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Ontario Enhancing Care and Services for Long-Term Care Home Residents


Ontario Enhancing Care and Services for Long-Term Care Home Residents

Ministry of Health and Long-Term Care

Ontario continues to enhance the care and services provided to residents in long-term care homes.


Funding for long-term care is projected to increase to $3.83 billion in 2013/14 from $2.12 billion in 2003/04, an increase of $1.7 billion, or more than 80 per cent.

Higher Standards and Quality of Care

The government has introduced a number of initiatives aimed at improving the care and comfort of residents, including:

  • The Residents First initiative to help long-term care home staff gain knowledge and skills to help residents avoid unnecessary emergency room visits, prevent falls, prevent pressure ulcers, and provide continence care.
  • Funding over 10,000 new full-time frontline staff since 2003, including creating 2,500 personal support worker positions and more than 900 nursing positions in long-term care homes.
  • Improving resident safety, quality of care and abuse prevention through new staff training and development through Behavioural Supports Ontario.
  • Providing specialized supplies and equipment for residents with complex needs.
  • Prioritizing the reunification of spouses in the same long-term care home.
  • Establishing nurse-led outreach teams to improve resident care by addressing non-urgent health problems, determining the need for hospital care and providing a range of services including intravenous therapy, antibiotic management and oxygen administration.
  • Increasing the personal comfort allowance by 20 per cent since 2003/04 to put more discretionary income in the hands of residents.

Long-Term Care Home Legislation 

The Long-Term Care Homes Act, 2007 (LTCHA) and the Ontario Regulation, 79/10 (Regulation) were proclaimed into force on July 1, 2010 and form the single legislative authority for safeguarding resident rights, improving the quality of care, and improving the accountability of long-term care homes for the care, treatment and well-being of residents. The LTCHA includes:

  • Policy to promote a zero-tolerance approach to prevent abuse and neglect of residents.
  • Enhanced reporting obligations for anyone aware of abuse, neglect, or improper care. 
  • Enhanced whistleblowing protections for individuals who report to an inspector or director.
  • An enhanced and more clearly enforceable Residents' Bill of Rights.
  • Strengthened, consistent and mandatory reporting requirements for homes related to abuse, neglect, and injuries resulting in transfers to hospitals.
  • Strengthened requirements related to the development of an integrated, interdisciplinary plan of care for every resident. 
  • A comprehensive policy to limit the use of restraints on residents.  
  • Improvements to the assessment and admission process. 
  • A substantively reformed and strengthened compliance inspection and enforcement system with new sanctions. 

Types of Inspections

Resident Quality Inspections

Resident Quality Inspections (RQI) are comprehensive, unannounced inspections which use independently validated, consistent methodology and trigger a number of additional inspection protocols as necessary.  The inspection involves questions to residents and their families as well as staff to help to identify areas of concern. The RQI is conducted by a team of inspectors over a number of days, depending on the number of protocols triggered during the inspection.

Complaint, Critical Incident or Follow-up Inspections

Long-term care home inspectors also visit homes to inspect on a complaint, a critical incident or to conduct a follow-up inspection (together called CCF inspections). These unannounced inspections are focused on issues raised in critical incident reports, mandatory home reporting of abuse, complaints reported by residents, family members, staff, or the public, and to follow-up on compliance orders issued. Relevant inspection protocols are used to inspect the issues in-depth and to determine if the home is compliant or non-compliant with the LTCHA and its regulations. All CCF inspections are prioritized based on risk to residents.

Service Area Office Initiated Inspections

Service Area Office initiated inspections are conducted in a home that has not had a CCF inspection or RQI for that calendar year. These inspections ensure the ministry meets its legislative obligations to inspect every long-term care home every year. The inspector may inspect against other care and safety issues dependent on concerns identified as a result of the inspection protocols followed.

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