Section 1: Introduction
& Overview
Order of Contents............................................................................................................................... ............................... 1
1.A. 1:
1.A. 2: History..................................................................................................................................... ............................... 2
1.A. 3:Accreditation........................................................................................................................... ............................... 2
1. B. Profile of Homes and Programs............................................................................................... ............................... 2
1. C. Admissions Process and Criteria............................................................................................ ............................... 5
1.C. 1: Population Served................................................................................................................................................... 5
1.C. 2: Referral Process for
Homes and Programs.......................................................................................................... 5
1.C. 3: Transition into
Homes and Programs.................................................................................. ............................... 6
1.C. 4: Moving On............................................................................................................................... ............................... 7
1.D. Rights and
Responsibilities...................................................................................................................................... 8
1.D. 1: Rights....................................................................................................................................... ............................... 8
1.D. 2: Responsibilities....................................................................................................................... ............................... 9
1.D. 3: Family/Support
Network Rights........................................................................................... ............................... 9
1.D. 4: Family/Support
Network Responsibilities.......................................................................... ............................... 9
1.D. 5: Informed Consent:
Risk versus Choice............................................................................... ............................... 9
1.D. 6: Confidentiality......................................................................................................................................................... 10
1.D. 7: Consent for Release
of Information..................................................................................................................... 10
1.E. Complaint Resolution ................................................................................................................ ............................... 10
1.E. 1: Overview................................................................................................................................................................... 10
1.E. 2: Rights and Responsibilities
regarding complaints............................................................................................. 11
1.E. 3: Compliance with
regulations................................................................................................................................. 12
1.E. 4: Procedure.................................................................................................................................................................. 12
1.E. 5: Complaints in the
community................................................................................................................................ 13
1.E. 6: Tracking complaints................................................................................................................................................ 13
1. F. Monitoring and
Safeguards...................................................................................................... ............................... 14
1.F. 1: Hiring......................................................................................................................................................................... 14
1.F. 2: Internal Monitoring................................................................................................................................................. 14
1.F. 3: Community Living
1.F. 4: Community Care
Facilities Act.............................................................................................................................. 14
1.F. 5: Worker’s
Compensation Act................................................................................................................................. 15
1.F. 6: Fire Inspections....................................................................................................................................................... 15
1.F. 7: Pharmacist Review.................................................................................................................................................. 15
1.F. 8: Policy, Procedure
and Other Manuals................................................................................................................. 15
1.F. 9: Miscellaneous.......................................................................................................................................................... 16
Kardel’s mission is to help people with developmental disabilities have a good life and to respect their personal choices.
Kardel is an incorporated company started October 15, 1987
by Dr.
We now have the capacity in the homes for 40 people, day programs for 21 and our individual support network serves 25 people. Our emphasis has moved increasingly toward informed choice, increased independence, and community inclusion for the people we support as well as maintaining a high quality of health care, safety and security.
In January 2004, Kardel’s homes and Futures Club day program were accredited for a period of three years by CARF. CARF is an independent, not-for-profit accrediting body whose mission is to promote the quality, value, and optimal outcomes of services through a consultative accreditation process that centres on enhancing the lives of the persons served. CARF establishes consumer-focused standards to help organizations measure and improve the quality of their programs and services. We have been through a rigorous peer review process and have demonstrated to a team of surveyors during an on-site visit that we are committed to conforming to CARF’s accreditation conditions and standards.
1: B: Profile of Homes and
Programs
Dustin is the home of three women and two men. It is
situated in a pleasant cul-de-sac on Cordova Ridge. The home is wheelchair
accessible and has a manual bath lift, a floor lift to assist with transfers
and a wheelchair adapted van. Two people attend a day program in the community
and the others participate in in house and community activities. The people are non-ambulatory and
augmentative communication is used with three people. Varying degree of support
is required for personal care. The staff ensures an active atmosphere that
meets the needs of the people who reside at
Futures Club-
Futures Club is a day program for twenty-one young men and women. The program provides approximately 80% community based activities and 20% centre based activities with variations based on the needs of the individuals. The program serves seven people who are non-ambulatory and is equipped with a Wispa lift. The program has two vans and one is wheelchair accessible. Augmentative communication and sign language are used for people as required in the program. With most of the participants being young, the energy level is high at Futures! People are assisted in volunteer work and newspaper routes. Basic work skills are encouraged and people are referred to Supported Work Programs as required. Educational groups and programs are offered for social and life skills. Bowling, swimming and music are just some of the routine recreational activities.
Some examples of services under the Individual Support Network are:
A contract is
established for each service with individual goals stipulated.
Home Share Program:
To expand the range
of residential options available within our array of services, Kardel developed
a home share program. Kardel recruits, screens, matches and monitors people who
choose to support people with disabilities within their home or in a suite in
their home. A coordinator is available to provide ongoing consultation.
Adults are referred to our services by Community Living British Columbia (CLBC) and meet their criteria for eligibility:
Children over the age of six, and youth are referred to our services by Ministry for Children and Family Development, Community Living Services Branch and meet the same eligibility.
Kardel serves people regardless of race, ancestry, political belief, religion, marital status, age, physical or mental disability, marital status, socio-economic status, political affiliation, gender, sexual orientation or criminal or summary conviction with the primary consideration being the ability to meet the needs of the person and the best fit with the other people within the home or program.
Services centre on individual needs and encompass social, physical, spiritual, cultural and psychological aspects of each individual. We aim at supporting people to maintain positive contact, involvement and participation with their family, community and culture.
CLBC refers potential people for service. With individualized funding, people may apply for service directly. Decisions about acceptance into the homes/program operated by Kardel are collaborative decisions among the person requesting service, their family, CLBC, Kardel administration and the program manager. The managers and the staff members of the home/program are most aware of the needs of the existing people supported in the homes and are in a good position to provide input and help determine the fit of a potential new person.
The CLBC analyst for Kardel is informed of openings or potential openings as soon as possible by Kardel Director of Programs and Quality Assurance.
For the homes and programs, people with the most urgent need for placement, as determined by CLBC, will be considered first. Only after the person with the greatest need is deemed to be an unsuitable match will the next person be considered. If all candidates on the short list have the same degree of urgency, consideration will be given to the best fit based on personality, temperament, and match with the other people in the home. A guiding principle is that only people who can be accommodated in a safe and secure fashion with the resources available will be considered. This may require negotiations with CLBC based on the individual needs of the person entering the group home/program.
When potential candidate(s) are selected, the family, the person (if appropriate on a first visit), or people from the person’s support network view the home/program and meet the manager, staff members, and potentially the other people in the home/program. This may occur over one or several visits, depending on the needs. In the programs, the analyst may have the manager contact the person and family/caregiver directly.
If the person and family/caregiver wish to proceed further, the manager will complete the profile, admission form with either the person or their family or caregiver and begin the process of information gathering to make a more informed decision regarding the appropriateness of the placement. The admission checklist form is used as a guide.The manager will be the primary contact and address any questions that arise.
It is understood that at any time the person, their family or the Kardel manager may decide it is not in the best interest of the person or the other people in the home/program to proceed. It is incumbent upon the manager to provide a clear indication of the reasons for not proceeding to assist the worker, individual involved, and family with their search for an appropriate placement.
For ISN, people may approach the coordinator with the plan they have developed with a facilitator and the coordinator will work with them to develop the plan.
The transition process is individualized with utmost consideration to the needs of the person, the placement urgency, the needs of the other people served within the home/program, and the suitability of employees, resources and space to meet the person’s needs.
Our goal is to introduce the person to our services in a manner that is most suitable to their needs, and comfort. We create a welcoming atmosphere, which ensures the participation of the person in the home/program and fosters their understanding that our aim is to make the home and/or program work for them.
The manager arranges a meeting with the person referred, and family/caregivers or members of their circle of support to determine the most appropriate transition plan. The manager completes a written transition plan for clarity of communication. The transition plan addresses issues of timing, length of visits; support requirements on visits; communication during transition phase; health, safety and medication issues; introductions and needs of the other people in the home around the integration of a new person; personal belongings and their management during transitions; parameters to determine suitability of placement; alternatives if the visits are not successful and either the person/family or Kardel staff members do not feel it is an appropriate placement; supplies that need to accompany the person; and other related details that need to be worked out. The Interview/Photographs/Video Consent Form is discussed. A written behavioural plan is completed as required, with the input of the family and includes discussion about appropriate interventions during the transition. If necessary, a safety plan is developed. Families are also being informed about the policy and procedure manual for further information on our services. Our handbook is presented to the person referred and their family and any questions that arise from that are addressed.
Social history, relevant reports and medical history information are collected to understand the person’s social and cultural, emotional, spiritual and physical needs for service. If the person has a history of aggressive behaviour, a written behavioural plan is required that will be shared with staff members prior to the transition process and if necessary, a safety plan.
All people are required to present an up to date immunization record; a TB screening test; and a medical form stating that they are free of communicable diseases (including hepatitis) that would place staff or other people at risk or require special precautions.
Before the person moves in permanently to the homes, banking arrangements, health care benefits, consent for health care procedures, and an inventory of personal belongings are completed. An individualized person centred plan (for children and youth, a comprehensive plan of care (CPOC) , individual care plan (within one month) and a health care plan will be developed for the person. We have an orientation checklist for new people entering the services. Measurable goals are established within three months of a person entering the home/program. The Manager informs the Director of Finance of the admission to arrange for accurate billing.
Visitors are welcomed and encouraged within the homes to improve the quality of life and decrease the possibility of social isolation for people supported. If desired by the person supported, a private location for a visit will be made available.
Kardel supports people as they grow older within their homes if their physical care needs increase. The aim is to ensure that people do not lose the stability and relationships established within the home because of increased needs for assistance. Generic services, such as hospice, are available to assist the system to support people remaining at home until death. Negotiations and advocacy occur on behalf of the person with CLBC to ensure adequate staff and equipment is in place to help the people we support.
Kardel also recognizes that people change and their needs and desires may also change. To remain sensitive to ongoing planning, a yearly update of the person centred plans, or in the case of children and youth, CPOC, is completed, reviewing the desires for the person in the year ahead. If the person expresses an interest in alternative living, an alternative day program or different services, CLBC is informed and the staff members will assist the CLBC facilitator in understanding the person’s needs, so a more suitable placement may be found. The person will be supported emotionally throughout the process and contact will be maintained during the transition period. An exit survey is completed to help us to understand the needs of people that leave our services. Aside from this yearly review, people may request a new placement/program at any time and this choice will be respected.
It may also become evident that the placement is no longer suitable from the standpoint of the system. Kardel aims to find an appropriate alternative first within our own system, which would ensure a smooth transition with potentially some continuity of staff relationships. If this is not possible, the facilitator will be asked, in writing, to seek out an alternative placement for the person, outlining the reasons why this is deemed necessary. A written discharge plan will be prepared for CLBC and the new service provider upon discharge from the service; or forwarded to the new service operated by Kardel. The manager will work with the new placement team to ensure a smooth transition. The summary would update the health care plans; summarize outstanding needs and issues; and provide information that would assist the new operator or program in meeting the needs of the person moving on. Our admissions form is passed on as an exit form with relevant information added.
1.D. 1: Rights
Our handbook outlines rights in plain language. Our library also contains a number of summaries of rights with pictures and, based upon the literacy and communication style of the person, the manager should seek out the best way to explain rights for comprehension. Under the community care facilities act, a document on the rights of persons supported must be posted in the home. The VIHA Bill of Rights is reviewed annually and this is tracked on the Person Centred Planning document. CLBC has circulated a guide “Rights and Safeguards: A guide for self-advocates”.
People have the following rights:
Services offered by Kardel are voluntary. People served by Kardel choose to use the services offered and are not forced to participate in the services. Kardel adheres to the basic assumption that adults with developmental disabilities are able to direct their affairs and make their own decisions. Adults have the right to self-determination to make decisions pertaining to their life.
It is incumbent upon staff members to provide information in plain language and in a manner the person understands to assist them with decision-making. People must be educated about the potential risks and benefits involved in decisions for informed decision making. For people to make decisions independently, facts must be provided, and coercion avoided.
In situations where the person is requesting, requires, or is agreeing to assistance with decision-making, family or advocates will be invited to participate with the person.
In situations where people have been judged by the Courts not to be capable, a Committee of the Person may be appointed to act on their behalf. In these situations, the Committee has the right to make all decisions pertaining to the person within the guidelines laid down in legislation. Our role as service providers is to ensure the Committee is involved in decision-making on the person’s behalf.
In situations where people have signed a Representation Agreement appointing a person(s) to be involved as their representative, the Representative ensures the wishes and values of the people are honoured. The Representative may make financial, legal, health or personal care decisions for the person. Our role as service providers is to involve the Representative in decision-making.
Consent to provide health care is sought by the professional providing the health care, including physicians, dentists, nurses, physiotherapists, psychologists, occupational therapists, optometrists, chiropractors and others. Our role as service providers is to provide information that may assist the professional. For example, service providers that are very familiar with the person may be able to clarify the person’s communication to assist the professional in assessing level of understanding of the treatment. Staff members should inform the practitioner when the courts have appointed a Committee and the name and phone number of that person for consent; or the name and phone number of Representative if a Representative Agreement is in place. Staff members should also provide the information on the appropriate Temporary Substitute Decision Maker if required.
The people supported their families and outside agencies entrust Kardel with important personal information. It is essential that staff members maintain the highest degree of confidentiality when they are dealing with personal information. Personal information is not shared outside the support team for the person.
Upon hiring, every employee must sign a “Confidentiality Agreement” (form kept in the forms book at the office under orientation). Long-term staff members will be requested to complete the agreement also so that a copy is on the personnel file. Confidentiality will be explained to the new employee and by signing, they are agreeing to maintain confidentiality, even after they have terminated their employment with Kardel. Violations of confidentiality seriously injure the reputation of Kardel and betray the trust of people receiving support. Breaches of confidentiality may result in discipline up to and including termination.
Staff members should be encouraging of people inquiring about the general well being of the person supported, but they must be careful not to speak on the person’s behalf or divulge any information that could be construed as private. An appropriate response to an inquiry may be an encouragement for the person to visit or phone the person. In this way the relationship is encouraged, the essence of the question is addressed, and confidentiality is maintained.
Peoples’ records are highly confidential and restricted for use by staff members who have a need to know, in order to provide high quality support. CLBC, Medical Health Officers and their delegates may access records when required to fulfill their obligations under the Community Care Facility Act and the Adult Care Regulations. As a service contracted by the CLBC, all records legally belong to CLBC.
When a situation arises where an individual asks a staff member to keep certain information confidential, it is expected that the staff person respect the request, except in situations whereby staff not sharing the information could result in that individual’s or someone else’s, health or safety being in jeopardy.
All people have access to their own records by requesting access from the manager. With the person’s permission, families and/or support network may also have access to the person’s records by request to the manager; in the case of children/youth, with the request through the social worker to the manager.
If a Representation Agreement is in effect, the Representative has the legal right to act on behalf of the person’s best interest and may make decisions pertaining to the release of information and access information on a need to know basis when the person supported is no longer able to give permission. A Committee appointed by the courts also has legal authority to make decisions on behalf of the person supported.
Relevant information concerning people being served may be shared with health care professionals and social service providers after obtaining the appropriate consents. The manager coordinates and is ultimately responsible for decision making around the release of information. The information shared relates to what is needed to provide high quality service. Consent for release for information should be signed on the approved Kardel Release of Information form, which stipulates the information to be released, to whom, and when the consent expires.
Kardel will make every effort to address the concerns of the people we support and stakeholders of our services in a comprehensive, timely, professional and sensitive manner. Complaints will not result in retaliation or barriers to service.
The people we support, families, employees, contractors, volunteers/students, advocates, and community members are encouraged to bring their concerns forward. The complainant is encouraged to speak directly to the person involved; however, in many instances this may not be possible or appropriate. For instance, if a person in the community expresses a concern regarding his/her conduct or that of the person being supported, the staff member should respond respectfully and request the complainant contact the Director of Programs and Quality Assurance, and provide the cards that employees carry for this purpose.
Kardel staff members must report any stakeholder complaint on the Conflict Resolution Form designed to track complaints and their resolutions.
With children supported, anyone who believes that the rights of a child or youth in care have been violated can make a complaint to the Ministry for Children and Family Development. The Ministry will attempt to resolve the concern through information and consultation. If the concern is not resolved in this manner, it can be submitted through the Ministry’s formal complaint resolution process, available from the social worker. If the complaint remains unresolved, the Children’s Commission has authority to hear and resolve the complaint.
It is the responsibility of all Kardel staff members to deal with
complaints in a prompt, effective, comprehensive and objective manner. Kardel
staff members are to inform any complainant of the Complaint Resolution
Process. All parties have a responsibility to deal with complaints with mutual
respect. Any private and personal information is disclosed only where it is
essential to the resolution of the complaint and is otherwise kept
confidential. All efforts at complaint
resolution will be guided by the following considerations:
·
Compliance with
applicable legal and other regulatory requirements
·
Compliance with
applicable Kardel policy
·
The best
interests of the person(s) being supported
·
Cultural
sensitivity and inclusion
·
General
principles of fairness and practicality
Anyone who may wish assistance with the presentation of a complaint may
contact the Director of Programs and Quality Assurance at the Kardel
administrative office (telephone: 250 382-5959 ext. 224; email Karen@kardel87.com)
1.E. 3: Compliance with Regulations
It is recognized that issues may arise where there are differences in the assessment of the best interest of the person served and the best methods for service delivery. Our goal is to work cooperatively whenever possible toward an acceptable resolution of the complaint. As service providers, however, we are required to meet standards for licensing, CLBC, health care plans developed by Health Services for Community Living, Ministry for Children and Families, accreditation, collective agreements, provincial and federal legislation and occupational health and safety. External bodies may have requirements that we are obliged to meet. Where these dictate the course of our actions, the details of the information will be provided to the complainant in writing for their information and consideration.
1.E. 4: Procedure
In situations of urgent health and safety concerns or rights violations, the complainant should make immediate contact with the Program Manager, whose contact information can be obtained through the administrative office. If the Program Manager is unavailable the Director of Programs and Quality Assurance (DPQA) should be contacted. Otherwise, the following steps apply.
Step 1: When a complaint is brought to the attention of a front-line staff member, he/she will:
q Listen to the concern and clarify the issue(s);
q Resolve the complaint if possible;
q Complete the Complaints Resolution Form.
q Forward the form to the Manager/PIC within two days of the complaint and if concerns remain, ensure the Manager has the necessary information to follow up.
Step 2: The Manager will meet with the complainant within seven days to:
q Verify whether or not a satisfactory resolution has been achieved
q If unsatisfactory, further explore the concerns and clarify the issues;
q Resolve the complaint if possible
q Within seven days, provide a written summary to the complainant as to the outcome and reasons for any administrative decisions taken with respect to the complaint resolution.
q Complete the Complaints Resolution Form.
q Forward the form and copy of the written summary (along with any pertinent supplementary information) to the Director of Programs and Quality Assurance within two days of the meeting.
Step 3: If the complaint is unresolved, the DPQA will follow up with the complainant within seven days of the Manager’s completed Complaints Resolution Form
q The DPQA will review the Complaints Resolution Form and related information
q Contact the complainant; the DPQA may propose the participation of an independent third party (e.g. CLBC analyst)
q Resolve the complaint if possible
q Provide a written summary of the issue, conclusions and reasons to the complainant within seven days of their meeting/discussions.
Step 4: If the complaint remains unresolved after Step 3, the complainant will be advised that an external review will be required and the complainant will be provided with the following contact information for their follow-up; a person supported or their families always have the option of approaching the following directly.
CLBC Regional Quality Service Office (250) 952-4067
Community Care Facilities Licensing Branch (250) 475-2235
Advocate for Service Quality: Enquiry B.C. (604) 775-1238
The BC Human Rights Commission (250) 387-5102
Public Trustee (250) 356-8160
Child and Youth Officer for BC (for people under 18) (250) 356-0831
The Ombudsman of BC (250) 387-5855
Information and Privacy Commissioner (250) 387-5629
Patient Care Quality Office (250) 370-8323
Kardel representatives will make themselves available and provide relevant documentation to third party investigators/mediators in support of a final resolution. Complaints will not result in retaliation or barriers to service.
1.E. 5: Complaints in the community
If a person in the community complains to a staff member about their conduct with a person they are supporting, the staff member should provide them with a special business card designed for this purpose with directions for them to follow up. Staff members should not argue with a person in the community.
1.E. 6: Tracking Complaints
Managers of each home/program keep a file for all complaints received, as does the Director of Programs and Quality Assurance. The DPQA is responsible for an annual review of complaints and identification of trends with respect to complaints, outcomes, resolutions process and recommendations. This review will occur as part of the planning phase for the annual strategic planning session. Our goal is to ensure that we create a community that is receptive to people with disabilities. Action taken to address complaints will be reflected in our annual Continuous Quality Improvement Plan.
1.F. 1: Hiring
Kardel works towards hiring exceptional employees who are committed to people with developmental disabilities. Employees are required to have relevant education i.e. community support worker certificate; resident care aide/home support worker certificate; licensed practical nurses certificate; university degree or college certificate in the human services field; or relevant experience. All candidates submit a resume and an employment application. Two work related and one personal reference are checked. Prior to hiring, the following documentation is submitted and checked:
Three managers complete the interviews and make the decision prior to proceeding to hire. The recruiter is permanently on all hiring panels for consistency and for processing documents, checking references and touring new staff members through the homes/programs to arrive at the best match for staff members and homes/programs. Employees serve a probationary period for the first three calendar months of continuous service or 520 hours of part time or casual hours. A Performance Evaluation is completed prior to the completion of the probationary period minimally. No staff member works alone on night shift until a performance evaluation has been completed. Employees may be oriented up to three shifts in each home in which they are registering to work where they are supernumerary to the staff members. They may be brought in for an additional five shifts outside the rules of seniority to give them additional experience if required.
Managers receive a manager’s orientation and a Manager’s manual. Kardel encourages managers to complete the Management Development for Residential Settings Certificate Program offered by the Justice Institute.
Each home and program is monitored by a variety of sources to ensure high quality service is provided within our organization and that safeguards are in place for the protection of the people we serve.
1.F. 2: Internal Monitoring
Direct care employees are responsible for monitoring the quality of service provided within the home and for bringing concerns to the attention of the manager.
Employees are oriented to the philosophy of the company and to the need to protect and empower the individuals they support. The manager is responsible for monitoring staff members with respect to their performance of their duties and their conduct. The manager is responsible for completing annual evaluations and the Director of Human Resources is responsible for completing annual evaluations of managers.
All persons visiting, or involved with the people served i.e. relatives, advocates, day program staff members etc., are welcome to offer feedback regarding service quality through the manager and also receive an annual survey regarding the quality of service.
1.F. 3: Community Living
CLBC is the funding agency of the services operated by Kardel. Each home has an assigned analyst who is responsible for overall monitoring of the home. CLBC stipulates expectations for reporting to the homes/programs and monitors for compliance. CLBC has established guidelines for the use of behavioural techniques. All children and youth have an assigned social worker through Ministry for Children and Family Development, Community Living Services Branch. The social worker ensures youth have information about their rights, including how the contact the Child, Youth and Family Advocate.
1.F. 4: Community Care Facilities Act
In a licensed home (i.e. three or more people) a licensing officer is responsible for ensuring that the home operates according to the regulations pertaining to the Community Care Facilities Act. A licensing officer and nutritionist will visit the home periodically for inspection and review of operating procedures. The “Incident Report for Community Care Licensed Facilities forms” is to be used in accordance with the instructions printed on the forms. A copy of this form is also sent to the CLBC representative.
Written staff logs and communication books kept within the homes/programs are legal documents and may be reviewed by the licensing officer. They may also be subpoenaed in a court of law.
1.F. 5: Workers Compensation Act
Kardel has an Occupational Health and Safety Committee and representatives for occupational health and safety issues in each home as required by the Workers Compensation Act. The goal is to monitor workplace health and safety and put in place procedures and protocols to reduce risk. Monthly statistics are submitted to the committee from each home and quarterly reviews are done within the homes. The committee visits each home annually. Kardel works with Worker’s Compensation Board to put work place safety programs into place.
1.F. 6: Fire Inspections
Fire inspections occur at least annually, and fire extinguishers and sprinkler systems are inspected according to established standards.
1.F. 7: Pharmacist Review
The pharmacist and the Medication Safety and Advisory Committee review the management of medications within the homes annually.
1.F. 8: Policy, Procedure and Other Manuals
A detailed Policy, Procedure and Personnel Manual is available at every home and program site offered by Kardel. This may be consulted for more detailed information. Each home and program also has a Fire and Emergency Manual, Infection Control Manual, Workplace Hazardous Materials Information System (WHMIS) sheets, HEU Collective Agreement, Medication and Van logbook, Violence Protection: Guide for the Prevention of Violence in the Workplace, a Field Guide on Death and Dying, and Occupational Health and Safety Manuals. The most appropriate support person i.e. manager, key worker, family, would be available to explain the information, assist the person emotionally through the process, and to record any disagreements the person has with the information contained within.
1.F. 9: Miscellaneous
All people are weighed monthly and weights are recorded and monitored. Charting of bowel movements and menstrual cycles are completed when people are unable to monitor their own health. Charting of seizures is done according to Health Care Plans. There is a night shift buddy system whereby employees phone during the night to another house to ensure all is well.