Update Summary: The following is the second update to the Memorandum issued on April 2, 2020. Staff members please note paragraphs 1. and 2. which set out the new requirements that staff wear surgical face masks at all times while inside St. Jacob’s Place Retirement Residence (the “Residence”) and that staff members working at multiple care homes limit themselves to working at only one such facility during the Provincial state of emergency. Residents and family members please note paragraph 3. which unequivocally restates the absolute necessity for residents to self isolate in their suites at all times in line with the advice of the local public health authorities.

It bears repeating that the measures outlined in this Memorandum are in place for the purpose of protecting residents, many of whom are high-risk candidates for the more severe symptoms of the coronavirus. It is not an indication that those present at the Residence are especially likely to contract the coronavirus. In fact, due to the implementation of these protocols, St. Jacobs Place Limited (“SJP”) staff and residents have a significantly reduced chance of becoming infected compared with the average member of the public. Given that the coronavirus is known to have a disproportionate impact on those in the sixty-five plus (65+) age category it is clearly essential that we prevent any instances of infection which, though relatively trivial for persons without underlying health conditions, could prove fatal to residents with deficient immune systems.

On April 8, 2020, the Chief Medical Officer of Health for Ontario, Dr. David C. Williams, (the “CMOH”) issued a revised Directive* mandating that SJP as the licensed operator of the Residence must take all reasonable steps to ensure compliance with the following protocols:

  1. all staff and other essential visitors to the Residence must wear surgical face masks at all times while inside the Residence (staff may remove their masks during breaks provided that they are at least two metres away from all other persons).Additional personal protective equipment (“PPE”) will be provided for staff and support workers where required. Staff will not be expected to interact with infected persons unless they have been provided with PPE sufficient to prevent infection – SJP has a legal obligation to protect your health which it fully intends on meeting at all times. If you require training in the use of PPE, please let us know;
  2. by Order of the Provincial Government, from April 22 onward a person may only work in one care facility until the Order expires or is revoked. This means that SJP staff must choose to either stop working at other care facilities or else be temporarily relieved of their duties at the Residence. There will be a separate communication to staff on this matter but please note that you are required to inform SJP by the end of the day today whether you currently work at any other care facility;
  3. again, we must emphasize that it is imperative that residents remain in their suites at all times pending further direction from the CMOH (with exceptions for medical reasons only). The decision to isolate residents in this way was taken in collaboration with the local public health authorities and is for the purpose of protecting your health.To take account of these self-isolation measures, our food service will continue to be operated as follows. All meals will be served at the customary times by the delivery of meal trays directly to a designated location immediately outside each resident’s suite door. At no time shall a staff member enter a resident’s suite to deliver a meal (exceptions will be made for medical reasons with the prior approval of the General Manager).We appreciate and understand that it is a lonely and isolating time for many residents, but SJP has a moral and legal duty to comply with the CMOH’s directions to ensure that the Residence is, and continues to be, the safest place to live and work in Canada. Therefore, all residents must continue to self-isolate in their suites and have no contact with other residents, and have contact with staff members only in accordance with all required safety protocols and procedures.We are considering the possibility of organizing a schedule to allow each resident to be permitted to spend a pre-determined block of time by themselves in the courtyard to the rear of the Residence or in the dining area. The final decision on this matter rests with the General Manager. We will keep you updated;
  4. as advised previously, any resident who leaves the Residence will not be allowed to re-enter until the state of emergency declared in the Province of Ontario is lifted. Admissions of new or returning residents have been put on hold indefinitely.This means that if a family member chooses to take their resident-relative out of the Residence for any reason, e.g. a walk or a drive, that resident will have to reside in the household of that relative or other family member until the state of emergency has been lifted. Exceptions to this prohibition will be made for the purpose of attending medical appointments only;
  5. likewise, the Residence remains closed to visitors, except for essential visitors (being staff, those providing essential support services or persons visiting a very ill or palliative resident) for the duration of this Provincial state of emergency. Restrictions will apply to persons visiting very ill or palliative residents, including a requirement to submit to screening for the coronavirus, to wear a surgical face mask throughout the visit and to avoid interaction with other residents. These restrictions will be discussed with those concerned on a case-by-case basis;
  6. all persons entering or leaving the Residence, except emergency first responders, will be screened for symptoms of the coronavirus (screening includes checking for fever, elevated temperature, cough, difficulty breathing and other mild respiratory symptoms) and will be required to wear face masks – deliveries will be made to the kitchen delivery door only and all delivery personnel entering the Residence must be symptom-screened and wear a face mask;
  7. all staff and residents of the Residence will be actively screened for the coronavirus at least twice daily, once at the beginning and once at the end of each day. As stated above, this active screening is for the purpose of protecting residents, many of whom are high risk candidates for the more severe symptoms of the coronavirus. It is not an indication that those present at the Residence are especially likely to contract the coronavirus.The front entry door will be the only entrance by which SJP’s staff may enter and exit the Residence until further notice;
  8. residents exhibiting symptoms consistent with a diagnosis of the coronavirus will undergo testing for the coronavirus (swab of the back of the nose and throat sent for laboratory analysis). Staff exhibiting symptoms will be directed to return home and self-isolate in accordance with applicable guidance from the CMOH and other public health bodies. Any other person exhibiting symptoms will not be permitted to enter the Residence;
  9. precautionary staff and resident ‘cohorting’ within the Residence will be implemented at the discretion of SJP, meaning that certain staff members may be allocated to work solely with unwell residents and residents may be relocated within the Residence to ensure minimal spread of infection. Please note that the risk of infection is minimal for staff (due to the availability of appropriate PPE), the purpose of these measures is to prevent the spread of infection amongst residents should the coronavirus or other disease enter the Residence;
  10. frequently-touched surfaces will be subject to increased sanitization;
  11. in the event of an outbreak or suspecting outbreak of the coronavirus, outbreak control measures will be implemented (including discontinuance of all non-essential activities, further restrictions on those entering and leaving the Residence, and use of enhanced PPE by all staff) and the health authorities will be notified; and
  12. 12. all deliveries of goods or items to residents from family or friends must be approved in advance by the General Manager. To avoid the introduction of the coronavirus into the Residence, such pre-approved deliveries will be quarantined on arrival at the Residence at a designated storage location for a period of three (3) days before final delivery to the recipient-resident. On receipt, quarantined goods and items will be handled by approved staff only and such approved staff will use gloves when moving goods and items into the designated temporary storage location. At the conclusion of the three (3)-day period, the quarantined goods and items will be delivered to the recipient-resident by placement in the designated location immediately outside their suite door. Staff shall not access a resident’s suite when delivering the goods and items unless such access is first approved by the General Manager.

In addition to these officially-mandated protocols, all staff and residents are asked to be regularly self-monitoring for symptoms of the coronavirus (including fever, cough and difficulty breathing and, less commonly, chest pain, sore throat, fatigue, muscle and joint pain and chills) to ensure that we are and remain the healthiest and safest retirement home in Canada.

Thank you in advance for your compliance with these directives. If these protocols are observed, we are confident that not only will the Residence remain unaffected by the coronavirus, but it will actually be the safest place for you to be during this time.

Yours truly,

St. Jacobs Place Retirement Residence

April 17, 2020

*Directive #3 for Long-Term Care Homes under the Long-Term Care Homes Act, 2007, S.O. 2007, c. 8, issued under section 77.7 of the Health Protection and Promotion Act, R.S.0. 1990, c. H.7 and applied to retirement homes pursuant to subsection 27(5) of Ontario Regulation 166/11 under the Retirement Homes Act, 2010, S.O. 2010, c. 11 as amended by Ontario Regulation 68/20 under that same Act. Full text available here: http://www.health.gov.on.ca/en/pro/programs/publichealth/coronavirus/docs/directives/LTCH_HPPA.pdf.