Frequently Asked Questions

Moving In

• How will consumers be informed about what to look for in selecting an assisted living residence?
• Can an individual still sign a contract if they have a committee of estate?

Moving In

How will consumers be informed about what to look for in selecting an assisted living residence?
A consumer guide will be available to assist the public in selecting an assisted living residence. The Registrar will maintain this guide and a list of registered residences on this Web site.

Can an individual still sign a contract if they have a committee of estate?
A committee of estate is someone appointed by the court to make decisions on another person’s behalf. While an assisted living occupant must be able to indicate it is their personal wish to enter into a contract, such as for personal care services, the legal authority to bind the individual to the agreement is provided by the signature of the individual holding committee of estate.

Hospitality Services

To what degree will the Registrar deal with hospitality issues?
The assisted living health and safety standards include minimum health and safety standards related to hospitality services. The Registrar will respond to health and safety concerns related to these services. The province is currently reviewing how matters that deal with the occupancy agreement between the residence operator and occupant will be handled.

What happens when operators do not provide all five hospitality services?
The five hospitality services in assisted living are meal services, housekeeping, laundry, social and recreational opportunities and a 24-hour emergency response. To apply for registration, an operator must meet the definition of assisted living contained in the Community Care and Assisted Living Act.
That means operators must provide housing and five hospitality services, as well as one or two prescribed services. However, the Registrar also has the discretion to designate a residence as assisted living, for example, if it is providing one or two prescribed services but does not have all five hospitality services.

For 24-hour emergency response, is it reasonable to have a staff member in close proximity (able to respond in 15 minutes) given the level of care some occupants will require?
The draft health and safety standards require an operator to provide a 24-hour emergency response system appropriate to the needs of the occupants that will alert staff to the location of an occupant when that person needs assistance.
Where occupants in an assisted living residence are frailer, operators would be expected to provide a 24-hour emergency response by onsite staff. If occupants are less frail, it would be a reasonable level of service for operators to provide a 24-hour response by staff in close proximity (able to respond in 15 minutes).

Personal Assistance

Does the Registrar determine the range of services offered by an assisted living residence?
The Registrar requires that assisted living residences provide at least one prescribed service. Other than this, operators may decide what services will be offered. Assisted living residences offer housing and care to a wide range of people, from seniors to adults with mental disorders and/or substance use disorders. Operators will advise the Registrar about what types of clients they will serve and the types of services they will offer.

Why do residences only provide two prescribed services?
Assisted living is designed for seniors and people with disabilities who need regular personal assistance, which is less complex than the full range of professional nursing services available in a licensed residential care facility. People who locate to assisted living must also be able to direct their own care.
The limited number and level of services in assisted living ensures that, as occupants’ care needs increase to require regular professional nursing or complex care or they become unable to direct their own care, they move into a another level of care, such as licensed care environment.

How will people with varying service needs be accommodated in assisted living?
Staff in assisted living residences, who have college home support/care aide training, provide a wide range of personal assistance services. Some of these personal assistance services require ‘delegation of duty’ and are supervised by a health care professional.

Occupants may also receive regularly scheduled visits from private or health authority funded nursing or rehabilitation services. Intermittent, continuous nursing care can be accommodated on a short-term basis. For example, occupants recovering from an illness, who require palliative care or are awaiting transfer to licensed residential care may purchase continuous nursing care from an operator or a private agency.

Occupants who meet the criteria may also be eligible for community nursing or rehabilitation services from their local health authority.

What happens when ongoing professional care is needed?
When ongoing professional nursing care is required, the occupant needs to move, typically to a licensed residential care setting. While an external agency or health authority can provide regularly scheduled professional health care services, such as nursing, physiotherapy or help with a special diet, occupants must be able to make their own care decisions.
Occupants who need occasional, continuous professional nursing care while they are recovering from a brief illness or hospital stay may be assisted through external agencies or through a licensed care facility operated by the same person who operates their assisted living residence.

What happens if people ‘wander’?
Assisted living is not intended for people who wander because of dementia or other conditions. Operators are only expected to provide a secure environment, safe from intruders, just as you would find in an apartment.

Will there be a standard format for personal services plans?
Personal services plans are a written description of the personal assistance services and service preferences an assisted living operator will provide to each resident. The Assisted Living Centre of Excellence (ALCE) could develop and recommend a template for use by operators. A consumer guide will also be developed, which will provide some suggestions to families and prospective occupants on what should be addressed in a personal services plan.

Health and Safety Standards

What if operators do not meet the health and safety standards?
If a complaint is relatively minor or a result of a misunderstanding, the Registrar will seek to support the operator and/or complainant to resolve the complaint directly. The Registrar may ask representatives of ALCE to facilitate a resolution between the operator and complainant. After Sept 30, 2004, if a complaint is more serious, the Registrar will immediately apply conditions to the operation of the assisted living residence. In dangerous situations, the Registrar can suspend or cancel a registration.

How will staffing levels be assessed and monitored?
The Registrar will be develop criteria by which to judge whether the health and safety needs of occupants are being met. ALCE may also assist operators with staffing models.

Upon registration, the operator must describe the occupants being served and the prescribed service(s) that will be provided. The health and safety standards require an operator to ensure staff members have the necessary knowledge, skills and understanding to deliver the prescribed services. The operator must provide documented evidence of staff training and skills.

Does a resident or family member have the right to see the various policy manuals that the health and safety standards require an operator to keep?
The health and safety standards require an operator, in the course of developing personal services plans, to inform a prospective resident of the personal assistance services the residence offers. Policies related to the provision of care would be available to the occupant and any family members or representatives on request.

Advisory Bodies

Will the Registrar have a public or an industry advisory body?
The Registrar will determine what advisory bodies are required and their purpose. Some may be established on a specific, time-limited basis. Others may serve a longer-term function.

What is the Assisted Living Centre of Excellent (ALCE)?
The five associations in British Columbia to which assisted living operators belong are in the process of establishing an industry body to promote compliance with established standards and provide support and education for operators needing to improve their practices. ALCE will help develop health and safety criteria and standards for the assisted living industry. Representatives of the assisted living industry and assisted living occupants will govern ALCE.

Complaint Resolution

Who will deal with what types of complaints?
The Registrar will deal with six types of complaints about registered residence: abuse and neglect, health and safety standards violations, provision of more than two prescribed services, inability of occupants to direct their own care, operators not providing all five hospitality services. For a registered assisted living residence, the Registrar will deal with health and safety concerns and potential standards violations.

The Registrar will also respond to concerns that an unregistered assisted living residence is being operated. The Ministry of Community, Aboriginal and Women’s Services is developing approaches for addressing complaints about tenure and hospitality services not directly related to health or safety.

Will there be overriding guidelines for how residences handle complaints?
The health and safety standards require operators to establish an internal complaint resolution process and, wherever possible, resolve complaints on their own. The onsite inspection process and standards for resolving complaints will be developed by the Registrar in conjunction with ALCE.

Are there protections for occupants or staff who report concerns?
The Registrar is reviewing protections for occupants of assisted living residences who, in good faith, report abuse. It is likely the health and safety standards will be adjusted to stipulate that an operator must not threaten to discontinue services to an occupant because that person reported an abusive situation. Where an allegation of abuse is made, an operator will be required to submit a health and safety plan to ensure the protection of the resident while the investigation is underway. The Adult Guardianship Act provides employment protection for employees making legitimate reports of abuse or neglect and for assisting in an inquiry about abuse or neglect.

If an industry body investigates complaints on behalf of the Registrar, will it be impartial?
ALCE is in the best position to educate and mentor residence operators. The Registrar will develop a policy on the types of complaints that will be referred to ALCE for investigation. The Registrar’s contractual agreement with ALCE will also provide a framework for complaint investigation, including the criteria ALCE will use in assessing complaints, the timeframe for complaint resolution and a final report format that includes findings and recommendations. The Registrar will follow up if complainants feel their complaints were not fairly dealt with.

Who is responsible for evaluating the assisted living service system? Which ministry will take responsibility for dealing with systemic problems?
The Registrar will monitor health and safety concerns and report on systemic concerns to the Minister of Health Services. The Registrar may consult with other ministries if the issue is out of the scope of her responsibilities.

Moving Out

Why do people need to leave assisted living? Ideally, they should be able to age in place.
Assisted living is a form of housing and light, supportive care for seniors and people with disabilities who can select and direct the personal assistance services they need. When occupants are no longer able to do this or require ongoing professional nursing care, they need to move to a setting that offers more oversight, care and protection, such as a licensed care facility.

Will operators be given guidelines for determining when a resident is no longer able to direct their own care?
The Registrar and ALCE will work together on the development of policies to govern transfer and transitional care while awaiting the move to another level of care. The “exit” criteria (advice on when a resident must be referred to another level of care) will be described in the occupancy agreement. If a resident disagrees with the operator’s decision, the operator or occupant can seek assistance from the local health authority.