COVID-19 at Peel Long Term Care

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

• To provide non-essential services, such as personal care service providers (e.g., hairdressers, barbers, etc.), entertainers, recreational service, animal therapy, tours, etc.
• 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.

General visitors have access to review the Centre's Visitor Policy and must adhere to the guidelines set out in the policy during their visits.

General visitors:

• Are asked to screen themselves (self-monitor) for symptoms of acute respiratory infection and exposure to COVID-19 or other respiratory illness prior to entering the centre.
• Must not visit the Centre if symptomatic for COVID-19 or other respiratory illness. Please follow public health guidance or your health care practitioner if you are symptomatic.
• If you have respiratory symptoms but test negative for COVID-19, you can return visiting the Centre after 5 days from the onset of respiratory symptoms or until symptoms have resolved, whichever is shorter.
• If tested positive for COVID-19, to the Centre for 10 days after symptom onset or date of positive test (whichever is earlier) and wear a surgical mask.
• You must perform frequent hand hygiene during the visit in the centre.

General visitors are not permitted in the Centre:

• If an area or the whole Centre is in outbreak as per local public health direction.
• When the resident visiting is symptomatic.

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 be vaccinated.
• During an outbreak or if resident is symptomatic, essential visitors will be permitted entry but must wear the appropriate PPE as directed by local public health and the centre staff. This may include a fit-tested or non-fit tested N95 mask, eye protection, gown, and gloves. You may also be asked to 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 provided by the centre for more information.

You can request a copy of the information package and the caregiver support form from the Long Term Care centre screener or receptionist.

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.

Caregiver visiting during COVID-19

• It is strongly recommended that visitors and caregivers to mask in resident area indoors except when with the resident in the resident’s room or when eating or drinking with a resident in communal spaces.
• There is no limit on the number of visitors a resident may have for indoor visits, space permitting.
• You must verbally attest that you've read or re-read the centre's visitor policy and education/information package.
• Note: Where visits cannot be avoided (e.g., essential caregiver visits), you may visit within the 10-day timeframe of experiencing COVID-19 symptoms providing that you are asymptomatic, or symptoms have resolved. You must follow measures to reduce the risk of transmission for 10 days from their symptom onset or positive test including wearing a surgical or procedural mask, maintaining physical distancing and notify Centre staff of your recent illness/positive test. It is also recommended that the Resident being visited wear a mask, if tolerated.
• Masks are recommended but not required, in all areas of the Centre.

Material to review before your visit

• Private caregiver education package
• Caregiver information package
• Managing visitors
• Putting on full PPE
• Taking off full PPE
• How to hand wash
• How to hand rub

You can request a copy of the private caregiver education package, the caregiver information package and the visitors policy from your Long Term Care centre screener or receptionist.

Visiting a resident with symptoms

Caregivers can visit and care for a resident who has symptoms of COVID-19 or who is self-isolating. There is no limit to the number of caregivers who can visit the resident at one time.

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 will be provided with and wear appropriate PPE.

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

• Visitors are asked to self-screen for symptoms of COVID-19 and other respiratory symptoms and not visit the centre if symptomatic.
• All staff, students, volunteers and visitors are highly encouraged to stay up to date with their influenza and COVID-19 vaccines for added protection.
• All residents are offered and provided with COVID-19 vaccination, respiratory syncytial virus (RSV) and annual flu vaccines onsite when eligible.
• All residents are monitored daily for symptoms.
• There is enhanced cleaning and disinfecting, especially on high touch surfaces.
• Infection prevention and control measures are ongoing at our centres (hand hygiene, auditing, etc.)
• Staff have completed additional training on COVID-19, infection prevention, and control, and PPE.

New admissions and readmissions

• We are accepting new admissions.
• When a centre is in a declared outbreak or under investigation of an infectious disease, new admissions or re-admissions applications are reviewed and approved by Peel Public Health.

Outbreaks

• During an outbreak, we work closely with Peel Public Health to protect everyone.
• Residents who test positive for COVID-19 or respiratory symptoms or are identified as a close contact of a known case are isolated and closely monitored.
• Staff who test positive for COVID-19 or respiratory symptoms 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 provide regular status updates when a centre is in outbreak.

Declaration 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.

Confirmed outbreak management will include the following steps:

• Defining the outbreak area of the centre (floor or unit) and cohorting based on COVID-19 status (infected or exposed).
• Initiating additional precautions for all symptomatic residents and those with suspect or confirmed COVID-19.
• Posting appropriate signage outside the resident's room, at the entrance and in the area of the outbreak.
• Resident close contacts who remain asymptomatic do not need to be placed on additional precautions, unless residing in the same room. A close contact is defined as an individual who has a high-risk exposure to a confirmed positive COVID-19 case, an individual with COVID-19 symptoms, or an individual with a positive rapid antigen test result.
• Centres should conduct enhanced symptom assessment (minimum twice daily) of all residents in the outbreak area to facilitate early identification and management of ill residents.

We use the following outbreak definitions:

A suspect outbreak

• One positive PCR OR rapid molecular test OR rapid antigen test in a resident, who has reasonably acquired their infection in the setting.

A confirmed outbreak in a centre

• 2 or more residents who are epidemiological linked (e.g., same unit, floor, etc.), each with a positive molecular or rapid antigen test, within a 7-day period, where both cases have reasonably acquired their infection 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.

Reporting positive tests

All positive PCR test results or rapid antigen test results in residents, staff, or visitors associated with a suspect or confirmed outbreak in the centre, must be reported to the Peel Public Health and the Centre's Outbreak Management Team.

Confirmed COVID-19 cases in our centres

Review the health care institution outbreaks report.

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.

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

• Davis Centre 905-857-0977 ext. 5419
• Malton Village 905-791-1179 ext. 5416
• Peel Manor 905-453-4140 ext. 5417
• Sheridan Village 905-791-8668 ext. 5418
• Tall Pines 905-791-2449 ext. 5415