Maxville Manor Family Council - 2024 Annual Report
Mission and Mandate: The Manor’s Family Council (FC) is a volunteer group open to all family and persons of importance to the residents of the Maxville Manor long-term care home. Members are welcome to remain on Council even if their loved-one passes. The Maxville Manor Family Council (FC) has been provided a mandate under the Fixing Long Term Care ACT 2021 as amended. Its mission is to improve the experience of families and residents of the Maxville Manor.
This is achieved by:
• Advancement of resident engagement and resident-centered care in all aspects of Manor life
• Providing a forum for families, residents, and the community to participate in quality improvement and information sharing
• Knowledge transfer, assistance, information and advice to residents, family members of residents and persons of importance to residents
• Advising the Manor of any concerns, commendations, or recommendations that Family Council has about the Operation of the Home
• Review of key documents including inspection reports and satisfaction surveys
• Encourage and support staff and volunteers who participate in delivery of programs
• Enhancing communication amongst staff, families, residents, and the community
• Exercise of any other powers provided for in the most current Long Term Care Homes Act and associated Regulations.
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 2021 Fixing Long-Term Care Act (FLTCA) as amended in July 2024 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 processes.
As Chair I write this annual report with mixed emotions for reasons that will become clear as you read.
Membership and Meetings:
We lost several members in 2024 as their loved ones passed away, but added considerably to the core distribution list, largely due to development of a permission form for inclusion in the new resident intakes. That form provides an email address and consent when completed. 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 continue to be one of the larger councils in Ontario. On the other hand, that just highlights how difficult it can be to attract volunteers that are resolute in their desire to advocate for the best interests of families and residents.
It’s commonly felt that a passing delineates the end of membership however the Ministry has made it clear that the passing of a resident does not mean that family council membership must cease. Their knowledge and experience continue to be welcome for the benefit of all residents for as long as they wish to continue to participate in the family council.
During 2024 the role of FC Administrator was passed from Cynthia Morgan, Executive Assistant to CEO Amy Porteous and back to Cynthia again after the Ministry LTC ordered that the CEO cannot act as the FC Assistant. We thank her for helping to coordinate meetings and special events, providing space and equipment, assisting with advertising of meetings and some limited posting to the Manor website.
2024 was a busy year for the Family Council notwithstanding our own personal lives, the on-going impacts of Covid-19, respiratory breakouts and restrictions. In some ways it was much better for loved-ones despite outbreaks as the Ministry clarified that while caregivers must take precautions, they cannot be legally excluded from visiting loved-ones during outbreaks. Too many residents died alone previously. 2024 was also the worst year on record for critical incidents and complaints at the Manor resulting in inspections by the Ministry of Long Term Care (MLTC) throughout the year. Note that Ministry inspection reports can be found on the Internet at https://publicreporting.ltchomes.net/en-ca/homeprofile.aspx?Home=c540&tab=1 . There is no public transparency of concerns and complaints raised internally.
Family Council endeavours to meet bimonthly with allowance for vacations, holiday seasons etc. Interaction, especially between the FC chair and senior Manor leadership, could only be described as difficult this year. There was significant staff turnover resulting in loss of relationships and lost continuity of effort yet the relationship with front-line staff providing direct care remains strong.
The FC thanks the Manor for its ongoing support of its own email address specific to the FC, familycouncil@maxvillemanor.ca and the ability to conduct our own Zoom meetings supported by the Manor’s paid account. Dual format meetings were conducted in 2024 enabling FC participants to attend in in person in the Manor Library or join via Zoom.
Rainer Pethke was acclaimed by vote of confidence to continue as Chair of the Family Council in 2024 Several members noted their appreciation for an increased focus on support for residents and for sharing information that they are not readily finding elsewhere. In 2024 the FC Terms of Reference were amended so that a Chair may continue by qualified vote even after 2 consecutive terms as originally specified, otherwise the council would be forced to shut down without an alternate volunteer. The Chair participated in a province-wide forum wherein other family council chairs indicate that they too have served for extended periods of time and multiple terms. The search for a new chair is now a regular agenda item.
Rainer chaired FC team meetings on:
• Jan 15, 2024
• Apr 8, 2024
• Jun 17, 2024
• Sep 9, 2024
• Nov 18, 2024
• with the next FC meeting scheduled for January 27, 2025, to allow time for the holidays.
All meetings were hosted in the Manor Library making use of the Manor’s conferencing ‘OWL’ technology. OWL is a central speaker and camera which quickly focuses in on the person speaking thereby enhancing dual format meetings including Zoom, if setup properly. We thank Cynthia Morgan as EA to the CEO and FC Assistant for providing connectivity for our Zoom sessions. Unfortunately, we experienced multiple issues particularly in the latter half of the year that impacted timely start times and/or smooth operations of our meetings.
2024 Activities:
The operating climate deteriorated from that found in our 2023 year-end report. 2023 concluded that the FC Chair and Manor CEO communicated and met as needed including discussions on the evolution towards a model of People-Centered Care. Unfortunately, any momentum towards People centered care is not to be found in the Manor’s 2024 accomplishments, as listed in a special newsletter from the CEO’s Executive Assistant on Jan 3rd 2025.
In 2023 we spoke of a good relationship with the CEO, Director of Care (DoC), and front office staff. Caring from the Heart was demonstrated may times as core to the conduct of previous DoC’s such as Kelly Keeler who we still believe deserves special mention for promoting a good working relationship. Our first FC meeting in January 2024 welcomed participation from the new DoC Anya Gwynn and new Assistant DoC Courtney Jeske.
In the opinion of several members including the Chair, 2024 saw a marked change in tone. We saw the sudden departure of Anya and promotion of the Assistant to be the new Director of Care early in the year as well as extended absences by the CEO in the latter half of 2024.
Special Note: The long form draft of this report (not released to the general public) documented over 25 examples to validate this sense that things deteriorated in 2024.
Examples range from the most reactive Ministry inspections ever recorded going all the way back to 2010, to exclusion of FC from quality meetings and the family and resident survey process even though mandated under long term care legislation, exclusion from manor redevelopment, to seemingly nonsensical demands such as removing the name of the Director of Care from all prior approved minutes in contravention of widely recognized Roberts Rules of Conduct. All prior FC minutes were deleted from the Manor website without notice. It’s further assumed that the frequent attendance by inspectors due to complaints and critical incidents negated any need for proactive inspections such as that seen in 2023.
Unfortunately, the significant upward trend in documented complaints and Ministry inspections casts the Manor in a less favourable light when families are researching placement for their loved ones. The unfortunate reality is that there are tens of thousands waitlisted for placement in Ontario so beds will always be full even if Maxville is not a first choice. We believe that a management focus on public transparency and measurements tied to a quality program to address complaints and concerns can yield positive results going forward and reverse this upward trend in complaints. This recommendation has been made for inclusion in the new 2025-2029 strategic plan.
Regardless, there are many good things the Family Council can be proud of:
All considered, the Family Council and Chair are pleased to report a continued growth of the Family Council, growing by over 400% since the current chair’s involvement.
• We are pleased to see new faces and welcome the familiar ones. One thing that stood out for us in the CEO’s own list of 2024 accomplishments was credit for working with the FC on the intake forms to add permission for the FC to contact new families. That was fundamental to our growth. The Chair previously rewrote the intake procedures based on his families own experience and offered recommendations for improvement, including this new process.
Some families are saying they still get most of their information from FC so this may be an area to review in 2025 with Manor leadership. Our focus is always to make things better where we can add value. The FC strove to include key presenters at each regular meeting, promote information sharing and support members in advocacy for our most vulnerable.
Highlights Included:
• Review of Inspection Action Plans - Former DoC Anya Gwynn and subsequently new DoC Courtney Jeske sometimes accompanied CEO Amy Porteous to present the Manor’s action plans resulting from Inspection Reports, particularly in the early part of the year. The FC made comments and recommendations to support the plan(s)
• Emergency Preparedness - Michelle Wilson - Staff Development and Lise Bray (Director of Environmental Services were invited and presented professional training modules covering different emergency codes/scenarios with possible causes and responses for the disruption of normal services for the benefit of FC members. This collaboration was very well received.
• Palliative Care - We presented to Manor leadership on Palliative care in the emerging Ministry models and general best practices that promote earlier recognition of end of life especially with a life limiting disease to make a person’s last days as pleasant as possible vis-à-vis the current Manor model which focuses on the last days. More information on the Ministry’s approach to Palliative Care can be found in section 61 of the regulation
https://www.ontario.ca/laws/regulation/220246#BK78
• Accreditation via Accreditation Canada – The FC continues to be a strong advocate for achieving accreditation. Some of the most highly respected LTC facilities such as the local Osgoode Care Centre proudly display the banner at their front entrance so why not Maxville too? It is believed to be a pathway to people centered care and possibly even improved funding from the Ministry.
• Interaction with Other Family Councils. - Eleanor Ryan and Shelly Sheedy from the Champlain Regional Family Council Network (CRFCN) joined us via Zoom in March. The Maxville Manor FC is an active participant with other homes in the Champlain Regional Family Council Network (CRFCN) and Family Councils Ontario (FCO).
The CRFCN is itself 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. FCO has a website https://fco.ngo/ with good resources.
• Participation in Research Projects - The Chair participates in research projects in a patient and family (PFAC) advisory council for the RESPECT program with Ottawa University and Bruyere. Notable projects include Big Life https://www.projectbiglife.ca/ which advises on how your future self is affected by the present. Interesting subprojects predict “how long will I live” or “am I living in my last years” . This can help homes such as the Manor identify needs for palliative care in advance and improve planning. Another is MyCare. MyCare is an interactive survey and education tool that aims to empower older adults to have meaningful conversations with their loved ones and healthcare providers about what is important to them and what they want. MyCare helps older adults who are facing serious illness and have a higher risk of death in the next year to receive medical care that aligns with their values and wishes.
• Advocacy and Active Learning - The Chair continues to be involved with advocacy for Long Term Care as well as the Ontario Health Coalition. He has participated in learning events with -
o Community Legal Education Ontario https://www.cleo.on.ca/en
o Steps to Justice - Step-by-step information about legal problems https://stepstojustice.ca/
o Ottawa Chapter of Dying with Dignity https://www.dyingwithdignity.ca/about-us/local-chapters/ottawa-local-chapter/
o Elder Abuse prevention Ontario https://eapon.ca/
o Ontario Caregivers Association https://ontariocaregiver.ca/
o Ontario Health Coalition https://www.ontariohealthcoalition.ca/
o Champlain Region Family Council Network https://www.champlainfamilycouncils.ca/
o Family Councils Ontario https://fco.ngo/
o MS Canada https://mscanada.ca/
o Advocates for Long Term Care in Ontario https://www.facebook.com/groups/322186134878345
• The FC researched and advocated for the rights of all residents when the decision was made to remove all recreational substances from their homes (their rooms are legally their home) without consultation of family, resident’s or resident council regardless of capacity or medical condition.
• Care Conferences. - The FC and Chair are strong advocates for annual Care Conferences led by their own unit manager and including representation by all those disciplines who provide direct care and know them best. That has not always been the case.
• The Terms of Reference for the FC were updated to avoid inadvertent shutdown of the FC pending a new volunteer candidate to replace a Chair who has served to term.
• Interaction with Residents Council – Members of the Residents Council leadership participated in Family Council led review of the Residents’ Bill of Rights as enshrined in the Fixing Long Term Care Act. The FC promoted the inclusion of the CLEO handbook with every new admission.
• Dental Care – Trish from Outreach Dental (Registered Dental Hygienist) was welcomed to present on the Canada Dental Care Plan. She offered techniques for proper dental cleaning as concerns were raised by family members. Trish provided a video which was shared with the Manor. She also offered to provide free training to all Manor staff as this has been an area of concern expressed by several members. This offer was passed on to the DoC. We eagerly wait acknowledgement of uptake as dental hygiene of some residents remains a worry.
• French Language Services - The FC recommended that the intake documents be translated into both official languages as the Manor is in a designated bilingual area and Ontario offers translation services to LTC. The CEO has indicated that this is under consideration for early 2025. Another suggestion is to simply use Google Translate to interpret daily menu board items in a bilingual format on the hallway screens to make Francophone only residents feel more at home. That seems an easy win but did not receive any commitment
• End of Life Planning. – The FC sponsored a speaker from Dying with Dignity to give a presentation on the current state of advance requests for medical assistance in dying with time for questions and answers from participants. The DoC was present during this event as was the EA.
• Family Visibility to Activities - The FC passed on a recommendation from other councils on the use of Wellbi a platform that would allow family caregivers a window to review their their loved-one’s participation in activities. This was acknowledged by the Director Activities who confirmed that they were satisfied with their current program. It’s since been identified that there is a cost to the public portal.
• Public Contact Info for the Manor Board. The Board was advised by the Chair that the information on the Manor website for the Board members was not accurate and that the only contact information posted for the Board - info@MaxvilleManor.ca - is also the general info email for the Manor itself. This email is monitored by the CEO’S front office making it literally impossible to raise any confidential matters as there is no way for families or the general public to contact the Board Chair or any individual on the Board without being screened. There is new contact info on the website now but no indication of who monitors.
• The Chair and a disabled resident provided input to the new facility design and planning led by the architects, as and when requested. One particular input was on room design for disabled persons with power chairs.
• Input to the Quality Steering Committee as and when invited. The FC is a strong believer in quality processes that include measurement, regular review, management accountability and public transparency as a direct path to better results for family and resident outcomes even in matters such as concerns and complaints. This recommendation was made to the QSC lead early in 2024.
• Family and Resident Survey – The FC quickly gathered and provided input in Nov 2024 regarding the annual survey after the Ministry identified to the Manor that it is indeed a requirement to consult. We eagerly await the opportunity to review the results and comment on the action plan in spring 2025 to help put forward the best interests of families and residents. It is our goal to add value beyond a checkbox in the exercise.
In Summary. The Family Council is a relatively small group of volunteers donating their time and expertise without compensation because they care, so my sincere thanks to each and every one who advocated for their loved ones, participated in the Family Council and our special events. Despite our mandate it’s an awkward reality that advocacy can be unwelcome, despite a council’s best intentions. Conversations with other organizations and other family councils confirm that it matters not whether for-profit, non-profit, charitable or municipally run - the culture/tone of the organization and satisfaction of residents and families depends primarily on leadership.
We hope the reader will recognize that our team made valuable contributions and had a productive year in a challenging environment. We are proud of our achievements in 2024 and are excited to build on those successes in 2025. We remain committed to working collaboratively with all stakeholders to support the rebuilding effort and best interests of families and residents.