ADULT SERVICE POLICY AND PROCEDURE MANUAL
Social Inclusion Philosophy
Reachingout Family Homes will assist transitional age youth and their families for
preparation and planning for a future that is socially inclusive and allows the
individual to work towards the maximum potential of their goals.
To provide individualized, socially inclusive programming to developmentally
disabled adults.
To provide transitional planning to adults in conjunction with their RFH families
and/or support teams.
Reachingout Family Homes aims to provide a warm, stable and supportive
atmosphere in all areas of programming, providing opportunities and
encouragement to have a responsible, fulfilling adulthood. The ultimate goal is to
provide each adult and youth with the strength, confidence and ability to enable
him/her to participate meaningfully in society.
Mission Statement
To support developmentally disabled adults in a manner that promotes social
inclusion. Support will be adapted to meet his/her self-determined needs and
goals with support from others where applicable. This will be within a family
based environment, respecting individual choices, supporting their independence
and their individual rights.
At Reachingout Family Homes, our program philosophy is to respect and support
each person as an individual. The focus will be on social inclusion, design and to
adapt programming to accommodate individual needs and goals to ensure that
each person can maximize his/her potential.
Service Principals
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We believe that everything starts with the individual. We will continue to
assist the individual in planning for their future. All individuals will be
empowered to achieve their goals. All supports will be individualized to
meet their independent needs.
We believe in the family unit. Reachingout Family Homes will continue to
support the individual while offering intense support to the family,
promoting independence and assisting the individual in achieving their
future goals.
We believe in a team approach in helping the adults work towards their
maximum potential while providing a safe environment and balancing
risks. We will promote the individuals participation in community activities
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of their choice including work, recreation, social, cultural and religious
events.
We will assist in advocating for funding services and programming that
best meets the individual’s choices and reflects their needs.
We believe everybody has the right to self-determination. This will include
supporting individuals to be full citizens of their community, as well as
directing and monitoring their services and budgets.
Statement of Rights and Responsibilities
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The individual has the right to be who they are.
The individual has the right to make informed choices.
The individual has the right to participate in their community the way they
choose.
The individual has the right to choose how they spend their free time.
The individual has the right to be informed of any possible costs relating to
services (rent, etc.).
The individual has the right to have their personal values and beliefs
respected.
The individual has the right to decide where they live and whom they live
with.
The individual has the right to decide who can share information about
them and provide consent when/where applicable.
The individual has the right to education and training.
The individual has the right to spend their money the way they choose.
The individual has the right to be in relationships, and to be alone when
they want to.
The individual has the responsibility to follow RFH rules while living in the
home.
The individual has the responsibility to be respectful to all those whom
they are living with.
The individual has the responsibility to keep their personal space in a
liveable condition.
Agency Documentation
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Upon admission to adult services the individual will receive a
mandatory orientation to Reachingout Family Homes mission
statement, service principals statements, and our rights and
responsibilities signed annually at the annual ISP.
All Reachingout Family Homes staff, volunteers and foster parents will
receive a mandatory orientation to the agency mission statement,
service principal statements, and our rights and responsibilities, which
will be signed annually.
Individual Support Plans (ISP)
Reachingout Family Homes will develop an Individual Support Plan in
conjunction with the client and the client’s support team. Reachingout Family
Homes will ensure that the following time frame be adhered to:
(a) Individual support plan in place upon admittance or transfer
from
children’s services.
(b) Individual support plan to be reviewed at 30 days of
commencement of transfer from children’s services or sooner if
required.
(c) Individual support plan will be reviewed annually thereafter or
upon request.
All reviews of ISP will be conducted with the individual and/or individual’s support
team should the individual desire. Results of the review will be shared with
appropriate individuals.
Reachingout Family Homes will be made aware by the individual and/or
individual’s support team, of any changes in the individual’s situation that would
affect and/or precipitate a change to their ISP.
Reachingout Family Homes will document by date that they have provided
information and support to the individual regarding their activity choices, including
consideration of risks. This is documented in their ISP.
Reachingout Family Homes staff and the individual will develop an ISP that
identifies the individual’s goals, preferences, needs and this will be documented
in the individual’s participation in the plan.
Reachingout Family Homes will review the ISP annually with the individual and
all members of the support team. The Reachingout Family Homes worker will
record the date of the ISP and ensure all persons involved also sign.
The ISP will include:
 Short & Long term goals
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Expected Outcomes
Actions required to achieve outcomes
Medical, vocational, recreation, cultural, social, or religious
resources required or utilized
The amount of resources
The level of support the individual has requested or requires to
manage their day to day finances
Identify the individual responsible for implementing actions
including specific roles and responsibilities
The next review date of the ISP
Reachingout Family Homes ISP reviews must be based on the stated goals and
preferences of the individual and any other clinical assessments.
Reachingout Family Homes will participate in monthly meetings and record all
information relating to the ISP, including notation of achievements and noted
concerns.
Reachingout Family Homes will complete an Incident Report when deemed
necessary as listed in the Serious Occurrence section below. This report will
remain on the clients file and will be shared with other parties as appropriate.
Reachingout Family Homes will complete an Incident Report if an individual
refuses service as identified in their ISP including medication administration.
Refusal of service will be reported to the appropriate parties.
FINANCIAL
Reachingout Family Homes will ensure that all individuals have a
Financial Trustee to assist with managing their finances if the individual
requests this or if the care team determines this is appropriate. It is
preferred that this will be a third party, however in some instances RFH
parents can take on this role. This decision will be discussed with all team
members involved.
Reachingout Family Homes will ensure regular reviews of bank
statements and ensure that comfort allowance has been received. If the
individual has a financial trustee, the financial trustee will provide the
individuals bank records annually. The RFH worker will review these
records.
HEALTH PROMOTION
General
1) Reachingout Family Homes will support the individual in understanding
anything pertaining to their health and wellbeing. This will be done at the
individual’s level of understanding to ensure that they are able to make
informed decisions about their health. A substitute decision maker can be
contacted if the individual is unable to make informed decisions.
2) Any and all health concerns will be clearly documented on the Individual
Support Plan. These will be reviewed every six months, with any changes
being noted.
3) Reachingout Family Homes will have documentation for medical services
and medication provided to the person. These will include health records,
annual medical forms, immunization records and health care provider visit
forms, which will summarize the medical appointment.
4) Reachingout Family Homes will ensure that all individuals are provided
well-balanced meals and/or snacks in accordance with Canada’s Food
Guide.
5) Consideration is given to the individual’s dietary needs, restrictions or
preferences related to cultural, religious or ethnic background.
Medication
1) Medication Administration
The person administering the medication will record any medication given to
an individual on the Medication Log. If the medication is administered on a
regular basis, administration of medication should be noted, but medication
details are not required to be logged daily. All medications must be in their
original packaging including dosage instructions.
2) Self Administered Medication
Recording of self-administered medication is to be documented on the
Medication Logs.
3) Medication Errors
Any medication errors will be followed up by a medical professional, if
necessary. This will be determined in the clients Individual Support Plan. Any
error must be recorded in the client’s file and reported to the appropriate
contacts, including MCSS.
4) Medication Refusal by Individual
All incidents involving refusal of medication are to be clearly documented and
reported as directed by the prescribing physician. A Serious Occurrence
Report will be filed by Reachingout Family Homes.
MEDICAL TRAINING AND MEDICATION
1) All medication will be stored in a locked box with keyed access. Only
emergency medication, such as an Epi-pen, will be allowed on the
individual’s person. RFH parents will access medication when needed
and document administration or self-administration of medication.
2) If medication is required to be transported during time at a program,
staff/family home parents shall carry medication on behalf of the client
for their safety as well as the safety of others.
3) Any training required for medical equipment and assistive devices will
completed by qualified instructor prior to or on the start day of
attendance at program. Staff will be notified and trained of any
changes or additions by client and/or client support team.
4) A stocked first aid kit will be at each Reachingout Home and easily
accessible.
5) All Reachingout Family Homes staff and parents will have current
training in First Aid and CPR.
6) Specific medication administration training will occur regarding special
needs of client by a certified instructor prior to or upon commencement
of client attending program.
ABUSE POLICY AND ABUSE REPORTING PROTOCOL
Reachingout Family Homes has a zero tolerance policy towards all forms
of abuse.
Reachingout Family Homes will review the Abuse Protocol annually.
Reachingout Family Homes will provide initial training to all parents and
staff on abuse prevention, identification and reporting. This will be
reviewed on an annual basis. Completion of training and reviews will be
noted in the annual evaluation.
What is Abuse?
Any action or behaviour that causes or is likely to cause physical injury,
psychological harm or both to a person with a developmental disability or
results in or is likely to result in significant loss or destruction of their
property and includes neglect.
The following are forms of Abuse:
Sexual Abuse: The unwanted touching of a person’s sexual body parts.
The lack of consent is the defining feature. Here it is important to note the
hierarchy makes it impossible for there to be consent between a person
with a disability and their care provider. Sexual abuse is also about the
denial of a persons’ right to engage in consenting sexual behaviour.
Physical Abuse: Is an act of assault, or a threat of an assault, such as
hitting, slapping, and burning that cause or could cause actual physical
injury or fear of physical injury.
Verbal Abuse: The use of demeaning language and name-calling.
Threatening an individual, swearing or using abusive language.
Psychological Abuse: Whenever constant criticism, insulting,
threatening, degrading, humiliating, intimidating or terrorizing of a person
occurs, this is deemed psychological abuse.
Emotional Abuse: Is the misuse of power, in any way, to cause a person
to lose respect for themselves.
**Psychological and Emotional abuse can also include the demeaning of
ones faith or beliefs or the imposition of another’s faith onto the person.
Financial Abuse: Constitutes the misuse, misappropriation or restriction
of someone’s financial assets for personal gain.
Neglect: The failure to provide the necessities of life such as food,
clothing, shelter, care or supervision. People with disabilities, in care, have
a right to expect that their basic needs will be met and they will be
provided with appropriate supervision for their age and their
developmental needs.
Exploitation: Taking advantage of a person’s disability to trick or
manipulate for personal benefit. This includes personal persuasion to do
things that are illegal or not in the individual’s best interest.
Harassment: The use of any comments, conduct or gestures that are
insulting, intimidating, humiliating, malicious, degrading, offensive or
discriminatory, directed toward an individual or group of individuals.
Sexual Harassment: The use of any comments or conduct of a sexual
nature undertaken with the intent of causing offence or humiliation.
Reachingout Family Homes parents and/or Support Staff may be made
aware of possible abuse by observation, reporting by the individual or a
report made indirectly about a client. Suspicion of abuse may come from
direct evidence such as torn clothing, bruising or bleeding. Bruising of
certain areas that are considered highly suspicious is as follows: inner
thighs, back of legs, eyes, upper arms and back. Repeated bruising or
injuries to a person who is physically incapable of moving independently
may also be considered suspicious. If there is suspicion of abuse without
direct evidence, such as a change in behaviour, this must be documented
as a pattern may develop.
If abuse is suspected but the possible victim is not talking, ask general
questions about how things are going.
All incidents of abuse and suspected abuse will be reported to
police. Reachingout Family Homes does not require consent from
the individual to report this abuse. Reachingout Family Homes does
require consent from the individual prior to notifying anyone other
than the Police.
All clients must be informed of Reachingout Family Homes’ policy on
abuse reporting upon admission. This policy shall be reviewed every six
months. Consent must be acquired from client to report the abuse to
anyone else and this discussion must not occur until after the police
investigation.
REPORTING ABUSE
When abuse is witnessed, suspected or reported by or about a client,
remain calm and outwardly unemotional.
If the information given is unclear, ask open-ended questions such as
“Can you tell me more?” Do not press for a response if they are unable to
give more details. Give the individual time and reassure them you are
there for support.
Do not ask direct questions (who, what, where etc.). Leading questions
can contaminate the investigation. As soon as the individual provides
enough information that indicates the allegation of abuse may be criminal
in nature, stop all discussion, support the client and contact the police.
Have client make the contact if they are willing.
Do not discuss allegations with others until police have arrived and taken
your statement and that of the person who was abused.
If you witness abuse, first intervene, stop the abuse, provide any medical
intervention necessary and immediately report to the police.
DOCUMENTING ABUSE
Reachingout Family Homes will ensure that all suspected, alleged, or
witnessed incidents of abuse would be immediately reported to the police
and our team. No internal investigation shall be initiated prior to the police
completing their investigation.
Remember your report can be used as evidence in a court of law.
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Make statement professional
Be objective
Do not use language the person did not use
Record any questioning or action you took
Use only black or blue ink
Do not use white out or rewrite the report. If you make an error,
cross it out and rewrite the words so it shows you did not
change your statement
Do not prejudice information by including extraneous
information. Make the report about the allegation made and
nothing more
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ABUSE REPORTING SUMMARY
1) Ensure there is a clear allegation
2) Ask objective questions, do not ask questions if you witness the
abuse
3) Stop all questioning as soon as there is a clear allegation
4) Call the Police
5) Support the individual
6) Encourage the person to not speak with others until the police
take their statement
7) Document incident
8) Inform the family or substitute decision maker if the person is
incapable
9) If you suspect substitute decision maker is the abuser do not
contact them
10) Take direction from the police
11) Contact RFH and RFH to complete Serious Occurrence Report
SERIOUS OCCURRENCES
DEFINITION
Serious Occurrences to be reported by the service provider to the
appropriate parties are defined as follows:
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Any death of a client that occurs whiles participating in a service.
Any serious injury to a client that occurs while participating in a
service. This includes:
 any injury caused by the service provider;
 a serious accidental injury received while in attendance
at a service provider setting, and/or in receiving service
from the service provider;
 an injury to a client, which is non-accidental, including
self-inflicted, or unexplained, and which requires
treatment by a medical practitioner, including a nurse or
dentist.
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Any alleged abuse or mistreatment of a client that occurs while
participating in a service. This will occur in compliance of
Regulation 299/10.
Any situation where a client is missing, where the service provider
considers the matter to be serious.
Any disaster, such as fire, on the premises where a service is
provided.
Any complaint concerning the operational, physical or safety
standards of the service that is considered by the service provider
to be of a serious nature, including any report of adverse water
quality.
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Any complaint made by or about a client, or any other serious
occurrence concerning a client, that is considered by the service
provider to be of a serious nature.
Any use of a physical restraint.
Note: Within the parameters of the preceding definitions, the service provider is
responsible for determining whether an incident is deemed to be a serious
occurrence.
A serious incident reported shall address the following:
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the nature and time of the occurrence
to whom it is reported
by whom it is reported
When a Serious Occurrence takes place, the program will notify the appropriate
parties within 24 hours.
POLICY AND PROCEDURE ON THE USE OF PHYSICAL RESTRAINT
1)
Definition of Physical Restraint
A physical restraint is defined as the physical control of a
client by one or more persons to safely restrict the
movement of a person, using one of a variety of holding
techniques, with the least amount of force necessary to
inhibit the ability of the client to move freely.
2)
Policy Statement
Reachingout Family Homes does not condone nor support
the use of ‘restraint’ within the program. Should the need for
physical restraint become absolutely necessary (if a client is
either in immediate danger or places another in immediate
danger) only individuals who have been trained in one of the
following:
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Nonviolent Crisis Intervention (CPI)
Prevention and Management of Aggressive Behaviour
(PMAB)
Therapeutic Crisis Intervention (TCI)
Understanding and Managing Aggressive Behaviour
(UMAB)
Training must be current.
3)
Service Provider Protocol
Alternative measures to use of restraint:
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Implementing non physical behaviour management techniques
Engaging the assistance of a third party to help calm the client
The use of behaviour management techniques such as time out,
removal to a quite area etc., must be looked at
Should the need for physical restraint become necessary, the
incident must be processed immediately following the event and
an incident report must be completed
Principals
If and when the use of restraint is considered, the following
principals should be looked at:
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that it be in the best interest of the client
that it be an appropriate and necessary response to a potentially
risky situation
that it be administered after attempting less invasive techniques
and only in response to a specified safety concern
must be administered by adequately trained individuals
must be reviewed following the use of a restraint
must be safe and effective
must include a process of debriefing in which the client and all
active participants are involved
SAFETY
FIRE SAFETY AND EMERGENCY PREPARENESS
1) Every Reachingout Family Home will have a fire safety plan and
emergency preparedness plan.
2) These plans will be reviewed to the capacity of the client with the
developmental disability upon intake.
3) Regular maintenance and inspection of fire extinguishers must occur
as per the Fire Departments rules and regulations. These will be
tagged and dated.
4) Annual Furnace inspections are to be conducted at all RFH Homes.
These documents are to be kept in the family file in the main office.
5) Fire alarm and carbon monoxide detector batteries are to be changed
annually.
HEALTH AND WELLNESS
1) Provide well-balanced meals and/or snacks in accordance with
Canada’s Food Guide.
2) Consideration is given to the individual’s dietary needs, restrictions or
preferences related to cultural, religious or ethnic background.
3) All food will be stored safely and disposed of according to the
manufacturer’s suggested guidelines.
PERSONAL BELONGINGS
1) Clients have the right to have their belongings with them at Reachingout
Family Homes. Reachingout Family Homes reserves the right to remove
items from a client that may be harmful to themselves, other clients or
staff. Property will be returned to client when they leave program unless a
safety and/or legal concern is noted. Inventory of belongings to be
reviewed at the ISP and will be kept on file.
HUMAN RESOURCES/ STAFFING
1) Police reference checks including Vulnerable Sector Screen for all
staff, Reachingout Family Home parents and volunteers and with direct
access to persons will be on file.
2) Three personal reference checks will be on file for all ReachingOut
Family Homes staff and volunteers. These will be kept in the
personnel files.
3) Reachingout Family Homes must be provided with copy of valid driver
license.
4) Reachingout Family Homes must be provided with copy of automobile
insurance coverage.
5) Reachingout Family Home parents, staff and volunteers will be
orientated and trained on all policies and procedures.
6) Reachingout Family Home parents, staff and volunteers will be trained
in Quality Assurance Measure Training. This training will be reviewed
annually.
CONFIDENTIALITY
All client information is confidential and may not be shared with anyone
without the client’s support team’s consent.
The only incident where this does not apply to is with regard to Abuse
Reporting Protocol.
SMOKING POLICY
1) Smoking is not permitted in any of Reachingout Family Home’s
facilities, homes or when transporting clients in cars. Reachingout is a
smoke-free environment for the comfort of all employees and clients.
2) Smoking is permitted outside of the buildings/houses.
GRIEVANCE PROCEDURES
A) PROCEDURE FOR THE CLIENT
1) When a client has a grievance, it is the responsibility of a Reachingout
Family Homes staff to inform the client of his/her rights and the proper
procedures to follow.
2) It is the aim of Reachingout Family Homes to work through difficulties
and concerns that the client may have before the client reaches the
stage of registering a grievance.
3) Once a grievance has been registered, it is the goal of Reachingout
Family Homes to reach reconciliation as quickly as possible.
4) Although a client may verbalize his/her grievance, it is necessary for
the grievance and its reasons to be put in writing.
5) If a client has a grievance against a Reachingout Family Homes staff
or foster parents, the order of grievance registration is:
a) Immediate Reachingout Family Homes staff, if not reconciled, then
b) Reachingout Family Homes supervisor, if not reconciled, then
c) Placing agency worker