to visit the homes. There is no vaccination requirement for this age group. Visitors 5 years or older will need to be fully vaccinated with 2 doses to enter the home.

General visitors younger than 14 years must be accompanied by an adult and must follow all applicable public health measures that are in place at the centre, including active screening, testing for indoor visits, physical distancing, hand hygiene, wearing masks and eye protection.

Outdoor visits

There is no limit on the number of people visiting outdoors, space permitting. Please contact the centre in advance of your visit to check if outdoors space is available. Outdoor visitors are required to wear masks at all times.

Outdoor visits may occur as long as:

  • A resident is not self-isolating or symptomatic.
  • The centre is not in a full facility outbreak.
  • The visit works with the centre’s schedule.
  • Space is available to allow for physical distancing.
  • General visitors need to enter through the front door wearing a mask. They must be screened by our staff on arrival.
  • General visitors must acknowledge they are fully immunized against COVID-19 to have close physical contact, during visits. They must follow physical distancing requirements during visits.

General visitors who visit with their loved ones outside must do the following:

  • Wear a mask that covers your nose, mouth, and chin.
  • Use the hand sanitizer provided and clean your hands.
  • Maintain physical distancing of 2 metres or 6 feet to the resident, if not fully immunized.
  • Maintain physical distancing of 2 metres or 6 feet to all others such as other groups of visitors.
  • Follow all infection prevention and control guidance

Indoor visits

  • A maximum of 4 visitors, including caregivers, may visit indoors at a time.
  • All visitors must be screened for COVID-19.
  • All visitors visiting indoors must be tested for COVID-19.
  • General visitors must be fully vaccinated, or have a valid medical exemption, to enter the centre, unless they are visiting a resident receiving end-of-life care. Infants under 1 year of age are not considered visitors and may enter the centre without COVID-19 surveillance testing. Virtual visits are preferred for infants and young children who are not vaccinated.
  • General visitors younger than 14 years of age must be accompanied by an adult.
  • “Day of” COVID-19 Rapid Antigen Testing is required unless tested for the previous day. Previous day’s negative test result must be shown prior to entry to the centre.
  • Must wear a surgical mask and eye protection at all times when in the centre. These will be provided when you pass screening.
  • Must perform regular hand hygiene when entering and exiting the centre.

Scheduling your visit

Please call the centre to schedule your visit. We’ll do our best to make it happen, taking into account the following:

  • The physical space we have available.
  • The staff we have available to accompany residents to entry points or visiting spaces.

Outdoor visits can also take place in the neighbourhood if a centre doesn’t have enough outdoor space.

Please refer to the attention visitors poster - outdoor visiting and the general visitor - indoor and outdoor information package for further information.

Essential visitors are people who perform essential support services. Examples include:

  • Support workers
  • People who deliver food 
  • Government inspectors
  • Maintenance workers
  • Healthcare service workers, such as those who provide x-ray and lab services
  • Essential caregivers
  • A person visiting a very sick or palliative resident

Visiting requirements for essential visitors visiting a very sick or palliative resident:

  • Essential visitors who are visiting a very sick or palliative resident do not need to have a COVID-19 test or attest to a negative result. However, if you are not fully vaccinated against COVID-19, we encourage you to be tested for your safety and for the safety of residents and staff.
  • If you fail screening, you will be permitted entry but must wear the appropriate PPE. You must also maintain physical distance from other residents and staff.

Essential caregivers are chosen by the resident or substitute decision maker. They give direct care to the resident.

Examples of essential caregivers:

  • Family member who provides meaningful connection
  • Private caregiver
  • Paid companion
  • Translator

Examples of things essential caregivers help with:

  • Feeding
  • Mobility
  • Personal hygiene
  • Cognitive stimulation
  • Communication
  • Help with decision-making
  • Meaningful connection

Designating an essential caregiver

If your loved one wants to designate an essential caregiver, complete the caregiver support form. Once you submit the form, we’ll review it to ensure it meets the needs of the resident, and the safety needs of residents and staff. We’ll notify you when the review is complete.

Refer to the information package on hiring a private caregiver for a resident or Substitute Decision Maker for more information.

Caregivers must be at least 16 years of age. The decision to designate a caregiver is up to the resident or their substitute decision maker, not the centre. The centre will document caregiver designations in the resident’s Electronic Health Record.

A person may be an essential caregiver for multiple residents in the same centre. However, the residents should be of the same cohort, i.e., they should reside in the same unit or floor. It’s not recommended that a person be a designated caregiver for residents in different long term care centres, although it is permitted.

A resident or their substitute decision maker may change the designation in response to a change in the following:

  • Resident’s care needs that are reflected in the plan of care.
  • Availability of a designated caregiver either temporary (e.g., illness) or permanent.

Visiting during COVID-19

  • Always wear a mask and eye protection during your visit to the centre.
  • Fully vaccinated caregivers, who complete the required surveillance testing, can join residents for communal dining or family-style meals, while wearing a mask and eye protection at all times.
  • All residents may have up to 2 general visitors and 2 caregivers at a time for indoor visits. If the resident is symptomatic or isolating, 1 caregiver per resident at a time can visit indoors.
  • Please contact the centre before your visit to ensure the centre has the space/capacity and PPE required.
  • Centres may restrict the length or frequency of your visits.
  • You must verbally attest that you’ve read or re-read the centre’s visitor policy and education/information package.

Material to review before your visit

Physical distancing and exceptions

You must maintain physical distancing of 2 metres or 6 feet at all times from residents, staff, and other visitors.

The following are exceptions to physical distancing:

  • When providing direct care to a resident.
  • When a fully immunized resident wants physical contact with their fully immunized essential caregiver(s) (e.g., holding hands, hugs).
  • During a compassionate/palliative visit.

Physical distancing

Physical distancing is not required for residents in the same cohort during communal dining, organized indoor social activities, and gatherings. Caregivers must maintain appropriate physical distance from other residents.

Caregivers are encouraged to get vaccinated against COVID-19. You’ll be asked if and when you’ve received COVID-19 vaccination. This information is required to determine the following:

  • If physical distancing exceptions apply between you and your resident.
  • If you may join a resident during mealtime. A fully immunized caregiver may join a fully immunized resident for meals.
  • If you are exempt from refrgular COVID-19 surveillance testing.

Visiting a resident with symptoms

  • If the resident has symptoms of COVID-19 or self-isolating, 1 caregiver per resident may visit at a time.
  • You may not visit any other resident or long term care centre for 14 days after visiting a resident who is self-isolating or symptomatic, or a home in an outbreak.

Self-isolation means that the resident is staying in a room away from other people under droplet and contact precautions and can only see essential visitors. The visitor must be provided with and wear appropriate PPE.

Screening

  • All visitors will be actively screened for symptoms and exposure history for COVID-19 before entering the centre or visiting outdoors.
  • Residents returning from day or frequent absences must also be screened and tested. Residents will be screened and tested by the nursing staff on their unit.
  • All visitors must verbally attest that, in the last 14 days, you have not visited another:
    • Resident who is self-isolating or who has signs and symptoms of COVID-19.
    • Home in an outbreak.

Testing

General visitors must pass screening, take a rapid antigen test, and test negative prior to visiting the resident for indoor visits.

We use rapid antigen testing as per the Minister’s Directive, COVID-19 long term care home surveillance testing and access to homes, effective October 15, 2021.

Screening

  • All visitors will be actively screened for symptoms and exposure history for COVID-19 before entering the centre or visiting outdoors.
  • All visitors must verbally attest that, in the last 14 days, you have not visited another:
    • Resident who is self-isolating or who has signs and symptoms of COVID-19.
    • Home in an outbreak.

Vaccination and testing of support workers

  • Support workers must be fully vaccinated before entry into the centre. Proof of vaccination must be shown.
  • Those who are partially vaccinated or unvaccinated require “day of” antigen testing unless tested the previous day. Your antigen test result is valid for 2 days. Testing must be complete before you enter the centre. If tested the previous day, you must show the previous day’s negative antigen test before you enter.
  • When a centre is in outbreak, support workers require weekly PCR testing. Antigen testing will be suspended. Additional testing for all visitors may be required as advised by Peel Public Health.

Support workers who are regulated health professionals (RHPs)

  • Require testing before entry but may have contact with residents if wearing appropriate PPE and following IPAC guidelines while awaiting results.
  • Specific RHPs may enter prior to receiving antigen results. This decision will be made by centre staff on a case-by-case basis.
  • If you visit more than once in a day, testing is only required at the first centre visited either on the same day or the previous day. Proof of the negative antigen test result must be provided. Refer to IDF-106 – Antigen Test Result Confirmation.

Caregivers

  • Caregivers who are fully vaccinated against COVID-19 (i.e., they’ve had 2 doses of an approved vaccine and 14 days have passed since their second dose) are not required to have a COVID-19 test.
  • Will have 3 antigen tests in a 7-day period when the centre is not in an outbreak.
  • All currently designated caregivers were required to provide proof of a first vaccine dose or a valid medical exemption by December 20, 2021 to enter a centre, unless they were visiting a resident receiving end of life care. These caregivers then had until February 21, 2022 to be fully vaccinated.
  • Caregivers eligible for a third dose by March 14 needed to receive the third dose by then. Those eligible for a third dose on or after March 14 must provide proof of having received the third dose by April 30.
    • Until fully vaccinated, these caregivers will be limited to visiting their loved one in their room. Wearing a mask and eye protection, and physical distancing is required for in-room visits.
  • Those who are partially vaccinated or unvaccinated require 3 antigen tests in a 7-day period when the centre is not in an outbreak.
  • If you’ve received a rapid antigen test at another location, you must provide proof of the negative antigen test result (refer to IDF-106 – Antigen Test Result Confirmation) or take a new antigen test.
  • The test must be completed before gaining entry to the centre. Visitors who refuse to take the test or who have a positive test result will not be allowed to enter the centre.
  • When a centre is in outbreak, unvaccinated caregivers will require 1 PCR test a week.
  • Additional antigen testing during outbreak may be required for all caregivers by the centre in consultation with public health and the medical director.
  • PCR testing for caregivers will be done at a community testing centre. See community testing locations.

Rapid antigen screening does not replace public health measures such as symptom screening, physical distancing, masking, eye protection, and hand hygiene.

We're following all government directives and guidelines, public health recommendations, and infection prevention and control measures to stop the spread of COVID-19.

Current safety measures

  • Everyone visiting the centres, whether for indoor or outdoors visitors, when permitted, is screened either when entering the centre or when visiting residents outdoors, to ensure they have no symptoms, haven't travelled, or had contact with COVID-19 cases.
  • Staff and support workers that were working in the centres prior to October 1 must have at least one COVID-19 dose by November 15, or have a valid medical exemption, to work in the centres. They must have both COVID-19 doses by December 13 or have a valid medical exemption. Staff and support workers hired after October 1 must be fully vaccinated or have a valid medical exemption to work in the centres.
  • All students and volunteers must be fully vaccinated against COVID-19.
  • All staff and visitors, are required to complete a point-of-care rapid antigen test and/or PCR test, depending on the outbreak status of the centre.
  • Staff or visitors with a positive rapid antigen or PCR test will not be allowed into the centre. We will ask them to go home and follow Public Health instructions.
  • All residents are offered and provided with COVID-19 vaccination onsite including a COVID-19 booster dose when eligible.
  • Residents are screened and tested upon return from temporary (overnight) and short-term day or frequent absences.
  • All residents are screened once daily for symptoms.
  • All staff who interact with residents or enter resident home areas wear surgical masks, eye protection and other personal protective equipment (PPE), as appropriate.
  • There is enhanced cleaning and disinfecting, especially on high touch surfaces.
  • Staff have completed additional training on COVID-19, infection prevention, and control, and PPE.

Maintaining staffing

  • Additional staff have been brought into our centres to support the pandemic response.
  • We're accepting pre-graduation students from nursing and other programs.
  • Our Human Resources department is continuously hiring and recruiting to meet the changing demands of staff due to the COVID-19 pandemic.

Personal protective equipment

  • Personal protective equipment (PPE) is used to protect staff and residents.
  • All staff who interact with residents or enter resident home areas wear surgical masks, eye protection, and other PPE as appropriate.
  • Staff who work with residents who have tested positive for COVID-19 or close contacts wear additional PPE to protect themselves and others.

We are continuously monitoring our supply of PPE to ensure sufficient supplies. We accept donations.

New admissions, readmissions, and return to the centres

  • We’re accepting new admissions.
  • New admissions are tested for COVID-19 before entry and isolated for up to 14 days, depending on their vaccination status, to ensure no symptoms develop.
  • When residents are readmitted or return to the home, they are screened, tested, and placed in isolation until a negative test result is confirmed. This does not include social day absences.
  • Residents going on overnight absences, will be actively screened upon return and be tested as per Ministry’s Directives.
  • When a centre is in a declared outbreak or under investigation of an infectious disease, we can only accept new admissions or re-admissions that are reviewed and approved by Peel Public Health.

Dropping off items to residents

  • If residents need more or different clothing, we are accepting clothing drop offs from families and key contacts. Contact the centre for details.
  • Other items, including food, are being accepted at this time.

Testing for COVID-19 at our centres

  • We have testing clinics to test all unvaccinated or partially vaccinated staff, students, volunteers, caregivers, support workers, and general visitors for COVID-19 as required by the Ontario government.
  • We work with Peel Public Health to investigate all cases.
  • Residents who show symptoms or have been in close contact with a known case are tested for COVID-19.
  • Staff who have symptoms or have been in contact with a known case are tested for COVID-19 and isolate for 14 days, as directed by Peel Public Health.
  • Staff who may have had contact with affected individuals are given specific instructions to self-monitor and limit contact with others.

Types of testing

There are two types COVID-19 testing in Peel long term care centres:

  • A validated real-time polymerase chain reaction (PCR) assay laboratory test. This test is performed onsite for staff, students, and volunteers only.
  • A point-of-care rapid antigen screening test. This test is performed onsite for staff, students, volunteers, caregivers, support workers and general visitors.
Rapid antigen testing

A rapid antigen test is a quick way to see if someone might have COVID-19. It is performed on asymptomatic people only by conducting a nasal swab. The swab is then tested onsite and the result is available in 15 to 20 minutes.

PCR testing

PCR testing is used:

  • As part of regular COVID-19 surveillance testing.
  • When someone has a positive rapid antigen test result.
  • When someone has been in contact with a confirmed COVID-19 case.
  • When someone is symptomatic.
  • When a centre is in outbreak.
  • When they are directed by local public health.

Testing for COVID-19 does not replace other public health measures such as symptom screening, physical distancing, masking, eye protection, and hand hygiene, appropriate use of PPE, and strong infection and prevention control practices.

Outbreaks

  • During an outbreak, we work closely with Peel Public Health to protect everyone.
  • Residents who test positive for COVID-19 or are identified as a close contact of a known case are isolated and closely monitored.
  • Staff who test positive for COVID-19 are sent home to self-isolate and follow Public Health instructions.
  • Staff who work with residents who have tested positive or close contacts wear additional PPE to protect themselves and others.
  • We'll provide regular status updates when a centre is in outbreak.
Definition of an outbreak

Peel Public Health can declare an outbreak based on their investigation. This includes defining the outbreak area and where outbreak measures should be applied, such as a single affected unit or the whole centre.

We use the following outbreak definitions:

A suspect outbreak

  • 1 lab-confirmed COVID-19 case in a resident.

A confirmed outbreak in a centre

  • 2 or more lab-confirmed cases in residents, staff, or other visitors in a centre with an epidemiological link, within a 14-day period, where at least 1 person could have reasonably acquired their infection in the centre.
  • Examples of reasonably having acquired infection in a centre include no obvious source of infection outside of the centre or known exposure in the centre.

Epidemiological link

  • 1 case has either been exposed to a confirmed case or has had the same high-risk exposure as a confirmed case (e.g., both were exposed to a known cluster or outbreak).
  • Local Public Health units will determine this as part of their investigation, which informs their decision on declaring an outbreak.

Confirmed COVID-19 cases in our centres

Visit the COVID-19 in Peel dashboard to learn about long term care and retirement home outbreaks in Peel.

While safety is our top priority, staff also focus on quality of life for residents to keep their minds and spirits healthy. Long Term Care and Adult Day Services staff are working to prevent social isolation.

Staff are also using technology to connect residents with families and friends. Window visits are allowed when the weather is nice. Outdoor and indoor visits can also occur with loved ones if the home is not in an outbreak or isolation.

We encourage people to send cards and drawings to their loved ones. This work was featured in a recent Toronto Star article: Through the Nursing Home Glass.

We also welcome you to check out what COVID-19 vaccination day looked like in our Butterfly unit at Malton Village.

We'll continue to provide up-to-date information for families. We will share it as it becomes available.

If you have questions, call the family information line at the centre your loved one is located.