Personal Support Worker service expanding in Caledon, says CCS

by Matthew Strader

Despite online concerns, CCS says PSW service in Caledon is expanding now and into the future. – Mark Wanzel

 

Changes to senior services in Caledon specific to the delivery of Personal Support Worker services have occurred, and Geraldine Aguiar, director of health services for Caledon Community Services, said it’s not being reduced — it is being expanded.

Some online traffic recently showed some residents concerned about an apparent decline in the services their parents were receiving, or a lack of PSWs (Personal Support Workers) present in assisted-living homes.

“It’s actually expanding,” said Aguiar. “But we saw the concerns, and we welcome addressing them.”

In Caledon, PSW service is provided within the Assisted Living Program, 24 hours a day, seven days a week and 365 days a year.

The Assisted Living Services for High Risk Seniors Policy, 2011, a Ministry of Health and Long-Term Care document, is the guiding literature. It informs the eligibility and implementation of the program.

One of the changes Caledon Community Services (CCS) recently experienced is its boundary for delivery. It has expanded to include all villages and hamlets of Caledon, and a fiscal 2018-19 target of 177 clients.

As well, individual clients’ schedules have been adjusted.

“Yes, starting in 2017, as part of our quality improvement work with the care-planning process, individual client schedules have been adjusted, in consultation with the clients,” Aguiar said, “to provide longer visits that are more meaningful and as close to their preferred time as possible, in an effort to decrease the amount of reported ‘client not home’ appointments.”

So instead of clients’ receiving several five-to-10 minute visits throughout the day, they now receive two to three visits that range from 20 to 30 minutes. Unscheduled care visits continue to be available if clients call the office, Aguiar said. She said the operational change was well received by clients.

All individuals within the program are assessed for eligibility by Home and Community Care (formerly the CCAC). A client’s eligibility will be based on standardized assessment tools. Once eligibility has been confirmed, the results of the assessment inform the level of PSW activity for each client. And each service-delivery profile is unique to the client’s needs and abilities.

Ongoing reassessment is part of the care co-ordination process and is done every six months or when there is a significant change in the client’s health status.

To qualify, interested people have to contact Home and Community Care (905-796-0040) to request an assessment for assisted-living services.

“We are funded to provide an average of one hour of PSW services per day, per client,” Aguiar said. “Eligible clients can receive PSW services free of charge.”

If clients require more than the funded program maximums, they are referred to other PSW programs that may involve fees for service. If clients require services that are out of the scope of the program, they are referred to other service providers within the community. If clients do not meet the eligibility criteria, they are provided with other community and fee-for-service options.

Discharges do take place, Aguiar said, and she fears that may be where some of the online criticism is stemming from, but the system simply can’t adapt to any need. It is about providing the care people require to those who require it.

Some, she said, simply disagree with what should be provided.

CCS has to operate the program in compliance with the policy document and in alignment with the funding envelope and targets, as directed by the Central West Local Health Integration Network (CWLHIN).

All assisted-living providers, in collaboration with the CWLHIN, can determine the types of services that are within the scope of the program. For example, CWLHIN assisted-living providers do not offer all the homemaking tasks outlined in the policy.

“We would discharge clients who no longer met the eligibility criteria; we would discharge clients who were declining approved services on a regular basis; and we would discharge and transition back to Home and Community Care those clients whose needs exceeded the scope of the assisted-living program,” Aguiar said. “CCS is in an active admit position. We currently have no wait-lists for assisted-living services in Caledon. We are working closely with Home and Community Care to identify additional eligible seniors within our Caledon borders. As previously stated, our target for this program has increased, and this means service for more people in Caledon.”

Today, CCS is approved to serve a maximum of 67 clients across all six Peel Living buildings in Caledon. Demand for the program in the buildings has decreased, and CCS is now serving more clients from outside the Peel Living sites.

“Service levels have actually increased in Caledon for assisted-living services. CCS PSW staff serve clients in the Peel Living buildings and in all the surrounding hamlets and villages within Caledon. Caseloads increase and decrease, depending on the location of the client and the acuity of care that they require,” Aguiar said. “PSWs that were once always visible in the Peel Living buildings are now being deployed to service clients outside the building. Their presence in the building has decreased, but that does not mean that service levels overall have reduced. We continue to provide scheduled and unscheduled care 24-7-365.”

Available assisted-living services

The following assisted living services are available to eligible high risk seniors:

• Personal support services include dressing, personal hygiene, assisting with mobility, assisting and monitoring medication use and other routine activities of living. These services are available at all times (24-7), both on a scheduled and unscheduled basis.

• Homemaking services, including shopping, housecleaning and meal preparation, that are necessary to maintain people in their own residences but that they are unable to perform safely for themselves. These services are available at all times (24-7), both on a scheduled and unscheduled basis.

• Security checks or reassurance services, including visits to assure client health or safety. These services are provided to address the individual needs of clients, based on their clinical condition or environment. These services are available at all times (24-7), both on a scheduled and unscheduled basis.

• Care co-ordination includes co-ordinating all elements of client care. The care co-ordination role includes the assessment of applicants’ needs, determination of eligibility based on the eligibility criteria, and the development, review, evaluation and revision of a plan of service relating to the provision of assisted-living services

How PSW service is funded in Caledon:

• The Ministry of Health and Long-Term Care funds PSW services through the Local Health Integration Networks (LHINs).

• Central West LHIN funds Caledon Community Services’ PSW service through the Assisted Living Program.

• There are funded and private agencies that provide PSW services.

•Health-service providers funded by the LHIN offer free PSW service to eligible clients.

• The funded PSW programs have service maximums, and every service provider has annual targets for number of clients served and number of PSW hours provided.

CCS serves the clients referred to it by Home and Community Care, in line with the relevant policy.

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