Update as of October 13, 2020
COVID-19 VISITORS POLICY
Beginning June 18th, 2020, Riverwood Senior Living began a careful, phased approach to the gradual resumption of resident visits during the COVID-19 pandemic ensuring Residents receive visitors safety to help protect against the risk of COVID-19. As the province moves into a second wave of COVID-19, in order to continue to balance Resident and staff safety and well-being, the province has developed a risk-based response system that is reflected in the changes to this policy.
All visitors will be instructed to adhere to the requirements set out in this policy to ensure the safety of all residents, staff and visitors, and allow for the continuity of visits that support the mental, physical and spiritual needs of residents for their quality of life while also supporting Residents in receiving the care they need and maintaining their emotional well-being.
This policy complies with the current ministry requirements per Directive #3 (September 9th, 2020) and aligns with the Ministry for Seniors and Accessibility (MSAA) Retirement Home COVID-19 Visiting Policy (October 5th, 2020). The rules in this policy are in addition to the requirements established in the Retirement Homes Act, 2010 and its regulation (O. Reg 166/11). Any non-adherence to the rules set out in the visitor policy will be the basis for discontinuation of visits.
Informed by the ongoing COVID-19 situation in the community and the residence, Riverwood Senior Living is taking a gradual, phased approach to the resumption of visits. As the pandemic situation continues to change, the residence's visitor policy will be reassessed and revised to allow for increased or decreased restrictions as necessary, as circumstances change in the community, within the residence and with new directives.
There is on ongoing need to protect retirement home residents and staff from the risk of COVID-19, particularly as some Residents may be more susceptible to severe effects of COVID-19 than the general population.
This visitor policy is guided by the following principles.
This policy is based on the principles of safety, emotional well-being, equitable access and flexibility. It is with compassion that we recognize the need for residents' connection with loved ones, and it is through in-person visits that this can be best achieved. We will take all reasonable steps to help facilitate visits within the parameters of ministry directives. Per ministry guidelines, the residence will follow the requirements for the minimum visit frequency and seek to accommodate more visits where possible. Where it is not possible or advisable for visits to occur in person, the residence will continue to provide virtual visiting options.
Riverwood Senior Living also recognizes the concepts of non-maleficence (i.e. not doing harm), proportionality (i.e., to the level of risk), transparency and reciprocity (i.e., providing resources to those who are disadvantaged by the policy). These concepts will inform the residence's decision making with regards to the scheduling and/or refusal of visits as appropriate.
Procedures: Requirements for Visits
If the residence has begun accepting visitors and enters into an outbreak, all non-essential visits must be discontinued, and the residence will adhere to the requirements of any applicable directives issued by the CMOH and directions from the local public health unit (PHU).
The following baseline requirements must be met prior to the residence being able to accept any visitors:
Note: Residents who are self-isolating for 14 days under the Droplet and Contact precautions may not receive non-essential visitors (i.e. general visitors or personal care service providers). However, Riverwood Senior Living may allow residents who are not self-isolating to receive general visitors and personal care service providers, provided the home is not in an outbreak or located in a community confirmed to be in High Alert status by the RHRA (see additional details in "Access to Residence").
Additional factors that will inform decisions about visitations at Riverwood Senior Living include:
Types of Visitors:
All visitors are responsible for adhering to applicable directives including Directive #3, MSAA guidelines and the Riverwood Senior Livings Visitor Policy. Visitors should consider their personal health and susceptibility to the virus in determining whether visiting the residence is appropriate. Outlined below are the three types of visitors.
Note: Riverwood Senior Living's staff and volunteers are not considered visitors as their access to the residence is determined by Riverwood.
1. Essential Visitor: Essential visitors include a person performing essential support services (e.g., food delivery, inspector, maintenance, or health care services (e.g., phlebotomy) or a person visiting a very ill or palliative resident.
2. General Visitor: A general visitor is a person who is not an essential visitor and visits:
3. Personal Care Service Provider: A personal care service provider is a person who is not an essential visitor and visits to provide personal services to residents such as hair dressing and nail care.
Please be aware that:
Access to Residence:
As identified throughout this policy, essential visitors are the only type of visitors allowed when a resident is self-isolating or symptomatic, the residence is in an outbreak, or is in High Alert status.
When the local public health unit declares an outbreak in the residence, they may also advise further restrictions on visitors in part or all of the home, depending on the specific situation.
If a home is in outbreak or in a community identified under Alert or High Alert status, the local PHU may recommend additional outbreak management control measures which may include restriction of essential visitors.
The RHRA in collaboration with the MSAA will identify if the residence requires additional actions due to:
Homes will be notified by the RHRA if they are in Alert or High Alert status.
Visits are only permitted if pre-booked and time is available on the visiting schedule.
Screening Protocols & Visitor Requirements
All home care and personal care service providers should:
Personal Protective Equipment:
Visitors must wear PPE as required in Directive #3:
Discontinuation of Visits
Accessibility Considerations: The residence is required to meet all applicable laws such as the Accessibility for Ontarians with Disabilities Act, 2005.
Appendix A – Information Package for Visitors:
Note Visitor Requirements Identified Herein: As part of Riverwood Senior Living's policy on visits during COVID-19, all visitors will be provided with the information package, including education on all required protocols. All visitors must review the contents of the information package prior to their visit. Any non-adherence to the rules set out in the visitor policy will be the basis for discontinuation of visits.
The visitor policy and information package will also be shared with residents to communicate the residence's visitor policy, including the gradual resumption of family visits and the associated procedures.
Physical Distancing Physical distancing means keeping our distance from one another and limiting activities outside the home. When outside your home, it means staying at least 2 metres (or 6 feet) away from other people whenever possible. Physical distancing, when combined with proper hand hygiene and cough etiquette, has been shown to limit the spread of COVID-19.
Physical distancing means making changes in your everyday routines in order to minimize close contact with others, including:
Physical distancing of 2 metres must be practiced during all visits on Riverwoods property to reduce the risk of COVID-19 transmission.
Read more about physical distancing at: https://www.publichealthontario.ca/-/media/documents/ncov/factsheet/factsheet-covid-19-guide-physical-distancing.pdf?la=enhere (Source: Public Health Ontario)
Things to Avoid:
It is important to help reduce the spread of illnesses by using proper respiratory etiquette. This means that instead of covering your mouth with your hands when coughing or sneezing, use your sleeve or a tissue. This reduces the number of germs on your hands, though it is still important to wash your hands after coughing and sneezing.
Respiratory etiquette must be practiced during all visits on the residence property to reduce the risk of COVID-19 transmission.
Following these steps is important:
Read more about respiratory etiquette at https://www.publichealthontario.ca/-/media/documents/C/2013/clincial-office-cough-signage.pdf (Source: Public Health Ontario)
Hand hygiene is a general term referring to any action of hand cleaning. Hand hygiene relates to the removal of visible soil and removal or killing of transient microorganisms from the hands. Hand hygiene may be accomplished using an alcohol-based hand rub or soap and running water.
Touching your eyes, nose or mouth without cleaning your hands or sneezing or coughing into your hands may provide an opportunity for germs to get into your body. Keeping your hands clean through good hygiene practice is one of the most important steps to avoid getting sick and spreading germs to others.
Prior to beginning each visitor with a resident, visitors must perform hand hygiene. Additionally, any time your hands become soiled for any reason during the visit, you must perform hand hygiene. Wash or sanitize your hands at the end of the visit as well.
Infection Prevention and Control (IPAC) Practices:
Infection Prevention and Control (IPAC) refers to evidence-based practices and procedures that, when applied consistently in health care settings, can prevent or reduce the risk of transmission of microorganisms to residents, staff and visitors.
All visitors must follow the residence's infection and prevention control protocols (IPAC), including proper use of masks.
IPAC practices include:
Read more about best practices for infection prevention and control at: https://www.publichealthontario.ca/-/media/documents/b/2012/bp-ipac-hc-settings.pdf?la=en(Source: Public Health Ontario)
Proper Use of Personal Protective Equipment (PPE):
PPE is clothing or equipment worn for protection against hazards. Examples of PPE include gloves, gowns, facial protection and/or eye protection. Using, applying and removing personal protective equipment correctly is critical to reducing the risk of transmission of COVID-19.
All visitors must comply with the residence's IPAC protocols, including donning and doffing of PPE and following instructions on use provided by the residence.
Family visitors must where a face covering at all times. If the visit is indoors, a surgical/procedure mask is required.
Visitors are responsible for bringing their own mask. If the residence is not able to provide surgical/procedure masks, no family visitors will not be permitted inside the residence. Essential visitors who are provided with appropriate PPE from their employer, may enter the residence.
For Essential Visitors only: Essential visitors providing direct care to a resident must use a surgical/procedure mask while in the residence, including while visiting the resident that does not have COVID-19 in their room. Essential visitors who are in contact with a resident who is suspect or confirmed with COVID-19, must wear appropriate PPE in accordance with Directive #5 and Directive #1. This includes contact and droplet precautions (gloves, face shield or goggles, gown, and surgical/procedure mask).
Putting On (Donning) and Taking Off (Doffing) PPE – See more information at: https://www.publichealthontario.ca/-/media/documents/ncov/ipac/ppe-recommended-steps.pdf?la=en or https://www.publichealthontario.ca/-/media/documents/l/2013/lanyard-removing-putting-on-ppe.pdf?la=en
During COVID-19: Expectations for Visits
Staying connected with others and the outdoors is important for everyone's wellbeing. To ensure the safety of residents and the whole retirement home community, all visitors must adhere to the following restrictions as per the Ontario Chief Medical Officer of Health (Office of the Premier, June 11, 2020) (CMOH, Directive #3). Visits will be re-opened in a gradual, phases manner that meets the health and safety needs of residents, staff, and visitors. Please refer to Ontario Governments Reopening Retirement Homes guidance document for more information (June 11, 2020).
The following requirements must be met for visits to happen, they include:
Guidelines for Visits: During COVID-19: