castle arms | cassellholme – organizational profile...d castle arms se n iors living man a g ement...

castle arms | cassellholme – organizational profile

managing care

D c a S T l e a r m S S e N i o r S l i v i N G m a N a G e m e N T

the Board of management determined their objectives through a consultative process. these objectives are fundamental to the on-going work at cassellholme.

accessWe will ensure that cassellholme’s secure resident environment is easily accessible to residents, families, caregivers and the community. that means more than physically-accessible spaces – it means keeping costs low, respecting language and cultural differences and much more.

equity

everyone in our diverse community is welcome at cassellholme and will be served with dignity and respect. this includes, but isn’t limited to, people of all economic situations, ages, ethnicity, sexual orientation or gender identity, religion and health status.

choice

When older ontarians are thinking about quality in a care home, they want choices in support services, transportation and connections to the community. cassellholme is already acknowledged as one of the best homes in the province and we intend to build on that reputation with expanded choices.

quality

everyone who works at cassellholme is providing quality care. Whether it’s tasty and nutritious meals, friendly staff, comfortable chairs, skilled healthcare providers, or good entertainment, we judge our success on our residents’ feedback. for the past few years, our survey results indicate satisfaction levels over 98%.

value

excellent care and innovation are top priorities at Cassellholme. We are the first not-for-profit care facility in ontario to promote entrepreneurial thinking and private sector investment.

We consistently look for ways to add value by improving practices and sharing our expertise. We’re proud of our high satisfaction ratings and the many clinical outcomes that exceed provincial averages.

We’ve managed all of this while reducing costs and creating new revenue opportunities. We are system innovators.

our commitments

c a S T l e a r m S S e N i o r S l i v i N G m a N a G e m e N T e

contents

WHERE WE CAME FROM 02

WHERE WE’RE HEADED 0405 re-imagining care07 castle arms Seniors living management08 who’s Paying for This?14 castle arms apartments

CASSELLHOLME TODAY 09

DELIVERING EXPERTISE 1111 mSSaa 12 DNSSaB 13 lSaa 14 Seniors villa of east Ferris15 v.o.N. & mow16 management Services clients17 castle arms apartments

THE TEAM 18

FORWARD... TOGETHER 21

CONTACTS 22

02 c a S T l e a r m S S e N i o r S l i v i N G m a N a G e m e N T

where we came fromin 1912 the ontario legislative assembly passed the “District houses of refuge act” for northern ontario to serve the unique and rapidly growing population of poor and indigent persons requiring custodial care. At the time, care was defined as a roof over the head and food in the stomach.

these homes were intended to serve all vulner-able persons, not just seniors. cassellholme has stayed true to that compassionate model of care for over 90 years. our new outward-focused vision will deliver an even broader choice of services.

cassellholme was originally built in 1924 with funding from 23 participating municipalities of nipissing. We continue to receive approximately 17% of our operating budget from nine of those municipalities.

shortly after the current building was constructed in 1962, the District of nipissing was split and cassellholme was designated as the District home for east nipissing.

in 1986, the Board of management created the non-profit seniors’ apartment corporation called Castle Arms. Today, these five buildings are home to more than 250 active seniors in north Bay and mattawa.

We will continue to be responsive to the needs of our diverse community with new care options, plus independent and assisted living services.

1924 – House of Refuge on Cassell Street, renamed Cassellholme by community

THEN$.07

resident/day

50LTC beds

60 unitsCastle Arms

NOW$229.00

resident/day

240LTC beds

241 unitsCastle Arms19

8819

24

c a S T l e a r m S S e N i o r S l i v i N G m a N a G e m e N T 03

Cassellholme in the near future

1982-1989 – construction [north wing, kitchen, restaurant, chapel and auditorium]

1982 – renovations [wards were renovated into private and semi-private rooms]

Cassellholme today

1986 – Castle Arms Senior Apartment Corporation was formed

1961– new Cassellholme is built to accommodate 196 Residents


where we’re headed

COMMUNITY

VulnerableCommunityMembers

+Volunteers

Castle Arms is consultingwith other communities –Seniors Villa of East Ferris,

Belvedere Heights,Trout Creek and Caresbridge –generating additional funding

for our new care model

MANAGEMENTSERVICESCASTLE

ARMS

Castle Arms I, II, III, IVand Mattawa [241 units]

+Life Lease [18 units]

ASSISTEDLIVING

Phased assistance to prolong individual social determination – a sort of supportive retirement living, with provided aid such as

homemaking, communal meals and PSWs [Personal Support Workers]

CASSELLHOLMELTC

224 LTC [Long-Term Care] Beds

+16 existing + 8 new = 24 DSU Beds

[Designated Specialized Units]+

16 Indigenous Unit Beds+

Commercial Court and

Seniors’ Wellness

MENU OF SERVICES

DevelopmentOperational [Cultural]

Maintenance [Support]Trouble Shooting [Transactional]

see a full list on pages 7 & 8

SENIORMANAGEMENT

TEAM


re-imagining care and a Fresh Business model the senior population is growing fast. in 2016, for the first time in history, there were more seniors than children in canada. today’s seniors are living longer and living well. growing old shouldn’t be scary – it should be a time to celebrate a life’s achievement, share knowledge and memories with others and continue to be part of your community.

cassellholme’s Board of management and local partners have adopted an entrepreneurial approach that looks beyond the traditional/historic model to make services available to all citizens, not just residents inside the buildings. our objec-tive is to reduce the need for long-term care and create a place for people to age in a healthy, active manner. We are also working towards reducing the volume of emergency room visits to the north Bay regional health centre.

The redevelopment plans focus on diversification of the existing site, with an expansion of service boundaries. here’s what you can expect:

� updated dementia-care units to meet a growing demand

� additional independent and assisted living facilities

� an additional 25-30,000ft2 in the existing north wing for clinical space and outreach programs

� complementary services such as medical clinics and counselling; rental spaces for groups such as the alzheimer Society and Nipissing University

� use of areas like laundry, kitchen and community spaces to support other functions such as seniors’ housing, community support [meals on wheels] and an assisted living complex

� committed resources for indigenous and Francophone clients

� completely new long-Term care units with the latest in technology

� community involvement, recreation, retail and much more

Cassellholme – proposed north elevation


our research highlighted a province-wide gap with respect to delivering seniors services and strong management practices. our history of creating a positive culture using policies, practices, relation-ships and experience has enabled our clients to save money, reduce grievances, improve compli-ance and deliver a higher quality of product.

Creating more benefits from a similar investment is the only way to make healthcare sustainable in the years ahead.

since 2015, our organization has received a greater than 98.5% satisfaction rate and high referral rates. Better culture translates into better care, reduction in costs and more satisfied Residents and families.

We will ensure financial sustainability, public accountability and innovative care solutions for our diverse community.

There will be no reduction in services to the community or our residents throughout the redevelopment process.

our family council and Board of management, plus local municipalities, service agencies, orga-nizations such as amo and advantage ontario, our local hospital and nipissing University were involved in this plan’s development.

although the redevelopment is driven by a desperate need for regional long-term care beds, our emphasis is to create change in the system and start supporting people sooner through enhance-ments to retirement living, supportive housing, home care, community involvement, etc.

When completed, we’ll have 120 new ltc beds, state-of-the-art equipment, specialized accommodation, larger parking lots, expanded green space, and a broader scope of service to the entire community.

Cassellholme – proposed west elevation


2. operational – building a positive, progres-sive and sustainable model a strong corporate culture fosters continuous improvement. it shows people how to work together, what values should drive their performance and what practices should be implemented to achieve the vision. critical foundational elements include:

� iT software & software suite require-ments [incredibly important]

� organizational chart[s] and job descriptions

� recruiting and on-boarding strategies and services

� full policy and procedures

� training packages

� pharmacy, physiotherapy and mainte-nance contractor procurement

3. maintenance – establishing quality business values, conventions and norms this phase can last 3 to 5 years and includes:

� management oversight & coaching senior team

� financial performance and reporting, including budget-to-actuals on a quarterly basis

� procurement and accounts payable

� accounts receivable [i.e. resident accounts]

� payroll, including T4 and year-end reconciliation

� human resources services – specifically labour relations

castle arms seniors living management castle arms seniors living management has earned a reputation for innovation, sound finan-cial management and the development of leading practices.

our goal is to share that experience and expertise with other organizations. While helping them, we can support our own organization by offsetting costs and creating modest revenue.

an innovative and practical vision is needed to navigate the healthcare system and meaning-fully serve today’s seniors. the ability to manage in a responsible and pragmatic manner is essen-tial. By sharing what we’ve learned about the complexities of the aging process, we can help more seniors live better lives.

1. Development – getting started on the right foot! castle arms seniors living management provides industry insights related to the organizational structure of projects. this may include:

� facilitating discussions with ministry officials

� working with architects

� developing a financial master plan

� designing an operational plan

� addressing operation related inquiries [i.e. furniture, fixtures and equipment, vendor selection, service contract advice]


castle arms seniors living management can also facilitate future growth in the following areas:

� branding, communication, website development and advertising

� transportation to complement resident activities

� establishing seniors’ recreation programs and/or day programs

� commercial offering [i.e. oT services, on-site physician office, clinic space]

� education/research foundation in conjunction with a local college and/or university.

management services clearly add to the orga-nization and are expected to help offset costs and create revenue to serve our community. We are a non-profit organization in which our share-holders are our clients. We see managing smaller ltc/supportive living and retirement homes as a means to help improve the overall quality of aging for many seniors.

� contract management [i.e. information technology, pharmacy, physiotherapy and facility contractors]

� service/qualitycontrol audits [i.e. clin-ical services, dietary, laundry, house-keeping and building maintenance]

4. Trouble shooting – we’ll be standing by! once up-and-running independently, castle arms seniors living management staff remain available with services and support in:

� payroll

� human resources

� coaching

� audits

� working with the local oHT, ontario Health or ministry of Health and long-Term care

capital plan

52% Provincial Expansion Funding $ 35,053,916

37% Municipal Capital Funding $ 25,000,000

11% Castle Arms Management Services $ 7,246,067

Estimated, non-tendered construction values.


castle arms seniors living management is a coordinated collection of a number of services – delivering long-term care for people 18 years of age and older. We also provide respite services for those that require short stay accom-modation. cassellholme builds and operates seniors housing through castle arms seniors living management. We currently have over 270 residents in our 241 units, in our six buildings.

the complex and evolving needs of the ever- growing population of seniors in the nipissing region is the top priority at cassellholme. Working with our community care partners: northeast lhin, DnssaB, V.o.n. meals on Wheels, Belvedere heights and the north Bay Alzheimer Society, Cassellholme has identified programs and services that maximize the quality of care we provide, safeguard financial sustain-ability and provide public accountability.

1. make long-Term care the method of last resort for the community.

� involve and engage seniors early, before disability or illness

� reduce emergency department visits and the demand for alc beds in the region

� assist in preventive measures/medical interventions

� address isolation and loneliness throughout our community

2. maximize quality of care at cassellholme.

� develop completely new long-Term care units with the latest technology and only private and semi-private rooms

� develop a Designated Specialized Unit for at-risk adults and for residents with behavioural issues [i.e. Dementia], acquired Brain injuries or addictions

3. integrate cassellholme and the community by expanding service boundaries.

� create spaces for the community within cassellholme – geriatric health clinic, recreational facilities, social programs, retail spaces

� share cassellholme’s expertise with other healthcare organizations

� invite our community partners to utilize spaces within our walls

Last year, through our community support division, we made over 33,000 house calls – providing services such as personal care, housekeeping and respite to seniors living in the nipissing region. castle arms seniors living management also hosts meals on Wheels, the Alzheimer Society, room rentals, salon services and special events.

cassellholme today


4. integrate cassellholme ‘families’ to increase community comfort with the levels of care available.

� add assisted living services such as adult Day Programs and integrate those residents with castle arms and cassellholme residents

� blend castle arms, cassellholme and assisted living residents/participants whenever possible

� operate a shuttle for transporting residents into the community for more activities. working with the Ne lHiN and the private sector [Ted Thomson Financial Partners] we launched a program in September, 2018 that re-opened the city to seniors to shop, bank, reconnect and participate in social events.

5. engage and provide spaces for our indigenous community.

� negotiate a partnership with the Nipissing First Nations community leadership to address our environment, staffing and culturally appropriate care

6. reduce staff and resident stress by recon-figuring the Behavioural beds within the Designated Specialized Unit [DSU].

� incorporate specialized sensory spaces [i.e. Snoezelen or other controlled multi-sensory environment – mSe]

� facilitate space to stroll and explore

� create access to outdoor areas to allow freedom for exercise and relaxation

7. maximize the spending power of the avail-able levels of funding.

� implement technology to reduce costs

� leverage local vendors and businesses [i.e. butchers, growers, grocers] to ensure our raw food budget goes further while providing higher quality food

� work with local hospital to provide a seamless continuum of care

8. Ensure financial sustainability.

� offer additional housing and services – accompanying fees will supplement existing revenue stream

� create retail and rental spaces for addi-tional income

� partner with the local hydro provider to reduce utility and operating costs

� export our in-house expertise to assist other “like” organizations – creating a modest income stream

� use additional revenue streams to offset the loss of levies from departing municipalities

We are invested in the health of our community and committed to compassionate care for life’s full journey.


delivering expertisemssaa – mUlti sector serVice accoUntaBility agreement

cassellholme community support services [ccss] is committed to a health care system as envisioned by the local health system integrations act 2006 that will further develop patient-centered, integrated, accountable, and transparent at-home community health care system.

We provide clients with high quality and continuous improvement in the delivery of health services and in all aspects of the health system, including iden-tifying and addressing the root causes of health inequities.

ccss is dedicated to servicing clients in their homes with personal support services including, but not limited to; personal care, homemaking, respite services, and home maintenance.

our intricate scheduling system provided 33,000 in-home visits with services in 2017 and continues to provide evolving provincial priorities.

our employees travel to the homes of each of their clients, sometimes multiple times per day in order to provide specialized services to the individuals who are enrolled in our program.

the mssaa project is owned in collaboration between cassellholme and the lhin - local health integration network.

this service accountability agreement reflects and supports the commitment of the lhin and cassellholme community support services [ccss].

1979 – ongoing

Project Value: $2,235,014 per year


delivering expertiseDnssaB – the District of nipissing social serVices aDministration BoarD – afforDaBle seniors hoUsing

castle arms apartments provide 241 apart-ments that offer a market rent/affordable rent program and a rent geared-to-income program. as part of this contract, castle arms apartments must maintain eligibility guidelines for prospective tenants, manage a wait list, adhere to occupancy standards and maintain all assets associated.

tenants undergo an evaluation process in order to become eligible for housing and services.

affordable seniors housing is jointly operated by the District of nipissing social services Administration Board and Castle Arms Non-Profit apartment corporation.

this service agreement reflects and supports the commitment of the nipissing social services Administration Board and Castle Arms Non-Profit apartment corporation.

1993 – ongoing

Project Value: $818,902 per year

Housing vulnerable people has been our mission for close to a century. a community grows stronger by ensuring that all citizens are treated with respect and care.


lsaa – long-term care home serVice accoUntaBility agreement

cassellholme is committed to the vision of the local health system integrations act 2006 that will further develop a patient-centered, integrated, accountable and transparent health care system.

We provide residents with continuous improve-ment in the delivery of high quality health services, in all aspects of the health system, including iden-tifying and addressing the root causes of health inequities. cassellholme is dedicated to providing personal support services including; activities of daily living, medication, administration, meal service, housekeeping, laundry services and end-of-life care.

We provide specialized services to 240 residents in long-term care on a daily basis, including orga-nizing information for each individual’s unique care requirements.

cassellholme also coordinates outings and appointments for our residents. We ensure that the appropriate measures are in place to safely transport and care for seniors between the long-term care home and various destinations throughout north Bay and surrounding area.

delivering expertisethe lsaa project is jointly operated by cassellholme long-term care and the lhin - local health integration network.

this service accountability agreement reflects and supports the commitment of the lhin and cassellholme long-term care.

1963 – ongoing



delivering expertiseseniors Villa of east ferris

seniors Villa of east ferris provides 28 apartments that offer an affordable rent program.

as part of this contract, east ferris must main-tain eligibility guidelines for prospective tenants, manage a wait list, adhere to occupancy stan-dards and maintain all assets associated.

there is an evaluation process, based on points, which tenants must undergo in order to become eligible for housing. eight of the apartments are fully accessible.

Project Management: $30,000/year


delivering expertiseV.o.n. – Victorian orDer of nUrses - moW – meals on Wheels

cassellholme’s meals on Wheels program is committed to providing an outreach program, assisting frail, elderly community members who require assistance in the activities of daily living.

this moW program is a community service that delivers nutritious meals to individuals living in their own homes. the program provides our clients with high quality nutritious meals on a daily basis, within the community of north Bay. We service more than 275 clients, providing over 12,780 meals to our community each year.

the cassellholme meals on Wheels specialized service takes into account the dietary needs and restrictions of every client.

We schedule each client’s delivery times and number of meals based on an assessment of their needs. there is an evaluation process in order to become eligible to receive meals on Wheels services.

meals on Wheels – moW, is jointly operated by the Victorian order of nurses – Von, and the cassellholme meals on Wheels program.

this service agreement reflects and supports the commitment of the Victorian order of nurses and cassellholme meals on Wheels program.

Pre-dates 1985 – ongoing

Project Value: $102,000 per year


delivering expertisemanagement serVices clients

Belvedere heightsRevamping their financial systems, we created a more useable and efficient budget. We focussed on enabling them to recognize financial issues before they became problems. our cfo fashioned the general ledger – making monthly budget-to-actuals more accessible to the organization and Board of management. castle arms seniors living management set up a budgeting regime to ensure a more accurate outcome.

Management Fee: $30,000/year

trout creekthe day the ministry of health and long-term care revoked the licence of the owner of the lady isabelle home, castle arms seniors living management stepped in to assist the community with developing a new senior’s campus. this included negotiating with the Minister’s Office, Ministry staff, local munici-pality, designing a number of financial models for the owner, participating in a “town hall meeting,” working with a developer, architect and engineers and helping to organize a contractor. the campus will ultimately include a seniors living complex, inde-pendent living space and a long-term care facility.

Phase One - Planning $20,000

Construction Value $33,000,000 at maturity

caresbridgelike the trout creek project, we have worked with this developer to bring the pieces of a senior’s campus to life. however, the group continues to search for a suitable parcel of land in the Durham region. castle arms seniors living management will assist with this project once the site is secured.

Value Undisclosed


delivering expertisecastle arms apartments [i, ii, iii, iV & mattaWa]

residents enjoy independent living in a secure setting, with the convenience of a variety of services available:

� activity spaces and programming

� transportation for shopping, bank trips and excursions

� alzheimer’s Day programs

� outdoor bbq and gardening spaces

� community support services [rN, PSws & homemakers]

as part of our restructuring, a number of units in the current building will be developed as “life-lease” units. this will give seniors who want to own their own place, but desire the security that comes with being part of a supportive commu-nity, a great option for aging in place. close to shopping, transit and entertainment, castle arms apartments are a desirable and convenient place to call home!

castle arms apartments currently offer 241 one and two bedroom market rent and rent-geared-to-income apartments for adults 65+.

1986 – ongoing



COMMUNITYSUPPORTSERVICES

250 clients

33,000 homevisits per year

Mattawa to WestNipissing

service area

CASSELLHOLMELONG-TERM

CARE

240 LTC beds

320+ employees

98% +satisfaction rating

CASTLEARMS

APARTMENTS

271 tenants

6 buildings

Mattawa,North Bay,East Ferris

MANAGEMENTSERVICES

retirementand

supportivehousing

EXECUTIVE COMPOSITION – CASTLE ARMS

Chief inancial Officer, Richard Campbell CPA

Resident xperience Lead, illian uchesne

Retirement Living Lead, Camille Bigras RPN

Clinical Advisor, r. Paul Preston

ietitian Nutritional Lead, Tara Blake

CASTLE ARMS | CASSELLHOLMEamie Lowery, Chief Executive Officer

CASTLE ARMS

the team


senior executivesJamie Lowery – Chief Executive Officer Jamie is a flexible, compassionate team player who leads by example. his vision is to integrate long-term care into communities and bring community life into long-term care.

Jamie has decades of experience managing large complex organizations with multiple loca-tions. he is a skilled strategic thinker, with the ability to translate complex regulatory issues. he understands the importance of communication and cooperation with all levels of government, internal unions, and community partners.

During his time as ceo of cassellholme east nipissing District home for the aged, Jamie introduced an enterprise model for ltc that helps realize new revenue streams. castle arms is currently managing senior and retirement living projects in st. thomas and east ferris, while developing projects in newmarket, muskokas and Belleville.

By re-imagining the delivery of services, refining systems and ensuring staff are productive, Jamie has become a catalyst for change in ltc in ontario.

Richard Campbell – Chief Financial Officer Ric has managed finances in Long-Term Care for over thirty years. he has been instrumental in castle arms seniors living management efforts to help a variety of LTC Homes solidify their finan-cial planning and recording procedures. he is a detail-oriented team-player who enjoys passing on his proven best practices.

ric has the depth of experience required to main-tain the finances of a large organization, while balancing the needs of other smaller projects.

in the employ of cassellholme, he maintained complex and transparent financial records, deliv-ered timely reports and managed a staff of highly skilled individuals.

His background with a not-for-profit municipally-funded organization and his experience organizing the care of vulnerable individuals within the north Bay region, make ric a valuable asset.

camille Bigras rpn - retirement living lead camille has spent two decades as a healthcare practitioner and leader – including serving as the administrator of a retirement and supportive housing enterprise [marina point retirement Village – north Bay].

her expertise includes developing and imple-menting compliance systems, promoting profes-sional links between healthcare professionals and the community, educational sessions for Developmental services staff, training workshops for physicians and community partners, over-seeing complaints, staff resolutions, recruitment and performance reviews.

camille’s current role is grounded in leading the delivery of care and ensuring coordination among the various departments [Dietary, activation, housekeeping, maintenance and clinical].

Jillian duchesne - resident experience leadJilly has over 15 years of ltc experience, with a broad exposure to key departments. her passion is resident and family advocacy. she is a skilled communicator and problem-solver, often called upon to assist on multidisciplinary teams. in addi-tion to helping families and residents adjust to their new accommodations, Jilly currently leads the charitable foundation at cassellholme. her positive, customer-service philosophy leads to innovative and effective client-centred outcomes.


Dr. Paul Preston, Clinical Advisorpaul is the is the ontario health [north] clinical Vp. he has practised in northeastern ontario for 30+ years in a variety of roles including: medical Director and chief of primary care at nBrhc, family physician at the Blue sky fht, in long-term care and with inmates at the north Bay Jail. he is also an assistant professor in the northern ontario school of medicine.

Paul is the first to hold this new position at Ontario health [north], formerly ne lhin. it was created as part of putting the patients first legislation into action – connecting primary care to other parts of the healthcare system. he brings an in-depth understanding of day-to-day patient realities to government policy and delivery decisions.

after accepting the position, paul told reporters, “no decision that affects medical care will be made without a medical opinion ...it makes sense to have a responsible physician embedded near the top.”

Tara Blake, Dietitian/Nutrition Leadtara was formerly with the lady isabelle nursing home. she brings 23 years of experience in the community to the job.

tara will oversee the assessment, monitoring and evaluation of resident’s nutrition care plans. she is a skilled educator for both patients and staff. tara believes in life-long learning to expand skills, as well as professional and regulatory experi-ence. she is a strong team player with excellent communication skills.


the complex and evolving needs of seniors in the nipissing region is a top priority at castle arms senior living management and cassellholme. the Board of management is committed to doing more than simply replacing old beds – we want to help enhance the system.

investing in this project is a step forward for both the healthcare system and the quality of life for those we serve. While the project considers the needs of medically complex residents, it also focuses on enriching and enhancing all citizens’ life journey.

We genuinely want to be a constructive partner and a leader in the provision of seniors’ care.

the goal is to make long-term care the method of last resort by:

� keeping seniors involved and engaged

� reducing emergency Department visits

� assisting in preventive measures/medical interventions and addressing isolation and loneliness in our community

� developing and growing organizations to better serve seniors in a manner that is financially responsible and sustainable, as well as meeting the goals and interests of our clients

forward...together


contacts

BDO Canada LLP, North BayDeaN Decaire, ParTNerTel: [email protected]

North East Local Health Integration Network / Réseau local d’intégration des services de santé du Nord-Est

meGaN waqUé,SUB-reGioN DirecTor /DirecTrice De la GraNDe réGioNTel: 705.482.0261cell: [email protected]

Alzheimer Society Sudbury – Manitoulin, North Bay

STePHaNie leclair, execUTive DirecTorTel: [email protected]


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jamie loweryceo, caSSellHolme aND caSTle armS705-474-4250 exT. [email protected] olive STreeTNorTH Bay, oN P1B 6j4

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