Consultation on Leveraging the Role of Resident Support Personnel in Long-Term Care Homes
Regulation Number(s):
Ontario Regulation 246/22
Instrument Type:
Proposal
Bill or Act:
Fixing Long-Term Care Act, 2021
Summary of Proposal:
Under the ministry's current legislative and regulatory framework, only persons who meet the educational qualifications noted in section 52 of Ontario Regulation 246/22 under the Fixing Long-Term Care Act, 2021, or meet the listed exceptions such as being a registered nurse or registered practical nurse who meet certain criteria, can be hired by a licensee as a personal support worker or to provide personal support services (i.e., to assist with the activities of daily living, including personal hygiene services).
During the COVID-19 pandemic, the ministry introduced a transitional staffing qualification provision, which provides that licensees do not need to comply with requirements in section 52, including the requisite personal support worker training. This transitional staffing qualifications flexibility provision has been in effect as of October 11, 2023, and will expire on July 1, 2025.
The ministry understands that resident support personnel have been used in long-term care homes to safely assist with providing some personal support services to low-risk residents (for example, helping brush a resident's hair or teeth, helping open containers at mealtime) since the transitional staffing qualifications flexibility provision first came into effect.
To stabilize an approach for the role of resident support personnel beyond July 1, 2025, the ministry previously consulted the Regulatory Registry from September 29, 2023, to November 20, 2023, on the scope of the resident support personnel role and whether they should be permitted to permanently provide personal support services to low-risk residents. The goal of the consultation was to determine whether to propose regulatory amendments that, if approved, could permanently permit a personal support role to assist low-risk residents into the future or to allow the flexibility to expire without further amendment (in which case, resident support personnel would not be permitted to provide any personal support services to residents).
Based on that consultation, the ministry generally received support for maintaining the resident support personnel role in long-term care as a supplement to personal support workers. Specific feedback from that consultation notes:
Resident support personnel play an important role in providing timely care to residents and can help ease the burden on personal support workers and nurses, allowing them to perform the specialized tasks for which they have received the necessary training and education.
The resident support personnel role provides an essential pathway to enter the long-term care sector and has allowed these staff to explore and transition into other careers within the sector.
There were some concerns raised about whether resident support personnel have the sufficient training to provide direct care and supports related to activities of daily living without supervision.
There is a desire for the ministry to issue additional guidance to the sector on the role of resident support personnel.
Based on the feedback received, the ministry is proposing to amend Regulation 246/22 under the Fixing Long-Term Care Act, 2021 to enable homes to continue to leverage resident support personnel in long-term care homes once the transitional flexibility provision expires on July 1, 2025. The ministry is proposing to enable the following:
Licensees would have the flexibility to hire an individual to work as a resident support personnel providing personal support services to low-risk residents without meeting personal support workers educational requirements if they are of the reasonable opinion that the individual has the adequate skills and qualifications to perform their duties and the Director of Nursing and Personal Care is of the reasonable opinion that the individual can safely provide services based on residents' care needs.
The Director of Nursing and Personal Care would be responsible for ensuring tasks are assigned to the appropriate staff member based on an assessment of the resident's care plan, needs and risk-level (in consideration of any health conditions, mobility concerns, medications, and responsive behaviours). The type of personal support service a resident support personnel can provide, if any, would be based on this assessment in consideration of the resident support personnel's training and knowledge.
Depending on the risk level of the resident and the type of assistance the resident support personnel is providing, they may be supervised by a nurse or a personal support worker.
If a resident is deemed to be high risk, then resident support personnel will not be permitted to provide personal support to them.
Pursuant to the Fixing Long-Term Care Act, 2021, licensees must continue to ensure that plans of care are based on the needs and preference of residents. Residents may have a need or preference for a certain care provider (for example, a nurse or personal support worker).
The ministry would issue guidance for homes on how to safely leverage resident support personnel in this capacity, including providing guidance on tasks that may be in and out of scope for resident support personnel to perform.
The ministry currently supports resident support personnel to upskill to personal support workers through the Learn & Earn Accelerated Program (offered in English and French), without needing to leave their community. The ministry will explore other opportunities to further support resident support personnel to upskill to personal support workers.
For more information on how this approach, if approved, would work in practice, please see the addendum.
The ministry is seeking feedback on this approach in granting more flexibility for homes to leverage resident support personnel in providing personal support services while prioritizing resident quality of care.
During the COVID-19 pandemic, the ministry introduced a transitional staffing qualification provision, which provides that licensees do not need to comply with requirements in section 52, including the requisite personal support worker training. This transitional staffing qualifications flexibility provision has been in effect as of October 11, 2023, and will expire on July 1, 2025.
The ministry understands that resident support personnel have been used in long-term care homes to safely assist with providing some personal support services to low-risk residents (for example, helping brush a resident's hair or teeth, helping open containers at mealtime) since the transitional staffing qualifications flexibility provision first came into effect.
To stabilize an approach for the role of resident support personnel beyond July 1, 2025, the ministry previously consulted the Regulatory Registry from September 29, 2023, to November 20, 2023, on the scope of the resident support personnel role and whether they should be permitted to permanently provide personal support services to low-risk residents. The goal of the consultation was to determine whether to propose regulatory amendments that, if approved, could permanently permit a personal support role to assist low-risk residents into the future or to allow the flexibility to expire without further amendment (in which case, resident support personnel would not be permitted to provide any personal support services to residents).
Based on that consultation, the ministry generally received support for maintaining the resident support personnel role in long-term care as a supplement to personal support workers. Specific feedback from that consultation notes:
Resident support personnel play an important role in providing timely care to residents and can help ease the burden on personal support workers and nurses, allowing them to perform the specialized tasks for which they have received the necessary training and education.
The resident support personnel role provides an essential pathway to enter the long-term care sector and has allowed these staff to explore and transition into other careers within the sector.
There were some concerns raised about whether resident support personnel have the sufficient training to provide direct care and supports related to activities of daily living without supervision.
There is a desire for the ministry to issue additional guidance to the sector on the role of resident support personnel.
Based on the feedback received, the ministry is proposing to amend Regulation 246/22 under the Fixing Long-Term Care Act, 2021 to enable homes to continue to leverage resident support personnel in long-term care homes once the transitional flexibility provision expires on July 1, 2025. The ministry is proposing to enable the following:
Licensees would have the flexibility to hire an individual to work as a resident support personnel providing personal support services to low-risk residents without meeting personal support workers educational requirements if they are of the reasonable opinion that the individual has the adequate skills and qualifications to perform their duties and the Director of Nursing and Personal Care is of the reasonable opinion that the individual can safely provide services based on residents' care needs.
The Director of Nursing and Personal Care would be responsible for ensuring tasks are assigned to the appropriate staff member based on an assessment of the resident's care plan, needs and risk-level (in consideration of any health conditions, mobility concerns, medications, and responsive behaviours). The type of personal support service a resident support personnel can provide, if any, would be based on this assessment in consideration of the resident support personnel's training and knowledge.
Depending on the risk level of the resident and the type of assistance the resident support personnel is providing, they may be supervised by a nurse or a personal support worker.
If a resident is deemed to be high risk, then resident support personnel will not be permitted to provide personal support to them.
Pursuant to the Fixing Long-Term Care Act, 2021, licensees must continue to ensure that plans of care are based on the needs and preference of residents. Residents may have a need or preference for a certain care provider (for example, a nurse or personal support worker).
The ministry would issue guidance for homes on how to safely leverage resident support personnel in this capacity, including providing guidance on tasks that may be in and out of scope for resident support personnel to perform.
The ministry currently supports resident support personnel to upskill to personal support workers through the Learn & Earn Accelerated Program (offered in English and French), without needing to leave their community. The ministry will explore other opportunities to further support resident support personnel to upskill to personal support workers.
For more information on how this approach, if approved, would work in practice, please see the addendum.
The ministry is seeking feedback on this approach in granting more flexibility for homes to leverage resident support personnel in providing personal support services while prioritizing resident quality of care.
Analysis of Regulatory Impact:
The feedback received will be used to propose specific regulatory amendments to section 52 of the Regulation in the future, and the ministry will undertake necessary analysis to identify associated regulatory impacts at that time.
Further Information:
1. Addendum Resident Support Personnel Approach in Practice Flow ChartProposal Number:
24-HLTC017
Posting Date:
May 1, 2024
Comments Due Date:
June 15, 2024
Contact Address:
6th Floor, 400 University Avenue
Toronto ON
M5G 1S5
Toronto ON
M5G 1S5
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