b'SPEECH-LANGUAGE PATHOLOGYImplementing on-sitespeech-languagepathology atKensington HealthBy Joshua ChanT he Gardens, the long-termInsufficient staff support How this SLP Modelcare sector of KensingtonFrontline teams struggled to maintainis structured Health, piloted an on-sitea consistent and safe approach toThe Gardens launched its dedicated Speech-Language Pathology (SLP)feeding and swallowing. Nurseson-site SLP model on August 1, 2024. service model in response to internaland dietitians often had questionsAlthough implemented in partnership observations, sector-wide evidence,or concerns about diet textures orwith external providers, the model and recognition that existingaspiration risks but lacked timelywas deliberately structured so that the dysphagia management was notaccess to the specialized expertiseSLP functioned as a fully integrated adequately meeting the needs ofrequired for confident decision- member of the Kensington team.residents or staff.making. This created variability inConsistent presence and staffing Their experience mirrors thecare, uncertainty among staff, and challenges faced by many long-termput stress on team members to makeThe Gardens assigned one regular care organizations across Ontario:decisions outside their primary scopeSLP on-site one day per week, rather increasingly complex resident needs,of practice. than a rotating pool. Continuity allows rising choking incidents, limitedthe clinician to build familiarity with Long waits and limited scoperesidents, understand unit dynamics, access to external SLPs, and thewith standard SLP modeland collaborate effectively with team overextension of existing clinical staff such as registered dietitians (RDs).Traditionally, swallowing concernsmembers. This relationship-building is By establishing a dedicated on-sitewere referred externally to Ontarioessential for resident-centred care and SLP model, Kensington sought toHealth at Home. This involvedfor reliable follow-up.strengthen resident safety, streamlinemultiple steps: identifying whoDefined responsibilities processes, and build a morecould submit, navigating the RM&R collaborative and competent circle ofsystem, faxing forms, interacting withThe SLPs scope includes:care within their long-term care coordinators, and waiting forSwallowing assessments care home. agencies to find an available clinician. Dysphagia management, with Delays of two to four weeks were Why Kensington decided toeducation to residents and staff on introduce an onsite SLPcommon. Many assessments werealtered diet texturesThe Gardens decision was shapedvirtual, limiting access for residents with cognitive impairment or oral- Recommendations for safe by three major pressures that increasingly affected clinical qualitymotor challenges. These systemicswallowing strategiesand confidence across the home. barriers reinforced that a different approach was needed. Support for resident Rising choking incidents andcommunication challengesunmanaged dysphagiaA literature review confirmed that Over recent years, the Gardensthese issues were widespread inThis last point is significant: because experienced an increase in chokinglong-term care across Canada:traditional community-based SLPs incidents, some of which becamelimited SLP availability, highprioritize dysphagia-related concerns, critical events. These incidents aredysphagia prevalence, and reliancethe Gardens intentionally created a often traced back to incomplete oron non-SLP clinicians for swallowingbroader scope to support itsmissing documentation, inconsistentcare. Recognizing the risks ofresidents needs.swallowing assessments, anddelayed specialized care and theIntegrated onboardingmissed signs of aspiration risk. Withmounting pressure on staff, theand training 350 residentsmany presentingGardens chose to challenge theKensington treats the contracted SLP with complex needsthe Gardensstatus quo and design a modellike a regular staff member:recognized that failing to managethat aligned with their circle-of-care dysphagia properly was a seriousphilosophy: holistic, resident-centredFull organizational orientation andsafety concern. and team-based. access to training modules46 LONG TERM CARE TODAY Spring/Summer 2026'