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Children and youth RESIDENTIAL SERVICES STAFF HANDBOOK
March 30, 2009, June 29, 2009 This manual is divided into the 10 functions of the St. Leonard’s Community Services Planning & Evaluation Model. This manual contains information that is common to all residential programs licensed under the Child and Family Services Act (CFSA) as noted in the table of contents as well as an appendix, which contains program specific information relevant to the particular program location. The information found in each section is as follows:
Although this manual is comprehensive, all relevant policies or procedures relating to the operation of the Children and Youth Residences are not listed. Other manuals, containing relevant policy information include the Policies and Procedures Manual of St. Leonard’s Community Services, the Ministry of Children and Youth (MCYS) Residential Licensing Manual, the Ministry of Children and Youth Justice Services Manual and the Child and Family Services Act. TABLE OF CONTENTS – GENERIC SECTION 1.0 Planning 1.1 Departmental Operating Plan 2.0 Documenting 2.1 Information Sharing
3.1 General
4.0 Finances 5.0 Facilities 5.1 Facility Tours 6.0 Human resources 6.1 General
7.0 Internal Communications 7.1 General 8.0 Community Relations 9.0 Marketing 10.0 Client Service 10.1 General10.2 Intake/Admission Process 10.3 Residential Routines 10.4 Role of the Counsellor (Primary Worker) and Supervisors in Treatment/Action Planning 10.5 Timelines for Developing and Reviewing the Treatment/Action Plan 10.6 Client Progress Reports 10.7 Client Property 10.8 Discharge Summary 10.9 Client Clothing and Clothing Allowance 10.10 Client Property Upon Discharge 10.11 Personal Care Items 10.12 Mail 10.13 Spiritual Service/Religion 10.14 Contraband 10.15 Room Searches 10.16 Personal Searches 10.17 Contacting Police in Emergencies 10.18 Dealing with Off-Site Emergencies 10.19 Client’s Approved Contact List 10.20 Visitors 10.21 Supervision of Clients 10.22 Transporting Clients in the Community 10.23 Food and Mealtimes in the Residence 10.24 Discipline and Consequence 10.25 Nutrition, Medical and Behavioural Advice 10.26 Client Health 10.27 Provision of Health Care Services 10.28 Consent to Medical/Dental Treatment and History Verification 10.29 Emergency Medical/Dental Treatment Consent 10.30 Emergency Medical Treatment 10.31 Accidents and Injuries 10.32 Arrest and Open Detention of Agency Client 10.33 Client Voting in Municipal, Provincial and Federal Elections 10.34 Individual Counselling 10.35 Group Counselling 10.36 Recreation Programs 10.37 Community Involvement 10.38 Transportation 10.39 Family/Guardian/Caregiver Visiting/Reintegration 10.40 Day Treatment 10.41 Running Appendices 1 Healthy Eating Matters – Food and Nutrition Toolkit for Residential Care Settings 1.0 Planning 1.1 Departmental Operating Plan Each year staff are involved in the development and implementation of a departmental operating plan. This plan is reviewed regularly. The operating plan is found in the staff office computer in the planning directory and on the Agency’s intranet site. 2.0 Documenting 2.1 Information Sharing For programs licensed under the Child and Family Services Act (CFSA), a client in residential care CANNOT be identified in any manner. The appropriate response for ALL STAFF when contacted for requests for information is as follows: "For client confidentiality reasons, I am prevented from discussing this with you.” All calls requesting information MUST be directed to the Manager, Supervisor or Shift Co-ordinator. At intake, when making initial contact with a client’s parent/guardian/caregiver or probation officer (where applicable), staff must instruct them to always ask for the client’s Counsellor (Primary Worker). If the staff member they ask for is not working, they may go on to say that they are the parent/guardian/caregiver of client ... and would like to speak to the staff member in charge of the shift (i.e. Shift Coordinator). In the event a telephone call is received and the callers identity is known to staff, staff are not required to verify the caller’s identity. If staff are sure of the callers identity, a message may be taken for the client. In the event a call comes from an apparent official source (i.e. CAS worker, police, lawyer etc), staff are to use the above call response and then verify the caller’s identity by:
All calls from an official source or those inquiring about serious or significant information must be directed to the Manager or Service Director. 2.2 Client List Each department completes and circulates a daily client list, which contains basic client information. This list is completed a minimum of once per week and is circulated according to program requirements (See appendix). Faxing is a regular way to send documents to other programs and agencies. Although email is the preferred mode of communication, items containing the last names of clients are not to be emailed. 2.4 Database The Agency uses an electronic database to store and manage client information. Basic client information is entered on the database. All staff have a responsibility to ensure that all client information is up to date and accurate. All of the staff computers have access to the central database so that information can be entered from a variety of different locations. With good information going into the system, the database becomes a powerful and useful tool to manage client documentation. All staff require a username and password to log on to the server. All passwords should be 7 characters in length and contain at least one number or symbol. Passwords must not contain names. 2.5 Internal Memos Internal memos are kept in the staff office and are an important communication tool. Staff are expected to review memos during each shift. Staff are to initial each memo after reviewing. 2.6 Progress Notes Progress notes are written for each client on every shift. Staff use progress notes to record observations of the client’s daily activity and progress during each shift. This information is used for case planning and goal setting. The notes should be clear and concise so that all staff are able to read and understand what has been happening with each client. Notes can be brief if the client has had a positive or uneventful day/evening. When documenting client progress, staff are to outline the activity the client was involved in during that shift and describe significant situations, events and behaviour. 2.7 Forms Program forms described in this handbook are available on the database and as paper copies in the staff office filing cabinet. Staff are not to alter forms. 2.8 File Naming and Saving All departments organize computer files according to the Agency Planning & Evaluation Model. Subdirectories are established by function. The functions are as follows: planning (pl), documenting (doc), regulating (reg), finances (fin), facilities (fac), human resources (hr), internal communications (ic), community relations (cr), marketing (mkt), and client service (cs). (eg. c:\rwh0708\cs\). Files, which are letters or memos, are named by the person they are going to and by date – 8 alpha 4 numeric (e.g. c:\rwh0708\csd\hncas0321). Files, which are not letters or memos, are named descriptively. Minutes would be named – c:\rwh0607\ic\staffmin0321. Reports involving neighbourhood complaints would be named and dated. E.g. c:\rwh0708\cr\neighbour0522. Outside of the database, all documents record the path and filename. The path and filename is to be inserted at the bottom of every document using the following steps:
For Excel documents, the process is as follows:
2.9 Hard Drive Back Up System The full time static night staff are responsible for backing up all residential computer files on a rewritable CD or memory stick. Each computer is to be backed up a minimum of twice per week. Backed up CD/memory sticks are to be forwarded to the Manager for secure storage. 3.0 REGULATIONS 3.1 General All Agency programs operate in accordance with the policies and procedures of St. Leonard’s Community Services and government legislation (i.e. Youth Criminal Justice Act, Child and Family Services Act, MCYS Residential Licensing Manual) through the Ministry of Children and Youth Services. Policy Manuals The following labeled binders are located in the staff office:
All staff are required to know the contents of this material. 3.2 Health RegulationsFood, Nutrition and Menu Planning Meals provided are nutritionally balanced, portioned and prepared according to the requirements of Canada’s Food Guide to Healthy Eating prepared by Health Canada. The residences ensure that special diets are available as per client dietary or cultural needs (See Staff Handbook – CS - Food and Mealtimes 10.23) and that food restrictions for disciplinary purposes are not tolerated under any circumstances. Meal portions are adequate for the physical growth and development of clients and are monitored by staff. Three meals and at least two snacks are provided at set times for clients, staff, students and volunteers within every 24-hour period. The residences strive to have menus that reflect the cultural diversity of clients and are developed with client input. Accommodations are made to allow for special dietary requirements (e.g. food allergies); modified meal schedules, including medical diets, religious diets and/or lifestyle diets. Special diets are accommodated as recommended by a physician or nurse practitioner as well as any religious dietary requirements as identified by a parent/guardian/caregiver. Clients who are absent during the day are to be provided with a meal upon their return to the residence. Current menus are posted in the kitchen and are retained for a minimum of 30 days. Food is served in accordance with the menu and any substitutions are noted on the posted menu. A Food/Nutrition Diary is maintained by staff. The Diary details the contents of each meal, the number of clients who ate the meal and the Diary identifies the clients who were involved in meal preparation. Food Handling/Kitchen Facility Practices The storage, handling, preparation and serving of food comply with all applicable sanitation and health codes. Night staff and/or the cook are responsible for most of the cooking and maintaining an appropriate stock in the kitchen area. Since food preparation is an excellent life skill, the clients are encouraged to get involved with the meal preparation, handling and storage. Food preparation information is done in a format that is suitable to the client’s level of understanding. Staff directly supervise all kitchen work and promote the importance of sanitary rules and proper food storage. Clients and staff are required to rinse their dishes before placing them in the dishwasher; where applicable. The refrigerator and freezer have a thermometer and are checked daily to ensure they are maintained at an appropriate level. A major kitchen chore occurs each Saturday, where all appliances are thoroughly cleaned, cupboards are emptied, wiped out with disinfectant and re-organized, floors, walls and counters are disinfected. Further information on food and meal preparation is available in the Staff Handbook Binder, which also includes the MCYS Tool Kits for Healthy Eating Matters – Food and Nutrition Toolkit for Residential Care Settings, Achieving Cultural Competence - A Diversity Tool Kit for Residential Care Settings. 3.3 Food Storage Food is stored in designated food storage areas. The cook/staff do the majority of the cooking in the residence. It is the responsibility of the cook/staff to clean the designated food storage area at the end of the month while completing inventory and to dispose of any expired food items. This task will include:
Health Standards It is important to adhere to all health standards and ensure that facilities are clean. The interior and exterior of the properties will be inspected daily ensuring that a high standard of cleanliness and tidiness is maintained. These inspections must occur at a minimum of once per shift. 3.4 Food Services Equipment Staff and clients are trained in the safe operation and use of the food service equipment. Clients can use sharp knives provided they are under the direct supervision of staff. Residential programs with gas stoves are monitored regularly. The Service Director or delegate maintains a file that contains the maintenance plan for tools and equipment in accordance with the manufacturers’ guidelines. All routine and/or emergency repairs are submitted via work order to the maintenance department. The Service Director or delegate will ensure that all equipment that no longer meets the manufacturers’ standards is replaced. For Peter Willis Residence – the kitchen area is searched by staff when security items are missing. 3.5 Hygiene and Sanitation As per the requirements of the local health units, all staff and clients who participate in food preparation are expected to comply with regulated food handling practices for dry, refrigerated and frozen foods. Food is stored appropriately, sanitized and inspected prior to preparation. Measures to reduce the risk of food spoilage or spread of food-borne diseases are taken. All spoiled food items will be disposed of. A generator is available in the event of a power outage. All staff and clients who are involved in preparing and serving meals are monitored by staff to ensure that proper health and personal hygiene is maintained. Wearing suitable clothing and footwear is expected in order to ensure compliance with Health and Safety standards. Proper food handler practices are expected to be followed and include but are not limited to:
A regular cleaning schedule will ensure proper food handling is utilized and the risk of food spoilage and spread of food-borne diseases is reduced. The local health unit inspects the residences on an annual basis and provides a written report of their findings and recommendations for improvement. Bathing, Washrooms, Showers and Bedrooms The residences provide bathing, shower and separate toilet facilities to ensure privacy. Facilities provide a ratio of one device, with hot and cold running water per five clients. The bedrooms provide a minimum of 5.58 metres (75 square feet) of floor area per client, exclusive of closet space. Water Sanitized bottled water adequate for all clients and staff is purchased from a licensed water distributor. Five bottles of drinking water are available at any given time. 3.6 Water Temperature The hot water system is capable of supplying a minimum hot water temperature of 43 degrees Celsius and a maximum of 49 degrees Celsius for bathing and a minimum of 72 degrees Celsius for dishwashing machines. The Agency ensures that the above policy is met through regular checks being made by the PUC and the maintenance company who services the Agency. 3.7 Rights of Clients in Care As outlined in the Child and Family Services Act, “young persons” have specific rights and responsibilities. It is the responsibility of staff to know the rights of “clients” in care and to help protect them. During intake and during treatment plan meetings, clients and their parents/guardians/caregivers are provided with information outlining his/her rights. This process is documented by all parties signing the Rights, Responsibilities and Complaint Acknowledgement form. Religious and Cultural Respect – Clients have the right to service and care that respects his/her cultural, religious and regional differences. Right to be Informed – Clients have a right to be told in a language they can understand, about his/her rights and responsibilities while being a client and how to go about making complaints. Right to be Heard - Clients have the right to express his/her opinion regarding decisions about medical treatment, training, work or Agency programs. Clients have a right to speak privately with the following people:
Education, Training and Work Programs – Clients have the right to education, training or work programs that are in keeping with his/her aptitude and ability. Recreation – Clients have the right to participate in appropriate athletic activities in regular community settings that are suited to his/her interest and ability. Treatment/Action Plan – Clients have a right to a Treatment Plan that is designed to meet his/her needs. They have a right to participate and have input into his/her plan. 4.0 FINANCES 4.1 General Staff are responsible for finances as they pertain to day-to-day activities in the program. This includes petty cash for recreation, parking and gas, client finances and any purchases that staff are required to make on behalf of the program. The Manager of the residence monitors all purchases. Large purchases or capital needs are made in consultation with the Service Director. The assigned Counsellor (Primary Worker) works closely with the client to develop budgeting skills where appropriate. Clients are encouraged to develop responsibility and self-discipline in dealing with finances. 4.2 Program Budget A departmental budget is developed each year and is broken down into the following areas:
4.3 Purchase Procedure All requests must be submitted to the Manager for approval.
All money coming into the residences will be accounted for via a ledger and stored in a secure area. 4.5 Recreation Money The programs have a recreation budget and the money is dispensed weekly as per the recreation schedule. Any staff member spending money is responsible for documenting the expense and submitting a receipt to the petty cash clerk. 4.6 Purchase OrdersPurchase Orders are used for items directly billed to the Agency. The Purchase Order is completed by the Manager/delegate with the authorization of the Service Director. Copies are circulated as follows: White –to the supplier, Upon delivery, staff on shift will obtain an invoice from the customer and inspect the goods/service. The invoice is to be attached to the gold copy of the PO and forwarded to the Manager. 4.7 Petty Cash The program maintains a petty cash system, which is monitored by a delegated staff person (a.k.a. petty cash clerk) who performs the necessary administration duties. This system is for allowances, life skills supplies, emergency food, art, recreation, parking and other miscellaneous expenses related to the operation of the program and approved by the Manager. Receipts and change must be returned to the petty cash clerk totalling the original request. Access to petty cash is limited to the Petty Cash clerk and the Manager. In the event that staff need to purchase something for the program, a petty cash request form should be completed. This is to be requested well in advance to ensure the money is available for the date required. The following procedure is to be followed:
4.8 Cheque Requisition Request Cheques are available to make program purchases. A cheque requisition form is to be completed and forwarded to the Manager, who forwards the form to the Service Director for approval. Requests should be submitted well in advance to allow for proper approval and processing. 4.9 Grocery Shopping The designated staff member will complete a grocery list planned in accordance with the Canada Food Guide and based on the week’s menu plan. All grocery receipts must be attached to a Purchase Summary and forwarded to the Manager following each purchase. Designated staff will complete a food inventory at the end of each month, which will be forwarded to Administration. 4.10 Allowances Clients receive an allowance. Allowances at Roy Walsh, Peter Willis and Varency Home are earned by completing chores in the residence. 5.0 FACILITIES Staff complete inside and outside house tours on each shift and document these in the logbook. Staff address all cleaning and maintenance issues as they occur. Issues that cannot be addressed immediately are passed on to the next shift, for follow up. After changeover, the designated Shift Coordinator is responsible for completing a tour of the entire facility, grounds and vehicles to ensure safety and security is maintained. Security, damage, maintenance, control, health, fire and safety issues are the focus of the inspection. Issues arising from a tour are to be documented and followed up on immediately. While completing the shift tour, a fire check is also to be completed. A shift tour consists of inspecting all rooms and areas of the residence and includes checking the condition of the following:
Ground tours must occur at least once each shift to ensure both security and overall maintenance. As part of the ground tour, the following should be particularly noted:
5.3 Window Coverings All windows must be “dressed” at all times to ensure an appropriate appearance of the residences, as well as to promote privacy for the program. This includes bedroom and bathroom windows. 5.4 Chores It is essential that the residences are safe, comfortable, and provide a positive clean environment for clients and staff. All staff are responsible for ensuring the general upkeep of the interior and exterior of the residence on his/her shift. House maintenance and general cleanliness are life skills. Clients have chores that are to be checked thoroughly, and approved by staff. Staff must set a high standard, supervise clients and help them complete chores properly. Helping with chores is a good opportunity for role modeling and relationship building. All staff are responsible to ensure the house is clean and maintained at all times. If clients do not complete chores, staff are to ensure that the house is clean and presentable at all times. Staff are to ensure the house is clean before leaving shift. 5.5 Garbage and Recycling Garbage and recycling removal is a chore on the list and requires careful monitoring by all staff. Garbage is stored on the property until the weekly garbage/recycling removal day. When the garbage and recycling are taken out of the residence, it is to be in the designated garbage canister/shed. 5.6 Bedroom Guidelines Client bedrooms meet space requirements as outlined by government regulations. Each bedroom is equipped with appropriate furnishings. Within reason, clients may have their personal property in their room. Bedrooms must be kept clean and tidy and are to be locked when not in use. The following criteria should be kept in mind when inspecting and touring the bedrooms.
5.7 Laundry Facilities All clients complete their own laundry a minimum of once per week on their assigned laundry day. 5.8 Damage Reporting/Maintenance Board/Work Orders The process for reporting damages and follow up is as follows:
When a maintenance worker comes to the residence:
As a matter of practice, the maintenance workers will not carry out work that has not been documented on a work order and authorized. Work Orders will be filed by night staff, for future reference. 5.9 Tools The program has basic tools for repairs that can be completed by staff and clients on shift. Client use of tools must be directly supervised by staff and tools must be returned after each use. 5.10 General Staff Office Guidelines The staff office is the security control centre of the residence and is to remain locked at all times when not in use by staff. It is important to keep offices professional looking, as this is a reflection of the entire program. The following procedures must be adhered to by all staff:
5.11 Program Keys There are several sets of colour/number coded key rings. Each staff member will be issued a set of keys at changeover and the colour/number code is documented in the logbook. The staff member is responsible for that set of keys for the entire shift and for returning them at the end of the shift. The teacher, if applicable, has a set of keys containing a master key and other keys that are unique to the school program. These keys will be issued, signed out in the log and returned at the end of the day as noted above. If a set of house keys go missing, everything stops until they are found. Staff who take keys home from shift must inform the staff member in charge of the shift and return them immediately, unless otherwise arranged with staff on shift. The Manager has a personal set of keys that are not part of the colour/number coded system in the event that they must attend the residence during a crisis. When keys are not in use by a staff member, they are to be stored and locked in the key cabinet. Clients are not permitted access to program keys. The extra keys for the program vehicles can be found in the office key boxes or locked petty cash box. 5.12 Heating and Cooling System The residences are equipped with a furnace, including central air conditioning. An appropriate winter setting is heat on 20; summer is cool on 20. The minimum temperature of the residence is at least 17 Celsius or 62 Fahrenheit. Staff take the residence cell phone while escorting clients in the community. A back up charger is provided. The vehicle cell phone battery must be fully charged at all times. 6.0 HUMAN RESOURCES 6.1 General The program is staffed and organized to meet the treatment and care needs of the clients. The Service Director, the on-site Manager, Supervisors, Counsellors (Primary Workers) and Support Counsellors, comprise the staff team. The major responsibilities, outlined in the residential job descriptions are the care and provision of service to youth. The residence is staffed 24 hours per day, 7 days a week with awake staff on all shifts. Staff work a rotational shift model or a static shift model. Supervisory staff are available on most shifts or they are “on call.” A full time on-site Manager is available to oversee the day-to-day activities of the residential programs Staffing patterns are determined based on the needs of the residential client population. The scheduling of staff ensures adequate staff/client ratios at key times. The staff spend time at every shift change orienting the oncoming staff about any issues or needed planning. Staff scheduling also provides for attendance by team members at weekly case management meetings and or multi disciplinary team meetings where the client’s treatment plan and progress are reviewed. The staff schedule also reflects the commitment of key staff to be in attendance at case conferences, consultations, treatment plan meetings, community meetings, etc. The program uses part time Support Counsellors to maintain the client/staff ratio for safe and effective service. From time to time, one on one staffing coverage is provided for clients who need extra support. At the YRC, there is a minimum of 3 staff on day and night shifts (1 staff for 6.6 clients) and 4 staff on the afternoon shift (1 staff for 5 clients). At RWH and VH, there is a minimum of 2 staff on day shift (1 staff for every 4 clients), 2 staff on the after shift (1 staff for every 4 clients) and 1.5 staff (1 staff for every 5.3 on nights). At PWR, there are 3.5 staff on days (1 staff for every 4.29 clients), 3.5 staff on afternoons (1 staff for every 4.29. clients), 2 staff on nights (1 staff for every 7.5 clients). The staff schedule is maintained by the Manager or delegate. It is posted up to 4 weeks in advance. Schedule changes must be requested and approved by the Manager/delegate in advance. A request or email is to be directed to the Manager, specifically outlining the request. Every effort is made to accommodate requests; however there may be times when a change is not possible. Staff are not permitted to “swop” shifts without the authorization of the Manager/delegate. Staff who are unable to report to work due to illness must inform the Shift Coordinator and request coverage at their earliest convenience. It is the responsibility of the Shift Coordinator to find coverage for the staff member calling in sick. All efforts must be made to cover the shift with part time staff. If coverage is not available within the department, part time pool or full time staff may be used. In the event that a staff member calls in sick and coverage is not available, the Shift Coordinator will make a decision as to which staff member on duty is required to work until other arrangements can be made. If the staff member on duty is scheduled to work an upcoming shift within the next 24 hours, on-call personnel will be contacted to arrange coverage for that upcoming shift. 6.3 Shift Coordinator All shifts have a designated Shift Coordinator, which is highlighted on the staff schedule. In most cases, the Supervisor, full time staff or senior staff person will be designated. It is the responsibility of the Shift Coordinator to take charge of the shift and ensure that all shift tasks are delegated and completed. The Shift Coordinator is also responsible for administering medication, co-coordinating contact with on-call/police and maintaining the logbook, unless specifically delegated to another staff member. 6.4 Decision Making on Shift An integral and crucial element of the smooth operation of a residential setting and particularly, in working with an adolescent target group is decision-making. The model noted below should be used on every shift for general decision making. 1. Stop and Think 2. Problem Identification 3. Gathering Information 4. Alternatives 5. Evaluate consequences and outcomes. 6.5 Part Time Staff Sign in Sheets It is the responsibility of all part time staff to document all hours worked on a Part Time Sign In Sheet. A new sheet is started at the beginning of each pay period. Hours not documented will not be paid. Staff are assigned to on call duties to provide support and consultation in crisis situations. The On Call responsibility rotates between the Supervisors and the Manager. The Service Director may be used as a back-up if necessary. The On-Call person carries a cell phone or pager and the on call phone number is documented on the staff phone list. If there is a crisis situation, staff should be prepared to relay all facts and outline a solution. On-call support should not be sought for the purpose of looking for answers without completing the problem solving process as outlined in Human Resources 6.4 of this handbook. If the On Call person does not answer the on-call cell phone/pager, leave a message. If there is not a timely response and the situation is urgent, staff may attempt to call another Supervisor, the residence Manager or Service Director. If this is not successful, staff are to make a decision in consultation with the Shift Coordinator.On call staff are to be advised of decisions made in crisis situations. 6.7 Panic Buttons Staff are provided with panic buttons for use in the event of an incident that threatens security or personal safety. Roy Walsh Home, Peter Willis Residence and the Youth Resource Centre (YRC) are monitored by Damar Security. The Varency Home program is monitored by Owl Tech Security. Each program has a sufficient number of panic buttons. The YRC and Varency Home have 4 active panic buttons and Roy Walsh Home and Peter Willis Residence have 5 panic buttons. All buttons are on individual medallion chains. The following procedures must be adhered to while on shift:
In the event of an incident that threatens security or personal safety, staff will activate the panic button. Examples of an incident that warrants the activation of a panic button include:
It should be noted that panic buttons do not work outside of the residence. Activation of the Panic Button When the panic button is pushed, the keypad will sound. It automatically takes over priority on line 1 of the phone system; therefore rendering line 1 unavailable for phone calls. Staff must use line 2 for out-going phone calls. Upon activation of a panic button, the following will occur:
False Alarm/Accidental Use of the Panic Button Should a false alarm be activated, the police will still respond. Staff can call the appropriate security monitoring company and advise of the false alarm. The staff member will be asked to identify himself/herself and to provide the system number and password. The relevant system numbers and passwords should be given to all staff before or on their first shift. It is the responsibility of all staff to know these numbers and passwords:
The above programs will contact Damar Security on line 2 of the phone at 519-753-7710 to advise of the false alarm.
Varency Home can contact Owl Tech Security at 1-877-526-8221 on line 2 of the phone to advise of the false alarm. Testing Panic Buttons Testing is completed weekly by the night staff to ensure functioning. Each button is numbered so that a faulty panic button can be detected. When a panic button is not functioning, it is generally due to a low battery. The procedure for testing the panic buttons is as follows:
7.0 Internal Communications 7.1 General The residences are fast paced environments. Good communication is essential to ensure that quality service is provided. The following meetings and internal communication formats/forums have been implemented to foster effective communication. 7.2 Clip Boards/Binders Each department has various clipboards or binders that contain program information. Staff are expected to review the information prior to going on the floor for shift. The following is a list of the information that is maintained:
7.3 Shift Changeover and Audio Communication Shift changeover can involve a combination of verbal, written and audio information. The Shift Coordinator is responsible for ensuring a good changeover is provided to the on-coming shift. This is completed by documenting significant information on the Shift Changeover form. Staff are to use the Planning and Evaluation Model functions as a prompt in relaying information. All staff must receive changeover information within the first hour of the shift. The Shift Coordinator is responsible for planning the shift in conjunction with the team. Tasks will be divided up that need to be completed and delegated to specific staff. The Shift Coordinator will check the status of items prior to the end of the shift. If items are outstanding, a plan will be put into place to ensure that they are completed. As one of the tools in the changeover process, some of the residences utilize a voice recording system. The Manager erases recordings on a regular basis. Staff are not to delete information off the tape recorder without authorization from the Manager. 7.4 Case Management Meetings and Process Case management meetings occur weekly and are a key way to review client progress. It is the role of the Counsellor (Primary Worker) to complete a Case Management Weekly Report with the clients on their caseload. In their absence, the Supervisor is responsible for ensuring the report is completed. This report is presented by the Counsellor (Primary Worker)/Supervisor at the Case Management Meeting. Counsellors (Primary Workers) and Supervisors are expected to attend Case Management Meetings. Other staff are welcome and encouraged to attend but participate on their own time. Purpose of Case Management Meetings The purpose of the Case Management meeting is to provide staff input into the assessment, treatment and discharge planning of clients. This includes information sharing, problem solving and decision making in order to develop, implement and monitor treatment/action plans. Case Management Agenda Format is as follows:
Case Management Weekly Reports This report is developed weekly via a 1:1 meeting between the client and the Counsellor (Primary Worker) prior to the Case Management meeting. The meeting consists of a review of the treatment/action plan, a review of the client’s activities over the previous week, problem solving, and development of an action plan for the upcoming week. This information is documented by the Counsellor (Primary Worker) on a Case Management weekly report and includes the client’s perspective of their progress. Both the Counsellor (Primary Worker) and the client sign and date the weekly report. Specific items that must be included in the report are:
The Counsellor (Primary Worker) or the Supervisor presents the Case Management Weekly report at the Case Management meeting. Case Management Minutes Process
7.5 Communication Tools There are numerous tools to ensure good communication is maintained. All communication formats listed below are available and should be reviewed prior to the start of a shift.
7.6 House Meetings House meetings are held a minimum of once per month. The Supervisor or delegate chairs the meetings and records the minutes within 24 hours of the meeting. The purpose of this meeting is to communicate with clients, engage them in problem solving issues and gather program input. Minutes are forwarded to the Executive Director, Service Director and Manager. The agenda follows the following format:
All non-residential programs are equipped with high-speed Internet access. Staff should ensure that the Agency website displays as the home page when accessing the Internet. The Agency website is www.st-leonards.com. Staff can access the Intranet through this site. Staff can access their email through the Intranet. When connecting to the Intranet, accept the security warning and enter your user name and password. The Intranet is a valuable communication tool for Agency information – click on the “Shared Documents” link to review current Agency updates or “Archived Documents” for historical information. Linked to the website, is the Agency Program Directory. This directory lists all Agency programs, eligibility criteria, location and contact information. Upon hire, all staff will be assigned an Agency email address and password. Your password should not be written down and is not to be shared with anyone. Should you forget your password or you believe it has been compromised, call the IT Co-ordinator for direction (see Policy and Procedures, Human Resources, 6-640 Staff Use of Electronic Technology). To enhance the efficiency of email communication, the following guidelines are to be used:
Client use of computers and resource equipment is outlined in the program specific appendix. 8.0 Community Relations8.1 General Guidelines – Community and Neighbours The residences are members of the community and neighbourhood. Partnerships with the community are necessary for the successful operation of Agency programs. It is essential that the residences have a positive neighbourhood image. It is important for all staff to develop and maintain positive relationships with neighbours and the community at large by adhering to the following guidelines:
Any community or neighbour complaints are to be documented in a non-client incident report and brought to the immediate attention of the Manager and Service Director. 8.2 Telephone Etiquette When answering the telephone in the residences, the following standard response must be cited:
8.3 RPAC (Residential Placement Advisory Committee) Under the Child and Family Services Act (Section 34- 36), the local RPAC committee reviews all residential placements for Brant children and youth placed at YRC, RWH and VH, if the placement is intended to last 90 days or more. The review must occur as soon as possible but within 45 days of placement. According to the RPAC Terms of Reference, the RPAC committee will:
Upon determining that a client meets the above RPAC criteria, the Supervisor will ensure that the RPAC referral form is completed and faxed to the Contact Agency. Any documentation related to this process must be placed in the client file. 9.0 MARKETING 9.1 Program Presentations Program presentations are completed on a regular basis to various community groups. These presentations inform and educate the community on Agency services. Some tools used for these presentations are brochures, power point presentations and annual reports. 10.0 Client Service The Agency provides therapeutic residential programs. Staff use a cognitive behavioural approach, social learning, role modeling, problem solving and natural and logical consequences to empower clients and provide them with living skills, problem solving and decision-making skills. The programs provide a safe and healthy environment for clients. Residential services are provided in a manner appropriate to the chronological age and developmental level of the clients being served. 10.2 Intake/Admission Process With the exception of the YRC and PWR programs, admission takes place on a planned basis, whenever possible. The client’s transition to the residences is managed with sensitivity, respect and in a manner that reflects the preferences of the client and parent/caregiver/guardian. Staff empathize and work to lessen the anxiety and separation issues of the client’s experience when moving into a residential program. Upon intake, all clients (and their parents/guardians/caregiver) receive an initial orientation to the program. For clients involved with child welfare agencies, the CAS Worker signs the required admission documents. A valid health and green shield/benefit coverage card must be presented by the CAS Worker at time of admission.
Clients’ acknowledge his/her understanding of the information contained in the Client Handbook. They also acknowledge the Rights of Clients in Care and the complaint procedure. These signed acknowledgements are placed in the client file. For RWH and VH client admissions, it is expected that clients will arrive with his/her medical already completed. Documentation of this is to be provided by the CAS Worker at time of admission. In the event that a medical examination has not taken place within 30 days prior to the youth’s admission, each client is required to have a medical examination within 72 hours. The medical examination can be conducted by a physician or a registered nurse in the extended class- commonly referred to as a nurse practitioner. The initial dental appointment is arranged within 90 days unless it has occurred within 6 months prior. Further information on the client orientation is found in the Client Service Model, the Client Orientation Policy, Consent to Service Policy, Client Complaint Policy, and the Release/Obtain Information Policy. 10.3 Residential Routines Weekday RoutinesConsistency through daily routines helps promote a safe, predictable and comfortable environment. The program routine, for the most part, runs the same from day to day. The following general times provide a brief overview of what an average week in the residence consists of. 7:15 am Wake ups
Morning routine (getting washed or showered, hair combed, teeth brushed, dressing) 8:00 – 8:45 am Breakfast 8:30 am Clients attending community school leave for classes 9:00 am School/work/training program begins 12 – 12:30 pm Medications administered 12:30 – 1:00 pm Free time 1:00 pm – 3:00 pm School/work/training program resumes for the afternoon 3:00 – 5:00 pm Appointments, weekly meetings with Counsellor (Primary Worker), free time 4:00 pm Medication administered 5:00 pm Supper 5:30 – 7:00 pm Supper clean up, house chores, opportunity to complete homework, free time 7:00 – 9:00 pm Evening individual and group recreation (in and out of the residence), lifeskills and group sessions 9:00 – 9:30 pm Medication administered
9:30 pm Bedtime settling routines begin. Clients prepare for bed by washing their hands and face, brushing their teeth, changing into appropriate sleep attire, etc. Clients who shower in the evening are required to do so before their bedtime. Depending on their bedtime and how much time is available after they have completed everything, there may also be an opportunity for free time, bedtime story, reading, etc. Each client has a different bedtime depending on his or her program. Bedtimes range from 9:30 pm to 10:30 pm. Weekend Routines For some of the clients, this is a time where they can practice their goal areas in their home environment. Through case planning, weekend visits in the family residence are encouraged and supported. Some of the clients will visit home for the entire weekend leaving Friday evening and returning on Sunday. For others, home visits may be limited to day visits only. For those clients who are for various reasons, unable to have visits in the family home, weekends at the residence are more relaxed. Clients have the option of sleeping in a little later and enjoying a later breakfast or brunch. For those on individual programs, community time may be requested to visit friends or significant others. For those clients who remain at the residence, spontaneous and planned recreation occurs throughout the weekend. The following times provide a brief general overview of what an average weekend consists of. 8 am – 9 am Medication administered 8 am – 11 am Bedrooms tidied, morning hygiene routines, kitchen open for breakfast 11 am – 12 pm Free time 12 pm – 1 pm Medication administered 1 pm – 3 pm Recreation 4 pm Medication administered 5 pm Supper 6 pm – 7 pm Free time 7 pm – 9 pm Scheduled recreation 9 pm Medication administered 9:30 pm Bedtime settling routines begin. Clients prepare for bed by washing their hands and face, brushing their teeth, changing into appropriate sleep attire, etc. Clients who shower in the evening are required to do so before their bedtime. Depending on their bedtime and how much time is available after they have completed everything, there may also be an opportunity for free time, reading, bedtime story, etc. Each client has a different bedtime depending on the system. Bedtimes range from 0930 pm to 1100 pm. 10.4 Role of the Counsellor (Primary Worker) and Supervisors in Treatment/Action Planning Counsellor (Primary Worker) will ensure:
Supervisors are responsible for:
10.5 Timelines for Developing and Reviewing the Treatment/Action Plan Detailed information on Treatment Planning is located in the Policies & Procedures manual, Client Service Model. Timelines to be followed are: The Initial Treatment/Action Plan - The initial Treatment/Action Plan must be developed within 30 days following the admission of a client and a meeting involving the client, the CAS worker, family, probation officer and others will take place at that time. 30-Day Reviews - The Treatment/Action Plan must be reviewed a minimum of once per month. Counsellors (Primary Workers) review the Treatment/Action Plan with each client during the weekly meeting. Clients provide input and acknowledge his/her participation in the process by signing the weekly report, together with the Counsellor (Primary Worker). The client’s perspective is also recorded on the weekly report. Quarterly Treatment Plan Reviews - The Treatment/Action Plan is reviewed in a formal meeting including the child, social worker, family, probation officer and others every three months. The first Treatment/Action Plan review occurs 90 days from the admission of the client and then, every 90 days following. 10.6 Client Progress ReportsProgress Reports inform CAS Workers and Probation Officers about client activities outside of the Treatment/Action Plan over a period of time. Progress Reports are completed by the Counsellor (Primary Worker) at the same time intervals as the Treatment/Action Plan (i.e. 30 days following admission, 60 days following the initial progress report and every 90 days thereafter). The Progress Report includes the following information (if applicable):
Progress Reports are presented during Treatment/Action Plan meetings and reviews. Copies of the Progress Report are provided to the client, parent/guardian/caregiver, CAS Worker and /or Probation Officer. At the Peter Willis Residence, Progress Reports are completed using the Ministry mandated Case Management Plan document. 10.7 Client Property All property items must be documented on the client’s property list. Missing items should be listed on a separate property form. Property in the client’s possession, but not on the client's property list, must be listed on a separate property form and bagged. This property will not be forwarded to the client until such time as he/she can prove ownership. It is the client's responsibility to ensure all property is on his/her property list. The client must sign all forms, witnessed by a staff member. Staff ensure that all clients have an adequate supply and quality of clothing relative to the client's age, size, activities and current weather conditions. Upon intake, clients will be provided with adequate bedding that is appropriate for the weather. All property is to be placed on an itemized property list. The client and staff will sign the property list acknowledging what has been brought into the residence. Staff are to be specific when recording property, using brand names if possible. Jewellery should be recorded as yellow or white metal rather than gold or silver. In the event that a client refuses to sign, a notation will be made on the Property List form indicating such. Staff are to examine all property to ensure that contraband or dangerous goods are removed and stored until they are removed from the residence. Staff may remove, withhold or refuse access to property for safety or security reasons i.e. suicide watch. Property of excessive value should not be brought into the residence. In the event excessive quantities of property are brought into the residence, staff will limit the amount and the remaining property will be inventoried and placed in the basement. Immediate arrangements are to be made by the client to have the belongings removed from the residence. Counsellors (Primary Workers) will periodically go through property lists and ensure they have not accumulated excessive amounts. If accumulation is a concern, property will be boxed, recorded and sent to the client’s home or to his/her CAS Worker. Property Allowed in the Residence
Property Not Allowed in Residence
10.8 Discharge SummaryUpon discharge from the program, a discharge summary is prepared by the Primary Worker. The discharge summary contains a:
The “draft” discharge summary is forwarded to the Manager for approval within 14 days following discharge. The Primary Worker forwards the approved discharge summary to the residence the client is discharged to or the person or agency to whom the client is discharged no later than 30 days of discharge. Additionally, a copy of the discharge summary is offered and/or provided to the client and the CAS worker (where applicable). 10.9 Client Clothing and Clothing Allowance The Agency ensures that all clients have an adequate supply of clothes in suitable size and quality in relation to the client's age, activities and current weather conditions. Upon admission, all property (including clothing) is documented on the client’s property list. Upon admission, the staff on duty will take an inventory of the client’s clothes. If the client is a CAS client and requires additional clothing, a clothing allowance will be requested from the referring CAS. On approval of the clothing allowance request, the Manager or delegate will arrange for a cash disbursement in the appropriate amount to go to the Counsellor (Primary Worker), who will arrange the purchase of the clothing indicated on the list. Receipts must be kept for these expenses and given to the Manager for monthly billing to the CAS. CAS clients receive a seasonal clothing allowance from the program, three times each year; spring/summer, back to school and winter. Non CAS clients will receive required clothing after discussion with parents/guardian/caregiver or other community supports. 10.10 Client Property upon Discharge Upon discharge, the property list is reviewed with the client, whenever possible and all articles are accounted for. Once this is complete, the property is stored in a secure location until discharge. This procedure is to ensure clients are not taking things out of the program that do not belong to them. Clients sign a property release form acknowledging that property will be held for only 60 days following discharge. Authorized individuals noted on the acknowledgement are also permitted to pick up the property. Every effort will be made to contact the client prior to disposal of the property. Packing Client Property for an Unplanned Discharge The following is the procedure that must be followed when clients leave the program to go into custody or to hospital:
10.11 Personal Care Items Clients are provided with basic personal hygiene and grooming products such as body wash, razors, shave cream, toothbrush and paste and comb/brush. If clients wish, they may purchase their own products approved by staff. For safety and security reasons, razors are kept in the staff office, in the locked medicine cabinet. Aerosol cans and colognes are also kept in the staff office. Clients may keep items such as gels, foams, toothpaste and hand creams in their rooms. Clients are provided access to haircutting services. 10.12 Mail The Agency respects the client's privacy in receiving and sending mail. No correspondence to or from a client is to be opened, read or inspected unless the Service Director or delegate believe on reasonable grounds that the content of the mail may be prejudicial or harmful to the client or the safety and security of the residence. If it is deemed necessary for staff to open client’s mail, consultation should occur with the parent/guardian/caregiver. If a decision is made to open the mail, it should be opened in the presence of the client and documented in the client file. If there are reasonable grounds for staff to believe that the contetns of a client's outgoing or incoming mail may involve criminal activity, staff are to contact the local police service, withhold the correspondence pending police response and document the incident in the client's file. 10.13 Spiritual Service/Religion At intake and during Treatment/Action Plan reviews, each client is informed of his or her right to access and benefit from voluntary spiritual and religious care. His/her affiliation and the name of their community spiritual/religious care provider is documented in the client file. If a client expresses an interest in attending church or other faith groups, it is the responsibility of staff to make appropriate arrangements. The Agency will provide religious contacts for clients as required/needed. Parents/guardians/caregivers will be consulted and involved in this process as well. In cases where clients have identified spiritual and religious interests, this is addressed in their Treatment/Action Plan. Clients may have unsupervised visits from their community clergy or a religious care provider of their faith group. Such visitors will be screened as per the standard visitor’s policy. A written description of community resources is available in order to respond to the religious and spiritual needs of the clients. Staff are encouraged to contact the Ontario Multi-Faith Council on Spiritual and Religious Care (OMCSRC) and/or Chaplaincy Ontario, for overall guidance and if the staff member has questions or concerns about a particular faith group or individual, or to seek information regarding the procedures for approving and handling sacred items, literature and worship and study materials. Staff are required to advise spiritual and religious care providers that they must follow legislative requirements when collecting, updating, using and disclosing information. Staff will ensure that all clients are provided the opportunity to practice the religious diets and fasts of recognized faith groups. Further information on Spiritual Service/Religion is available in the Staff Handbook binder (MCYS Tool Kit on Healthy Eating Matters – Food and Nutrition Toolkit for Residential Care Settings, Achieving Cultural Competence - A Diversity Tool Kit for Residential Care Settings). 10.14 Contraband Contraband is considered to be any prohibited weapon (or facsimile), potentially dangerous device, unauthorized drugs/alcohol, stolen property, or inappropriate literature/music/ paraphernalia, which is in the possession of a client. For clients under 16 years of age and all clients of Peter Willis Residence, cigarettes, tobacco, matches, and lighters are considered contraband. These items have varying degrees of seriousness and are confiscated. Depending on the seriousness and significance of the contraband, its removal must be documented in the log book and on a case note or an incident report or a serious occurrence report. All contraband items must be forwarded to the Manager and stored in a secure location. Contraband issues are reported to the Probation Officer and/or CAS Worker (where appropriate). Drugs – In the event that staff suspects a client is in possession of drugs, the Police may be notified in order to search the client. If the client is in possession of drugs, the Police Officer may choose to arrest the client. Depending on the drug and quantity, staff may recommend to the Officer that the client remain in the program. Staff should consult with the Supervisor on Shift or On Call staff for this decision. If drugs are found during any house tour or search, they should be handled by one staff member and placed in an envelope that is sealed and initialled (date and time) by the staff making the discovery. The drugs should then be turned over to Police immediately and documented. Staff are not permitted to transport illegal contraband to the police station. Weapons – In the event weapons are discovered, they should be handled in a fashion similar to drugs and turned over to Police. Depending on the particular weapon and the circumstances, staff may want police to interview and or arrest a client(s) suspected of being the owner(s) of the weapons. This may require On Call consultation. Searches – Searches of clients are conducted to prevent contraband from entering the residence(s) that could put staff and clients at risk to be harmed. The decision to search must be based on a reasonable balance between maintaining safety/security and respecting the client’s right to privacy. The following procedures are to be followed when completing property searches:
Any client that is returning from an Unauthorized Absence should be searched immediately. Clients that have been deemed high risk to bring contraband into the residence may be searched upon return from unsupervised community access, including community school, visits, community time etc. 10.15 Room SearchesRoom searches occur randomly if there is suspicion that contraband or weapons may be present. The client’s right to privacy needs to be considered, therefore, searches should not become a daily routine unless specific safety and security issues with a specific client exist, i.e. extremely volatile and assaultive with weapons, suicidal or self abuse issues. In such cases, a safety contract is to be put into place that advises the client that frequent searches will occur in order to maintain his/her safety. The following procedures are to be followed when completing searches:
As a matter of practice, bedrooms should be inspected for safety, security and maintenance issues during daily tours. 10.16 Personal Searches Searches are not to involve physical contact between a client and staff. A search should be conducted using the least intrusive to most intrusive measures. For example, if the client is suspected of returning to the residence with drugs or weapons, a more intensive search is warranted.
A search should be conducted using the least intrusive to most intrusive measures. If the client is known to return to the residence with drugs or weapons, a more intensive search is warranted. Depending on the nature of the search, the client may be asked to remove the following items for inspection and adhere to the following procedures:
If there is good reason to believe that a client has something in his/her possession that is considered illegal and/or potentially dangerous, the client is to be isolated and contained in an area under direct staff supervision. The client should be given every opportunity to surrender the item. If a client is non-compliant, staff supervision should be increased. On-going supervision and searches of the areas of the residence where the client has been may be helpful in retrieving an item the client disposed of. (Peter Willis Residence only – if it is deemed necessary, the Brantford Police Service will be called in to conduct a frisk and/or body cavity search). If staff believe a client has contraband that is considered dangerous, police contact may be warranted. In these situations, staff should contact the On Call Supervisor for authorization and guidance. All incidents involving personal searches are to be documented in the client’s file and in the logbook. 10.17 Contacting Police in Emergencies It is important to maintain a clear perspective on the types of problems facing clients and what types of behaviour might be reasonable from their perspective. Even clients who have had the benefit of a positive home environment and who have not experienced significant hardship, engage in antisocial behaviours such as lying, stealing, rule breaking, manipulating, disrespect, etc. Some even get into physical fights with their siblings, peers and other community members. The clients the Agency works with are subject to all the normal experiences of adolescence. Agency clients may have experienced a great deal of loss and trauma which can include sexual abuse, emotional abuse, neglect, abandonment, loss of family, witness to violence, substance abuse, etc. Additionally, many suffer from a variety of mental health concerns over which they have limited control, including anxiety, depression, bi-polar disorders, conduct disorders, etc. At a time when these clients are most in need of support, consistency and stability, they are asked to live with a group of peers they do not know and a group of staff with considerable power and authority over their lives. Based on this reality, staff should fully expect that clients will not only continue to present the symptoms which may have landed them in care in the first place, but in fact that these symptoms may intensify. Aggression, disrespect, not following the rules and running away are reasonable responses to the reality these children face while living in care. The role of the Agency is to assist clients with their problems and to give them the help they need. Staff must look beyond symptoms and focus on the core issues that give rise to these behaviours from a nurturing and supportive perspective rather than relying on punitive interventions from the police. Staff must be committed to working through issues with clients using a cognitive behavioural approach and natural and logical consequences. Police are not called in situations where a client is acting out behaviourally. Staff should attempt to deal with these situations without police as long as it can be done safely, using standard methods of behaviour management (See Policies and Procedures Manual, Behaviour Management Policy 10-130). The Agency will contact the police when a client becomes violent and/or significantly injures another person in the residence, a client is found to have an illegal weapon in his/her possession, or when a client sexually assaults another person in the residence. The Agency will involve the police in circumstances where there is an immediate and significant threat to the well being of a client, a staff member or anyone else in the residence. The Manager, Supervisor on shift or designated On-call Supervisor must be consulted prior to any call to the police to deal with client incidents, unless safety is a serious issue. On call Supervisors must notify the Manager via email or telephone of any police contact. Exceptions to the above procedure are:
Clients with Probation Terms, Recognizance Orders, or Undertakings There are situations where particular clients might benefit from an organized and coordinated approach to police involvement and other interaction with the Youth Criminal Justice system. In most cases, this plan would be identified in the treatment/action plan. Furthermore, the safety of clients, staff and community can often be enhanced by working collaboratively with police, probation, bail officers and the crown. There should never be an automatic process by which staff report apparent breaches of terms to the police without first consulting with the Manager or the Supervisor on shift or the On-call Supervisor. 10.18 Dealing with Off-Site Emergencies If an emergency occurs during an out of town trip, staff are to use good judgment and ensure the health and safety of all clients. Emergencies include, but are not limited to accident or injury to a staff member or client, missing client, extreme out of control behaviour by a client, or a serious community complaint or issue. Staff call the residence immediately and inform the Supervisor on shift or on call Shift Coordinator that an emergency has occurred. Clients are to be returned to the residence immediately. Police involvement may be necessary. If a client refuses to return to the residence, or if a client has gone missing, a staff member must remain at the location with the client until relieved by support staff, or until police have taken charge of the situation. Under no circumstances are staff to leave a client behind. 10.19 Client’s Approved Contact List Client status may impact who the client is able to have contact. On admission, this list is developed in consultation with the Children’s Aid Society - Worker or the Probation Officer. This information is located in the database and on the paper client file on the Approved Contact List. Any changes to this list must be documented as they occur. 10.20 Visitors Visiting by family or friends of clients is permitted and encouraged. Visitors are permitted at the discretion of staff and are to remain in designated areas. Visitors causing a disturbance or violating program rules are asked to leave the facility. Providing appropriate supervision to clients will help to ensure the reduction of risk to clients with regards to personal injury, physical, sexual or emotional abuse. Good supervision of clients and being able to “read” the group will benefit staff when there are concerns with the group dynamics. Monitoring interactions, observing group dynamics, body language and verbal cues provides staff with valuable information. Clients should not be left unsupervised in the kitchen. During meals, staff should position themselves so that they have a view of all clients. One staff member should be seated at the table with the clients at all times to provide good supervision. Staff should strategically place themselves when there are known problems with specific clients. Where staff sits can assist in minimizing negative group dynamics. 10.22 Transporting Clients in the Community Staff use Agency/program vehicles for client transportation unless the vehicles are not available and public transportation is considered to be inappropriate. Permission from the Manager is required to use personal vehicles and one million dollars liability insurance is necessary. All staff providing transportation must possess a valid Drivers Licence. Preplanning is required for trips and will include:
The staff member driving will be responsible for the safe operation of the vehicle and security of the vehicle and keys. Additional information is available in the H/R Safe Driving Policy 6-740. Staff keys open the sliding door or the passenger side doors of the vehicle while clients enter to ensure their safety and supervision. Clients must wear seatbelts and remain seated while vehicles are in operation. After each outing, the driver is to inspect the vehicle for security and cleanliness and to ensure the vehicle has adequate gas for the next outing. Further information on Agency Vehicles is found in the Human Resource – Safe Driving/Vehicle Policy. 10.23 Food and Mealtimes in the ResidenceFood is not only important because it serves the basic needs of individuals, but also because it provides a wide range of opportunities for personal and group development, therapeutic relationships, skill development and other important aspects of providing effective client care for children and youth. Some of the areas and contexts in which the value of food can be maximized include: Skill Development – teaching clients how to cook, making menus, understanding nutrition and the use of the kitchen appliances, etc. Celebrating/Recognizing Diversity – ensuring that menus reflect cultures and allowing clients to cook within their cultural traditions. Therapeutic Value – self esteem building through skill development, therapeutic interaction between staff and clients, nurture and comfort building. Program Development/Support – adding food to program activities in order to create a more nurturing and comforting environment, building program components around food related activities. Guidelines Related to Food and Mealtimes in the Programs The following guidelines have been developed to support the inclusion of food in the overall therapeutic process:
Further information on meeting client needs in this area is available in the Staff Handbook binder (MCYS Tool Kit on Healthy Eating Matters – Food and Nutrition Toolkit for Residential Care Settings, Achieving Cultural Competence - A Diversity Tool Kit for Residential Care Settings). 10.24 Discipline and Consequence Discipline covers all methods used to train and teach clients self-control and socially accepted behaviour. Discipline does not inflict physical or psychological harm. When clients break rules and/or do not follow program expectations, they may receive consequences. Consequences should be consistent with the age and stage of the client’s development. Good disciplinary practices include:
Consequences should be discussed with all staff on the shift. The client needs to know that all staff supports the consequence being issued.
Clients will benefit from supportive interventions and consequences that:
When thinking about applying a consequence, the following questions should be considered:
Staff should be creative and thoughtful when giving consequences. Since each client is a unique person, consequences should reflect this. Sometimes allowing the client to have input into the consequence can be a valuable experience for everyone. The following are some examples of consequence options that might be considered:
Further information regarding behaviour management and discipline can be found in the Policies and Procedures Manual, Client Service # 10-130. 10.25 Nutrition, Medical and Behaviour Advice The Agency ensures that medical and behavioural advice and support is sought if a client:
Further information on meeting client needs in this area is available in the Staff Handbook binder (MCYS Tool Kit on Healthy Eating Matters – Food and Nutrition Toolkit for Residential Care Settings, Achieving Cultural Competence - A Diversity Tool Kit for Residential Care Settings). 10.26 Client Health The programs ensure that clients have access to counselling, emergency dental, medical, psychiatric and psychological services, ensuring that any client suspected of having a contagious disease or an acute illness receives immediate medical attention. Upon admission, clients are referred for medical examination within 72 hours after admission (if not completed 30 days prior to admission). Clients are referred for a dental examination within 90 days after admission (if not completed within 6 months prior to admission. If appointment times for these examinations cannot be secured because of physician schedules, etc., the reasons for the delay must be noted in the client file. Upon request and according to need, clients are referred for emergency dental, psychological, psychiatric, medical and counselling services. All doctor, dental and vision appointments and outcomes are recorded in the medical section of the client file. All clients have at least one annual assessment of their health, dental, vision and hearing status. Procedures recommended by the doctor or the health unit are followed for the prevention and control of disease. Clients receive basic education and life skills instruction, suitable to the client’s level of understanding in personal hygiene and health care. Basic areas covered include:
All clients receiving medication have a medication chart in the staff office, which is signed and dated each time a staff member dispenses drugs. Medications are kept in a locked cabinet at all times. Where in the opinion of the physician, a client under the age of 16 will derive some benefit from the responsibility of administering their own medication; a copy of the physician’s written self medication order will be kept in the client file. Prescribed medications will be provided only on time limited written orders from a physician. All prescribed medication is labelled with name and dosage, the name of client, the name of prescribing doctor and a number or code identifying the written order. Drugs are disposed of by returning them to the pharmacy. A form is signed by the pharmacy showing receipt of the medication. Medical services are provided by qualified health care professionals who adhere to professional standards and ethical codes. Specialized services for clients with developmental or physical disabilities are provided. Staff regularly communicate with physicians and dentists to meet the ongoing medical and dental needs of the client. Staff are responsible for fully explaining any proposed medical or dental treatment to the client in language appropriate to their age and comprehension. Staff will also follow the procedures recommended by a health care professional for the prevention and control of infection or disease and other health-related matters. Staff will seek a qualified health care professional to monitor and assess a client’s health in unusual situations such as hunger strikes, substance abuse etc. 10.28 Consent to Medical/Dental Treatment and History Verification
10.29 Emergency Medical/Dental Treatment Consent Client consent to treatment will be in accordance with the provisions of the Health Care Consent Act, 1996. In the case where the client may not be able to provide consent to treatment, staff are to obtain consent from the parent/guardian/caregiver or CAS Worker. Upon intake, staff will inform the client’s parent/guardian/caregiver of the various types of dental or medical treatment that may be received while in the program. Parents/guardian/caregiver are advised when medical attention is provided for serious issues. A report to a Children’s Aid Society (CAS), followed by a Serious Occurrence Report will be made in situations where elective medical or surgical care is required, but the parent/guardian/caregiver is unable or unwilling to give consent. Staff must also then contact the Probation Officer, where applicable. The written report must include:
10.30 Emergency Medical Treatment Clients and staff requiring emergency medical attention are to be escorted by staff to the hospital or to the after hours medical clinic. Staff must use their own judgment in determining whether an ambulance is required to transport to the hospital or clinic. The Ministry of Health describes the following as situations that require emergency medical treatment:
Staff may also contact Telehealth Ontario at 1-866-797-0000 24 hours a day/7 days a week, which is sponsored by the Ontario Government. They may help staff determine if a trip to the hospital or doctor is necessary. 10.31 Accidents and Injuries The Agency requires that all clients and staff who are injured receive first aid treatment and professional medical attention as soon as possible. Client accidents and injuries are to be documented in a case note or Incident Report. Accidents and injuries of a serious nature may require the completion of a Serious Occurrence Report. 10.32 Arrest and Open Detention of Agency Client An internal Agency protocol has been established with the Peter Willis Residence, Open Detention Program in situations where clients in residential care are arrested and placed in the Peter Willis Residence. This protocol provides an opportunity for preplanning to help manage clients and support continuity of care. The following procedures are to be followed:
10.33 Client Voting in Municipal, Provincial and Federal Elections 10.34 Individual Counselling Staff provide individual counselling to assist clients with behavioural, emotional, educational, employment, addiction and mental health issues. Counselling is provided to empower clients to resolve problems and to increase their overall sense of well-being. Goals for change are negotiated and clients are encouraged to take an active role in the process. All clients attend programming that focuses on Problem Solving, Youth Anger Control, Cognitive Living Skills, Life/Social Skills and Independent Living Skills. 10.36 Recreation Programs The Agency provides opportunities for residential clients to become involved in positive leisure activities, which include the use of the community resources. The Agency encourages clients to participate in recreational and leisure activities that promote physical, social and cultural benefits for clients in their care. Daily activities are noted on the monthly calendar, which is completed with client participation and is based on a monthly budget. This schedule cannot be altered without the authorization of the Manager or delegate. The purpose of the recreation schedule is to get clients out for some form of exercise each day. The recreation schedule fosters this based on the client’s individual risk levels, interests and abilities. Participation is highly encouraged by staff. Staff are also encouraged to organize in-house recreational activities. In-house activities can include playing board games, movies, video games, cards, crafts, baking etc. Equipment will be modified and activities altered in order to address mobility issues as they apply to certain clients. Staff are responsible for ensuring that safety precautions are adhered to and include the following:
Further information on meeting client needs in this subject area is available in the Staff Handbook binder (MCYS Tool Kit on Healthy Eating Matters – Food and Nutrition Toolkit for Residential Care Settings, Achieving Cultural Competence - A Diversity Tool Kit for Residential Care Settings). 10.37 Community Involvement The residential programs have supportive relationships with neighborhood and local community services in order to provide clients with opportunities to learn and develop skills and interests with other youth and adults. Involvement in community groups, events or volunteer work is geared to match the client’s ability and needs. 10.38 Transportation The residential programs provide transportation and staffing for clients to attend court, recreation, medical and clinical appointments. Where and when appropriate, clients are encouraged to use public transit. At RWH and VH transportation is provided for regular family visits within the immediate local area. Out of town visits are the responsibility of the family or the Children’s Aid Society. 10.39 Family/Guardian/Caregiver Visiting/Reintegration Whenever possible, family involvement and visits are encouraged. Visits may occur within the residence or in the community. At RWH and VH the level of family involvement and the number of family visits are determined by the CAS Worker at intake and during treatment/action plan reviews. At PWR, all family visits take place in the residence and are supervised by staff. PWR clients may also be eligible to spend time at the family home on reintegration leaves. 10.40 Day Treatment St. Leonard’s Community Services provides day treatment classrooms. The Agency refers to these classrooms as Learning Centres. Learning Centres are available at the following sites: 1. Youth Action Centre 2. Peter Willis Residence 3. Addictions and Mental Health Centre Target Population Youth (aged 16 – 19) residing in the community and youth in the residential program at the Youth Resource Centre may access the classrooms at the Youth Action Centre. Applicants under the age of 16 will be considered on an individual basis. Youth (aged 12- 18) residing in the open detention/open custody program at the Peter Willis Residence may access the classroom at that location. Youth (aged 12 – 17) residing in the residential program at Varency Home may access the classroom at that site. Youth (aged 12 – 17) residing in the residential programs at Roy Walsh Home, may access the classroom at the Addictions and Mental Health Centre. Appropriate Referral Appropriate referrals include clients with emotional, social, legal, mental health and/or behavioural problems, which have interfered with their educational progress. The Learning Centre classroom is an appropriate option for clients who have not benefited from interventions within the regular school system. Inappropriate Referral Some clients may not be deemed appropriate as a result of intellectual or physical disabilities that would interfere with their ability to benefit from the Learning Centre classroom. The introduction of the client into the Learning Centre classroom should not interfere with the safety and functioning of the classroom or the treatment of existing clients. Intake/Admission Process Admission to the Learning Centre takes place on a planned basis, whenever possible. Relevant history, assessment findings and known risk factors are communicated to the Learning Staff in a timely manner, preferably prior to admission. Whenever possible, at least one visit takes place at the Learning Centre prior to admission. The client’s admission to the Learning Centre is managed with sensitivity, respect, transparency and in a manner that reflects the preferences of the client and parent/guardians. Staff understand and work with separation issues for clients admitted into a Learning Centre setting. Admissions are processed as vacancies occur. PROGRAM DESCRIPTION The Learning Centres offer an integrated treatment and educational classroom for clients between the ages of 12 and 19 years. The Learning Centres are offered in partnership with the Grand Erie District School Board (GEDSB). A full time teacher and a Classroom Counsellor are assigned to each Learning Centre classroom. The Learning Centres are designed to ensure that the curriculum and environment are provided in a manner appropriate to the chronological ages and development levels of the clients referred. Clients attend the Learning Centres during normal school hours. A range of academic, educational and/or work activities are offered, appropriate to the learning style, needs and achievement level of the clients in the program. Staff promote the assimilation of learning and transference to future situations. The Learning Centre staff work “moment to moment” with clients, using situations that arise daily in the classroom as opportunities to intervene. Staff are able to apply behaviour management techniques appropriate to the client’s development and level of understanding. For clients involved in Agency services with a Counsellor (Primary Worker), the Counsellor (Primary Worker) and Classroom Counsellor cooperatively assess and develop a Treatment/Action Plan with the client. Where there is multiple service involvement and there is no Counsellor (Primary Worker), the Classroom Counsellors will act as the primary contact. The Learning Centre staff are part of the multidisciplinary process; planning, monitoring and reviewing the educational treatment plan for each client enrolled in the Learning Centre classroom. Communication is fostered through activities such as staff meetings, memos, progress reviews, supervision, case conferences and case management meetings. Grand Erie District School Board teachers and Classroom Counsellors from St. Leonard’s Community Services, staff the Learning Centres. Classroom Counsellors also provide support for clients who are integrating back into community classroom settings or into the labour market. The Learning Centres operate throughout the school year and during regular school hours. The Peter Willis Residence Learning Centre provides a summer school opportunity for clients who reside at that location. Where necessary, the residential programs provide transportation to and from the Learning Centres for Agency residential clients. Transportation for community participants is not provided by the Agency. Clientsmay run away from a residential program for a variety of reasons, including:
Clients who run away usually plan to do so in advance and they are sometimes well prepared. It is important to recognize the possible warning signs that a client is thinking of running away:
Pro-active measures are the key to prevent running. The best way to prevent running is to know the client. If a client has a history of running behaviour, a treatment/action plan specifically designed to address prevention of future occurrences should be put in place. Where the client has no history of “running” but has started to engage in this activity, a time limited (up to 72 hours) safety contract should be drawn up immediately to respond. The safety contract is negotiated with the client, the Counsellor, other involved Agency staff and whenever possible, other external service providers. The safety contract will identify a course of action in the event that the client does leave or is thinking of leaving. This may include some one on one time with a staff member to do something meaningful that will reduce the stress and risk of running. The safety contract will be documented in the client file and will be signed by the client and the Counsellor. The safety contract is reviewed daily and if the running continues, an immediate treatment/action plan goal will be developed. When staff become aware that a client may be missing, they will:
When a client is missing from the residence for 24 hours or more, or less than 24 hours and is considered to pose a serious threat to self or others, the absence is considered to be a Serious If a client residing at PWR does not return as expected from a Reintegration Leave, they are considered Unlawfully At Large and the Manager/Supervisor or staff on call is to be notified. PWR clients who run from a staff escorted outing or from the PWR facility are considered to have escaped from lawful custody. If this occurs, the PWR staff will advise the Manager, Supervisor or staff on call. When the client is deemed missing, staff will take the following action:
Knowledge of Whereabouts of a Missing ClientIf staff become aware of a missing child’s location, staff are not permitted to pick up the client. Staff should notify police of the suspected location of the client and that a missing person’s report has been filed. Staff will ask the police to return the client to the residence, with the exception of the Peter Willis Residence. If the Missing Client ReturnsStaff must immediately:
When possible, staff should provide comfort to the client by encouraging him/her to take a shower, have something to eat and sleep if necessary. |
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