What to Ask a Long-Term Care Home About Cleaning

What the province already asks

The Ministry's Checklist: Visiting a long-term care home is what most families are handed or find online. Across eleven pages it covers location, amenities, residents' rooms, washrooms, food and dining, staff, health care, daily life and family involvement in real detail. On cleaning, in full, it asks you to check that the home and grounds "look clean, well-maintained", that inside the home is "clean", "well maintained" and "odour-free", that washrooms are "clean, odour-free and in good repair", and that there are clean towels. Then it gives you four questions: how often are the washrooms cleaned, what are the home's policies regarding housekeeping, how often are personal clothes laundered, and how often are wheelchairs and walkers cleaned.

That last one is a better question than most families realise, and we come back to it below. But look at the shape of the set: they are all frequency and appearance. None of them asks how the cleaning is done, what with, who does it, or what happens when things go wrong — and in a building where infection moves between frail people, those are the questions that separate homes.

We clean commercial and care buildings for a living, so what follows is the part we can add. It is not a way to catch a home out. Most of it is what a well-run home is already doing.

Why "odour-free" is the wrong test

This is the most useful thing on this page, so it goes first.

Almost every family judges a home by smell in the first thirty seconds, and the province's checklist reinforces it by asking for "odour-free" twice. But a long-term care home is a building where a hundred frail people live twenty-four hours a day. Something will occasionally smell. A brief odour outside one room at eleven in the morning almost always means somebody had an accident and it is being dealt with right now, which is the system working.

Three things are worth noticing instead of a simple pass or fail:

• Is it contained or spread? One room is life. A whole corridor, or a wing, is a resourcing problem — it means things are not being reached quickly enough.
• Is it there at every hour? A smell that is present at 10am, when the morning round has just finished, is telling you something different from one at 7pm.
• Is anything covering it? A heavy floral or chemical smell should worry you more than a faint real one. Masking is a decision somebody made instead of cleaning. Plug-in fragrance units in corridors are worth one gentle question.

The same logic applies to a home that is immaculate on the day you visit. You are seeing one hour of a building that runs continuously. If you can, visit twice, and make one visit awkward — a weekend, an evening, right after a mealtime. Nothing else you can do as a family tells you as much.

The question the checklist doesn't ask: shared equipment

In a long-term care home, the highest-risk surfaces are not the floors or even the washrooms. They are the things that move from one resident to another. This is the single biggest gap between how families evaluate a home and how infection actually travels in one.

The items worth naming:

• Commodes and toilet chairs — shared in many homes, and the item where "between residents, not at end of shift" matters most.
• Transfer and ceiling-lift slings — these go under a person's body and are frequently shared. A sling is usually laundered rather than wiped, and a good home will know immediately which of its slings are resident-assigned and which are pooled.
• Wheelchairs, walkers and tub chairs — the Ministry asks how often these are cleaned. The better follow-up is who does it, and whether it happens on a schedule or between users.
• Bath lifts and shower trolleys — used by many residents in a single morning.
• Shared clinical items — blood pressure cuffs, glucometers, thermometers, pulse oximeters. These are the nursing team's responsibility rather than housekeeping's, and it is fair to ask who owns cleaning them, because a shared item with no clear owner is the one that gets missed.

You are not auditing anybody. Asking "how does a commode get cleaned between two residents?" takes ten seconds, and the quality of the answer — a clear description versus a vague one — tells you more than any amount of looking at floors.

How the cleaning is resourced

In an Ontario long-term care home, housekeeping, bed linens and laundry are part of what the home provides. They are not optional extras you pay for on top, the way they usually are in a retirement home. That sounds like good news, and it is — but it has a consequence worth understanding: because cleaning is bundled rather than itemised, under-resourcing it never shows up on a bill. It shows up as a corridor that smells at four in the afternoon.

So the useful questions are about staffing, not cost:

• How many housekeeping staff are on during the day? Is anyone on in the evening?
• Does that number change at weekends and on holidays?
• What happens when a housekeeper calls in sick — is there cover, or does the work simply not happen that day?
• Is housekeeping in-house or contracted? Either is fine. What you want to hear is that somebody in the building owns the standard, whichever it is.
• Is there a record of what was cleaned and when? Most well-run homes keep one.

The last two are the ones we would ask, because they are the difference between cleaning as a system and cleaning as whoever-gets-to-it.

Two things that decide whether cleaning works at all

These are technical, they are the same in every setting we work in, and they cost nothing to get right.

Clean first, then disinfect

Disinfectants are inactivated by organic matter. Applying one to a surface that still has soil on it largely wastes the product and leaves the surface contaminated. The order is always two steps: clean with detergent to physically remove the soil, then disinfect the surface that is now clean.

Contact time

Every disinfectant label states a contact time — how long the surface must stay visibly wet for the product to do what the label claims. It is often several minutes. A surface sprayed and immediately wiped dry has been cleaned, not disinfected. This is the most commonly skipped step in every kind of building, and it is why a room can look clean, smell clean, and still not be disinfected.

You will not stand there timing anybody. But if you ask what product is used and hear a description that includes leaving it wet, you are talking to a home that trains its staff properly.

Outbreaks: ask what changes, not whether they happen

The Ministry checklist does ask one strong question here — "what policies does the home have in place to protect residents from infectious diseases?" — and it deserves a real answer rather than a reassurance.

Outbreaks happen in long-term care homes. Any home claiming otherwise is either new or not telling you. What distinguishes homes is what changes when one is declared. Reasonable things to ask:

• What increases — how much more often are high-touch surfaces and washrooms done?
• Does the product change? For some organisms it has to, because the usual disinfectant will not do the job.
• Who is told, how quickly, and by what method — do families get a call, an email, a notice at the door?
• How are visits handled, and how is that decision communicated?

How a home talks about its last outbreak is more informative than whether it had one. Openness here is a good sign, not a bad one.

What you can look up and who you can call

More is available to families than most people realise, and all of it is free.

• The province's home search tool. Ontario publishes a long-term care home search on ontario.ca, alongside a three-step guide to choosing a home. Applications themselves go through Ontario Health atHome, whose placement coordinators know every home in your area — and you may apply to a maximum of five homes.
• The home's complaints process, posted publicly. By law every Ontario long-term care home must have a formal complaints process and must post it somewhere residents and the public can easily see it. If you cannot find it on a tour, ask the office. Its absence is itself an answer.
• Inspection reports. The Ministry of Long-Term Care oversees compliance with the Fixing Long-Term Care Act, 2021. Where an inspection follows a complaint, the ministry's own guidance to families says the inspector may explain how the report will be made publicly available. You can also simply ask a home for its recent inspection results — how readily it shares them is informative.
• The Long-Term Care Family Support and Action Line — 1-866-434-0144, open 8:30am to 7:00pm, seven days a week. You do not have to give your name, and the Act protects people who report concerns.
• The Patient Ombudsman — 1-888-321-0339, once you have tried the home and the Action Line.
• The family council. Not every home has one, but every home must offer the opportunity to form one. Asking whether there is a council, what it has raised and what came of it is one of the best questions on the Ministry's whole checklist.

If you complain to the home, it must let you know within 10 business days what it is doing about it. If your complaint alleges harm or risk of harm, the home must investigate immediately and send it to the ministry straight away.

Retirement home or long-term care home?

Families often use the terms interchangeably, and on cleaning they are genuinely different products with different regulators.

If the building you are touring is a retirement home, the housekeeping questions above still apply — but ask what is included in the base rent and what is billed on top, because that varies from home to home in a way it does not in long-term care.

What none of this means

It would be easy to take a list like this into a tour and go looking for failures. That would give you a worse decision, not a better one.

Long-term care homes in this province are staffed by people doing hard work under real constraints, and housekeeping is usually the first department squeezed and the last one thanked. The person showing you around is often a manager or a family liaison who does not set the housekeeping budget and may not know how many staff are on this Sunday. Not knowing is not the same as not caring.

What you are listening for is whether cleaning is a system or a hope. A system has named owners, a schedule that covers the awkward hours, a product chosen deliberately, a plan for the day somebody is off, and something written down. A hope has good people and a bad week. That difference shows in the answers well before it shows in the building.

And if a home answers all of this easily — say so. Housekeeping teams are almost never told they are doing well by anybody outside the building.

Frequently asked questions

What should I ask a long-term care home about cleaning?

Ontario's own visiting checklist asks whether the home looks clean and is odour-free, and how often washrooms are cleaned. Those are worth asking, but three others tell you more: how shared equipment is cleaned between residents, how many housekeeping staff are on and whether that changes at weekends, and what actually changes during an outbreak. Those three are about how the work is resourced rather than how the building looks on the day you visit.

Should a long-term care home smell of nothing?

No, and this is the most useful thing to understand before a tour. A home with real people living in it will occasionally smell of something, and a brief odour near one room usually means somebody had an accident and it is being dealt with. What matters is whether the smell is contained and passing, or spread across a corridor or a wing and present at every hour. A heavy floral or chemical smell is worth more concern than a faint real one, because masking is a choice somebody made instead of cleaning.

What shared equipment should I ask about in a long-term care home?

The things that move between residents: commodes, transfer and ceiling lift slings, wheelchairs and walkers, tub chairs and bath lifts, and shared clinical items such as blood pressure cuffs and glucometers. The Ministry checklist asks how often wheelchairs and walkers are cleaned, which is a good start, but the question that matters more is who cleans each item and at what point — ideally between residents rather than on a weekly round. Slings in particular are often laundered rather than wiped, and a home should be able to tell you which.

Is housekeeping included in the cost of a long-term care home?

Yes. In an Ontario long-term care home, housekeeping, bed linens and laundry are part of what the home provides, and are not an optional extra billed separately. That is different from a retirement home, where housekeeping, meals and laundry are typically services you pay for on top of rent. Because it is bundled rather than itemised in long-term care, under-resourcing it is invisible on a bill — which is why asking about staffing levels is more revealing than asking about cost.

What is the difference between a retirement home and a long-term care home in Ontario?

They are different things with different regulators. Retirement homes are privately owned, you pay rent plus fees for extra services, they do not provide 24-hour nursing care, and they are regulated by the Retirement Homes Regulatory Authority, which licenses them, inspects them and investigates complaints. Long-term care homes are licensed and funded by the provincial government under the Fixing Long-Term Care Act, 2021, provide 24-hour nursing and personal care, and are overseen by the Ministry of Long-Term Care. Applications for long-term care go through Ontario Health atHome.

Are long-term care home inspection reports public in Ontario?

Yes. The Ministry of Long-Term Care oversees homes' compliance with the Fixing Long-Term Care Act, 2021, and where an inspection follows a complaint the ministry's own guidance says the inspector may explain how the resulting report will be made publicly available. Separately, every home must have a formal complaints process and must post it somewhere residents and the public can easily see it. If you cannot find either, ask the home's office staff — and you can ask the home directly for its recent inspection results.

Who do I contact about cleanliness in an Ontario long-term care home?

Start with the home, which must acknowledge a complaint within 10 business days and tell you what it is doing about it. If that does not resolve things, the Ministry of Long-Term Care runs the Long-Term Care Family Support and Action Line on 1-866-434-0144, open 8:30am to 7:00pm, seven days a week. You do not have to give your name, and the Fixing Long-Term Care Act, 2021 protects people who report concerns. If both routes are exhausted, the Patient Ombudsman can be reached on 1-888-321-0339.

Is it fair to judge a home on how clean it looks during a tour?

Only partly. A tour is a single hour in a building where people live around the clock, and a home that is spotless at 11am on a Wednesday may be very different at 7pm on a Sunday. Visit twice if you can, and once at a less convenient hour. It is also worth remembering that the person showing you around usually does not control the housekeeping budget, so the useful posture is curiosity rather than examination — the answers still tell you what you need to know.

References & further reading

Everything factual on this page was checked against the primary source in August 2026.

• Ontario, Ministry of Long-Term Care. Checklist: Visiting a long-term care home (PDF, 11 pages) — the source of the cleaning questions described above.
• Ontario, Ministry of Long-Term Care. Choosing a long-term care home and Find a long-term care home, ontario.ca — the three-step process, the home search tool, and the five-home application limit through Ontario Health atHome.
• Ontario, Ministry of Long-Term Care. Long-term care home complaint process, ontario.ca — the 10-business-day acknowledgement, the posted complaints process, the Family Support and Action Line, whistleblower protection and the Patient Ombudsman.
• Ontario. Explore your care options, ontario.ca — the retirement home and long-term care home comparison, including what each includes and who regulates it.
• Fixing Long-Term Care Act, 2021, S.O. 2021, c. 39, Sched. 1, and O. Reg. 246/22.
• Retirement Homes Regulatory Authority (RHRA) — licensing, inspection and complaints for Ontario retirement homes.
• Public Health Ontario / PIDAC. Best Practices for Environmental Cleaning — the clean-then-disinfect sequence and contact time.
• Health Canada. Hard-surface disinfectants — Drug Identification Number (DIN).

Note: this is general information for families, not legal, medical or clinical advice, and rules change. Confirm anything you intend to rely on against the current primary source or with the home itself.

We wrote this because we clean care buildings and kept hearing this question from the family side of the counter. If you run a home rather than choose one, the operator's version is our guide to IPAC cleaning requirements in Ontario long-term care, the free long-term care cleaning checklist and the LTC cleaning log — all free, no strings. We also provide long-term care cleaning across the GTA, and you are welcome to use everything here without ever speaking to us.