Home Care in Ontario: How to Choose a Provider That’s Right for You

September 18, 2018

Finding the right home care provider can be a complicated process. With so many factors to consider like pricing, policies, and accreditation status, it can be hard to know where to start. That’s why this guide was created – to help you gather all the information needed before choosing a home care provider that’s right for you.

Background on Home Care in Ontario

In 2015-2016, service providers delivered over 39 million visits of publicly funded home care in Ontario, costing on average $3,400 per person. ^[1] Although the amount of publicly funded care provided by the Ontario government is substantial, some individuals don’t qualify or may require additional services, and often look towards purchasing additional care privately.

That’s why every year an estimated 150,000 Ontarians purchase private home care service to supplement care provided by the publicly funded system.^[2]

With long wait-lists (sometimes up to 5 years!) and high costs for long-term care homes, private home care is a great option for individuals that wish to remain independent in the comfort of their own home.^[3]

Publicly Funded Home Care vs. Private Home Care

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Publicly Funded Home Care

Publicly funded home care in Ontario is funded by the government, or more specifically, the Local Health Integration Networks (LHINs). These LHINs determine the level of care needed, as well as how long you’ll receive care. To apply for publicly funded home care, you would follow these steps.

The different home care services that the LHINs will fund include:

What most people don’t know, however, is that the LHINs aren’t the service providers themselves. Instead, they contract out the care to other organizations. The LHINs determine your care plan, and then pass on the service delivery requirements to a separate organization to provide the care. This is important to know, because most of the time these contracted organizations are the same ones you’d come across during your search for a private home care provider.

For more information about how the healthcare system works in Ontario, take a look at this guide Healthcare in Ontario: How does it Work and How is it Funded?

Private Home Care

Individuals may require private care services if:

They don’t qualify for publicly funded home care
They wish to supplement their publicly funded care with additional hours or services

Most often, home care providers that have a contract with the LHIN to provide publicly funded care will also provide private home care. If you’re already receiving care and are happy with the services you’re receiving, you can speak with the company directly about paying privately for more hours. If, however, you’re not happy with the service you’re receiving, you have every right to choose a different company when looking for private care.

When paying for private home care, you can choose to pay out-of-pocket, through private insurance, or through workplace benefit programs. But with so many companies offering home care, it’s important to ask the right questions and gather the right information when looking for a service provider.

Creating a Pool of Home Care Service Providers

Think of selecting a home care provider the same way as you would any other purchase decision; it’s very much like buying a car. You may have some brands in mind, a few models, colours, etc. on your long list, but you need to narrow that list down to just one perfect car, for the right price of course.

When shopping for a car, you can take test drives without any commitments. Although you always have the option of switching home care providers, you’d probably rather make the right choice the first time. Especially when you’re trusting this provider to come into your home and care for yourself or a loved one, you want to be absolutely sure the organization is reputable, trustworthy, and has proper hiring policies, among other factors.

Accreditation & Awards

You can get a good sense of what level of care you will receive by whether the home care provider is accredited. When a company has accreditation, it means that a third-party authority has assessed, recognized, and validated that they have excellent standards and use best practices. Some accreditation’s that you can look out for (often visible on a provider’s website) include:

Accreditation Canada: As a leading health care accreditation body in Canada, they work closely with health and social services organizations to drive positive change in the Canadian healthcare system. Home care providers get tested on hundreds of standards across several different categories. There are three levels of achievements that can be awarded, with Exemplary Standing being the highest.
ISO 9001:2015 Quality Management System : If a home care provider is an ISO 9001 registered company, it means that the provider has been designated as following stringent quality standards in the areas of customer satisfaction and service delivery.

Accreditation Canada and ISO

There are various other awards and accreditation’s, such as CARF and Canada’s Most Admired Award, but the ones listed above are the main ones to look out for when shopping for a home care provider.

Quick tip: When looking for these accreditation’s on a company’s website, take a look at the “About Us” page, or scroll down to the bottom and look in the footer section. A home care provider will proudly promote the fact that they have these qualifications!

Home Care Association Membership

The Canadian Home Care Association (CHCA) is a non-profit association in which its members include representatives from government, administration organizations, service providers, researchers, educators, and more. This association coordinates the sharing of information and manages projects that address priorities in the home care sector.

CHCA also acts as a catalyst for advancing excellence in home and continuing care. You will most-likely see a home care provider’s CHCA membership displayed alongside their other accreditations and designations.

If a company doesn’t have a CHCA membership, don’t cross them off the list immediately, but having this membership does emphasize the provider’s vision to help improve the home care sector.

Canadian Home Care Association

Number of Years Serving Your Community

Like most private organizations, when a company has provided services to a community for several years, it’s most-likely because they’re good at what they do. This holds true for home care providers – look for a provider that has a long history of providing care in Canada, with a good reputation throughout the community.

Most providers will also promote their involvement in the community. You should be able to find out if the home care provider has participated in any community sponsorship’s, charities, or medical research funding. A company that cares about its community is likely to care about its patients as well.

Quick tip: Some companies place their strategic plan in their “About Us” section of their website. Not only will you be able to see what they’ve done in the past, but you’ll see what they hope to do in the future as well.

male care provider

Reviews and Ratings

There’s some truth to the belief that people will leave a complaint more often than a compliment; however, low ratings and poor reviews are something to consider when choosing a home care provider.

Keep in mind that the number of reviews/ratings is also something to look at, and remember that one single negative review can skew the company’s overall rating if they only have a few reviews. More importantly, make sure to look beyond the number of reviews and overall score, and look at the content within the reviews to see what people are actually saying about the company.

Contract with the LHINs

As a reminder, publicly funded home care is coordinated through the LHINs, but the actual service delivery is through separate organizations. This means that when a home care provider has a contract with the LHIN, the government has done their due diligence and trusts the provider to deliver high-quality care. This is because home care providers are required to participate in an extensive prequalification and qualification process in order to be awarded a contract.

To find what service providers have contracts with the LHINs and for which services, you can look at Healthcare at Home’s Service Provider Listing and then download the Excel attachment – “Service Provider Organization Lists (Excel)” – at the bottom of the page. If a home care provider has a contract with a LHIN, it’s a good sign that they’re qualified to provide excellent home care.

Narrowing Your Pool of Providers – Creating a Short List

Now that we’ve made a list of potential home care providers, it’s time to narrow down that list by looking at staffing, policies, services, and costs, amongst others. For any of these factors, it’s a great idea to call, email, or chat with someone from each company; they’ll be happy to answer any questions you may have.

Service Providers

Each service provider (nurse, personal support worker, physiotherapist, etc.) will have different types of certifications and different levels of education. For example, if you’re looking for a physiotherapist, you should check that the company’s physiotherapists are all registered with the College of Physiotherapists of Ontario in good standing.

You should also consider the ways in which a company shows appreciation for their staff; whether it’s through monetary rewards, workplace benefits, ongoing training, or similar. Think of it this way – if an employee is happy with their employer, they’ll likely transfer that joy to their work.

Quick tip: If you want to know how much a provider pays its caregivers, check job postings for a similar role; you might be able to find information about wages, training, and if there’s a benefits program. Websites like Indeed, Workopolis and Glassdoor are a great place to start.

Provider Hours

Individuals that require home care, especially those that need personal support or nursing, will most likely need help outside of the typical 9am-5pm day. Most company’s now offer 24/7 care for support services, even during holidays, so this shouldn’t be an issue. You should also consider that your schedule may change and/or you might need additional hours, so you’ll want a provider that is flexible and can accommodate your needs.

Provider Consistency

It’s never a comfortable situation to have a stranger come into your home. That’s why it’s important to ask if you’ll have the same service provider on a regular basis. Eventually, you or your loved one will build a relationship with the provider, and when someone enters your home, trust is a priority.

Of course, scheduling issues may arise and it may not be possible to have the same provider perform every visit. But the company should do their best to make you feel comfortable in your own home, and that means staying consistent with the providers they send over.

Languages Spoken

Ontario is a very diverse province that speaks a number of different languages. If your native language is something other than English, it may be difficult to find an organization that can match you with a service provider that speaks your language. But that doesn’t mean you shouldn’t ask. When speaking with a representative, it’s worth inquiring about the different languages spoken by their services providers.

Customer Service

Customer Service Hours

In case you need to cancel an appointment or schedule additional home care visits, having access to customer service at all times is crucial. Whether it’s online chat support or a call centre, having someone to speak with 24/7 will help put your mind at ease.

Compliments & Complaints

If you have any feedback for your service provider, whether positive or negative, you should be able to easily provide a compliment or a complaint. A good home care provider will have a process for documenting these compliments and complaints, and should be able to share this information with you upon request.

Policies & Procedures

The policies and procedures that a home care provider has put in place are representative of the level of care you can expect to receive. Most companies will review specific policies and guidelines when hiring and training their employees, including things like:

Confidentiality & privacy policies
Social media usage guidelines
Client safety policies
Workplace violence and sexual harassment training
New medical equipment training
Criminal & health screening checks
Falls prevention policies

Let’s take a look at just a few of these and see how they can impact your decision when searching for a home care provider.

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Criminal & Health Screening Checks

Although most organizations are not legally obligated to request police record checks when screening individuals, most Canadian companies do require a criminal record check prior to an employee’s start date. In addition, there are a variety of different health screening checks that healthcare professionals may be required to get, including:

Health history (vaccines, health conditions, etc.)
Vital signs, height and weight
General physical assessment and range of motion
Vision and hearing screen
The Kraus Weber back assessment
Spirometry
Initial fit test (to verify the employee can perform lifts and transfers)

Confidentiality & Privacy

In Canada, legislation has been implemented that limits how businesses can use the information about their clients. The federal privacy law for private-sector organizations that outlines the rules for how businesses must handle personal information is called the Personal Information Protection and Electronic Documents Act (PIPEDA for short). Additionally, the Personal Health Information Protection Act (PHIPA) provides clear direction on the management of personal health information. For more information, visit the Summary of Privacy Laws in Canada web page on the Office of the Privacy Commissioner of Canada’s website.

What does all of this mean? Well, a home care provider should have a policy that outlines:

The purpose of collecting the information
The description of consent for both the individual and the company
Who has access to the information
How the company plans to keep your information confidential and avoid information leaks
The retention period of the information
Employee accountability. This could include a description of the role of the company’s Privacy Officer, office audits, privacy initiatives, privacy reviews, etc.
Safeguards set in place to protect the information
Procedures and documents set in place to educate employees about these policies

Falls Prevention Policy

Unfortunately, falls are extremely common, especially for older adults. Although home support does help minimize the risk of falls, there is still a chance that a fall can occur. It’s worth knowing if a company has a falls prevention policy that outlines how their employees manage this risk. There should be preventative measures to help avoid falls, and reactive measure in case a fall was to occur.

To learn more about falls prevention, check out this handy guide How to Prevent Falls: A Complete Falls Prevention Guide for Seniors and Caregivers.

Costs & Billing

Price

Price is always important, but it shouldn’t be the main factor when deciding on a home care provider. For example, a higher costing organization might be priced this way because they pay their staff higher wages, and that employee satisfaction can translate into better job performance.

Or you might choose to go with the cheapest option by finding a service provider that works independently from organizations. But searching through this “grey market” of independent providers comes with its own risks to consider:

Who is doing a background check on the provider?
Who will take accountability if things go missing from your home?
What happens if the provider goes on vacation?
Will they be available 24/7 if you need to change or cancel a visit?

Think about it like this, do you really want to cut corners and choose the cheapest option when deciding who to let into your house to care for a loved one?

Although the cost of home care may seem like an extremely important factor, it’s not. The most important things to consider are the company’s reputation, their policies, and your overall satisfaction.

Some companies also help navigate funding options such as the Ontario Disability Support Program and Veterans Affairs Canada. It’s a good idea to check if you’re eligible for any of these funding programs – it never hurts to ask.

Quick tip: Ask if there are any discounts offered based on the number of hours you’re expecting to purchase.

Payment Methods

How an individual wishes to pay for home care services is completely personal preference. Whether paying online by credit card, sending a cheque, calling in to pay over the phone, or setting up automatic payments, there is no one way that’s better than the others. Consider which method you prefer, and see if it’s offered by the companies on your list.

Selecting Your Home Care Provider

Hopefully you’ve narrowed your list quite a bit and you have just a few providers in mind. It may be useful to put all of the considerations mentioned above into a simple checklist, to compare your options. Remember, people have different expectations and set different levels of standards when making purchase decisions; there is no right or wrong decision, just the decision that’s right for you.

Home Care Chart checklist