TORONTO -- A newly released staff report says Toronto’s city-run long-term care homes benefited significantly from access to city resources in managing COVID-19 outbreaks and is recommending that the city spend $14.3 million to implement a number of measures to make sure the homes are prepared to deal with a possible second wave of the illness.

The report by Seniors Services and Long-Term Care (SSLTC) was tabled June 1 and was made public Monday. It sheds light on how the city handled the COVID-19 pandemic at the 10 long-term care homes which it directly operates.

According to the report, the city learned a great deal from early and significant outbreaks at three of its homes: Seven Oaks, Kipling Acres, and Lakeshore Lodge.

These early outbreaks “provided an opportunity for the division to better understand staffing supports, new outbreak protocols, and supplies that homes would require during an outbreak to maintain resident care standards,” the report states.

Experiences with those outbreaks led to the early adoption of a number of measures, including 14-day staff self-isolation following international travel or exposure to the virus; early adoption of active screening; physical distancing; restrictions to non-essential visitors; making sure that staff could only work at a single location; suspension of group activities; and early adoption of a universal mandatory masking policy.

Staff shortages have been cited as a major issue among Ontario homes that experienced the worst outbreaks.

According to the report, the city-run homes faced similar problems. SSLTC employs 3,300 people, but over two thirds are part-time workers and one third had multiple employers.

In addition, when the city restricted all non-essential visitors from the homes, some 2,100 volunteers were shut out, along with 145 students who were doing work placements.

However the homes were able to bolster their ranks by using nursing students, physiotherapist assistants, contracted cleaners, nursing agency staff, redeployed city workers, and newly hired staff.

As of May 8, the city had hired an additional 350 staff members, including 203 PSWs, 22 nurses and 38 cleaners.

As of that date, 190 city staff had been redeployed to the homes to do screening, enhanced cleaning, mealtime assistance and to work in food services.

The report also credits an accelerated on-boarding process developed in collaboration with People & Equity and CUPE Local 79.

“This accelerated hiring and access to contracted, redeployed and new staff were critical factors in SSLTC’s ability to maintain high quality resident care during the pandemic,” the report states.

The report also cited cooperation with and access to resources from other city divisions as a major asset in responding to the pandemic. Other city departments were able to provide assistance to the homes with occupational health, labour relations, redeployment, technology services, recruitment of new staff, and procurement.

“Without these valuable supports, the division's ability to respond proactively and quickly to the COVID-19 pandemic would have been significantly hindered,” the report says. “In addition, collaboration with health experts including Toronto Public Health, and provincial health partners, has been critical to the division's response.”

The report says that continued cooperation with other city divisions means that Toronto’s city-run homes are prepared to “respond proactively should a second wave of COVID-19 become a reality.”

The report lists 16 recommendations to make sure that the city stays prepared.

Those recommendations include:

  • Maintain and strengthen partnership with Toronto Public Health
  • Maintaining active screening of all individuals entering LTC homes.
  • Maintain twice daily monitoring of residents for signs and symptoms of COVID-19 (provincially mandated action).
  • Continue to test and re-test all residents and staff (provincially mandated action).
  • Maintain mandatory masking and full access to PPE (provincially mandated action).
  • Maintain strong IPAC practices and improve processes based on emerging scientific evidence and best practices.
  • Maintain physical distancing measures (provincially mandated action).
  • Conduct full assessment of physical environments of all existing LTC homes and planned redevelopments, including reviews of equipment, furnishing, and building layouts.
  • Continue to follow the Government of Ontario directive limiting staff to work for a single employer/location (provincially mandated action).
  • Continue to focus on full-time staffing complement to achieve 70:30 full-time and part-time target.
  • Create an Occupational Health Nurse function as primary staff contact for COVID-19 concerns.
  • Maintain expedited recruitment strategy for the hiring of new staff including modified on-boarding process.
  • Continue to redeploy non-essential City of Toronto staff as required.
  • Implement the Ministry of Health and Toronto Public Health guidance on the resumption of non-essential visitors (provincially mandated action).
  • Maintain virtual visits and expand the use of technology.
  • Maintain regular, home specific communications with family members

A comprehensive review of SSLTC’s response in each of its 10 long-term care homes is still underway.