Appendix – Varency Home (7/01/08 )
Table of Contents – Program Location

Varency Home Resource Description

DOCUMENTING

1. Distribution of Documents

FACILITIES

1. Program Vehicles

FINANCES

1. Financial Dealings on Individual and Group Outings

CLIENT SERVICE

1. Urgent Intake Protocol
2. Health Care Providers
3. One to One Coverage

Varency Home
RESOURCE DESCRIPTION

1.0  IDENTIFYING INFORMATION

Operator’s Name - St. Leonard’s Community Services
1100 Clarence Street South, Suite 101
P.O. Box 638
Brantford, Ontario N3T 5P9
Telephone - 519-759-8830
Executive Director - William B. Sanderson
E-Mail Address - wsanderson@st-leonards.com

Key Personnel

Jo-Anne Link, Director of Children’s Residential Services
Sherri Graham, Manager

Program Specialists

Clinical Consultant - Dr. Gwen Dutrizac, Child Psychologist

2.0  RESOURCE INFORMATION

Location
Address - 267 Concession 6 Road
Jarvis, Ontario
519-587-2007
Per Diem - $275.00

Bed Capacity - 8                                           

Type of Resource - Therapeutic Group Home

Association/Affiliation - Children’s Mental Health Ontario (CMHO).

3.0  PHYSICAL DESCRIPTION OF RESOURCE:

The residence is a large side split home on a one acre lot located in a quiet rural community.  The main floor of the home consists of a kitchen, dining room, living room, washroom, meeting room and staff office.  The first and second floor bedroom wings contain an office, bedrooms and bathrooms.  The basement area of the home contains a recreation room, a classroom, a utility room, a laundry room and general storage.  The home has a large fenced in backyard and a parking area.

Number of single bedrooms - 10                               Number of Bathrooms - 3
Number of shared bedrooms - 0
Bedrooms in basement - None

Bedrooms are equipped with the following for each client:

• bed,                      
• dresser,
• desk,         
• chair.

Clients are allowed free access to all living areas within the residence, with due regard for the privacy, safety and personal possessions of others.  Staff members knock before entering a client’s bedroom.  The program has a room in the residence for private visits and meetings.

Surrounding Community

Varency Home is located in Jarvis, Ontario.  Community facilities include 4 churches, a public library, an elementary school, an OPP sub-office and fire station, medical offices, a pharmacy, restaurant, a community centre and a few small businesses.  Other community facilities and services are located in the neighbouring communities of Simcoe, Port Dover, Townsend, Hagersville and Brantford.  Clients residing at Varency Home have access to local shopping, public parks, medical services, social service agencies and schools, community, recreation and social services.

4.0  PROGRAM DESCRIPTION

Target Population - Children/youth aged 12 – 17 years who are in care of child welfare agencies and/or youth aged 12 – 17 years with complex and multiple needs, who are in need of a long term structured residential placement.

Treatment Focus – Long-term care for relationship resistant children/youth, children/youth with trauma histories, children/youth with learning problems and children/youth with mental health challenges.

Appropriate Referral - Children/youth must be intellectually capable of responding to a cognitive behavioural program that involves counselling, problem solving and natural and logical consequences.  The residence can accommodate children/youth experiencing major social/emotional, or mental health difficulties, including anxiety, depression, ADHD, Conduct Disorder, Attachment Disorder, Oppositional Defiant Disorder, Youthful Offender behaviour, aggressive behaviours, destructive behaviours, poor peer relationships, learning disabilities, suicidal ideation and substance abuse, etc.

Inappropriate Referral - Children/youth younger than 12, or who have passed their 17th birthday cannot be accommodated and children/youth who are medically fragile or who have severe developmental delays are not appropriate candidates for the program.

Children/youth with serious psychiatric problems are not appropriate, although exceptions may be made if the disorder is managed by medication.  Children/youth, who are actively suicidal, have active psychosis, severe cognitive or social delays, active and recent fire setting behaviours, medical fragility (chronic unstable medical conditions) or active, recent sexual predatory behaviour would not be suitable candidates for the program.

DOCUMENTING

1) Distribution of Documents

Unless otherwise specified, all reports and minutes are to be reviewed by the Manager or delegate before distribution.  Some documents have a “circulation check off list” that must be completed to confirm the documents have been sent.  In all cases, the circulation checklist should be noted on the original document. 

The following chart outlines whom various reports and minutes will be distributed to in order to ensure good communication.

FACILITIES

1) Program Vehicles

Varency Home has two vehicles to accommodate program outings (2004 Blue Montana Van, licence plate ATLM 221, VIN #1GMDUO3E54D26449 and a 2004 White Van, licence plate ATLM 253, VIN#1GMDU03E64D259793)

The following security procedures must be adhered to:

• Vehicles must be locked at all times.
• Vehicle keys must be locked in the key box when not on a staff member’s person.
• Damage and maintenance issues must be reported immediately to the Manager.
• Vehicles will be sent in for oil change and general inspection every 3 months or 5,000 km.
• Garbage must be removed from the vehicle after every use.
• All damage or mechanical problems must be reported to the Manager immediately.
• Vehicles are to be inspected at the beginning of each shift to ensure there are no hazards or safety issues.
• No eating or drinking is allowed in the vehicles at any time, by either client or staff.
• No smoking is allowed in the vehicles at any time, by either clients or staff.

FINANCES

1) Financial Dealings on Individual and Group Outings

Primary Workers (Counsellors) are encouraged to take clients on their caseload for a one to one outing in order to develop and enhance relationships.  This could be incorporated into a weekly meeting or a one to one counselling session.  Outings may include treats that must be paid for by the Agency.

The program budget allows for a $2.00 purchase per client every couple of weeks.  In the event a staff member wishes to provide positive reinforcement by way of a meal, the Manager/delegate must approve the expenditure prior to the outing.  All expenses must be pre-approved and processed through petty cash.

Breakfast - $10.00 (2 people – staff member and client),
Lunch - $15.00 (2 people – staff member and client),
Supper - $20.00 (2 people – staff member and client).

During group outings, the purchase of treats must be preplanned and scheduled as part of the outing and it will be posted on the monthly recreation schedule.  Should the event be changed, an alternative plan must be negotiated with the Shift Co-ordinator.

CLIENT SERVICE

1) Urgent Intake Protocol

Typically, all referrals and admissions to Roy Walsh and Varency Homes are involved in a pre-placement process that ensures appropriate placement and planning for the young person in need of a placement. 

In some cases, the need for an urgent placement means that there is insufficient time to complete the regular pre-placement and admission process.  In order to provide the opportunity for an urgent placement while still maintaining the necessary planning steps, Roy Walsh and Varency Homes and the referring agency will abide by the following process.

• Roy Walsh Home can provide up to 1 urgent bed. 
• Varency Home can provide up to 1 urgent bed.
• The target population for the urgent available bed will be the same as the regular target group.
• Urgent referrals and admissions will be accommodated during regular business hours, Monday through Friday.
• On the date scheduled for admission, the Youth’s CAS Worker will arrive at the residence with the new client.  The CAS Worker will provide case file documentation and they will sign the required admission documents and service agreement.  A valid health and green shield (or other benefits card must be presented at time of admission.  Any medication prescribed to the youth, must also be presented during the admission session.
• Upon admission, the youth being admitted will receive an initial orientation to the program.  Orientation will include the following - A. Welcome, B. Orientation (signing all necessary admission documents), C. Introduction and Assignment to a Primary Worker (Counsellor), D. A copy and a review of the Client Handbook.  It is expected that new clients will arrive with their medical completed.  Medical documentation is to be provided by the CAS Worker at time of admission.  In the event that a medical examination has not taken place, staff will ensure this is completed within 72 hours.
• When an urgent referral is admitted, a Post Placement Review conference will be scheduled to take place within 72 hours of admission.  The conference will include the Manager, or delegate, the Intake Supervisor and Counsellor (Primary Worker).  The CAS representatives should include the referring worker, the child’s social worker, or other worker who is familiar with the client and able to speak to the case.
• The Post Placement Review Conference will be conducted to A) Share information, and B) Make decisions and plans about the placement.
• Sharing Information - The CAS Worker will bring any social history, assessments, school reports and admissions documentation that was not provided at admission.  Information will be shared about the client, family and plans.
• Decision Making and Planning – The Post Placement Review Conference will answer questions about client placement planning, including the following:

Agenda for Post Placement Review Conference

The following will be reviewed in the Post Placement Review Conference:

• The youth’s situation and their suitability for the program,
• The youth’s feelings about the placement,
• The youth’s future plans,
• The youth’s needs and goals.

If it is determined that Roy Walsh or Varency Home is a suitable placement and the youth is prepared to make a commitment to the program, a date for the 7-day visit will be set.  Additionally, during the Post Placement Review Conference, the following must also be addressed/completed:

• Staff ensure that all signatures have been obtained on admission information.
• Any outstanding identification, health card and green shield card to be obtained.
• The CAS Worker will bring the youth’s file.  The social history, assessments, school reports and admissions documentation that were not provided on the day of admission will be photocopied for the Roy Walsh Home client file.
• An approved contact list is to be developed, including the visitor screening plan.
• Clothing checklist and plans to obtain clothing.  A purchase budget is prepared.
• Long term and short term planning.  If it is a short term client, staff will establish a plan for discharge
• Special needs of the child – i.e. medical, referral to Addiction and Mental Health Services, counselling, court, etc.
• Additional resources needed – i.e.: special rate agreement, 1:1 staffing.
• Schooling – referral to Day Treatment Classroom required?
• Family plan for visiting or re-integration.
• Risk management issues – i.e.: medication? safety planning.
• Assessment – Does the client require a Psychological/Psychiatric Assessment?
• Staff identify the CAS Children’s Service Worker who will be taking the case.
• Setting a date for the 30-day treatment plan.

Details discussed and agreements made during the post placement conference review will be documented in a case note on the client file.

2) Health Care Providers

Clients can access their own dentist, physician, etc.  In the event that a client does not have health care providers, the residence uses the following health care providers/services:

Dental - Dr. Rassam, 2121 Main Street N, Jarvis, Ontario, 519-587-3368,
Optometrist - Dr. Richards, 12 Alma Street, Hagersville, Ontario (519) 768-5721,
Walk in Medical Centres - Fairview Medical Clinic, 222 Fairview Drive, Brantford, Ontario, 519-756-8340 and West Street Health Centre Walk-in Clinic, 216 West Street, Simcoe, Ontario, 519-428-0432,
Emergency Medical – West Haldimand General Hospital, 75 Parkview Road, Hagersville, Ontario, 905-768-3311.

3) One to One Coverage

Role and Responsibilities

From time to time, “One to One” staffing coverage is provided for clients who need extra support.  Where possible, it is a best practice to have a consistent staff person (s) providing this coverage.

The staff person carrying out the “one to one” role is responsible for the following, in and out of the residence:

• Provide direct supervision and support to the client.
• Be aware of all client information before beginning their shift.
• Identify themselves to the client at the beginning of their shift.
• Be available to the client they are working with and within close proximity. 
• Is aware of and works with the client on their Treatment/Action Plan goals.
• Supports the client in social settings and interactions by assisting with problem solving, coping strategies, crisis management or appropriate ways to engage their peers.
• Teaches, provides support and encouragement during daily routines (i.e. showers, hygiene, tidying their room, chores, etc.
• Provides support in the classroom by sitting with the client in school, assisting them with the completion of work.  This could include monitoring their performance, assisting in organizing their work, helping them to develop study habits, schoolwork comprehension, behaviour management support, etc.
• With the support of the Counsellor (Primary Worker), develops an individualized recreation plan or recreational outings for the shift.  All free time should be structured (recess, before dinner, lunch, etc.). 
• If the “one to one” staff requires a break, (i.e. bathroom, etc.) then the Shift Coordinator will decide upon an appropriate relief person and that person will identify themselves to the client requiring the one to one supervision and to the rest of the team on shift.  This will reverse when the assigned “one to one” staff returns from break.
• If the client assigned the “one to one” support, leaves the property on an unauthorized absence, the assigned “one to one” staff should follow the client while using calming, defusing, encouragement and other therapeutic counselling techniques to encourage the client to return to the program.  The house cell phone is to be utilized for safety and communication with the police and the residence during this time.  The only time a “one to one” staff will abandon this pursuit is if issues of safety present themselves.
• Consult and communicate regularly with the Counsellor (Primary Worker) in order to be consistent with approaches and planned interventions.
• Assists in assessing progress and risk.
• Records client progress, through progress notes, case notes, incident reports.
• Participates in shift briefing with the incoming “one to one” staff to update current situation and share information.

Note:  The “one to one” staff support will not be removed from the client to monitor someone else unless an extreme crisis situation is present in the residence.  The decision to take such action is made by a Supervisor on shift or Shift Coordinator.

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