Item - 2019.EC3.4

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.

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".

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.