Family Council Minutes

1.      Welcome and opening remarks by the Chair

We had a smaller attendance at this meeting but welcomed some new faces. Welcome to Jason and Julie.  Both had a wealth of unique family experience with the Manor. Their comments and discussion were very insightful and appreciated. We hope to see you again in future. Family participation is always encouraged.

The previous minutes from Jan 15 2024 and Oct 16, 2023 were circulated previously and considered approved at this time. Unfortunately, they cannot be posted due to continuing technical issues with the Manor website which will not be resolved pending the release of the new site. It is being populated manually now as none of the existing information will be copied over. Prior minutes from June, March and Jan 2023, can still be found here:  https://maxvillemanor.ca/family-council/. 

The Family Council had a very productive 2023 including Alzheimer’s and Parkinson’s information sessions and staff training on Multiple Sclerosis. Alexandra Laderoute from Lahie and Sullivan Funeral Homes presented on end of live planning.

The chair completed a 2023 year end summary and report of activities. They will hopefully be posted on the new website soon.

With thanks to the Family Council Liaison for setup of a laptop and connectivity to the large screen and the Manor’s Owl’ technology. Owl provides for a better hybrid meeting between those present and via Zoom. It focuses on the person speaking anywhere around the room rather than just those who have a laptop in front of them.

The chair absolutely missed Gail Seguin as she usually makes excellent notes and helps get them out quickly. These minutes were delayed as the chair developed these minutes from his own chicken scratching’s having only returned from the Philippines at the end of April. My apologies.

2.      Discussion Points

Ministry Inspection Reports.  An Inspection report dated Jan 26, 2024 was posted in time for this meeting but not discussed in the interests of time. https://publicreporting.ltchomes.net/en-ca/homeprofile.aspx?Home=C540&tab=1

A second inspection dated April 3^rd is accessible thru the above link. It was not available in time for this meeting but has since been posted. The Ministry indicates that it is supposed to be made available to the FC upon receipt by the licensee. That handoff is still pending at the time of this writing.

Staffing concerns were a point of lively discussion. Staff. The past period has been particularly difficult with constant reorganization. Residents and family never get a chance to know their caregivers or form relationships. There are so many new staff including Agency staffers. It was felt that Agency staff may not have adequate training. An example used was that an agency staff pulled off the blankets of a family member/resident at 4am just because the chart showed it was time for medication although it could have waited or been handled differently.

The Manor has experienced some significant turnover at the ADOC and DoC levels over much of the past year. Kelly is long gone. There was a temporary fill-in. DoC Anya Gwynn has now departed. No one has had personal experience with Courtney Jeske sufficient to form an opinion.

Identification Bracelets. It’s reported that residents have been measured for bracelets such as one would find in a hospital setting. The Family Council has not been consulted and is at a loss to understand how if implemented this enhances person centered care. Staff is expected to greet residents by name or the manner in which they wish to be addressed without first having to read an outstretched arm. 

Cleanliness of the Manor.  Shawn is to be commended for a great job by the cleaning staff.

Laundry. Laundry and labelling were felt to have room for improvement especially in regards to checking pockets before laundering. Multiple occasions of finding chocolates, Kleenex, tea bags or other things secreted after the fact.

Foot Care.    Every 6 weeks is felt inadequate.

3.      Tenure of the FC Chair

In January Rainer reaffirmed that his initial 2-year term as chair of FC will be coming up in time for the next meeting. Ideally someone will put their name forward to replace him as chair by a vote at the next meeting. He would be happy to continue in a supporting role. A request for nominees or expressions of interest was reissued in March.

No other candidates were put forth, so Rainer Pethke was acclaimed as Chair of the Maxville Manor Family Council for another 2 year term to be revisited in early 2026 at a minimum.

4.      Residents Bill of Rights

This was the intended main subject area of this meeting, and we welcomed two representatives from Residents Council leadership, A lively discussion was held using the February 2023 edition from CLEO.   Electronic copy can bee found at https://www.cleo.on.ca/en/publications/everyres.

There was so much to discuss that we went into overtime and had to accelerate through the last few topics. Regardless, the RC members seemed well versed. Some trepidation was expressed about exercising those rights if it would lead to reduced service or subtle forms of retaliation.

5.      Roundtable – final comments, feedback, schedule next meeting

Next Meeting: Monday, June 17, 2024 at 6:00pm  ** Note that this is a ½ hour earlier than our previous meeting times.

Carol offered to coordinate a Parkinson’s information session again.  Carol felt the Care and Cleaning of a CPAP machine would be of benefit. Jason suggested that an information session on Palliative and End of Life would make a good future topic. This is something the Chair agrees should be explored further including links to MAID.

 Please send an email to FamilyCouncil@maxvillemanor.ca if you have any other suggestions for future topics.

The meeting adjourned at 8:15 pm.   Thanks to all who participated, including the RC leadership and to our new attendees

Welcome and opening remarks

Between our meeting date and the issue of these minutes one of our Family Council members, Liane Greene, lost her Dad. He was a resident of the Manor as was her mother who passed in April 2022. We offer Liane and her family our deepest condolences and hope that we will continue to see her at the Manor and family council.

The Chair welcomed Eleanor Ryan and Shelly Sheedy from the Champlain Regional Family Council Network (CRFCN). They joined us via Zoom this evening.

Alzheimer’s information sessions are going well and will continue monthly thru June.

MS training for staff was held on March 1st. It was well received, so much so that another session maybe conducted.

The 2022 Family Council annual report and the previous minutes from January 2023 can be found here: https://maxvillemanor.ca/family-council/

Previous minutes are considered approved as they are typically circulated for comment and approval after the last meeting.

2. CRFCN Presentation

Eleanor Ryan explained that the CRFCN is a volunteer organization supporting 5 districts which include Hawkesbury, Cornwall, Maxville, Ottawa and Renfrew. It has 60 long term care homes within this district. The Champlain Region extends from Deep River in the west to Hawkesbury in the east and includes the City of Ottawa. More information can be found at their website https://www.champlainfamilycouncils.ca/

CFRCN works closely with Family Councils Ontario (FCO) which is a government funded organization out of Toronto. Family Councils of Ontario (FCO) has a website https://fco.ngo/ and contacts with good resources.

 If you contact eleanor.cm.ryan@gmail.com and provide your email address she would gladly add you to the CRFCN email distribution list with information, upcoming events and even bulletins from FCO.

Eleanor is familiar with the Manor and has worked directly with Dina in the past to establish and support family councils. She likes the “Person Centered Care” approach. Person-centered care is a philosophy that recognizes that individuals have unique values, personal history and personality and that each person has an equal right to dignity, respect, and to participate fully in their environment including decisions on health needs and care.

She stressed the importance of The Family Council having a good rapport with the Administration and staff assistants.

Recommendations are to have the Family Council invite guest speakers from different aspects of The Maxville Manor such as maintenance, director of care, cleaning, etc. to give an overview of their role and to better understand their impact on the residence and resident care.

Eleanor would like to coordinate an open session to bring all districts together to share ideas, key issues, round table, guest speaker. Possibly a Saturday morning in May or June.

Shelly Sheedy – is a welcome recent addition to the CRFCN executive. She spoke to the importance of interactions between the group of 3: Residents, Families and Staff. Shelly also spoke to care models including Butterfly Model, Person Centered Care and support for families and staff.

The chair spoke to upcoming actions by the Ontario Health Coalition (OHC) https://www.ontariohealthcoalition.ca/ to defend public healthcare and the erosion of resources to private for profit models. There is a local chapter based in Cornwall (CHC) that active on Facebook https://www.ontariohealthcoalition.ca/ that can use everyone’s support in organizing, fundraising and support for gathering signatures. The goal is to gather over a million signatures on a petition and present it to Queens Park at the end of May.

Alignment with the Manor’s Operational Priority Projects

An updated document (Draft V9 update to that presented by Amy Porteous in our Jan FC) was discussed for alignment with FC activities. In 2023 the FC will focus will be on:

· The quality program for improving resident care.

· Review and input to any updates to policy and procedures impacting families and residents.

· New resident and family orientation.

· Sponsor educational events including another MS awareness training session for staff. Parkinson’s information sessions for general audiences are planned after the current Alzheimer’s sessions complete in June.

· Support for the revamp of the Manor website and the information therein.

· The resident satisfaction survey and related initiatives

· Facility redevelopment efforts and a possible specialized unit for youth

· Growth of the Family Council with a focus on supporting families of residents.

· Closer ties with the Residents Council

· There was some discussion on fund raising. As a non-profit the Manor has to raise a certain amount before the government kicks in money for reconstruction.

In the past the Residents council provided a welcome basket or flowers to welcome new residents. It was well received. The Family council currently holds no funds or means of fundraising.

Resident Satisfaction Survey results.

· Dina gave a quick (as we were into overtime) overview of the survey result and action plan.

64 questions- 59 Multiple Choice- 5 Word Responses

89 Respondents- 12 Residents- 77 on Behalf of a Resident

Consistently approx. 16-20 respondents skipped each question.

Less participation for questions that required Word Responses

Duration of time living at Maxville Manor

Less than 6 months- 11.94%

6-12 months- 17.91%

1-2 years- 23.88%

3-5 years- 34.33%

6+ years- 11.94

Satisfaction of overall care and services Recommends Maxville Manor

Strongly agree- 54.93% Strongly agree- 61.97%

Agree- 42.25% Agree- 36.62%

Somewhat agree- 2.82% Somewhat agree- 1.41%

Highlights:

· optometry and dental care is provided at the Manor but was not well known.

· there will be more weekend programming for residence

· a better process to address missing clothing

· Ensure that staff know about tools they can use to keep “unwanted visitors” from entering a resident’s room E.g. yellow magnetic strips

· Dina applied for funding and was able to obtain a new interactive portable projector for residents.

Copies of the survey results and action plan were forwarded to all FC members after the meeting. Unfortunately, they cannot be found on the Manor website but could be obtained directly from Dina upon request. It was also noted that the Residents Council section of he website has not been updated since Sept 2022.

Roundtable – final comments, feedback, schedule next meeting

The next Family Council meeting is scheduled for Monday May 29th at 6:30pm. This is after the Victoria Day long weekend.

Emergency evacuation plans were previously suggested as a potential topic for the next meeting but will be deferred pending the development of a mandatory Emerg. Preparedness Policy and Procedures Manual by the Manor in Q2. Another is revisiting the resident intake process. Your ideas and input are welcome.

This was a dual Format Meeting conducted in person and via Zoom

1. Welcome and opening remarks by the Chair

The previous minutes from Mar 2023 can be found here: https://maxvillemanor.ca/family-council/. Previous minutes are considered approved at this time, as they are typically circulated for comment and approval after the last meeting.

Alzheimer’s information sessions are going well with one session left on June 21st.

MS training for staff was held on March 1st. Not everyone was able to attend, and additional staff have expressed an interest in so Kelly/Dina will look into holding another session.

This session was recorded and could be made available to FC attendees. The camera in the laptop provided by the Manor turned out not to be working so some visuals containing the attendees in the Manor Library were not captured.

Thanks to Gail Seguin once again for her excellent notes.

2. Inspection Report by DoC - Kelly Keeler

This inspection report dated April 27, 2023 was distributed prior to the FC meeting and is available at http://publicreporting.ltchomes.net/en-ca/homeprofile.aspx?Home=c540&tab=1

This visit was a follow-up to an earlier inspection. Ministry inspectors were onsite March 13, 14, 15, 16, 20, 21 2023 - Primary Inspector and two were being trained - Ministry inspection offsite March 22, 2023. Additional non-compliances most notably around the wearing of masks in proximity (within 6 feet) to residents were observed while inspectors were present.

A failure to report to the Director was noted re: a resident’s concern that they did not see their medication before it was put into their mouth. The conversation was noted in RPN reporting.

A resident room was observed to have a PPE donning station but additional precaution signage was not in place. The IPAC Lead was interviewed and confirmed the room had contact precautions in place for specific procedures. Contact precaution signage was put in place prior to the end of the inspection.

Three staff members were observed in the family room of a resident home area hallway with their masks removed and there was a resident in the room completing an activity. On the same day, two other staff members were observed in the town square area of the home seated at separate round tables behind residents taking part in an activity. Masks must be worn at all times in the Manor with limited exceptions such as eating but always when residents are in proximity.

Medication management was reviewed for Oct-Nov 2022 as part of the follow-up. A new system was implemented in December and the inspector found a concern therein.

During the Pandemic last fall the pharmacy encouraged less wastage because of shortages of certain medications. The Manor was asked to save as much medication as possible and followed procedures used elsewhere to label the syringe with patient’s name, date, dosage etc. The Ministry ruled that per legislation: medication must stay in the original bottle.

All things have been addressed and unfortunately there is some wastage of medications that leads to increased costs but legislation must be followed.

3. Update on Parkinson’s information by Carol Hambleton

An Information session is scheduled for July 10, 2023 at 6:30 to be presented by Donna Greenings. (Program Service Co-ordinator Parkinson's Canada). The host will conduct the session via Zoom from Saskatchewan.

Carol will prepare posters for the front lobby and nurse’s station.

Interested persons will be asked to register with Dina so that she has contact info to distribute the Zoom and any updates. Registration cut off will be the day prior to the session.

Participants can join via Zoom or an in-house option (10-12 capacity in the library) - Registration cut off will be the day before.

There is only one session planned at this time expected to be 45-50 minutes long with time for questions following presentation.

4. Intake Process review – a new resident’s experience Rainer Pethke

Prior to the FC meeting the chair distributed notes gleaned from his mother’s experience during a late April intake. Notes were based on personal observation and limited comments from other family members. The intent was to gain comments and feedback from other FC members to gain agreement on what worked well and areas that could be improved in general for the benefit of all future intakes. Unfortunately, the small attendance coupled with the amount of time that has passed, limited discussion on other intakes. Following are 22 recommendations based largely on this particular experience.

Key Recommendations:

1. Issue Resident handbook and FC materials the same day that the bed offer is confirmed.

a. Ensure website copy is kept up to date as it is not.

2. Identify a key contact person for questions and to be a family liaison. Identify where FC minutes and information can be found on the website and encourage participation.

3. Avoid intakes on the last days of the week as much as possible.

4. Reserve a meeting room or other private area with sufficient seating for the intake.

5. Implement extra staff awareness/instructions to weekend and shift staff when a new resident is admitted.

6. Implement a facilities room audit checklist and leave a copy of the completed checklist and staff contact information in the room for the new resident.

7. Confirm in advance of making the sign that the resident name is posted as commonly used/how they wish to be addressed.

8. Include the head nurse or unit manager in the intake to ensure that all relevant medical information and special needs are documented and part of their care plan from the first day.

a. 21+ days is felt too long and too much of a risk to find out something critical was missing.

9. Share the assessments/information that the Manor has documented, with the POA/Caregiver within the first 2 days of admission. It is felt that there exists a real risk of gaps without the 2-way confirmation.

10. Within 48 hours hold a review of the PSW summary sheet with the Unit Mgr and POA to ensure all key info is captured therein.

a. Ensure that it includes little things that add to comfort, such as providing reading materials, turning the tv on/off a certain time, a pillow behind their back if the chair tends to cause slouching, allergies, preferences etc.

11. Have the resident name and seating prepared at the dining area in advance of the first meal.

12. Ensure that roommates as well those sharing dining seating are properly introduced.

13. Confirm that snacks and drinks are part of the daily provisions starting the day of arrival.

a. This is especially important if the individual is a grazer who does not normally consume a full meal in one sitting, otherwise they may be increasingly confused/afraid of the changes if basic needs are not being met.

14. Do daily call bell reviews for the first few days and over the first few weeks and take action on Zero or low usage to train/assure the new residents’ that its ok to ask for help.

15. Provide regular activities report to families so that they can coordinate the calendar of activities with visits.

16. Develop a short written description of the activities found within the calendar that also includes the expected duration.

17. Confirm transfer of medical records from their current physician and pharmacy. Don’t rely on HCCS as their information can be dated or even incorrect. Apparently, the Manor pharmacy is to call the POA prior to admission but no-one present could confirm it happened.

18. Confirm the POA with the family as HCSS records were found to be dated or incorrect.

19. Communicate with families and caregivers regularly, promptly and often during the first few days, weeks and month until everyone is comfortable then monthly thereafter ( suggest alignment with when the invoice is issued) so that families better appreciate the service provided for the money. A summary report of the nursing notes, medications taken, activities attended, call bell report etc would all be appreciated.

20. A good first step would be considering what could the Manor do to improve an experience that was described from the new resident’s point of view. Right or wrong, there is a reason behind each comment and should not be discounted/discouraged.

21. Update the Admission Process accordingly as part of a quality process including the FC and RC.

22. Develop a new resident intake survey and integrate it into a QC process that includes regular review and updates.

- It was noted by Kelly that assessments are completed quarterly per legislation and coded information is sent to the MLTC that could not be easily communicated with family contacts. Family is contacted only if there is a change. Family is included in the annual reviews.

- The above recommendations were passed on to Kelly for discussion at a management team meeting as intake process review and updates are on the priority projects list for this quarter.

Roundtable – final comments, feedback, schedule next meeting

Thanks were expressed by Judith for the activity staff for the garden centre as well as noting the excellent work done on the completion of the FG Piper lounge after the fire.

Construction design activities have restarted for the Manor reconstruction. We can expect fundraising to start soon with a Spring 2024 target to start construction.

The next Family Council meeting is scheduled for Monday August 14th at 6:30pm.

Emergency evacuation plans were previously suggested as a potential topic for the next meeting pending the development of a mandatory Emerg. Preparedness Policy and Procedures Manual by the Manor in Q2. Your ideas and input are welcome for this and future FC meetings

This was a dual Format Meeting conducted in person and via Zoom

1. Welcome and opening remarks by the Chair

We had a particularly good attendance at this meeting, attributed in large part to the participation of CEO Amy Porteous. She mentioned that the Manor has one of the larger FC’s. Family participation is always encouraged. The previous minutes from June 5, can be found here: https://maxvillemanor.ca/family-council/. Previous minutes are considered approved at this time, as they are typically circulated for comment and approval after the last meeting.

Alzheimer’s and Parkinson’s information sessions were completed since our last FC meeting. are going well with one session left on June 21st.

Cynthia Morgan (executive assistant to the CEO ) has taken over from Dina Murray MacDonald as the liaison for both the Family and Resident councils. Welcome Cynthia.

The Manor’s new ‘Owl’ technology made for a better hybrid meeting between those present and via Zoom as it will focus on the person speaking anywhere around the room rather than just those who have a laptop in front of them.

Thanks to Gail Seguin once again for her help and excellent notes.

2. Proactive Inspection Report by CEO Amy Porteous

This inspection took place over 12 days between June 19th – July 27th. This report was distributed prior to the FC meeting and is available at: http://publicreporting.ltchomes.net/en-ca/homeprofile.aspx?Home=c540&tab=1

A Pro Active Inspection means that it was not scheduled in advance and initiated by the Ministry rather than as a result of a complaint or critical incident. This was the first such inspection for Amy in her 20 year career. It is a part of the Ministry’s new Fixing Long Term

care act and regulations and could include Fines- monetary penalties or orders to bring in management with impacts becoming become progressively more stringent if findings are not resolved.

We had a mix of some items being fixed before they left ( i.e. papers that are required to be posted but had disappeared from a bulletin board). The most significant order concerned Narcotic Control Policy. This order had to be complied with by Oct, 16, 2023.

The order is the most significant finding. Over the course of the last year some medications were hard to get and RN's were pulling additional doses from one unit of supply. Ministry didn't agree with this because it's a high-risk medication and only one dose is to be drawn and then discarded.

There is a new policy and the pharmacy has come in and trained the Registered Staff.

Previously During the Pandemic last fall the pharmacy encouraged less wastage because of shortages of certain medications. The Manor was asked to save as much medication as possible and followed procedures used elsewhere to label the syringe with patient’s name, date, dosage etc.

All things have been addressed and unfortunately there is some wastage of medications that leads to increased costs but legislation must be followed.

Rainer mentioned that he has had the privilege of a quarterly meeting with the Eastern Ontario Director for the Ministry Inspections Branch and was aware of the renewed thrust to Proactive Inspections but also that a new Response Group is supposed to be formed that will be better able to deal with systemic issues in LTC, - as opposed to the current inspection processes that focuses the inspection on predefined protocols. Unfortunately, the Response Group was unresponsive to an update in time for this meeting. Rainer clarified for Judith Stanway’s query that this contact is purely from a prior personal undertaking and has nothing to do with the Manor’s FC, although information gathered could be of general interest and that is why it was shared.

3. Changes to Senior Staff

Kelly Keeler has departed to be closer to family in Alberta, Amy is pleased to announce a new Director of Care Anya Gwyn. She will be starting Nov 20, 2023.

The following information is copied from the Oct 11th newsletter. Anyone who is not on the distribution and would like to be, should contact Cyntha at cmorgan@maxvillemanor.ca

“Anya was born, raised, and educated in Ottawa, graduating from U of O with BScN.

After starting her career in general nursing, she moved to Europe and the US for work opportunities and to raise a family. Returning to Canada specializing in Geriatrics, Anya has held several senior nurse leadership posts in both Ontario and Nova Scotia. Most recently she has been a Director of Care for a LTC home, and as an Administrator for a Residential Care Facility in Queens Co, Nova Scotia. She has a frontline-nursing focus, high-quality care delivery and strength-based leadership style which are the key to her work successes.”

There will be also be a new Assistant Director of Care that has not been announced yet. Caroyln Cameron will be going back to the floor once Anya starts.

4. 2023 Draft Resident and Family Annual Survey

The FC members were provided a draft copy in advance and asked to be prepared to provide feedback directly to Amy during this meeting.

It was felt that some suggestions from last year had not been fully addressed. Members provided updates to suggestions including but not limited to the following:

- Ensure the 2022 Survey action plan is fully addressed and communicated. Looking forward to seeing the 2023 results and plan.

- I am comfortable speaking to senior management if felt necessary

- Dietary – food texture consistent with my preferences and ability to chew

- I participate in the decision of where I sit and with whom

- Recreational – sufficient and aligned with my interests.

- Internet/Wi-Fi and television are available and meet my needs

- Transportation is an additional service at the Manor but is considered a necessity by some.

o Is it is available and affordable when needed?

o Free form – do you use transportation services yes/no and if so do you have feedback? This is meant to gather feedback for administration to consider.

The target is to issue the 2023 survey in November.

5. Draft Operational Priority Projects

The Operational Projects The current Strategic Plan comes to an end in 2024 and needs to be updated. Meetings are being held with staff and Amy is meeting one on one with her Directors.

A draft of the CEO’s 2024 Operational Plans and Priorities was released to the FC in advance. It includes the whole organization including Outreach Program and Senior’s apartments. Amy gathered comments during the FC meeting which were focused on LTC.

A key part is the quality program which includes a dashboard and indicators that will identify status. A quality program requires measurements and continuous

improvement/review. It was agreed in a quarterly quality meeting that Inspection reports should be part of the quality program.

The intake process will remain as is for this year.

Workforce planning is a priority.

- There is a recognized shortage of nursing staff in LTC as a whole as many are being recruited by the private sector under the current political environment.

- Nursing turnover has been noted and retention is a priority.

- Recruiting sufficient dietary support staff is an ongoing challenge for the Manor. T

- The FC requested support for plans and strategies to enhance family engagement. A great suggestion was made (by Judith) to add a FC table at the 55th Anniversary event on Nov 5th. Rainer is looking for volunteers to help with the booth.

The Manor is planning an overhaul and update of their Policies and Procedures Manual and to complete the redevelopment of their website. The entire P&P will not be publicly available, but one suggestion was to publish a table of contents

It was suggested that that as well as operational schedules for staff that the Redevelopment Master Plan include a resident centric section that considers resident activities and impacts to residents during reconstruction.

2024 should see now accounting software which will allow invoices and resident billing move to electronic.

Construction is targeted to begin in spring of 2025 with planning, detailed design and fundraising being the focus in 2024.

Roundtable – final comments, feedback, schedule next meeting

The Manor will be celebrating 55 years on Nov 5th . There will be refreshments and a photo booth for pics with your loved ones. Cynthia will work with Rainer to setup a FC table and hopefully recruit some new members.

Cynthia has a contact at Munroe and Morris who have offered to provide a presentation on End-of-Life Planning. Rainer and Cynthia will coordinate to host this session under the FC in the second half of November.

The December holiday season falls within the normal FC meeting timeframe, so the next Family Council meeting is scheduled for Monday Jan 15th at 6:30pm.

In the interests of time, topics for the next FC were not discussed. Emergency evacuation plans were previously suggested as a potential topic for the next meeting pending the

development of a mandatory Emerg. Preparedness Policy and Procedures Manual by the Manor in Q2 2023. Your ideas and input are welcome for this and future FC meetings.

2024 will see this Chair’s 2 year term complete. Please give some thought to taking over the role.

The meeting adjourned at 8pm after 1.5 hours. Thanks to all who participated and CEO Amy Porteous for leading much of the discussion

Maxville Manor Family Council - 2023 Annual Report
Mission and Mandate: The Manor’s Family Council (FC) is open to all family and friends of the residents of the Maxville Manor long term care residence. Its mandate is the enhancement of resident care and well-being. This is accomplished by working cooperatively with families, the Resident’s Council leadership and the Manor’s senior management.
The role and responsibility of family councils were first included in the Long-Term Care Homes Act, 2007 to recognize the important contributions Family Councils make to long-term care homes and the sector. The Phase 2 Fixing Long-Term Care Act as amended in July 2023 and regulation O:Reg 246/22 provides homes with additional guidance to ensure the voice of the Family Council is present and is heard as part of the Quality Improvement Committee.
The updated Act outlines several powers of a Family Council, such as;

providing assistance, information and advice to residents, family members of residents and persons of importance to residents,

including when new residents are admitted to the home,

advising residents, family members of residents and persons of importance to residents about their rights and obligations under the Act

attempting to resolve disputes between the licensee and residents;

sponsoring and planning activities for residents,

collaborating with community groups and volunteers concerning activities for residents,

reviewing the following:

Ministry inspection reports and summaries received under section 152,

a written plan for achieving compliance prepared by the licensee, that the Director may have ordered,

the detailed allocation by the licensee of funding under the Act and the Connecting Care Act, 2019 including amounts paid by residents,

advising the licensee of any concerns or recommendations the Council has about the operation of the home.

to exercise any other powers provided for in the regulations.
The FC Terms of Reference (ToR) went thru several iterations to confirm alignment with the LTC Act and a focus on residents. It clarifies membership, term, and roles. The Family Council brochure was updated in 2023 after the ToR received final approval late in 2022. It is posted on the Manor website.
Membership and Meetings: The FC regrets the loss of some key members during 2023 upon the passing of their family members. This is considered normal however it should be made clear that the passing of a resident does not mean that family council membership must cease. Their knowledge and experience continues to be welcome for the benefit of all residents.
We lost 2 members in 2023 but added 5 to the core distribution list. Attendance at meetings can be fluid as can responses to email distributions. Although family and resident councils are enshrined in legislation, participation is voluntary. Some institutions do not have a Family Council. Some may consist of as little as one member. We are pleased to report that we are one of the larger councils in Ontario.
Other members participated in specialized events that will be described later.

During 2023 the role of FC Staff Liaison was passed from Dina Murray-MacDonald - the Activities Director, to Cynthia Morgan, Administrator to the CEO. We thank her for helping to coordinate meetings and special events, providing space and equipment, assisting with communications, plus posting to the Manor website, when possible.
2023 was a busy year for the Family Council notwithstanding the impacts of Covid-19, respiratory breakouts and restrictions, although it was much better than that experienced in 2022.
Rainer Pethke continued as Chair of the Family Council in 2023.
Family Council endeavours to meet formally as a group every 2 months with allowance for vacations, holiday seasons etc. Interaction, especially between the chair and senior leadership, could be described as continuous when and as felt necessary. CEO Amy Porteous continued to be approachable but interaction at the Director of Care, Assistant Director of Care, Unit Manager and admin levels all suffered due to staff turnover/shortages during 2023 resulting in loss of relationships and lost continuity of effort. Note: that things are looking better at this writing – going into early 2024 - as key positions have been filled.
The FC continues to enjoy its own email address specific to the FC, familycouncil@maxvillemanor.ca – and the ability to set-up our own Zoom meetings supported by the Manor’s paid account. Dual format meetings were conducted in 2023 enabling FC participants to attend in the Library or join via Zoom.
Rainer chaired FC team meetings on:

Jan 16, 2023

Mar 20, 2023

Jun 5, 2023

Oct 16, 2023

with the next FC meeting scheduled for January 15, 2024, to allow time for the holidays.
All were hosted in the Manor Library. As the year progressed, we were offered use of the Manor’s new ‘OWL’ technology. OWL is a central speaker and camera which quickly focuses in on the person speaking thereby enhancing dual format meetings including Zoom.
Minutes of the first three meetings are posted on the Manor Website at https://maxvillemanor.ca/family-council/ . (** It’s important to note that subsequent pages must be accessed via the arrows in the lower left corner of each set of minutes. **) however, it has not been possible to post updates or new information due to unresolved technical issues at the website since mid-summer 2023. These issues with the overall Manor website will not be addressed, being deferred to the expected implementation of a new site in 2024.
Regular Activities:
The FC received 2 reactive Ministry of Long Term Care (MLTC) Inspection reports (dated April 27th and Nov 17th. for review. This is consistent with the previous 2 years. They can be found here ; http://publicreporting.ltchomes.net/en-ca/homeprofile.aspx?Home=C540&tab=1 . Note that inspections are typically reactionary as the result of a complaint. The November report was distributed in 2023 but pending further discussion in 2024.

The big news was a Proactive Inspection Report dated Aug 16th. Inspectors were onsite: June 19, 20, 21, 22, 23, 26, 28, 29, 30, 2023 and July 4, 5, 2023 The inspection continued offsite on June 27, 2023 and July 6, 7, 2023. The report itself is at https://publicreporting.ltchomes.net/en-ca/File.aspx?RecID=31607&FacilityID=20333. Note that the Manor was one of the first, if not the first, institution to receive a ‘proactive’ inspection under this new protocol announced as an enhancement to the Long-Term Care Act and Regulations. The FC received an Action Plan document from CEO Amy Porteous which was used as template for discussion in our October meeting.
All considered, the Family Council and Chair are pleased to report a continued good working relationship with the Senior Administrator and are generally comfortable that in 2023 matters brought forward to senior management’s attention were considered appropriately without feeling a need to resort to the formal complaint process within the Ministry LTC Investigations Branch. The relatively low number of incident reports casts the Manor in a favourable light when families are researching placement for their loved ones.
The FC Chair and Manor CEO communicated and met as needed including discussions on the evolution towards a model of Person Centered Care.
The Chair participated in working groups for the Manor facility upgrade and reconstruction as well as a redesign the Manor website, however activity declined in the latter part of 2023.
The FC hosted key presenters at each regular meeting. Included were:

CEO Amy Porteous presented early in 2023 to discuss her 2023 Operational Priorities; followed up with a 2024 update later in the year. The Priority project deliverables derive from the 2021-24 Strategic Plan which is due to be refreshed.
She also updated the FC on the facilities redesign and timeline.
She responded to questions on the fire and reconstruction of Piper’s Lounge in FG, and solicited input on the design of the 2023 Resident Survey. Her active participation and information sharing was much appreciated.

DoC Kelly Keeler and CEO Amy Porteous attended in regards to Inspection Reports.

Dina Murray-MacDonald presented the results of the 2022 Resident Satisfaction Survey for discussion. The 2023 survey is currently being assessed with results expected to be shared with the FC in early 2024.

Eleanor Ryan and Shelly Sheedy from the Champlain Regional Family Council Network (CRFCN). They joined us via Zoom in March. The CRFCN is a volunteer organization supporting 5 districts which include Hawkesbury, Cornwall, Maxville, Ottawa and Renfrew. It has 60 long term care homes within this district. The Champlain Region extends from Deep River in the west to Hawkesbury in the east and includes the City of Ottawa. More information can be found at their website https://www.champlainfamilycouncils.ca/. CFRCN works closely with Family Councils Ontario (FCO) which is a government funded organization out of Toronto. Family Councils of Ontario (FCO) has a website https://fco.ngo/ and contacts with good resources.

Several activities identified in the CEO’s Caregiver Support Strategy have not moved forward as hoped in 2023 and should be revisited in 2024. More Specifically:
Caregiver ID. - https://ontariocaregiver.ca/caregiver-id-formal-recognition-of-the-caregiving-role/. Judith Stanway has prior experience with Caregiver badges at the Manor and volunteered to work with a designate from Amy’s team to define ‘essential caregivers’ and put the program in place. This would include awareness between residents, staff and caregivers of the significance of someone wearing a Caregiver ID in future. This program did not proceed as planned.
Family Liaisons – Some Family Council members have been seen sporting new yellow name tags that identify them as a Family Liaison for new admissions. A list of the individuals names are listed within the nurse’s stations but for various reasons this activity has not come to fruition as anticipated. It will be an area to review in 2024, if this is in fact of value, if we have sufficient volunteers, or if it might be better communicated during intake.
Admission Process for New Residents and Families. The outgoing DoC was provided with a document describing the experience of a new family member along with 22 recommendations for improvement. Considering that the writer was already quite familiar with the Manor and many staff, it highlights how difficult it can be for new families, especially if they are elderly, remote, new to LTC or without support.
Promotion of the Family Council membership. While gains continue to be made in areas such as newsletters this process could still benefit from a review of the intake process supported by quality processes to measure, review and report on family communications regarding the FC.
Quality Care Teams – The FC continued to support quality team meetings to the best of our abilities. Carol – Falls and Restraints committee, Judith – Responsive Behaviours Committee. Rainer as Chair, attends the over-arching Quality Steering Committee. This central role in quality processes for the FC Chair is as prescribed in legislation. As such, the FC Chair successfully advocated for the inclusion of Ministry Inspections in the quality processes. The departure of the DoC impacted further Steering Committee Meetings after May 24, 2023 but they are scheduled again beginning in Jan 2024 under the new DoC Anya Gwyn and Assistant Doc Courtney Jeske. Both started in the last couple of months of 2023 after the departure of Kelly Keeler in the August timeframe.
Special Activities undertaken by the FC in 2023 include:
Input to the new facility design and planning led by the architects.
Alzheimer’s Information Sessions for caregivers and families were organized and hosted at the Manor through the Alzheimer’s Society in 2022 and continued thru June of 2023. They were conducted by Josee Desrochers-Leduc josee.desrochersleduc@alzheimer-cornwall.ca. 11 participants registered including two from FC. Thanks to Dina for coordinating meeting space and for communications on the schedule.
FC member Carol Hambleton, with the support of Dina, coordinated a Parkinson’s Information Session to commence once the Alzheimer’s sessions completed. It was conducted by Zoom from Saskatchewan on July 10, 2023 at 6:30pm by Donna Greenings.

(Program Service Co-Ordinator Parkinson's Canada). There were 11 participants registered on the Zoom. The FC hosted most participants in the Manor’s Library meeting room.
The FC with the support of the Manor’s Training Coordinator and the MS Society, promoted MS Training for Staff which was held on March 1st. It was well received, so much so that another session is anticipated in 2024.
On Nov 28th two representatives from Lahie and Sullivan presented a well-received information session on End-of-Life Planning under FC sponsorship. It was delivered in person at the Manor. Some participants attended via Zoom. Participants were able to ask questions and if desired, receive a personal follow-up (and an attendee discount) from Alex Laderoute Family Services Counselor 613-932-8482 Alexandra.turcotte@dignitymemorial.com
The FC chair continues to be an active participant in the Ontario Health Coalition, the Canadian Health Coalition, Family Councils Ontario (FCO), The Champlain Regional Family Council Network (CRFCN), Ontario Caregiver Organization (OCO) and added the Ottawa Chapter of Dying with Dignity in 2023. https://www.dyingwithdignity.ca/about-us/.
The Chair completed several research surveys as well as webinars related to LTC and continues to participate in a multi-year research program focused on identifying and improving Palliative Care supports in retirement facilities and LTC. This is sponsored by the University of Ottawa and Bruyere Research Institute.
The Chair has had the privilege of regular Teams meeting with the Eastern Ontario leadership of the Ministry Inspections Branch and became aware of the renewed thrust to Proactive Inspections but was not involved in that planned for the Manor. Also touched upon was the development of a new Response Group that will be better able to deal with systemic issues in LTC, - as opposed to the current inspection processes that focus on predefined checklists and protocols on point issues. This contact was initiated purely from a prior personal family concern and had nothing to do with the Manor’s FC per se although it’s hoped that input on province wide gaps and issues in the inspection processes contributed to a welcome announcement made at the time of this writing. https://news.ontario.ca/en/release/1004060/ontario-launching-new-long-term-care-home-investigations-unit . The new unit is now active and will investigate allegations such as:
• failing to protect a resident from abuse or neglect,
• repeated and ongoing non-compliance,
• failing to comply with ministry inspector’s orders,
• suppressing and/or falsifying mandatory reports, and
• negligence of corporate directors.
• The FC was offered a table and we participated in the Manor’s 55th anniversary celebrations held on Sunday Nov 5th. Several conversations were held with interested attendees and a significant number of brochures were distributed with thanks to the Manor for printing of the same. Brochures have been made available by the Manor’s sign in sheets as well as on the Manor’s bulletin board in the entrance breezeway.

The Family Council is a group of volunteers donating their own time and expertise without any compensation for their time and personal expenses so my sincere thanks to each and every one who advocated for their loved ones, participated in the Family Council and the special events. Despite being enshrined in legislation it’s an awkward reality that advocacy can be seen as interference in the operations of a home, especially when things get busy, or staff relationships change, despite a council’s best intentions to improve the lives of residents as a whole. Since several unit managers, our FC Liaison, Director of Care and Assistant DoC all changed this year, kudos to CEO Amy Porteous for her leadership and for bridging the changes herself when she was already more than busy because of staffing challenges and legislative requirements. We hope the reader will agree that our little group added value and had a productive year in a challenging environment. We are proud of what we accomplished in 2023 and look forward to building upon those successes in 2024. Special thanks to CEO Amy Porteous for her sponsorship, leadership and understanding.