May 29th, 2025
Do Not Enter: Ensuring Fairness When Issuing Trespass Notices
After a heated meeting with staff, a family caregiver was barred from entering the long-term care home to visit their parent. It’s a difficult situation that no one wants to find themselves in, and yet, is not uncommon.
In 2023/24, Patient Ombudsman addressed 62 complaints from patients and caregivers who felt their no trespass notices were unfair. Our office received 50 of these complaints in 2017/18 when we highlighted the issue in our annual report for the first time and made recommendations to health organizations.
When making decisions around trespass notices, health organizations have many competing considerations: that being with family and loved ones is hugely important to both mental and physical health, while at the same time meeting their obligations to keep staff, patients and residents safe. With this in mind, how can this issue be addressed head on?
Our newly released Fairness by Design resource, Trespass and Other Restrictions on Attendance gives health organizations such as hospitals and long-term care homes tools to review their current processes and help ensure their policies and procedures around trespass notices are fair.
Considerations
In general, when reviewing complaints about restrictions to health facilities, Patient Ombudsman looks to ensure they are proportional and fair. While there may be situations where restrictions are used to address significant risks to safety, any restriction should:
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be limited and in place no longer than needed to address the risk,
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be based on evidence or experience,
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be proportional to the risk the person poses, and
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allow for exceptions based on compassionate grounds.
Our Fairness by Design resource lays out some key considerations health organizations should make, including whether it considered the impact on the patient/resident, what is the actual risks the person poses, consistency with the Residents’ Bill of Rights under the Fixing Long-Term Care Act, 2021,and whether there is a middle ground, among others.
How Patient Ombudsman has helped
In one complaint we received, an individual was issued a trespass notice based on aggressive behaviour toward hospital staff, including physical contact. We reviewed security video and read reports on the incident. Although we found the hospital acted fairly in issuing the notice based on the individual’s behaviour and because it did not restrict the individual from accessing health care, we also found the hospital did not have a formal policy or appeal process to ensure trespass notices were being applied fairly. The hospital agreed to create a policy, to regularly review its no trespass notices, and to reach out to the individual to let them know how they could request a review.
Policies are more than just paperwork; they can be an important part of ensuring fairness and something we review when helping resolve complaints. If an organization does not have a policy that outlines how it will handle certain situations, it’s something we want put in place. If the organization has a policy, we review if staff are being trained in using the policy and following the policy consistently. Developing a new policy means an organization has to review evidence to support its position, to make commitments, and to ensure staff understand their responsibilities.
Our Fairness by Design resource outlines what should be included in a comprehensive policy. By making use of proactive tools like our resource , health organizations can ensure a fairer process to keeping their premises safe.