Universal Policy Manual Island Crisis Care Society (Operations & Programs)

Transcription

Island Crisis Care Society
Universal Policy Manual
(Operations & Programs)
Revised: 11 June 2014
ICCS Universal Program Policy Manual
1
Table of Contents
Introduction 5
About this Policy Manual and ICCS Policies 5
What is a policy? ....................................... 5
Verbal Understandings ....................................... 6
Governance Policies and the Board of Directors ....................................... 6
Procedures ....................................... 6
HISTORY 8
Who Started ICCS? ....................................... 8
Why was ICCS started? ....................................... 8
Is the Society a Registered Non-Profit Society? ....................................... 8
Does ICCS have Church affiliations? ....................................... 8
What does ICCS Do? ....................................... 9
ICCS Motto ....................................... 10
ICCS Vision Statement ....................................... 10
ICCS Mission Statement ....................................... 10
Universal Employee Policies
1 Payroll & Work Practice
11
11
2 Hiring, Orientation, Training & Performance
34
3 Relationships
52
4 Conduct
58
5 Information & Communication
92
1.1
Wages, Statutory Holidays, Vacations, Employee Benefits ....................................... 11
1.2
Paycheque Distribution ....................................... 11
1.3
Statutory Holidays ....................................... 12
1.4
Meals and Rest Periods ....................................... 13
1.5Hours of Work ....................................... 14
1.6
Sickness and Sick Leave ....................................... 15
1.7
Requesting Time Off ....................................... 18
1.8
Relief Coverage Flow Chart ....................................... 19
1.9
Short and Long Notice ....................................... 20
1.10
Call in Procedure ....................................... 21
1.11
Overtime Call in ....................................... 24
1.12Block Assignment of Additional Hours ....................................... 25
1.13
Positions ....................................... 28
1.14
Job Abandonment ....................................... 31
1.15
Continual Employee Presence On site ....................................... 32
2.1
Criminal Record Checks ....................................... 34
2.2Training Required ....................................... 36
2.3
Orientation ....................................... 38
2.4
Probationary Period ....................................... 40
2.5
Performance - Evaluations ....................................... 41
2.6
Performance - Discipline ....................................... 42
2.7Attendance Management ....................................... 43
3.1
Working with Coworkers ....................................... 52
3.2
Working with Management ....................................... 53
3.3Employment of Relatives ....................................... 54
3.4Dating Between Employees ....................................... 56
4.1
Code of Ethics for ICCS Employees ....................................... 58
4.2Harassment and Bullying ....................................... 76
4.3Abuse ....................................... 82
4.4Dress Code, Personal Appearance, Name Tags ....................................... 85
4.5Theft ....................................... 90
4.6Transactions ....................................... 91
5.1Gender Pronouns in ICCS Material ....................................... 92
5.2
Scheduling ....................................... 93
5.3Bulletin Boards ....................................... 94
5.4
Meetings ....................................... 95
5.5
Change of Address ....................................... 96
5.6Employee Resignations ....................................... 97
5.7
Use of Personal Devices & Electronics ....................................... 98
5.8
Use of Communication Systems ....................................... 99
5.9
Personnel Files ....................................... 102
5.10
Release of Personal Information ....................................... 103
5.11
Mail ....................................... 104
5.12
Media Contacts ....................................... 105
2
6 Health and Safety
106
6.1
Unsafe Situations, Tasks, or Operations ....................................... 106
6.2
Injury on Duty ....................................... 106
6.3
Smoking ....................................... 108
6.4
Substance Misuse ....................................... 109
6.5
Violence in the Workplace ....................................... 110
6.6Hazardous Materials ....................................... 112
6.7
Storage of Cleaning Products ....................................... 115
6.8
Cleaning up Blood and other Biohazards ....................................... 116
6.9
Snow Shoveling ....................................... 117
6.10No Pets ....................................... 120
6.11
Working Alone ....................................... 122
Universal Program Policies 123
7 Legal & Ethical
123
7.1Non-discrimination ....................................... 123
7.2
Confidentiality ....................................... 124
7.3Gifts, Loans and Bequests ....................................... 128
8 Client Care 129
9 Critical Incidents
184
10 Operations Policies
217
8.1
Objectives of Client Care ....................................... 129
8.2
Client Rights ....................................... 130
8.3
Personal Care ....................................... 133
8.4
Personal Service Plan ....................................... 134
8.5Admittance ....................................... 136
8.6Discharge ....................................... 136
8.7Disease and Parasites ....................................... 137
8.8
Curfew ....................................... 148
8.9
Client Dress Code ....................................... 149
8.10
Medications,vitamin,Etc. ....................................... 152
8.11
Client Telephone Use ....................................... 159
8.12
Visitors/ Drop-In ....................................... 160
8.13Laundry and Shower ....................................... 162
8.14
Suicide ....................................... 163
8.15Alcohol and Similar Substances ....................................... 166
8.16
Search Of Client’s Room & Belongings ....................................... 167
8.17
Safety Checks ....................................... 168
8.18
Client Grievances, Concerns, and Complaints ....................................... 170
8.19
Client Privacy ....................................... 176
8.20
Client Related Abuse & Harassment ....................................... 177
8.21
Psychosocial Supports ....................................... 178
9.1General Emergency Plan ....................................... 184
9.2Definition of Critical Incident ....................................... 187
9.3
Incident Reports ....................................... 190
9.4Fire ....................................... 193
9.5Earthquake ....................................... 195
9.6Death ....................................... 198
9.7
Serious Infectious Diseases ....................................... 199
9.8
Pandemic ....................................... 200
9.9Tampering and Poisoning ....................................... 216
10.1Groceries, Food, Meals ....................................... 217
10.2Laundry ....................................... 219
10.3
Pest Control ....................................... 222
10.4
Per Diem Funding Shortfalls ....................................... 224
11 Volunteers
11.1
225
Reimbursement of Volunteers & Employees ....................................... 225
12 Operational Financial Practices at ICCS
227
Program Specific Policies
1 Samaritan House Program Specific Policies
234
234
12.1Financial Reports and Budgets ....................................... 227
12.2Audits ....................................... 228
12.3Accounting Practices and Controls ....................................... 229
12.4Gift in Kind Donation Policy ....................................... 230
12.5
Use of Requisitions ....................................... 231
12.6
Use of Business MasterCards ....................................... 232
1.1Access ....................................... 234
3
1.2
Restrictions of Access ....................................... 238
2.1
Medication Policy ....................................... 245
3.1
Informed Consent to Service ....................................... 246
2 Bridge Program Specific Policies
3 Registered Assisted Living Programs
4
245
246
I n t r o d u cti o n
About this Policy Manual and ICCS Policies
What is a policy?
A policy is an official statement that informs and guides decisions and
behaviour.
Policy offers reference points and rationale to aid understanding and ensure consistent practice. Therefore it is important, where possible, to follow
each policy carefully and consistently.
Careful adherence to written policy, however, is not always enough.
Understanding the spirit and intention behind each policy yields the best
practice of all. Even a great set of policies can not resolve every question.
Being legalistic about a policy misses the point.
ICCS policy is informed, considered, researched and supported by evidence; and above all it reflects not just the current best practices in the
field, but also the larger philosophical framework of the organization and
it’s core values.
Island Crisis Care Society’s larger philosophical framework is summed up
in the saying, “And now these three remain: faith, hope and love. But the
greatest of these is love.” Love is our primary value and essential quality.
It informs a generous attitude in how we treat each other and the people
we serve. It is expressed in grace and empathy and a mindful intention to
accept others without condition. If a policy is incomplete, ask the question, what is the most loving thing to do?
How are ICCS policies created?
The policies in this manual have been created collaboratively. At the
program level a program manager identifies a need for a policy and asks
for input from her team. The manager presents her recommendations at
a policy meeting with the management team. When the team reaches
consensus1 on the goal and wording of the policy it is edited and authorized for publication by the Policy and Publications Manager or the Executive Director.
1 When consensus is not achieved, and a policy is urgently needed, a strong majority will suffice.
5
Once formed, a policy is followed or practiced until it is reviewed. Policies
can always be made better.
Verbal Understandings
Some policies exist as verbal understandings amongst colleagues and
these policies, while less formal, may still be considered official Policy. Writing down policies and publishing them takes time, so if a written policy
does not exist, ask if there is a verbal understanding in place and if so, follow that.
Governance Policies and the Board of Directors
The Board of directors of ICCS is responsible for excellence in governing
the society, including the creation of governance policy.
Governance policies are different from the policies contained in this manual. This manual contains operational and program policies.
For the policies that govern the Board of Directors, the Executive Director,
and the society as a whole, see the society’s Governance Policy, which is
available to ICCS members upon request.
Management develops and maintains this policy manual, which, by
Board of Director mandate, shall be provided to all employees.
The Board of Directors, while chiefly responsible for governance policy,
does review all operational policies quarterly and all operational policies
must be reviewed by the Board of Directors.
Procedures
A policy often contains a procedure or set of procedures. In general the
procedures change more often than the policy, but occasionally policies
must also be changed to meet the changes in law, a collective agreement, or the contract with a funding agency, or because the situation
that lead to a policy has changed.
Procedures are methods – they are ways of carrying out a policy. Forms
may be part of a procedure. In other words, to carry out a procedure it
may be necessary to complete one or more forms.
Note: If a policy in this manual or its application are contrary in any way
6
to the collective agreement the collective agreement shall take precedent.
7
HISTORY
Who Started ICCS?
The society was started in 1989 by Matthew Brown and another man.
Other early members included: Phil Dockerill, Barry G. Low, Steven Roper,
and Terrance Totzke.
Why was ICCS started?
In 1984 Matthew & his friend were working for the Salvation Army and realized that there was a need for emergency and temporary housing that
was not being met by existing Salvation Army programs. Since a solution
remained beyond the capabilities or mandate of the local Salvation Army
at that time they felt called to step out in faith and provide shelter for
those they saw in need.
Is the Society a Registered Non-Profit Society?
Yes. The society was incorporated as a Charitable Non-Profit Society on
March 30th, 1989. BN/ Registration Number 13707 7111 RR 0001.
Does ICCS have Church affiliations?
Island Crisis Care Society is an independent entity with members from a
broad spectrum of Christian denominations. Over the years the board of
directors have included individuals from the following denominations: Salvation Army, Baptist, Lutheran, Presbyterian, Catholic, Christian Reformed,
and Pentecostal. ICCS is interested in working with any Christian denomination or group that wishes to help us in our work with those in need.
8
What does ICCS Do?
Since our Mission is to provide shelter and care for those in need our efforts
have been focused around housing. We offer emergency temporary shelter for Women and Children at Samaritan House and have tried several
different models for transitional housing, the most successful model being
a form of short term supported housing we call crisis housing.
Crisis housing is safe, dependable shelter under the supervision of the society and accompanied by in-services from professional health care workers. It is designed primarily for individuals who need short term crisis stabilization and emotional support in a non-clinical environment. Acute and
post acute withdrawal symptoms and behaviour are common in stabilizing clients. We offer crisis housing at Hirst House, Safe Harbour House, and
Crescent House.
The Bridge is an extension of Safe Harbour House and provides long term
supported housing with a recovery focus.
For more information on the mission statements of your program, see the
program section below.
9
ICCS Motto
Hands of Care in the Heart of the Island
ICCS Vision Statement
To provide shelter and care for those in need, reflecting the love of God in
loving one another.
ICCS Mission Statement
• Being hands of care in the heart of the Island we will endeavour to:
• Help meet the immediate physical needs of those who come to our
doors.
• Provide counsel, guidance and prayer to aid those in need.
• Develop and provide programs to improve the quality of life of those
who seek our help.
• Recognize that the whole person (body, soul and spirit) needs care.
• Bring comfort through the provision of quality Christian care.
10
U n i v e r s a l E m p l o y e e P o l ici e s
1 Payroll & Wo rk P ra c tice
1.1
Wages, Statutory Holidays, Vacations, Employee Benefits
1.1. A) For guidance on wages, statutory holidays, vacations, and employee benefits please refer to the following sections of the collective agreement:
1.2
1
Holidays - Article 17
2
Vacation - Article 18
3
Sick Leave - Article 19
4
Leaves - Article 20
5
Wages - Article 26
6
Benefits - Article 27
7
Appendix A - Wage Grid
Paycheque Distribution
1.2. A) Payperiods are 2 weeks in length
11
1.3
Statutory Holidays2
1.3. A) ICCS recognizes the following as paid statutory holidays:
1
New Year’s Day
2
Family Day
3
Good Friday
4
Easter Monday
5
Victoria Day
6
Canada Day
7
British Columbia Day
8
Labour Day
9
Thanksgiving Day
10
Remembrance Day
11
Christmas Day
12
Boxing Day
2 Policy Revised 15 April 2014
12
1.4
Meals and Rest Periods
1.4. A) Most ICCS worksites are staffed by only one employee at a time and
rest periods sometimes must be taken to accommodate busy periods.
Rest periods are provided according to the collective agreement
Section 14.3.
1.4. B) ICCS encourages all employees to take their meal break with residents and as such are provided as time worked at straight-time including the accrual of all benefits.
1.4. C) Sharing a common meal with clients has benefits beyond meeting
nutritional needs; it also provides an opportunity to demonstrate commonality and a shared humanity. Many workers find the opportunity
strengthens rapport with clients and encourages a healthy relationship of trust and cooperation that can not be achieved in other ways.
13
1.5
Hours of Work
1.5. A) Shifts at all ICCS programs are 8 hours in length to easily create 40
hour full-time positions and to match the language of the collective
agreement.
14
1.6
Sickness and Sick Leave
1.6. A) All ICCS programs operate 24 hours a day, 7 days a week. This kind
of schedule increases the number of workers needed each day, and
by extension, increases the number of potential gaps from absenteeism. For this reason we rely, more than many other work places, on
employees consistently fulfilling their work commitments, except when
prevented from doing so by accident, illness, or bona fide emergency3.
1.6. B) Employees who are unable to report to work at the scheduled time
due to illness must advise their program manager as soon as it is clear
they will not be able to attend work. The preferred means of notification is by telephone.
1.6. C) When illness is sudden and occurs just before the ill worker’s shift is
due to begin; and when it occurs during times of the day when a
manager is off shift, the notification shall be to the support worker on
shift at the time, or an alternative person designated for the task by
the program manager.
1.6. D) Last minute notice of an inability to attend work usually gives rise to
anxiety and stress in other workers, and is an inconvenience. While
last minute notices may not be avoidable with sudden-onset illnesses,
in most cases of common illnesses like the flu or a serious cold advanced notice is possible. Therefor, ICCS expects all of it’s employees
to exercise courtesy by providing early warning of absenteeism when
possible.
1.6. E) Employees are encouraged to take personal responsibility for preventing illness by exercising best practices such as hand washing,
work site surface sanitation, and outbreak prevention protocols.
1.6. F) Yearly flu shots are usually offered free of charge to ICCS employees
and the best current medical advice states that any potential harm
from receiving flu shots is outweighed by the potential harm and suffering caused by an influenza infection.
1
ICCS understands that some employees will choose not to take flu
shots for various reasons, and they are not “mandatory” for ICCS employees.
2
Employees are encouraged to take precautions to protect themselves and others from contracting an illness, including immune boosting alterative measures when flu shots are not taken.
3
Masks may be mandated by the health authority for employees who
3 Revised 16 May 2014
15
do not receive a flu shot. See the program specific section for more
details.
1.6. G) Employees must report any incidence of communicable disease to
their program manager.
1.6. H) ICCS has a policy and program for attendance management. Both
the policy and program are designed to address non-culpable absenteeism; were the legitimacy of the employee’s absences is not in
issue but the level of absenteeism is a concern. See the table of contents to locate this policy.
1.6. I) Culpable absenteeism is a matter for discipline.
1
Culpable absenteeism most often occurs when an employee claims
sickness and is absent, but evidence reveals or suggests that the true
cause of the absence is not sickness, but some other reason.
2
Where an investigation determines absenteeism to be culpable, the
matter will be dealt with through the imposition of appropriate discipline. See the Attendance Management Policy for more details.
1.6. J) See the collective agreement, Article 19, for information on the accumulation of sick leave credits, and other details related to sick leave.
1.6. K) As indicated in Article 19, regular full-time employees who have completed their probation period accrue sick leave credits at the rate of
one day per month to a maximum of one hundred and fifty six days.
1.6. L) Employees must have banked a full day of sick leave credits (8 hours)
in order to take a paid sick day --with two exceptions:
1
Sick leave credits of less than 8 hours may be used for medical appointments that cannot be scheduled outside of the employee’s
work hours, in which case the time away from the work site to attend
the appointment may be claimed as sick time;
2
Sick leave credits of less than 8 hours may also be used when an
employee becomes ill at work and needs to leave. In this case, the
portion of the shift not worked may be claimed as sick time.
1.6. M) The collective agreement states that employees must wait until their
probationary period has been completed in a permanent position
before they can use sick time, but in practice this does not happen,
because our payroll software, ADP, starts accruing credits as soon as
an employee is awarded a permanent position.
1.6. N) When approving sick time on the ADP timecard, managers will make
sure that employees have enough sick time credits to cover the re16
quested sick time, as the system will go into the negative without an
exception.
1.6. O) When recording the leave in ADP, permanent employees should use “general leave” as the pay code and casual employees should use “absent” as
the pay code. “Sick unpaid” is only used when an employee is off on long
term sick leave and is paying their own benefits.
17
1.7
Requesting Time Off4
1.7. A) Vacation requests must be submitted as per 18.5 of the
collective agreement.
1.7. B) Vacation requests made after those dates specified in
the collective agreement5 shall be submitted through
ADP 14 days prior to the date of the requested vacation day(s).
1.7. C) Requests for general leave (20.6) must be submitted
through ADP 14 days prior to the date of the requested
time off.
1.7. D) Sick leave (19), compassionate leave (20.1), special
leave (20.2), leave for full-time Union or public duties
(20.3), leave for court appearances (20.4), and leave
for elections (20.5), are not subject to the 14 day deadlines.
4 Requesting Time Off re-worded for clarity 11 December 2013
5 (18.5.a 1&2)
18
1.8
Relief Coverage Flow Chart6
6 “When to Use Short and Long Notice” flow chart revised 14 November 2013
19
1.9
Short and Long Notice7
7 Call in diagram revised 14 November 2013
20
1.10 Call in Procedure
1.10. A)For Covering Vacation and Sick Time
1
The Call in Procedure is illustrated by the preceding diagram and the
Call in Rules that apply to the procedure as outlined below.
2
Employees who have filled out an availability form (see below)will be
called by phone for available shifts that match their availability. Texting and e-mail may be used instead of a phone call but if a response
is not received to a text or e-mail, a phone call must be made.8
3
Seniority
•
Employees will be assigned, listed, and called in order of Seniority.
--
Qualified available employees will be assigned work in
order of seniority as per Article 14.2(e) of the collective
agreement.
--
All casuals will be listed in order of seniority on one “call-in”
list that is updated bimonthly (as per Art. 30.2(b)).
--
All casuals will be called in order of seniority as indicated
in the collective agreement Article 30.3. The Call In Rules
below were developed in response to Article 30.3.
4
The Call In Rules were developed in response to article 30.3.
5
If the shift being filled is qualified as an overtime shift the overtime will
be given out equitably using the “overtime sharing log”.
1.10. B)Call-in Rules
1
2
Regular Part Time Employees
•
Regular part time employees who wish to work additional hours
(up to their full-time maximum) must register their request for
more hours using the Request Hours Form1.
•
Regular part time employees who have filled out a Request For
Additional Hours form must also fill in a Shift Availability form for
each month.
•
A regular employee may adjust or remove her availability at
any time prior to being assigned work by using the Shift Availability Form or requesting that her Request for Additional Hours
form be removed from her file.
Casual Employees
•
Shift Availability
8 Allowance of texting and e-mail added December 2013
21
•
3
--
Casual Employees must fill in a Shift Availability Form for
EACH month. This form is due on the 1st of the month prior
to the month of availability. i.e. December availability is
due November 1st.
--
Casuals will be considered active as long as they complete the Shift Availability Form.
--
Casuals failing to complete an Availability Form will be
placed on an “inactive” list and will no longer be called.
--
Casuals who have not handed in an availability form
by the due date 3 consective months in a row shall be
deemed to have resigned from their employment with
ICCS. 9
Availability. Casuals must be available:
--
to work midnight to 8:00 a.m. (00:00 - 08:00) shifts (unless
not working nights has been authorized by a manager),10
--
to work Statutory Holidays,
--
to work a minimum of fifteen (15) days per month (unless
limited availability has been authorized in writing by the
manager);
--
to work a shift Saturday and Sunday of the same weekend on 2 weeks each month (unless limited availability has
been authorized in writing by the manager).
•
A Casual must accept and work at least 1 shift per month if one
or more shifts are offered to them in a given month.
•
Casuals who refuse three consecutive shifts for which they have
stated they are available (for reasons other than injury, illness
or serious family emergency) will be deemed to have resigned
from their employment with ICCS.
•
Casuals who accept shifts are expected to work them. Casuals
who call in to “give away” shifts they have previously accepted
may be subject to discipline up to and including termination.
•
Casuals must return calls to the person calling to fill a shift (or
shifts) even if it has been more than 15 minutes since they received the call. This is to aid in clarity when filling out the call-in
log. Casuals must indicate that they are either accepting or
refusing the shift11.
All Employees
•
Mandatory Requirements for all Employees Who have Request-
9 Policy Revised 16 Apr 2014
10 Requirement to work midnight to 8:00 added December 2013
11 Requirement to call back the person making calls to fill a shift added December 2013
22
ed Additional Shifts
4
--
reports directly to the Manager
--
supplies the Manager with at least one (1) but not more
than three (3) contact phone numbers
--
remains aware of their scheduled hours of work once they
are assigned
--
shows up on time for scheduled shifts once they are assigned
--
calls the Manager at least four (4) hours before the start of
a shift if they cannot work the shift because of illness; or as
soon as possible in case of an emergency
--
informs the Manager of shifts already worked and/or assigned that would cause the employee to be unavailable
or in a position that would attract overtime pay or create
a scheduling conflict
--
fulfills scheduled shifts once they are assigned under the
same obligations as regularly scheduled work
The Manager (or person designated by the manager to perform
scheduling)
•
Will assign shifts in advance as soon as is reasonably possible
from the time the vacancy is known
23
1.11 Overtime Call in
1.11. A)If no casuals are available to fill a vacant shift, an overtime call in can
be performed according to the instructions on the over time call in
log.
24
1 . 1 2 B l o c k A s s i g n m e n t o f A d d i t i o n a l H o u r s 12
1.12. A)This policy ensures efficient scheduling through a simplified process
of assigning additional hours (see note 1 below) first and foremost by
blocks.
1.12. B)This policy shall be followed in concert with the Call in Procedure and
the Relief Coverage Flow Chart which were both updated on 16 June
2010 and again on 13 November 2013 to compliment this policy.
1.12. C)Once immediate and pressing scheduling needs have been covered
using the “short notice” procedure as outlined in the Call in Procedure, remaining blocks of work shall be assigned as follows:
1
Blocks of work shall be offered as a unit to the first available and qualified employee in the program who has requested additional hours in
writing and can work the entire block.
2
The assignment of the block will be made using the Call in Procedure
“Long Notice” instructions.
3
Employees already working part time positions may accept a block if
it does not require them to leave their existing position or amend their
existing rotation of shifts.
Important Note: An employee’s commitment to a “position” as outlined
in the Positions Policy below supports this priority to positions. The positions
Policy (Published on August 19, 2008) states that, “A regular worker must
work all of the shifts in his or her rotation each week.” This is a fundamental component of business efficiency and long standing policy at ICCS.
Therefore, regular employees will not be assigned blocks of work that
require them to leave their appointed positions and associated shift rotations.
4
If shifts can not be allocated as a block, as outlined above, the manager of the program (or person delegated to perform scheduling by
the manager) has the discretionary right to do the following:
•
Break the block into smaller blocks and offer each bock by seniority.
•
Break the block into smaller blocks and individual shifts and offer
each block or shift by seniority.
•
Break the block into individual shifts and offer each shift by seniority.
1.12. D)Background
12 Edited to conform with changes to the call in policy December 2013
25
26
1
In 1995 a grievance by a casual medical aide who was the most
senior employee on the casual list for her position went to arbitration because the Employer’s refused to break up blocks to accommodate her availability schedule. The arbitrator had to decide if the
employer could continue to assign blocks under their own discretion,
breaking them or keeping them together depending on the needs of
the program, or if the Employer was obligated to offer work which will
accommodate the grievor’s availability.
2
The employer favoured block booking because it was administratively easier, and it provided for greater continuity in a given job.
3
A previous decision (see note 2 below) had concluded that, “A
person who is available for only a portion of a casual vacancy is
not available to fill that vacancy and is therefore not entitled to the
work.”
4
The arbiter denied the 1995 grievance.
5
The primary explanation was that Management has a presumptive
right to direct its work force. This includes the hiring, scheduling and
replacing of employees. Management’s general rights are limited by
legislation and the terms of the Collective Agreement.
6
At ICCS the topic of block booking was not raised at collective bargaining and attempts to accommodate worker’s schedules in one
program have been time consuming and have directly contributed
to management burnout and turnover.
7
Our collective agreement speaks of casual “assignments,” a term
that implies some notion of work beyond a single shift. This was a supporting element in the 1995 decision.
8
Another decision (see note 3 below) concluded that, “Management has the presumptive privilege of making changes in the organization of its work force, as long as it is exercised in good faith and for
purposes of business efficiency, rather than the undermining of provisions of the agreement.”
9
This policy, therefore, establishes in good faith and for the purposes of
business efficiency instructions for filling blocks of shifts that have become available through vacations, sick leave, and other short term
absences.
10
Notes:
--
Note #1 These additional hours are those that have become available as a result of absence from work by a
regular employee due to illness, vacation, leaves, etc. It
does not refer to additional hours of work that result from
new funding, restructuring, or vacancies due to an employee leaving a regular position through retirement or
similar circumstances.
--
Note #2 Arbitrator Larson’s award in respect of Health
Labour Relations Association and the Hospital Employees’
Union. Local 180, unreported, June 30, 1983.
--
Note #3 Re Canron Ltd. Pipe Division and International
Molders and Allied Workers, Local 64 (1973) 4 L.A.C. (2d)
326, Arbitrator Hinnegan
27
1.13 Positions
1.13. A)The purpose of this policy is to support simple schedules made up primarily of positions that employees are obligated to work regularly.
1.13. B)ICCS runs on a model of scheduling in which “regular” employees are
awarded positions by appointment, and “casual” employees work a
variety of shifts without having been appointed to a position.
1.13. C)Positions are made up of a worker’s regular rotation of shifts. This rotation is specified in the original posting.
1.13. D)A regular worker must work all of the shifts in his or her rotation each
week.
1.13. E)Exceptions to the requirement include: vacations, statutory holidays,
sick leaves, and other leaves outlined in the collective agreement.
1.13. F)Changes to a position’s weekly rotation of shifts can be made only
when an exchange is possible with another employee (See article
15.1 of the collective agreement) or if a leave or vacation is granted
(see articles 18 – 21). Program managers can change an employee’s
rotation with 14 days notice (or less) as per article. 15.5.
1.13. G)Regular employees are entitled to pick up extra shifts within their classification and worksite (See article 14) to a maximum of 40 hours per
week as long as they continue to work their regular shifts and do not
contravene the collective agreement, labour standards, or ICCS policies.
1.13. H)Positions Policy requirements
28
1
Program Managers are responsible for drafting monthly schedules
which include all the regular posted positions, noting those shifts
within regular positions which are being covered temporarily by other
workers due to vacations or leaves.
2
This policy supersedes and replaces all previous policies.
3
All employees must be informed of this policy and are expected to
abide by it.
4
This policy must be available for reference at each work site.
5
This policy must be presented at a Staff Meeting by October 31st 2008
and presented regularly thereafter at the discretion of the Program
Manager.
6
All Programs of ICCS must meet the requirements of this policy.
1.13. I) Expectations related to the Positions Policy for Employees:
1
Employees will work their regular rotation of shifts consistently and
completely, except when illness, vacation, or other legitimate leaves
are granted, or if shift swaps are authorized.
2
Employees will submit their request for additional shifts in writing to
their program managers.
3
Employees will familiarize themselves with the sections of the collective agreement that relate to hours of work, shifts, and leaves and
vacations.
4
Employees will cooperate with program managers and fellow employees when illness and vacation necessitate changes to a program’s work schedule.
5
Employees will fill out all forms necessary to request vacations and
leaves such as the “Request for Compassionate Leave” form and the
“Request for Special and Other Leaves of Absence” form.
1.13. J) Expectations related to the Positions Policy for Managers
1
Managers will ensure that employees files include written requests for
extra shifts.
2
Managers will ensure that the monthly work schedule includes each
posted position’s rotation and identifies any gaps or shortages.
3
Managers will obtain and consult the most recent seniority lists prior to
the allocation of all vacation and sick leave shifts and will offer employees such shifts in the following sequential order:
4
•
Regular full time employees to a maximum of 40 hours per week
per employee by seniority
•
Regular part time employees to a maximum of 40 hours per
week per employee by seniority
•
Casual employees to a maximum of 40 hours per week per employee by seniority
Managers will ensure that any changes proposed for program work
schedules follow this policy and the collective agreement.
1.13. K)Positions shall be established by a committee consisting of at least
one program manager and at least one Executive prior to being
posted.
--
Notes: If, prior to the establishment of a “position” an
employee works a regular shift, week after week, and
those shifts have not been posted as a temporary posting,
then the worker is by definition working regularly. To avoid
grievances regarding the status of such positions, program
29
managers must post any recurring shift alone or as part of
a rotation in the form of a “position” as soon as possible.
30
--
An employee is required to give written notice of her desire for additional hours.
--
No employee can work more than 5 consecutive days
without receiving two consecutive days off, except where
an waiver of this right exists.
--
There must be a minimum of 8 hours off between shifts,
--
Hours of a shift can not be divided to allow a regular employee to stay within the 40 hour per week maximum;
1.14 Job Abandonment
1.14. A)Employees have a responsibility to report to work when scheduled.
1.14. B)Any employee who fails to report for work for two (2) consecutive
work days without notifying her supervisor and who cannot give an
acceptable reason for her absence shall be considered as having
abandoned his employment.
31
1 . 1 5 C o n t i n u a l E m p l o y e e P r e s e n c e O n s i t e 13
1.15. A)ICCS worksites designated as “continually staffed” will maintain a
continual employee presence at all times, except in the following two
cases:
1
Where fire, natural disaster, or similar circumstances prevent it;
2
Where a person in the house poses an imminent and immediate
threat of violence, attack, or assault and fleeing the worksite is
deemed by the employee to be the safest course of action.
•
In such cases, an employee may choose to lock themselves in
a safe location or carry out other actions she deems as “safer,”
than leaving the site.
•
In all such cases calling the police or activating the “panic button” shall be a top priority.
1.15. B)Continually staffed sites include Crescent House, Hirst House, Safe
Harbour House and Samaritan House. The Bridge, Mary’s Place, and
Rent Subsidies are not continually staffed.
1.15. C)All employees are expected to arrive at the work site and be ready to
work by the time their assigned shift is scheduled to begin.
1.15. D)Support Workers working in single staffed “continually staffed” programs will remain on-site until a replacement employee arrives to
replace them.
1
Overtime provisions are in place to compensate employees should
they have to remain on site beyond specified daily and weekly limits.
Please refer to the Collective Agreement for details.
2
An employee who has an appointment or other urgent matter to
attend to after their shift and who finds their replacement has not arrived to replace them, will try to quickly find a replacement as per the
instructions below. If unsuccessful she will contact the program manager who will arrange immediate coverage or will come and relieve
the employee in person.
3
The failure of an employee to show up for a shift constitutes an emergency because it potentially leaves clients and program property
vulnerable to harm.
1.15. E)If a Support Worker who is scheduled to work at a single staffed “continually staffed” program does not arrive by the start of the shift, the
employee who is on shift and preparing to leave will not leave the
worksite until the person coming on site for the next shift arrives, or a
replacement is found (except see above for urgent replacements).
32
13 Policy Added 11 June 2014
1
The Support Worker waiting to leave will call, text, or use other means
to attempt to ascertain the expected employee’s estimated time of
arrival.
2
If the expected Support Worker says she can arrive within a 1/2 hour
of the beginning of the shift, the employee waiting to leave will remain on site until the expected employee arrives.
3
If the Support Worker waiting to leave can not contact the expected
Support Worker in a reasonable time, she will initiate a call in procedure to find a replacement.
4
If the expected Support Worker shows up more than a1/2 hour after
the shift is scheduled to begin, and a replacement worker has already begun work, the replacement worker shall remain to finish the
shift and the scheduled worker will have relinquished their shift.
1.15. F)On worksites where more than one Support Worker (or equivalent) is
on shift at a time, the above rule need not necessarily be followed.
The goal is to not leave a site unsupervised or unsafe because of insufficient workers.
1.15. G)Managers are authorized to make exceptions to this policy in order to
insure an uninterupted staff presence on designated worksites.
33
2 Hiring , Ori e n t a t i o n , Tr a in in g & P e r fo r m a n c e
2.1
Criminal Record Checks
2.1. A) Island Crisis Care Society will comply with the Criminal Records Review Act and all related Acts.
2.1. B) ICCS will inform all existing employees and all potential job candidates of the requirements of the Act.
2.1. C) Volunteers, visitors, and trades people may also need to be informed
of the requirements of the Act if they interact with clients during site
visits.
2.1. D) All existing employees will be provided with and will be asked to fill
out and submit the Ministry of Public Safety and Solicitor General’s
“Criminal Records Review Program Consent to a CRIMINAL RECORD
CHECK” form (#PSSG10-031 — For working with children and / or vulnerable adults) which can be downloaded here: http://www.pssg.
gov.bc.ca/criminal-records-review/shareddocs/consent-form.pdf.
2.1. E) All job applicants chosen for employment through the standard ICCS
screening and interview process are required to complete and pay
for the above mentioned criminal records check prior to training
and may not be trained until such time as the registrar (or deputy
registrar) confirms that no relevant criminal record presents a risk.
2.1. F) Existing employees who have an outstanding charge with a relevant
offense will be deemed unqualified to work for ICCS and their employment will be terminated until such time as they make appeal with
the registrar and are deemed by the registrar to not be a risk. Individuals who successfully win an appeal may re-apply for employment.
2.1. G) ICCS will keep track of each employee’s 5 year cycle of criminal record checks and will provide a one-time reminder 2 pay period prior
to the anniversary of the date at which time authorization must again
be given.
2.1. H) Employees failing to give authorization for their 5 year criminal record
check before their anniversary date will be deemed inappropriate to
be employed by ICCS and their employment will be terminated.
2.1. I) Filling Out the Form
1
34
All employees will check “A” on the CRC form beside “Schedule
Type.”
2
Employees working at Crescent House, Safe Harbour House, The
Bridge, and Hirst House will check “works with vulnerable adults” on
the CRC form.
3
Employees at Sophia House and Samaritan House will check “works
with children and vulnerable adults.”
2.1. J) Since the Act states that, “If an employee who works with children or
works with vulnerable adults is charged with or convicted of a relevant offence subsequent to a criminal record check, the employee
must promptly report the charge or conviction to the employee’s
employer and provide to the employer a criminal record check authorization for a further criminal record check,” all ICCS employees
are required to notify their manager if they are charged with a relevant offence between record checks. Failure to immediately report
to ICCS any criminal charge will result in immediate termination of
employment.
2.1. K) Additional Information:
1
The Criminal Record Review Act is located here: http://
www.bclaws.ca/EPLibraries/bclaws_new/document/ID/
freeside/00_96086_01#section1
2
The Mental Health Act is located here: http://www.bclaws.ca/EPLibraries/bclaws_new/document/ID/freeside/00_96288_01#section1
3
The Health Authority Act is located here: http://www.bclaws.ca/EPLibraries/bclaws_new/document/ID/freeside/00_96180_01#section1
2.1. L) For further information on the Criminal Record Review Act contact
the Criminal Records Review Program at 250-387-7867.
2.1. M) For the ICCS Policy Brief see the society documents section of the
ICCS website.
35
2.2
Training Required
2.2. A) Table of Required Courses:
Is this training
required prior to
employment?
Who pays
for the initial
training?
How often
must this
training be
renewed,
updated, or
refreshed?
Who pays
for the
refresher
course?
Are Employees paid
to attend refresher
training?
Foodsafe
Yes2
The Employee
Not
Applicable
No
First Aid3
Yes
The Employee
No refresher
course is
required
Once every
three years
ICCS4
Managing
Hostile
Interactions or
Equivalent
No, but new
employees who do
not have this training
are encouraged to
take it as soon as
possible
The Employee
Annually
ICCS
Permanent
employees shall have
no loss of pay to
attend.
Permanent
employees shall have
no loss of pay to
attend.
2.2. B) A certificate indicating successful completion of First Aid and Foodsafe must be presented by job applicants as part of the hiring process. New employees may not proceed with training until these documents are submitted to the program managers.
2.2. C) Standard First Aid – Level C CPR is required for Samaritan House Employees and Emergency First Aid – Level A CPR is required for all other
programs.
2.2. D) Interested applicants and existing employees will take the required
training from one of the organizations recommended in the Worksafe
BC Document entitled, “First Aid and CPR Training Providers” located
on the Worksafe BC website and the ICCS website under Employee
Resources. Online training and certificates will not be accepted.
2.2. E) A certificate indicating successful completion of a refresher course
must be hand-delivered to an employee’s program manager. Course
costs will not be reimbursed without this proof of certification.
2.2. F) A permanent employee who is scheduled to work on the day a First
Aid course is offered may attend the course if her manager approves
the absence. In such cases the employee will receive her regular pay
if a certificate of completion is provided. This provision does not apply
to casual employees.
2.2. G) As of January 2013 ICCS is seeking a new source for online training in
Preventing Sexual Harassment and Preventing Employment Discrimination. Once new training is available employees will be required to
36
present proof of completion to such training to their program managers.
2.2. H) Employees interested in taking training not listed in the above table
may do so at their own expense. ICCS employees are also eligible for
in-service training provided by the Vancouver Island Health Authority,
Shelternet, BC Housing, and the BC Non-profit Housing Association.
Topics include: suicide prevention, understanding mental illness and
substance use, and developing communication and job-related skills.
37
2.3
Orientation
2.3. A) All newly-hired employees are expected to attend an orientation session immediately following their starting date.
2.3. B) The purposes of conducting such orientation sessions are to:
1
Introduce the new employee’s to existing workers and the work site
culture
2
Thoroughly acquaint the new employee with the mandate of the
program and the requirements of her new job
3
Lay the groundwork for productive and satisfying interpersonal relationships between present members of staff and the new employee
2.3. C) The orientation session will cover is not limited to:
1
Vision, purpose, and values of the agency
2
The program philosophy
3
Organizational structure
4
Services provided to clients and the role of the worker
5
Overview of core policies
6
Daily routines and procedures (e.g. human resources policies, payroll
information)
7
Parking
8
Fire and disaster programs
9
Evacuation training
10
Occupational health and safety
11
Tour of house
12
Introduction to union stewards
13
Shadowing a worker to see the total range of situations and decisions
that are encountered in an average day
14
Gradual transition to full assumption of duties
2.3. D) The program manager or a worker designated by the manager will
be responsible for more in depth orientation as time permits, including
38
1
Introduction to infrequently used policies or procedures
2
Assessment of basic knowledge and readiness for independent work
3
Identifying areas of focus for additional training
2.3. E) Confirmation that the orientation was conducted shall be placed in
the new employee’s personnel file.
39
2.4
Probationary Period
2.4. A) All newly hired individuals serve a probationary period of 90 days during which time their suitability for employment is evaluated.
2.4. B) The first 30 days of the probation period is served without representation or membership in the union, although union dues are collected
from the first day of employment.
2.4. C) In the interest of our clients and employees ICCS seeks to hire and
retain individuals who are naturally talented with human interaction
and possess superior social skills. A combination of these specific human abilities and formal or experiential training is essential in building
and maintaining a healthy program team serving in the area of mental health and addiction services.
2.4. D) If an individual on probation is found to be unable to perform to
established standards or to have a personality or style that is poorly
matched to the social service field they will be dismissed without
prejudice during their probation period.
2.4. E) Upon completion of their 30 day probation and upon recommendation from the program manager they will be offered a position on the
team and required to fill out a union membership application.
2.4. F) Probation may be extended for a longer period of time at the discretion of the manager to communicate to a new employee that they
are not yet performing at the expected level. Union representation,
however, is unaffected by such an extension and begins at the 30
day mark.
40
2.5
Performance - Evaluations
2.5. A) Formal performance evaluations will be conducted twice during probation. Once after the first 30 days, and again at the end of 90 days.
Evaluations will also be conducted periodically as needed during the
first year of employment.
2.5. B) Performance evaluations will be carried out annually after the initial
year of employment.
2.5. C) Evaluations may be performed more often than once a year if the
feedback helps promote higher performance standards.
41
2.6
Performance - Discipline
2.6. A) ICCS uses training, coaching, evaluations and reminders to assist employees to perform to expectations.
2.6. B) If an employee’s performance falls below expectations and performance does not improve with regular reminders, progressive discipline may be uses as outlined in our guide: Managing Employee
Performance.
2.6. C) An employee who breaches a policy may also be subject to discipline such as a written warning, a suspension, or dismissal -- depending on the severity of the breach.
2.6. D) The goal of progressive discipline is to correct unacceptable behavior
by working with the employee to try and resolve the problem without
imposing a severe penalty. In cases where the behavior is not corrected, the penalty will increase in proportion with the seriousness of
the misconduct and other relevant factors.
2.6. E) Progressive discipline contains the following stages:
1
Verbal warning(s)
2
Written warning(s)
3
Suspension(s)
4
Termination
5
For more details see 2.7. L,M,N below.14
However, the nature of the incident warranting discipline may be such
that the program manager determines it is appropriate to bypass the normal steps of progressive discipline. In cases of serious misconduct, discipline may commence at suspension and lead to termination, or discipline
can start and end with termination. For example, in cases such as resident
abuse or theft, termination is the appropriate disciplinary measure.
14 Revised 28 November 2013
42
2.7
Attendance Management
2.7. A) Island Crisis Care Society relies on our employees in order to fulfill our
contractual obligations to our funding agencies. As part of the employment relationship, employees must attend work as scheduled
and on a regular and consistent basis.
2.7. B) We will work proactively with our employees to assist them in meeting
our attendance expectations.
2.7. C) Island Crisis Care Society assists employees to meet attendance expectations by:
1
communicating with them regarding attendance concerns,
2
providing health and welfare benefits,
3
and working with the employees and the BCGEU in providing modified or graduated return to work programs and accommodating
employees with disabilities pursuant to human rights legislation.
2.7. D) Attendance Management Program
1
Our attendance management program is designed to address the
issue of employee absenteeism due to illness or injury in a positive
manner.
2
The program provides guidance to managers on how to manage attendance concerns through communication with employees.
3
It will be applied fairly and in a flexible manner that is appropriate to
each individual employee’s attendance and/or health concerns.
4
Non-Culpable
5
•
The program is designed to address non-culpable absenteeism;
that is, absenteeism where the legitimacy of the employee’s absences is not in issue but the level of absenteeism is a concern.
•
The Attendance Management Program is not disciplinary in
nature.
Culpable
•
Where absenteeism is culpable in nature, it will be dealt with as
such, outside of the parameters of the Attendance Management Program.
•
Culpable absenteeism most often occurs when an employee
claims sickness and is absent, but evidence reveals or suggests
that the true cause of the absence is not sickness, but some
other reason.
43
•
Where an investigation determines absenteeism to be culpable,
the matter will be dealt with through the imposition of appropriate discipline.
•
When an employee is absent from work for culpable reasons,
the ICCS attendance management approach is progressive
discipline. This may ultimately result in the employee’s dismissal,
depending on the seriousness of the immediate offence and
other relevant circumstances. In order to justify dismissal for
culpable absenteeism, Managers will first demonstrate that they
have used progressive discipline to stress the seriousness of the
concerns.
•
Employers have a right to conduct a full investigation when culpable absenteeism is suspected. The manager or management
team may use one or more of the following methods for obtaining information related to absenteeism. See Establishing and
Responding to Culpable Absenteeism section below for more
information.
2.7. E) Responsibilities and expectations
1
Managers are responsible for reviewing employee attendance and
for implementation of the Attendance Management Program.
2
Employees are expected to follow ICCS policies regarding notification to their program managers if unable to attend work as scheduled, and to communicate with their manager while away regarding
their progress and anticipated return to work date.
3
As noted above, employees are expected to attend work on a regular and consistent basis.
4
Employees are responsible for taking proactive measures that will
assist them in meeting attendance expectations, such as general
health promotion measures, as appropriate.
5
Employees are expected to cooperate with their physicians’ recommendations.
6
If absent for three (3) consecutive calendar days or longer, employees are required to provide medical certificates confirming illness
and/or fitness to return to work.
2.7. F) Attendance standards
1
44
Employee attendance will be compared to the annual median absenteeism at ICCS. Absenteeism that exceeds the median absenteeism level at ICCS is an indicator of an attendance concern. However,
there may be occasions when absenteeism above the median level
does not indicate an ongoing attendance problem (for example,
where an employee is absent for a period of time due to a single
injury or illness).
2
Employees who are incapable of regular and consistent attendance
may be subject to termination.
3
ICCS will communicate expectations to employees and offer assistance in meeting acceptable attendance levels.
2.7. G) Accommodation of employees with disabilities
1
ICCS will work together with the employee and the BCGEU to seek an
appropriate accommodation for those employees who establish the
existence of a disability and a need for accommodation arising from
that disability.
2
Employees are expected to provide full medical information that will
assist ICCS in determining the limitations that arise from the disability
and in searching for an appropriate accommodation. Employees are
expected to participate in the search for accommodation and to
cooperate with accommodation efforts.
3
The BCGEU will be invited to participate in meetings along with the
employee to identify accommodation needs and to explore potential means of accommodation.
2.7. H) Attendance reviews
1
Managers are expected to review employees’ attendance records
on at least a quarterly basis.
2
Employees who have been identified as having attendance concerns may be monitored on a more frequent basis in accordance
with the goals of the program.
3
Attendance reviews will include review of the following:
•
Total number of days absent.
•
The incidence of absences (i.e. number of occurrences of absenteeism as opposed to the duration of the absence).
•
Absences frequently attached to days off, vacation or other
leaves.
•
Absences occurring at the same time each year.
2.7. I) Attendance Management Intervention
Where an employee’s attendance is not meeting expectations, the
manager will meet with the employee to discuss attendance concerns.
These meetings will be documented in a letter placed on the employee’s personnel file.
1
First meeting with the employee
45
•
•
2
46
The manager will meet with the employee and review the attendance concern. The discussion with the employee will include the following:
--
Advising the employee of her absenteeism to date and
how this compares with the median absenteeism in the
organization.
--
Advising the employee of any patterns of absences that
are of concern.
--
Reviewing the organization’s requirements of regular attendance.
--
Asking the employee whether there is any underlying condition or other issue of which the organization should be
aware that may be responsible for her absenteeism.
--
Advising the employee of the availability of the Employee
and Family Assistance Program.
--
Asking what plans the employee has to improve attendance.
--
Setting a goal for improvement of attendance.
--
Setting a date for a follow-up meeting within the next two
(2) months.
The discussion will be documented in a letter to the employee.
Second meeting with the employee
•
If the employee’s attendance has improved to a satisfactory
level by the time of the second interview, the manager will
confirm the attendance has improved and encourage the employee to continue her efforts in this regard. The discussion will
be documented in a letter. The manager will advise the employee that attendance will continue to be reviewed and that
a further meeting may be scheduled should further attendance
concerns arise.
•
If the employee’s attendance has not improved to a satisfactory level, the manager will meet with the employee to discuss
the ongoing attendance concerns. The discussion with the employee will include a review of the following:
--
Reviewing and confirming the first meeting with the employee.
--
Advising the employee of the absenteeism to date and
how this compares with the median absenteeism in the
organization.
--
Advising the employee of any patterns of absences that
are of concern.
•
3
--
Reviewing the organization’s requirements of regular attendance.
--
Asking why, in the employee’s opinion, the goal for improved attendance has not been met.
--
Confirming whether there is any chronic medical condition or disability that is affecting the employee’s ability to
attend work regularly.
--
Confirming whether there is any other factor in the employee’s life of which the organization should be aware
that is affecting the employee’s ability to attend work
regularly.
--
Advising the employee of the availability of the Employee
and Family Assistance Program.
--
Reinforcing the requirement for regular attendance.
--
Asking what plans the employee has to improve attendance.
--
Setting a goal for improvement of attendance.
--
If applicable, requesting the employee provide a medical
certificate from a physician of her choosing attesting to
the medical condition of the employee.
--
Setting a date for a follow-up meeting within the next two
(2) months.
Third meeting with the employee
•
level by the time of the third interview, the manager will confirm
attendance has improved and encourage the employee to
continue her efforts in this regard. The discussion will be documented in a letter. The manager will advise the employee that
attendance will continue to be reviewed and that a further
meeting may be scheduled should further attendance concerns arise.
•
If attendance has still not improved to a satisfactory level, the
manager will meet with the employee to discuss the ongoing
attendance concerns. The discussion with the employee will
include a review of items set out for the second meeting and, in
addition, the following items:
--
Emphasizing the organization’s ongoing concern regarding absenteeism and lack of improvement.
--
Alerting the employee that ongoing absenteeism that
does not meet expectations may jeopardize her employICCS Universal Program Policy Manual
47
ment.
•
4
Further meetings and warnings
•
level by the time of a further interview, the manager should confirm in writing that attendance has improved and encourage
the employee to continue her efforts in this regard.
•
Where the employee’s attendance has not improved to an acceptable level after a third meeting or further meeting(s), the
manager will review the employee’s attendance records, patterns of absenteeism and the reasons given by the employee for
the absenteeism in determining how to proceed.
•
Further interviews similar to the third interview and letter may be
appropriate, with further warnings that place the employee on
notice that her employment may be terminated if attendance
does not improve to an acceptable level.
•
Prior to termination for non-culpable absenteeism, there will be
a careful examination of all of the circumstances surrounding
the employee’s absenteeism.
•
The employee will be provided a final warning that clearly states
the attendance required and the period during which the attendance will be monitored. The employee will be advised that
should her attendance fail to meet the established target level,
her employment may be terminated. The employee will be
asked to provide any information that is relevant to her ability to
attend at work regularly in the future, given the ongoing failure
to meet an acceptable level of attendance in the past.
2.7. J) Establishing and Responding to Culpable Absenteeism
1
2
48
An investigation into potentially culpable absenteeism may be conducted if:
•
An employee is frequently absent,
•
uses all of her sick days on a regular basis,
•
uses sick time in a regular pattern,
or if
•
the employer witnesses an employee engaged in activities in
the community (such as working elsewhere, or engaging in active recreation),
•
an employee who requested but was denied a day off, then
calls in sick for the day requested off.
•
An investigation may include:
•
--
An interview with the employee to discuss the behavioural
patterns or events outlined above.
--
An interview with others who may have witnessed culpable behaviour.
--
A request for more information regarding the medical basis for a claim. Where such information is sought, a letter to
the employee’s doctor requesting more information may
be given to the employee to give to her doctor, but the
manager is not empowered to speak directly to the employee’s physician.
--
Surveillance. The admissibility of surveillance evidence is
at the discretion of the arbitrator. The general approach
is to balance the employee’s right to privacy against the
employer’s right to investigate sick leave abuse. There
must be reasonable cause to conduct surveillance. The
circumstances must show there was a strong foundation
for suspicion and that other options were unrealistic or
unreasonable.
Following are some examples of practices that will support the
admissibility of surveillance.
--
Initiating surveillance because of accurate and reliable
evidence of a problem, rather than merely rumour or innuendo.
--
Hiring a third party expert to conduct the surveillance,
rather than management conducting it themselves.
--
Avoiding causing harassment or nuisance to the employee
who is under surveillance.
--
Respecting the employee’s expectations of privacy when
deciding on the location of the surveillance, the degree of
surreptitiousness and intrusiveness and the potential involvement of family and friends.
--
Conducting surveillance of only those employees under
suspicion rather than all employees.
--
Confirming that surveillance is the best way to investigate
the employee’s activities because there are no alternative
means of gathering reliable information.
2.7. K) Managers must comply with the BC Personal Information Protection
Act (PIPA).
1
The Ministry of Management Services website contains detailed information about PIPA at www.mser.gov.bc.ca/privacyaccess/Privacy/.
2
The website of the Information and Privacy Commissioner, who is
responsible for administering PIPA, also contains considerable helpful
49
information: www.oipcbc.org/sector_private/resources/.
2.7. L) Progressive Discipline for Culpable Absenteeism
1
Progressive discipline is the proper response to culpable absenteeism. As set out above, if there is concern about the legitimacy of an
employee’s absence, the manager must investigate to determine
whether sufficient proof exists that the employee was absent without
a legitimate reason.
2
The discipline appropriate for any given act of culpable absenteeism will depend on all of the circumstances of the particular situation,
including:
•
The seriousness of the immediate offence (including the consequences of the absence).
•
The employee’s prior disciplinary record.
•
Any mitigating factors (or the absence of mitigating factors),
such as length of service, whether this was an isolated incident
or part of a pattern, whether the absence was merely careless
or was planned or premeditated, whether similar absences by
other employees have been overlooked, whether the employee has shown remorse, etc.
2.7. M) The progressive disciplinary steps are listed below.
1
Oral warning
•
2
Managers will first issue an oral warning when the culpable absenteeism is minor and it is a first offence. The purpose of an oral
warning is to ensure the employee understands her conduct
was unacceptable and that repetition of the conduct will result
in more severe discipline.
Written reprimand
•
Managers will issue a written reprimand if an oral warning does
not motivate a change in behaviour. The written reprimand will
inform the employee that her culpable absenteeism is unacceptable and she may be subject to more severe discipline if it
is repeated.
Note: A written reprimand does not need to be preceded by an oral
warning. If the investigation reveals significant breach of the employment relationship, a written reprimand may be issued immediately.
3
Short-term suspension
•
50
A short-term unpaid suspension normally lasts from one to three
days. Suspensions may be imposed for serious culpable absenteeism or where an oral or written reprimand has not succeed-
ed in correcting the misconduct. The purpose of a short-term
suspension is to bring home to the employee the fact that there
is a serious concern about her behaviour and that continued
misconduct will result in further, more serious disciplinary action,
including termination of employment.
4
Long-term suspension
•
5
An unpaid suspension of one week or longer should be considered prior to discharge. Long-term suspensions will be issued
if the lesser forms of discipline have failed to bring about a
change in the employee’s conduct or if the culpable absenteeism is very serious. A long-term suspension should make it clear
to the employee that her job is in jeopardy and that if the conduct is not corrected, her employment will be terminated.
Discharge
•
Discharge may be an appropriate response where lesser forms
of discipline have not corrected an employee’s culpable absenteeism and the absenteeism is serious.
Note: There is no rule or requirement that all of these steps must have
been taken before a manager moves to serious discipline or dismissal.
If an employee’s first offence was sufficiently serious, a manager may
proceed directly to a lengthy suspension or even dismissal, depending
on the circumstances.
2.7. N) During each stage of progressive discipline careful notes must be
kept by the manager for use in grievance and arbitration.
51
3 Relatio n sh i p s
3.1
Working with Coworkers
3.1. A) It is expected that employees will work as a team. Unresolved issues
between staff can have a negative impact in the workplace and it
is expected that employees who experience a conflict with a fellow
employees will:
1
Sit down, as soon as possible, and discuss the issues/conflict directly
with the specific staff member.
2
If still unresolved, bring the issue to the attention of the Manager. The
Manager will mediate and assist the staff in communicating and resolving the issue(s).
Note: It is expected that staff will discuss their concerns with the specific
staff member first before bringing the issue to the attention of management.
3.1. B) It is expected that staff will not discuss their issues, with other staff or
with clients as this can promote hostility and affect the cohesiveness
of the house as a whole.
52
3.2
Working with Management
3.2. A) The program manager promotes an open door policy by being available and by welcoming ideas and questions from all employees.
3.2. B) It is the program manager’s responsibility to insure that employees follow established policies and procedures.
3.2. C) The program manager is responsible for dealing with any issues that
may come up and any corrective coaching and disciplinary action,
which can include verbal warnings, written warnings, suspensions, or
dismissal.
3.2. D) As the program manager is responsible for the overall running of the
facility, the program manager will recommend policy changes to the
executive team who will be responsible to make all final decisions
relating to policy revisions.
3.2. E) Insubordination by employees will not be tolerated.
53
3.3
Employment of Relatives
3.3. A) The purpose of this policy is to insure that all employees receive fair
and equitable treatment regardless of their familial relationships to
other ICCS employees. This policy is intended to avoid favouritism,
graft, discrimination, and conflict of interest.
3.3. B) Relatives may not work together if there is an official differential of authority or power between their positions or if one relative must report
to or be supervised by the other. For example a manager may not supervise a relative and a human resource worker may not participate
in the review or discipline of a relative.
3.3. C) Relatives may work at different sites providing section (b.) above is
observed.
3.3. D) Relatives may work at the same site if section (b.) does not apply and
if they first participate with the site supervisor in the development and
implementation of a signed memorandum of understanding clarifying the boundaries and safeguards necessary to insure that their familial relationship does not interfere with the work environment or the
well being of other workers. This memorandum must contain a clause
indicating an annual review schedule insuring that the understanding
remains relevant and in force.
3.3. E) A relative of an employee may be refused employment or a transfer
to a new work site/area when a conflict of interest would occur as
indicated by section (b.).
3.3. F) New employees will not be hired for the purpose of specifically providing service to a relative and where a conflict of interest occurs as
indicated by section (b.).
3.3. G) In situations where family members work at the same site the chain
of command must be respected and maintained. A family member
should always report directly to his or her supervisor or manager with
questions, concerns, or requests for instruction on proper procedure
in cases where procedures are not covered in the written procedures
manual.
Example: John works with his wife Mary at an ICCS program. During
John’s shift a client arrives with her two children and asks if they can stay
for dinner. John suspects that such a situation is not allowed but when he
checks the policy and procedure manual he finds no clear guidelines.
John should contact his supervisor or manager, even though a call to
Mary might seem easier and quicker. If he gets into the habit of calling
Mary instead of his supervisor, he may undermine his supervisor’s author54
ity and put Mary in a difficult position should her advice turn out to be
incorrect. If John does call Mary she should refer John back to the supervisor.
55
3.4
Dating Between Employees
3.4. A) The purpose of this policy is to provide a framework for defining which
romantic relationships are forbidden within ICCS, and managing permissible romantic relationships in a way that will reduce any negative
impact on the workgroup or work environment.
3.4. B) From time to time a worker may enter into a romantic relationship
with a co-worker or with a worker in a partner agency. ICCS does not
encourage such relationships. Workplace romances can create awkward situations and claims of favoritism. Breakups can include sexual
harassment claims and revenge-motivated complaints. This policy is
intended to minimize these negative effects.
3.4. C) No romantic involvement may continue between a program manager and a worker under his or her authority. If involvement continues, the manager must step down from her position of authority or be
transferred to a separate program.
3.4. D) No romantic involvement may continue between an executive and a
manager or worker.
3.4. E) No romantic involvement may continue between an ICCS worker
and a contract manager or funding agency executive.
3.4. F) No romantic involvement may continue between a Director and an
executive, manager, or worker. If the individuals wish to continue in
their relationship the Director will resign from the Board.
3.4. G) All other workplace romantic involvements must be reported to both
the Manager of any program involved and the Executive Director.
3.4. H) Couples must sign a consensual relationship agreement as part of
their professional obligation to the society.
3.4. I) Consensual Relationship Agreements
56
1
Consensual Relationship Agreements are designed to keep permissible romantic relationships free from the potential for gossip and
rumor. By acknowledging such relationships integrity is maintained.
2
The agreement stipulates that:
•
It is not a legal document but instead a professional courtesy.
•
The relationship is mutually agreeable, consensual, and unrelated to ICCS.
•
Both participants acknowledge that their romantic relationship and any ending thereof, shall not affect their work performance.
•
Signers fear no pressure to continue the relationship and should
fear no retribution if they choose at any time to end the relationship.
•
The couple is aware of the policy against sexual harassment
and the process for resolving harassment.
•
The signers agree to settle any relationship dispute related to the
worksite or workgroup through binding arbitration or third party
intervention and not via a lawsuit.
57
4 Condu c t
4.1
C o d e o f E t h i c s f o r I CCS E m p l o y e e s
4.1. A) This code is a set of instructions and guidelines that outline the best
way to behave in accordance with our most important values and
ethical principles.
4.1. B) ICCS workers belong to a segment of professionals and paraprofessionals that include social workers, health workers, and human service
workers and this code reflects the values and principles of our organization within this larger professional community and applies specifically to the context of our vision, mission, and service goals.
4.1. C) The phrase “support worker” is used in this code, but it is understood
that all ICCS employees are bound by this same code and that some
ethical standards may be higher or different for management, executives, and others.
4.1. D) Core Values and their Related Ethical Principles
1
Value #1: Heart (agape15)
•
Ethical Principle: Support workers provide care from a heartfelt
decision to contribute to each client’s well being and future
success.
--
2
Support workers suspend private agendas while at work
and behave in a way that does no harm, either through
words or actions, to the people they work with. These people include clients, workers, supervisors, and case workers.
Support workers are compassionate, kind, and patient in
all verbal responses and acts of service.
Value #2: Integrity
•
Ethical Principle: Support workers behave in a trustworthy manner.
--
Support workers are continually aware of their own values
and ethical principles and standards, and those of ICCS.
They act consistently from these values and principles and
by so doing, present to clients a reliable presence. They
remain focused on their job duties and role and are clear
on the limitations of both.
15 Agapē is a Greek word used in Christian ethics to refer to a unified state of mind and heart that brings forth caring regardless of circumstance. Agape
has elements of patience and kindness but also a component of mindful intention that goes beyond the limits of self-interest and seeks the welfare of
others without prejudice and without regard for merit or standing. It can even motivate compassion when feelings of affection and empathy are ebbing, or
when the natural inclination might be repulsion or revulsion. It allows a person to overcome the fear of being taken advantage of and grounds altruistic
motives. In the words of the Apostle Paul, “Agape doesn’t harm a neighbour. It is, therefore, the fulfillment of the [Hebrew] law” (Romans 13:10). It does
this by fostering in an individual a variety of virtues that provide strength and inner resolve. These virtues include humility, endurance, selflessness,
optimism, and temper.
58
3
Value #3: Acceptance
•
Ethical Principle: Support Workers demonstrate positive regard
and allocate service without preference.
--
4
Value #4: Relationship
•
Ethical Principle: Support workers improve all worksite relationships through clear communication, consistent boundaries, and
warm social interaction.
--
5
Ethical Principle: Support workers earn trust from their team
members, clients, and client’s case workers.
--
Ethical Principle: Support workers respect the inherent dignity
and worth of the person.
--
Support workers treat each person in a caring and respectful fashion, mindful of individual differences and
cultural and ethnic diversity, and regardless of behaviour,
functioning, disability, illness, or health challenges. This
includes clients, fellow employees, case managers, addictions counsellors, and other clinicians.
Value #7: Competence
•
Ethical Principle: Support workers act within their areas of competence and do not go beyond those areas.
--
8
Support workers act reliably and follow guidelines and policies consistently so as to be, and be perceived as, trustworthy.
Value #6: Respect
•
7
Support workers understand that relationships between
and among clients and health workers are an important
vehicle for change. Support workers engage clients, case
workers, and other involved professionals as partners in the
helping process.
Value #5: Trust
•
6
Support workers suspend their personal preferences, attractions, and repulsions, and see each client as equally
worthy of care, compassion, kindness, and service -- regardless of the client’s behaviour, physical condition, or life
choices.
Support workers continually strive to increase their professional knowledge and skills and to apply them in practice,
ever mindful of the limitations and extents of the support
worker role.
Value #8: Empathy
•
Ethical Principle: Support workers give service to clients without
59
conditions or limitations in the same manner that they would
want to receive service if they were in the client’s situation. This
requires imagining being each client with the needs, perspectives, and life histories of that client. This level of service requires
support workers to be aware of their own judgements and fears
and make a conscious choice to empathise daily with a client
and extend compassion and care.
4.1. E) Ethical Standards
1
Personal Ethics versus Professional Ethics
•
Personal ethics is an awareness of what is good for oneself, for
others, and for society, and what is harmful or potentially harmful. It is a developed understanding of obligations, duties, and
boundaries in relationships, and a commitment to the highest
standards of interaction.
•
Personal ethics enable people to do what is good and to refrain
from doing what is harmful, hurtful, or counterproductive. Most
people hold a personal ethics which has been influenced by
natural inclinations, experience, reasoning, and by the culture,
religion, and society in which the person was raised.
•
Professional ethics are formalized rules that govern the conduct,
transactions, and relationships within a profession and among its
members.
•
Professional ethics usually originated in the personal ethics of
those who first practiced the profession and have been formalized over the years through policy, legal determinations, and
the recommendations of committees and task forces charged
with defining ethical standards. These written standards of behaviour show how members of the profession can best interact
with one another and the clients, consumers, or customers who
make use of the profession’s services.
4.1. F) Sources of Ethical Guidance
60
1
This Code is a primary source of ethical guidance as is the ICCS Universal Policy Manual.
2
Support workers at ICCS educate themselves and temper their own
actions through careful reading of these documents, as well as other
society and program procedures and guidelines.
3
Support Workers attempt to understand the spirit of each policy,
procedure, and guideline and generalize from that spirit when faced
with novel and unique situations. While a careful adherence to the
letter of the law is appropriate in black and white situations such as
sanitation or food safe practices, ICCS encourages all employees to
surpass written standards when improvising solutions to ethical situations that do not have written or established policies, procedures, and
guidelines.
4
Support workers develop their ethical skills by discussing challenging
situations with superiors and colleagues and through self development, thoughtful reflection, and spiritual growth. See “competence”
below for additional guidance.
4.1. G) Ethical Responsibilities To Clients
1
Primary Responsibility
•
Support workers’ primary responsibility is to provide services and
support that may increase the well¬being of clients. In general,
clients’ interests are primary. However, support workers’ responsibility to the larger group or specific legal obligations may, on
limited occasions, supersede the needs or well being of individual clients. (Examples: when a support worker is required by law
to report that a client has abused a child or has threatened to
harm self or others; or when police ask about a client in a program.)
4.1. H) Client’s Right to Choice and Self Determination
1
Support workers respect the right of clients to make choices and set
goals independent of coercion or pressure as long as they do not
violate program rules, their case or personal plan, and any municipal,
provincial, or Federal laws.
2
Support workers may limit clients’ right to self determination when, in
the support workers’ judgment, clients’ actions or potential actions
pose a serious, foreseeable, and imminent risk to themselves or others.
4.1. I) Informed Consent
1
Support workers provide services to clients only in the context of a
professional relationship that is based, whenever possible and appropriate, on valid informed consent.
2
Support workers use clear and understandable language to inform
clients of the purpose of the services, relevant costs, reasonable alternatives, and clients’ right to refuse or withdraw consent, and the time
frame covered by the consent. Support workers should provide clients
with an opportunity to ask questions.
3
Consent should be in the form of writing (intake forms, permission
forms, etc.) when possible.
4
In instances when clients are not literate support workers should provide a detailed verbal explanation and check to make sure the client
understood the explanation.
5
All clients are free to receive or refuse all services and no support
worker will attempt to force a service on a client against their will.
6
Support workers obtain clients’ informed consent before photoICCS Universal Program Policy Manual
61
graphing, audiotaping, or videotaping the client or before printing
the client’s story in any format. Permission will also be obtained before transferring any information about a client to a third party in any
form.
4.1. J) Competence
1
Support workers provide services and represent themselves as competent only within the boundaries of their job description, regardless
of the extent of their training and knowledge.
2
Support workers provide services only using methods, techniques,
and strategies approved by the organization. Some of these include:
motivational interviewing, non-violent communication, and active
listening.
3
When generally recognized standards and practices do not exist with
respect to an emergency or novel situation, support workers should
exercise careful judgment and avail themselves when possible of
consultation with other professionals and their peers, and superiors,
to ensure the competence of their work and to protect clients from
harm.
4.1. K) Cultural Respect
1
Support workers respect culture and its function in human behaviour
and society, recognizing the strengths that exist in all cultures.
2
Support workers demonstrate competence in the provision of services
that are sensitive to clients’ cultures and to differences among people and cultural groups.
4.1. L) Conflict of Interest
1
Support workers should be alert to and avoid conflicts of interest that
interfere with the exercise of professional discretion and impartial
judgment. Support workers should inform clients when a real or potential conflict of interest arises and take reasonable steps to resolve the
issue in a manner that makes the clients’ interests primary and protects clients’ interests to the greatest extent possible. In some cases,
protecting clients’ interests may require the inclusion of a program
manager, case worker, or ICCS executives.
2
Support workers should not take unfair advantage of any professional
relationship or exploit others to further their personal, religious, political, or business interests.
4.1. M) Boundaries
62
1
Boundaries are mutually understood physical and emotional limits in a
relationship.
2
Within ICCS all relationships between a worker and a client are pro-
fessional and governed by professional boundaries.
3
The term “professional” in this context means behaviour and conduct
that is held to a high standard. In general professional services have
the quality of excellence and expertness which reflects a studied
deliberation and a practiced manner. A professional has a mastery of
her own behaviour, a reliably consistent performance of service, and
a reassuring demeanor.
4
“Professional boundaries” are boundaries that are not arbitrary or
optional but are part of the job and conform to standards that are
commonly recognized in the field, in our case, the field of social work.
5
Reasons to Maintain Boundaries.
6
•
When physical and emotional limits are altered, what is allowed
in the relationship becomes ambiguous, and this ambiguity can
cause a client to feel uncertain, anxious, suspicious, or defensive.
•
ICCS programs are designed to help clients feel accepted,
supported, safe, and able to make changes. Boundaries help
reduce fear, foster trust, and avoid reactive behaviour.
•
Objective consistent professional kindness with firm boundaries
on the part of the support worker insures that the worker is not
seen as a threat or as a potential friend, landlord, of romantic
interest. They remain safe because of the minimal number and
degree of emotional triggers.
•
Clients need to be able to consistently predict the actions
and responses of their workers. Clients may interpret a Support
Worker’s behaviours or verbalizations in a variety of ways based
on their past experiences, so repeated verbal reminders about
boundaries are often necessary. This assurance around boundaries allows clients to focus their attention on their recovery
instead of on their relationship with their worker.
•
Support workers maintain professional boundaries between
themselves and clients during care, and for a period of 2 or
more years after the client is no longer receiving care from ICCS
or it’s partner agencies, depending on the progress of the client’s recovery after care.
Imbalance of Power.
•
The relationship of a helper and the one being helped means
that there is an inherent imbalance of power. Any time there is
an imbalance of power, the one with the power must assume
responsibility to use the power to do no harm. Support workers
assume the responsibility both of exercising professional judgement in the use of their power, and in the establishment of
boundaries.
•
Because of the imbalance of power this unique relationship
63
is especially vulnerable to abuse. Therefore a support worker
remains vigilant to her own needs and desires and consciously
monitors her behaviour to insure that she does no harm to any
client and exercises her professional powers responsibly.
7
Boundary Crossing.
•
8
9
64
The term ‘boundary crossing’ is used to refer to ‘benign deviations from standard practice’ , whereas unwarranted and dangerous crossings that are exploitative or potentially harmful to a
client are called boundary violations.
Boundary Violations.
•
For support workers boundary violation occurs any time the
client/support worker relationship becomes more than just a
helper and a client being helped.
•
What is “helpful” is clearly spelled out in our contracts for service. Generally this includes cues, reminders, motivational interviewing, active listening, meal preparation, enforcement of
house rules, household sanitation duties, and monitoring behaviour so that case managers are notified about areas of concern.
•
If a support worker uses his or her power over a client for a tangible or intangible benefit or gains that is a boundary violation.
•
If a support worker gives unsolicited advice, offers uninvited
counsel, derides other workers, fosters dependency, berates or
belittles the client or other clients, or acts out of personal motives for personal gain, a boundary violation has occurred.
•
Boundary violations can include not acting consistently to enforce house rules.
Self disclosure.
•
Although in some cases self disclosure may be appropriate,
support workers need to be careful that the purpose of the self
disclosure is for the client’s benefit. A number of dangers may
exist in self disclosure including shifting the focus from the needs
of the client to the needs of the support worker or moving the
professional relationship toward one of friendship. The blurring
of boundaries can confuse the client with respect to roles and
expectations. The primary question to be asked by a support
worker when wondering about sharing some details about
themselves is, “Will this self disclosure serve the client’s therapeutic goal?”
•
The following information should be kept private and not disclosed:
--
Detailed Information about where you live, your family,
your neighbourhood, and so on.
--
Detailed Information about your personal life, your friends,
and your religious and political views.
--
•
10
Information related to your social networks, including
Facebook and similar services.
The following information is permissible to share:
--
The nature of a support workers role and duties and what
you enjoy about your work
--
Public information such as would be seen on TV or at a
library
--
General information about where you live, i.e. Nanaimo or
Parksville, etc.
--
General information about your personal life, friends, and
views, such as you preference in movies and food or your
preference is sports teams.
Boundaries in Debriefing
•
Work at ICCS can be challenging. At times support workers
experience interactions with clients that unsettle, upset, or disillusion them and they may even experience traumatic events.
Debriefing with colleagues after a difficult encounter with a
client or after a traumatic event is considered by health care
authorities to be helpful and ICCS encourages such debriefing
both with ICCS colleagues and with health authority clinicians
through the Brooks Landing office.
•
All debriefing sessions must be done in strictest confidence and
support workers should use nonviolent communication to express their feelings and to request and give empathy. By talking
about the way an encounter felt, and identifying the thoughts
that trigger anxiety and stress, debriefing can first of all bring
some resolution of those feelings, and secondly restore objectivity. Objectivity and discussion help everyone find the best way
to serve complex clients and cope with each client’s unique
behaviour patterns.
•
Excessive re-imagining of a traumatic event can re-traumatize
anyone, therefore it is important to debrief in a way that includes others in the event in a calming way. If a debriefing session is making things worse, conclude the session and seek the
help of a trained social worker, nurse, or therapist
•
In this spirit of self-care, the following guidelines are recommended for debriefing:
•
Talk and listen without judgement
--
Identify the strongest emotions and thoughts in yourself
and others and give and receive empathy for these emotions and thoughts
65
•
•
•
11
66
--
If blaming begins in yourself or others, redirect attention to
the emotion behind the desire to blame and the values
and needs related to those emotions
--
Watch out for in-group/out group divisions, seek team
unity, and notice and avoid gossip, slander, and name
calling — even in jest.
--
Build up fellow workers with encouragement and identify
each other’s strengths
Make a plan for next time
--
Remind yourself and others of your responsibilities and of
what is not your responsibility. Remind yourself and others
of what is “part of the job” and “not part of the job.”
--
If errors have been made by you or others, acknowledge
them with kindness
--
Talk about and imagine a better responses in the future
--
Notice learning opportunities and discuss how to take advantage of them
--
Refocus yourself and others on the values, mission, and
purpose of ICCS and your program
--
Make recommendations for improved safety to your Manager
Keep it confidential
--
Keep debriefing at work with colleagues who you can trust
and remind those you speak to that you are legally bound
to preserve client’s confidentiality
--
Facebook and other social mediums are never places for
airing your feelings about clients, fellow workers, or anything related to work
Debriefing is not a substitute for therapy. If you discover deeper
issues in yourself and others seek and recommend talking with
someone with more expertise in such matters.
Giving or receiving personal gifts.
•
Giving or receiving personal gifts is contrary to professional conduct because of the risk of changing the worker/client relationship. For example, a client who receives a gift from a support
worker could feel pressured to reciprocate to avoid receiving
inferior care. Conversely, a support worker who accepts a gift
from a client risks altering the worker/client relationship and
could feel pressured to reciprocate by offering “special” care.
•
Gifts from clients can be therapeutic expressions of appreciation and gratitude and may be received warmly as such when
discretion is used to clarify the professional context of the gift.
For example a support worker might say:
12
--
“What a generous gift of chocolates, I will enjoy sharing
them with everyone,”
--
or
--
“Thank you for thinking of me with this beautiful work of art
you have made, I will hang it here in the office for everyone to enjoy this week and then return it to you,”
--
or
--
“That is thoughtful of you and I appreciate you thinking of
me, but unfortunately we are not allowed to receive gifts
from clients.”
Dual and overlapping relationships. Support workers avoid dual relationships. A dual relationship exists when you serve a person as a support worker and also have another significant relationship with them,
or have a business interest in their lives, or belong to a social group or
sports team, or are related to them, or any similar significant connection outside of the professional role. Dual relationships confuse authority, attachment, and emotional connections.
•
Reasons to avoid Dual Relationships:
--
To prevent exploiting the inherent power imbalance in the
service relationship.
--
To prevent mixed motives during care.
--
To prevent complicated emotions in both yourself and the
client.
--
To preserve confidentiality.
--
To promote motivational interviewing and other empathic
listening techniques.
--
To keep the client/Support Worker relationship clear and
professional.
--
To avoid fear in a client of unpredictable consequences.
--
To allow the client to focus on their recovery when you are
supporting them professionally.
•
Overlapping relationships, while potentially problematic, may
not always be possible to avoid.
•
Such overlapping relationships can occur in situations where, for
example; the client and support worker are both members of a
particular religious or ethnic group; or have children at the same
school, with the same learning disability, or on the same team.
Family members may be friends. Overlapping relationships can
67
also occur where both the support worker and client are active
in a local association or political party, or volunteer for the same
organization.
13
14
68
•
Situations where there may be overlapping relationships need
to be judged on a case by case basis, but in general it is the responsibility of the support worker to, whenever possible, absent
themselves from the social relationships for that period of time
until the client is no longer receiving services from ICCS.
•
This responsibility to protect the client by minimizing contact
outside of the working relationship is part of the support worker’s
professional obligation. It expresses consideration for the client’s
well being, preserves integrity, and promotes trust.
Special Favours.
•
ICCS employees avoid relationships with clients outside of program activities where either the support worker or client is in a
position to give a special favour, or to hold any type of power
over the other.
•
For example, some situations to be avoided include: employing a client or his or her close relatives, involving oneself in business ventures where one could benefit financially from a client’s
expertise or information, or joining a community group, entertainment activity, or church group where the client is already
active.
•
Similarly, members should refrain from requesting favours from
clients, such as baby-sitting, typing, or any other type of assistance that involves a relationship outside of work.
Friendships.
•
Employees will not become friends with clients and will refrain
from socializing with clients, including sharing a social network,
including online services such as Facebook. This does not mean
that support workers will be unfriendly or distant, but will instead
provide professional attention, kindness, and care.
•
Support workers must use their judgment in assessing the appropriateness of friendship even years after service has ended. Potential power imbalances may continue to exist and influence
the client well past the end of the professional relationship.
•
While a client is actively receiving service from ICCS a support
worker may find herself in activities that resemble friendship with
a client, such as going on a program-related outing, attending
a client’s performance, wedding, or special event. In all cases
it is the support workers responsibility to ensure that the relationship maintains a careful level of professional distance and does
not develop into a friendship or a romantic involvement.
•
It is appropriate to verbally clarify this for clients who may mis-
understand professional attention, kindness, and care as friendship.
15
•
An example of how to clarify the role might be to say, “Earlier
today you said I was your best friend, and I wanted to talk with
you about my role in your life right now. We have been having
fun together and you have been able to share some personal
stories with me and I value our time together as an opportunity
for me to support you in your recovery. It is important that you
understand that I am here for you in a professional capacity
and that my care for you is heartfelt, but I can not be your friend
and your support worker at the same time.”
•
The support role is tacitly maintained even after a client is no
longer receiving direct service and may persist in the clients
mind until the client has establishes other supports in the community. Therefore a support worker will not contact, associate
with, or develop a friendship with any client for a minimum of 2
years after the client last received services from ICCS or one of
our partner organizations.
Family Members of Clients.
•
16
Previous Friendships, Family Members, and Other Relationships.
•
17
A Support Worker will not knowingly take into her private care
a child or other family member of a client who is receiving care
from ICCS or it’s partner agencies and neither will she take into
her care a child or other family member of a client who received care from ICCS or it’s partner agencies within the last 2
years.
When a Support Worker discovers that a client who has been
admitted to an ICCS program is a former romantic partner, a
friend, or a family member, the Support Worker will immediately
follow the ICCS procedure entitled, “Procedure for Reporting
Previous Relationships with Clients &/or Their Family Members.”
These procedures are designed to guide the best behaviour
in such circumstances. They are intended to preserve the freedoms, options, and peace of mind of clients and to protect support workers from boundary violations.
Romantic or Sexual Relationships.
•
Support workers will not engage in romantic or sexual activities
or sexual contact with clients, whether such contact is consensual or not.
•
Support workers will not engage in romantic or sexual activities
or sexual contact with clients’ relatives or other individuals with
whom clients maintain a close personal relationship.
--
Romantic or sexual activity with clients’ relatives or other
individuals with whom clients maintain a personal relationship has the potential to be harmful to the client and may
69
make it difficult for the support worker and client to maintain appropriate professional boundaries.
18
•
Support workers—not their clients, their clients’ relatives, or other
individuals with whom the client maintains a personal relationship—assume the full burden and responsibility for setting clear,
appropriate, and culturally sensitive sexual boundaries.
•
Support workers should not engage in romantic or sexual activities with former clients for a period of two years from the time
that the client last accessed services from ICCS or one of our
partner organizations. To do so is to risk potential harm to the
client.
•
If support workers engage in romantic or sexual activity contrary
to this prohibition or claim an exception to this prohibition, they
will be considered in contravention of this code and their Professional Conduct Agreement and must resign or be terminated
from employment.
•
Support workers should avoid providing service to individuals
with whom they have had a prior romantic or sexual relationship. Providing services to a former sexual partner has the potential to be harmful to the individual and is likely to make it difficult
for the support worker and individual to maintain appropriate
professional boundaries.
Sexual Harassment.
•
19
70
Support workers will not sexually harass clients. Sexual harassment includes sexual advances, sexual solicitation, requests for
sexual favours, and other verbal or physical conduct of a sexual
nature. For more details see the ICCS policy on harassment (below).
Physical contact.
•
There are a variety of ways of using touch to communicate nurturing, understanding and support such as a pat on the back or
shoulder, a hug or a handshake. Such touch can however, also
be interpreted as overly personal, sexual, or inappropriate which
necessitates careful and sound judgment when using touch
for supportive or therapeutic reasons. Support Workers must be
cautious and respectful when any physical contact is involved,
recognizing a diversity of cultural norms exist with respect to
touching. The support worker stays cognizant that such behaviour may be misinterpreted and documents all occurrences
which she thinks might have been unsettling or disturbing for a
client.
•
Some unique situations, such as when clients are very sick during
social detox, or when a client is sick from an illness may require a
limited amount of touching, stabilizing, or help with bedding or
clothing. When such touch is necessary, it is important to explain
this to the client and ensure the client’s understanding, and the
client’s fully informed consent. If there is concern that a particular client may misinterpret such actions, employees should have
another professional present in the session, consider an alternate solution or approach, or contact the program manager
or the client’s case worker for instruction. Document all occurrences of this kind of care.
20
Maintain Established Conventions.
•
21
Ignoring established conventions that help to maintain a necessary professional distance between clients and members can
lead to boundary violations. Examples include acting overly
friendly in social encounters outside of work, not maintaining
clear boundaries between a program’s living and office space,
or between support workers personal sleeping area and program sleeping areas, or entering into discussions with clients that
are less than professional.
Clients who are Related.
•
When support workers provide services to two or more people
who have a relationship with each other (for example, couples,
family members), support workers should clarify with all parties
which individuals will be considered clients and the nature of
support workers’ professional obligations to each.
4.1. N) Privacy and Confidentiality
1
Support workers respect clients’ right to privacy. Support workers
do not solicit personal information from clients unless it is essential to
providing services or conducting support work evaluation or research.
Once private information is shared, standards of confidentiality apply.
2
Personal Information.
3
•
Personal Information is defined in the Personal Information Protection Act as “information about an identifiable individual and
includes employee personal information but does not include
contact information, or work product information.”
•
Personal Information is defined in the Freedom of Information
Protection Act as, “recorded information about an identifiable
individual other than contact information,”
•
“’Contact information’ means information to enable an individual at a place of business to be contacted and includes the
name, position name or title, business telephone number, business address, business email or business fax number of the individual.”
Disclosing Confidential Information.
•
Support workers may disclose confidential information when
appropriate with valid consent from a client or a person legally
authorized to consent on behalf of a client. Support workers
71
should inform clients, to the extent possible, about the disclosure
of confidential information and the potential consequences,
when feasible before the disclosure is made. This applies whether support workers disclose confidential information on the basis
of a legal requirement or client consent.
4
72
•
In all instances, support workers should disclose the least amount
of confidential information necessary to achieve the desired
purpose; only information that is directly relevant to the purpose
for which the disclosure is made should be revealed.
•
See the ICCS Confidentiality Policy subsection “Consent,” for
further details.
Protecting Confidential Information.
•
Support workers protect the confidentiality of all information obtained in the course of professional service, except when compelling professional reasons suggest otherwise. The general expectation that support workers will keep information confidential
does not apply when disclosure is necessary to prevent serious,
foreseeable, and imminent harm to a client or other identifiable
person, or when law enforcement officers are involved.
•
Support workers will discuss with clients and other interested
parties the nature of confidentiality and limitations of clients’
right to confidentiality. Support workers will review with clients
those circumstances where confidential information may be
requested and where disclosure of confidential information may
be legally required. This discussion should occur as soon as possible in the support worker/¬client relationship and as needed
throughout the course of the relationship.
•
Support workers do not discuss confidential information in any
setting unless privacy can be ensured. Support workers do not
discuss confidential information in public or semi-public areas
such as hallways, waiting rooms, elevators, and restaurants.
•
Support workers protect the confidentiality of clients during legal
proceedings to the extent permitted by law.
•
Support workers protect the confidentiality of clients when responding to requests from members of the media.
•
Support workers protect the confidentiality of clients’ written
and electronic records and other sensitive information by taking
all reasonably measure to secure such records.
•
Support workers take reasonable steps to ensure that clients’
records are stored in a secure location and that clients’ records
are not available to others who are not authorized to have access.
•
In practice this means preventing clients from access to computers, filing cabinets, bulletin boards, or other areas where
sensitive or confidential information might be kept. This includes
not leaving a client alone in an office where other client’s files
are kept.
•
Support workers transfer or dispose of clients’ records in a manner that protects clients’ confidentiality and is consistent with
provincial and federal laws such as PIPA and FIPA.
•
Support workers do not disclose identifying information when
discussing clients with consultants, or in publications, or for the
purposes of training or workshops, unless the client has consented to disclosure of confidential information or there is a compelling need for such disclosure.
•
Support workers protect the confidentiality of deceased clients
consistent with the preceding standards.
•
For more detailed information on confidentiality, see the ICCS
Confidentiality Policy and agreement.
4.1. O) General Conduct
1
Language.
•
Support workers do not use derogatory language in their written
or verbal communications to or about clients. Support workers
use accurate and respectful language in all communications to
and about clients.
•
Support workers use decorum and care with their speech and
do not utter profanities, curses, or foul language.
•
Support workers use appropriate vernacular language when
talking with clients and avoid technical, academic, and abstract words.
•
Support workers use technical and precise language when
writing in logs and make an effort to maintain an objective and
respectful style.
4.1. P) Responsibilities To Colleagues
1
Respect.
•
Support workers treat colleagues with respect and represent
accurately and fairly the qualifications, views, and obligations of
colleagues.
•
Support workers avoid unwarranted negative criticism of colleagues in communications with clients or with other professionals. Unwarranted negative criticism may include demeaning
comments that refer to colleagues’ level of competence or to
individuals’ attributes such as race, ethnicity, national origin,
color, sex, sexual orientation, gender identity or expression, age,
marital status, political belief, religion, immigration status, and
73
mental or physical disability.
•
2
Confidentiality.
•
3
4
5
74
Support workers cooperate with colleagues in the field of Social
Services and with colleagues of other professions when such cooperation serves the well¬being of clients, or has a therapeutic
value to a client.
Support workers respect confidential information shared by
colleagues in the course of their professional relationships and
transactions. Support workers ensure that such colleagues understand a support workers’ obligation to respect confidentiality
and any exceptions related to it.
Interdisciplinary Collaboration.
•
Support workers who are members of an interdisciplinary team
should participate in and contribute to decisions that affect the
well¬being of clients by drawing on their perspectives, values,
education, and experiences including those that may exceed
the requirements of their job classification, but must always
qualify statements as such when they exceed the scope of their
job descriptions.
•
Support workers for whom a team decision raises ethical concerns should attempt to resolve the disagreement through
appropriate channels. If the disagreement cannot be resolved,
support workers should pursue other avenues to address their
concerns consistent with client well¬being.
Disputes Involving Colleagues.
•
Support workers do not take advantage of a dispute between
a colleague and an employer to obtain a position or otherwise
advance the support workers’ own interests.
•
Support workers do not exploit clients in disputes with colleagues
or engage clients in any inappropriate discussion of conflicts
between support workers and their colleagues.
Consultation.
•
Support workers seek the advice and counsel of colleagues
whenever such consultation is in the best interests of clients and
does not go beyond the function of a Support Worker. Consultation at ICCS may be made with fellow support workers in the
same program, the program manager, Health Authority case
workers, crisis team nurses, addiction counsellors, and other professionals who are directly associated with a given client.
•
Support workers do NOT consult with professionals not already
associated with a given client.
•
Support workers consult mainly with their program manager and
the client’s assigned case worker. Other consultations should
occur only occasionally and when the program manager or
case worker is unavailable or unable to help.
•
Support workers keep themselves informed about colleagues’
areas of expertise and competencies. Support workers seek
consultation only from colleagues who have demonstrated
knowledge, expertise, and competence related to the subject
of the consultation, or who exist within the chain of command or
area of need.
•
When consulting with colleagues about clients, support workers should disclose the least amount of information necessary to
achieve the purposes of the consultation.
75
4.2
H a r a s s m e n t a n d B u l l y i n g 16
4.2. A) According to the Government of BC (as of 29 October 2013) Harassment is a form of discrimination and occurs whenever a person or
group is subjected to unwelcome comments or behaviours that are
insulting or demeaning, or is otherwise offensive.
4.2. B) In BC it is illegal to harass a person because of their: race; colour; ancestry; place of origin; religion; marital status; family status; physical or
mental disability; sex (includes pregnancy, breast-feeding, and sexual
activity); sexual orientation; age (19 and over); criminal conviction;
political belief; or lawful source of income, among others. For more
information see the Human Rights in BC Harassment Bulletin and the
Worksafe BC Harassment Policy.
4.2. C) Common examples of harassment include name-calling, telling offensive jokes, and making offensive gestures. It can be any conduct by
an individual that he or she knew or ought reasonably to have known
would cause offence or harm.
4.2. D) Bullying is form of harassment. The Workers Compensation Board define bullying as:
1
Any inappropriate conduct or comment by a person towards a worker that the person knew or reasonably ought to have known would
cause that worker to be humiliated or intimidated; but
•
excludes any reasonable action taken by an employer or supervisor relating to the management and direction of workers or
the place of employment.
4.2. E) Worksafe BC further states that, “Day-to-day managerial functions
and activities such as work assignment, performance management,
and progressive discipline are not considered personal harassment.”
4.2. F) ICCS expects all employees to constrain behaviour prohibited in Bill
14, including workplace bullying.
4.2. G) ICCS prohibits all forms of harassment and bullying by its employees
including both quid quo pro harassment and hostile work environment harassment.
4.2. H) Failure to meet the appropriate standards of workplace conduct
including the requirements of Bill 14 may result in discipline, up to and
including termination of employment.
16 Policy Revised 15 April 2014
76
4.2. I) No one in a leadership or managerial role at ICCS shall threaten or
insinuate, either explicitly or implicitly, that an employee’s submission to or rejection of sexual advances will in any way influence any
personnel decision regarding that employee’s employment, wages,
advancement, assigned duties, shift schedule or any other condition
of employment.
4.2. J) Expectations for Employees regarding Harassment
1
Employees are expected to act professionally and respectfully towards everyone they encounter on the work site including but not
limited to clients, fellow workers, case managers, and professional “in
service” providers.
2
Employees who believe they have been treated in an improper or offensive manner are expected to communicate to the offending party
their discomfort, if such a communication is not in itself overly distressing. The Employee is further expected to contact her manager if such
a communication with the offending party is unheeded or uncomfortable. They may also inform a union representative.
3
They can expect to have this policy reviewed and enacted.
4
They can expect prompt action if they report an incident of harassment to their manager.
5
They can expect to be treated without fear of embarrassment or
reprisal when dealing with a harassment situation.
6
They will be expected to cooperate with a mediator and to participate in a problem resolution process before proceeding with the
complaint process.
7
Harassment Complainants, respondents and witnesses
•
Complainants, respondents and witnesses are expected to provide accurate information as requested.
•
They are expected to co-operate in the mediation and complaint process if and when called upon to do so.
•
They are expected to limit the discussion of the complaint to
those who need to know.
•
They can expect to review their statement as recorded by the
investigator, to confirm its accuracy, prior to the final report being submitted.
•
Complainants and respondents may request information related
to the complaint in writing, including allegations, and in accordance with the principles of procedural fairness.
•
Complainants and respondents may have with them, during
meetings and interviews related to the resolution of the comICCS Universal Program Policy Manual
77
plaint, a person of their choice who has agreed to accompany
them and who is not a party to the process.
•
Complainants and respondents may request a copy of the final
report.
•
The results of the investigation, including any disciplinary measures will be communicated to both the complainant and the
respondent.
4.2. K) Expectations for Managers regarding Harassment
1
Managers are expected to lead by example.
2
Managers will periodically be offered training in resolution of harassment complaints and in conflict resolution.
3
They are expected to ensure that employees are aware of the policy
and to remind them of its contents as deemed necessary.
4
They are expected to intervene promptly when they become aware
of improper or offensive conduct and to involve the parties in resolving the problem.
5
They are expected to address any alleged harassment of which they
are aware, whether or not a complaint has been made.
6
They are expected to handle all harassment situations confidentially
and to ensure that others act accordingly.
7
They are expected to work with the mediator to restore a positive
working relationship between the complainant and the respondent.
8
Managers are expected to be impartial in any complaint process in
which they are involved.
9
They are expected to apply the established steps in the complaint
process.
10
They are expected to cooperate with the investigator fully.
11
They are expected to ensure that corrective and/or disciplinary measures are taken, where warranted.
4.2. L) Harassment Investigators
78
1
Investigators are expected to compile all relevant information in their
course of investigation.
2
They are expected to apply the principles of procedural fairness.
3
They are expected to limit their investigation to the complaint, and
report secondary issues back to the manager.
4
They can be any member of the management team, a contracted
third party, or a volunteer with appropriate skills.
4.2. M) Complaint Process
1
There are two avenues to resolve harassment: Early informal resolution, and the formal complaint process. The informal process is an effective and conscientious approach which should be exercised first.
4.2. N) Informal early resolution of Harassment
1
The objective of early resolution is to stop the harassment in a cooperative way and in a timely manner to prevent the situation from
escalating. Every attempt should be made by all parties to resolve
the complaint in a fair and respectful manner without having to resort
to a formal investigation. Every effort should be made to resolve the
issue early with open communication and in a constructive manner.
The use of supportive techniques such as coaching, counseling and
facilitation can in many instances resolve the issue and prevent the
situation from recurring.
2
An allegation of harassment is serious. If a worker believes that he or
she has been harassed, the following actions should be taken before
filing a formal complaint.
•
Talk about the offense. The person who feels offended by the
actions of a fellow worker is encouraged to make it known to
the alleged harasser (the respondent) that she finds the actions
offensive. She should then respectfully request that the actions
end.
•
Request intervention. If the harassment does not end or if the
offended person cannot speak directly with the respondent, the
offended person should meet with his or her manager to discuss
intervention.
•
Talk to the Human Resource Worker. If the manager is the one
charged with harassment, the offended person should meet
with the Human Resource worker or with the Executive Director.
•
Allow management to address the issue. Management must
make every effort to resolve the issue between the parties as
quickly as possible, if necessary with the assistance of the Human Resource worker, a mediator, or the Executive Director.
4.2. O) Formal Harassment complaint
1
If informal resolution is not successful an employee may file a formal
complaint in writing within six (6) months of the latest alleged occurrence directly to the Executive Director. Upon receipt of the written
complaint, a delegate from the Executive team will notify in writing
the Union representative. The sharing of information related to the harassment complaint with the parties must comply with the principles
of privacy, confidentiality, and access to information legislation.
2
The alleged harasser (the respondent) shall be given notice of the
79
substance of such a complaint under article 29.3 of the collective
agreement and shall be entitled to attend, participate in, and be
represented at any hearing pursuant to the same protections of privacy noted above.
3
The Formal Complaint Process
•
Step 1 of the Formal Complaint Process - Filing a complaint
--
•
•
80
The complainant submits a complaint in writing to the
Executive Director. The complaint must include the nature of the allegations; the name of the respondent; the
relationship of the respondent to the complainant (e.g.,
supervisor, colleague); the date and a description of the
incident(s); and, if applicable, the names of witnesses. The
information provided should be as precise and concise
as possible. The complaint should state, “I wish to lodge a
formal complaint.”
Step 2 of the Formal Complaint Process - Acknowledgement of
complaint
--
Upon receipt of the complaint, the Executive Team reads
and acknowledges receipt of the complaint and proceeds with the process if:
--
- The complaint is filed within 6 months of the alleged harassment leading to the complaint, unless there are extenuating circumstances
Step 3 of the Formal Complaint Process - Review of the complaint
--
The Executive Team designates an investigator who investigates the complaint and submits a report to the Executive Team in writing within fifteen (15) days of receipt of the
complaint. The Executive Director, within ten (10) days of
receipt of the report, gives such orders as may be necessary to resolve the issue. The Union Staff Representative,
the complainant and the respondent are then apprised of
the Executive Director’s resolution.
--
Both the complainant and the respondent shall be given
the option of having a steward present at any meeting
held pursuant to the above investigation.
--
Pending determination of the complaint, the Executive
Director may take interim measures to separate the employees concerned if deemed necessary.
--
In cases where harassment may result in the transfer of an
employee, every effort will be made to relocate the harasser, except that the complainant may be transferred
with her written consent.
--
In the case of alleged harassment by a client or a mem-
ber of the general public, the employee claiming to be
harassed has the right to discontinue contact with the
alleged offender without incurring any penalty, pending
determination of the facts of the case. The Employer shall
not require the employee to provide service to an alleged
offender.
•
Step 4 of the Formal Complaint Process – Independent Adjudicator
--
Where either the complainant or the respondent, in conjunction with the Union, is not satisfied with the Executive
Director’s or independent investigator’s response, the
Union will put the complaint, within thirty (30) days, before a mutually agreed upon independent adjudicator
who specializes in cases of personal harassment or sexual
harassment. The adjudicator works with the parties to
achieve a mutually acceptable resolution and if this is not
achieved, the adjudicator shall have the right to:
--
dismiss the complaint; or
--
determine the appropriate level of discipline to be applied
to the harasser; or
--
make further recommendations as are necessary to provide a final and conclusive settlement of the complaint.
4
Disciplinary action taken against a harasser pursuant to this policy
shall not form the basis of a grievance.
5
Where the complaint is determined to be of a frivolous, vindictive or
vexatious nature, ICCS will take appropriate action which may include discipline.
4.2. P) Additional Considerations related to Harassment
1
If harassment is based on one of the grounds of discrimination prohibited under the Canadian Human Rights Act, employees have the
right to file a complaint with the Canadian Human Rights Commission.
2
Assaults including sexual assault are considered abuse and are covered by the Criminal Code and in such cases the police should be
contacted.
3
If a complaint on the same issue is or has been dealt with through
another avenue of recourse, the complaint process under this policy
will not proceed further and the file will be closed.
81
4.3
Abuse
4.3. A) The purpose of this policy is to insure than employees and clients experience an environment of safety and security of person.
4.3. B) All ICCS employees and clients should be free from the threat or possibility of all forms of violence from either persons or systems.
4.3. C) Therefore all ICCS programs have a zero tolerance policy for abuse
of any sort. Employees who violate this policy will be immediately
placed on suspension.
4.3. D) Further, employees who witness any situation they suspect may be
abuse and who fail to review the situation with the manager, may be
subjected to disciplinary action.
4.3. E) Because many forms of abuse are a criminal offence, this policy does
not suggest that the measures listed here are a substitute for legal action, and in no way are intended to replace any aspect of the criminal justice system or give solutions to this grievous behaviour.
4.3. F) Examples of Abuse:
82
1
Sexual abuse: Non-consensual, forced physical sexual behaviour including rape or sexual assault. Psychological forms of abuse, such as
invasive verbal behaviour involving sexual threats or stalking. The use
of a position of trust for sexual purposes.
2
Physical abuse: Where one person inflicts physical violence or pain on
another.
3
Verbal abuse: When a person uses profanity, demeaning talk, or
threatening statements to injure.
4
Emotional or psychological abuse: humiliation, intimidation, relational
aggression, and all instances where one person uses emotional or
psychological coercion to force or compel another person to do
something they do not want to do, or that is not in their best interests.
This can include manipulation of a person’s emotional or psychological state in an aggressive manner using what may seem like non-violent methods to inflict mental or emotional suffering.
5
Spiritual abuse: Force or coercion used for spiritual goals. This can
take the form of brainwashing, aggressive proselytizing, and badgering. May include threats and intimidation, distortion or misuse of the
concept of spiritual authority, and social control powered by fear
and guilt. Often used to produce unquestioning obedience, group
conformity, and stringent tests of loyalty. May also include manipulation of individuals with claims that certain truths or insights can only be
gained by joining a spiritual community or participating in a particular
ritual or rite.
6
Drug abuse: The active and purposeful misuse of drugs, alcohol or
other substances. Usually but not always a form of self-inflicted abuse.
Law enforcement officials, among others, often define drug abuse as
“any” use of illegal drugs, whether or not use is actually harmful to the
user or to anyone else.
7
Human rights abuse: Violation of human rights.
4.3. G) How is abuse different from Harassment?
1
The distinction between harassment and abuse is often unclear and
usually defined in terms of the degree of suffering experienced. This
policy manual is not intended to replace or represent legal advice. In
general harassment is considered to be a less serious form of abuse.
For example sexual harassment usually refers to persistent and unwanted sexual invitations or jokes whereas sexual abuse involves a
physical act which is non-consensual and perpetrated with force.
Both Harassment and Abuse are serious issues.
4.3. H) What to do if Abuse occurs:
1
If the behaviour of any employee or client toward another employee
or client or any person associated with the house or the society seems
to be abuse, it shall be reported to the manager of the program in
which the behaviour occurred.
2
Support Worker
3
•
Verbally report any incident, or suspected incident, of client or
employee abuse immediately to the manager.
•
Complete an Incident Report and submit to the Manager.
Manager
•
Advise the person reporting the incident that the complaint is
being taken seriously, and a full investigation will be undertaken.
•
If the alleged victim is a client the following guidelines for action
may not apply. The following guidelines for action are primarily
designed for abuse between employees. If the abuse situation
is different than this, please contact the Executive Director immediately. You may be asked to contact the Health Authority
worker to obtain direction regarding the client.
•
If the alleged victim is an employee meet with them privately:
--
If an employee reports the abuse and is not the alleged
victim, inform the alleged victim of the report and for confirmation of the abuse.
--
If the alleged victim confirms the report, ask if she or he
understands the seriousness of the allegations and of false
83
allegations.
84
--
Ask the alleged victim if he or she has reported the incident to the police or if he or she wishes to.
--
Assure the complainant that if she or he intends to pursue
legal action that ICCS will cooperate fully with all law enforcement personnel.
--
Ask for permission to proceed with an investigation. If permission is granted, proceed with the investigation. If permission is not granted, inform the alleged victim that the
Executive Director will be contacted for further instructions.
•
At the direction of the Executive Director or with permission from
the alleged victim, initiate a full investigation without delay,
regardless of legal actions that might be initiated. Do not cease
from investigation except at the instruction of an RCMP officer
or the Executive Director.
•
Inform the Executive Director of the incident and ask for direction regarding suspension of the alleged abuser (respondent).
--
Inform the alleged abuser (respondent) of the allegation
and, at the directions of the Executive Director regarding
suspension.
--
Document in full the details of the investigation including: the complainant’s statement(s), the respondent’s
statement(s), the results of witness interviews, relevant
schedules, photos of injuries if appropriate (i.e. grab marks
on arms, etc.), job descriptions, and any relevant documentation including involvement by outside authorities
such as the RCMP and VIHA.
--
f legal actions are not taken, set a date to address the
complaint with the respondent.
--
Advise the employee alleged of perpetrating the abuse
(respondent) of: the occurrence and details of the complaint, the meeting date set to address the complaint.
--
If criminal charges are laid, cooperate in full with law enforcement officers.
4.4
Dress Code, Personal Appearance, Name Tags
4.4. A) The ICCS dress code was revised on August 31, 2011 and again on
October 31, 2012. Three criteria guided the collaboration process:
safety of employees, safety and comfort of clients, and a modest
and professional image.
4.4. B) Employees are asked to use sensitivity and care when considering
how to dress for the worksite.
4.4. C) Because the people we serve often have limited means or income
and may live below the poverty line, employees should take care to
not wear expensive, designer, or high prestige clothing and jewelry.
4.4. D) This Dress Code applies to employees working in ICCS programs.
Employees who attend community and professional meetings in the
course of their work should dress accordingly. Employees who go on
outings with clients will dress according to the outing, i.e. swimwear
for a visit to the beach, evening wear for a visit to the symphony, etc.
4.4. E) Modesty, cleanliness, and utility have been the standards for ICCS
dress for many years. This revised code builds on these standards and
offers specific examples and clear guidelines.
4.4. F) The Basics
1
All aspects of appearance, including footwear, clothing, jewelry, and
grooming, must be neat and clean and reflect standards of modesty,
functionality, utility, health, and safety.
2
Clothing that reveals cleavage, your back, your chest, your feet, your
stomach, or your underwear must not be worn. Sheer clothing that
does not fully hide these areas, should also not be worn.
3
Employees may wear scrubs.
4
Pressed or ironed clothing is not required but excessively wrinkled
clothes are not acceptable.
5
All seams must be finished.
6
Do not wear ripped, torn, dirty, or frayed clothing.
4.4. G) Words, Logos, Images, Tattoos
1
Use discretion when wearing clothing that has words, terms, images
or pictures, especially where the words and pictures convey a message, slogan, or advertising. We can never know all the images and
words that can be triggers for clients or contribute to a client’s decline in mental wellbeing. When in doubt choose clothing with miniICCS Universal Program Policy Manual
85
mal or no words and images.
2
Logos and registered trademarks are acceptable as long as they are
small and unobtrusive. Clothing with the ICCS Logo or name can be
worn.
3
Tattoos with graphic or disturbing images e.g., displaying violence,
drugs, sex, alcohol, tobacco products are not allowed to be visible.
4.4. H) Slacks, Shorts, and Pants
1
Employees may wear jeans, “dockers” corduroys, Capri pants, and
informal slacks.
2
Comfortable well fitting “Sweatpants” may be worn on night shifts,
but should not be worn during business hours.
3
Pyjamas may be worn for sleeping, but employees working shifts that
include morning meal preparation or other morning routines should
change into regular work attire.
4
Employees may wear shorts as long as they extend to within an inch
of the knee.
5
Do not wear short shorts or any skin-tight or form-fitting shorts or pants
such as people wear for exercise or when biking.
6
Leggings and Jeggings may be worn under sweater dresses, long
tunics, and other long shirts or tops that extend to or below the midthigh.
7
Sheer or see-through leggings and jeggings may not be worn.
4.4. I) Shirts, Skirts, Dresses, and Jackets
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1
(In this policy “shirts” refers to all shirts, tops, and blouses.)
2
Tailored shirts, dress shirts, sweaters, and turtlenecks may be worn.
3
Tank tops may be worn as long as they have broad straps.
4
T-shirts may be worn during night shifts and during business hours if
they are made of a thick material and are not overly tight or baggy,
or liable to cling.
5
Sweatshirts may be worn during night shifts, and during the day if they
are not baggy or worn.
6
Dresses, skirts, skirts with jackets, two-piece knit suits or sets, and skirts
that are split at or below the knee are allowed but discouraged
because they can be impractical for cleaning, cooking, and other
domestic duties.
7
Most suit jackets or sport coats are acceptable but take care not to
dress too “upscale” or businesslike.
8
Do not wear short tight skirts that ride halfway up the thigh.
9
Do not wear dresses or shirts with spaghetti straps.
10
Do not wear halter-tops, tube tops, strapless shirts, or shirts with completely bare shoulders or plunging necklines.
11
Do not wear sun dresses and beach dresses.
12
Do not wear mini-skirts or skorts.
13
Do not wear skin-tight shirts or dresses.
14
Do not wear midriff shirts or dresses.
15
When clients have infectious diseases employees should be aware
that long sleeves and other unduly loose clothing increase the potential of cuffs and loose fabric coming into contact with clients and
becoming contaminated. For this reason trim neat clothing is recommended.
4.4. J) Shoes and Footwear
1
At all times employees will wear clean nonslip footwear.
2
Shoe “uppers” (i.e. the parts of the shoes that are not the soles)
should be constructed of an impervious, non-absorbent material.
Leather, vinyl, rubber, and plastic are best, but water repellent fabrics
are also acceptable.
3
Styles of shoes that may be worn include athletic shoes (sneakers,
runners, tennis shoes) walking shoes, dress shoes, oxfords, loafers, and
flats.
4
“Crocs” brand of backless shoes may be worn. Other solid form shoes
similar to crocs may be worn if they are nonslip and cover the toes.
5
Sandals such as “Keens” that are nonslip and provide some protection for the toes may be worn.
6
Do not wear thongs, flip-flops, slippers, open toed sandals, or heels
higher than 2 inches.
4.4. K) Accessories and Jewelry
1
In general a minimal amount of accessories and jewelry should be
worn. Religious necklaces and jewelry may be worn beneath clothing.
2
Rings with stone settings must not be worn as they compromise hand
hygiene. One plain band or equivalent is acceptable.
3
Limit the visibility of body piercing. Earring posts or studs may be
worn.
4.4. L) Makeup, Perfume, and Cologne
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1
Excessive makeup is unprofessional in our sector.
2
Clients and employees may be allergic to the chemicals in perfumes,
hair products, and makeup, so do not wear perfume, cologne, or
other strongly scented products.
3
Lightly scented deodorant is allowed.
4.4. M) Fingernails
1
Fingernails must be kept clean, well-cared for, and no longer than 1/4
inch from fingertip in length.
2
Do not wear press-on or glue-on nails.
3
Nail polish, if worn, must be maintained. Chipped nail polish is not allowed.
4.4. N) Head Covering
1
Do not wear hats, caps, bandanas, hair sacks, etc.
2
For food-safe compliance tie hair back or wear a hair net.
3
Head Covers that are required for religious purposes or to honour cultural tradition are allowed.
4.4. O) Hair, Moustaches, and beards
1
Hair should be clean, neat and tidy.
2
Long hair will be secured off the shoulders in the following circumstances and all foodsafe rules apply:
•
During meal service
•
When preparing or handling food
3
Hair longer than collar length must be pulled back and secured with
neutral elastic. Hair fastenings should be minimal and hair adornments (flowers, sparkled clips, jewelled clips, etc.) should not be worn.
4
Moustaches or beards must be neatly groomed and relatively close
to the face.
4.4. P) ID Name Tags
1
88
This ID name tag policy is part of ongoing efforts to increase safety for
employees. Official Identification allows case managers, police officers, fire fighters, city bylaw officials, paramedics, neighbours, clients,
and others, to quickly Identify employees. This can save time during
an emergency and create clarity and comfort in non-emergency settings.
2
Beginning on November 1st, 2012 all regular ICCS employees will be
issued with an ID name tag.
3
Casual employees who have completed their probation period will
also be issued with an ID name tag.
4
New employees who have not completed their probation period will
wear one of the generic ID name tags provided to each work site.
5
If an employee loses or destroys their ID name tag, they must order a
replacement from the ICCS office at a cost of $5.00. They must wear
a generic ID name tag while waiting for their new personalized tag to
be made. To order a replacement tag e-mail the Administrative Support Manager, Michelle Authier, at mauthier@iccare.ca
6
The ID name tag is for identification purposes only and does not bestow rights, authority, or privileges.
7
All ICCS employees will wear an ID name tag at all times while at
ICCS program locations.
8
When an employee’s shift includes provision for sleep she may remove her name tag just prior to retiring but must put it back on when
she get up from sleep for any reason.
9
The ID name tag is to be worn on the upper torso so that it is visible
and easy to read.
10
Employees will wear their own personalized name tag and no-one
else’s, and will not allow any other person to wear their personalized
tag.
11
If an employee forgets their ID name tag at home, they will wear the
generic ID name tag that is located at each work site.
12
If an ICCS employee regularly fails to wear an ID name tag while at
work, or regularly forgets to bring their personalized ID name tag to
work; it shall be considered a breach of this policy and as such may
result in discipline.
13
Program managers are responsible for keeping track of generic ID
name tags and will order new ones if those provided go missing.
14
All ID name tags are the property of ICCS. When an employee leaves
employment with ICCS her ID name tag must be returned to the program manager or the ICCS office.
15
Program managers are responsible to ensure that all employees
are informed of their responsibility to wear identification as outlined
above, and for enforcing this policy.
89
4.5
Theft
Theft by a staff member will result in discipline up to and including dismissal.
90
4.6
Transactions
4.6. A) No transactions of any kind will occur between ICCS employees and
clients or residents.
1
This includes but is not limited to the sharing or selling of cigarettes,
the selling or sharing of items and services, the trading of favours, the
lending of money, the rental of accommodations or equipment, and
any similar transaction.
4.6. B) Such transactions change the worker/client relationship by adding
elements of reciprocity and negotiation. These elements confuse
professional boundaries and as such contravene the Professional
Conduct Agreement. Such contravention is grounds for dismissal.
4.6. C) Transactions between a client and an employee’s family and friends
should be discouraged except where professional boundaries exist.
1
Family and Friends Examples:
•
An employee should not introduce a client to her father who is
selling a car or a friend who has puppies to give away.
•
If a client visits the law offices of an employee’s brother, however, the brother’s professional boundaries and those of the ICCS
employee will include confidentiality and therefore not present
a problem.
•
An employee who “recommends” their brother’s services to a
client, however, may constitute a violation, depending on the
context and circumstances, and therefore such recommendations should be avoided.
•
An employee, likewise, should not purchase a car, camera, etc.
from a client’s immediate family or hire a client’s family member
to do housework, or similar activities.
•
The same guidelines apply to rentals. Where possible clients
should be encouraged to rent from people outside a workers
circle of family and friends, and visa versa.
Please also see the related policy on Gifts, Loans and Bequests: 7.3
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5 Infor ma t i o n & C o mm u n ic a tio n
5.1
G e n d e r P r o n o u n s i n I CCS M a t e r i a l
5.1. A) The female pronouns “her” and “she” are used in all ICCS information
and communication when a non-specific pronoun is need. Traditionally “he” and “his” have been used because English lacks a neuter
pronoun.
5.1. B) Our decision to switch to the female pronoun was threefold. First it
avoids the awkward he/she and him/her nomenclature, secondly because the larger share of our employee and client base are women,
and thirdly to avoid triggers that workers and clients may have with
male pronouns because of those word’s association with patriarchal
cultures.
5.1. C) In some cases male pronouns may also occur in gender neutral contexts and represent older documents written before this policy was
widely applied, or as a result of force of habit.
5.1. D) The intention of this policy is to reduce anxiety, be respectful, and
increase consistency; not to make a political or philosophical statement.
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5.2
Scheduling
5.2. A) It is the responsibility of each Program Manager to ensure all shifts are
scheduled according to established positions and routines.
5.2. B) Work schedules must be posted fourteen (14) calendar days in advance of the beginning of the work schedule. Generally the program
will operate on a month by month schedule.
5.2. C) Changes to the posted work schedule may be made for bona fide
business reasons with forty-eight (48) hours notice.
5.2. D) If the change to the employee’s schedule is initiated by the Employer
with less than forty-eight (48) hours notice, the employee shall be paid
a premium of eighty-five cents (85¢) per hour for work performed on
the first shift of the revised schedule. This penalty does not apply if
the change is initiated by the employer with less than forty-eight (48)
hours notice because of an unanticipated absence of a scheduled
employee, and no casual employees are available.
5.2. E) All shift exchanges must be requested in advance in writing to the
program manager for approval in compliance with article 15.1 of the
collective agreement.
93
5.3
Bulletin Boards
5.3. A) Notices, posters and similar materials shall be posted on designated
boards only. Walls, windows and other surfaces are not to be defaced with notices, posters and other materials.
5.3. B) A union bulletin board is located in each program and only union
stewards may post items on these boards.
5.3. C) Job posting are to be posted on ICCS internal business bulletin boards
and the ICCS website.
94
5.4
Meetings
5.4. A) Programs managers will call regular voluntary staff meetings to provide an opportunity for program teams to meet and discuss matters
of concern, and to receive information, instruction, and training.
1
Attendance at voluntary meetings is optional but highly recommended.
2
Employees receive their regular rate of pay for attending voluntary
meetings.
•
Employees who have already worked during the day, or who
are on a day off when the meeting is scheduled do not receive
overtime pay for voluntary meetings.
5.4. B) Occasional mandatory staff meetings may be scheduled.
1
An employee who is required to attend a meeting outside of her regular working hours which results in hours worked that exceed 8 hours
a day, will be paid the appropriate overtime rate of pay for all time
spent in excess of 8 hours a day, for her attendance at the meeting.
2
Employees who are not working on the day of the meeting, may be
scheduled into the regular work schedule as 2 hour shift for the duration of the meeting. They shall be paid their applicable rate of pay
for the 2 hour shift. Where the meeting is longer than 2 hours employees shall be compensated at straight time rates in fifteen (15) minute
increments.
95
5.5
Change of Address
5.5. A) It is the responsibility of each employee to keep the employer informed at all times of any changes in his name, address, telephone
number, marital status or number of dependents. These changes
should be given to the program manager and also the Manager of
Finance and Administration.
5.5. B) When resigning from the agency, a forwarding address must be filed
with the employer to ensure the employer can forward income tax T4
slips and other relevant documentation.
96
5.6
Employee Resignations
5.6. A) Regular employees shall endeavour to give reasonable notice of their
intent to terminate employment to their supervisor at least fourteen
(14) calendar days in advance.
Best Practices Suggestion: It is important to note that the Employment
Standards Act does not require an employee to give notice to the employer. However, the courts have stated that employees are required
to give their employers “reasonable notice” of their intent to terminate
employment. While there is no specific definition of “reasonable notice”
in this context, case law suggests the responsibilities, length of service,
salary and time it would take the employer to replace the employee
must be taken into consideration when determining the appropriate notice period. An employer should include a provision for employee notice
of termination in manager and executive employment contracts.
97
5.7
Use of Personal Devices & Electronics
5.7. A) The use of personal devices and electronics, i.e. cell phones, iPods,
laptops, tablets, etc. is limited to rest and break periods and are not
to be used at any other time.
5.7. B) Speaking on personal cell phones, texting, and all other forms of
personal communication are to be reserved for rest periods and meal
breaks. They may not be used at any other time.
98
5.8
Use of Communication Systems
5.8. A) Use of ICCS’s communication systems must be lawful, ethical and
consistent with ICCS’s professional reputation, standards, policies, procedures and guidelines.
5.8. B) In using all communications systems, each employee must exercise
good judgment and follow the spirit of this policy.
5.8. C) ICCS communication systems include telephone, email, voicemail,
the website, computers networks, and cell phones.
5.8. D) This policy applies while using communication systems on ICCS’s
premises or while using remote access via ICCS’s internet accounts
or website, as well as any other forms of communication provided by
ICCS.
5.8. E) Prohibitions
1
The following uses of communications systems are prohibited:
•
Illegal, unethical or immoral uses
•
Sending, receiving or accessing offensive, objectionable, abusive, pornographic, obscene, sexist, racist, harassing or provocative messages, images or other materials, including adult-oriented websites or news groups
•
Defamatory, derogatory or false messages
•
Distributing email chain letters or similar solicitations to forward or
distribute non-work related material
•
Political activities, solicitation of funds or advertising goods or
services
•
Other commercial or business uses
•
Unauthorized access to other users’ email, data or communications
•
Uses that infringe copyright or other intellectual property rights
•
Unsecured disclosure of confidential or privileged information
•
Unauthorized use of data encryption
•
Uses that may compromise system integrity or degrade system
performance
5.8. F) Personal Uses
99
1
Communications systems may be used for personal purposes (e.g. to
send and receive email, voicemail messages of a personal nature, to
access the internet for personal use) ONLY during employees meal
and rest breaks and only provided that in the opinion of ICCS those
uses do not interfere with the agency business and do not compromise the integrity and efficiency of the agency’s communications
systems, the agency’s professionalism or its reputation.
2
All personal uses of the communications systems must comply with
this policy and the agency’s other policies, procedures and guidelines.
3
It should be carefully noted that all communications systems, data
and uses, including email, voicemail and internet, are not private and
are subject to ICCS access and control.
5.8. G) Third-party access
1
Non-employees are not permitted to use or access the communications systems, including the agency’s internet and email accounts,
without prior written authorization from the employer.
2
Clients are not permitted to use ICCS communication systems unsupervised. Some clients may be allowed to use ICCS communication
systems under controlled or monitored situations. Check with your
manager before allowing a client any access to ICCS communication systems.
5.8. H) Confidential communications
1
Email and data transmission is not secure or private unless it is encrypted. Email and other data sent using ICCS communication systems may pass through many computers and systems that are not
under ICCS’s control and may be subject to unauthorized access. For
this reason, confidential email or other data SHOULD NOT be sent or
received via email unless it is secured by encryption software authorized by the employer.
2
No client details are to be sent via e-mail without encryption.
5.8. I) Privacy
100
1
Employees should assume that unless encryption is used there is no
privacy when using an ICCS communications systems, Further, some
data contained in the communications systems, including email and
voicemail can not be encrypted and must therefor be assumed to be
in the public purview.
2
Communications systems and all data contained in the communications systems, including email and voicemail, are the property of ICCS.
3
ICCS may access, inspect, retrieve, review, read, copy, store, archive,
delete, destroy, distribute or disclose to others (including courts and
law enforcement authorities) all communications systems data and
uses, including email, voicemail and internet use, without any further
notice as may be considered necessary or appropriate. ICCS has no
obligation to monitor communications systems use and data.
4
Users who want their internet use or email or voicemail communications to be private should not use ICCS communications systems.
5.8. J) Email Protocols
1
Email has the same legal and practical effect as other written communications.
2
Users should thus exercise the same good judgment and discretion
when sending email as they would when sending a formal letter, written memorandum or other correspondence.
5.8. K) Email sent via ICCS communications systems reflects the image of
users, the program from which it was sent, and the agency. Accordingly, all email messages must be consistent with ICCS’s professional
reputation and standards.
5.8. L) Use of Communications Systems after Termination
1
Employees who leave ICCS no longer have any right to any communications systems data, including email messages, nor will they
be allowed access to the agency’s communications systems and its
internet accounts.
5.8. M) Compliance
1
Use of ICCS communications systems is governed by this policy, as
well as all other policies that guide the conduct of employees. This
policy is part of the employment terms and conditions for all employees.
2
Use of the communications systems is a privilege and must not be
abused. Use of the communications system may be revoked at the
agency’s sole discretion.
3
Failure to comply with this policy may have serious ramifications and
may result in disciplinary action up to and including termination.
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5.9
Personnel Files
5.9. A) Personnel files on each employee shall be maintained and will contain information such as:
1
Application for employment
2
Criminal Record Check
3
Letter of offer/acceptance
4
Letters of expectation
5
Written performance appraisals
6
Records of disciplinary action (time limited according to the collective agreement)
7
Rates of pay
8
Orientation checklist
9
Attendance record
10
Benefit selection list
11
Other information relevant to the employee’s employment
5.9. B) Personnel files will be kept in a secure area and shall not be accessed
by anyone other than management employees, designated board
members and designated administrative employees.
5.9. C) An employee shall be permitted to review his personnel file upon giving the employer seven (7) days written notice.
102
5.10 Release of Personal Information
5.10. A)The collection, use and disclosure of personal information will be managed in compliance with the provincial or federal privacy legislation
requirements.
5.10. B)Generally, employees’ personal information shall not be given out
without the employees’ authorization except under the conditions
outlined below as required by the operation of the employer’s business.
5.10. C)The employer shall not release personal information on any employee
to any person without prior written permission. This shall in no way limit
the employer’s right to provide employment-related information to
requests related to the proper operation of the employer’s business
(including the provision of employment references to other employers).
5.10. D)Should an employee wish to have personal information released, he
shall provide the employer with a written statement authorizing the
employer to release the information.
5.10. E)When a request for the release of personal information is received
and where the employee has not authorized the employer to release the information, the employer shall respond to the inquirer with
a statement that it is not the agency’s policy to give out information
without the employee’s prior approval.
5.10. F)The employer is not responsible for advising the employee when a
request has been made.
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5.11 Mail
5.11. A)Employees may not use a program’s address or the society’s post office box address for personal mail.
5.11. B)The important status ascribed to mail by the legal system, and the
penalties associated with impeding or opening mail in the Canada
Post Corporation Act (48, 49, 50), highlight the necessity to safeguard
the handling of all mail passing through ICCS programs.
104
1
For this reason, only staff members may handle mail prior to it being
delivered to the person for whom it is addressed.
2
No client will be given the task of carrying mail that is not addressed
to them.
3
Likewise no client may be allowed to take possession of mail not their
own.
4
If a client should offer to carry mail, within the program or to or from a
post office, that request shall be denied.
5
All employees of ICCS will decline to post mail for a client. All clients
residing in ICCS programs are deemed capable to post their own
mail. If a client is incapable to do so, they shall be referred to their
case manager for assistance.
5.12 Media Contacts
5.12. A)Media contacts will be handled by designated senior employees
only. All other personnel will not comment to the media in their capacity as an employee of the agency. Please refer all reporters and
members of the media to your program manager or the executive
director.
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6 Health a n d S a f e t y
Most guidance related to health and safety is adequately outlined in the
collective agreement. Please refer to Article 22 for details.
6.1
Unsafe Situations, Tasks, or Operations
6.1. A) If an employee has reasonable cause to believe that a situation, task,
or operation is unsafe or will create undue hazard to the health and
safety of anyone in the house or building she must immediately report
the concern to her manager and record the concern on the Health
and Safety Concern List for that worksite.
1
The manager or person deemed “in charge” who receives a report of
this nature must immediately investigate the matter and take reasonable and timely action to make the worksite safe.
2
BC Health and Safety Regulation 3.9 mandates that a remedy for
unsafe conditions must be made without delay.
6.1. B) Employees and managers shall make every effort to solve health and
safety concerns at each worksite before referring the concerns to the
Occupational Health and Safety Committee, or it’s members. (as per
the recommendations of the OHSC, 08 March 2013.)
6.1. C) Anything reported to Worksafe BC and everything considered ‘critical’ or unsolvable should be reported to and discussed at a OHS
meeting.
6.2
1
The OHS committee’s job is to consider concerns that have not been
resolved in-house and to recommend actions and policies to the employer that will prevent and reduce risks, injuries, and illnesses.
2
Significant issues that require a new or revised policy will be referred
by the program manager to the society executive in charge of policy.
Injury on Duty
6.2. A) All workplace incidents resulting in injury to employees shall be thoroughly documented in writing and promptly reported.
6.2. B) Employees must report all injuries immediately to their manager and
complete online WorkSafeBC forms on all injuries.
6.2. C) Procedure
1
106
All incidents of employee injury shall be reported, and the program
manager notified.
2
In the event of absence of the program manager, notification shall
be made to the person in charge in the managers absence, or the
executive director.
3
Online WorksafteBC form shall be completed.
4
ICCS incident report shall be filled using the web-based ICCS database.
5
The database shall be set to automatically send electronic Incident
reports to the Executive Director, or notification of a new report being
created.
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6.3
Smoking
6.3. A) The act of smoking will occur only under the conditions laid out in British Columbia’s amended Tobacco Control Act.
6.3. B) Most significantly smoking will not occur within any building owned
or operated by ICCS nor within a distance of three meters from any
doorway or window of such a building, according to .22 of the Tobacco Control Act.
6.3. C) An employee found smoking in a non-designated area will be subject
to disciplinary action.
6.3. D) Employees are not allowed to smoke with clients. To do so crosses an
important professional boundary. Please see the Code of Conduct
for more details.
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6.4
Substance Misuse
6.4. A) Employees will not arrive on the worksite under the influence of alcohol or nonprescription drugs.
6.4. B) Any state of intoxication on the job that may endanger others, regardless of the source, is grounds for discipline including a one day’s
suspension.
6.4. C) Any employee reporting for duty under the influence of alcohol,
drugs or other prohibited substance(s) which endanger her health or
safety or the health or safety of other persons will not be permitted to
remain on the premises.
6.4. D) It is the responsibility of the employee to seek treatment for substance
abuse or misuse at the earliest possible opportunity.
6.4. E) Sub-standard performance due to alcoholism or drug dependency,
as in any form of illness, will not be condoned. Treatment will be supported in principle and time off will be given under the sick time provisions for treatment.
6.4. F) Storage, possession or consumption of alcohol or drugs by any employee on the premises are prohibited.
6.4. G) Violation of this policy will be grounds for discipline up to and including termination.
6.4. H) On a first offence, the employee shall be sent home for the remainder
of the shift without pay and be given a written warning regarding the
seriousness of the incident. The employee will be encouraged to seek
professional counseling.
6.4. I) On a second offence, the employee will face serious disciplinary
measures up to and including dismissal.
6.4. J) Employees reporting for duty or found on duty in a condition of prescription/non-prescription medical drug impairment which interferes
with job performance will be sent home on sick leave and may be
required to supply a doctor’s certificate.
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6.5
Violence in the Workplace
6.5. A) All program staff and managers shall take reasonable steps to reduce
or eliminate physical or emotional injury to employees and clients,
threats to employees’ personal safety, damage cause by aggressive
behaviour or any other overt action by a client, volunteer or another
employee.
6.5. B) Employees who, in the course of their duties, may be exposed to violence or aggressive conduct shall receive training in recognizing and
handling such episodes. See the “Training Required” subsection under
Hiring, Orientation, Training & Performance section for more details.
6.5. C) ICCS shall provide the employee with pertinent information relative to
the potential for experiencing violence, physical aggression, and/or
verbal abuse within any particular worksite.
6.5. D) The employee shall be informed of specific instruction on the approach to be taken when providing care for a potentially violent client, and in responding to violent episodes.
6.5. E) Immediate defusing, debriefing and, where deemed appropriate by
a qualified medical practitioner, post-traumatic counselling for individuals who have been exposed to violence of an unusual nature,
including physical assault, will be made available to employees by
qualified outside practitioners where such services are available at no
cost to the Employer. Where an employee requires time off to attend
defusing or debriefing, it will be without loss of pay.
6.5. F) At the request of an employee who has been exposed to violence,
including physical aggression or verbal abuse, the Parties will meet as
soon as possible to determine remedies up to and including transfer.
6.5. G) Where repeated incidents of violence occur, including physical aggression or verbal abuse, the Joint Safety and Health Committee,
after review of the circumstances, may request a review by the Workers’ Compensation Board.
6.5. H) Where an employee has experienced a critical incident related to
their work responsibilities, the Employer will assist the employee to obtain WCB counselling and such other support as may be reasonably
available.
6.5. I) The incident or act may involve, but is not limited to any of the following:
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1
Use of a weapon.
2
Physical abuse such as hitting, biting, scratching and/or pinching.
3
Inappropriate written material.
6.5. J) Any violent conduct or behaviour is unacceptable and perpetrators,
where mentally competent, will be held accountable for their behaviour. Clients who conduct in any of the above behaviour toward another client or employee will be instructed that they are discharged
from the program.
6.5. K) Employees who breach this policy directive may be subject to disciplinary action up to and including dismissal.
6.5. L) PROCEDURE
1
Complete an Incident Report. Follow the policy and procedures for
Incident Reports under the Critical Incidents section of this manual
and other supporting documents.
2
Ensure the clients’ agency is aware of the consequences of violent
conduct or behaviour.
3
If violent conduct or behaviour occurs, the client responsible will be
told they are discharged from the program.
4
If client is unwilling to leave the program on their own, the police will
be called immediately to assist.
5
Inform the program manager or director of the clients’ behaviour, as
criminal charges may result.
6
Investigate the incident and recommend appropriate follow- up.
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6.6
Hazardous Materials
6.6. A) Program managers will ensure that all hazardous materials stored or
used by program personnel are identified and labelled and, where
applicable, supplied with Workplace Hazardous Materials Information
System (WHMIS) Material Safety Data Sheets(MSDSs) that meet regulated requirements.
6.6. B) For all work locations where WHMIS-controlled materials are used,
handled or stored, complete information regarding these hazardous
materials will be made readily available to workers exposed to such
materials by providing an MSDS file or binder. During orientation of
new employees the location of the MSDS file or binder will be noted.
6.6. C) Program Managers will ensure all employees exposed to hazardous
materials have been trained in the recognition and safe handling of
these materials as well as all proper use and storage procedures.
6.6. D) The information and training regarding hazardous materials will be
reviewed on a regular basis.
6.6. E) Program Managers will ensure that workers who use or handle WHMIS controlled (or other hazardous products) have been adequately
trained to recognize standard hazard symbols, understand risk phrases and first aid measures, and implement appropriate protective
measures as required by law.
6.6. F) Program Managers will ensure that sufficient labelling, MSDSs and protective equipment are available at work locations to meet regulated
requirements.
6.6. G) WorksafeBC provided templates for MSDSs will be used and are located at: http://www2.worksafebc.com/topics/whmis/MSDS.asp
6.6. H) Workers are responsible for following procedures and instructions
provided for safe use, handling, storage and transport of hazardous
products. Lastly, workers are responsible for reporting containers that
are unlabeled, illegibly labelled or incorrectly labelled.
6.6. I) Hazardous Materials Controls
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1
Program Managers are responsible to establish and maintain an inventory of WHMIS-controlled and other hazardous products.
2
Standardized inventory control forms developed by the management
team will be used for this function.
3
Program Managers will review purchases and adjust inventory records
accordingly.
4
Managers will regularly inspect areas where materials are stored and
note staff practices to ensure all safety measures are observed.
5
The inventory will be reviewed as often as necessary to ensure that it
is maintained up-to-date.
6
At the time of ordering or purchasing new materials, the supplier must
be requested to identify which products, if any, are covered by hazardous materials legislation.
7
Where multiple products that are used for the same purpose are
available, the least hazardous material will be obtained if practicable.
8
All WHMIS-controlled hazardous materials ordered through central
purchasing or ordered directly to a program location may only be
accepted if accompanied with applicable labelling and MSDSs.
9
Any person that orders new materials is responsible for checking that
supplier labels have been provided and applied to controlled products received at the workplace. Improperly labelled products must
not be handled or used except to be held in storage.
10
With bulk shipments, if the supplier sends a supplier label, the receiver
must apply or post it to individual containers. Where the supplier only
sends labelling instructions, the receiver must apply, at minimum, a
workplace label to containers.
11
Workplace labels are also necessary on containers of controlled
products which have been transferred or decanted from a supplier’s
bulk container.
12
Workplace labels will provide three types of information: product
name, safe handling information, and a reference to the MSDS
13
The employee who receives new materials must ensure that MSDSs
are obtained for all controlled products supplied to the workplace.
14
In addition, the employee who receives the products must contact
the supplier for an updated sheet if the preparation date on an MSDS
indicates it is more than three years old.
15
Copies of MSDSs must be made accessible to employees, close to
their work areas and available during the work shift.
16
All employees are responsible to monitor and correct the conditions
of storage of any materials they find to be improperly stored.
17
All employees will report improperly stored materials to their manager.
18
On the basis of WHMIS and other health and safety information, management, in cooperation with the executive team, will develop work
procedures that ensure worker health and safety.
19
Hazard control measures may include:
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20
114
•
engineering controls such as ventilation, process modification or
isolation of the hazard source,
•
administrative controls such as work procedures, storage arrangements, maintenance and shift scheduling,personal protective equipment such as respirators, gloves and protective
clothing.
Workers who use hazardous materials or work in proximity to them are
required to have received previous instruction in:
•
hazards of the materials they will be exposed to,
•
procedures for safe use, handling and storage of the product as
contained on labels and MSDSs,
•
recognition of symptoms of overexposure,
•
overexposure emergency response procedures,
•
responsibilities for reporting injuries, and reporting containers
that are unlabeled, illegibly labelled or incorrectly labelled.
6.7
Storage of Cleaning Products
6.7. A) In compliance with Worksafe BC OHS regulations part 5 and WHMIS
regulations:
1
ALL cleaning fluids, cleaning powders, chemicals, and similar materials must be stored in a LOCKED storage areas such as a cabinet,
drawer, cupboard, lockers, or closet.
2
All cleaning products must be stored safely in accordance with supplier’s Material Safety Data Sheets.
3
Storage areas must be clearly identified by a sign such as “Cleaning
Products -- for Staff Use Only.”
4
Storage areas may not be in parts of the building that are regularly
occupied by clients or workers; for example not in a bedroom, eating
area, or living room.
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6.8
C l e a n i n g u p B l o o d a n d o t h e r B i o h a z a r d s 17
6.8. A) ICCS employees will adhere to “standard precautions” when performing clean-up and disinfection of major blood spills and when
handling bio-contaminated items.
6.8. B) The Guide to Prevention and Control of Infectious Diseases in the
Workplace, a joint Initiative of the BC Government and Service Employees’ Union and the BC Public Service Agency gives detailed
instructions (4.2.4) on the best practices in this area. In general the
guide follows “universal precautions” or “standard precautions” and
contains helpful explanations on these and related procedures.
6.8. C) ICCS employees will refer to the Guide to Prevention and Control
of Infectious Diseases in the Workplace if further instructions are required.18
17 Policy Revised 15April 2014
18 http://www2.gov.bc.ca/local/myhr/documents/safety/infectious_disease_guide.pdf
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6.9
Snow Shoveling
6.9. A) Removing snow from walks, stairs, and driveways is a top priority for
support workers because of the potential for serious injury from slips
and falls. In programs where a custodian is employed, support workers play a back-up role for this duty. When a custodian is not on duty
during the time when snow is falling, support workers are expected to
clear snow until the custodian arrives.
6.9. B) In most cases, clients are not permitted to assist in this work. Check
with your manager if you need further clarification.
6.9. C) The Clinical Manager at Kessler Institute for Rehabilitation states
that, “People don’t realize that shoveling, combined with the cold
weather, puts a great deal of stress on the body. For older or more
sedentary individuals, there is an increased risk of injury. But generally, by using proper warm-up and lifting techniques, along with some
common sense, individuals can help to reduce their risk of injury – and
may actually benefit from the exercise.”
6.9. D) Careful snow shoveling following the recommendations in this policy
should be no more dangerous than a brisk walk.
6.9. E) Since support workers are required in their job descriptions to “possess
and maintain a moderate level of physical fitness,” snow shoveling
of the sort described here should be possible for all support workers.
However, if a temporary medical condition prevents such activity,
please speak with your program manager. Time off for inability to
shovel snow must be recorded as sick time.
6.9. F) If a chronic health concern exists, such as a serious heart condition or
back problems, and you believe your health conditions prevents you
from maintaining moderate levels of physical fitness, speak with your
doctor and program manager. The requirement for moderate levels
of fitness may disqualify you from further service as a support worker.
6.9. G) Using the proper warm-up and lifting techniques is crucial to avoid
injury and therefore the following practices must be followed when
removing snow. These practices are taken from the recommendations of Worksafe BC, the Heart and Stroke Foundation, and the Kessler Institute for Rehabilitation .
6.9. H) Safe Snow Shoveling Practices
1
Before you Begin
•
Shovel several hours after a big meal, not right after eating. Your
117
body works hard to digest food; adding physical activity on top
of that could put unnecessary strain on your heart;
2
•
Don’t shovel after drinking alcohol. Alcohol can increase the
sensation of warmth and cause you to underestimate the extra
strain on your body in the cold;
•
Avoid caffeine or nicotine before shoveling. These stimulants
can increase your heart rate and cause your blood vessels to
constrict, which places extra stress on the heart;
•
Take time to do a few minutes of warm-up activity. Walk around
inside first, march in place, and gently stretch the muscles in
your arms and legs. Warm muscles will work more efficiently and
are less likely to become injured;
•
Dress in layers and be sure to wear a hat, gloves, and sturdy,
non-skid footwear. Be prepared to take a few layers off as you
go: Overheating will increase your blood pressure further so
make sure you can strip down to just a sweater if needed.
Pick the right Shovel
•
Use a snow shovel that feels comfortable for your height and
strength. Don’t use a shovel that is too heavy or too long.
•
The snow shovel should be sturdy and have an open end that
releases the snow easily when tossed.
•
Don’t use a garden spade or square-ended “coal” shovel.
3
Try to shovel fresh snow rather than partially melted and packed
snow;
4
On Vancouver Island snow can be particularly wet and heavy, therefore it is best to frequently shovel small accumulations rather than
letting it pile up;
5
It is always preferable to scoop the snow in a forward motion and
step in the direction that you throw the snow. Avoid twisting and tossing the snow over your shoulder or to the side. If possible, try pushing
the snow forward rather than lifting.
6
When pushing the snow, keep the shovel close to your body, space
your hands on the shovel to increase leverage, and shovel an inch or
two off the top of the snow first if it is deep;
7
It is better to push the snow rather than lift it — but, if you must lift the
snow, lift it properly;
•
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When lifting the snow, don’t stoop over the shovel but instead
fill the shovel with a reasonable amount of snow from a standing position, then squat with your legs apart and your knees
bent, then try to keep your back as straight as possible while you
stand up with the load. Then walk to where you want to dump
it. Turn by moving your feet, not by twisting your back;
•
Lift small amounts at a time and ignore contrary advice and
teasing from people who may be watching;
•
Do not hold a shovelful of snow with your arms outstretched – it
puts too much weight on your spine;
8
Only shovel snow for fifteen minutes at a time. This is the equivalent of
“moderate physical activity,” and has a similar effect on your body as
a brisk walk. If you feel you are working harder than you would on a
brisk walk, slow down and take it easier.
9
Stop shoveling at once if you experience symptoms suggestive of a
heart attack or stroke and follow safety protocols for such circumstances.
10
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6.10 No Pets
6.10. A)This policy was mandated to be presented at staff meetings in the fall
of 2007 and was inadvertently left out of policy manuals after 2010. It
was revised and re-instated in January 2013.
6.10. B)Pets are animals kept for companionship.
6.10. C)Most pets do best in a stable predictable home environment and bond
to a small group of individuals such as a family. Dogs in particular thrive
in these stable alternatives to the “pack.”
6.10. D)ICCS recognizes the importance a pet can have in the life of its owner.
6.10. E)The value of pets to people living in crisis and transitional housing is less
clear. In fact the disadvantages and potential dangers to both humans and animals in such settings argues convincingly in favor of a no
pets policy. See the supporting document, “Advantages and Disadvantages of Pets in Crisis and Transitional Housing Programs” for more
details.
6.10. F)For the reasons outlined in “Advantages and Disadvantages of Pets in
Crisis and Transitional Housing Programs” no animals of any kind are allowed at any ICCS worksite.
6.10. G)Employees may not bring animals to the worksite and may not harbour
stray animals on any worksite. The SPCA or the City Pound can be contacted to remove stray animals for proper care.
6.10. H)Clients who arrive with a pet must be informed of this policy. Staff may
assist clients to make arrangements so that the pet may be sheltered
at the SPCA or an alternate safe location for the duration of the client’s
visit.
6.10. I) This policy shall apply universally with two exceptions:
1
In situations where extreme weather threatens the life of an animal it
may temporarily reside in a secure container within a program while efforts are made to find a space for it at an animal shelter. The existence
of extenuating circumstances such as inclement weather does not
invalidate this policy.
2
An animal that aids an individual with a disability such as a guide dog
for a visually impaired person is exempt from this policy.
6.10. J)“No Pets” signs must be displayed at all ICCS Worksites.
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6.10. K)ICCS partner agencies must be informed of this policy.
6.10. L) If a client arrives at the house with a pet:
1
If the partner agency worker who is admitting a client asks for the
client’s pet to be allowed to stay with the client, the ICCS employee
who is conducting the admission should politely inform the worker of
this policy.
2
Then the ICCS employee should offer to call the SPCA to arrange for
temporary lodging of the pet at the SPCA animal shelter.
3
It is not the responsibility of ICCS employees to take a client’s pet to
the animal shelter and the will not do so.
4
See below for location and contact information for the Nanaimo and
District Branch and the Parksville-Qualicum Beach and District Branch
of the SPCA:
•
Nanaimo and District SPCA
2200 Labieux Road
Nanaimo, BC V9T 6J9
Phone: (250) 758-8444
Fax: (250) 758-5424
Email: nanspca@shaw.ca
www.spca.bc.ca/nanaimo/
--
•
Nanaimo SPCA Shelter Hours: Tuesday to Saturday 12:00
p.m. - 5:00 p.m. Closed Sundays, Mondays & Holidays.
SPCA Parksville-Qualicum Beach and District Branch
1565 Alberni Highway
Errington (Parksville), BC
Phone: (250) 248-3811
Fax: (250) 248-3050
Email: pqspca@island.net
www.spca.bc.ca/parksville/
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6 . 1 1 W o r k i n g A l o n e 19
6.11. A)According to WCB regulation, to work alone or in isolation means “to
work in circumstances where assistance would not be readily available to the worker (a) in case of an emergency, or (b) in case the
worker is injured or in ill health.”
6.11. B)To ensure that workers have immediate access to emergency response personnel for themselves and for clients the following practices will be followed:
1
Support Workers will carry a well charged phone and a “panic button” device at all times.
2
Aprons with an ICCS logo will be worn at all times to carry keys and
the phone.
3
In all emergencies first dial 911; if unable to safely dial 911 then activate the panic button.
4
Pass the panic button to the next worker coming on shift during shift
exchange.
5
Report the loss of a panic button to the program manager immediately.
6
In those programs with opportunistic sleep shifts, keep the panic button beside the bed while sleeping.
7
A “plug in” corded-style phone will be located in all programs (purchased if necessary) so that if the power goes out for an extended
period of time phone service will still be possible through the telephone line (available at London Drugs and thrift stores)
8
Failure to follow this policy will result in discipline up to and including
suspension and dismissal.
19 Working Alone Policy added 18 December 2013
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U n i v e r s a l P r o g r a m P o l ici e s
7 Le g a l & E t h i c a l
7.1
Non-discrimination
7.1. A) Since its inception in 1985 Island Christian Care Society has held a
conviction that it will provide shelter and care to anyone who needs
it.
7.1. B) The society does not discriminate against individuals on the basis of
race, colour, sex, sexual orientation, religion, disability, age, veteran
status, ancestry, or national or ethnic origin in the administration or
operation of any of our programs and activities. ICCS applies the
same rules of non-discrimination to its employees and is firmly committed to a policy of equal opportunity in all aspects of employee relations, including but not limited to, employment, salary administration,
employee development, promotion and transfer.
7.1. C) ICCS does reserve the right to refuse service to a client under certain
circumstances. See program specific Access and Service Restriction
Policies for more details.
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7.2
Confidentiality
7.2. A) All ICCS programs protect the confidentiality clients and its internal
affairs while, at the same time it complies with all applicable legal
requirements.
7.2. B) While providing services to our clients, members, and employees we
collect, use and disclose some of their personal information. Protecting the confidentiality of this information is one of our highest priorities.
7.2. C) We strengthened our commitment to protecting personal information
as a result of British Columbia’s Personal Information Protection Act
(PIPA). PIPA, which came into effect on January 1, 2004, sets out the
ground rules for how B.C. not-for-profit organizations may collect, use
and disclose personal information.
7.2. D) We inform our clients, members, and employees of why and how we
collect, use and disclose their personal information, obtain their consent where required, and only handle their personal information in a
manner that a reasonable person would consider appropriate in the
circumstances.
7.2. E) This Personal Information Protection Policy, in compliance with PIPA,
outlines the principles and practices we will follow in protecting client’s, members and employee’s personal information. Our privacy
commitment includes ensuring the accuracy, confidentiality, and security of our client’s, members and employee’s personal information
and allowing our clients, members, and employees to request access
to, and correction of, their personal information.
7.2. F) Scope of this Policy
1
This Personal Information Protection Policy applies to ICCS and all its
operations and applies to any service providers collecting, using or
disclosing personal information on behalf of ICCS.
7.2. G) Collecting Personal Information
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1
We will communicate the purposes for which personal information is
being collected.
2
We will only collect client, member, or employee information that is
necessary to fulfill the following purposes:
•
To verify identity;
•
To identify client, member, or employee preferences;
•
To deliver requested services;
•
To enrol the client in a program;
•
To send out information;
•
To contact our clients, members, and employees for business
related to the operation of our society;
•
To ensure a high standard of service to our clients, members,
and employees;
•
To meet regulatory requirements;
•
To assess suitability for tenancy, residency, or short term accommodation;
•
To collect and process rent payments;
•
To verify identity, we may collect name, home address, and
home telephone number and birth date.
•
7.2. H) Consent
1
We will obtain client, member, or employee consent to collect, use or
disclose personal information (except where, as noted below, we are
authorized to do so without consent).
2
Consent can be provided orally, in written or electronic form, or it can
be implied where the purpose for collecting using or disclosing the
personal information would be considered obvious and the client,
member, or employee voluntarily provides personal information for
that purpose.
3
Consent may also be implied where a client, member, or employee
is given notice and a reasonable opportunity to opt-out of his or her
personal information being used, and chooses not to opt-out.
4
Clients, members, and employees can withhold or withdraw their
consent for ICCS to use their personal information. They must, however, provide the information if it is necessary to provide the service or if
the withdrawal of consent would frustrate the performance of a legal
obligation. A client’s, member’s, or employee’s decision to withhold
or withdraw their consent to certain uses of personal information may
restrict our ability to provide a particular service or product. If so, we
will explain the situation to assist the client, member, or employee in
making the decision.
5
We may collect, use or disclose personal information without the
client’s or employee’s knowledge or consent in the following limited
circumstances:
•
When the collection, use or disclosure of personal information is
permitted or required by law;
•
In an emergency that threatens an individual’s life, health, or
125
personal security;
•
When the personal information is available from a public source
(e.g., a telephone directory);
•
When we require legal advice from a lawyer;
•
For the purposes of collecting a debt;
•
To protect ourselves from fraud;
•
To investigate an anticipated breach of an agreement or a
contravention of law
7.2. I) Using and Disclosing Personal Information
1
We will only use or disclose client, member, or employee personal information where necessary to fulfill the purposes identified at the time
of collection. For example we might:
•
conduct client, member, or employee surveys in order to enhance the provision of our services;
•
contact our clients, members, and employees directly about
services that may be of interest;
•
We will not use or disclose client, member, or employee personal information for any additional purpose unless we obtain
consent to do so.
•
We will not sell client, member, or employee lists or personal
information to other parties.
7.2. J) Retaining Personal Information
1
If we use client, member, or employee personal information to make
a decision that directly affects the client, member, or employee, we
will retain that personal information for at least one year so that the
client, member, or employee has a reasonable opportunity to request access to it.
2
Subject to policy 7.2.J.1 above, we will retain client, member, or
employee personal information only as long as necessary to fulfill the
identified purposes or a legal or business purpose.
7.2. K) Ensuring Accuracy of Personal Information
126
1
We will make reasonable efforts to ensure that client, member, or employee personal information is accurate and complete.
2
Clients, members, and employees may request correction to their
personal information in order to ensure its accuracy and completeness. Such a request must be made in writing.
3
If the personal information is demonstrated to be inaccurate or in-
complete, we will correct the information as required and send the
corrected information to any organization to which we disclosed the
personal information in the previous year.
7.2. L) No employee, other than an Executive of the Society, shall transmit
information about the internal affairs of the Society to persons who
are not a part of the organization. Information about clients must not
be transmitted to anyone not directly involved with the client.
7.2. M) All new employees shall sign a Confidentiality Pledge form.
7.2. N) All requests for information about a client shall be referred to the client’s agency with the exception that some information may be given
to a police officer who comes to the house.
7.2. O) If a police officer presents on site and requests information about a
client the employee will immediately notify the client that an officer
would like to speak to them. If the client is not present the employee
will disclose to the officer the last known time the client was in the
house and when they are expected back.
7.2. P) A person calling the house on the telephone claiming to be a police
officer may not be a police officer. Therefore the employee will take
down the name given and the information needed and call the nonemergency RCMP number (754-2345) and ask if that officer is on shift
and say that the information the officer requested is available. If the
request for information is legitimate the person on duty will relay the
information to the officer.
7.2. Q) Should any member of the media request information about a client
or the society, the request is to be passed on to the Executive Director.
7.2. R) Staff will ensure that any and all discussions about a client are to be
conducted in a private setting so as to maintain the confidence of
the participants.
7.2. S) Staff will ensure the all the clients’ records and files are kept in a secure place and are not to be removed from Samaritan House.
7.2. T) Any requests for information about the internal affairs of the Society
shall be referred to the Executive Director.
7.2. U) Any requests for information about employees or society members will
be referred to the Executive Director.
127
7.3
Gifts, Loans and Bequests
7.3. A) Employees and/or their immediate family will not accept from or
proffer to a client or his/her family members gifts or loans of any kind
(including cash and currency). Doing so may shift the client’s perception of either the role of the employee or change the power dynamic
of the relationship.
7.3. B) Procedure
128
1
If the client and/or family member insists on giving a minor gift such
as chocolate, the employee may accept the gift on behalf of the
program staff.
2
If the client and/or family member insists on giving a substantial gift
such as money, please refer the matter to the Manager or an Executive of the Society.
8 Cli e n t C a re
8.1
Objectives of Client Care
8.1. A) ICCS employees will maintain a high standard of service that responds to the needs of each client based on the client’s development across the bio-psychosocial-spiritual spectrum.
1
The client’s communication style, strengths, abilities, challenges, disabilities, responsibilities, relationships, and preferences will all be taken
into account when it is practical to do so.
8.1. B) GUIDELINES
1
In our day-to-day work with our clients, all employees of ICCS undertake to engage clients in the following way:
•
Provide quality care to clients as individuals, regardless of race,
colour, religion, sex or social status.
•
Maintain clear and carefully communicated boundaries.
•
Foster an accepting, homelike atmosphere where expectations
are clearly communicated to all clients.
•
Inform clients of their rights and responsibilities.
•
Inform clients of the services that are available to them and also
which services are not available.
•
Provide a safe, supportive environment that enables the client
to make wise choices.
•
Recognize that clients, as individuals, have both rights and responsibilities for their own well being and are free to make their
own choices in a wide variety of situations. Choice, when at all
possible, should be maintained and fostered in the delivery of
services.
•
Employees will study and remember client care plans, and other
less formal instructions from case managers and will serve clients
accordingly.
•
Each client’s individual personal and/or case plan is the first
point of reference for daily actions. See the Personal Plan section for more details.20
•
Employees will provide cues and reminders for client’s important
activities. These activities include the consumption of medication attending appointments, setting goals, making important
phone calls, looking for housing, and similar activities.
20 Edited 2 December 2013
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8.2
C l i e n t R i g h t s 21
8.2. A) The following Client Rights and Responsibilities Statement will be posted in all ICCS programs, along with the chart of needs, and will be
reviewed at intake in all Assisted Living Programs.:
8.2. B) Client Rights
1
Right to choose which services you will accept without pressure and
at your own pace22;
2
Right to receive services that meet your essential needs (see table below);
3
Right to meet your own secondary needs (see table below);
4
Right to fair distribution of all services and opportunities23;
5
Right to courtesy, respect, and professional kindness24; and;
6
Right to report your concerns, complaints, and make requests related
to your needs.
8.2. C) Client Responsibilities
1
Follow program or house rules;
2
respect the rights of others to feel safe;
3
respect the cultural backgrounds and privacy of others;
4
follow the program’s schedules for meals, clean up, and bed time;
5
let program staff know if you are unable to keep an appointment
and need to reschedule;
6
Inform staff if you feel that any staff member has breached the code
of ethics, confidentiality or has treated you unfairly.
21 Client Rights Policy added 15 April 2014
22 Services are accessible on a voluntary basis.
23 Services are extended to all clients regardless of age, race, faith, socioeconomic status, physical or mental capabilities or sexual orientation.
24 Professional Kindness is defined in a document titled “Professional Kindness” and is available on the ICCS website and on each job site for review
by staff and clients.
130
8.2. D) Needs
8.2. E) Additional Information for Employees regarding Client Rights and Responsibilities as related to human needs:
1
Note ii from chart above is: “According to Beatrice Harrison Zuluaga,
R.N., M.N., FRCNA”
2
In general unsheltered homeless people (“street homeless”) have
been described as being deficient in physiological needs such as
food, clothing, and shelter (Burt & Cohen. 1989); in safety needs
(North, Smith, & Spitznagel. 1994), in love and belonging (Solarz &
Bogat, 1990; La Gory, Ritchey. & Fitzpatrick, 1991). and in self-esteem
needs (Snow & Anderson. 1987)25; therefore providing for these needs
is the priority in most emergency shelter and crisis stabilization programs.
3
Additional needs such as cognitive, aesthetic, self-actualizing, and
transcendent needs have been considered non-emergency in nature and have accordingly received less emphasis.
4
Since ICCS takes an integrated bio-psychosocial-spiritual perspective
on human needs and development we consider all identified needs
to be potentially urgent to clients entering our programs but in general the first 6 listed above receive the most attention.
5
Pioneering work done by Abraham H. Maslow illuminated the role of
25 Brief Index of Self-Actualization: A Measure of Maslow’s Model. By: Sumerlin, John R., Bundrick, Charles M., Journal of Social Behavior & Personality, 08861641, Jun96, Vol. 11, Issue 2
131
needs in human development and his conceptualization of needs
occurring on a hierarchy with some needs becoming salient only after lower needs were met, has been widely contested. The identified
needs, however, have generally been supported.
6
Recent models of human needs26 have emphasized the dynamic
interaction of environment with individuals creating complex and
highly individualized conceptions of which needs are felt and when.
The Zuluaga-Raysmith model, for example, proposes that every human being has 10 basic human needs and to the extent that these
needs are perceived by a person to be satisfactorily met, the person
will function independently in the community without seeking community services (Raysmith, 1972). This is the model that was used in
developing this policy.
7
Some clinicians believed that a movement to higher levels of wellness
are achieved through skilled interventions, educational programs,
interdisciplinary referrals, and judicious utilization of community resources. The “high level wellness model” focuses on four dimensions:
physical activity, nutrition awareness, stress management, and selfresponsibility (Travis, 1977). As the resources of ICCS programs are limited, education in nutritional awareness and stress management may
not be possible but self responsibility can be encouraged through the
rights and responsibility association outlined above.
8
Employees are encouraged to focus their attention on meeting client
needs through direct service and through the creation of a healthy
environment. Education and skill development are secondary priorities.
9
ICCS programs abides by the Canadian Charter of Rights and Freedoms.
26 The Max-Neef Model of Human-Scale Development; the Zuluaga-Raysmith (Z-R) Model for Assessment of Perceived Basic Human Needs; the
Emergent, Cyclical, Double-Helix Model of the Adult Human Biopsychosocial Systems - C. W. Graves, and others
132
8.3
Personal Care
8.3. A) No employee will lift a client for any reason.
8.3. B) If a client falls and can not get up, make the person comfortable
where they are and call 911.
8.3. C) Employees will not provide regular assistance to clients with activities
of daily living such as grooming, bathing, mobility assistance, incontinence care, or dressing. These are prescribed services.
8.3. D) Personal care can be offered at a non-prescibed level as per assisted
living regulations. Generally non-prescribed services include services
such as cues and reminders that do not require personal contact.
8.3. E) For a full list of non-prescribed and prescribed services see the Prescribed Services Worksheet in the Assisted Living Registrant Handbook.
133
8.4
P e r s o n a l S e r v i c e P l a n 27
8.4. A) ICCS programs provide clients with the opportunity to create a personal plan. Each plan is a reference for both the client and ICCS staff.
The plan aligns services and other program activities with the purposes and goals for the client’s stay.
8.4. B) The plan will record:
1
the services provided by ICCS and other agencies;
2
the client’s relevant needs, preferences, and triggers;
3
Client identified goals and priorities and how staff can support clients
to reach those goals and maintain those priorities;
4
strategies or techniques the client has found effective at managing
or enhancing their health;
5
clients involvement in the program;
8.4. C) The plan will:
1
list risks to safety;
2
contain additional rules that may be necessary to insure safety and
understanding;
3
describe or summarize all agreements and understandings between
the program and the client, including behavioral contracts where applicable;
4
be revised or re-written regularly to reflect the client’s changing goals,
needs, skills, accomplishments, and circumstances;
5
reference additional documents that may relate to client care,
health, or daily activities;
6
reference any assessments, diagnoses, or health standards relevant
to the client’s recovery or progress;
7
be signed or initialed by both parties, when created and revised;
8
comply with Assisted Living Registrar Standard 6.1 (Registrant Handbook, Standard 6, page 43).
8.4. D) The client, or legal designate, must be involved in the creation, review, and revision of the plan.
8.4. E) Vital points of the plan will be created at intake but the full plan need
not be complete at that time if clients are under the influence, traumatized, excessively distracted, overly tired, or in poor mental health.
27. Added to the Policy Manual 05 December 2013
134
The essential components of the plan must, however, be in place
within 1 week after intake.
8.4. F) Review of the plan will be done at the convenience of both the client
and staff. A client may request to review or revise their plan no more
than once per day. A review shall be done at least once per month.
8.4. G) Health Authority case managers and other professionals will participate in the creation and review of plans in those programs where
they have traditionally done so or where contracts specify such involvement.
8.4. H) The PSP of each client is confidential and will only be viewed by the
client, staff, VIHA workers as per above, and law enforcement officials
who present a warrant or similar authorization.
8.4. I) If a client requests a copy of their PSP it shall be provided in a timely
manner.
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8.5
Admittance
Admittance policies are different for each program. Please see your program’s specific policy for more details.
8.6
Discharge
Discharge policies are different for each program. Please see your program’s specific policy for more details.
136
8.7
Disease and Parasites
8.7. A) General Precautions
1
A risk assessment should be performed at all worksites for disease and
parasite transmission every few years. Risk assessments should be performed by an infection control officer of the health authority, where
possible, or by an outreach nurse, or by another qualified individual.
All recommendations that result from such an assessment should be
implemented where possible.
2
Clients will be asked during intake if they have any communicable
diseases or parasites. This information shall be entered in the “Case
Information” section of the “Add New Client” screen on the ICCS database and/or additional intake forms.
3
Treatment of Parasites
•
4
6
--
Ongoing residency at the program is contingent on the client continuing with all prescribed treatments.
--
Due to health and safety regulations we must restrict
clients from entry if they refuse to cooperate in efforts to
treat an infestation.
--
Clients can be referred to a walk in clinic or hospital emergency room if treatment at the program is not possible.
Rooms
•
5
When a client is discovered to have an infestation of lice, scabies, or other potentially contagious parasites it is imperative
that immediate and proper treatment procedures be followed.
If a room is discovered to be infested it is to be closed until treatment of the room eliminates all parasites and the potential for
further infection is removed.
Air Filtration
•
Air filtration and treatment devices shall be used where budget
and logistics allow to purify the air and reduce the chance of
infection by air born viruses and bacteria.
•
Such devices when installed must be inspected and maintained
regularly and any filters replaced according to manufactures
instructions.
Cleaning and Sanitation
•
Cleaning, vacuuming, and sanitation shall be performed regularly to insure an environment that is non-conducive to the transmission of disease.
•
The use of chemical cleaners shall be carefully managed to preserve air quality. Alternative and “green” methods such as micro
137
fibre sanitation shall be used when effective and appropriate.
8.7. B) Communicable Disease
1
If an employee discovers or suspects that a client may have a serious
communicable disease she shall report immediately to her manager
and notify the client’s case manager. The employee will then speak
with the client about options for continued residency according to
the following guidelines.
2
Communicable Disease guidelines
•
Employees are responsible to protect all clients from risk of serious communicable diseases. Employees must continually observe for visible symptoms of infections/diseases and ask questions to identify whether individuals may have infections or other
communicable diseases.
•
Employees are to err on the side of caution if a person’s condition is questionable and should consult with her manager, a
nurse, or other health professional before proceeding with an
intake when concerns about infection exist.
•
If the client develops symptoms that indicate a serious disease
after being admitted, or if the manager of the program approves residency subject to certain conditions, then such a
client will be isolated from other clients in the short term, and be
referred as soon as possible to a walk in clinic, the emergency
department of the hospital, or her doctor’s office, depending
on the severity of the symptoms.
--
•
If the client is unable to walk or shows signs of potentially lifethreatening symptoms, emergency measures should be taken
including when appropriate, calling an ambulance.
•
Other measures may include:
•
138
Client’s utensils and other items of personal use should also
be isolated.
--
First aid, hydration, OTC medication, etc.
--
Calling the client’s case manager
--
Calling the Nurses Hotline
--
Calling the Crisis Response Team (which has nurses on
staff)
--
Calling the client’s doctor
--
Calling 911
Request the medical personnel provide an appropriate medical
plan within the context of the shelter services when possible.
3
Where the infection or disease is determined to be of lesser risk, or
where medical professionals support residency in the program, then
employees are to provide clear instructions to the individual about
any conditions that may be temporarily implemented to reduce the
spread of disease.
4
These conditions may include:
5
•
wearing a mask
•
regular hand washing
•
reduced exposure to other clients
•
sneezing etiquette
•
more stringent sanitation protocols
Clients with confirmed cases of diseases such as meningitis, measles,
Tuberculosis, whooping cough, scarlet fever, diphtheria, and new
strains of influenza may only be housed in a program if they can be
isolated in a private room and if the program has the staffing and
resources to enact the levels of sanitation and isolation necessary to
protect other clients from infection.
•
Outbreaks of these class of diseases may be considered a critical incident and should be treated accordingly.
•
In such cases, medical practitioners must communicate all necessary safety measures prior to the client receiving permission to
reside on the premises.
•
All cases of such diseases must be reported to the program
manager, to ICCS executives, and to the funding providers,
i.e. VIHA or BC Housing. As well all precautions being taken to
prevent infection of others must be summarized in an incident
report or in the client’s file.
6
At no point is staff to put any individual (including an employee) at
risk by placing a person with a serious infection or communicable disease in a program without first following the above policies.
7
General precautions
•
All staff are to wash hands frequently.
--
Appropriate reminder signs are to be posted in kitchens,
washrooms and other areas deemed appropriate.
•
All staff may wear masks if they wish to protect themselves from
infection.
•
Where more than two people have cold/flu symptoms within a
48 hour period, the Manager is to be informed.
•
Employees must remain alert to any emerging signs or symptoms
of illness, such as diarrhoea, fever, general malaise, excessive
139
tiredness, changes in behaviour, etc. in clients residing in the
program.
8
All employees, including maintenance personnel and other support
staff employees, are to be notified as soon as they arrive on a work
site where a client is residing with a serious contagious disease.
9
When a client with a serious contagious disease is in residence support workers will keep detailed documentation to ensure that future
shifts know all aspects of the client’s conditions of stay and medical
instructions.
10
The program manager will initiate Critical Incident Debriefing for staff
and clients if required following the outbreak of a serious communicable disease.
8.7. C) Bed Bugs
1
To reduce the risk of bedbug infestations within all ICCS programs,
employees must monitor all clients coming onto each premise for
signs of insect bites, rashes, or other evidence of bedbug contact.
2
If bed bugs are suspected or if the client reports having been in a
location where bed bugs are present the procedures listed below for
“Intake of Clients with Possible Bedbug Contamination” will be followed.
3
If bedbugs are found in a program the employee who discovers signs
of infestation will notify the Manager by phone on the next business
day, or leave a note in the log concerning the situation. Segregation and treatment of the room(s) must be implemented immediately
and does not require authorization from the manager except where
noted below. The affected room or rooms are to be treated following the “Room Treatment” procedure listed below. It is imperative for
quick action to occur to reduce the risk of the bugs traveling to other
areas of the facility.
4
If employees make home visits they are to take a minimum of items
on the visit. Do not put belongings such as purses or backpacks
down. Use a double sealed bagging procedure when moving any
clientele belongings. Transport all clientele belongings in sealed bags
to prevent movement of insects. Store in sealed bags until chemical
treatment has been completed.
5
Application -- This policy applies to all programs and work sites operated by Island Crisis Care Society. The full regime of this policy does
not need to be enacted where no bed bug infestations have occurred in the past but employees are to remain vigilant in monitoring
clients at entry for signs of recent contact with bed bugs.
6
Definitions
•
140
Bed Bug Photos:
7
•
Figure 1 Prior to feeding:
•
Figure 2 while feeding:
•
Figure 3 After Feeding:
•
Bed bugs are insects. Cimex lectularius is the species most commonly found in our area. Adult bed bugs have oval-shaped
bodies with no wings. Prior to feeding, they are about 1/4 inch
long and flat as paper. After feeding, they turn dark red and
become bloated. Eggs are whitish, pear-shaped and about the
size of a pinhead. Clusters of 10-50 eggs can be found in cracks
and crevices. Bed bugs have a one-year life span during which
time a female can lay 200-400 eggs depending on food supply
and temperature. Eggs hatch in about 10 days. There are currently no known cases of disease associated with bed bug bites.
Most people are not aware that they have been bitten. People
who are more sensitive to the bite can have localized allergic
reactions. Scratching the bitten areas may lead to infection.
Policy Requirements
•
All employees and clients must be informed of this policy and
are expected to abide by it.
•
This policy must be available for reference at each work site.
•
All Programs of ICCS must meet the requirements of this policy.
•
This policy supersedes and replaces all prior policies on this subject.
141
8
Exceptions
•
9
This policy shall apply universally with two exceptions:
--
Job sites where no clients visit AND where no beds are
present are not subject to this policy.
--
Where a union contract or other binding agreement contradicts or supersedes it.
Procedure
•
Employees are to disinfect and clean all common surfaces such
as couches, chairs, car seats and tables as part of their regular
cleaning regime.
•
Intake of Clients with Possible Bedbug Contamination:
--
Employees shall monitor all clients entering programs for
the signs of bed bug activity (see “Signs of Contact with
Bed Bugs” below) and are to ask each client if they have
recently encountered bed bugs. All clients who present
an infection potential are to be informed of the Bed Bug
Policy. Their belongings are to be treated using the following procedure:
--
1 Items that can be washed are to be washed immediately.
--
2 Items that can be steamed, such as carry bags and suitcases are to be steamed immediately.
--
3 Other items must be stored in double sealed bags until
chemical treatment can be performed or until the individual leaves the premises.
Important Note: In any program that has experienced bed bug infestation on a regular basis, ALL packages, clothing and belongings that are
brought onto the premises are to be treated in the above fashion.
10
142
After determining that a client may pose an infection potential the
following steps should be taken:
•
Clients must bath thoroughly and be given disinfected clothing
to wear while their personal clothing is laundered. As with other
issues, employees are to be as supportive and encouraging as
possible in what may be an embarrassing situation for clients. It is
quite appropriate to reassure clients that bed bug contact can
happen to anyone and that there is no known serious health risk
associated with their bits.
•
Where an individual refuses to bathe, or refuses to permit their
belongings to be treated or segregated, they must be informed
that under this policy employees are required to ask clients who
first refuse to follow this policy to reconsider. If they persist in their
resistance the client’s worker shall be contacted and informed
of the dilemma. If the worker is unable or unwilling to persuade
the client or if the client has no worker, then refusal of service
becomes an option. Note: Refusal of service for potential bed
bug contamination must be made by a manager.
11
•
Double bagging: All personal packages/belongings coming
onto any All ICCS programs premises that cannot be treated by
washing or steaming are to be double bagged with each bag
sealed separately. Pesticide, Bug Patrol Bed Bug Killer, or a similar treatment is to be sprayed within the bag containing the belongings. Employees are to use gloves when spraying, and take
care that the spray is only within the bag. The spraying should kill
live bugs, but may not affect eggs. See Pesticide Safety below.
•
An on-site supply of clean clothing, especially sweat pants,
underwear, and t-shirts, are to be maintained at each site. Each
site will refill their supplies of clothing on a regular basis from the
Product Distribution Centre, ICCS storage, or from other ICCS
programs where possible, or through other free clothing providers such as Thrift Stores, church, or private donations.
•
Any belongings or packages a resident brings with them must
be immediately segregated and treated prior to being returned
to the resident. This includes equipment (e.g. radio’s, microwave
ovens, coffee makers), furnishings (including couches, chairs,
etc.), tools, clothing, bedrolls, hats, shoes, etc.
•
Small non washable items including radios and CD players, are
to be bagged and put in a freezer for a period of 48 hours to kill
eggs.
•
Larger items, e.g. furniture - are to be segregated in parking
areas and treated. Treatment may be pesticide treatment, Bug
Patrol Bed Bug Killer, steam cleaning or a combination of two
treatments. Pesticide treatment by employees is to be done
wearing gloves and masks. Please see the Pesticide Safety notice below.
•
Clothing is to be washed and disinfected using the hottest
water possible and dried in a hot clothes drier. Heat effectively kills bed bugs and their eggs and larvae. Where clothing
is not washable (e.g. some leathers, silks, etc.), they are to be
treated with sprays or double bagged until the client leaves the
program. The owner of the clothing is to be advised that employees of ICCS acting in accordance with this policy are not
responsible for damage to clothing. Client’s input into washing
vs. spraying should be seriously considered. All spraying should
contact the article on the INSIDE of the unwashable article of
clothing.
Pesticide Safety
•
Care must always be taken to prevent accidental exposure to
143
pesticides even though all registered products are considered
safe to use if handled properly. When you use pesticides, always
read and follow the instructions on the label. Use gloves when
handling the pesticide, and a mask when spraying into the air.
12
144
Room Treatment
•
A combination of preparation prior to treatment, pest proofing,
and chemical treatment will effectively eliminate bed bugs. As
soon as the room preparation is complete, the Manager may
arrange professional pest control services. For heavy infestations, expect multiple treatments.
•
Upon discovery that a room or area is likely or absolutely infested with bedbugs, employees are to immediately implement
segregation and treatment procedures according to the following guidelines:
--
The area should be designated as “off-limits” and vacated
as soon as possible to reduce the risk to all. Where visible
signs of live bedbugs are seen, area spot spraying should
occur, using the pesticide safety precautions.
--
Clients who had been in the area are to be provided with
newly laundered clothing and requested to bathe immediately. Any item removed from the off-limit area is to be
placed in the double sealed bags to prevent accidental
spreading of the insects.
--
As soon as possible, and within 48 hours at the latest, the
following treatment is to be implemented:
--
a. Launder all clothes and linens on hot settings and dry
in a hot drier. Transport in sealed bags to prevent movement of insects. Store in double sealed bags until laundered or the chemical treatment has been completed.
--
b. Remove all belongings from furniture, tables, wardrobes and closets. If free of bedbugs, store in tight fitting
containers or double bag. Leave electronic equipment in
place as they could ‘host’ insects.
--
c. Move furniture to centre of room, away from all walls
and edges. Dismantle bed (particularly taking bed legs off
to ensure chemical treatment access) and other furniture
if possible. (e.g. drawers out).
--
d.
--
e. Eliminate clutter using the double sealed bag process.
--
f. Steam clean all cracks and crevices in walls, ceilings and floors, and pay particular attention to the area
around pipes. Steam cleaners are available at Samaritan
House. Ask your Manager if one cannot be located.
Remove pictures, electrical outlet covers from walls.
13
--
g. Caulk cracks and crevices in walls, ceilings and floors.
Large gaps, especially around pipes, should be filled in
with steel wool prior to being sealed. Pipe ‘collars’ should
be used and caulked into place.
--
h. Fill holes in walls and ceilings or where paint is peeling
or chipped and apply fresh paint.
--
If heavy infestation has occurred, mattresses and fabric
furniture may have to be discarded after initial treatment.
Welded seam steel beds may need to be purchased as a
replacement for wooden framed beds and box springs.
--
Mattresses or fabric furniture that are discarded are to be
slashed significantly to reduce the risk of someone else utilizing them and therefore spreading the infestation. Transport in sealed bags to prevent movement of insects.
--
Any area to be treated with pesticides is to be:
--
a.
--
b. After chemical treatment, the area is to be kept vacant for 4 to 8 hours (24 hours if person is pregnant, or has
respiratory ailments, allergies or is sensitive to chemicals).
--
c. aired out well when the after-treatment period has
ended.
--
d. Quarantine the area after treatment for a period to
be determined by the professional pest control service.
--
e. Re-entry time will vary depending on pesticide used,
method of treatment and individual susceptibility. Always
follow the advice of the pest control applicator.
Vacated during treatment.
Frequently Asked Questions
•
Q. What do bed bugs feed on?
•
A. Bed bugs prefer to feed on human blood, but will also bite
mammals and birds. Bed bugs bite at night, and will bite all over
a human body, especially around the face, neck, upper torso,
arms and hands. Bed bugs can survive up to six months without
feeding. Both male and female bed bugs bite.
•
Q. How do bed bugs get in?
•
A. Bed bugs are often carried on objects such as furniture and
clothing. Bed bugs can be found in areas such as:
--
seams, creases, tufts and folds of mattresses and box
springs
--
cracks in the bed frame and head board
--
under chairs, couches, beds, dust covers
145
14
15
between the cushions of couches and chairs
--
under area rugs and the edges of carpets
--
between the folds of curtains
--
in drawers
--
behind baseboards, and around window and door casings
--
behind electrical plates and under loose wallpaper, paintings and posters
--
in cracks in plaster
--
in telephones, radios, and clocks
--
Bed bugs can also travel from apartment along pipes,
electrical wiring and other openings.
Signs of Contact with Bed Bugs
•
Complaints of itching or stinging welts/wheals, often greater
than I cm in size, or swelling at the bite site. The wheals decrease
in size leaving red spots that may remain for several days. Bites
may be 3 - 4 sports in a line. (Note: Bed bug bites can occur on
any exposed skin from “head to toe” unlike flea bites that usually occur around the ankles).
•
Blood stains (black/red) sports of fecal material on sheets, pillows, mattress and box springs. Unpleasant sweet musty odor
can occur with a severe infestation.
Recommendations for Staff
•
146
--
If you work in or visit a home with a bed bug infestation there
is minimal risk that a bed bug will hitch a ride on your clothing.
However, if you have a concern, please refer to the following
recommendations.
--
Minimize the amount of personal and work related items
taken in to the home (sweaters, bag & equipment)
--
Inspect clothing and equipment after the visit.
--
Try to wear light coloured clothing for easy detection and
avoid wearing pants with cuffs.
--
Any items taken in to the home should be protected by
being hung up rather than being placed on beds or other
furnishings.
--
Launder your clothing and dry in hot dryer. Any clothing not laundered immediately should be stored in tightly
sealed bags.
16
Important Notes:
It is very unlikely that bed bug eggs could attach to clothes or equipment during a visit as eggs are usually strongly attached to rough surfaces close to their daytime hiding places.
It is unlikely that clients at non residential worksites could introduce a bed
bug infestation given the regular cleaning that occurs. The office environment does not suit the life cycle of bed bugs.
Disclaimer: This policy has been produced based on the policies and
procedures of Lookout Emergency Aid Society in Vancouver. This draft
has not been independently researched. Revisions will follow as new
information is obtained. The use of pesticides is discouraged by ICCS so
effective alternatives are being sought.
147
8.8
Curfew
8.8. A) Each program will maintain and enforce a nightly curfew. See your
program specific policy for the details.
148
8.9
Client Dress Code
8.9. A) Employee Attitude
1
Choices in clothing, as well as hygiene and grooming, are commonly
affected by addiction and mental illness.
2
Clothing is a source of comfort and familiarity for many and disrobing in a new room or house can give rise to feelings of vulnerability,
anxiety, and loss.
3
Therefore employees will exercise empathy, discretion, tact, and sensitivity when encouraging clients to change or launder their clothing
and when enforcing the standard of dress.
8.9. B) Laundering
1
While exercising the attitude outlined above, support workers will
encourage regular laundering of clothing and bedding. Regular laundering of clothing and bedding is important for health and sanitation,
especially where infectious disease, parasites, and pathogens are
or may be present. Lice, fleas, and bedbugs do not survive standard
laundering practices, especially hot clothe-dryers.
8.9. C) Standard of Dress
1
The following general standard of dress applies in all ICCS programs
but in all cases a client’s personal care or case plan will supersede
this standard when the case plan and dress code are not in agreement.
•
At all times in all ICCS programs a client must wear a shirt with
pants or shorts or a skirt; and hard soled or non-slip shoes, sandals, or slippers.
•
Dresses may also be worn.
•
Pyjamas may be worn as long as they include a top and bottom.
•
Beachwear such as bikinis and swim shorts should be reserved
for the beach or swimming pool.
•
In programs where both men and women reside, clients are
asked to consider how their appearance may affect other client’s in the program and are encouraged to dress modestly.
8.9. D) Pyjama Plans
1
Some case plans will stipulate that clients remain in pyjamas for a period of time to emphasize recovery, to dissuade a client from leaving
the program, or to give a client permission to stay in their room, sleep,
or “settle in” in comfort. Clients on such plans may still be encourICCS Universal Program Policy Manual
149
aged to launder their pyjamas and be given a change of pyjamas
when necessary.
8.9. E) Donated Clothing
1
Staff will endeavour to supply a change of clothes from donated
items to those clients entering the house with only the clothes on their
back.
2
Staff will also refer those who are short of clothing to the Salvation
Army or other organizations that offer free or low cost clothing.
8.9. F) Words, Logos, Images, Tattoos
1
Words, sayings, and images on clothing may be unsettling or triggering to some clients. For this reason everyone will be encouraged to
reserve clothing with such words or images for trips outside the program.
2
Tattoos with graphic or disturbing images e.g., displaying violence,
drugs, sex, alcohol, tobacco products, etc. should be covered up
when possible.
8.9. G) Scents, Perfume, and Cologne
1
Clients and employees may be allergic to the chemicals in perfumes,
colognes, hair products, and makeup, so clients are asked to not
wear perfume, cologne, hair products, or other substances with such
chemicals.
2
Lightly scented deodorant is allowed.
8.9. H) Hygiene
150
1
The Centers for Disease Control and Prevention states that high levels
of personal cleanliness are associated with good health. For this reason good hygiene practices are encouraged for most clients.
2
Some ICCS programs include hygiene education as part of their
contracted services (Hirst House) and others follow any directives that
are given in client’s individual case plans (Crescent House and Safe
Harbour House).
3
While good hygiene is encouraged for most clients it is not mandatory
in order to remain in a program and to continue receiving care. Bladder or Bowel Incontinence combined with an unwillingness to comply
with bathing and laundering routines, however, will necessitate referral to a higher level of care than ICCS programs can provide.
4
In all cases encouraging good hygiene should be done for the therapeutic benefit of each client, not simple to relieve the discomfort a
worker feels being with someone with poor hygiene.
5
Poor hygiene is tolerated when a client is not stable enough to understand the need for good hygiene or who has not reached a stage in
their recovery where hygiene can be contemplated as part of the
recovery process.
6
Poor hygiene is also tolerated in ICCS programs when hygiene itself is
related to the client’s trauma, phobia, or other mental illness.
7
In general ICCS workers defer to the expertise of VIHA clinicians in determining the best approach to hygiene education and awareness.
8
If the hygiene of a client deteriorates it may be a sign of an increase
in substance use or an increase in mental illness and should be reported to the program manager and the client’s case manager.
151
8.10
Medications,vitamin,Etc.
8.10. A)The Roles and Responsibilities of Clients and Employees
1
In ICCS programs all medications prescribed to and in the possession
of clients are the property of clients, under the control of clients, and
administered by clients.
2
The employee’s role is to safely store medications on behalf of clients,
allow clients convenient access to medications when they need
them, and also to observe medication use to responsibly document
any deviations from prescription doses or instructions on medication
containers.
•
If deviations occur, or if client’s experience adverse effects from
medication use, the employee is to notify the program manager, relevant case manager and/or VIHA staff, or to call 911 in
emergencies.
8.10. B)The following statements clarify these roles.
1
Clients are expected to use their medication accurately and safely,
according to their physician’s and pharmacist’s instructions.
2
Procedures and protocols will support clients to maintain responsible
control over their own prescription drugs, over-the-counter drugs, and
vitamins and herbal preparations.
3
Clients will take their own medications only, and will not share their
medication with others.
4
All ICCS programs except Samaritan House will instruct clients to order
their medication bubble packed, if the client’s case manager has not
already arranged this.
5
Medications are stored on behalf of clients, not Dispensed.
•
No Island Crisis Care Society program is a medical facility and
we do not employ nurses, doctors, or other medical professionals qualified to oversee medication use.
--
6
152
Therefore ICCS employees will not “dispense” medications
or provide medical advice.
•
ICCS employees are not responsible to determine if a client is
able to safely self-administer prescription medications. This determination has been made by, and is the responsibility of, the
client’s physician.
•
Other clinicians, such as the client’s addictions counsellor or
case manager, may provide additional instructions which ICCS
employees will follow.
Regardless of an employee’s personal knowledge or opinion of a
given prescription medication, OTC medication, vitamin, or herbal
preparation, she shall not supersede or contradict a clinician’s instructions. If she has concerns, she shall document them and bring them to
the attention of the program manager and a case manage or nurse
involved in the client’s care.
7
Employees are prohibited from providing clients with medication of
any sort including vitamins and herbal preparations from their personal supply, from their own personal residence, or that they purchase
with their own money.
8.10. C)Medications are Stored Safely
1
2
Employees will ensure that during intake all medications are handed
over for safe keeping with the exception of PRN medications for
breathing or heart conditions which may be kept on the client’s
person if indicated by the doctor/case manager or on the printed
prescription.
•
Clients must store all other Doctor prescribed and over-thecounter medications, as well as all vitamins and herbal preparations in the designated locked cabinet(s) or fridge.
•
Over-the-counter and non-prescription medication bottles not
already labelled with a client’s name shall be so labelled.
•
No medications of any sort, including prescription medications,
OTC medications, vitamins and herbal preparations, shall be
accepted without the original content labelling. Any of these
which are presented shall be stored and not used until discharge.
Only employees will unlock and re-lock the medication cabinet(s) or
fridge(s) so that clients can take their medications. Under no circumstances will residents be given the keys to the medication cabinet/
fridge. (See the Program Specific section for exceptions to this, i.e. at
The Bridge.)
8.10. D)Clients storing medications OTC medications, vitamins and herbal
preparations in the locked cabinet(s) or fridge(s) will do so with the
understanding that ICCS staff observe this non-prescribed courtesy
but can not, under the definition of supportive housing and supportive recovery homes, take responsibility for assisting clients to achieve
medication compliance or in any way manage medications, determine doses, or keep records of how often medication was taken.
8.10. E)Observe, Provide Access to Information, Communicate Concerns,
Document, Notify
1
All medications will be self-administrated by clients in the presence of
an ICCS employee.
2
Clients who are leaving the program for the day may take with them
a supply of medication as indicated on their prescription. Said mediICCS Universal Program Policy Manual
153
cation will be clearly labelled with name and time to be taken, as it is
on the prescription bottle.
3
ICCS employees will observe the consumption of all medications and
document any concerns in the daily log and/or the client file depending on the needs and practices of the program and case workers.
4
Concerns over any aspect of medication use, including dosage and
frequency, shall be tactfully and courteously voiced to the client without delay.
•
Use “I” statements and NVC to avoid triggering defensive responses from clients
•
Refer to prescriptions and the instructions on medication bottles
when appropriate
•
Refer to case, care, or personal plans when appropriate
•
Offer the client access to toll free health hotlines such as:
--
HealthLink BC: Dial 8-1-1 Client can speak with a nurse,
pharmacist or dietician.
--
Alcohol & Drug Information & Referral Service: Dial 1-800663-1441 - Provides information and referral services that
are primarily related to substance abuse and misuse.
--
PharmaCare: (including the Fair PharmaCare Plan) Dial1800-663-7100 Monday to Friday, 8 a.m. to 8 p.m., Saturday
8 a.m. to 4 p.m.
--
Poison Control Centre: Dial 1-800-567-8911
--
Sexually Transmitted Disease: Dial 1-888-488-7444
8.10. F)Notify Case Manager
1
Employee shall notify the client’s case manager immediately if a client seems unconcerned or unmindful of the concerns raised by an
employee.
2
The employee will follow any directions given by the case manager.
8.10. G)Document Concerns
154
1
An employee will report on a Client Documentation Page in the Client Binder (CB) that the case manager has been notified and document all instructions from the case manager. See the Documentation
Guidelines for more details.
2
Observations of medication use are only to be recorded on the Medications Sheets in the CB.
8.10. H)Weekends and Evenings
1
On weekends and evenings employees will leave detailed voice
messages with case managers that summarize concerns about a client’s medication use.
2
When a consultation with a case manager regarding medications
is not possible, support workers will pay particular attention a client’s
health and will provide frequent and high levels of observation and
care.
3
Use non-violent communication to help clients ascertain their immediate medication needs and suggest moderation as a guide for self
administration.
4
Remind clients of the instructions provided with each medication.
5
If non-emergency medication-related symptoms or behaviours are
distressing the client, other clients in the house, or the support worker,
the following VIHA Teams may be contacted for consultation:
6
•
In Nanaimo, in a non-life threatening emergency, the Crisis
Response Team is available weekdays 7:00 am to 10:00 pm and
weekends 8:00 am to 10:00 pm. ICCS employees (not clients)
shall call the on-call nurse pager at: 250-739-5757.
•
The Assertive Community Treatment Team (ACT) is available on
week days from: 8:30 am to 8:30 pm; weekends and STATs from
11:00 am - 7:00 pm thru pager 250-739-5704 (leave a message).
For a list of services provided by ACT see: http://www.viha.ca/
mhas/locations/victoria_gulf/act.htm#services
At the sign of a medical emergency, employees will call 911 without
delay.
8.10. I) Monitor Clients Health
1
When a verbal expression of concern has been given to a client, and
the case manager has been notified, support workers will document
all actions taken and monitor and document the health and behaviour of the client.
2
They will be prepared to call 911 if signs of distress, overdose, or adverse reactions occur.
8.10. J) Medication from Dentists
1
With the exception of Samaritan House clients, all other clients will
have medication prescribed by Dentists bubble packed in the same
way that medications from their doctor or psychiatrist are.
2
If clients arrive at a program, except Samaritan House, with medication that is not bubble packed, the bubble pack rule will be explained to the client and subsequent prescriptions will be ordered
155
bubble packed.
8.10. K)Methadone
1
As of June 1, 2011 Methadone falls within the above policy and no
special restrictions or policies apply to Methadone use within ICCS
programs.
8.10. L) Over-The-Counter Medications
156
1
At the discretion of each program manager small supplies of “ICCS
approved” over-the-counter medication may be kept for client use,
but such medication will be offered only for occasional or emergency use in a similar fashion to first aid. A client requiring more than
one dose of an OTC medication will be asked to purchase their own
supply.
2
The following Over-the-counter medications were researched and
then reviewed at a Team Management Meeting. They are approved
for purchase and can be stocked within a program, but are not required to be stocked. Some programs may not stock any OTC medications.
Generic/Scientific Name
Brand Names
Function or Use
acetaminophen
Excedrin; Tylenol
analgesic
acetylsalicylic acid
Bayer; Bufferin; Aspirin
analgesic
Aloe vera
Burn Aloe, Sun Care - Aloe Gels Topical wound and burn treatment
Ammonium carbonate
Buckley’s Cough Syrup — Non
DM formula
Buckleys is a relatively safe cough syrup in it’s
original form, without dextromethorphan
Bacitracin
Polysporin
antibiotic ointment
calcium carbonate
Tums; Rolaids
antacid
dimenhydrinate
Dramamine; Calm-X; Gravol
motion sickness
guaifenesin
Robitussin
expectorant
ibuprofen
Advil; Nuprin; Motrin-IB
anti-inflammatory
lidocaine
Xylocaine (topical cream)
anaesthetic
magnesium salts
Milk of Magnesia
antacid; laxative
melaleuca oil
Tea Tree Oil
antiseptic, acne treatment
meclizine
Dramamine II
motion sickness
miconazole nitrate
Monistat(topical cream)
anti-fungal
Bismuth subsalicylate (pink
bismuth)
Pepto Bismol, Kaopectate
anti-diarrhea; anti-emetic
polymyxin B
Neosporin(topical cream)
topical antibiotic
pramoxine
Anusol, Gold Bond
relieve pain and itching caused by sunburn,
insect bites or stings, poison ivy, poison oak,
etc. Also an anti-hemorrhoid
sodium bicarbonate
Alka-Seltzer
antacid
tolnaftate
Tinactin
anti-fungal
3
Over the Counter Medications that are Not Approved:
Generic Name
Brand Names
Function or Use
Concern
codeine
Robitussin A-C
cough suppressant
Codeine can be used as a recreational
drug, especially by opiate users.
antihistamine; motion
sickness; sleep aid
Diphenhydramine is a potentiator. (a
substance that intensifies the effects of a
given drug) It is also used recreationally
as a deliriant, depressant, or as a potentiator of alcohol, DXM and some opiates.
diphenhydramine
dextromethorphan
4
Benadryl;
Sominex;Unisom;
Nytol
The quick consumptions of cough
syrups with dextromethorphan as an
active ingredient can produce in people
a sensation similar to being high. Some
cough syrups that contain Dextromethopha
also contain acetaminophen which can
cause liver damage when taken in high
amounts. At doses higher than medically
recommended, dextromethorphan is
classified as a dissociative psychedelic
drug. It can produce distortions of the
visual field, feelings of dissociation,
Robitussin Pediatric
Cough; Sucrets;
cough suppressant (anti- distortions of bodily perception, excitement,
as well as a loss of comprehension of time.
Vicks Formula 44 tussive)
phenolphthalein
Ex-Lax
stimulant laxative
Concerns over carcinogenic nature of the
active ingredient have many calling for it to
be removed from store shelves.
phenylephrine
hydrochloride
Dristan; Sinex
decongestant
Causes Hypertension
pseudoephedrine
hydrochloride
Chlor-Trimeton;
Dimetapp; Drixoral;
Sudafed; Triaminic decongestant
Stimulant
Other Cautions with Over the Counter Medications:
•
Laxatives — Can be overused by people with eating disorders.
Overuse causes problems in the digestive tract when the body
stops producing natural enzymes used in the digestion process.
•
Diet Pills — Diet pills, such as Stacker lls, are misused to curb
appetite and give an extra burst of energy. At one time, these
capsules contained ephedrine, but now they contain other
ingredients similar to and including caffeine.
8.10. M)The selling or giving for consumption of medications by clients to
other clients or staff is strictly forbidden and will result in immediate
dismissal from the premises.
8.10. N)Discharge
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158
1
When a client is discharged all medications will be given back to the
client except when the worker performing the discharge has reason
to believe the client will misuse the medication in a life threatening
way. In such cases, the medication will be held until such time as the
client’s case worker can be contacted for further instructions.
2
If a client self-discharges and leaves their medication at the program,
employees shall inform the client’s case worker and bag and label
medication for pickup by the case worker.
3
Clients who show up at a program after a self-discharge are not to
be given medication unless to fail to do so would be life threatening.
They must contact their case worker.
4
Clients who are re-admitted to a program within a short period of
time (several days) may be given back their medication as long as
new medication has not been purchased during their absence. If
there are any questions about returning medication, the client’s case
manager shall be consulted.
5
For other program specific policies and procedures related to medications, please see the program specific section below.
8.11
Client Telephone Use
8.11. A)Clients have the right to access the clients’ telephone for local calls
only, according to a program’s own rules, providing it is not disruptive
to the house. Telephone use should be kept to a minimum, as other
clients may need to use the phone.
8.11. B)Procedures
1
Support Workers will direct the clients to use the telephone according
to the times permitted by the program rules.
2
Clients may give the office number as a contact for other agencies if
they are expecting news or appointments.
3
Clients are not to abuse the client phone by giving the number out to
those involved in illegal activities such as prostitution or drugs.
4
Clients may make arrangements to use the office phone to make
brief long distance calls within Canada and the U.S.
159
8.12 Visitors/ Drop-In
8.12. A)In general ICCS programs do not allow visitors on site for any reason.
Some exceptions may apply depending on the program and situation. See the program specific section, and the following policy for
details.
8.12. B)From time to time an executive or director may arrange a site tour for
members of the public or may permit groups or individuals to visit a
site to drop off Christmas gifts or donations. In such cases where these
visitors might see, meet, or otherwise encounter a client, the visitors
shall be asked to sign the ICCS confidentiality pledge prior to the visit.
1
In cases where a person is only delivering a donation to the doorstep,
a confidentiality pledge is not required.
2
The Pledge is available on the ICCS website in the “Society Documents” section.
3
When site visits are scheduled in advance, client’s must be given the
option to retire to their rooms, or be off-site during the visit, and every
consideration should be given to their right to privacy and confidentiality.
8.12. C)Individuals who regularly visit a program for extended periods to
provide a service, such as pest control workers, plumbers, and electricians should be asked if they have completed the Ministry of Public
Safety and Solicitor General’s “Criminal Records Review Program
Consent to a CRIMINAL RECORD CHECK” form (#PSSG10-031 — For
working with children and / or vulnerable adults) which can be downloaded here: http://www.pssg.gov.bc.ca/criminal-records-review/
shareddocs/consent-form.pdf.
8.12. D)Clients who have graduated from a program are discouraged from
dropping in on the program except where after care practices have
been approved. Please see the program specific section for details
on your program.
8.12. E)Procedures for handling visit that have not been authorized by management:
160
1
At intake, and when needed, employees will inform clients that visitors
are not allowed on site.
2
If visitors come on site, an employee will explain the policy and ask
the visitor to leave or wait for client outside of the house.
3
All employees will ensure that visitation does not occur on the property.
4
All employees must be polite when informing visitors, including family
members, of the visitor policy but are instructed to be firm.
5
5.Employees will not make any exceptions to the “no visitors” rule.
8.12. F)Suggestions for Responding to Visitors
1
“This is a safe house, so we don’t allow visitors on site except if they
have been authorized by a clinician or by an executive or director of
the Society”
2
“I’m going to have to ask you to leave or wait outside because we
have a “no visitors” policy.”
3
“I wanted to let you know that we have a no visitors policy, so you will
need to arrange to meet your friend at a coffee shop or some other
locations, and I will have to ask you to leave now.”
4
“You may not be aware that we have a “no visitors” policy, so I am
letting you know that you need to either take your visit off site, or arrange to meet at another time and place.”
8.12. G)Suggestions If challenged:
1
“Our ‘no visitor’ policy has always been on the books, and we have
recently begun to remind people about it.”
2
“I’m sure this might seem unnecessary to some people, but it is to
protect the confidentiality of people staying here, which is a legal
requirement of our society, and to insure safety and a positive therapeutic environment for all our clients.”
3
“If you were part of an approved after care program, or if you received written permission from a VIHA clinician or from ICCS, you
would be able to visit, but unless you fit one of those categories, I will
have to ask you to leave.”
161
8.13 Laundry and Shower
8.13. A)All ICCS programs provides both laundry and shower facilities to all
clients.
8.13. B)Support Workers ensure clients are aware of both laundry and shower
facilities and rules related to them, as well as any laundry schedules
that may be in place at the program.
8.13. C)As stated in the client dress code, support workers will encourage clients to regularly launder their clothing and bedding. Please note:
1
BEDDING> Regular laundering of bedding is mandatory for health
and sanitation, especially where infectious disease, parasites, and
pathogens are or may be present. Lice, fleas, and bedbugs do not
survive standard laundering practices, especially hot clothe-dryers.
2
CLOTHING> Clients will launder their clothing regularly except where
to do so would be contrary to a therapeutic relationship or would
traumatize the client. For details see the client dress code (8.8).
8.13. D)Support Workers ensure clients are aware of the procedures related
to showers and bathing.
8.13. E)As with laundering of clothing, regular bathing will be encouraged
except where compliance would seriously threaten the therapeutic
nature of the relationship or would contribute to the decline of the
client’s mental health. See the client dress code (8.8.H) for a more detailed policy on hygiene and mental health.
8.13. F)Where laundering of clothing or regular bathing may be triggers for
trauma or other mental health issues, the matter will be discussed with
the client’s case manager and included in the Personal Service Plan.
8.13. G)For details on household laundry, including the laundering of dish
rags, mops, etc. Please see the operations policy on “Sanitary
Laundry.”28
28 Laundry and Shower Policy updated 05 December 2013
162
8.14 Suicide
8.14. A)ICCS employees will intervene at any point when they believe that
self-harm is possible.
8.14. B)Procedures
1
Call the clients case worker with your concerns.
2
For those programs with access to the crisis response team, that team
may be called when regular case workers are not available.
3
Recommend that the case worker come to the program to assess the
client if you believe self harm risk is great
4
If no case worker is unavailable and you believe that self-harm risk is
great, call 911 and ask for ambulance to transport client to hospital.
•
Pack up client’s belongings
•
Document client’s behavior/actions in the log
•
Complete Incident report if necessary
8.14. C)Assessing Suicide Risk
1
2
The following indications must be considered:
•
history of previous suicide attempt(s)
•
method of seriousness of past attempt(s)
•
suicides of close peers or other family members
•
specific situation context i.e. one or more losses
•
current emotional state
•
current suicidal ideation
•
suicide plan (detail closely; lethality, availability, impulsivity
The above risk factors are to be balanced by the following factors:
•
can identify a range of feelings and situations i.e. sees choices
•
can make concrete plans regarding alternate actions in crisis
situations
•
can identify some social or community supports
•
some feelings of self-worth
163
3
Above criteria should also be viewed in a context of predisposing
vulnerability, and history of :
•
depression psychiatric or mental disorder
•
drug and/or alcohol abuse
•
anti-social behavior
•
impulsivity
8.14. D)Indicators Of Imminent Suicide Risk
1
articulates a suicide plan - Thoughts, Intent, Means, Imminence
2
breakdown of defensive structure
3
evidence of severe hopelessness and/or helplessness
4
accessibility of method
5
loss of present relationships; loss of contact with significant others
6
increased feelings of low self-worth
7
intensification of depressive feelings
8
evidence of psychosis
9
present alcohol/drug use
10
debilitating terminal illness
11
arranging personal affairs with a view to dying e.g. giving belongings
away
12
recent increase in demands or expectations eg. move of residence,
new job
13
increase in energy due to early stage response to anti-depressant
medications
8.14. E)Confirmation Of Suicide Risk:
1
164
The individual must be questioned about their intent and approached directly. For those with demonstrated psychosis, substance
use and/or evasiveness, probing may be necessary. The following
are examples of appropriate questions:
•
“Are you thinking about suicide as a solution to your problem?”,
or
•
“Do you sometimes think you’d be better off if you weren’t
here?”, or
•
“How are you planning to take your life?”
•
“Do you plan to hurt yourself now or soon? (Imminence) What
is your (Plan)?”
•
“Do you have the (Means) to harm yourself? What means?
Availability?”
•
“Are you going to follow through with your plan? (Intent)”
•
“Will you agree with me for a period of time to not harm yourself? (Contract)”
Note: Suicide Thoughts or Ideation can be just that and do not necessarily indicate the client is Actively Suicidal.
2
Actively Suicidal - (See Indicators)
•
Thoughts
•
Intent – Plan
--
Lethal means - accessibility to same
--
Imminence
--
Client will not agree to refrain from harming self
165
8.15 Alcohol and Similar Substances
8.15. A)ICCS programs have different designations related to substance use
and misuse. These range from low barrier programs such as Samaritan
House and Crescent House, to medium barrier programs such as Safe
Harbour House and Hirst House.
8.15. B)None of our programs would be classified as wet housing, however,
so the possession and use of alcohol and illegal drugs is prohibited on
all worksites and in all programs without exception.
See program specific policies for more details.
8.15. C)Procedures
166
1
Discuss this policy with all clients upon admission
2
Assess clients for substance misuse and make a note on their intake
form.
3
If a client is found in possession of a prohibited substance, the substance will be seized and a search of their clothing, possessions and
room will be made.
4
The staff member will dispose of any alcohol into the bathroom sink.
Paraphernalia, marijuana and any other unknown chemical will be
placed in the biohazard container.
5
Any unknown pills will be placed in the a biohazard container
8.16 Search Of Client’s Room & Belongings
8.16. A)In the interest of safety for clients and staff, the belongings of an individual brought into any ICCS program will be assessed for potential
use for injury to self or others, upon admission.
8.16. B)Belongings and bed searches will be done at any other time when
staff have reasonable and probable grounds to believe an individual
is at risk for self harm or presents a danger to others.
8.16. C)At no time will a full body search be done on any client.
8.16. D)Procedures
1
2
3
Upon Admission
•
The client will be asked what is in their pockets and potentially
harmful items will be removed.
•
Cell phones, wallets, and other valuable will be stored in the
locked cabinet designated for this purpose.
•
The belongings of the client will be searched and any potentially harmful items will be removed.
Upon Request from Clients’ Case Manager
•
The client will be asked what is in their pockets and potentially
harmful items will be removed.
•
The belongings of the client and their room will be searched
and any potentially harmful items will be removed.
If Suicidal Ideation Expresses or Assessed As Being a Danger
•
All potentially harmful objects will be removed from the client’s
belongings and from the client’s room.
Note: The above is only carried out if there is reasonable to probable
grounds to believe a client is at risk to harm self or others.
167
8.17 Safety Checks
8.17. A)Safety checks will become part of the daily routine as outlined below,
effective December 17th, 2012
8.17. B)Samaritan House, Crescent House, Hirst House, and Safe Harbour
House will perform safety checks twice a day.
1
The first will be at shift change at 00:0029.
2
The second will be at 07:00
8.17. C)The procedure for performing safety checks is as follows:
1
The support worker will take a flashlight, phone, and keys to begin the
safety check.
2
The support worker will stand outside the first client bedroom and rap
lightly on the door, saying in a normal conversational tone, “Hi it’s
Mary doing the safety check, I’m going to open the door now.”
3
The support worker will open the door just enough to shine the flashlight in and make visual confirmation that the client is in the room and
is alive and well. Then she will quietly close the door.
•
In dorm rooms, each client will be identified and confirmed as
alive and well.
4
The support worker will go to the next bedroom door and repeat the
procedure.
5
When all bedrooms have been checked and everyone is accounted
for, the support worker will record “Safety check performed, all are
safe and accounted for” in the daily log.
6
If a client is not in her designated room, or anywhere else in the building, the support worker (at all programs except Samaritan House) will
leave a voice message for the case manager letting her know the
client is not in the program, and the time the client’s absence was
discovered, and will note the same information in the client’s file. In
this case the log entry should read, “Safety Check performed, all are
safe and accounted for except for [name of client] who was not
found within the building. See client binder for details.”
7
Since case management is provided at Samaritan House by the program Director, it is not necessary to leave a voice mail for her, she will
learn about the absence from reading the log or client file the following day. When a client has a case manager outside of the program
(i.e. with one of the Health Authority teams) the support worker who
discovers the client is absent should notify the Health Authority case
manager, if and when that case manager (or team) has asked to be
notified.
29 As of January 7th 2013 Samaritan House safety checks will be at 07:00 and 23:00 till further notice. All other programs remain as above.
168
8
Samaritan House Support Workers will include the transitional units in
their safety checks.
9
If client’s object to the intrusion or disruption of sleep, workers are encouraged to reassure clients that the procedure is carried out impartially with all residents in the house to ensure that everyone is safe and
accounted for.
8.17. D)All house rules where safety checks are performed will state as part of
the rules:
1
Safety checks are performed at midnight and 7:00 am. The support
worker on shift knocks on and then opens each bedroom door to
insure that everyone staying in the house is safe and accounted for.
8.17. E)The same wording from the house rules must be posted on the inside
of each bedroom door as a laminated sign or inside a protective
sleeve. Administration staff will create signs as needed.
8.17. F)ICCS workers performing intake with new clients will describe the procedure as outlined above so that clients will be aware of the routine
and not be overly surprised or distressed when the checks occurs.
8.17. G)The sign also will be saved in the ICCS Dropbox folder for program
managers to print out, in case the provided signs become damaged
or lost.
8.17. H) Example of sign to be posted:
169
8.18 Client Grievances, Concerns, and Complaints
8.18. A)All ICCS programs will ensure that all clients in the program have opportunity to express concerns, complaints, and grievances without
diminishment of service.
8.18. B)Further, client’s concerns, complaints, and grievances will be acknowledged and a response will be given in a timely fashion.
8.18. C)The objective of this policy is to provide clear instructions on how a
client can voice concerns and make complaints and how those concerns and complaints will be addressed.
8.18. D)All clients have the freedom and opportunity to evaluate the service
component of their stay and ICCS employees and management shall
make every effort to hear and understand concerns and complaints
raised by clients.
8.18. E)Additionally clients have the right and responsibility to request prompt
action when household necessities such as plumbing, appliances,
and heating fail or are damaged.
8.18. F)Clients can expect ICCS employees and management to respond
to all concerns and complaints in a considered and fair manner, and
to address safety issues as soon as is reasonably possible. Clients can
expect that less urgent matters will be taken under consideration
as part of the due process of maintaining and improving service. In
some cases an investigation will be required. Investigations will involve
interviews with residents and staff and — when related to employees
— may require the involvement of union representatives.
8.18. G)Client can expect consistent application of house rules, fair treatment, impartial allocation of food and supplies, privacy, respect,
safety, and a calm and orderly atmosphere.
8.18. H)Complaints and concerns that will receive the greatest attention will
be those relate to these standards and that can be acted upon in
a tangible measurable way. For this reason we ask that client complaints be specific and substantial and with as many facts and observations as possible.
8.18. I) Complaint Resolution Procedures
1
170
Many concerns can be resolved informally between clients and between clients and support workers. When possible, this is the preferred
approach.
2
When a complaint is voiced by a client to a support worker the support workers shall follow these guidelines:
•
FIRST - Confirm the complaint verbally. The first step to resolving
an informal complaint involves firstly an attempt to restate or
rephrase the complaint to the client in order to confirm that you
have understood the complaint correctly. Many times, just being heard is enough to resolve a complaint.
--
Example #1:
--
A client might say, “That meal really sucked. I hate all the
noodles and salad, where’s the beef?”
--
An appropriate rephrasing might be, “It sounds like you
would have preferred something different for supper. Do
you like more meat than pasta and vegetables in general
or was it just the way they were prepared that you didn’t
like?”
--
Example #2:
--
A client might say, “That staff person on last night was a
real jerk, he made me take everything out of my pockets when I got here so he could paw through it, and then
he took away my cell phone without any explanation. It
seems really unfair that I should be treated this way while
I’m staying here.”
--
An appropriate rephrasing might be, “It sounds like you are
upset because you like having your cell phone with you
and privacy is important to you. It that right?”
•
SECOND - Decide who should be involved and/or informed.
•
Once a client confirms that you have heard them correctly, the
next step is to decide if it is an issue you can resolve alone, or if it
requires input from the manager.
•
Actions you can take without checking with your manager:
--
Turning heat up or down (within prescribed levels)
--
Asking noisy clients to moderate their noise
--
Relieving boredom with an activity like a game or outing
(where program parameters allow)
--
Offering reassurance, active listening, and motivational
interviewing
--
Mediating conflicts over house resources, such as the remote control or snacks
--
Talking with two clients who are having trouble getting
along
171
•
•
172
--
Redirecting attention away from insoluble issues onto neutral subjects or subjects the clients are interested in
--
Reminding clients of house rules
--
Improving cleanliness, tidiness, and the spices or portions
of meals while on your shift
--
Adjusting your own language, conduct, attitude, and professional kindness
Issues that must be referred to a manager:
--
Complaints or recommendations for:
--
a.
Changes to house routines
--
b.
Changes to security measures
--
c.
Changes to room or bed assignment
--
d.
Changes to personal plans
--
e.
Changes to rules or procedures
--
f.
Changes to meals ingredients
--
Complaints about other staff
--
Complaints about other agencies and workers
Issues that require or would benefit from a written grievance or
complaint:
--
1. Safety concerns
--
2. Severe symptoms, reactions to medication, changes
in behavior
--
3. Medical needs (including mental health needs) that
your program cannot meet
--
4. Significant changes in a client’s perceived or actual
medical needs
--
5.
--
6. Allegations of harassment, abuse, assault, or being
touched in an inappropriate way
--
7.
Breaches in confidentiality
--
8.
Allegations of theft
--
9. Complaints that are serious and ongoing and have
been previously voiced but not resolved.
--
10. Discrimination - if a client feels they have been treated differently or unfairly by a staff member because of
Ongoing or severe anxiety or depression in a client
race, colour, ancestry, place of origin, religion, marital status, family status, physical or mental disability, sex or sexual
orientation.
•
•
--
11. Violations of privacy or confidentiality - if a client feels
that a staff member has seriously violated her privacy or
has used information about them in an inappropriate way.
--
12. Criminal action - if there is evidence that a staff
member has acted illegally while in a work capacity (e.g.
using their position to carry out criminal behavior, extorting
money, physical abuse, etc.)
THIRD - Record All complaints and offer feedback forms when
appropriate
--
For written complaints the “Concerns and Complaints
Form” is an excellent means of expression because it offers
a bounded and tangible vocabulary. This form is a checkbox style form that covers most common issues that arise
and provides room for situations not covered in the form.
--
For clients who prefer verbal communication, they may
request a meeting with the program manager or their
case worker to discuss their concerns or complaints. Many
clients may not know they have this option or may feel
their situation does not warrant such a meeting, so support
workers should feel free to offer it where appropriate.
--
Verbal concerns or complaints must be documented by
the program manager and all concerns and complaints
must be reported to the Executive Team.
--
Clients leaving the program are encouraged to fill out
either the short “Evaluation” form or the longer “Service
Evaluation” form which also provides opportunity for concerns and complaints.
FORTH - Documentation
--
•
If in doubt, support workers should always document a
concern or complaint raised by a client. Frustrations experienced from living with other people which can be
resolved through redirection or active listening and conflict resolution need not be noted in a client’s file(i.e. client
binder), but even conflicts of this nature can be documented if the support worker believes they have not been
adequately resolved or may lead to more serious complaints later on.
FIFTH - Incident Reports
--
Some complaints arise from critical incidents and in such
cases documentation is very important. Please refer to
specific incident reports in your documentation or when
173
verbally communicating with the program manager.
3
4
Emergency Discharges
•
Emergency discharges and restrictions are non-negotiable
because they have a short duration and are made to ensure
safety and security in the heat of the moment.
•
Emergency discharges and restrictions are often the subject of
a client’s complaint.
•
An Emergency Discharge and Service Restriction is made at the
discretion of staff on shift, sometimes but not always after discussing the matter by telephone with the program manager.
•
A client who is discharged should report to their case worker as
soon as possible if re-admission is desired.
•
If re-admission is desired the case worker will arrange a meeting with the program manager to discuss the discharge and the
context and severity of the situation will be taken into account
by the program manager who has the authority to re-admit the
client.
•
During the readmitting process the client should be offered a
chance to voice her concerns about the process and when appropriate written complaints should be taken.
•
In general it is ICCS policy to trust the clinical expertise of the
case worker in all placements and no placement will be contested except in very unusual circumstances. If a manager
believes that the case worker is placing a client in a program
against clear evidence against such a placement, she will report the placement to the ICCS Executive Team who will investigate the placement in detail.
The Role of ICCS Managers
•
The manager should assess the nature of each complaint and
determine the best course of action to address the issue raised.
•
The manager should:
--
Assess the nature of each complaint and determine if
documentation is necessary
--
Investigate complaints that involve a Service Standards
issue, an ethical matter, or a safety concern.
Investigations should include interviews with relevant employees and
clients
--
174
Document the complaint and any corrective action which
has been taken
5
--
Create a report with as much detail as necessary to clarify
all issues
--
Report the complaint to the Executive Team if the complaint is serious or has potential for legal action
--
Forward all written complaints and reports to the executive
team
--
Create a critical incident report where appropriate
--
Implement changes to the program where necessary
If a grievance or complaint involves the program manager, or if it is
felt that the manager has inadequately dealt with a grievance, the
client should contact their case worker for instructions.
•
We ask that case managers report all complaints regarding
ICCS staff to the program manager, or in the case of the program manager, the ICCS Executive Team.
•
In such cases ICCS asks outside agencies to ask client’s to detail their grievance(s) in writing. In order to resolve outstanding
complaints of this nature we may also ask that the case managers and the client meet with ICCS executives to clarify their
grievance(s) and discuss resolution.
175
8.19 Client Privacy
8.19. A)All ICCS programs will make every effort to protect and ensure every
client’s right to privacy.
8.19. B)Procedures
1
Respect each client’s personal space, including their right not to
share personal details about their life,
2
Respect each client’s personal possessions.
3
Respect each client’s need for privacy in personal care areas.
THE NEED FOR SAFETY OVERRIDES THE RIGHT TO PRIVACY
176
8.20 Client Related Abuse & Harassment
8.20. A)All ICCS programs are committed to the ongoing health and safety
of all clients. Where a client is in danger of threats, assault, abuse or
harassment, Support Workers will take immediate action.
8.20. B)The policies related to abuse and harassment in the personnel section
apply to clients with few exceptions. Please refer to that section of this
manual for further details.
8.20. C)Procedures
1
Encourage clients to respect each other.
•
Report all potential and existing health and safety risks to the
appropriate agency
•
Complete an Incident Report in detail for any assaults, abuse, or
harassment
•
Remove the client immediately from harm
Access police and ambulance services as necessary
177
8 . 2 1 P s y c h o s o c i a l S u p p o r t s 30
8.21. A)This policy describes the psychosocial supports that are allowed and
encouraged. Not all supports listed are appropriate in all programs or
situations, or with all clients.
8.21. B)The kind of psychosocial supports that are given are determined by
the needs, goals, and priorities identified in a clients personal service
plan and in conversation with staff throughout the day. They are continuously adjusted to meet the client’s changing needs and goals.
8.21. C)Psychosocial supports enhance a client’s quality of life, foster resilience, and encourage recovery, while avoiding creating dependency on the support worker.
8.21. D)Clients are informed about a program’s psychosocial supports before
or during intake.
8.21. E)All psychosocial supports that are provided at a prescribed level
comply with ALR Standard 8.1 (Registrant Handbook, Standard 8,
pages 47 and 50 to 52).
8.21. F)Recovery
1
Recovery is: “a deeply personal, unique process of changing one’s
attitudes, values, feelings, goals, skills, and/or roles.” It is, “a way of
living a satisfying, hopeful, and contributing life even with limitations
caused by illness. Recovery involves the development of new meaning and purpose in one’s life as one grows beyond the catastrophic
effects of mental illness.”
2
This definition applies to the misuse of substances because the way
the client uses the substance is seen as detrimental to her mental
health. Recovery from substance misuse may or may not be a goal
that a client identifies in her personal service plan.
3
The harmful use of substances is often an outward sign of a person
struggling to cope with a significant difficulty. The type of difficulty
can range from something dramatic like a trauma, to something less
obvious like a profound belief that one is inadequate. The trauma of
being abused, contracting a serious disease, or losing a loved one (to
name only a few of the common traumas) has put the person outside
of a sense of resourcefulness or ability to respond adequately to the
situation. Substances are often used to dull the pain of the trauma, or
as a way to avoid a painful memory, or simply as a distraction from a
feared event or situation.
4
With this understanding in mind ICCS workers provide psychosocial
30 Policy added 11 June 2014
178
supports that start with listening and empathy, and move to more
directive supports as rapport develops.
8.21. G)Emotional Supports
1
In general when a client first arrives they have a need for hospitality services and safety. Hospitality services are described elsewhere.
Physical safety is created by the house rules and a close relationship
with Law Enforcement. Emotional safety is created by the following:
Active Listening, Empathy, and Reframing.
8.21. H)Active Listening
1
Active Listening describes attentive gestures a Support Worker gives
that indicate they are listening with genuine concern and not offering
either judgment or advice.
8.21. I) Empathy
1
Empathy is a chosen response to a person in pain and has 4 qualities:
•
taking the other person’s perspective,
•
staying out of judgment about the person,
•
recognizing their emotions, and
•
communicating your recognition of those emotions to the person who is suffering.
2
Additionally empathy requires that a worker suspend the desire to
offer verbal reassurance. Instead the worker remains with a person
in their pain and attempts to feel what they are feeling. Empathy
doesn’t attempt to refocus the person on the good things in life, but
just acknowledges how difficult and challenging the current crisis is.
3
It is appropriate to express empathy with phrases such as, “I can see
this is hard for you,” and “It sounds like you are pretty sad about that,”
and “I can see how you would feel that way.” for more details see
the 8th value in the ICCS code of conduct.
4
Open-ended questions can allow a person to talk and feel heard;
but questions can sometimes trigger paranoia and escalate unhelpful behaviour. Use open ended questions with discretion and if they
increase agitation or distress, redirect the conversation. Examples of
open ended questions include:
•
How did that go?
•
How do you feel about what happened?
•
What’s your gut feeling about it?
•
What is really bothering you?
•
What are you concerned will happen?
•
What was the most upsetting part of all that?
179
•
•
What do you wish would have happened instead?
Tell me more about that.
8.21. J)Reframing
1
Reframing is not instruction to “see the world differently” but a natural
outgrowth of providing listening and empathy. When a client shares
her pain and is heard and accepted in that pain, the frame shifts
from “me alone in my pain” to “me in my pain with this other person.”
It involves bringing more and more people and resources into the
frame in a way that helps the client find healthy ways to alleviate or
cope with her pain.
8.21. K)Interaction Supports
1
While emotional safety is being created, it is important to actively interact with clients in ways that support their personal goals and priorities and maintains their residency. These interactions include redirection, cues and reminders, and boundaries.
8.21. L) Redirection
1
Redirection is usually towards the rules of the house and other social
and cultural rules that govern the smooth flow of life. A support worker reminds every client of the rules and offers suggestions for activities
and techniques that shift attention away from any established patterns of rule-breaking or unhelpful thinking that may have contributed
to, or be contributing to, a client’s difficulties. It can be as simple as
changing the subject of conversation.
8.21. M)Cues and Reminders
1
While cues and reminders are technically not considered to be psychosocial supports, they become so when they contribute to a client’s consistent use of strategies for relapse prevention or when they
support identified goals such as weight management, exercise, medication management, smoking cessation, and so on.
8.21. N)Boundaries
1
Boundaries are described in detail in the Code of Ethics for ICCS
Employees. They are the mutually understood physical and emotional
limits in a relationship and demarcate what a support worker can and
can-not provide. Communicating these limits helps a client have a
realistic expectation about what they can expect from the program
or a person and demonstrates how to express and maintain boundaries in a healthy manner.
8.21. O)Skill Development Supports
180
1
Skill development supports are the most directive of the psychosocial
supports. In ICCS programs they most often occur informally as a part
of life in the program. They include:
•
Crisis management skills
•
Illness management skills
•
Life skills and recreation
8.21. P)Crisis Management Skills
1
The energy of a crisis often provides motivation to make necessary
changes. Reminding a client of this fact creates an opportunity to discuss how that “crisis energy” can be used. This can involve help with
creating lists of what needs to be done (finding housing, attending
AA meetings, etc.) and sharing common techniques for dealing with
the feelings, distractions, and temptations a crisis evokes. The occasion of the crisis is also a time to identify triggers.
2
Support workers refer clients to support groups, courses, counselors,
and so on who can provide tools and strategies to avoid or prepare
for future crises. Such referrals provide topics for discussion when the
client returns to the program. These conversations, in which the client can re-cap what they have learned supports the integration of
the training through recall. “Tell me again what you learned at that
course?” is a great way to begin a therapeutic conversation.
8.21. Q)Illness Management Skills
1
Support workers help clients develop skills to manage and live with
their illness by:
•
Listening to client’s concerns about their illness,
•
actively inquiring about client’s health and wellbeing,
•
suggesting techniques and tools that have helped others with
similar illnesses,
•
providing overviews of the courses offered by the health authority (i.e. through the Brooks Landing and Barron’s road offices),
•
encouraging clients to speak with professionals that can help
with specific aspects of their illness,
•
discussing and teaching basic mindfulness and self-care methods,
•
brainstorming helpful routines such as ways to keep track of
medications or respond to unhelpful thoughts about their illness,
•
giving instruction on how to use calendars, alarms, and other
devices as reminders for group and medical appointments,
•
directing clients to DVDs, books, and other ICCS resources reICCS Universal Program Policy Manual
181
lated to their illness,
•
modelling and mirroring appropriate responses to hostile interactions with others,
•
debriefing with clients when they have encountered workers
in the health system and elsewhere who become impatient or
judgmental.
8.21. R)Anger management can also be modeled but generally when a client is seeking help with anger management professional therapy is
required.
8.21. S)Support Worker’s use motivational interviewing techniques to ask
questions about relapse prevention and to mirror responses in a way
that allows the person to come to her own understanding about her
triggers and the changes that are needed to identify and avoid scenarios that may lead to relapse.
8.21. T) Life Skills and Recreation
1
Life skills are those set of actions required to respond to the demands
of life. If a person doesn’t know the actions required, she can’t respond adequately. Developing these skills is directly related to resiliency and to fitting in with the rest of society. By learning what actions
to take in a given situation, and practicing those actions over time,
resiliency is developed.
2
The ICCS support worker observes client behavior and helps clients
identify gaps in their skill sets. It is appropriate to prompt a client with
a phrase such as, “I noticed you struggling to respond when Bob kept
asking you for cigarettes, would you like to hear what I do in that kind
of situation?”
3
Life skills include learning how to cook, clean, maintain hygiene, manage finances, shop for groceries, and navigate interpersonal relationships with enhanced social skills. Often what is needed is role models
of good communication and healthy interactions. Such modeling
and coaching can occur at any time in a program but are particularly helpful during recreational activities. Such activities provide a
safe and contained environment for exploring and practicing these
skills. Support Workers will identify people’s interests and schedule “fun
times” and both for the enjoyment of the activity and for the opportunity to model social skills and provide experiences that can be
referred to later.
8.21. U)What Psychosocial Support Is Not
1
182
Support workers do not provide clinical assessments, in depth counselling, or treatment for mental disorders, trauma, sexual abuse or
complex interpersonal issues.
•
Support Workers at Samaritan House may be directed by their
manager to carry out some assessments related to the Samaritan House Pilot Project. Outreach Workers also carry out assessments. These assessments are to gather information and are not
used to make a diagnosis or prescribe treatment or therapy.
•
Support Workers and Outreach Workers will direct a client to
their VIHA team or other clinicians or professionals in the community if the client needs that level of support.
2
Psychosocial support is also not giving advice or telling a client what
she needs to do, or should do. While some direction is necessary
regarding safety and getting along with others, advice generally has
limited impact and can be counterproductive. If a worker thinks they
have some valuable suggestions they should ask the client first if she
is open to feedback on the subject. If the client says or implies “no,”
then nothing further should be said. If the client says “yes,” then care
should be taken to clarify that the feedback is not clinical or professional.
3
Approval or guidance is needed from a VIHA case manager or other
qualified mental health clinician before providing psychosocial supports for individuals with severe mental disorders.
4
The following activities are not prescribed psychosocial supports but
may, where time and resources allow, be provided in ICCS programs:
5
•
assisting a client to obtain identification, a driver’s license or a
bank account;
•
linking residents to community-based programs or services such
as educational programs, employment programs, general
medical care, substance use counsellors, mental health and
substance use teams or support groups;
•
conducting regular group meetings to discuss conforming to
house rules or topics of mutual interest;
•
generally monitoring and providing feedback to residents on
their life and interpersonal skills;
•
establishing peer support for residents who are attending inhouse or community based programs or services.
It is also not considered to be a prescribed service to provide space
to a third-party provider who, independent of ICCS, sets up a program for residents (e.g., Alcoholics Anonymous, Mood Disorders support groups). All such services are to be approved by management.
8.21. V)Documentation
1
When clients provide feedback about which psychosocial support
are helpful and which are not, that information must be documented
in the client’s personal service plan.
183
9 Cr itica l I n c i d e n t s
9.1
General Emergency Plan
9.1. A) An emergency is a situation that poses an immediate risk to health,
life, property, or environment, and requires immediate action.
9.1. B) The term “critical incident” is often associated with an emergency,
but “emergency response” personnel who are trained to respond
to emergencies do not view every emergency as being critical, i.e.
potentially disastrous. Their training allows them to take actions to prevent a situation from worsening and to slow, stop, or contain a chain
of events that pose real danger.
9.1. C) See 9.2 below form a complete definition of a critical incident.
9.1. D) An emergency plan is designed to provide a mandate for training as
well as practical preparations so that during an emergency a rapid
response is more likely. With a plan in place those trained to respond
will be less likely to be traumatized by the event because they will
have the skills and resources they need to handle common emergencies.
9.1. E) Whenever an ICCS worker deems a situation to be an emergency she
shall take measures to protect herself and those around her. Specific
responses will vary depending on the context and type of emergency.
9.1. F) Emergencies include:
184
1
Natural Disasters such as flooding, weather events, wildland fires,
tsunamis, earthquakes, fires and Wildlife Interfaces, disease outbreaks,
HAZMAT and spills, landslides, avalanches, drought, volcanoes, and
backcountry accidents.
2
Medical Incidents such as bodily pain and trauma including head
injuries; ballistic trauma (gunshot wounds); respiratory troubles including asphyxiation, choking, drowning, smoke inhalation, asthma, etc.;
shock; obstetrics related issues such as bleeding in a pregnant woman; sexual crises such as assault (rape) and testicular torsion; exposure and hypothermia; psychiatric crises, dehydration, poisoning and
venomous bites and stings; burns; serious infections; cardiac events
including heart attacks; and any other injury or illness that is acute
and poses an immediate risk to a person’s life or long term health.
3
Crimes that endanger safety or well being including assault, breaking
and entering, kidnapping, issuing threats, arson, hostage taking, and
trafficking.
4
Violence and wartime events such as murder, sedition, terrorism, and
torture.
9.1. G) Written policies exist for the following emergencies: Fire, Earthquake,
Death, Suicide, Serious Infectious Diseases, Pandemics, and Tampering and Poisoning. Please see these policies for further information.
9.1. H) This General Emergency Plan policy mandates that all employees are
familiar with the common emergency situations, and are familiar with
the policies related to each.
1
A committee of the organization, such as the health and safety committee will review and amend this policy and create supporting documents to assist in preparing for and responding to common emergencies.
9.1. I) All support workers and program managers must be trained in first aid
level 1 and be able to perform CPR.
9.1. J) When an employee is faced with a medical emergency beyond her
training, or an medical emergency of a serious nature she must, without delay, call 911.
9.1. K) For Natural Disasters the Executive Director is charged with acting as
the Emergency Manager for the Society, enacting the emergency
plan, and directing the emergency response.
9.1. L) In the event of an natural disaster, the Executive Director will also act
as the Emergency Manager for any program left without a manager
or will appoint an alternative person to manage such a program
either from the executive or management team, or from within the
program.
9.1. M) General Emergency Preparedness Measures:
1
Each program will maintain a supply of emergency response tools:
flashlights, windup radio, work gloves, safety glasses, hard hat, blankets, candles, and a first aid kit.
2
Each program will have and maintain an emergency supplies kit in a
location that is likely to be accessible after an earthquake.
3
Each program will have post-emergency contact numbers near all
phones.
9.1. N) Communicating
1
Phones. In a large scale emergency like an earthquake, local phone
numbers may not work while out of area numbers may still work.
185
2
ICCS will develop a relationship with an organization outside of the
immediate area to act as a “buddy” organization to provide mutual
communication support in case of a natural disaster.
3
Each program will have a designated meeting place where residents
and staff will meet following a natural disaster.
9.1. O) Training
186
1
Staff will be trained on the General Emergency Plan.
2
Staff will be trained on the use of emergency tools
9.2
Definition of Critical Incident
9.2. A) A critical incident is a relatively sudden significant event or situation
that falls outside of the usual day-to-day activity of a program. The
event is often beyond an employee’s control and usually causes
strong emotional reactions for all involved. It can be but is not always
life-threatening or threatening to an employee’s or client’s health
and safety. Because of the intense nature of a critical incident an
employee’s ability to respond is often challenged and the event may
result in trauma or may cause great damage (i.e. a disaster).
1
A trauma is when a critical incident disconnects a person from a
sense of their own resourcefulness, safety, or coping. A trauma creates an ongoing sense of anxiety or fear which can last from a few
days to weeks, months, or even years.
2
Critical incidents include:
•
a physical injury or trauma
•
all incidents which involve a 911 call
•
a suicide
•
an unusual condition or change in conditions
•
a robbery
•
a fire
•
structural failure of the building or a significant part of the building (roof, deck, railings)
•
an assault
•
violence
•
a death
•
a serious workplace accident
•
an outbreak of a serious disease
•
natural disasters -- floods, fires, earthquakes
9.2. B) Critical incidents do not include the routine, but admittedly challenging, situation that are part of life in a crisis stabilization program, emergency shelter, or supportive recovery program.
1
Examples of challenging but non-critical incidents include:
•
a client shouts insults at an employee and leaves the building in
a hurry
•
a water pipe breaks and causes a small flood but no significant
187
damage
2
•
a client takes more medication than is prescribed
•
a window is broken when a tree limb hits it in an overnight storm
•
a client will not shower or bathe and other clients complain
about the smell
•
a client has a seizure and afterwards is sent by taxi to her doctors office
•
a client breaks a house rule like smoking in her room
•
a conflict occurs between two clients over the use of a bathroom and voices are raised
•
a client does not return to a program after going out with a
friend
•
a client is caught with alcohol in her room
•
a client has a conversation with an empty chair, believing that
he is talking to his dead mother
•
an incident resulting in minor damage to buildings, property,
equipment etc.
All these kinds of occurrences may call for action on the part of program staff, but are normal inevitabilities of program life. Documentation of these events should be made in the log and client files, but not
as an incident report.
9.2. C) All critical incidents must be documented with an Incident Report
and be followed by critical incident debriefing.
9.2. D) If an employee has questions or needs support or debriefing immediately following a critical incident, she should first call her manager (or
acting manager, when her manager is on vacation or sick leave).
1
If a manager or acting manager is not available, she should call a
member of the executive team.
9.2. E) Debriefing
188
1
Employees involved in a critical incident have the right and are
encouraged to participate in critical incident debriefing. Such debriefing is available through The mental health services at the Brooks
Landing walk in clinic. This service is made available, free of charge
and off record, to all ICCS employees who identify themselves as
ICCS employees.
2
As well, for regular full-time and regular part-time employees who are
scheduled to work twenty (20) regular hours or more per week profes-
sional counselling is available through the Employee Benefit Program.
3
The program manager in consultation with the Executive Director
may choose to offer debriefing in-program and employees have
the option of attending this debriefing and/or the debriefing services
through the medical system (Brooks Landing) and the Employee Benefit Program.
189
9.3
Incident Reports
9.3. A) Beginning May 1st, 2012 all Incident Reports will be recorded electronically through the ICCS website at www.iccare.ca by an employee who was involved in the incident or her manager.
9.3. B) Incident Reports must be created for all critical incidents and large
scale events such as natural disasters, may require ongoing note taking as the event unfolds. The manager of each program will appoint
a “note taker” in such an event.
9.3. C) Incident Reports must be filled out according to an objective reporting method such as the Critical Incident Technique or a similar method. If you are unfamiliar with these methods complete the incident
report by providing clear descriptions of what you saw, heard, and
did. Try to keep your interpretations, judgements, and opinions out of
the report except where they explain how you reacted or how you
decided on a course of action
9.3. D) Beginning January 1st, 2013 all incidents considered to be serious that
occur in an ICCS program funded by the Ministry of Social Development and Social Innovation31 must be reported to the registrar of Assisted Living. Serious incident reports must be submitted to the Assisted
Living Registrar within 24 hours of an incident as per Guideline 2.8 of
the Assisted Living Registrar Health and Safety Standards and Guidelines,
9.3. E) According to the ALH&S Standards and Guidelines for Mental Health
or Substance Use Residences serious incidents include:
1
attempted suicide by a resident;
2
missing person,
3
unexpected deaths reported to the Coroner;
4
disease outbreaks reported to the local Medical Health Officer;
5
abuse or neglect;
6
medication error that requires emergency care by a physician or
transfer to hospital; and
7
fire or flood that causes personal injury or building damage.
31 Revised November 28, 2013
190
9.3. F) Documentation Example:
Incorrect Documentation
Correct Documentation
Cindy “the trouble maker”
Washburn got Naomi Clark
all riled up by telling her how
ugly she is and Naomi flew
into a rage and walloped
Cindy good with a chair.
Cindy bellyached about it so
I called an ambulance which
took Cindy to the hospital to
have her head examined. I
reprimanded Naomi and had
her case manager take her
away. Cindy is ok now.
Cindy Wasburn told Naomi
Clark that the jeans Naomi was
wearing made her look fat.
Naomi Clark picked up and
threw a kitchen chair across
the dinning room which struck
Cindy Washburn on the head,
knocking her to the ground
and opening a 2 inch wound
on her forehead.
Cindy complained loudly
of pain and I called an
ambulance which arrived
within 10 minutes of the
incident and took Cindy to the
Hospital.
I asked Naomi to retire to her
room and after Cindy was
out of the house I discussed
the incident with Naomi and
explained that it was grounds
for discharge from the program
and that I would need to talk
with her case manager.
I called Naomi’s case manager
who arrived 30 minutes later.
The case manager confirmed
a spot at a different program
and Naomi was discharged
and went with the case
manager at 4:52 pm after
collecting all her belongings
from the house.
Cindy returned from the
hospital with stitches in
her forehead and written
instructions for care of her
wound which I photocopied
and placed in her file.
9.3. G) All employees will complete the incident reports in a timely fashion, as
soon as possible following the event.
9.3. H) Work Safe BC must be notified if the following occurs:
1
Any incident that kills, causes risk of death, or seriously injures a worker
2
Any unusual event involving explosives
191
3
A major leak or release of a dangerous substance
4
A major structural failure or collapse of a structure, equipment, construction support system, or excavation
5
Any serious mishap
9.3. I) To report such an incident, submit an Incident and Injury Report online
or complete and send in the Employer’s Report of Injury or Occupational Disease (Form 7).
9.3. J) If the worker received first aid on site, the first aid attendant must
complete a first aid record. This must be retained at the work site for
a minimum of three years. If the worker was referred to and received
treatment at a clinic or hospital, the employer must submit an Incident and injury report (electronic Form 7) or complete and send the
Employer’s Report of Injury or Occupational Disease (Form 7 - PDF 81
kb) to WorkSafeBC.
9.3. K) Some incidents need to be brought to the attention of ICCS executives or funding partners but are not critical and in such cases an
incident report can be created.
1
Employees should consult with a program manager before creating a
report for such incidents
2
Incidents which may be written up on an incident report include but
are not limited to:
•
aggressive or unusual behaviour -- i.e. aggressive or unusual
behaviour by a client towards other persons, including another
client, which has not been appropriately assessed in the care
plan or which may indicate a major change in a client’s stability
•
attempted suicide
•
choking that requires first aid but not hospitalization
•
verbal or physical abuse by a case worker or other care provider (witnessed by an ICCS employee)
•
a bad fall that does not require medical attention
•
a medication error -- an error in the administration of a medication outside the program but which adversely affects a client in
the program or requires emergency intervention or transfer to a
hospital
9.3. L) Refer to the Worksafe BC website for the latest up to date criteria for
reporting.
192
9.4
Fire
9.4. A) In case of fire the ICCS employee on site will follow these procedures:
1
If the program has a fire alarm, activate it
2
If the program does not have a fire alarm, shout “fire” repeatedly and
loudly
3
If the fire is small, if a fire extinguisher is at hand, and if using the fire
extinguisher will not present an unreasonable risk to anyone’s health,
the employee should use it on the fire in an attempt to put it out
•
If the fire is extinguished an employee should turn off the fire
alarm, contact the program manager, and begin an incident
Report.
4
If the fire is not extinguished, dial 911 and report the fire
5
Alert all clients, staff and visitors and immediately evacuate the building. Direct clients to the safe mustering station outside
6
Fire Exit Procedures
•
The fire exit procedures for clients should be posted visibly in
each bedroom, and are as follows:
--
Roll out of bed.
--
Touch back of hand to the door, if the door is cool, open
it a crack; if you do not smell smoke, open the door and
leave the building.
--
If the door is hot, DO NOT OPEN IT – leave by the window. If
necessary, use a chair to break the window.
--
If the fire alarm is not sounding, pull the nearest fire alarm
or yell “fire”.
--
Follow the directions of program staff.
7
On the way out, if it is safe to do so, an employee should collect the
daily log and client binder.
8
At the mustering station confirm that all clients, staff and visitors have
evacuated the building but DO NOT GO BACK IN THE BUILDING
9
When the Fire Department arrives, speak to the officer in charge. If
required give the officer a set of keys for the building
10
Contact the program Manager or his/her delegate as soon as possible
11
If the weather is inclement and if the evacuation will not be short,
activate the business continuation protocols
12
Contact other ICCS programs and community agencies in the comICCS Universal Program Policy Manual
193
munity, inform them of the situation and ask for assistance in providing temporary shelter for the clients
194
13
For a false alarm or other short term evacuation, direct occupants
back into the building once the Fire Department has authorized an all
clear.
14
Complete a Critical Incident Form
15
and clients if required
9.5
Earthquake
9.5. A) In the event of an earthquake the Red Cross recommends the following:
1
If you are inside when the shaking starts:
•
Drop, cover and hold on. Move as little as possible.
•
If you are in bed, stay there, curl up and hold on. Protect your
head with a pillow.
•
Stay away from windows to avoid being injured by shattered
glass.
•
Stay indoors until the shaking stops and you are sure it is safe
to exit. If you must leave the building after the shaking stops,
use stairs rather than an elevator in case there are aftershocks,
power outages or other damage.
•
Be aware that fire alarms and sprinkler systems frequently go off
in buildings during an earthquake, even if there is no fire.
9.5. B) The Government of Canada recommends:
•
Drop under heavy furniture such as a table, desk, bed or any
solid furniture.
•
Cover your head and torso to prevent being hit by falling objects.
•
Hold onto the object that you are under so that you remain
covered.
•
If you can’t get under something strong, or if you are in a hallway, flatten yourself or crouch against an interior wall.
•
Stay away from windows, and shelves with heavy objects.
•
Face away from windows.
•
If you are in a wheelchair, lock the wheels and protect the back
of your head and neck.
9.5. C) The USA Federal Emergency Management Agency advises: “Use
a doorway for shelter only if it is in close proximity to you and if you
know it is a strongly supported, loadbearing doorway.”
9.5. D) The “triangle of life” describes an area beside large objects like
couches which seem to provide some additional safety in collapsing structures in less developed countries. ICCS does not recommend
that clients or employees seek the “triangle of life,” for the following
reasons:
195
1
No governmental agency in Canada (i.e. Earthquakes Canada, Public Safety Canada, Health Canada, etc.) supports the theory of the
“triangle of life,”
2
According to United States Geological Survey, the Triangle of Life is a
misguided idea about the best location a person should try to occupy during an earthquake.
3
Critics have argued that it is actually very difficult to know where
these triangles will be formed, as objects (including large, heavy
objects) often move around during earthquakes. It is also argued that
this movement means that lying beside heavy objects is very dangerous.
4
Statistical studies of earthquake deaths show most injuries/deaths occur due to falling objects, not structures.
5
Also, given that there are no warnings for earthquakes, you are more
likely to be injured trying to move during an earthquake rather than
immediately seeking a doorway, furniture, or near an interior wall. This
strategy, combined with good engineering and educated search
and rescue teams is the safest.
6
The Triangle of Life theory encourages individuals to put themselves at
far higher risk by seeking safe zones which they are unlikely to reach.
9.5. E) When the earthquake has subsided assess the situation and if there
are injuries, damage, fire, a natural gas leak or a natural gas odour or
a heavy water leak, call 911.
9.5. F) Follow the fire policy above if there is a fire.
9.5. G) Evacuation
1
If there is a natural gas leak or odour, hot water or steam leak or other
hazardous objects or obstacles evacuate the building until informed
by a official that it is safe to re-occupy the building.
•
To evacuate—alert all clients, staff and visitors and immediately
leave the building. Direct clients to the safe mustering station
outside.
•
Staff should collect the daily log, as well as extra keys if to do so
is safe
•
At the mustering station confirm that all clients, staff and visitors
have evacuated the building.
9.5. H) If the program manager is not already aware of the status of the
evacuation or situation contact her as soon as possible.
9.5. I) Each program manager will contact the Executive Director who will
196
compile information on each program and plan a redistribution of clients to ICCS programs which have space in order to accommodate
as many clients as possible.
9.5. J) After an Earthquake:
1
Stay calm.
2
Help others if you are able.
3
Be prepared for aftershocks.
4
Listen to the radio or television for information from authorities. Follow
their instructions. Place telephone receivers back in their cradles; only
make calls if requiring emergency services.
5
Put on sturdy shoes and protective clothing to help prevent injury
from debris, especially broken glass.
6
Check the building for structural damage and other hazards. If you
suspect it is unsafe, do not re-enter.
7
If you have to leave for medical attention and are able, post a message in clear view, indicating where you can be found.
8
Do not waste food or water as supplies may be interrupted.
9
Do not light matches or turn on light switches until you are sure there
are no gas leaks or flammable liquids spilled. Use a flashlight to check
utilities and do not shut them off unless damaged. Leaking gas will
smell.
10
If tap water is still available immediately after the earthquake, fill a
bathtub and other containers in case the supply gets cut off. If there
is no running water, remember that you may have water available in
a hot water tank (make sure water is not hot before touching it) and
toilet reservoir (not the bowl).
11
Do not flush toilets if you suspect sewer lines are broken.
12
Carefully clean up any spilled hazardous materials. Wear proper
hand and eye protection.
13
Organize rescue measures if people are trapped or call for emergency assistance if you cannot safely help them.
14
Place a HELP sign in your window if you need assistance.
9.5. K) The program manager will initiate Critical Incident Debriefing for staff
and clients if required.
197
9.6
Death
9.6. A) If an employee discovers a client who has died in the program, the
following procedures must be followed:
198
1
Call 911, explain the situation, and provide all information required.
You may be transferred to ambulance services
2
do not touch, and insure others do not touch, anything in the vicinity
of the deceased person
3
Vacate and secure the room where the deceased is located and
keep the location off limits until the police, ambulance, or other officials arrive. Post a sign and lock the door if possible
4
Find and inform any other staff on shift
5
If the program manager has not already been informed of the situation, contact her and provide an update
6
Give attending police access to the room where the deceased is
located and provide any information they require including if asked,
a copy of log entries you made on the client
7
Notify police of any of the client’s remaining medications and if they
do not take them, put them in a container and label the container
with the client’s name and date and lock it away securely
8
Do not disturb anything in the room where the client was found, or in
the client’s room if it is different from the location of demise until the
police give permission for the room to be opened
9
In rare cases the police may take everything. Most of the time they
will not take anything. When given permission by the police, pack up
the client’s belongings and store them for next of kin or the executor
of their will
10
Complete an incident report
11
The manager must notify the executive team and the funding agency (VIHA or BC Housing) of the death and provide a copy of the
incident report
12
and clients if required
13
If an executor does not contact the program within 2 weeks, contact
the client’s listed contact or next of kin and inform them that the belongings are being held
14
Hold belongings for 2 additional weeks and then recycle them according to regular protocols
9.7
Serious Infectious Diseases
9.7. A) Serious infectious diseases must be reported and treated according
to health authority guidelines, the disease and parasite policy above,
and the following pandemic policy, if the outbreak qualifies as a pandemic.
199
9.8
Pandemic
9.8. A) This policy outlines the emergency response procedures that will be
implemented at Samaritan House in the event of a pandemic outbreak.
9.8. B) Other ICCS programs shall follow the policies listed here amending
them for their unique context.
9.8. C) This policy also provides background information on pandemic influenza and directions to employees related to self and client care.
•
“Look After Yourself”- a pandemic preparedness guide produced by Vancouver Coastal Health, is a reviewed resource
that may be ordered for distribution
•
The Toronto Pandemic Influenza Plan - A Planning Guide for
Homeless and Housing Service Providers June 20, 2006 - was
used for the construction of this policy.
9.8. D) Introductory Information
200
1
A pandemic is a wide spread outbreak of a new strain of a virus that
sweeps through a population.
2
It was predicted in 2009 that a new sub-type of the influenza A virus could cause a pandemic in the coming years. Since pandemic
influenza will simultaneously affect the City, the Province and other
jurisdictions, for planning purposes we are assuming that there will be
no aid from other sources.
3
When the World Health Organization (WHO) declares “Pandemic
Phase 6” (which means increased and sustained transmission in the
general population), the pandemic influenza strain will probably appear in Vancouver a short time afterwards.
4
There will be two or three waves of pandemic influenza activity over a
one to two year period. During the course of an influenza pandemic
it is estimated that 15 to 35% of the population will become ill enough
that they will be unable to continue with their usual activities for a
period of time.
5
The severity of illness and the death rate may be just moderately
worse than in the usual influenza seen every winter or it may be much
more severe. Specifics such as who will be most affected and how
they will be affected will not be known until the pandemic virus actually emerges. Children and otherwise healthy adults may be at more
risk of becoming ill than elderly adults. Elderly people may have some
residual immunity if the pandemic is caused by a virus related to one
that has previously caused widespread influenza, and if they were
infected by that virus earlier in their lives.
6
Physical illness is not the only effect of an influenza pandemic. The
psychological impact on the public may be significant. Important
services and programs may need to be curtailed, consolidated, or
suspended because of widespread absenteeism in the workplace.
7
ICCS activities may need to be curtailed or cancelled to prevent the
spread of infection.
8
Supply chains of resources from every sector will likely be disrupted.
9.8. E) What is influenza?
1
Influenza, commonly known as “the flu,” is a highly contagious and
common respiratory illness caused by a virus. There are three known
types of influenza virus - A, B, and C. Types A and B cause seasonal
influenza. Only type A is associated with pandemics. Influenza is usually transmitted from person to person by droplet spread or direct
contact.
•
Droplet spread refers to spray with relatively large, short range
droplets produced by sneezing, coughing, talking or singing.
These droplets may spray up to one meter (about three feet)
and can land directly in the eye or be breathed in through the
nose or mouth.
2
Direct contact occurs when there is immediate transfer of the virus through skin to skin contact or kissing. For example, an infected
person may cough into his or her hands and then shake hands with
another person who may then touch his or her eyes, nose or mouth.
3
The incubation period (the time between being exposed to the virus
and the point at which one starts to experience symptoms) is one to
three days. Most people recover in seven to 10 days. Most adults are
infectious to others between 24 hours before and up to five days after
they develop symptoms. Children and some adults may be infectious
for seven or more days after they develop symptoms. Humans are
usually infected by other humans. However, in some rare cases, humans may be infected by close contact with infected birds or mammals such as pigs.
4
About 30 to 50% of those who are infected by the influenza virus
experience no symptoms at all. The remainder will experience symptoms ranging from mild to severe.
5
The first symptoms are usually fever, headache, chills, muscle aches,
physical exhaustion, and a dry cough. “ Later, the infected person may have a sore throat, a stuffy or runny nose, and a worsening
cough. “Children may feel sick to their stomach, and may vomit or
have diarrhea. “
Elderly people and those whose immune system is weak may not develop a fever.
6
These symptoms may be caused by other viruses or bacteria, not just
the influenza virus.
7
Diagnosing influenza depends on laboratory testing and epidemioICCS Universal Program Policy Manual
201
logical characteristics.
8
In North America, the influenza season is usually from October to April.
9
The virus is constantly changing or mutating, resulting in minor changes known as “antigenic drift.”
10
A new vaccine must be developed every year based on current and
emerging viral strains identified through worldwide disease surveillance.
11
For most people, seasonal flu is not life-threatening. The most seriously
affected are the elderly, people with chronic medical conditions,
and children less than two years old. For these people, the flu may
lead to complications such as pneumonia, which can be fatal.
9.8. F) Annual influenza immunization
202
1
The medical community recommends that individuals protect themselves from seasonal influenza by getting vaccinated every fall. The
influenza vaccine (or “flu shot”) is made from particles of influenza
viruses that have been killed and contains three different types of influenza viruses (two types of influenza A and one type of influenza B).
Every year, doctors and scientists around the world identify the strains
of influenza virus that are circulating, and the vaccine is prepared to
protect against the types that are most likely to occur that year. The
body needs about two weeks after being vaccinated to build up
protection against the virus, and this protection lasts about four to six
months. The influenza virus changes each year, so a different vaccine
has to be created and used each year. Everyone should consider being vaccinated against seasonal influenza each year. This immunization may also reduce the chances of a new influenza virus emerging
through genetic mixing. What is an influenza pandemic? An influenza
pandemic occurs when there is an abrupt and major change in the
structure of the influenza “A” virus (known as “antigenic shift”). This
change may occur in two ways:
2
When two different influenza viruses infect the same cell, their genetic
material may mix, resulting in a completely new strain of virus. For
example, this may occur when a bird virus and a human virus both
infect a pig. Such mixing most often occurs where pigs, birds, and
humans live in close proximity to one another.
3
A virus may undergo random mutation. This type of change may occur during the sequential infection of humans and other mammals
and lead to a virus more efficiently transmitted between humans.
4
Since people have little or no immunity to the completely new strain
of influenza A virus, it can spread very quickly. When outbreaks occur
in one or more countries or worldwide, the event is called a pandemic. The exact nature of the pandemic virus (such as how severely it
affects people, how long the incubation period is, and how easily the
virus is transmitted from one person to another) cannot be known until
the new strain emerges. How often do influenza pandemics occur?
From historical records, we know that a pandemic strain of influenza
tends to emerge three or four times each century.
5
In the last century, influenza pandemics occurred in 1918 (Spanish flu),
1957 (Asian flu) and 1968 (Hong Kong flu). The pandemic of 1918-1919
caused between 20 and 40 million deaths worldwide, while the pandemics of 1957 and 1968 caused much less mortality and morbidity. It
is generally believed that another influenza pandemic will occur but
there is no way of predicting when that might be, nor precisely the
level of illness that might result.
6
Avian influenza or “bird flu” is a contagious disease of animals,
caused by influenza viruses that normally infect only birds and sometimes pigs. Avian influenza viruses have on rare occasions crossed the
species barrier to infect humans.
•
Infection with avian influenza viruses cause two main forms of
disease in domestic poultry. One is a mild form that causes hens
to have ruffled feathers and produce fewer eggs, and the other
is very severe, spreading rapidly and killing most infected poultry.
•
The H5N1 sub-type that is currently circulating in Asia and parts
of Europe is the severe form. This sub-type has infected some
humans who have been in close contact with infected birds
and over half of these infected individuals have died. There is a
possibility that the virus may change to a highly infectious form
that spreads very easily from person to person. Such a change
could mark the start of a pandemic.
•
However, current strains of avian influenza will not necessarily become a pandemic strain. The next pandemic could arise
from a different influenza virus altogether.
9.8. G) Human Resource during a Pandemic
1
Health Canada estimates that 15 to 35% of the population will become ill during the course of a pandemic and will be unable to work
for a period of time. Many people who are not ill may be required to
stay home to care for children, other family members, or friends who
are ill.
2
Strategies to manage staffing shortages will include redeploying staff
from non-urgent activities or drawing on additional workers such as
recent retirees, students, or volunteers including Residents.
9.8. H) Communication
1
Communication is critical to an effective response to a pandemic.
2
Samaritan House will ensure that Employee contact information is
kept up-to-date.
3
Regular pandemic bulletins will be issued.
203
4
The Manager of Policy and Publications will assist ICCS Managers in
the communicating of essential health, service and program related
information to Staff, Residents and community stakeholders.
5
Staff will be informed as to infection control precautions and the
proper use of personal protective equipment if such measure become necessary.
6
Updates and information related to pandemic preparedness will also
be provided at staff meetings and on Staff and Resident’s bulletin
boards.
9.8. I) Skill set inventory
1
The skills of all Samaritan House employees will be recorded and will
be updated periodically.
2
The skill set inventory will be used to identify transferable skills that will
allow an Employee to be transferred from one task, job, or workplace
to another without the need for extensive training or close supervision.
9.8. J) Employees who are Sick
204
1
During an influenza pandemic ill employees must stay home.
2
The requirement for Employees to obtain a physician note due to
illness for an extended period of time may be suspended if it is determined that the health care system is overwhelmed with people seeking necessary medical attention.
3
Employees must not come into work when they have influenza-like
symptoms.
4
Employees who develop symptoms of influenza while at work must
leave the workplace as soon as is reasonably safe to do so and not
return to work until five days after the onset of symptoms, or when
they feel well enough to return to their duties, whichever is longer.
•
This procedure will help slow the transmission of the virus in the
workplace. Ill employees will be requested by their Manager to
leave work even if they do not have sick day credits.
•
Most adults infected with influenza can transmit the virus from 24
hours before and up to five days after they begin to experience
symptoms.
•
For some adults and for young children, this period may last
for seven or more days. Some experts believe that people are
most infectious in the first three days after they are infected
with influenza. However there are no clear data on how long a
person should wait before returning to work to minimize the risk
of infecting others.
•
The best advice at the time of this writing is that adults should
not return to their usual activities for at least five days after they
begin to experience influenza symptoms (seven days for young
children) or when they feel well enough to return to their duties,
whichever is longer.
5
If employees are required to sleep in the program due to overtime
shifts or short notice change-overs due to operational demands, or
who may have difficulty securing transportation to and from their
homes as a result of a pandemic related strain on the community
transportation resources will be provided sleeping quarters on-site.
9.8. K) Staff Briefings
1
In the event of an all out pandemic, staff will be briefed during staff
rotation changes.
•
Topics of discussion will include updates regarding health bulletins & community news, residential services updates, revisions to
job assignments, other critical information. Emergency scheduling / changes in staffing and redeployment High rates of absenteeism may result due to absence. This will affect staffing, supervision, hours of work, and/or employee responsibilities.
•
Based upon skill set and availability, employees from non-urgent
activities and programs will be temporarily reassigned to essential programs.
•
Otherwise, the priority system indicated below will be used to fill
staffing needs for critical ICCS programs in the event of a pandemic.
9.8. L) Where an essential House, i.e. Samaritan, has a staffing need, the
need will be filled by
1
Employees within the House affected by absenteeism
2
Temporary casual hires
3
Management of the House affected by absenteeism
4
Employees from outside House not affected by absenteeism and with
applicable skill sets
5
Management from outside House not affected by absenteeism
6
Volunteers (including Residents)
7
It must be stated that leading up to and during a pandemic event,
every effort will be made to maintain all Housing services currently
operating within ICCS and to keep Employees within the House they
normally work. Discontinuation of “other House services” and redistribution of staff will only occur when
•
Abnormal Staffing shortages due to pandemic influenza occur
•
A marked increase in illness among Residents occurs resulting
205
in significant increases in House workloads or needs to increase
staffing
•
8
It is determined that to do so will prevent potential spread of
influenza virus
In all cases, Funding and critical program requirements, BC Employment Standards, the terms of the Collective Agreement between
ICCS and the BCGEU will govern staffing and redeployment in the
event of a pandemic.
9.8. M) Psychosocial support
1
Recognizing that employees may require emotional and psychological support during a pandemic event, employees will be encouraged to seek counseling services and assistance through whatever
source they can, i.e. Employee Assistance Program.
2
Regular Critical Incident Debriefing will be an ongoing part of the
work environment during a pandemic.
9.8. N) Notification Procedures
1
Notification regarding the threat or actual development of a pandemic influenza outbreak will be according to a graduating system of
“phases” as outlined further in this document.
2
Depending on the phase, the Manager of Policy and Publications will
provide general information and direction to program managers.
3
Alert Phases
•
206
Pre-pandemic Phase
--
this policy will be reviewed during the pre-pandemic
phase.
--
Pandemic related health bulletins and public health notices related to influenza will be posted as received on staff
and residential bulletin boards.
--
Hand washing notices will be posted over all washroom
and public sinks within the building.
--
General personal hygiene information will be posted at
sinks and bulletin boards throughout ICCS programs.
--
All staff and residents will be encouraged to follow proper
and accepted basic hygiene practices and obtain a seasonal influenza vaccination.
--
Sneeze/cough” privacy barriers will be installed between
beds in all dorms.
--
Samaritan House will, wherever possible, make plans for
regular shipments, and will stockpile six to eight weeks of
critical supplies (those required to maintain service operations).
--
•
•
Included in these critical supplies; adequate supply of
disposable tissues, hand sanitizers, and hand-washing supplies, gloves, masks and safety eyewear, medications used
to bring fevers down, such as acetaminophen, soap, paper towels, hand wipes, cleaning supplies, garbage bags,
and other waste disposal supplies, and thermometers.
Notification Phase 1 - in the event of a confirmed pandemic
outbreak elsewhere in the world
--
Samaritan House management, employees, residents
and volunteers will be advised regarding the confirmed
outbreak by posted notices within 48 hours of confirmed
outbreak.
--
If more than 6 months has elapsed since this policy was
distributed to Staff - redistribution will occur.
--
Pandemic related health bulletins and public health notices related to influenza will continue to be posted as
received on staff and residential bulletin boards.
--
The program managers will share skills set inventories and
make plans for the redeployment of employees.
--
Certain activities, though vital in and of themselves, will be
deemed non-urgent due to staffing shortages in the Houses in the event of a severe or sustained pandemic. In this
phase Management will plan for wind down of non-urgent
programs and activities.
--
Extra hand sanitization stations may be installed at the entranceways to all residential rooms, in the main entranceway, etc.
--
Hand soap will be made available to all residents.
outbreak within Country, Province or community
--
Samaritan House management, employees, residents
and volunteers will be advised regarding the confirmed
outbreak by posted notices within 24 hours of confirmed
outbreak.
--
Pandemic related health bulletins and public health notices related to influenza will continue to be posted as
received on staff and residential bulletin boards.
--
Team Managers at the Team Managers Meeting will finalize plans for reassignment of staff between programs.
207
•
outbreak within ICCS: Samaritan House
--
A pandemic outbreak will be considered to have occurred at an ICCS program when one or more residents
or staff are confirmed or suspected with reason to have
contracted the pandemic influenza virus.
--
The outbreak will be considered severe when 10% or more
of staff or residents have been confirmed or suspected to
have contracted the pandemic influenza virus.
--
In the event of a confirmed pandemic outbreak that
reduces the work beyond the capacity of the casual list
to compensate, the applicable management will work
with ICCS executives and BCGEU to reassign employees
from other programs, as necessary, for short term relief only
if such reassignment will not endanger the employees in
question.
9.8. O) General Guidelines
1
Samaritan House dorms - should a resident be confined to their room
due to infection, the risk of contamination to other residents is great.
The first one or two residents infected may be quarantined if space
allows.
2
Bed assignments will be adjusted to ensure that House residents who
are infected are not residing in dorm rooms with unaffected residents.
3
House residents who are infected will be assigned a bed in designated “convalescent” dorm rooms and allowed to remain in bed during
the day. Extra housekeeping duties will be assigned to House dorms
to ensure that washrooms are kept clean and sanitized and to deal
with infected linen and garbage.
9.8. P) Self Care / Client Care Information
1
This section provides general information on infection prevention and
control. Infection control measures are actions that can help prevent
the spread of the influenza virus in the workplace and other settings.
These measures include:
•
208
Practice hand hygiene
--
Clean your hands frequently with an alcohol-based hand
sanitizer or soap and water, especially after you cough,
sneeze, or blow your nose.
--
A 60 to 90% alcohol-based hand sanitizer is the preferred
agent for hand hygiene unless your hands are visibly
soiled. If your hands are visibly soiled, you should wash
them with soap and water. If you are not near water and
your hands are visibly soiled, clean your hands with a moist
towelette to remove visible debris, then use an alcoholbased hand sanitizer.
•
•
--
The influenza virus is easily killed by soap, hand wash or
hand sanitizer products. Therefore gloves or special antibacterial hand wash products are not needed.
--
Hand washing/sanitizing is a very important method to
prevent the spread of pandemic influenza.
--
Hand washing procedure: Wet hands; apply soap; lather
for 15 seconds; rub between fingers, back of hands, fingertips, under nails; rinse well under running water; dry hands
well with paper towel or hot air blower; turn taps off with
paper towel, if available.
--
Hand sanitizing procedure: Follow the manufacturer’s recommendations on the amount of hand sanitizer to use. Apply the alcohol-based sanitizer to the palm of one hand.
Rub hands together. Work the sanitizer in between fingers,
the back of hands, and fingertips (covering all parts of the
hands and fingers). Keep rubbing hands until they are dry.
Practice respiratory etiquette
--
People should be encouraged to cover their mouth and
nose when they cough or sneeze. This will help stop the
spread of germs that can make people sick. It is important
to keep your distance (e.g., more than one meter/three
feet) from people who are coughing or sneezing, if possible.
--
Cover your cough procedure: Cover your mouth and
nose with a tissue when you cough or sneeze or, if no tissues are available, cough or sneeze into your upper sleeve
or elbow -- not your hands. Put your used tissues into the
waste. Wash your hands with soap and water or clean with
alcohol-based hand sanitizer.
Avoid touching your eyes, mouth and nose Influenza spreads
when the infected respiratory secretions from the mouth or nose
of one person come into contact with the mucous membranes
(mouth, nose or eyes) of another person. Without even realizing
it, you may touch the infected nose and mouth secretions of
someone who has influenza (e.g., by shaking hands). If you go
on to touch your mouth, nose or eyes, the influenza virus may
gain entry into your body causing infection.
9.8. Q) Use of masks
1
Staff may request masks for protection on the job. The use of masks is
a difficult and unresolved issue. There is no evidence that the use of
masks in public will protect an individual from infection when the influenza virus is circulating widely in the community. However, a person
209
wearing a surgical mask properly at the time of exposure to influenza
may benefit from the barrier that a mask provides.
2
At the time this policy was written, federal and provincial plans recommend the use of surgical masks and eye protection for health
care workers who provide direct care involving face-to-face contact
to patients with influenza-like illness.
3
The plans also recommend that people who are ill with influenza-like
illness and who must leave their home to receive medical attention
should wear a mask.
4
The plans do not recommend the widespread use of masks as a
community-based disease control strategy. However, the federal
plan states that members of the public may wish to purchase and use
masks for individual protection.
•
How to put on and remove a surgical mask
--
Wash your hands before putting on a mask. Secure on
head with ear loops. Place over nose, mouth, and chin.
Fit flexible nose piece over bridge. Adjust fit - snug to face
and below chin. To remove a mask, front of mask is ‘dirty’;
handle by earpieces. Remove from face, in a downward
direction, using ear-loops. Dispose of the mask in an appropriate receptacle, such as a garbage can. Do not reuse the mask. Wash your hands after removing the mask.
9.8. R) Vaccine administration and distribution In the event of an influenza
pandemic
1
It will take approximately four to six months to produce a suitable
vaccine. Initially, there will not be enough vaccine for everyone. The
federal and provincial governments have identified “priority groups”
to receive the vaccine. The groups, listed in order of highest to lowest
priority, are:
•
health care workers, essential service workers, persons at high
risk of serious illness, healthy adults, healthy children
•
The priority groups may change depending on the nature of the
influenza pandemic.
9.8. S) Use of antiviral medication
1
210
The Provinces are developing a stockpile of the antiviral medication
oseltamivir (Tamiflu). Currently the stockpile is limited. Therefore during a pandemic antiviral medication will most likely be used to treat
those with severe influenza illness. However, as the antiviral stockpile
increases, the goal will be to provide treatment to everyone who is
ill with influenza. Although the effectiveness of antiviral medications
against a novel pandemic virus is unknown it is likely that they will
reduce the severity of influenza illness caused by a pandemic. At this
time, the potential role of antiviral medication for prevention of infec-
tion (or prophylaxis) during an influenza pandemic is being considered at both the federal and provincial levels of government.
9.8. T) Cleaning workplaces
1
People with influenza may contaminate their surroundings with respiratory secretions from their nose and mouth. Surfaces that are
touched frequently by people (e.g., door knobs, computer terminals,
bathroom faucets or other shared equipment) should be cleaned
more often than usual during a pandemic, if possible. The influenza
virus is easily killed by regular cleaning products, therefore special
cleaning agents or disinfectants are not required. Organizations
should follow their current infection control protocols for cleaning and
disinfecting. Garbage created by a person with known or suspect influenza does not need any special handling and may be placed with
the regular garbage for disposal.
2
Do laundry frequently.
3
Every day, clean common rooms and rooms where ill individuals
are staying. Be sure to clean tables, doorknobs, and other surfaces
that are touched frequently. Use a solution of bleach and water. For
general disinfecting, use a mix of 1 part bleach to 100 parts water
(approximately 1 teaspoon bleach to 2 cups water). For surfaces that
may be contaminated with body fluids, use a more concentrated
solution of 1 part bleach to 10 parts water.
4
Wipe down phones, computer keyboards, and other equipment with
a cloth dampened with a bleach and water solution. During a pandemic, consider wiping communal phones and computers between
each use or restricting the use of frequently used items.
5
Dispose of all waste promptly.
9.8. U) Social distancing in the workplace During an influenza pandemic,
the more people you are in contact with, the more you are at risk of
coming in contact with someone who is infected with influenza. Social distancing means reducing or avoiding contact with other people as much as possible. Some workplace strategies to achieve this
may include:
1
minimizing contact with others by using stairs instead of crowded
elevators; canceling non-essential face to-face meetings and using teleconferencing, e-mails, and faxes instead; staying one metre
(three feet) away from others when a meeting is necessary. Sit next to
rather than in front of a coughing client when providing care. “avoiding shaking hands, hugging, or kissing people “ bringing lunch and
eating at your desk or away from others
9.8. V) Cleaning up body fluids
1
Ensure that the area where the body fluid spill has occurred is
211
blocked off.
2
Wash hands for 15 seconds.
3
Put on disposable rubber gloves specific for cleaning. Do not use latex gloves, as they are not designed to withstand cleaning solutions.
4
Pick up any needles or sharps using tongs and place them in a sharps
container.
5
Wipe up the spill using disposable paper towels, then place paper
towels in a garbage bag.
6
Pour the bleach disinfecting solution (see above) onto all contaminated areas. Be careful not to spill the solution on your skin or clothing.
7
Let the bleach solution sit for 20 minutes.
8
Wipe up any remaining bleach solution with a mop or paper towels.
9
Soak mops or non-disposable materials in the bleach solution and let
them air-dry.
10
Remove gloves and place in the garbage bag. Double bag and
secure the garbage bag before throwing it out.
11
Wash hands for at least 15 seconds using soap and water.
9.8. W) Food services
1
During an influenza pandemic, it has been recommended that community living settings should reinforce routine food safety and sanitation practices. Facilities should also consider the following:
•
reinforce regular hand washing by staff members who prepare
food
•
discourage the sharing of dishes, cutlery, and other items
•
use disposable cutlery and pre-packaged food, if staffing levels
are low
•
consider stockpiling a 6-8 week supply of non-perishable food,
in case deliveries of food are disrupted
•
if regular services are interrupted, plan for alternative food supplies
9.8. X) Reduce client mobility
1
212
Homeless and under housed populations tend to be highly mobile in
part because services are spread across multiple agencies. Over the
course of a day, one individual may visit several agencies. During a
pandemic, this high mobility may promote the rapid spread of the
virus through this population. Strategies to reduce individuals’ mobility
include:
•
limiting the movement of residents, such as transfers between
shelters
•
limiting the number of clients or visitors at drop-ins or other day
programs
•
canceling or postponing group activities, if possible
•
providing incentives to reduce mobility; for example, re-organizing services so that three meals are offered at one facility,
instead of one meal each at three different agencies
9.8. Y) Identifying influenza symptoms
1
What are the symptoms of influenza? Infection with influenza can
result in a wide range of illness. Half of the infected people will experience symptoms and the other half may not have any symptoms.
Symptoms may include the following:
•
sudden onset of fever, headache, chills, muscle aches, physical
exhaustion, and a dry cough
•
subsequent onset of sore throat, stuffy or runny nose, and worsening cough
•
children may feel sick to their stomach, vomit or have diarrhea
•
elderly and immune compromised people may not develop a
fever How do I know someone has a fever? Sometimes we think
someone has a fever by simply touching their forehead or neck
but it is important to confirm a fever by checking his/her temperature. We can measure a person’s temperature by using a
thermometer with a sleeve placed in the mouth (oral), the ear
(tympanic), under the armpit (axillary) or in the bum (rectal).
The use of glass mercury thermometers is not recommended as
mercury is a toxic substance and there is a risk that glass may be
broken. Ideally, a digital thermometer should be used for taking
oral, axillary or rectal temperatures and a special ear thermometer should be used for taking a tympanic temperature. These
thermometers can be purchased at drug stores. Someone has a
fever if:
--
The oral/tympanic temperature is 38°C (100.4°F) or higher.
--
The axillary temperature is 38°C (100.4°F) or higher.
--
The rectal temperature is 38.5°C (101.3°F) or higher.
9.8. Z) Isolation
1
Not all ill individuals will be able or need to be hospitalized. As a result,
ill residents will need to be isolated in their rooms. Ideally, an ill individual should be isolated as soon as possible to reduce the transmission
213
of the virus.
2
Individuals in isolation need easy access to washrooms. This may pose
challenges in dormitory-style settings. When accommodating a group
of ill individuals, consider access to washrooms.
3
If communal washrooms are used, clean them frequently.
4
Ill individuals need access to food, drinks, and medications. Staff
need to wear appropriate PPE when bringing supplies and providing
support to ill individuals (e.g., surgical mask and eye protection if providing direct face-to-face care within 1 metre of the ill person).
5
It has been recommended that agencies like ICCS develop strategies
for handling violent, aggressive, or non-cooperative clients who are ill
and are required to remain in isolation.
6
Ill individuals in isolation may also have other mental health issues that
require intervention.
7
During an influenza pandemic, policies related to access to smoking,
drugs, or alcohol may need to be changed, particularly for individuals in isolation.
8
Individuals in isolation may need to refill prescriptions or need access
to daily medications such as methadone. Consider what assistance
clients and guardians may need for obtaining and taking regular or
over-the-counter medications.
9.8. AA)Deaths from Pandemic
1
An ill individual may die from influenza while residing at Samaritan
House. Follow the Critical Incident policy on Death if needed
2
The bodies of people who die of influenza are not considered contagious to others
3
Particular cultural responses to death should be considered when
handling human remains
4
Staff and clients may experience heightened anxiety if a death occurs on site
5
If a deceased person can not be collected in a reasonable period of
time they shall be transferred to the outside cedar shed
9.8. AB) Children whose parents are ill
1
If a client with children becomes ill in a family shelter and is unable to
supervise his or her children, consider the following strategies:
•
214
Ensure client emergency contact information is up to date and,
if possible and appropriate, ask clients to identify temporary
caregivers for their children.
•
Try to locate family members or friends of the client who could
care for the children temporarily.
•
Find appropriate caregivers within the agency.
•
Call Ministry of Child and Family Development for support or to
arrange temporary custody
215
9.9
Tampering and Poisoning
9.9. A) All suspected cases of poisoning must be taken seriously. 911 should
be called if poisoning is suspected. An incident report must be completed and reported to the director as quickly as possible.
9.9. B) If food or medication tampering is suspected an investigation must
be done by the program manager and if deemed appropriate the
RCMP will be called.
9.9. C) The program manager will initiate Critical Incident Debriefing for staff
and clients if required.
216
10 O p e r a ti ons P ol i c i es
10.1 Groceries, Food, Meals
10.1. A)Groceries are to be bought by the Manager or an assigned grocery
shopper. Screened and trained volunteers may be grocery shoppers.
1
If staff notices lack or need of groceries they are to write down the
groceries needed on the grocery list.
10.1. B)Meals must follow society authorized (dietician approved) menus
except where programs use meal planning as part of life skills training
for clients. Under those circumstances some flexibility is allowed.
10.1. C)Food Safety
1
All preparation and storage of food must follow the Food Safe guidelines and practices.
2
Because food, and food safety are central to the hospitality focus of
our programs, one staff with food safe training must be present on site
at every program at all times and that staff person (or persons if more
than one trained employee is on site at a given time) will be considered the authority on food safety during that shift.
3
Clients are not to prepare or serve food, except in such programs
where they are trained to do so as part of the program’s life skills objectives.
4
Clients may not bring their own food and snacks into ICCS programs
as this presents three problems:
5
•
First there are concerns over food storage and food safety. ICCS
can not be responsible for the safety of food that was purchased by others.
•
Second there are concerns over the compromise of food preparation areas by individuals not trained in food safe.
•
third there is the concern that food and snacks can be a source
of conflict between residents of a program and sharing and
exclusion a source of conflict.
A program manager may overrule the prohibition against outside
food entering the program for the following reasons:
•
A client’s religious or personal dietary choices involve food items
not readily available from the program’s regular sources.
•
A medical doctor, dietician, herbalist, or naturopathic doctor
prescribes a food item that falls outside the program’s budget
or is of such a unique nature that it is not easily obtained by the
grocery shoppers.
217
•
A program has life skill training as part of it’s mandate; and
cooking is done in a peer to peer sharing context; and a client wishes to prepare a cultural or family recipe which requires
ethnic or specialty food items that the client volunteers to bring
or purchase for such a dish that will be shared with all in the
program.
•
All clients and staff on during a shift have agreed and received
prior permission from the manager for a client to provide prepackaged snacks for a special occasion such as a birthday
celebration or televised event. The manager will only authorize
such an exception if the snacks will be distributed in a “share
and share alike” manner.
10.1. D)Food Contamination
218
1
Food preparation, handling and storage areas are kept clean and
food handlers maintain good standards of personal hygiene at all
times.
2
All foods are cooked properly, especially meat
3
Foods are kept at the right temperature with chilled foods maintained
cold and hot foods cooled as quickly as possible and then chilled
4
Raw foods are prevented from cross-contaminating ready to eat
foods.
5
Food donations will only be served if the donor is a recognized food
safe handler.
6
In the event food contamination is suspected, food is disposed of.
7
Food that has reached expiration is properly disposed of and the item
and amount is recorded in the disposal log.
1 0 . 2 L a u n d r y 32
10.2. A)There are three levels of clean laundry: standard, enhanced, and
sanitized. 33
10.2. B)Standard. ICCS programs provide clients with the opportunity to wash
their clothing to a standard level of cleanliness (see 8.1.2 for more
details). This laundry must be washed with laundry detergent and
dried in a hot dryer except where to do so would damage clothing.
Client clothing is not required to be sanitized.
10.2. C)Enhanced. Bedding and towels shall be washed according to PSE
standards (Revised in September 2013).34 These guidelines require:
1
That sheets, towels, pillow cases, and other items that contact the skin
of clients be handle as little as possible and with gloved hands.
2
That the workers do not rinse items before laundering to reduce cross
contamination.
3
Soiled laundry be washed daily in a washing machine and dried in a
clothes dryer set at the highest temperature setting.
4
Clean laundry of this sort is to be stored in a clean and protected
environment.35
10.2. D)Sanitized. There are three ICCS approved methods for sanitizing laundry.
1
Authorities agree (see end of policy) that laundry is sanitary if it has
been washed in water of at least 60C and dried on the highest dryer
setting.
2
Alternately a chemical agent can be used to achieve sanitation.
3
If above methods are not available the items will be washed and
then heated in a large pot of water on the stove to 60C and kept at
that temperature for at least 3 minutes. This process of “boiling” for
sanitation may be used for Norwex clothes.
10.2. E)Laundry required to be sanitized:
1
dish rags, dish drying towels, and cloth napkins (if used)
32 Policy added 17 December 2013
33 The EPA Standard defines “Clean” as “the process that physically removes debris from the surface or area by scrubbing, washing and rinsing. It may
be accomplished with soap or detergent and water; “Sanitize” as the process that “kills 99.9% of specified germs;” and “Disinfect” that kills nearly 100%
of specified germs.”
34 A personal service establishment (PSE) in British Columbia is a business in which a person (e.g., an esthetician or tattoo artist) provides a personal
service to or on the body of another person.
35 http://www.health.gov.bc.ca/protect/pdf/pse-guidelines.pdf
219
2
all mop heads and cloths used to clean floors and bathrooms.
10.2. F)Group 1 above must not be laundered with group 2 and neither can
be laundered with other laundry.
10.2. G)If employees judge bedding or other items to require sanitization,
they have the prerogative to treat the items in this way. In general,
however, standard laundering practices as outlined above for bedding are adequate.
10.2. H)Dispose of all cloth and fabric items covered in blood or other body
fluids, rather than laundering them. See the “Cleaning up Blood and
other Biohazards” policy for more details.
10.2. I) Periodic sanitization of washing machines can be achieved by running an empty machine with a sanitizing agent such as bleach or
hydrogen peroxide solutions.
10.2. J)Only hydrogen peroxide bleach and chlorine bleach are effective
sanitizing agents in our programs. Alternatives such a white vinegar
and borax do not sanitize laundry from all pathogens.
10.2. K) References:
1
Lloyd Arnold, M.D., in American Journal of Public Health set the standard when he stated, “A
temperature of 74C (165 to 175 F) with a chlorine (bleach) concentration of 0.01 per cent
in the fourth suds cycle [of a commercial washing machine], held for 15 minutes is an effective germicidal process. This temperature prevents accumulation of bacteria in the washing
apparatus.”36
2
“Recent studies indicate that hygienically safe laundry can be processed with warm water
laundry formulations (not containing chlorine bleach) at temperatures of 60C (120 to 140 F).
Hot air dryers are a necessary step when chlorine bleach is not included in the formulation.
The Centers for Disease Prevention and Control concurs. The requirement to add a disinfecting
agent (chlorine bleach) to warm water (120° - 140°laundry formulations is hereby rescinded.”37
3
Anne Helmenstine, Ph.D. states that: “Borax has many chemical properties that contribute to
its cleaning power. Borax and other borates clean and bleach by converting some water molecules to hydrogen peroxide (H2O2). This reaction is more favorable in hotter water. The pH of
borax is about 9.5, so it produces a basic solution in water, thereby increasing the effectiveness
of bleach and other cleaners. ... The boron, salt, and/or oxygen of boron inhibit the metabolic
processes of many organisms. This characteristic allows borax to disinfect and kill unwanted
pests. Borates bonds with other particles to keep ingredients dispersed evenly in a mixture,
which maximizes the surface area of active particles to enhance cleaning power.38”
4
“Do environmentally friendly products such as baking soda, vinegar, or borax sanitize? While
these products can be used to physically remove dirt and debris (clean) by scouring and wiping surfaces, they do not kill germs well enough to be used to sanitize in child care. So, although
they may be good, low cost choices for cleaning, the extra step of sanitizing is still needed for
36 Vol. 28 AMERICAN JOURNAL OF PUBLIC HEALTH A Sanitary Study of Commercial Laundry Practices LLOYD ARNOLD, M.D., F.A.P.H.A. Department of Bacteriology and Public Health, University of Illinois College of Medicine, Chicago, Ill. July, 1938
37 Bureau of Medicine and Surgery NAVMED P-501O-2 (Rev. 1995) Washington, D.C.
38 How Does Borax Clean? Chemistry of Borax or Sodium Borate, from about.com
220
many surfaces in child care”39
39 California Childcare Health Program • 1950 Addison Street, Suite 107 • Berkeley, CA 94704-1182 - Bulletin 10/08
221
10.3 Pest Control
10.3. A)All programs will take measures to prevent the access of pests such as
insects, rodents, and birds into all program buildings by sealing points
of access (holes or openings in the exterior of the building) and by
keeping doors and windows closed or screened when open. Devices
to automatically close doors should be installed where doors are frequently inadvertently left open.
10.3. B)The feeding of pigeons and raccoons is prohibited.
10.3. C)Bird feeders will be used only when so doing will not attract pests to
fallen seeds.
10.3. D)Garbage, food scraps, compost, and other attractants will be managed to reduce or eliminate their availability to pests. Garbage cans,
dumpsters, and compost bins will have tight fitting lids and secure
bottoms. If Garbage cans or compost bins are punctured or develop
holes large enough to admit pests, they will be replaced.
10.3. E)Vegetables and plants with seeds will not be left to attract pests but
will be composted.
10.3. F)All food will be stored in their original unopened containers or in tightly sealing pest impervious containers.
10.3. G)Pantries, storage areas, and closets which contain items of interest to
pests will be monitored regularly for signs of pest activity.
10.3. H)For occasional and infrequent pest issues program-implimented measures such as placing out mouse traps, may be used. If such measures
do not eradicate the presence of pests within 3 days, professional
services must be used without delay.
10.3. I) If at any time insects (roaches, etc.) rodents, or birds are found to
have entered a building, or if evidence of their presence is found
(droppings, chew marks, nest material), and if program-implemented
measures are not appropriate or have failed to eradicate the pests,
pest control professionals must be notified and an inspection completed as soon as possible.
10.3. J)For programs that experience ongoing pest-related issues an annual
contract with a pest control company will be maintained until such
time as no pest issues are present for three consecutive months.
10.3. K)In some cases an annual contract is less expensive than periodic calls
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without a contract, in which case a contract will be maintained even
in the absence of pest issues for as long as the program manager
deems prudent.
223
10.4 Per Diem Funding Shortfalls
10.4. A)In ICCS programs partly funded by the Ministry of Social Development
through per diem payments, those clients who do not qualify for MSDASI funding will be offered the opportunity to pay all or part of the
per diem amount.
10.4. B)Clients who receive only a part of the total per diem funding will also
be offered the opportunity to pay for all or part of the shortfall.
1
For example, the Ministry may instruct that a client is receiving a
stipend and therefore the Ministry will deduct $33 from the total per
diem payment of $40 and will instruct that the client must pay the $33
from their stipend. In such a case the client would be offered the opportunity to pay the $33 as indicated.
10.4. C)When a program manager receives notification from the Ministry (usually via the Admittance and Discharge form) that someone admitted
to the program is not covered or only partially covered, the manager
will inform the client’s case manager of the Ministry’s direction. While
the decision to stay in the program and cover the outstanding costs is
the client’s, it is the case manager who is best able to advise the client on options.
1
Where the client is impaired from comprehending or unable to comprehend the situation, the manager will discuss the matter with the
client’s case manager and seek a solution through whatever means
are available to the client’s team.
2
Where a client’s resources are exhausted or depleted and therefore
the individual is unable to pay, the manager will discuss a waiver of
this policy with the ICCS Executive Director.
3
The goal of ICCS is to provide housing and support to those who need
it, and a client should not be denied shelter solely on the basis of not
qualifying for this portion of funding.
10.4. D)Alternative sources of funding for this portion of the stay typically
include CPP, EI, pensions, trust funds, insurance, or Worksafe BC payments as indicated by the ministry.
10.4. E)Funding that is independent from the client’s own resources, but that
may be applied by the Executive Directors to such costs include ICCS
surpluses, VIHA special funds, and sponsorship via ICCS sponsor programs.
224
11 Vol u n teers
11.1 Reimbursement of Volunteers & Employees
11.1. A)The policy on the Reimbursement of Volunteers is reprinted here from
the Governance Policy for easy reference.
11.1. B)The Executive Director may, on a case by case basis, reimburse volunteers and employees for out of pocket expenses.
11.1. C)Any payment out of pocket for which a volunteer or employee hopes
to be reimbursed must not be made until the volunteer or employee
has requested reimbursement from the Executive Director.
11.1. D)Receipts must be presented for all reimbursements except fuel reimbursement.
11.1. E)All requests for reimbursement for fuel expenditures must be made using the ICCS kilometrage form.
11.1. F)Reimbursements for volunteers can only be made when funds are
available from non-program sources.
11.1. G)Reimbursements can not be made for services performed by volunteers.
11.1. H)Definitions
1
Volunteer – an individual confirmed by the Volunteer Coordinator or
Executive Director as meeting the requirements and qualifications for
a volunteer and who has completed the volunteer orientation and
training.
2
Out of Pocket Expenses – expenses paid for from a person’s own resources.
•
Examples of Out of Pocket Expenses
--
The most common out of pocket expenses that is regularly
reimbursed is for gas used in personal vehicles during volunteer activity including the moving of furniture, supplies,
and donated items or by employees who must use their
vehicle in the performance of their duties. Other legitimate
expenses might include meals consumed during long ICCS
related tasks, repairs on vehicles as a result of frequent use
for society business (this does not include regular maintenance), and the purchase of tools necessary for volunteer
activity.
225
11.1. I) Conditions
1
The existence of this policy is not to be used to authorize every request for reimbursement. Because reimbursements of Volunteers are
made from non-program funding the Executive Director may deem
other expenses as taking higher priority and deny a request.
11.1. J)Procedure
1
Volunteers unable to contact the Executive Director directly shall
contact the Volunteer Coordinator who will present all requests received for reimbursement to the Executive Director.
226
12 Op era ti on a l F i n a n c i a l P r a c ti c es a t I CCS
12.1 Financial Reports and Budgets
12.1. A)Financial Reports will be created by the Executive Team and distributed to the Board of Directors quarterly.
12.1. B)Program and operational budgets will be prepared each year for
submission to the Audit Committee by December 31st.
12.1. C)The Board of Directors will be alerted to any financial concerns or significant changes to contracts or agreements in a timely manner and
shall be provided with all pertinent information in order to make an
informed review.
227
12.2 Audits
12.2. A)There shall be an annual external audit.
12.2. B)ICCS staff, managers, and executives will comply with all requests
from the auditor and will provide financial and other information in a
timely manner.
12.2. C)ICCS staff, managers, and executives will follow the recommendations of the auditor and make all changes recommended in the audit
report as soon as possible.
228
12.3 Accounting Practices and Controls
12.3. A)Accounting practices at ICCS are designed to support and meet the
“Ends” as outlined in the Governance Policy, section 1.
12.3. B)ICCS staff, managers, and executives will follow standard accounting practices and develop policies and procedures to support these
standards.
12.3. C)The Executive Director will insure that the equivalent of 1 month of
expenses is held in reserve in each account.
12.3. D)Fund raising and administration of ICCS will not exceed 20% of total
revenues.
12.3. E)As outlined in the governance policy, “The Executive Director will ensure that management’s financial controls are developed and written
to define procedures for achieving maximum efficiency in controlling
operational expenses within board established policy.”
229
12.4 Gift in Kind Donation Policy
12.4. A)When a gift in kind donations is made ICCS follows these rules:
1
ICCS will issue the receipt for the fair market value of the goods received. Receipts must not be issued for goods of nominal value. (i.e.
used clothing, furniture etc.) The receipt must be clearly marked “Gift
in kind”
2
If the item is valued at under $1,000 a knowledgeable staff member
may establish the fair market value. For items over $1,000 you must
use an independent appraiser who is not associated with the recipient charity or the donor to establish the item’s value.
12.4. B)3.ICCS cannot issue gift in kind receipts for donations of time or services. In order to qualify as a gift in kind donation it must be a gift of
tangible goods with their ownership transferred to the charity.
12.4. C)4.When ICCS issues a gift in kind donation receipt, our bookkeeper
records the value of the gift in the financial statement as gift in kind
income with an offsetting entry to the associated expense line. The
bookkeeper ensures that ICCS retains documentation supporting the
valuation of each item for all gift in kind donations and ensures that
ICCS states the related income and expense appropriately.
230
12.5 Use of Requisitions
12.5. A)Island Crisis Care Society will insure accountability and transparency
through the practice of requisitions for all purchases of products or
services with a market or retail value greater than $200.00.
12.5. B)Managers will submit to the Executive Director, or her designate,
purchase requests and service requests using the established standardized forms. These forms shall be designed to list 2 or 3 quotes and
managers will obtain at least two quotes for all purchases that meet
the above criteria.
231
12.6 Use of Business MasterCards
12.6. A)Each manager and the Executive Director will be issued a MasterCard with a Board approved predetermined monthly spending limit.
The MasterCard account will also have a combined monthly spending limit approved by the Board of Directors.
12.6. B)Changes to the spending limit will be made by the Executive Director up to a maximum of 5% per year. Where higher limits are required
they must be authorized by the Board of Directors.
12.6. C)The cards will be used for all possible program purchases authorized
in the monthly budget and also for purchases beyond the regular
monthly budget where a requisition is submitted and is authorized.
12.6. D)The use of the MasterCard will not preclude purchasing goods and
services through petty cash or by direct billing, but must not extend
the total expenditures for the month beyond the budgeted amounts.
12.6. E)Regular monthly purchases may include groceries, household staples,
office supplies, cleaning and sanitation products, tools, carpet and
drape cleaning, plumbing services, duct cleaning, tree and yard
waste removal, eaves trough cleaning, replacement of windows and
doors, re-keying of locks, inexpensive furniture, vacuum cleaners,
bedding, and general maintenance and repairs.
12.6. F)Cards will not be used for extraordinary payment such as major
renovations or vehicle purchases which should instead be paid by
cheque or when additional security is required, certified cheque or
secured bank draft.
12.6. G)Card holders will safeguard their card and keep it on their person or
locked in a secure location at all times, except during transactions, at
which time the card holder will insure that the card does not leave his
or her sight.
12.6. H)Cards will not be used by any other person except the person whose
name appears on the card.
12.6. I) If the card becomes lost or stolen the card holder will notify MasterCard without delay to have the card suspended and or a stop-payment designation applied. The card holder will follow and comply
with all instructions given by MasterCard and cooperate with any
investigation into the theft of the card.
12.6. J)The card holder will contact the Executive Director to inform her
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when a card is lost and stolen and to confirm that MasterCard has
been notified.
12.6. K)Cards are for ICCS purchases only and no personal purchases shall
be made with these cards.
12.6. L) The balance of the MasterCard account will be paid in a prudent
manner and charges will not remain on the card from one month
to the next except where accounting practices require a delay.
The goal is to pay the account in full each month and avoid interest
charges.
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P r o g r a m S p e ci f ic P o l ici e s
1 Sama ri t a n H ou s e P r ogr a m Sp ec i fi c
Poli ci es
1.1
Access
1.1. A) OBJECTIVE
The purpose of this policy is to enhance the access experience for clients
at Samaritan House and describe who is eligible to stay in the shelter.
1.1. B) Values
1
Samaritan House welcomes homeless women with compassion, empathy, and professional kindness.
2
Services are provided without prejudice40 or judgement and in spite
of challenging behaviour which may result from mental illness, traumas, injuries, pain, substance misuse or similar challenges.
3
Acceptance, respect, and tolerance are shown to all clients regardless of their circumstances or how often they have accessed services
in the past.
1.1. C) Eligibility
1
Women who are “under the influence” are eligible for service.
2
Women and their children (under the age of 19) are eligible for service with some restrictions (see Family Stay policy).
3
Many clients will be complex, co-morbid, and will have concurrent
disorders and challenges. These conditions do not make them ineligible.
4
No woman is turned away unless she falls within the specific criteria
for service restriction.
1.1. D) Ineligibility
40. See the ICCS Policy entitled Non-discrimination .
234
1
The shelter will not accept more than 20 clients into the program at a
time41.
2
Women who already have a “home” (as defined below) are ineligible for admission.
3
Only the Grounds for Restrictions in the Restriction Policy will be used
to restrict services.
4
Women on the Restricted Service List are ineligible for service. Restrictions may be appealed – see the Restriction Policy for details.
1.1. E) Women with Children, and Unaccompanied Children
1
Women with children are welcomed and can stay at the shelter as
long as certain conditions are met. See the Family Stay policy for details.
2
All women and their children who stay at the program must be accommodated in a private room according to the Samaritan House
“Family Stay” protocols.
3
If a female under the age of 19 requests service at the shelter she will
be provided service according to the following conditions:
•
If she is with her mother or guardian, she will receive shelter according to the Family Stay policy.
•
A Social worker acting under the Child, Family and Community
Service Act, must authorize service for all females under the age
of 19 who are not accompanied by their mother or guardian.
--
MCFD phone numbers are:
Telephone: 250 741-5444
Fax: 250 741-5440
After-hours Line: 1 800 663-9122
•
Employees will keep the child safe (in the office for example)
while they seek authorization.
•
If authorization takes time or can not be provided immediately
children must be the top priority for protection, comfort, and
emotional support.
41. Exceptions to the maximum capacity of the shelter (20 people) can be made at the manager’s discretion, usually during times of extreme weather in
accordance with the City of Nanaimo Extreme weather plan. Room and Meal Plan units are not counted in the 20 person maximum and therefore the
building may shelter at any given time a total of 24 clients.
235
•
All authorized stays must be documented with the name of the
person who authorizes the stay and the date and time of authorization.
•
All authorized children who are unaccompanied by a parent
must have a private sleeping space.
•
If no private sleeping space is available, they must be referred
elsewhere in consultation with the Ministry of Children and Family Development.
•
Even if authorization is not given every effort will be made to
protect the child from harm until alternative arrangements are
available.
1.1. F) Level of Barrier
1
Samaritan House operates under a low barrier designation. Clients
are not allowed to use substances on site, but may do what they
choose off site. They must retire to their beds if they return to the program under the influence or they may have the option to “walk off”
their intoxication.
2
There is no requirement of sobriety to reside in the shelter, only a requirement to not consume substances on site.
1.1. G) PROCEDURES
1
Records
•
2
Admission and discharge records for all clients must be maintained through the BC Housing Website and ICCS database
and all service restrictions must be noted in client’s electronic
and hard copy files.
Admission Process
•
Employees will admit new clients at all times during their shift
provided the applicant meets service criteria and is not disqualified under the Grounds for Service Restriction list.
•
Family members will not be dispersed between shelters when
program space and the resident cohort will allow them to safely
remain together (if they wish) and receive service as an intact
family.
•
Shelter rules and expectations for client behaviour and responsibilities will be explained to new clients at admission or as soon as
is reasonably possible. In particular clients will be made aware
of this policy upon admission or as soon as reasonably possible.
1.1. H) Access Definitions
1
236
Family – Samaritan House is able to accommodate a mother and her
under age children as long as the total number of family members
does not exceed 4. See the Family Stay policy for further information.
(Under development)
2
Home – a safe, secure, dry, heated room or rooms with access to
washroom and cooking facilities.
3
Homeless – A person is homeless if they do not have a home to live in.
The homeless population includes people who are living with brain injuries, mental illness, addictions, and physical and medical challenges
but not all homeless people face these challenges.
4
In danger of Homelessness – a person is in danger of homelessness
when his or her resources are inadequate to maintain permanent
housing. For example, they may not be able to pay their rent, utilities,
or mortgage. They may already have been evicted. They may be living in substandard housing.
5
Hidden Homeless – refers to people who are not visible on the street
because they are living in their car or sleeping temporarily on a floor
or couch at a friend’s place. They are considered to be homeless
because they do not have an explicit right to reside where they sleep
or the quality of their sleeping arrangements does not constitute a
home.
6
Low Barrier – In this context the term refers to the barriers the shelter
creates to a person accessing service – especially with regard to
safety. Under the low barrier designation clients are not allowed to
use substances on site, but may do what they choose off site. They
must retire to their beds if they return to the program under the influence or they may have the option to “walk off” their intoxication.
There is no requirement of sobriety to reside in the shelter, only a requirement to not consume substances on site.
237
1.2
Restrictions of Access
1.2. A) POLICY OBJECTIVE
The purpose of this policy is to provide clear and unequivocal guidelines
for those rare occasions when a client needs to be restricted from accessing services as Samaritan House.
1.2. B) Samaritan House is often the last option for people denied service
elsewhere; therefore every effort must be made to understand and
manage difficult behaviour so that restrictions are not necessary
1.2. C) Samaritan House employees are trained to handle behaviour associated with mental illness and substance misuse. These behaviours are
not grounds for discharge or service restrictions:
1
verbal outburst, agitation, disorientation, compulsive habits, errors in
thinking and speaking, hallucinations, swearing, anger, insults, and
irrational actions and behaviour
1.2. D) Physical symptoms and conditions associated with life on the street
may require first aid treatment and special measures which staff are
trained to provide. These conditions are not grounds for discharge or
service restrictions
1
These conditions include incontinence, lack of hygiene, parasites, illnesses, minor wounds, minor burns, inadequate foot care, and other
non-emergency ailments
1.2. E) Restrictions are only made when the safety of clients or workers is
threatened or a client’s needs are beyond the capacity of the shelter
1.2. F) Grounds for Restriction. Behaviors that are grounds for immediate or
emergency restriction by support workers:
238
1
violence
2
abuse
3
harassment
4
refusal to relinquish a weapon when asked by a shelter worker
5
possession of a concealed weapon
6
issuing threats of a serious nature such as death threats
7
criminal behaviour on the premises such as theft or drug dealing
8
being on the Restricted Access List
9
the use of alcohol or illegal substances on the premises
1.2. G) Other Behaviours that are grounds for restriction made in cooperation
with the program manager or case manager:
1
significant or repeated vandalism or damage to shelter property
2
medical needs beyond the capacity of the program
3
unwillingness or refusal to seek medical attention when directed by a
shelter worker
4
severe dementia, mania, or psychotic behaviour that requires a support worker’s constant attention
5
highly disruptive behaviour in an uncooperative or unmanageable
individual
1.2. H) Even though the above behaviour is grounds for restriction, it does not
require a restriction. Discretion may be used when it is safe to do so
1.2. I) Some discharges and service restrictions may be made even if the
behaviour exhibited is not listed in the list above. In other words, this
policy does not claim to describe every possible threat to safety
1.2. J) The length of time a restriction is in effect must be related to the
grounds for restriction and the context of the restriction
1.2. K) Samaritan House offers many chances for each client to try again at
living peacefully within the shelter
1.2. L) Restrictions are carefully documented and clients have access to an
appeal process
1.2. M) The terms discharged and restricted42 shall be used in all cases. No
other terms shall be used.
1.2. N) PRIORITIES
1
Safety — The first priority at Samaritan House is safety for all clients
and employees
2
Tolerance — Women who are homeless are not all the same and
42 The following words and phrases will not be used in referring to service restrictions or discharges: ban, banned, life-time ban, bar, barred, evicted,
ejected, expelled, disciplined, sent packing, turned out, thrown out, put out, kicked out, tossed out, booted out, shut out, ousted, and other similar colloquial phrases.
239
may experience different needs and different levels of need. They
also have different abilities to cope and relate to others and can
exhibit a wide variety of behaviours. Samaritan House employees will
tolerate a wide diversity of behaviours, expressions of emotion, and
requests for service.
Important Note: Restrictions are made for the benefit of all clientele and
for the safety of employees but not for the convenience of employees
3
Access — Access must not be restricted outside of the guidelines
listed in this policy except in extraordinary circumstances.
4
Appeal — All discharges and service restrictions are subject to appeal and review. See the Appeal and Review booklet (under development) for details on the process.
1.2. O) PROCEDURES
1
Records
•
2
3
The Restricted Access List
•
Additionally a Restricted Access List must be printed whenever
it changes and must list all individuals on temporary or indefinite
service restriction. The list must be available for all employees
to see but protected from distribution to the public in order to
insure compliance with the Privacy of Information Act.
•
The Restricted Access List must include client names, the date
the service restriction was issued, the reason for the service
restriction, the date the service restriction is to be reviewed
with the client, the date the service restriction will be lifted, the
Shelter or other destination to which the client was referred, the
name of staff who issued the service restriction and the name of
manager or case manager who approved the service restriction if applicable.
•
Release of information regarding clients who have been placed
on our service restriction list will be done according to the Release of Information protocols (under development). All client information, including their admission to or discharge from
Samaritan House is personal and private and therefore will be
handled in such a way as to comply with the PIPA and FIPPA.
How Restrictions Apply to Admissions and Discharges
•
240
Admission and discharge records for all clients must be maintained through the BC Housing Website and ICCS database
and all service restrictions must be detailed in client’s electronic
and hard copy files.
Employees who deny access to a client during admission will
follow the procedures outlined in the “Protocol for restricting
service during intake” listed below, and provide a referral if the
person would like a referral and where services for that person
exist.
•
Employees will admit new clients at all times during their shift
provided the applicant meets service criteria and is not disqualified under the Grounds for Service Restrictions listed in the policy
statement above.
•
Explain the Rules
--
•
4
Discharge
--
To the extent that a client is willing to participate, discharges made under this policy will be planned and orderly and
include the option for referral to other services.
--
It is recommended that shelter staff work with community
partners, family, or members of the client’s team, in insuring the least amount of emotional or physical trauma during a discharge.
Protocol for Restricting Service During Intake
•
5
Shelter rules and expectations for client behaviour and
responsibilities will be explained to new clients at admission
or as soon as is reasonably possible. In particular clients will
be made aware of this policy upon admission or as soon
as reasonably possible.
Consult the Restricted Access List prior to beginning intake.
--
If the client’s name is on the list, or
--
If the client’s name is not on the list but the client exhibits
behaviour listed in the Grounds for Service Restrictions,
--
Then the intake can not proceed and the client will not
have access to the shelter.
•
After informing the applicant about the restriction and prior to
escorting the applicant from the premise employees will offer to
provide an application for appeal and provide the application
if the applicant desires one. Employees will help the applicant
complete the appeal form if they are not posing immediate
danger to the employee or others.
•
The employee will notify the manager or case manager of the
restriction of service and any application submitted.
•
The employee will document the restriction using the “Restrictions during Intake” form. (to be developed)
•
The program manager or case manager will arrange the appeal process if one was requested.
Guidelines for Emergency Discharge
241
•
In some cases a support worker may require a client to immediately leave on an involuntary basis.
--
Behaviours 1 through 8 listed above are grounds for immediate discharge
--
In such cases, a peace officer must be called immediately
if the client does not listen to clear instructions and leave
the premises
--
The involvement of a peace officer for other behaviours
should be avoided if possible because it can cause or
escalate feelings of shame and fear
--
When necessary, however, an employee should not hesitate to call the police
--
Emergency discharges shall be done with due care and
attention to safety for all involved but also as quickly as is
reasonably possible to insure that no further incidents occur.
--
In all cases the support worker must witness violence or
have good reason to believe that violence will soon occur
to perform a discharge without permission from the manager or case manager.
--
Other behaviour described in the Grounds for Service
Restrictions list are serious matters for immediate attention,
but must be decided in cooperation with the program
manager or case manager before action is taken.
--
When permission is received the support worker will instruct
the client to leave the premises for a specific period of
time to calm down or compose themselves, or reconsider
their behaviour. The following suggestion may be used as
an example of how to phrase the instructions to leave:
“Mary, your current behaviour is contributing to an unsafe situation. You
are going to have to leave now and you can return after [7 o’clock] if
you would like to be re-admitted. I will give you a copy of the Grounds
for Discharge so that you can see what behaviours you need to avoid
in the future. I will not be on shift after [7 o’clock], but I will write up an
incident report explaining what happened. I want you to be safe as you
leave and will escort you to get your coat and whatever else you need
till you return at[7 o’clock]. If you do not cooperate with me in this, I will
have to involve others such as the police. Will you cooperate with me
now?”
242
--
Additionally a support worker may ask a client to leave
and return at a certain time the next day for an interview
by the manager or case worker prior to re-admittance.
--
Employees have an obligation to assist discharged cli-
ents to link with other appropriate services at the time of
discharge if doing so will not further endanger the worker
or other clients. Such linkage may include, among other
things, allowing a last phone call, making referrals to another service, or providing the clients with resources to
leave safely. It may also include bus tickets, taxi fare, or
other means of client support that will enable a peaceful
departure. Care should be taken that these practices not
become a goal for misbehaving.
--
•
Staff should always remain non-judgmental in their approach to the client. Workers are to be honest with the
client about why she is being asked to leave.
Plan for and Manage Anger
--
The client may react with anger to an involuntary discharge and employees may be the target of that anger.
If there are concerns that this may happen, staff should
ensure that they are not alone during the procedure.
--
If a client becomes angry and or violent and de-escalation techniques are ineffective it may become necessary
to involve a peace officer.
--
Additionally, as noted in the example above, an emergency discharge may require the involvement of the police if
the client is noncompliant.
--
Employees may also act to remove themselves and other
clients from the vicinity of an enraged client if de-escalation techniques are ineffective and the client poses immediate danger to the worker or the other clients.
1.2. P) Definitions Related to Restrictions
1
Emergency Discharge - Emergency Discharges are short term restrictions to address specific threats to safety as outlined above.
2
Temporary Restriction - Temporary restrictions provide a cooling off
period for situations in which conflicts or behaviours have escalated
beyond safe limits. Temporary restrictions can be from 1 to 30 days.
Temporary Restrictions may be conditional. For example they may
only apply for as long as a client refuses to surrender a weapon or for
as long as a client continues to threaten other clients.
3
Indefinite Restriction - Indefinite restrictions provide ongoing safety for
others in the shelter when an individual is recalcitrant in her behaviour
and unwilling or unable to act in a safe manner. An indefinite restriction should only be applied to clients who have been temporarily
restricted on more than one occasion or who exhibit such startlingly
dangerous or damaging activities that clients or employees have
been traumatized by their behaviour.
1.2. Q) Important Notes:
243
1
Temporary and indefinite restrictions are determined by the manager
or case manager.
2
Only the manager or case manager has authority to amend or
change the restricted access list.
3
Therefore support workers must obtain permission to discharge and
restrict clients in all cases except those outlined above.
1.2. R) Additional Considerations
244
1
Service restrictions are a necessary option to insure safety and to
promote a predictable environment within the shelter. Workers and
clients need to know that the kinds of behaviour listed under the
Grounds for Restrictions will be treated with the seriousness that such
behaviour demands.
2
It must be stressed, however, that many other techniques and approaches are available to workers and should be tried prior to restricting service when possible and practical.
3
Annual training opportunities are available in the areas of non-violent
intervention, non-violent communication, and de-escalation and
ICCS encourages all staff to take advantage of this training to learn
or refresh knowledge of these techniques. ICCS will subsidize training
when funds permit.
4
Any discharge or service restriction made for reasons not listed in the
policy statement shall be investigated by a manager.
5
Investigations that reveal favouritism by employees will become part
of an internal review and may lead to discipline.
2 Bri d g e P ro g ra m S p ec ific P o lic ie s
2.1
Medication Policy
2.1. A) The Bridge Medication Policy amends the ICCS Universal Medications,
Vitamin, Etc. Policy in the following ways:
1
Clients medications are delivered to ICCS Safe Harbour House next
door by: client’s at intake, by case workers, or by delivery from a
pharmacy.
2
Monthly or weekly supplies of client’s medication are locked in the
Safe Harbour House office.
3
All Bridge clients will be deemed capable to self-administer their daily
medication according to their physician’s instruction.
4
Daily Routine:
•
VIHA Assertive Community Team members will meet with Safe
Harbour staff each morning to secure Bridge client’s medication
for the day.
•
Then VIHA Assertive Community Team members will distribute
daily medication to Bridge clients.
•
When clients receive their daily medication from VIHA Assertive
Community Team members they will store their daily medication
allotment in their room in a locked cabinet.
•
Clients will be responsible to manage and consume their daily
medication according to their physician and pharmacist’s
instructions without observation by Bridge or VIHA staff; except
where individualized personal plans indicate otherwise.
•
Case managers and Bridge and Safe Harbour staff will coordinate observation of Bridge client medication consumption
when indicated in a client’s personal plan.
•
Bridge staff will daily collect empty bubble packs for disposal
and examination and will note any medications which were not
consumed according to established documentation practices.
5
Bridge staff will document (log) and report to Case Management
any observed behaviour and statements made by clients that might
indicate changes in medication use.
6
Please Note: Individual medication plans, as appropriate, may be
developed according to client’s individual needs.
245
3 Regis t ered A s s i sted L i vi n g P r ogr a m s
3.1
I n f o r m e d C o n s e n t t o S e r v i c e 43
3.1. A) Every person arriving at intake to a program registered as “assisted living” will participate in an interview in which they will have the opportunity to review all pre-entry information and then sign an informed
consent to service form.
1
They will also be offered the opportunity to have copies made for
them of all documents reviewed.
2
The client’s case manager must be present.
3.1. B) In all such programs designed for crisis stabilization, the process of obtaining consent must not contribute to the client’s destabilization.
1
Intake interviews must be conducted in a way and at a time that is in
the best therapeutic interest of the client.
•
The support worker will monitor the intake process to make sure
the paperwork component is not adversely affecting the client’s
ability to understand and cope with the process.
•
In cases where distress occurs, the process will be adjusted to
accommodate the needs of the client.
•
Adaqute time will be given for the applicant to consider all
documents and meet any needs necessary for understanding
the documents.
•
Sensitivity to level of literacy and mental health will be maintained at all times. Where a client is finding literacy a barrier
to entrance the support worker will make every effort to read
and explain all documents using appropriate tone of voice and
word choices.
3.1. C) The purpose of consent is to ensure all persons requesting intake have
a full and complete understanding of the program, terms and conditions of residency, required participation, costs and requisites; and
to provide information that will enable the applicant to provide an
Informed Consent to Service.
3.1. D) The goal is to document that applicants have been provided pre-entry information and that they accept service based on that information. The signed Informed Consent to Service form is this documentation.
3.1. E) The intake interview and all documents will comply with ALR Standard
43 Policy Added 15 April 2014
246
1.2 (Registrant Handbook, Standard 1, Tab 1, pages 19, 21)
3.1. F) Procedures:
1
During the Intake Interview the Support Worker will:
•
Give the applicant a tour of the residence, if not previously
done;
•
Review all material listed in the Informed Consent Interview Information Check List;
•
Ensure each applicant has access to all information for ongoing
reference, including having personal copies;
•
Complete the Informed Consent Interview Information Checklist
and place the list in the applicant’s file;
•
Explain the Informed Consent to Service to the applicant and:
•
--
Ensure the applicant has opportunity to ask questions;
--
Provide answers to questions from the applicant;
--
Presume the applicant to be capable of providing an
informed consent unless the applicant through behavior or
lack of understanding gives reason to question a presumption of capability;
--
Not accept a consent from an applicant who appears
incapable of giving an informed consent, and discuss the
matter with the applicant’s case worker;
--
Not coerce or pressure the applicant to sign the consent if
she is unwilling;
--
Inquire of an applicant who refuses to sign a consent to
determine provide information to allay the applicant’s
concerns and inform the applicant that the consent is essential to enter the program;
--
if the applicant continues to refuse, she will be informed
that the consequence of not signing the consent is that
she cannot enter the program;
--
Document all cases where an applicant chose not to give
consent, including the reasons given by the client.
Place consent forms signed by the applicant in his/her file, and
give a copy to the applicant.
247
248
249
250
251
252
253
254
255
256

Universal Policy Manual Island Crisis Care Society (Operations & Programs)

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Universal Policy Manual Island Crisis Care Society (Operations & Programs)