St. Leonard’s Place Peel (SLPP) understands the impact of the novel coronavirus (COVID-19) outbreak on all residents, staff and the larger community. We are closely monitoring this situation and have developed a disease prevention control strategy that includes education and risk mitigation protocols to reduce the spread of coronavirus (COVID-19) within our facility. Our strategy includes the following:
I. DEVELOPMENT OF INFECTION DISEASE CONTROL POLICY AND PROCEDURES SPECIFIC TO COVID-19
These policies were developed for staff and require all employees of the agency provide confirmation of having read and agreed to these protocols. The objectives of these policies are to:
1. Ensure staff are aware of best practice and routine infectious disease control practices
2. Emphasize the responsibly of each staff to comply with infectious disease protocols
3. Outline infectious disease protocols, such as:
• Risk mitigation / risk assessment
II. STAFF EDUCATION AND TRAINING
These mandatory education and training materials were developed for staff. The participation rate for these trainings is 100%. Education and training objectives include:
1. Educating staff on the symptoms and mode of transmission of COVID-19
2. Educating staff on the infection control policy and procedure/protocol for a suspected case.
3. Using the SBAR tool to clearly and effectively communicate suspected cases to the nurse practitioner.
4. Educating staff on the appropriate order for donning and doffing of personal protective equipment (PPE) and proper handwashing techniques to reduce the spread of infection.
5. Educating staff on the effective use of infrared thermometers and how to safely clean face-shields.
III. CLIENT EDUCATION AND TRAINING
These education and training materials were developed specifically for clients and included written materials and in-person trainings. Clients that were unable to attend live sessions continue to receive over the phone notification about the policies and procedures mentioned herein. Objectives of client training sessions included:
1. Educating clients on the symptoms and mode of transmission of COVID-19
2. Educating clients on the infection control policy and procedures
3. Educating clients regarding quarantine and community access restriction policies
4. Educating clients on screening processes
IV. SOCIAL DISTANCING
SLPP has put a number of procedures in place to optimize social distancing among residents and staff:
1. Quarantining residents
2. Discontinuation of communal meals
3. Discontinuing of group programs
4. Adjusting medication access procedures to optimize safe distancing between clients and staff
5. Common areas are temporarily closed
6. The gym is currently unavailable for use
V. ACTIVE SCREENING PROTOCOLS
Currently, residents are admitted on a case-by-case basis. Active screening is completed over the phone and/or by questionnaire prior to admission.
Mandatory Pre-admission COVID-19 Testing
Prior to admission, residents are required to complete a COVID-19 test and quarantine as per Public Health Standards.
Active screening and Temperature Checks
Staff complete wellness check-ins with all residents at minimum every 4 hours. Residents are aware that they must disclose any symptoms to staff as soon as possible to be assessed by the Nurse Practitioner for further action.
Signage is posted on the entry door, at the reception window, in common areas, hallways and washrooms instructing residents to self-identify, perform hand hygiene, wear a procedure mask, and have access to tissue and a waste receptacle. All residents should be instructed to cover their nose and mouth with a tissue or with their elbow when coughing and sneezing. Residents have been educated through small group sessions and written communication (e.g., letters).
VI. PROTOCOL FOR SUSPECTED CASES
• Residents who present with symptoms are immediately self-isolated in a designated waiting room or in their room if appropriate
• Staff provide the resident with a mask and practice social distancing
• The Nurse Practitioner conducts an assessment to determine next steps (the Nurse Practitioner is on call 24/7 and can conduct virtual assessment if not onsite)
• If required, the Nurse Practitioner will contact Public Health and act as the liaison.
There are currently 4 self-isolation rooms available onsite with private washrooms and the ability to develop additional isolation rooms if required
• Wellness checks are completed every 2-3 hours
• Meals are delivered to the room
VII. CLEANING & PROTECTIVE GEAR
Keeping the residence clean and disinfected has been instrumental to SLPP keeping the residence free of the COVID-19 virus. Our community maintenance program engages a professional cleaning agency, staff and residents in daily cleaning and monitoring.
• Each floor of both buildings is cleaned every day by a professional contracted cleaning service
• Cleaning focuses on high touch surface areas – door knobs, desks, tables, chairs, doors, floors, foyers, rotunda and shared bathrooms are being cleaned daily
• Deep cleaning is also performed
• Cleaning supplies remain in stock
• Clients and cleaners are given cleaning supplies in volumes appropriate for their community maintenance shift, and are asked to advise staff when products run low for top up
The agency has not experienced a shortage of supplies since the onset of the quarantine and the following supplies are made available daily:
• Bathroom supplies including soap and paper towels
• Personal hygiene products (normally resident’s responsibility but we are providing when needed)
• General cleaning products
• Sanitizing wipes
• Hand sanitizer
• Garbage bags
• Gloves for waste removal
• Disinfectant / glass cleaner
Personal Protective Equipment
• SLPP is following medical best practices for the wearing all protective equipment including face masks
• Mandatory use of face masks for all staff and clients
• Front line staff are required to use face shields at all times and administrative/management staff when they are moving around the buildings are required to use face shields
• Healthcare staff are mask fit tested and outfitted with N95 masks to use for COVID-19 positive cases requiring direct personal care.
• Interdisciplinary staff are trained on how to use surgical masks as per Public Health guidelines
• Protocols for using Personal Protective Equipment (PPE) as outlined in the COVID-19 Guidance for Homelessness Service Providers will be observed.
• SLPP’s PPE supply is being monitored and reported to the Region of Peel
VIII. ADDITONAL KEY RISK MITIGATION MEASURES
• Communal dining is suspended
• Residents are called down in groups of 5 to pick-up pre-packaged meals and return to their room.
• Group programming remains suspended
Returning from Outside
• Outings are restricted and must be approved by staff for essential activities (e.g., appointments)
• Hand sanitizer stations and signage are posted at entry.
• Staff ensure that residents hand sanitize as per protocol
• Active screening and temperature checks are performed
• No visitors are permitted onsite.
• Transportation is limited
• If required, staff can transport residents to appointments, or a taxi service will be used.
Daily incident reporting
SLPP will report any cases to our funders on a daily basis along with any significant developments with our infection control strategy.
Mass swabbing for COVID-19 was conducted on several occasions for both staff and residents.