Simon's Megalomaniacal Legal Resources

Retirement Homes (Ontario)
Legal Guide

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Chapter 3 - Procedural Rights

1. Overview
   
2. Written Agreement Required
   (a) Agreements v Leases
   (b) Written Agreements
   
3. Information Package
   (a) Information Package
   (b) Comment
   
4. Required Public Displays in the Retirement Home
   
5. Residents' Council
   (a) General
   (b) Residents Council Membership and 'Powers'
   (c) Residents Council and the Licensee
   (d) Immunity from Legal Liability
   (e) Reprisals and the Residents Council
   (f) Comment
   
6. External Care Providers
   
7. Licensee Duty Regarding Abuse and Neglect
   (a) Definitions
   (b) Duties
   (c) Written Policy

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1. Overview

These 'rights' are mostly procedural, but can be just as or more important than any rights set out in the Bill of Rights [Ch.2, above]. It is important to realize that they do not have the automatic 'contract' remedial potential that those rights do - that is, they are only enforceable under the administrative complaint procedures dealt with in s.5 (unless some of them are incidentally included in the RH agreement).

These rights are listed below in no necessary order.


2. Written Agreement Required

(a) Agreements v Leases

Section 53 of the RHA is careful to refer to 'agreements' (not leases) that bind the resident and the RH operator, although most of the agreements will be governed by the RTA which for all purposes renders them to be leases. In fact, they could be leases even though they are not governed by the RTA. Leases, while akin to contracts (such as licenses), are - in the Canadian common law heritage - distinct from contracts as Professor La Forest explains in the below case quote:

. V Hazelton Limited v. Perfect Smile Dental Inc.

In V Hazelton Limited v. Perfect Smile Dental Inc. (Ont CA, 2019) the Court of Appeal considered the nature of a common law lease:

[27] Professor Anne Warner La Forest describes the nature of a landlord and tenant relationship at common law and some of the relevant terminology in Anger & Honsberger Law of Real Property, vol. 1, 3d ed. loose-leaf (consulted on 7 May, 2019) (Toronto: Canada Law Book, 2006) at §7:10:

The relationship of landlord and tenant is an interest in land created by a contract, express or implied, by which one person who is possessed of an interest in real property, and who is called the “landlord” or “lessor”, confers on another person, called the “tenant” or “lessee”, the right to exclusive possession of the real property or some part of it for a period of time which is definite or can be made definite by either party, usually in consideration for a periodic payment of “rent” in either money or its equivalent. The interest in the property remaining in the landlord, being the interest which is not disposed, is called the “reversion”. The interest or estate which the tenant has in the land is known as the “term”. [Citations omitted; emphasis added.]

[28] At common law, a lease has long been viewed as creating a property relationship between the lessor and lessee once the lessee goes into possession. A lease does not simply create a licence to occupy property; rather, it conveys a legal interest in the property: Jason Brock & Jim Phillips, “The Commercial Lease: Property or Contract?” (2001), 38 Alta. L. Rev. 989, at p. 990.

[29] Despite the property origins of leases, it is important to understand that a commercial lease also has contractual elements. The leading case on the dual nature of a commercial lease is the judgment of Justice Bora Laskin in Highway Properties Ltd. v. Kelly, Douglas and Co. Ltd., 1971 CanLII 123 (SCC), [1971] S.C.R. 562. Justice Laskin considered the issue of the availability of contractual remedies in a commercial lease. He took a practical approach to the issue, finding it “no longer sensible to pretend that a commercial lease … is simply a conveyance and not also a contract”: Highway Properties, at p. 576.

Bill of Rights #11 (above) ["Right to Know of RTA Status"] bears on the issue of whether the agreement is also a lease.

(b) Written Agreements

The RHA requires that there be a written agreement between the parties before occupation, that it contain the regulation-prescribed requirements (below) and that it "must be expressed in plain language that is clear and concise" [RHA 53(1-3)]. This duty does not apply with residents who have commenced residency before July 1, 2012 [Reg 64.8].

The licensee must provide a copy of the resident's agreement to the resident or their substitute decision-maker (1) "as soon as possible after the agreement is made", and (2) "whenever the resident or any of the resident’s substitute decision-makers, if any, reasonably requests a copy after the time described" in (1). This wording indicates that residents may request a copy even after they have been given one earlier, in case of loss or otherwise [Reg 8].

The agreement must contain the heading “Retirement Homes Act, 2010 Provisions” or the equivalent in the language of the agreement with the following underneath [Reg 9]:

• "a notice to the resident that sections 77 and 80 of the Act authorize an inspector or an investigator respectively to inspect, copy and remove records containing a resident’s personal information, including personal health information, from the home for the purpose of determining whether the licensee is in compliance with the requirements of the Act;"
  
  
• "a statement as to whether or not the licensee will indemnify the resident against loss of the resident’s possessions and if so, the details of the indemnification, including the extent to which the resident’s possessions are insured by the licensee", and
  
  
• a statement from the licensee that,
  
  (i) they have given to the resident the information package [under RHA 54(1)(a)];
  
  (ii) the package includes all of the information required [under RHA 54(2)], and
  
  (iii) they warrant that all of the information was accurate and complete on the date of the agreement.

3. Information Package

(a) Information Package

The RHA requires an extensive information package be given to a resident "and to the substitute decision-maker of the resident, if any, before the resident commences his or her residency" [RHA 54(1)(a)]. This duty does not apply with residents who have commenced residency before July 1, 2012, unless the resident or the substitute decision-maker requests it [Reg 64.9].

Also, "the package of information is made available to family members of a resident of the home and persons of importance to the resident if the resident or the resident’s substitute decision-maker so consents" [RHA 54(1)(b)].

Minimally, the package shall itemize these components [RHA 54(2), Reg 10]:

• the Residents’ Bill of Rights;
  
  
• a statement that, if the retirement home also falls within the meaning of a care home as defined in the Residential Tenancies Act, 2006, nothing in this Act overrides or affects the provisions of the Residential Tenancies Act, 2006 that would otherwise apply with respect to the home as a care home;
  
  
• the licensee’s policy to promote zero tolerance of abuse and neglect of residents [under RHA 67(4)];
  
  
• the licensee’s procedure for complaints [under RHA 73(1)];
  
  
• the licensee’s policy regarding the use of personal assistance services devices for residents [under RHA 68(3)];
  
  
• the name, telephone number and e-mail address of the licensee;
  
  
• information about the role of the Authority and its contact information;
  
  
• information about the Residents’ Council, including any information that the Residents’ Council provides for inclusion in the package;
  
  
• an explanation of the protection afforded for whistle-blowing [under RHA 115];
  
  
• information relating to the contents of the written agreement that section 53 requires each of the residents and the licensee to make;
  
  
• an itemized list of the different types of accommodation and care services provided in the retirement home and their prices, "made available in print or electronic form, or both, to any person on request, in accordance with the regulations, if any" [RHA 55(3)];
  
  
• a statement that a resident may purchase or apply for care services, other services, programs or goods from external care providers;
  
  
• information about the licensee’s process for assisting residents to purchase or apply for care services and other services, programs or goods from external providers;
  
  
• information regarding the rights of residents if the licensee chooses to reduce or discontinue the care services that the licensee provides to residents;
  
  
• disclosure of any non-arm’s length relationships that exist between the licensee and external care providers;
  
  
• contact information for the local health integration network within the meaning of the Local Health System Integration Act, 2006 for the geographic area in which the retirement home is located;
  
  
• information relating to the assessments required to prepare a plan of care, including a resident’s right to apply for publicly funded assessments;
  
  
• information about the licensee’s process for assisting a resident in his or her transition to a long-term care home or other place of residence;
  
  
• information as to whether the retirement home has automatic sprinklers in each resident’s room;
  
  
• information relating to staffing, including night time staffing levels and qualifications of staff of the retirement home;
  
  
• a statement as to whether the retirement home is required to have a resident-staff communication and response system and whether the home has such a system and, if so, details of the system [under RHA 60(2)];
  
  
• a statement that section 62 of the Act requires the licensee to assess a resident when the resident commences residency in the home and to reassess the resident every six months but that the licensee is not authorized to assess or reassess a resident without the resident’s consent;
  
  
• a statement that the residents have the right to form a Residents’ Council if one does not yet exist;
  
  
• a statement whether the licensee offers programs, activities or services to encourage the mental stimulation of residents and, if so, information about them;
  
  
• a statement whether the licensee offers programs, activities or services to address the social, recreational and spiritual needs of residents and, if so, information about them;
  
  
• information about how to reduce the incidence of infectious disease outbreaks, including the need for and method of maintaining proper hand hygiene and the need for and process of reporting infectious illness;
  
  
• information about the strategies the licensee has implemented to reduce or mitigate the risk of falls in common areas of the home;
  
  
• a statement as to whether or not services in the home are provided in French or in any other languages in addition to English and, if so, a list of those languages;
  
  
• a statement that section 68 of the Act prohibits the licensee and external care providers who provide care services in the home from restraining a resident of the home in any way including by the use of a physical device or by the administration of a drug except as permitted by section 71 of the Act when immediate action is necessary to prevent serious bodily harm to a resident or to others;
  
  
• a statement whether the licensee allows a resident of the home to entrust money to the care of the licensee on behalf of the resident and if so, a copy of the written trust account policy and procedures [under RHA 57(7)];
  
  
• a statement that the Act does not require the licensee to audit trust accounts into which the licensee is required to deposit money entrusted into the licensee’s care on behalf of a resident but that the Registrar may order the licensee to audit any such trust account; and
  
  
• a statement that sections 77 and 80 of the Act authorize an inspector or an investigator respectively to inspect, copy and remove records containing a resident’s personal information, including personal health information, from the home for the purpose of determining whether the licensee is in compliance with the requirements of the Act.

(b) Comment

This extensive written notice requirement is reminiscent of consumer protection legislation [like the Consumer Protection Act, 2002], but in doing so it fails miserably. Any such 'information', certainly of the extensive nature we see here (above), is logically required for purposes of informed contractual consent before the legal commitment is made to the RH residency agreement. Yet the Act only provides that the package be given "before the resident commences his or her residency", which is invariably after the legal commitment is made.

Disclosure before occupation, which is what is required here, gives no assurance that the information is made available to enlighten the resident for that central contractual decision, as it's disclosure is only required after the 'deal is closed'. Barring licensee scruples, it can be basically an "oh, is this what I've agreed too?" moment, accepting the licensee-drafted contract unseen.

This unilateralism is furthered by provisions that require (and thus allow from the licensee's perspective) [RHA 54(1)(c-d)]:

• the package of information is accurate and revised as necessary; and
  
  
• any material revisions to the package of information are provided to any person who has received the original package and who is still a resident of the home or substitute decision-maker of a resident of the home.

These two provisions - by Ontario law - that additionally acknowledge and allow for the licensee to vary or modify the "information", cannot help but become part of the resident's agreement - unilaterally (again). To give an idea of the risk of abuse that these provisions pose to the contract-formation process, compare it to the current accepted legal test for unconscionability on the formation of a contract [Swampillai v. Royal & Sun Alliance Insurance Company of Canada (Ont CA, 2019)]:

[6] At para. 38 of Titus, this court endorsed four elements necessary for unconscionability:

1. a grossly unfair and improvident transaction;

2. the victim's lack of independent legal advice or other suitable advice;

3. an overwhelming imbalance in bargaining power caused by the victim's ignorance of business, illiteracy, ignorance of the language of the bargain, blindness, deafness, illness, senility, or similar disability; and

4. the other party knowingly taking advantage of this vulnerability.

All of these elements are furthered by such an antiquated consumer-perspective as we see here in the RHA, indeed in element (3) we see "blindness, deafness, illness, senility, or similar disability" - all common senior handicaps, expressly cited as factors furthering unconscionability. This is just sad, antiquated and paternalistic.


4. Required Public Displays in the Retirement Home

The following information shall be made available by the licensee in the home in an easily accessible location [RHA 55(1)]:

• the information package (above) [under RHA 54(2)],
  
  
• copies of the final reports done by inspectors [under RHA 77] in the previous two years for the retirement home, "with all personal information and personal health information redacted",
  
  
• Orders made by the Registrar with respect to the retirement home that are in effect or that have been made in the previous two years, "with all personal information and personal health information redacted",
  
  
• Decisions of the Tribunal or the Divisional Court that were made under this Act with respect to the retirement home within the previous two years,
  
  
• the minutes of the most recent Residents’ Council meeting, if the Council consents to their disclosure.
  
  
• All other information that is prescribed by the Regulations [SS: there are no Regulations here yet].

Additionally, the licensee shall ensure that the following information shall be "posted in the home in a conspicuous and easily accessible location" [RHA 55(2), Reg 11]:

• the Residents’ Bill of Rights;
  
  
• The licensee’s licence for the home;
  
  
• An explanation of the measures to be taken in case of fire;
  
  
• Contact information for the Authority;
  
  
• A statement as to whether or not services in the home are provided in French or in any other languages in addition to English and, if so, a list of those languages;
  
  
• An explanation of the procedures to be followed in the case of an evacuation;
  
  
• Information about reporting to the Registrar matters relating to the care and safety of the residents of the home that is on a sign that the Registrar provides or that is in a form that the Registrar approves;
  
  
• A statement that sections 77 and 80 of the Act authorize an inspector or an investigator respectively to inspect, copy and remove records containing a resident’s personal information, including personal health information, from the home for the purpose of determining whether the licensee is in compliance with the requirements of the Act;
  
  
• A copy of the most recent final inspection report prepared by an inspector under section 77 of the Act, subject to section 114 of the Act.

5. Residents' Council

(a) General

In a phenomenal bit of patronizing to the elderly and the handicapped (and this from a generation who prided themselves on advocacy throughout their lives), the RHA provides that "licensee(s) of a retirement home shall allow the residents of the home to establish a Residents’ Council for the home" [RHA 56(1)]. Is this to counter the automatic forfeiture of basic human rights the elderly and handicapped otherwise experience? All snideness aside, and in fairness to the legislative drafters, it may be to counter prior contractual practices by the retirement home industry that prohibited such groups.

(b) Residents Council Membership and 'Powers'

It gets worse, this stuff runs through 4 sections of the RHA [s.56-59]. Next, s.56(2) provides that "(o)nly residents of the retirement home may be members of the Residents’ Council", ruling out those mischievous family members to focus on the more-manageable residents.

When residents do in fact form a 'Residents' Council' they may enjoy such further expressive and adult-like "powers" as to [RHA 56(3)]:

• inform residents of their rights and obligations under this Act;
  
  
• inform residents of the rights and obligations of the licensee under this Act and under any agreement relating to the home;
  
  
• attempt to resolve disputes between the licensee and residents;
  
  
• sponsor and plan activities for residents subject to any requirements that the licensee may have regarding the licensee’s liability arising from any such activities;
  
  
• collaborate with community groups and volunteers concerning activities for residents;
  
  
• report to the Registrar any concerns and recommendations that in the Council’s opinion ought to be brought to the Registrar’s attention;
  
  
• act as a tenants’ association under the Residential Tenancies Act, 2006;
  
  
• advise the licensee of any concerns or recommendations the Council has about the operation of the home;
  
  
• provide advice and recommendations to the licensee regarding what the residents would like to see done to improve care or the quality of life in the home.

"If the Residents’ Council has advised the licensee of concerns or recommendations" under the last two items above [RHA 56(3)(f) or (g)], the licensee shall, within 10 days of receiving the advice, respond to the Residents’ Council in writing" [RHA 56(4)].

(c) Residents Council and the Licensee

If a Residents' Council is formed, "the licensee of the home shall appoint a Residents’ Council assistant who is acceptable to the Council to assist the Council" [RHA 57(1)] - although to counter any paranoid this might inspire, "(a) licensee of a retirement home shall not attend a meeting of the Residents’ Council for the home unless invited to do so and shall ensure that the staff of the home do not attend a meeting unless invited to do so [RHA 58(3)]. The 'assistant', in "carrying out his or her duties, ... shall take instructions from the Council, ensure confidentiality if the Council requests it and report to the Council" [RHA 57(2)]. This melange of rules does allow for licensee staff persons to act as the 'assistant', and I suspect this is the rule, not the exception.

The licensee shall makes themselves available to the Residents' Council personally, or by representative if the licensee is a corporation [RHA 58(2)].

Otherwise, the licensee shall co-operate with the Council and the assistant and provide it with "the prescribed information and assistance within the prescribed time" and "consult regularly with the Residents’ Council and at a minimum at least every three months" [RHA 58(1)]. The 'prescribed information and assistance' means, "within 10 days of receiving a request from the Residents’ Council", the licensee shall, "to the extent that it is reasonably practicable to do so" [Reg 12]:

• "provide to the Council any information that the Council requests with respect to building maintenance, resident safety and personal care, programming, food and other aspects of life in the home";
  
  If the licensee cannot do this within 10 days of the request, they shall "within the 10 days, advise the Residents’ Council of the reasons for the delay and the date by which the licensee reasonably expects to be able to provide the information or assistance, as the case may be; and provide the information or assistance, as the case may be, to the Residents’ Council as soon as is reasonably practicable" [Reg 12(2)]. If it is not reasonably practicable for the licensee to provide the information or assistance requested, the licensee shall, within 10 days of receiving the request, advise the Residents’ Council of the reasons why the licensee will not be providing the information or assistance, as the case may be [Reg 12(3)].
  
  
• "make available to the Council, for the purpose of holding meetings from time to time, an area within the home that is easily accessible to all residents and that allows the Council to hold meetings that are closed to the licensee and the staff of the home"; and
  
  
• "make available to the Council, for the purpose of posting notices and other information, an area within the home that is easily accessible to all residents."

(d) Immunity from Legal Liability

Council members and assistants are immunized against legal proceeding for "anything done or omitted to be done in good faith in that capacity" [RHA 59]. This appears to extend beyond civil liability, to regulatory as well ["(n)o action or other proceeding"].

(e) Reprisals and the Residents Council

Lastly, a range of reprisal-protections exist against a licensee, who [RHA 58(4)]:

• shall not interfere with the meetings or operation of the Residents’ Council;
  
  
• shall not charge any fees to the Residents’ Council for any purpose relating to the Residents’ Council’s creation, administration or activities;
  
  
• shall not prevent a member of the Residents’ Council from performing any duties as a member of the Council and shall not otherwise hinder, obstruct or interfere with such a member carrying out those duties;
  
  
• shall not prevent a Residents’ Council assistant from entering the retirement home to carry out his or her duties or otherwise hinder, obstruct or interfere with such an assistant carrying out those duties; and
  
  
• shall ensure that no staff member does anything that the licensee is forbidden to do (as above).

(f) Comment

This entire 'Residents Council' regime has to be placed in perspective. These are 'association' rights that, were the other side a government, restrictions would be prohibited by Charter law as a fundamental freedom ["s.2(d): freedom of association"]. That tells us something about the concerns that authors of the RHA had when they drafted these provisions. The regime appears to be that, in exchange for some (albeit sensible) information and "assistance" requirements of the licensee, complete contractual prohibition of a 'Residents Council' is itself prohibited. That shows me that the legislators feared complete contractual prohibition by licensees.

As an advocacy arrangement these statutorily-defined 'Residents Councils' are patronizing, weak and vulnerable to compromise by the licensee. This, were it not so serious in this age of COVID-inspired death toll, would be merely sad - but as it is it's risks are huge. If absolutely nothing else, children or relatives of residents should be allowed on the Council as members.

Resident and non-resident advocates should consider a true Residents association, free from the RHA-restrictions. This would force the licensee to either deal with true advocacy, or to boldly assert a plain 'only-RHA-sponsored-Council' rule and to attempt to bar independent advocacy by contract, trespass law, or otherwise. At least then the problem would come out in the open. In doing so, residents may wish to advance this provision of the Human Rights Code under the 'age' category:

s.12
A right under Part I is infringed where the discrimination is because of relationship, association or dealings with a person or persons identified by a prohibited ground of discrimination.

6. External Care Providers

It is a common human monopolistic tactic when a dominant economic actor physically controls the living accomodation of others [ie. trailer parks, company towns] to exclude other goods and services suppliers. Thus the RHA concern about 'external care providers', to ensure that the residents are not a 'captive market' to the retirement home, or it's non-arm's length businesses.

As a consequence, there is a prohibition against preventing a resident "from applying for care services from an external care provider of the resident’s choosing" [RHA 61(1)], and neither shall a licensee "interfere with the provision of care services to a resident of the home by an external care provider" [abuse and restraint (including drugs) protection under RTA 67-68 excepted] [RHA 61(2)].

If the resident advises that they want an external care provider to perform a care plan assessment, "the licensee shall facilitate the resident’s access to the provider" [RHA 62(7)].

If a resident requests information about external care providers, residents shall be provided with it by the RH promptly and "with such information that is readily available" to them [RHA 63(1)]. As well, if a care plan assessment reveals that the resident needs care services that the RH cannot provide, the RH shall provide the information and "enable the resident to obtain those services from an external care provider" [RHA 63(2)].

The licensee shall "ensure that there are protocols to promote the collaboration between the staff, external care providers and others involved in the different aspects of care of the resident" [RHA 62(8)].

"As soon as is practical" after they learn that "external care provider is or will be providing care services to a resident in the retirement home", the licensee shall provide the external care provider "with information with respect to the home’s policy to promote zero tolerance for abuse and neglect of residents" [Reg 14.1] (see s.7: 'Licensee Duty Regarding Abuse and Neglect'), next following.

Licensees shall not thereby have any responsibility "for ensuring that the services provided by an external care provider meet the prescribed care standards" [RHA 61(3)].

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7. Licensee Duty Regarding Abuse and Neglect

(a) Definitions

. Abuse

The term 'abuse' is widely-used in the RHA in relation to a resident: physical abuse, sexual abuse, emotional abuse, verbal abuse or financial abuse [RHA 2(1)]. Each form of abuse is defined as follows [Reg 1(1)]:

• "emotional abuse” means,
  
  (a) any threatening, insulting, intimidating or humiliating gestures, actions, behaviour or remarks, including imposed social isolation, shunning, ignoring, lack of acknowledgement or infantilization that are performed by anyone other than a resident, or
  
  (b) any threatening or intimidating gestures, actions, behaviour or remarks by a resident that causes alarm or fear to another resident if the resident performing the gestures, actions, behaviour or remarks understands and appreciates their consequences;
  
  
• “financial abuse” means any misappropriation or misuse of a resident’s money or property;
  
  
• “physical abuse” means, subject to subsection (2),
  
  (a) the use of physical force by anyone other than a resident that causes physical injury or pain,
  
  Physical abuse does not include the use of force that is appropriate to the provision of care or assisting a resident with activities of daily living, unless the force used is excessive in the circumstances [Reg 1(2)].
  
  (b) administering or withholding a drug for an inappropriate purpose, or
  
  "Drugs" means a drug as defined in the Drug and Pharmacies Regulation Act [Reg 4(1)].
  
  (c) the use of physical force by a resident that causes physical injury to another resident;
  
  
• “sexual abuse” means,
  
  (a) subject to subsection (3), any consensual or non-consensual touching, behaviour or remarks of a sexual nature or sexual exploitation that is directed towards a resident by a licensee or staff member, or
  
  (b) any non-consensual touching, behaviour or remarks of a sexual nature or sexual exploitation directed towards a resident by a person other than a licensee or staff member;
  
  Sexual abuse does not include [Reg 1(3)]:
  
  (a) touching, behaviour or remarks of a clinical nature that are appropriate to the provision of care or assisting a resident with activities of daily living; or
  
  (b) consensual touching, behaviour or remarks of a sexual nature between a resident and a licensee or staff member that is in the course of a sexual relationship that began before the resident commenced residency in the retirement home or before the licensee or staff member became a licensee or staff member.
  
  
• “verbal abuse” means,
  
  (a) any form of verbal communication of a threatening or intimidating nature or any form of verbal communication of a belittling or degrading nature that diminishes a resident’s sense of well-being, dignity or self-worth, if the communication is made by anyone other than a resident, or
  
  (b) any form of verbal communication of a threatening or intimidating nature made by a resident that leads another resident to fear for his or her safety if the resident making the communication understands and appreciates its consequences.

. Neglect

“Neglect”, in relation to residents, means the failure to provide a resident with the care and assistance required for his or her health, safety or well-being and includes inaction or a pattern of inaction that jeopardizes the health or safety of one or more residents [RHA 2(1)].

...................

(b) Duties

Licensees shall ensure that residents shall be protected from abuse by anyone [RHA 67(1)], and that they themselves and staff do not neglect them [RHA 67(2)]. These duties do not apply when the resident is outside of the RH, "unless the resident continues to receive care services from the licensee or the staff of the home" [RHA 67(3)].

...................

(c) Written Policy

In addition to the above duties, the RH "shall ensure that there is a written policy to promote zero tolerance of abuse and neglect of residents and shall ensure that the policy is complied with" [RHA 67(4)]. The zero tolerance policy shall minimally [RHA 67(5), Reg 15(3)]:

• clearly set out what constitutes abuse and neglect;
  
  
• provide that abuse and neglect are not to be tolerated;
  
  
• provide for a program for preventing abuse and neglect;
  
  This program shall "entail training and retraining requirements for all staff of the retirement home, including [Reg 15(1)]:
  
  
  • training on the relationship between power imbalances between staff and residents and the potential for abuse and neglect by those in a position of trust, power and responsibility for resident care.
    
    
  • situations that may lead to abuse and neglect and how to avoid such situations.
  
  
• contain an explanation of the duty to report to the Registrar [under section 75; see Ch.6, s.1] regarding improper or incompetent treatment, abuse or neglect, unlawful conduct, misuse or misappropriation of a resident’s money;
  
  
• contain procedures for investigating and responding to alleged, suspected or witnessed abuse and neglect of residents [RHA 67(5)(e)];
  
  "The procedures for investigating and responding to alleged, suspected or witnessed abuse and neglect of residents ... shall include details outlining who will undertake the investigation and who will be informed of the investigation" [Reg 15(2)];
  
  
• set out the consequences for those who abuse or neglect residents;
  
  
• contain procedures and interventions to assist and support residents who have been abused or neglected or allegedly abused or neglected;
  
  
• "contain an explanation of the prohibition on borrowing, receiving or holding a resident’s money or other property" [see Ch.4, s.7 'Trust for Resident Money'];
  
  
• contain procedures and interventions to deal with persons who have abused or neglected or allegedly abused or neglected residents, as appropriate;
  
  
• identify measures and strategies to prevent abuse and neglect;
  
  
• "provide that the licensee of the retirement home shall ensure that the resident’s substitute decision-makers, if any, and any other person specified by the resident,
  
  (i) are notified immediately upon the licensee becoming aware of an alleged, suspected or witnessed incident of abuse or neglect of a resident that has resulted in a physical injury or pain to a resident or that causes distress to a resident that could potentially be detrimental to a resident’s health or well-being, and
  
  (ii) are notified within 12 hours upon the licensee becoming aware of any other alleged, suspected or witnessed incident of abuse or neglect of a resident";
  
  "The policy is not required to provide, and a licensee is not required to ensure, that the resident’s substitute decision-maker or any other person specified by the resident is notified about the alleged, suspected or witnessed incident of abuse or neglect of the resident or about the result of an investigation" [under RHA 67(5)(e), see above] "if the licensee has reasonable grounds to suspect that the substitute decision-maker or the other person is responsible for the abuse or neglect" [Reg 15(4)].
  
  
• provide that the licensee of the retirement home shall ensure that the resident and the resident’s substitute decision-makers, if any, are notified of the results of an investigation [under RHA 67(5)(e), see above] immediately upon the completion of the investigation;
  
  "The policy is not required to provide, and a licensee is not required to ensure, that the resident’s substitute decision-maker or any other person specified by the resident is notified about the alleged, suspected or witnessed incident of abuse or neglect of the resident or about the result of an investigation" [under RHA 67(5)(e), see above] "if the licensee has reasonable grounds to suspect that the substitute decision-maker or the other person is responsible for the abuse or neglect" [Reg 15(4)].
  
  
• provide that the licensee of the retirement home shall ensure that the appropriate police force [pending: "police service", see below] is immediately notified of any alleged, suspected or witnessed incident of abuse or neglect of a resident that the licensee suspects may constitute a criminal offence; and
  
  
• provide that the licensee of the retirement home shall ensure that,
  
  (i) an analysis of every incident of abuse or neglect of a resident at the home is undertaken promptly after the licensee becomes aware of it,
  
  (ii) at least once in every calendar year, an evaluation is made to determine the effectiveness of the policy and what changes and improvements are required to prevent further occurrences of abuse and neglect of residents,
  
  (iii) the results of the analysis undertaken under subclause (i) are considered in the evaluation mentioned in subclause (ii),
  
  (iv) the changes and improvements mentioned in subclause (ii) are promptly implemented, and
  
  (v) a written record of everything provided for in subclauses (ii) and (iv) and the date of the evaluation, the names of the persons who participated in the evaluation and the date that the changes and improvements were implemented is promptly prepared.

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