Order of Contents

Order of Contents...........= ...........................................................................= ......................................... ............................... 1

4. A.: Prevention of Critical Incidents

4.A. 1: Overview.............= ...........................................................................= ...........................................................................= 4

4.A. 2: External Authorities and Legislation.................................................................= ......................................................... 4

4.A. 3: Occupational Health and Safety Committee.................................................................= ............................................ 4

4.A. 4: External Inspections and Equipment maintenance:..........................................= ......................................................... 4

4.A. 5: Health Services for Community Living (HSCL) Backup..........................................= ................................................ 5=

4.A. 6: Working Alone........= ...........................................................................= ........................................................................ 5

4.A. 7: Prevention of Release of Vulnerable Adults to High Risk Situations..........................= .............................................. 5

4. B. Protection from Abuse..........= ...........................................................................= .......................................................... 6

4.B. 1: Whistle Blower Protection: .....................................................................= .................................................................. 6=

4.B. 2: Definitions of inappropriate and abusive conduct..........................................= ........................................................... 6

4.B. 2. a): Bullying.........= ...........................................................................= ...........................................................................= .. 6

4.B. 2. b): Physical Abuse...= ...........................................................................= ....................................................................... 7

4.B. 2. c): Sexual Abuse.....= ...........................................................................= ......................................................................... <= /span>7

4.B. 2. d): Verbal Abuse.....= ...........................................................................= ........................................................................ 7

4.B. 2. e): Emotional Abuse..= ...........................................................................= ...................................................................... 7

4.B. 2. f): Humiliation......= ...........................................................................= ...........................................................................= 7

4.B. 2. g): Retaliation......= ...........................................................................= ...........................................................................= . 7

4.B. 2. h): Financial or other Exploitation.................................................................= ............................................................ 7<= /o:p>

4.B. 2. i): Neglect..........= ...........................................................................= ...........................................................................= ... 7

4.B. 2. j): Unauthorized Restrictive Procedures.................................................................= ................................................... 7

4.B. 2. k): Harassment.......= ...........................................................................= ......................................................................... <= /span>7

4.B. 3: Legal Responsibilities..........................................................................= ...................................................................... 8

4.B. 4: Alleged: Abuse, Critical Incidents, Misuse of Funds or Assets,

&nbs= p; or Health = and Safety Risks: Reporting and Follow up..........................................................................= ................ 8

4.C. Reporting of critical incidents.................................................................= .................................................................. 9=

4.C. 1: Licensed Programs: Reportable Incidents to Vancouver Island Health Authority (VIHA)...................................... 9

4.C. 2: Licensed Homes: Reportable Incidents to CLBC = ...........................................................................= ......................... 10

4.C. 3: Other Programs: Reportable Incidents.........= ...........................................................................= .................................. 11

4.C. 4: Minor Incidents or Injuries relating to Person Supported..........................................= ............................................... 11=

4.C. 5: Vehicle and Property Damage.....................................................................= ............................................................... 12

4.C. 6: Annual Review........= ...........................................................................= ........................................................................ 12

4.C. 7: Work Related Staff Injuries.....................................................................= ................................................................... = 12

4.C. 8: WCB Forms............= ...........................................................................= ........................................................................ 13

4.C. 9: Accident Investigation Report...................................................................= ................................................................ 13<= o:p>

4.D: Infection Control, Standard Precautions.................................................................= ................................................ 13

4.D. 1: Infection Control and Universal Precautions..........................................= ................................................................... = 13

4.D. 2: Influenza Immunization and Control of Influenza Outbreaks..........................................= ......................................... 14

4.D. 3: Communicable Diseases= ...........................................................................= ................................................................. 15=

4.D. 4: Staff Responsible for Reporting Communicable Diseases..........................................= .............................................. 15<= /p>
4.D. 5: Scabies Protocol.....= ...........................................................................= ......................................................................... <= /span>16

4.D. 6: Head Lice............= ...........................................................................= ...........................................................................= . 17

4.D. 7: HINI.................= ...........................................................................= ...........................................................................= ... 18

4: E: First Aid Procedures.................................................................= ...........................................................................= ...... 19

4.E. 1: First Aid Procedures.= ...........................................................................= ...................................................................... 19

4.E. 2: Human Bites..........= ...........................................................................= .......................................................................... = 20

4.E. 3: Hot and Cold Compresses4.E. 4: Emergency Survival Kits and First Aid Kits..........................................= .................................................................... 21

4.E. 5: Essential Information for all Staff Members..........................................= .................................................................... 21

4.E. 6: Managing Medical Situations for people supported..........................................= ........................................................ 22<= /o:p>

4. F: Fires.........= ...........................................................................= ...........................................................................= .............. 22

4.F. 1: Fire and Emergency Drills.......................................................................= ................................................................... = 22

4.F. 2: Fire Evacuation Procedures......................................................................= .................................................................. 2= 2

4.G.: Evacuation..........= ...........................................................................= ...........................................................................= ... 23

4.G. 1: When evacuation is appropriate..................................................................= .............................................................. 23

4.G. 2: Complete evacuation from the physical facility..........................................= .............................................................. 23

4.G. 3: The safety of evacuees..........................................................................= .................................................................... 23

4.G. 4: Accounting for all persons......................................................................= ................................................................... = 24

4.G. 5: Evacuation: Emergency Accommodations.................................................................= ................................................ 24

4.G. 6: Emergency Notification of Authorities.................................................................= .................................................... 24

4.H: Continuation of Essential Services during evacuation ..............................= ........................................................... 25

4.H. 1: Medication Disaster Supplies ...................................................................= ............................................................... 25

4.H. 2: Adaptive Equipment...= ...........................................................................= ................................................................... = 25

4.H. 3: Medical and Health Information..................................................................= .............................................................. 25

4.H. 4: Service Plans........= ...........................................................................= ...........................................................................= 25

4.H. 5: Personal Possessions.= ...........................................................................= ..................................................................... 25

4.H. 6: Emergency Staffing...= ...........................................................................= ...................................................................... 25

4.H. 7:Communication Headquarters during a Disaster..........................................= .............................................................. 25

4.H. 8: Out of Province Contact4.H. 9: Emergency Phone Numbers

4.I. Emergency Procedures ..............................= ...........................................................................= ....................................... 26

4.I. 1 a): Bomb Threats..........................................= ...........................................................................= ..................................... 27

4.I. 1 b): Natural Disasters..........................................= ...........................................................................= ............................... 29

4.I. 1 c): Snow Storms..........................................= ...........................................................................= ...................................... 29

4.I. 1 d): Utility Failures..........................................= ...........................................................................= ................................... 29

4.I. 1 e): Medical Emergencies..........................................= ...........................................................................= .......................... 29

4.I. 1 f): Violent, Aggression or= other Threatening Situations..............= ...........................................................................= ...... 30

4.I. 1 g): Sentinel Events..............................= ...........................................................................= ............................................... 31=

4.I. 1 h): Biohazardous Material Incidents...........................= ...........................................................................= ...................... 32

4.I. 1 i): Lightning ..........................................= ...........................................................................= ............................................ 32

4.I. 1 j): Missing People..........................................= ...........................................................................= ................................... 32

4.I. 1 k): Suicide Prevention..........................................= ...........................................................................= .............................. 32

4.I. 1 l): Tsunamis..........................................= ...........................................................................= ............................................. 33
4.I. 1 m): Weapons..........................................= ...........................................................................= ........................................... 33

4.I. 2: Emergency Drills and Safe= ty Education for the People we support.= .......................................................................... = 34

4.J: Hospital Admission Procedur= e..........= ...........................................................................= .............................................. 34<= /span>

4.J: 1: Planned Admission to Hospital...................................................................= ............................................................... 34

4.J: 2: Emergency Admission to Hospital.................................................................= ............................................................ 34=

4.J: 3: Exceptional Considerations......................................................................= ................................................................... = 35

4.K: Death of a Person Supported= ..........= ...........................................................................= ................................................ 35

4.K. 1: Unexpected Death.....= ...........................................................................= ..................................................................... 35

4.K. 2: Anticipated Home Death..........................................................................= ................................................................. 35=

4.K. 3: Duties after Death...= ...........................................................................= ....................................................................... 36

4.K. 4: Memorial Services....= ...........................................................................= ...................................................................... 36

4.L: Annual Competency Based Tra= ining.........= ...........................................................................= ...... 37

4.L. 1: Overview.........................= ...........................................................................= ................................................................ 37<= o:p>

4.L. 2: Health and Safety Practices......= ...........................................................................= ....................................................... 37

4.L.3: Unsafe Environmental Practices......= ...........................................................................= ................................................. 37

4.L.4: Emergency Procedures................= ...........................................................................= ..................................................... 37<= /span>

4.L.5: Evacuation procedures...............= ...........................................................................= ...................................................... 37=

4.L. 6: Identification and Reporting of Critical Incidents.................................................................= ..................................... 37

4.L.7: Medication Management..........................................= ...........................................................................= ....................... 37

4.L. 8: Reducing Physical Risks..........= ...........................................................................= ....................................................... 37

4.M: Release of a Person Supported<= span style=3D'mso-tab-count:1 dotted'>..........................................= ...........................................................................= ............ 38

4.M.1: Overview............................= ...........................................................................= ............................................................ 38=

4.M. 2: Restrictions or prohibition by a court order or an order under an enactm= ent..........................................= ................ 38

4.M. 3: Health , safety or dignity risks.= ...........................................................................= ..................................................... 38<= /span>

4.M. 4: Form Part 6: 78 Residential Care Regulations................................................................= .......................................... 38
4.A. Prevention of Critical Inc= idents:

4.A. 1: Overview

Kardel is committed t= o a safe and healthy environment for the people we support and our employees.

4.A. 2: External Authorities

The Occupational Heal= th and Safety (OH&S) Regulations of the Workers’ Compensation Act apply = and a copy of the regulations is available in every home and program. (Cross reference other legislations: 2.F.5)

A copy of the Communi= ty Care and Assisted Living Act and Regulations is kept in the Kardel office. Regulations are at every home. “Meals and More” which outlines licensing nutrition and food safe requirements is available in each home and program.

4.A. 3: Occupationa= l Health and Safety Committee

The OH&S Committee consists of a minimum four members: two union representatives, and two empl= oyer representatives. Other representatives may be appointed by mutual agreement. Meetings are held monthly. Employer representatives and union representativ= es alternate role of chair and secretary on a bi-annual basis. The OH& S committee is respons= ible for spotting trends, ensuring corrective action and monitoring the success = of training.

Each site has an OH&a= mp;S representative. The representative is responsible to the OH&S Committee= for monthly statistics of work related injuries and in conjunction with the pro= gram manager, is expected to follow-up with accident investigations. On a quarte= rly basis, OH&S representatives, in conjunction with the program manager, a= re responsible for workplace inspections, completion and submission of the for= m. This is to occur in January and July on day shift, and in April and October= on afternoon shift. Night shift staff will be requested to complete the semi-annual worksite safety inspection form in April and in October. Ensuri= ng follow up of the recommendations is the joint responsibility of the representative and the manager. The committee will review all inspections a= nd if on-site inspection is required, the committee will follow up.

The work place inspec= tions, accident investigations and collection of data are to be completed during normal working hours. If this is not possible, time required is to be appro= ved by the program manager/person in charge (PIC). Committee members and progra= m representatives shall be granted leave without loss of pay, or receive straight time regular wages, to participate in the OH&S committee activities as per collective agreement. The representative and the program manager will normally carry o= ut investigations jointly.

The Occupational Heal= th and Safety Committee will receive annually an average of eight hours of trainin= g as required under the Act.

4.A. 4: External Inspections and Equipment maintenance

Inspections are condu= cted by the local fire department of the homes, minimally, once per year. Licensing conducts inspections every 18 months. BC Housing conducts annual inspection= s. Building inspections may also be completed. A copy on inspections should be forward to Central office of all external inspections to the attention of Director or Programs and Quality Assurance.

Managers/PICs arrange= annual servicing of fire extinguishers and the sprinkler system. B.C. Housing Homes i.e. Amelia, Hillside, Lakes, Paskin, Patterson= , have fire extinguishers maintained by B.C. Housing and their sprinkler syst= ems maintained by Western Canada Fire Inspection in June of each year. The owner maintains Sentinel’s equipment. Griffin= maintains all other sprinkler systems in September, October or November.

For Fire Extinguisher= s,

Home/Program           &nb= sp;           Supp= lier of Service     &nb= sp;            =            Annual maintenance

Henry             =             &nb= sp;            = Sidney Fire Equipment     &nbs= p;                 &= nbsp;   October

Maryland   &nb= sp;            =             &nb= sp;     Sidney Fire Equipment     &nbs= p;                 &= nbsp;   November.

Tillicum         &= nbsp;           &nbs= p;            &= nbsp; Crest        &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;      January

Dustin         &= nbsp;           &nbs= p;            &= nbsp;    Victoria Fire Equipment     &nbs= p;            &= nbsp;      October.

Futures         &= nbsp;           &nbs= p;            &= nbsp;         &= nbsp;   Crest        &= nbsp;           &nbs= p;            &= nbsp;              &= nbsp;   June.

Office            =             &nb= sp;            = Capital        &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;    April

The following are tes= ted monthly by the manager or designate and results recorded on “Monthly/Yearly check records” form: Ground Fault Breaker; Smoke Alarms; Fire extinguishers

4.A. 5: Health Services for Community = Living (HSCL) Nursing Back Up

Back up nursing suppo= rt is available for the people registered with Health Services for Community Livi= ng. HSCL Nurses may be reached from 8:00 A.M. to 12:00 P.M. (numbers posted by phone in homes) and through the emergency department at Royal Jubilee Hospi= tal from 12:00 P.M. to 8:00 A.M. to provide nursing services according to health care plans/protocols. HSCL Nurses should be informed of hospital admissions= . It is written in the health protocols when they need to be called.

Policy Group:    &nbs= p;      Health and Safety

Issued:     = ;            &n= bsp;    1998

Revised:    &nbs= p;            &= nbsp; December 2000, May 2002, April 2007

Reference:         &= nbsp;      Occupational Health and Safety Regulations: Workers’ Compensation Act; Article 11.= 14 (b)

4.A. 6: Working Alone

Employees are not eli= gible to work alone on night shift until after the completion of their first perform= ance evaluation where they meet expectations, which is to take place between 30 = and 120 hours of work.

Homes have developed = the following “buddy” system to assist with monitoring the safety a= nd security of staff members working alone. Employees in the following homes p= hone each other throughout the night:

Maryland/Sentinel; Amelia/Henry; Dustin/Tillicum; Hillside/Paskin; Sentinel/Patterson; Lakes/Paskin. Schedules for calls a= re established by the manager based on the needs of the home.

A night call-in sheet= is to be used to record calls with the date and time. The schedule of phone calls= is arranged between “buddy” homes. The employee is to phone “buddy” home and document the time and response. If there is no answer, dial again. If there is no response a second time, wait another 5 minutes and call again. If there is no response on the third attempt, call = the non-emergency number of the police station and request that they check on s= taff working alone, leaving your phone number for follow up. Night staff should carry the cordless phone on their person while attending to the people supp= orted to ensure they answer the phone promptly.

Ensure the police re-= contact you or have buddy home contact you to ensure all is in order.

In the event of injur= y, illness or incapacity, use the staff callout list or, if no one is availabl= e, contact the manager, or Directors or CEO to have staff relieved. The Direct= ors and CEO’s home phone numbers are listed on the yellow sheet in each h= ome. Staff members are to exercise due caution to ensure they do not place themselves in situations of risk when they are working alone. Exercise judg= ment re: risks/benefits of your actions. For example, avoid standing on a stool = to reach a high item when you are alone. However, if inadequate lighting is po= sing a safety risk, change the light bulb using caution.

Policy: Group:    &nb= sp;            =          Health and Safety

Issued:     &nbs= p;            &= nbsp;           &nbs= p;       March 1998

Revised:    &nbs= p;            &= nbsp;           &nbs= p;     September 2000; November 2002; May 2007

Reference:     &= nbsp;           &nbs= p;            &= nbsp; Workers’ Compensation Board 4.21, 4.22, 4.23

4.A. 7: Prevention= of Release of Vulnerable Adults to High Risk Situations (cross reference 4.L.8)=

Kardel’s admission form asks for the name(s) of any individual legally restricted or prohibited from accessing the person in care or whom there is the belief th= at the person may pose a risk to the health, safety or dignity of the person in care. Staff members are alerted to the need to protect vulnerable adults. Individual plans are developed in conjunction with CLBC to inform staff members/home share providers of the appropriate protocol.

4.B. : Protecti= on from Abuse:

We are committed to protecting the people we support and the staff members within our services = from abuse as outlined in the definitions of inappropriate and abusive conduct below. Kardel wants every staff member to feel safe and comfortable in his = or her work environment. Abuse may take many forms and due diligence is requir= ed by all staff members. We protect

Ø      Against mis= use of funds or assets;

We ensure:

Ø      That people= are not exposed to health and safety risks that they do not choose to take;

Ø      That people= are not exploited for the gain or pleasure of others;

Ø      That people= are not humiliated because of their disability; and

Ø      That people= are not neglected from having their physical, emotional, social or spiritual ne= eds met.

4.B. 1: Whistle Bl= ower Protection:

No person we support = or their families/advocates or staff members will receive any negative retaliation o= r be denied any service because of reporting abuse, suspicion of abuse, or a con= cern or complaint.

4.B. 2: Definitions of inappropriate and abusive conduct:

<= /span>

4.b.2 a): Bullying= at work is the repeated, malicious, health-endangering, mistreatment of one employee by one or more employees. = Bullying is usually defined as acts of verbal comments that could ‘mentally= 217; hurt or isolate a person in the workplace. Bullying usually involves repeat= ed incidents or a pattern of behaviour that is intended to intimidate, offend, degrade or humiliate a particular person or group of people.[1]

[1] Canadian Centre for Occupation Health and Safet= y

Bullying behaviours i= nclude, but are not limited to:

Ø      Gossip, or innuendo that is not true

Ø      Excluding or isolating someone socially

Ø      Intimidatin= g a person

Ø      Undermining= or deliberately impeding a person’s work

Ø      Physically abusing or threatening abuse

Ø      Removing ar= eas of responsibilities without cause

Ø      Constantly changing work guidelines

Ø      Withholding necessary information or giving out the wrong information=

Ø      Making joke= s that are ‘obviously offensive’ by spoken work or electronic means

Ø      Pestering, = spying or stalking

Ø      Yelling or = using profanity

Ø      Criticizing= a person persistently or constantly

Ø      Belittling a person’s opinion

Ø      Tampering w= ith a person’s personal belongings or work equipment

Ø      Displays of temper, tantrums or emotional tirades

Ø      Suggestions= or threats of negative job related consequences or job loss<= /p>
Ø      Blaming the person for errors and/or stealing credit for their work.<= /p>
<= /span>

4.B.2. b): Physica= l Abuse is the gratuitous or excessive physical force c= ausing pain or discomfort. It includes slapping or striking a person or any form of corporal punishment. Examples may include, but are not limited to such thin= gs as cold baths, aversive stimuli put on the tongue, corporal punishment, pushing, body or strip searches etc.

4.B.2. c): Sexual = Abuse is indulging in any form of sexual stimulation or sexualized behaviour

or comments with the = people we support; as well as unwelcome conduct of a sexual nature from staff memb= er to staff member. Sexual assau= lt is covered under the Criminal Code. Examples of sexual abuse may include but a= re not limited to masturbating a person supported, sharing erotica, making sexualized comments etc.

4.B.2. d): Verbal = Abuse is using words to attack, insult, intimidate or= defame a person’s character. Examples may include but are not limited to mak= ing derogatory comments, shouting or swearing, taunting, using phrases or tone = of voice which communicate emotional rejection or which is known to escalate t= he person emotionally etc.

4.B.2. e): Emotion= al Abuse is causing emotional pain and injury. Examples = may include but are not limited to ignoring emotions i.e. joy, fear, anger, sadness, disrespecting people’s moral and ethical choices etc.

4.B.2. f): Humilia= tion is the act of reducing to a lower status the val= ue of people in their own eyes or in the eyes of other people. =

4.B.2. g): Retalia= tion is getting revenge or getting even. Examples may include hurting someone because they have hurt y= ou; or punishing someone because they have levied a complaint about you. <= /o:p>

4.B. 2. h): Financ= ial or Other Exploitation is taking advantage of another person’s resources for your own advantage. Examp= les may include but are not limited to using the material possessions or financ= es of another for your own purposes; demanding work be done that is outside the realm of approved work programs that meet the exploiter’s needs rather than interests of the person or the program. Theft or fraud is also include= d as exploitation.

4.B.2 i): Neglect = is the failure to follow established procedures = and/or standards of safety or care, which could compromise the mental or physical well-being of another. Examples may include but are not limited to the fail= ure to complete oral hygiene programs, to delay personal care after a bowel/bla= dder accident, to misuse a person’s medications etc.

4.B.2. j): Unauthorized Restrictive Procedures: No restrictive procedure may be used without f= ormal authorization, the exception being immediate safety concerns. Examples of restrictive procedures may include but are not limited to locking a person behind a door so they can’t come out, placing a tray in front of them= so they may not move etc.

4.B.2. k) Harassme= nt is a form of discrimination defined as any unwel= come and/or demeaning conduct or comment based on race, colour, ancestry, place = of origin, political belief, religion, marital status, family status, physical= or mental disability, person’s body, attire, gender, sexual orientation,= age or unrelated criminal conviction that may detrimentally affect the team spi= rit or lead to adverse results in the home, program or service for the victim of the harassment. The Canadian Human Rights Code considers harassment to incl= ude also: displaying offensive or derogatory pictures; practical jokes which ca= use awkwardness or embarrassment; unwelcome invitations or requests; leering or other gestures; condescension or paternalism, which undermines self respect= and causes unnecessary physical contact.

<= /span>

4.B. 3: Legal Responsibilities

There exist provincia= l and federal statues and legislation that protect people’s rights. Examples where employer compliance is required include, but are not limited to, the = B.C. Human Rights Code; Community Care and Assisted Living Facilities Act; Child, Family, and Community Service Act; Workers Compensation Act. Violati= ons under these acts by employees will lead to investigation, disciplinary acti= on up to and including termination of employment. When it is believed that a criminal offense has been committed, the incident(s) will be reported to the police immediately.

<= /span>

4.B. 4: Alleged: Abuse (as noted in any of the defi= nitions above), Critical Incidents, Misuse of Funds or Assets, or Health and Safety Risks: reporting and follow up

<= /span>

Any incidents of obse= rved or suspected abuse, critical incidents, misuse of funds or assets, or health a= nd safety risks must be reported immediately to the manager/PIC or designate. = All reported incidents require preliminary inquiries be made by the manager/PIC= or designate to gain a brief overview of the situation and to determine the necessary course of action as outlined in our Policies and Procedures and/o= r in accordance with the Community Care Facilities Act, Child Welfare Act and the Policies and Procedures of C.L.B.C.

If the situation warr= ants reporting as outlined under the Community Care Facilities Act, Child Welfare Act or under the Policies and Procedures of C.L.B.C., reporting will be don= e by the manager/PIC or designate to the appropriate body promptly in the manner outlined within these Acts and/or Policies. (See Incident Reporting section 4.C.)Where there is ambiguity, the licensing officer should be contacted im= mediately by phone for clarification. Otherwise, the report should be mailed to Licen= sing. Once notification has been given to Community Care Facilities Licensing Officer, the Police or the C.L.B.C. official, the manager/PIC will proceed = in consultation with these officials. Managers/PICs help facilitate the interv= iews with the people supported and staff members as requested. Accurate, timely = and unaltered records are made available to the licensing officer, social worke= r or the police when requested. Every effort will be made to deal with the matte= r in the most expeditious manner and with full cooperation with outside bodies. =

Licensing Branch has = stated that they will make every reasonable effort to hold an investigation-planni= ng meeting with the licensee, facility manager and funding agency representati= ves to review the allegation of abuse and determine if a preliminary investigat= ion is required prior to contacting the police department. If the preliminary investigation determines that there is insufficient evidence, based on a balance of probability to substantiate the allegation of abuse, then the po= lice department is not contacted. If, at any point of the preliminary investigat= ion, it is determined that there is sufficient evidence to indicate a crime has = been committed, then the police department will be immediately contacted by licensing.

To assist the owner/o= perator in making timely decisions pertaining to employment status, the manager/PIC= is to record the basic details regarding the allegations and send a written re= port to the owner/operator as soon as possible and no later than 24 hours from t= he time they become aware of the incident and/or have suspended an employee. <= o:p>

The manager/PIC will = inform the person(s) accused of the allegation(s) immediately after the manager/PIC becomes aware of the incident(s). Depending on the urgency of the situation, his/her union representative will be requested to be present. The manager/P= IC may consult with the Director of Human resources or CEO if the situation warrants it. The manager/PIC without notice, but with pay may suspend the employee(s) from duty, for up = to one week, as the protection of the people supported during the time of investigation is paramount; or, given the nature of the incident, the manag= er may put restrictions on duties. Kardel internal inquiries to determine culpability and to make decisions pertaining to employee status, will occur during this one-week time period. This employer/employee process will not interfere with investigations being conducted by the police, licensing offi= cers or C.L.B.C.

If an incident involv= es a volunteer or student, the volunteer or student will be suspended during the time of the investigation.

Every attempt to resp= ect the confidentiality of the parties concerned and to ensure a fair process witho= ut undue assumption of blame or guilt is essential. Staff members and managers should maintain the highest standard of professional conduct avoiding gossip and rumour.

The manager/PIC will = inform the family of any investigation as early as practical within the process. T= he manager/PIC will let the family know that they will be kept informed throug= hout the process, and that safeguards have been put in place to protect their fa= mily member.

If the allegations pr= ove to be substantiated during the internal inquiries, the consequences will depen= d on the nature and extent of the abuse and/or infraction. Action taken may incl= ude:

Immediate termination of employment;

Suspension from duties for a pre-determined= time without pay;

A written reprimand with a copy sent to C.L= .B.C. representative and a copy placed on the employee’s file;

Failure to inform the manager/PIC of a possible abuse or infraction indicates that the witness may condone the abuse and this failure to report may in itself result in disciplinary action. The people we support will be informed of incidents th= at are reportable to the level of their comprehension using plain language.

            =             &nb= sp;

Policy Group:    = ;       Human Resources

Issued:     = ;            &n= bsp;    1992

Revised            &= nbsp;       October 2000; May 2001, June, 2001,December 2001, May, 2003; January 2006; September 2007: July 2009

References: =              Community Care Facilities Act; Community Care Facilities Programs: Policies and Procedures 5.3.76; Child Welfare Act; Child, Family and Community Service A= ct; Community Support Services Policy Manual: Part 2, Section 2; Subsection 3: Guidelines for Use of Behavioural Techniques Guiding Principles for Service Delivery: Community Living Services; B.C. Human Rights Code; Canadian Chart= er of Rights and Freedoms; Collective Agreement HEU

   = ;            &n= bsp;            = ;    Letter: November 23, 2001 from Chief Residential Care Licensing Officer<= /span>

4.C: Incident Reporting:

4.C.1: Licensed Programs: Reportable Incident= s to Vancouver Island Health Authority (VIHA)=

The Vancouver Island = Health Authority provides incident report forms.&= nbsp; Each licensed home will have a pad of incident report forms and “reportable incidents” are listed and defined on the inside of = the front cover of the pad. The attending staff member completes the form and the manager/PIC shall review = the information on the incident report form, sign it, and forward the white cop= y by mail, as soon as possible, to the licensing officer and Fax the Pink Copy to the Funding Agency (CLBC Analyst). In a situation where licensing investiga= tion will be required, phone the licensing officer immediately and report detail= s; or if after hours, leave a message on their answering machine. The yellow copy is retained on fil= e at the home and a fax is to be forwarded to the Kardel Office for the attentio= n of the Director of Programs and Quality Assurance who will review and forward = to the Director of Human Resources, the Nurse Consultant or the CEO as appropriate= .

In the case of childr= en and critical incidents, the after hours duty worker through MCFD must be notifi= ed at 250 310-1234 immediately.

Reportable Incidents:=

Aggressive/Unusual Behaviour: Aggressive or unusual behaviour by a person in care towards other persons, including another person in care which has not been appropriately assessed in the individual’s care plan.

Attempted Suicide;

Death;

Disease outbreak/occurrence above the incid= ent level beyond that which is normally expected;

emergency restraint;

Emotional abuse e.g. verbal harassment, yel= ling, confinement;

Fall: A fall of such seriousness experience= d by a person in care, as to require emergency care by a physician or transfe= r to a hospital;

Financial Abuse; The misuse of funds and as= sets of a person in care by a person not in care or the obtaining o fthe property and funds of a person in care by a person not in care without= the knowledge and full consent of the person in care or their substitute decision maker;

Medication error which adversely affects a = person in care or requires emergency intervention or transfer to hospital;

Missing/wandering;

Motor Vehicle Injury;

Neglect: The failure of a care provider to = meet the needs of a person in care (e.g. food, shelter, care supervision)

Other injury: requiring emergency care by a physician or transfer to a hospital;

Physical abuse: force that is excessive, or inappropriate to a situation involving a person in care by a person no= t in care

Poisoning;

Service Delivery Problems: Any condition or= event which could reasonably be expected to impair the ability to provide ca= re or which affects the health, safety or well being of persons in care;<= o:p>

Sexual Abuse: Any sexual exploitation, whet= her consensual or not;

Unexpected illness of such seriousness that requires a person in care to receive emergency care by a physician or transfer to hospital.

4.C.2: Reportable Incidents to CLBC

CLBC also requires the reporting of incidents that are not reportable to VIHA. In these situations= , a CLBC critical incident report is completed on the Form for “unlicensed homes and community inclusion activities and licensed homes for incidents n= ot reportable to licensing. They are given or faxed to the Manager, who forwar= ds to CLBC and Central Office.

Items to be reported = to CLBC on Critical incident form are as follows:

Use or possession of weapons: A situation in which an individual receiving service has, uses, or threatens to use an object as a weapon. Also, a situation in which a weapon is used by oth= ers to harm or threaten an individual receiving service. A weapon is any object being used to threaten, hurt or kill a person or destroy proper= ty. Weapons may be used to attach, defend, or threaten and included loaded= or unleaded firearms, knives, swords, mace, pepper spray, or their derivatives; and improper use of laser beams.

Use or possession of licit or illicit drugs= : The misuse or overuse of a legal substance for a non-therapeutic or non-medical effect; such as the over-indulgence in and dependence on alcohol or a narcotic drug. Also covers any use of an illicit substanc= e, or the use of a psychotropic drug without appropriate medical authorization.

Use of seclusion (which is not permitted in Kardel’s services): Separation of an individual form normal participation and inclusion in an involuntary manner. The person is restricted to a segregated area and denied the freedom to leave it. Seclusion is different from containment in that the person is left alo= ne. It is considered a prohibited practice as identified in the Behaviour Support and Safety Planning Guide of CLBC.

Use of Exclusionary Time Out; The removal o= f an individual from a situation and environment for a limited period of ti= me so as to prevent harm to him/her or others. It does not include positi= ve re-direction of a person to a safe, quiet place; it also differs from seclusion in that the person is not left alone. Exclusionary Time-Out = must be part of an approved Behaviour Support-Safety Plan, Each incident mu= st be reported and documented on an individual’s file.

Restriction of Rights: The removal of the individual’s access to activities. It does not include standard safety practices or reasonable house rules. Restriction of rights must= be part of an approved Behaviour Support-Safety Plan. Each incident must = be reported and documented on an individual’s file.

Communicable Disease: Any occurrence of an illness caused by a micro organism (bacteria, virus or fungus, parasite and transmissible from an infected person or animal to another person = or animal. Transmission can be by direct or indirect contact with infected persons or with their excretions (e.g. blood, mucus, semen) in the air, water, food, or on surfaces or equipment)

Biohazardous Accidents: An accident involvi= ng any material that can cause disease in humans or animals, or cause signifi= cant environmental or agricultural impact. Bio hazardous material includes viruses, fungi, parasites, and bacterial and their toxic metabolites; = as well as blood, other body fluids, and human tissues, cells or cell culture.

4.C.3: Hillside= , Futues Club, Individual Support Network, Home Share: Reportable Incidents

Kardel operates one h= ome, a day program, home share sitautions and an individual support network that a= re not licensed. Reporting requirements exist for reporting to the Funding Age= ncy, CLBC, and the Kardel Office. The form used is “Critical Incident Repo= rt for unlicensed Homes and Community Inclusion Activities.” For definit= ions of reportable incidents, see 4.C.1 and 4.C. 2.

4.C.4: Minor Incidents or Injuries rel= ating to Person Supported

All homes and program= s are to document minor incidents or injury on the form entitled “Minor Incident Report: Person Supported” which includes a description of the incident, and the manager’s/PIC’s comments. Where applicabl= e, the manager should make recommendations regarding corrective action and prevention of future incidents.

The following inciden= ts, when they do not warrant an incident report to licensing under VIHA or CLBC defi= nitions on their forms or defined above, are to be recorded:

Aggression

Self-abuse

Accidents/falls

Property destruction

The goal in completin= g the minor incident reports on aggression, self-abuse, accidents/falls, and prop= erty destruction is:

1.&n= bsp;      to monitor = new or emerging behaviours,

2.&n= bsp;      ensure a cl= ear plan of action is in place for addressing the issues,

3.&n= bsp;      evaluation = of the effectiveness of action taken for curbing the behaviour,<= /p>
4.&n= bsp;      determinati= on if environmental modifications are required or equipment needed,

5.&n= bsp;      a written r= ecord for communication and information among the staff team, administration and consultants if appropriate.

Any person that displays aggressive behaviour towards staff requires an external consultant to develop a behavioural plan. If a tracking system is included = in the behavioural plan, it is not necessary to complete the minor incident fo= rm. If falls are a frequent occurrence and tracked on the seizure record, it is= not necessary to complete the minor incident form.

Fax minor incident re= ports that involve physical aggression to Occupational Health and Safety Committee chair through Central Office where the person supported does not already ha= ve a behavioural plan, or where there is an indication of an accelerating patter= n. This ensures the committee is aware of any behaviours that place people at potential risk.

If corrective counsel= ing and/or discipline result from the incident a copy of the incident report is= placed on staff member’s personnel file.

Managers are responsi= ble for maintaining an incident report file, looking for emerging trends, and setti= ng in place corrective action as required. Minor incident reports are tracked company wide on the Occupational Health and Safety-Monthly Incident Statist= ics to ensure monitoring of compliance with reporting and to assess new and emerging problems within the company.

Policy Group:    &nbs= p;      Health and Safety; Reporting

Revised:    &nbs= p;            &= nbsp; June 2007; July 2009

Reference: &= nbsp;           &nbs= p; Administration Minutes, June 2007; Community Care Facilities Licensing Incident Report

   = ;            &n= bsp;            = ;    CLBC SE4.080 Critical Incidents Policy July 2009

4.C. 5: Vehicle and Property Damage

All homes and day pro= grams are to report vehicle and property damage on the “Vehicle and Property Damage form. The report will include a description of the incident and manager’s comments. Where relevant, t= he manager should make recommendations regarding corrective action and prevention of future incidents. A copy of t= he form shall be faxed to the office to the Directors. A copy will be placed on personnel file if the incident results in corrective counseling and/or discipline.

4.C. 6: Annual Revi= ew

A summary is complete= d of all incidents annually and reviewed for trends by the OH&S committee and CQI committee. A copy of the Annual Review of Incident Reports is forwarded to CLBC. The goal is to highlight any emerging trends within the company and to assist with highlighting training needs and resource allocation.=

Policy Group:    &nbs= p;      Health and Safety; Reporting

Revised:    &nbs= p;            &= nbsp; March 2005; August 2005, July 2006; May 2007; July 2009

Reference:    &n= bsp;           Com= munity Care Facilities Licensing

      =             &nb= sp;            = SE4.080 Critical Incidents Policy July 2009

4.C. 7: Work Relate= d Staff Injuries

The Blue Book is used to report all injuries, no matter how minor.<= span style=3D'mso-spacerun:yes'> It contains blank First Aid Report= s and the OH&S First Aid report tally sheet.

Each entry must conta= in the following:

q      = Full name of the injured worker

q      = The date and time of injury or report of illness=

q      = Date and time the injury or illness was reported= to the employer or employer’s representative

q      = Name of witnesses (print)

q      = Description of how the injury or illness occurre= d

q      = Description of the nature of the injury or illne= ss

q      = Description of the treatment given and any arrangements made relating to the injured worker

q      = Description of any subsequent treatment given fo= r the same injury or illness

q      = Signature of the attendant or person giving firs= t aid, and if possible, the signature of the worker receiving treatment.

q      = The manager or OH&S Rep signs the entry.

One form is completed= for each injury. The manager forwards the completed form to chair of the OH&= ;S committee, who reviews the form, initiates any further follow-up necessary,= and ensures the form is kept on the employee’s personnel file. The manager completes the Tally Sheet for each First Aid Report submitted with basic information on the Name of the Person injured, WCB Claim#, Date of Injury, = Type of Injury, Time/Lost and Comments. The OH&S representative gets the mon= thly statistics from this tally sheet. The tally sheet serves as an ongoing reco= rd maintained in the home/program for all injuries.

First Aid records for= an injury or illness must be kept for 10 years. The First Aid Records: Blue Bo= ok is a legal document, which can be used in a court of law.=

4.C.8: WCB Forms

Employer’s Report of Injury or Occupational Disease (WCB Form 7): This form must be completed by the manager/PIC= , or designate, and forwarded (by fax) to WCB within 72 hours. Information from the injured emplo= yee and/or from the Blue Book = may be used to complete the form. Any workplace injury that results in time loss or a visit to a doctor requires = the completion of a Form 7. The original completed Form 7 must be put on the Employee’s personnel file.

Application for Compensation and Report of Injury or Occupational Disease (WCB Form 6):=   It is the Employee’s responsi= bility to complete this form when applying for compensation through WCB for time l= oss due to work related injury.

4.C. 9: Accident Investigation Report

To be completed by the program manager and an Occupational Health and Safety (OH&S) Program representative. The investigation will attempt to determine the cause of an accident, which results in an employee’s injury. An accident investigation must be done for any incident that a Form 7 or Form 7A is completed. A copy of the investigation form is to be sent to the WorkerR= 17;s Compensation Board and the OH&S Committee. Information from the investigation will be used in developing corrective action to prevent simil= ar accidents in the futures.

4.D: Infection = Control, Universal Precautions (Standard Precautions) and First Aid

4.D. 1: Infection Control and Universal Precautions (Standard Precautions)

Universal precautions= are required at all times when coming in contact with feces, nasal secretions, sputum, saliva, sweat, tears, urine and vomitus. It is a strategy, which requires employees to treat body fluids and blood of all persons as potenti= al sources of infection, independent of diagnosis or perceived risk. It involv= es the routine wearing of gloves, other protective clothing, hand washing and = such infection control measures that are designed to place a barrier between potentially infectious blood and body fluids and the employees. =

The use of Universal Precautions will minimize the risk of transmission of infections e.g. HIV, = Hep B from person supported to employee, from employee to a person supported, f= rom one person supported to another, or from employee to employee. <= /span>

Universal Precautions= are intended to minimize transmission from sharps e.g. needles contaminated from infected blood or body fluids penetrating the skin and infected blood or bo= dy fluids splashing into the eye or other mucous membranes, onto broken skin or into a cut.

Specific Recommendati= ons:

1: Barrier Precaution= s: Gloves should be used whenever one has contact with blood or body fluids. T= hey are not necessary when staff members are feeding a person and no direct sal= iva contact occurs. Gloves are changed and hands washed after each contact. The employer will provide a variety of gloves in a range of sizes, latex or vin= yl, sterile and non-sterile. Masks for mouth-to-mouth resuscitation are availab= le. Non-porous waterproof dressings are available for employees with chapped or broken skin.

2: Hand Washing: Hand= s and other skin surfaces must be washed immediately and thoroughly if contaminat= ed with blood and body fluids. Hands must be washed after gloves are removed. Also, hands must be washed for general infection control after use of the bathroom and prior to contact. Hands must be washed before preparing or ser= ving food, and administering medications. Wet hands. Use soap. Wash for 20 secon= ds. Rinse. Dry. Turn off water with a paper towel.

3: Sharp Items: All s= taff members must take precautions to prevent injuries caused by sharp objects. Placement of clearly marked sharps containers for disposal of sharps as clo= se as practical to areas where sharps are being used must be in place. Full sh= arp containers must be replaced by the manager making arrangements with the loc= al lab. No one touches sharps after they are placed in the container.

A training video: “Infection Control for Community Care Workers” is in the Kardel library for loan.

4.D.2: Influenza Immunization and Cont= rol of Influenza Outbreaks

To help decrease the = risk of infection and complications for any vulnerable person that we serve, all st= aff members are strongly encouraged to be immunized against influenza each fall prior to the onset of influenza season. People living in the homes operated= by Kardel are generally immunized against influenza.

The Capital Health Re= gion Deputy Medical Health Officer and Manager, Disease Surveillance, as well as= the Canadian National Advisory Committee on Immunization recommend influenza immunization of health care workers.

Influenza immunizatio= n is provided to all employees at no cost through the Capital Health Region clin= ics or through individuals’ family physicians. The B.C. Ministry of Health will cover the cost of immunization for health care workers.

Staff members are req= uested to inform their manager of the date they were immunized. Managers are responsible for recording the immunization status of all staff members with= in the home/program.

Non-immunized staff m= embers may be excluded from work in the event of an influenza outbreak in a home or program with the recommendation from the Medical Officer of Health or their delegates under the authority of the Health Act Communicable Disease Regulations. Non-immunized staff members would not be able to work in anoth= er home or program that does not have an outbreak for at least 3 full days aft= er stopping work in the outbreak home or program. This time period will determ= ine whether or not they are incubating the virus as symptoms develop within 3 d= ays of exposure.

If non-immunized staff members do not wish to interrupt their work during an outbreak of influenza, they may be required to take an anti-viral medication (currently, amantadin= e) at their own cost for the duration of the outbreak, or, if they choose to be immunized against influenza, they need to take an anti-viral medication (currently amantadine) for only the first 14 days following their immunizat= ion, at which time the vaccine will provide adequate protection. Non-immunized s= taff members will be able to return to work when the outbreak is declared over by the local Medical Health Officer.

Influenza is spread i= n the following ways:

q      = Airborne, by tiny droplets of respiratory secret= ions

q      = Direct person-to-person contact

q      = Contact with soiled articles
q      = Virus persists in dried mucus for hours

If staff members beco= me sick during an influenza outbreak, they should remain off work for at least 5 da= ys or until the symptoms resolve completely, whichever comes first. This appli= es whether or not the staff member has been previously vaccinated or has taken anti-viral medication (amanatadine). Staff members will be requested to pro= vide documentation from their physicians indicating they are safe to return to w= ork.

Volunteers and practi= cum students who are not immunized will be excluded from involvement in a home/program during the time of an influenza outbreak.

The National Advisory Committee on Immunization released a consensus recommendation that those who suffered a moderate to severe Oculo-Respiratory Syndrome (ORS) in 2000/2001 should defer their influenza vaccination in the 2001/2002 flu seasons. Employees should consult their physicians for future years.

4.D. 3: Communicable Diseases

All people moving int= o a home are required to comply with the immunization program of the Ministry of Hea= lth and participate in its tuberculosis control program. People supported are screened prior to admission by their physician for communicable diseases to protect other people residing in the home and ensure adequate precautions f= or staff members

If a person is a know= n Hep B carrier, Kardel will arrange for a course of Hep B immunization to all employees and people supported who have regular contact and are therefore exposed at the work site. A full course of Hep B vaccine is given and consi= sts of three doses give at zero, six months and one year. The full course must = be given to provide adequate protection. Employers should be screened and asse= ssed for preconversion to determine need for a fourth dose.

To prevent the spread= of communicable diseases in a situation of a pandemic or a very serious diseas= e, the person who is sick would be encouraged and taught to avoid contact with other people in the home as much as possible. Group activities in the home = will be avoided, including meals, and the person will be served in his/her bedro= om. One staff member on each shift will be assigned duties to the person who is sick; however, he/she will continue to have duties in relationship to other= s in the home. A supply of masks is available in each home as a precaution in the early stages of flu.

Policy Group:    &nbs= p;      Health and Safety

Issued:     = ;            &n= bsp;    October 2000

Revised:    &nbs= p;            &= nbsp; August 2005; October 2005, October 2006

Reference:    &n= bsp;           Adu= lt Care Regulations 4 (3) (a) BC Pandemic Influenza Preparedness Plan: Annex I=

4.D. 4: Staff Responsibility for Repor= ting Infectious Conditions

Staff members are scr= eened by their doctor prior to employment by Kardel. Staff members who develop an infectious condition that require precautions to prevent transmission, have= an obligation to notify their manager/PIC. Failure to do so could result in discipline up to and including termination. Employers are responsible to minimize risk to people supported and staff members. Management may limit t= he work locations of an employee to ensure safety.

Policy Group:    &nbs= p;      Health and Safety

Issued:     = ;            &n= bsp;    October 2000

Revised:    &nbs= p;            &= nbsp; January 2002, May, 2002, June 2002

Reference:    &n= bsp;           B.C. Care Staff Influenza Immunization Policy: July 1, 2000; Letter October 16, 2000: Capital Health Region Deputy Medical Health Officer re: influenza immunization program for group homes; Letter November 8, 2001from P.R. Kendall, Provincial Health Officer

4.D. 5: Scabies Pr= otocol:

Scabies is an infesta= tion of the skin caused by a very small insect-like parasite called a mite.

Symptoms may include:=

Itchiness; Rash; Little blisters; Red spots; Red lines in the webs of fingers, inside = of the wrists or elbows, around the waist or on the breast in women and the genitals in men

Scabies is spread by extended, skin-to-skin, personal contact with an infested person.

Sharing clothes, towe= ls or bedding are less common ways of becoming infected with scabies. =

If a person has had s= kin-to skin contact within the last 4-6 weeks with an infested person, they must undergo treatment. Once the person is treated, the individual is no longer considered to be infected.

Procedure when staff = member or person supported develops symptoms:

Report to the manager or PIC immediately

Limit exposure to others i.e: person suppor= ted stays home from day program; no outings with public. Staff member and person supported limit exposure to others.

Person affected obtains diagnosis and treat= ment instructions from physician

Launder all clothing, bedding and towels in= hot (60 degree) soapy water or dry clean

Stuffed animals should be stored away from = human touch in sealed plastic bags for ten days

Thoroughly vacuum all upholstered furniture= and disinfect the home

Notify everyone that has come into skin-to-= skin contact with the symptomatic person within the past 6 weeks. They must= be treated as though infected. This should occur within a 24 hour period.=

Staff member may return to work 72 hrs after treatment of confirmed case.

Person supported may resume normal activiti= es 72 hrs after treatment of confirmed case

Procedure for Manager= once a case is discovered at group home or day program:

Manager or PIC contac= ts Kardel’s Director of Programs and Quality Assurance at Kardel

VIHA is contacted by Director of Programs a= nd Quality Assurance

Manager contacts staff members and others w= ho have been in skin-to-skin contact with symptomatic person(s) during pa= st 6 weeks.

Staff members who has been in skin-to-skin contact who chooses not to be treated within the 24-hour period, must remain away from the home for 6 weeks.

For day program, written notice is sent hom= e with program participants and staff members informing of single case advisi= ng treatment for people in skin-to-skin contact

Procedure for Manager= when two or more cases are discovered within 2 weeks at group home or day progra= m”

This is considered = an outbreak

Manager informs Director of Programs and Qu= ality Assurance at Kardel

VIHA is contacted by Director of Programs a= nd Quality Assurance at Kardel

Notice is given to staff members and stakeh= olders by Director of Programs and Quality Assurance at Kardel advising:=

That there is a scabies outbreak.

The group home will be off limits to visit= ors for 72 hours (three days)

Staff members working at the group home mu= st use stringent infection control precautions

The day program will be closed for 72 hours (three days)

Staff members, caregivers, visitors and fa= mily members must be treated before returning to day program. The form “Confirmation of Treatment: Scabies” must be submitted to= Manager.

If a staff member, visitor, caregiver or f= amily member does not the obtain treatment, they must remain away from the Kardel homes/programs for 6 weeks.

Policy Group:    &nbs= p;      Health and Safety

Issued:     = ;            &n= bsp;    May 2006

Reviewed:     &n= bsp;           May 2010

Reference: &= nbsp;           &nbs= p; B.C. Health Files Number 09 September 2003; VACL protocols; GHC protocols; VIHA Infection Cont= rol Manual Continuing Care Facilities Section 3: Precautionary Techniques<= /o:p>

4.D. 6: Head Lice:
Kardel follows the mo= st current information provided on BC Health Files.

Head Lice symptoms in= clude constant itching of the scalp. Lice are most easily identified by the prese= nce of silvery, oval shaped nits (the dead egg of the lice) in the hair. Live n= its can be difficult to spot as they are tan-coloured and blend in with the hai= r. Nits are the size of a sesame seed. They may be found glued tightly to stan= ds of hair very close to the scalp-commonly located behind the ears and at the back of the neck. Public Health nurses can provide education regarding the = life cycle of the head louse and outline proper treatment options.

Shampoo treatment: two shampoo treatments are required, 7-10 days apart. The second shampoo ensures the eggs that had not hatched when the first treatment occurred are killed.= The second treatment may be waived with verification that it is not required fr= om a health professional. Consult a pharmacist to help you select a shampoo. It = is necessary to remove nits following shampoo treatment. A nit comb, available= at pharmacies, is a fine-toothed comb used to remove dead head lice and nits attached to individual hairs.

Prevention of re-infe= station:

As head lice can spre= ad through close personal contact, it is important to inform the friends and family of anyone who is discovered to have head lice and has had close pers= onal contact. Head lice have little ability to move off the hair and do not pose= a risk of infesting others through casual contact with furniture or carpeting. The articles which are most likely to enable lice to move from one head to another are hats and other head gear, coat collars, scarves, combs, brushes= and hair ornaments. Items should be washed in hot water and put through the dry= er on a hot cycle. Those that cannot go into the dryer can be placed in a plas= tic bag for 10 days or placed in a freezer for 24 hours. There is no evidence to indicate that a major clean of the house environment is necessary or effect= ive in getting rid of head lice.

For people residing in licensed community care facilities, the shampoo has a drug information numb= er. Contact must be made with the physician for him/her to prescribe and have t= he shampoo added to the MAR sheets.

For people attending = one of Kardel’s programs, employees contact the family or caregiver of the infested individual and request that the individual not attend until the treatment with shampoo has occurred. Verification of proper treatment with = the shampoo must be confirmed in a telephone conversation between the Manager a= nd the person who assisted with the treatment.

If the person has had= close personal contact with others, the Manager informs the others and it is expe= cted that those individuals also undergo treatment.

Employees determine i= f any other individuals have regular interactions with the infested individual. T= hose individuals, their families, and/or caregivers will be informed of the infestation with a telephone call and request that they be extra aware and = on the lookout for symptoms of head lice over the next several days. The Manag= er sends a memo alerting all program participants, families and caregivers of = the diagnosed case ensuring the name is kept confidential. All employees with t= he program are informed.

If a person attending= the program lives with a person who has been diagnosed with head lice and they = have close personal contact, the person will be expected to receive treatment pr= ior to returning to the program. The person’s caregiver is to confirm treatment by phone with the Manager.

Policy Group:    &nbs= p;      Health and Safety

Issued:     = ;            &n= bsp;    April 2009

Reference: &= nbsp;           &nbs= p; B.C. Health Files Number 06 March 2007; Policy from Garth Homer Centre

4.D. 7 Exposure Control Plan in response to H1N1

<= /span>

Purpose: to reduce the impact on staff members and people supported of the H1N1 pand= emic

Responsibilities: The Occupational Health and Safety Committee will be monitoring company wide illnesses of people supported or staff members for an early alert system. A= ll staff members are responsible for reporting any signs and symptoms experien= ced to their Manager, or potential signs and symptoms with the people supported. Managers are to forward information to the OH&S Committee. Staff members are strongly encouraged to be vaccinated when the vaccine is available.

How severe is illness associated with 2009 H1N1 flu virus?
Illness with the new H1N1 virus has ranged from mild to severe. While most people who have been sick have recovered without needing medical treatment, hospitalizations and deaths from infection with this virus have occurred.

In seasonal flu, cert= ain people are at “high risk” of serious complications. This includ= es people 65 years and older, children younger than five years old, pregnant women, and people of any age with certain chronic medical conditions. About= 70 percent of people who have been hospitalized with this 2009 H1N1 virus have= had one or more medical conditions previously recognized as placing people at “high risk” of serious seasonal flu-related complications. This includes pregnancy, diabetes, heart disease, asthma and kidney disease.

About one-third of ad= ults older than 60 may have antibodies against this virus.

Within the homes, a r= isk assessment should occur based on the information available. Health care workers generally as a= group are considered higher risk than average. Many of the people supported have chronic medical conditions that would place them at higher risk.

<= /span>

How does 2009 H1N1 virus spread?
Spread of 2009 H1N1 virus is thought to occur in the same way that seasonal= flu spreads. Flu viruses are spread mainly from person to person through coughi= ng or sneezing by people with influenza. Sometimes people may become infected = by touching something – such as a surface or object – with flu vir= uses on it and then touching their mouth or nose.

What are the signs and symptoms of this virus in people?
The symptoms of 2009 H1N1 flu virus in people include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. A significant number of people who have been infected with this virus also ha= ve reported diarrhea and vomiting.

How long can an infected person spread this virus to others?
People infected with seasonal and 2009 H1N1 flu shed virus and may be able = to infect others from 1 day before getting sick to 5 to 7 days after. This can= be longer in some people, especially children and people with weakened immune systems and in people infected with the new H1N1 virus.
Take these everyday s= teps to protect your health:

Cover your nose and m= outh with a tissue when you cough or sneeze. Throw the tissue in the trash after= you use it.

Wash your hands often= with soap and water, especially after you cough or sneeze. Alcohol= -based hand cleaners* are also effective.

Avoid touching your e= yes, nose or mouth. Germs spread this way.

Try to avoid close co= ntact with sick people.

If you are sick with = flu-like illness, Centre = for Disease Control recommends th= at you stay home for at least 24 hours after your fever is gone except = to get medical care or for other necessities. (Your fever should be gone witho= ut the use of a fever-reducing medicine.) Keep away from others as much as possible to keep from making others sick.

Other important actio= ns that you can take are:

Follow public health = advice regarding avoiding crowds and other social distancing measures. =

Be prepared in case y= ou get sick and need to stay home for a week or so; a supply of over-the-counter medicines, alcohol= -based hand rubs,* tissues and other related items might could be useful and help avoid the need to make trips out in public while you are sick and contagious

<= /span>

If I have a family member at home who is sick with 2009 H1N1 flu, should I go = to work?
Employees who are well but who have an ill family member at home with 2009 = H1N1 flu can go to work as usual. These employees should monitor their health ev= ery day, and take everyday precautions including washing their hands often with soap and water, especially after they cough or sneeze. Alcohol-based hand cleaners are also effective.* If they become ill, they should notify their Manager and stay home. Employees who have an underlying medical condition or who are pregnant should call their health care provider for advice, because they might need to receive influenza antiviral drugs to prevent illness.

Communication: <= /o:p>

OH& S committee w= ill coordinate communication from Central office to ensure staffing coverage and adequate supplies in the homes and programs. A copy of the emergency staff = list is kept within the home program Fire and Emergency manual, with the binder = for on-call managers, and with central office as communication headquarters.

The chair of the comm= ittee will keep staff members informed of outbreaks within the company and travel limitations.

Day Programs:

For people supported = that attend day programs, communication should occur between the Manager and the= day program to ensure any outbreaks are reported to the home. Where the disease= is suspected, VIHA would provide direction regarding the necessity of program closures. We would comply with their direction.

If Futures Club is re= quired to close, staff members who have not been exposed to the H1N1 virus would be reassigned.

Families and Friends:=

Families and friends = should be informed of the status of the H1N1 pandemic within the home. In some situations, families may choose to take their family member home to avoid exposure. Good communication is essential.

Privacy Rights: =

The employer may ask = a sick employee how contagious he/she might be, and with whom he/she was in contac= t. Where an employee has fallen ill, it is also acceptable for the employer to inform other employees that he/she may have been exposed to an illness. Additionally, employers may be able to advise that there might have been an exposure in the workplace, without disclosing who had the communicable dise= ase.

4.E: First Aid Procedures

4.E. 1: First Aid Procedures: All staff members are required to have a curre= nt First Aid/CPR for Adult Care Workers Certificate from an approved course by= the Ministry of Health to be considered eligible to work. Kardel offers an appropriate training course four times a year for staff. The special projec= ts coordinator tracks certificates.

In the case of serious accident/injury to people supported or co-workers, attending staff members would commence first aid. Ambulance service (911) to the hospital is to be arranged if the severity of the incident requires emergency hospital assess= ment and/or treatment. Notify the manager as soon as practicable, and notify the person’s doctor. Employees are encouraged to err on the side of safet= y in calling for medical assistance.

If an ambulance is not required but medical assessment and/or treatment is required.

transportation may be arranged by phoning taxi cab if necessary. This number is posted by the pho= ne under emergency numbers. The taxi number will vary depending upon home/prog= ram location.

If there is adequate = coverage in the home to meet the needs of the other people in the home, one employee should accompany the person in the ambulance. The Kardel Client Profile and Transfer Form should be taken to the hospital with a copy of the most recent Medication Administration Record and any advanced health care plans. <= /o:p>

The manager/PIC or de= signate is responsible for notifying relatives and ministry staff and sending the incident report to licensing.

4.E. 2: Human Bites: First Aid

Human bites can be ev= en more dangerous than animal bites because of the types of bacteria and viruses contained in the human mouth. If someone cuts his or her knuckles on another person’s teeth, this is also considered a human bite.

If a human bite resul= ts in the skin being broken:

Stop the bleeding by applying pressure;

Wash the wound thoroughly with soap and wat= er;

Apply an antibiotic cream to prevent infect= ion;

Apply a clean bandage. If the bite is bleed= ing, apply pressure directly on the wound using a sterile bandage or clean cloth until the bleeding stops;

Seek emergency medical care.

If your tetanus immun= ization is over five (5) years, your Doctor may recommend a booster and this should= be done within forty-eight (48) hours.

4.E. 3: Hot and Cold Compresses

If the person support= ed has a health problem wherein the use of hot/cold compress is addressed in his/her Health Care Plan, follow the directions as outlined in the Health Care Plan= .

The use of heat in an= y form i.e. hot water bottle, heating pad, bean bags are not permitted or approved for = the safe use of people supported. The risk of a burn is too high especially whe= n an individual is non-verbal and expressive communication is limited. For comfo= rt measures, the use of a warmed towel is recommended. Heat the towel in the d= ryer and apply to the affected area. Never put it directly on the person’s skin. The use of a paper towel will provide the protection required to prev= ent any skin irritation. The use of a warm towel is addressed in the personR= 17;s Individual Care Plan with directions on when and how to use. Individual Care Plans are reviewed annually.

The use of cold compr= esses is reviewed with staff members in the First Aid recertification which is done every three years.

The use of a cold com= presses is part of First Aid measures. Apply cold therapy to bruises, toothaches, simple headaches, insect bites or muscle spasms. The best approach is RICE: rest, ice, compression and elevation.

Apply a cold compress= for up to a maximum of 20 minutes. NEVER apply directly to he person’s skin. Co= ver the ice pack with a wet warmed towel to enable the person to tolerate the compress. Stay with the person and assess their comfort. Reduce the time if= the person is not able to tolerate. Reapply after 30 minutes and continue to as= sess the person’s ability to tolerate. Continue in 30 minute segments as required.

If the person support= ed is able to make independent decisions pertaining to health care decisions, our role is to educate them pertaining to safety as per above. Staff members wo= uld not facilitate inappropriate use of heat and cold.

4.E. 4: Emergency Survival Kits and Fi= rst Aid Kits

First Aid Kits approv= ed by WCB are in all homes/programs. Each home and program has emergency survival kits on site to meet the needs of all people supported and the number of st= aff members likely to be on duty for a period of three days. These are kept in a marked container. Managers/PICs or representative must review the contents quarterly and update outdated supplies.&nb= sp; Mark the expiry date of food, water and batteries on the outside of = the container for easy review. When any item is taken from the first aid kits or emergency survival kit, the item should be noted on a paper in the kit for = ease of replacing the item. The OH&S committee reviews kits during bi-annual site visits.

4.E. 5: Essential Information for all = Staff Members

Staff must be aware o= f the following information

q      = Address of the home/program as known by the Fire= Hall: (Posted on or next to phones) __________________________________________________________________

q      = All names of people supported and bedrooms withi= n the homes

q      = All staff members on duty in the home that must = be accounted for in an evacuation situation.

q      = Staff members will sign in and out and check oth= er staff working in the home.

q      = Staff members must always minimize risk of injur= y to themselves or others.

q      = They must use equipment provided within the home= to prevent injury.

q      = Safety hazards must be reported to their manager= or designate as soon as possible. Managers or designates are responsible for correcting the safety hazard or arranging follow up as soon as possible.

q      = Staff members must keep their home address curre= nt in personnel files and ensure accurate information on the Staff Emergency Cont= act List form, which is kept in the Fire and Emergency Manual in case of a seri= ous accident/injury to an employee.

q      = If you are taking people supported to a more rem= ote area i.e. park, nature walk, two staff members must be in attendance in cas= e of an emergency.

q      = Search and Rescue codes: The following code syst= em is used by search and rescue in an emergency, and signs are in each home/progr= am and should be placed on the front window or door: *Red: Immediate assistance needed; *Yellow: Help needed in 24 hours*Green: No assistance required=

Know the Location of<= o:p>

q      = Designated safe area to gather after evacuating = house (ensure it is not at a needed fire hydrant);

q      = An alternate assembly area is required because ruptures in city water or sewer may affect your assembly area. <= /span>

q      = A designated safe area ensures staff are able to= do a head count to ensure everyone is safely out of the home/program.=

1:<= /p>
=

2:<= /p>

<= /p>

q      = Telephones and emergency telephone number: (911)=

q      = Nearest pay phone to the home/program. Location: ________________        =             &nb= sp;

q      = Smoke detectors and fire extinguishers

q      = All exits from each room and emergency exits fro= m the building. Review floor plans. Can beds wheel through the doors? =

q      = First aid, emergency supplies, emergency file in= formation

q      = Shut off for water, gas, sprinkler system, compu= ters and electrical panels.

q      = Fire and Emergency Manual and knowledge of infor= mation contained therein.

q      = The closest pharmacy that could provide medicati= ons. The home’s pharmacy may be too long a distance to travel before roads= are accessible. Pharmacies are provincially linked. Address and nearest Pharmacy: _______________________

q      = Knowledge and phone number our out of province contact: Signature Support Services: Grand Prairie (780) 532-8430 during business hours or (7= 80) 518-1469 for evening’s weekends and holidays. Free pay phones will st= art working before residential lines. An employee would phone the one number wi= th a report on the people living in the home and staff members. The peoples̵= 7; families would have this phone number and would phone for information. One = out of province contact number frees up phone lines, time, and makes information updates available as quickly as possible.

q      = Radio Coverage during any local emergency: All l= ocal Victoria radio s= tations have agreed to broadcast emergency information in the event of a local emergency. However many don’t have live broadcasts during the night a= nd have pre-produced programs instead. Therefore CFAX is the best station to tune into (107= 0 AM on your radio dial) CFAX is live all the time, night and day. The Provincial Emergency Preparedness Plan is to have radio broadcasts of important information on the hour and the half-hour.

Policy Group:    = ;            &n= bsp;          Health and Safety

Issued:     = ;            &n= bsp;            = ;        May 2002; Revised: November 2006

Reference:    &n= bsp;            = ;            &n= bsp;            = ;      Victoria Coordin= ator Provincial Emergency Program (PEP)920-3355

4.E. 6: Managing Medical Situations for People Supported:

In life and death sit= uations, the ambulance is phoned and the ambulance attendants will provide on site assessment and make a decision re: taking the person to hospital. In situat= ions where staff requires medical advice, and the person is not registered with HSCL, or a Doctor’s advice is required, the family doctor should be phoned or go to the nearest clinic or emergency. If it is after hours, a ca= ll number may be available which allows staff to get direction from a physicia= n. Going to a clinic may be more appropriate than emergency because of the long wait times in emergency and the difficulty created for some of the people supported in that setting. If x-rays are required, then the clinic Doctor c= an write the order and the person by passes the emergency room wait.

4.F: Fires<= /o:p>

4.F. 1: Fire and Em= ergency Drills

All staff members must participate in fire drills not less than three times per year and emergency drills for each emergency situation annually: bomb threats, natural disaste= rs/earthquake, utility failures, medical emergencies, snow storm, and violent/threatening situations. Fire drills wi= ll be arranged and recorded by manager/PIC. They must occur on all shifts. Bec= ause some people supported may be distressed by fire drills, it may not be neces= sary to evacuate the house for the drill. This will vary from home to home so co= nfer with the manager. Written Emergency Drill Forms must be completed for each drill. The staff members complete the form, OH&S representative’s reviews it for correct procedure and the manager monitors to ensure the pro= cess is functioning for the needs of the home/program.

4.F. 2: Fire Evacuation Procedures

In the event of a fire presence of smoke, the first priority is the safety of people supported and staff members.

Sound the FIRE ALARM = and yell fire.

Remove the people sup= ported from immediate danger and alert other occupants of the house

Call the Fire Departm= ent: 911: Give the name, address and describe the emergency

If possible, meet the= Fire Department on their arrival and advise them of the location of the fire.

Confine the fire and = smoke by closing doors to rooms with fire and all other bedroom doors (and windows, = if possible).

Evacuate (if necessar= y). Remove people closest to the fire and then the other people in the house. Remove them to pre-determined safe designated area. If the home has a sprin= kler system and the people could not be safely evacuated in two minutes, close t= he doors and don’t attempt to move them. Direct the fire department to t= he room where the people need to be evacuated. The most senior staff member working within the home is designated to ensure all occupants are accounted= for after evacuation.

Do not endanger yours= elf in an attempt to extinguish the fire. Use discretion. If from your experience = and training, you feel you can extinguish the fire with a portable fire extinguisher, attempt extinguishments only after all the people have been m= oved to a safe area. A rule of thumb is that you should not attempt to put out anything larger than a wastepaper basket size.

Remember that in most= cases, the installed fire sprinkler system in licensed homes will control or extin= guish the fire.

It may be easiest to = evacuate non-ambulatory people by wrapping them in blankets and pulling them outside= .

No one is to re-enter= the building without the permission of the Fire Department. <= /p>
Do not attempt to move vehicles from the parking area without the direction of the Fire Department= .

Vehicles should never= block emergency exits and entries to homes.

A fire extinguisher t= hat has been used must never be placed back in service or re-hung. Notify the manag= er/PIC so it can be refilled and immediately replaced.

4.G: Evacuation:

There are situation where, for the safety of the people and staff members, we are required to evacuate and find alternative accommodation on an emergency bas= is.

4.G. 1: Wh= en evacuation is appropriate

Evacuation is a serious decision because of the disruption to people supported. <= /o:p>

Some examples of when evacuation may be necessary is after a fire and on the instruction of the fire department; with toxic fumes; with structural damage from a storm; with long term power outages that result in the need for warm= th. We have to submit a safety plan to licensing if people are being temporarily re-located because of house painting with noxious fumes. This is not an exhaustive list.

Staff members should exercise good judgment keeping the safety of all as paramoun= t. If time and the situation permits, directions may come from fire officials, police, search and rescue, or senior management in the company. =

4.G. 2: Complete evacuation for the ph= ysical facility

Situations may arise = where only part of the physical facility needs to be evacuated: for example, water damage in one bedroom. Contact would be made with the licensing officer and= CEO to determine the most judicious course of action.

4.G. 3: The safety of evacuees

In all situations, th= e safety of the people we support is paramount. After emergency numbers, Immediately call for assistance to ensure that other staff members and management can assist in the crisis. Relationships have been formed with many neighbours, = and in an evacuation the help of neighbors to take in and keep warm the people = we support with staff assistance would be advisable. All homes should evaluate their evacuation strategies.

4.G. 4: Accounting for all persons

Though our homes and = programs are small, it is essential that in a disaster one person is assigned to ens= ure all people are accounted for. The fire department and search and rescue need our assurance. The Manager working within the home is designated to ensure = all occupants are accounted for after evacuation. If it occurs when the Manager= is not in the home, the most senior staff person is to assume this responsibil= ity.

4.G. 5: Emergency Accommodation when complete evacuation is necessary:

Staff members should take the people supported to the closest safe home within the company to have a base from which to make phone calls and to make arrangeme= nts: Amelia/Henry; Maryland/Sentinel/Patterson; Paskin/Dustin; Hillside/Tillicum; S= helby would come to Central office. Futures Club would use the Board room at Cent= ral office. Lakes would go to family members of the people supported in the are= a.

Staff members should seek out emergency accommodation in the following order:

For people suppor= ted with involved families/advocates nearby, families/advocates should be contacted to determine if they want to take their family member/friend home on a temporary emergency basis;

If there is a vac= ancy within the company, phone the home with the vacancy to determine if th= ey can accommodate a person(s);

Have one of the h= omes fax out to all homes to determine if there is capacity to offer space = in an emergency;

Futures Club coul= d be utilized on a short-term emergency basis. For emergency assistance, contact Futures Club staff member(s) who all have keys;

Wheelchair access= ible units are available at the Traveler’s Inn= on the

Gorge 389-1000

In a community wi= de disaster, emergency accommodation is set up at neighborhood schools and recreation centres. Often these locations are chaotic and would be a p= lace of last resort in an emergency.

The van log book contains a list of group homes operated by other companies in the regi= on, and an indication if they are wheelchair accessible.

4.G. 6: Em= ergency Notification of Authorities

If you have to temporarily re-locate in a disaster, licensing officer must be notified immediately to approve the location. An application form must be submit= ted. CLBC would be notified as soon as everyone was safely settled at another si= te. CEO should be contacted as soon as possible.

Policy Group:    = ;            &n= bsp;          Health and Safety

Issued:     = ;            &n= bsp;            = ;        November 2006

Revised:     &nb= sp;            =         &= nbsp;       November 2007; June 2008

Reference:    &n= bsp;            = ;            &n= bsp;         &= nbsp;       Emergency/Temporary Relocations: http://www.viha.ca/mho/licensing

<= /span>

4.H: Continuati= on of Essential Services during evacuation

4.H. 1: Emergency: Medication Disaster Supplies

The College of Pharmaci= sts position is that maintaining an extra supply of medications for a disaster = on site is unsafe and would be unfeasible from both an economic and a logistic= al point of view

With PharmaNet, a person’s profile can be accessed and prescription labels generated in emergency situations through any pharmacy in the province. Hence, if employ= ees are with people supported in an emergency, contact with any pharmacist will allow the person’s profile to be accessed.

Policy Group:    = ;            &n= bsp;          Health and Safety

Issued:     = ;            &n= bsp;            = ;        May 2002

Reference:    &n= bsp;            = ;            &n= bsp;         &= nbsp;       College of Pharmacists; Licensing Newsletter = 2001

4.H. 2: Emergency: Adaptive Equipment<= o:p>

Each home base manage= r is responsible for having a back up plan for adaptive equipment in case of emergency i.e. power outages, breakage etc. These back up plans should be recorded in the individual care plans: safety and security section.

4.H. 3: Emergency Medical and Health Information

A copy of all individ= ual care plans are kept at Central office and may be accessed through there. A copy = of all health care plans is on file with the service provider through HSCL. A = copy of the admissions and hospital transfer form, containing essential medical = and health information is kept locked in the van log book. This would allow sta= ff members to reconstruct a master file quickly.

4.H. 4: Emergency Service Plans

A copy of all person = centred plans is kept at Central office as well as at the homes/programs and may be accessed through there. Families also receive a copy of person centred plan= s.

4.H. 5: Emergency Personal Possessions=

Because of the distan= ces among the homes operated by Kardel, it is unlikely that all homes would be involved in a disaster. Homes not involved would be expected to assist with= the provision of possessions i.e. clothing, radios etc. until the items can be replaced. Families may also be able to assist. .

4.H. 6: Emergency = Staffing

All staff members are required to remain on duty during a fire or other emergency until the situa= tion is under control and all people supported and staff members are safe. In the case of a community wide disaster, off duty staff members are asked to get = to the nearest home/program within walking distance if possible, after they ha= ve secured their own safety and that of their family. In a community wide disaster, staff members scheduled for duty may not be able to get to the ho= me for their shift.

Managers maintain an emergency-staffing list of staff members that live in the vicinity of the home/program for such an emergency. Managers also maintain an emergency staffing list of staff members that are no longer registered at the home/program but who could be contacted in an emergency. This would include staff members that have worked in the home but have since moved onto another job within the company.

Communication Headqua= rters will coordinate communication from Central office to ensure staffing covera= ge. A copy of the emergency staff list is kept within the home program Fire and Emergency manual, with the binder for on-call managers, and with central of= fice as communication headquarters.

4.H. 7: Emergency: Communication Headquarters during a Disaster

Central office would = be Communication Headquarters if it were a safe site after a disaster. In a disaster, CEO, OH&S committee chair, Director of Human Resources and Director of Programs and Quality Assurance would be required to report to Communication Headquarters immediately. All managers/PICs would be expected= to report to his/her home/program immediately, and facilitate communications on site. If Central office were not a safe location, the Chair OH&S would determine the most suitable home/program to serve as communication headquar= ters and forward this information to key staff members. Because of proximity to = the office, Tillicum would be the first home location considered as alternate. Information on the phone numbers for home/program phone numbers, staff memb= ers, family and next of kin phone numbers will be stored at the homes of those individuals who would be expected to staff a communication HQ as well as at= a home in Sidney (Amelia) and a home in Victoria (Tillicum). This provides multiple accesses to critical phone numbers.

Policy Group:    &nbs= p;            &= nbsp;         Health and Safety     &nb= sp;            =             &nb= sp;

Issued:     &nbs= p;            &= nbsp;           &nbs= p;       June 1998

Revised:     &nb= sp;            = September 2000; January 2002, October 2002, June 2003

Update on communication headquarters: November 2005, November 2006

Reference:     &= nbsp;           &nbs= p;            &= nbsp; Community Care Facilities Act; Search and Rescue Coordinator

National Fire Code of Canada 1995;

National Building Code of Canada = 1995

B.C. Fire Code Regulation under Fire Services; Section 6.8 deals with standards that emergency lighting must meet

B.C. Building Code Regulation

B.C. Building Code section 3.2.7 deals with standards that eme= rgency lighting must meet.

Occupational Health and Safety Regulations (s. 4.13 to 4.18) deals w= ith Emergency Preparedness and Response.

Occupational Health and Safety Regulations (part 33) deals with first-aid regulation for B.C.; Section 4.69 deals with emergency lighting requirements; Section 4.27-4.31 deals with Violence in the Workplace

Personal Information and Electronic Documents Act (emergency contact information)

Carl Griffith and Rick Vulpitta, “Effective Emergency Response Plans…anticipate the worst, prepare for the best results”. Nati= onal Safety Council Website (online: www.nsc.org/issues/emerg/99esc.ht= m

William H. Avery and Jamie Soo, “Emergency/Disaster Guidelines= and Procedures for Employees”. CCH Canadian Limited. Toronto, Ontario= 2003 (online: www.cch.ca)Telus Custo= mer Service and Information Pages 23; Community Connections

<= /span>

4.H. 8: Out of pro= vince contact

Emergency preparednes= s is essential in all of the homes and programs. After a disaster, it is often easier to call out of the region, as local phone lines will be tied up. We have arranged an out of province contact with Signature Support Services in Grande Prairie, Alberta. Signature is a sim= ilar agency to Kardel, serving people with developmental disabilities in both ho= mes and day programs.

Contact Information :=         &= nbsp;           &nbs= p;        Darrin Stubbs

1-780-831-4033 (24 hour response)      1-780-532-= 8436 (business hours)

In a disaster, one st= aff member from the home would phone as soon as possible to alert Signature of = the status of the home, staff members and the people residing in the home. Communication Headquarters team would phone Signature to get the report on = all people that reported in. From = Grande Prairie, families may be contacted to alert them to the status of their family member.

Policy Group:    &nbs= p;            &= nbsp;         Health and Safety     &nb= sp;            =             &nb= sp;

Issued:     &nbs= p;            &= nbsp;           &nbs= p;       July 2008

Reference:     &= nbsp;           &nbs= p;            &= nbsp; Government of Canada: Self-Help Advice: Be Prepared, Not Scared: Emergency

      =             &nb= sp;            =             &nb= sp;    Preparedness starts with you

4.H. 9: Emergency Phone Numbers

Emergency phone numbe= rs are posted in all homes. They are also kept in the van logbook in the vans for = when evacuation is necessary

<= /span>

4. I: Emergency Procedures and Drills

Fire drills are done three times per year by all staff members and other drills: bombs are done annually. (See 4.F. 1)<= /o:p>

<= /span>

4.I. 1 a): Bomb Threats

In the event of a bom= b threat made to the home/program/office by phone, signal to staff members and peopl= e in the home to proceed to designated safe area outside as soon as you are awar= e of the threat. Signal to other s= taff members, if available to immediately go to another telephone or cell phone = and Dial 911. Have them await further instructions and advice from 911 personne= l.

Attempt to keep the p= erson on the phone as long as possible and gain as much information as you can from = the person making the threat. Ask:

Where is the bomb loc= ated?

When is it set to go = off?

What does it look lik= e?

What will cause it to explode?

Did you place the bom= b? Why?

What is your name? Ad= dress? Telephone Number?

Do not hang up. Keep = the line open even if the other party hangs up. It is very important not to hang up.= Pay attention to the particulars of the caller i.e. gender, age etc. Pay attent= ion to background voices and noises.

If you find a bomb or suspicious item, or suspect you have

Do not touch it. Ask = all persons to leave the area within the home/program/office.=

Seal the area as best= as possible (e.g. block entrances)

Immediately go to ano= ther area and Dial 911.

Await further instruc= tion and advice.

Direct staff members = and people supported in the home to proceed to designated safe area immediately= .

Ensure all staff memb= ers and people supported are accounted for.

If you open a written= threat, avoid handling the document further and place it in a safe location for pol= ice.

After the people supp= orted are safe, complete the forms in the Fire and Emergency Manual, section: Hazards, Disasters etc. to assist police with their investigation. Notify t= he manager/PIC and the OH&S committee.

4. I 1. b): Natural Disasters

Employees must protec= t themselves first. Co-workers and people supported need you to be able to help them thr= ough the disaster.

In the case of a disa= ster, it may be best for people supported to stay at their group home/day program because public reception areas will be chaotic and this may prove distressi= ng for them. Negotiate with another group home or one of the employees who live nearby to act as a back-up emergency place to take people supported during = an emergency if the home has to be evacuated. In a large earthquake the program may be on its own for up to three days. Employees who live close to a group home should ensure their own family is safe, and then report to the group h= ome as soon as possible to assist. Many employees will not be able to reach the homes/programs. Employees should put a note on their home indicating where = they have gone to assist.

Ensure all staff memb= ers and people supported are prepared for an earthquake.

Know the safe spots i= n each room: under sturdy tables, desks.

Know the danger spots: windows, mirrors, hanging objects, fireplaces and tall, unsecured furniture= .

Practice natural disa= ster drills one time per year.

Ensure you know how t= o shut off gas, water, sprinkler system and electricity. Do not be surprised if the fire alarm and/or sprinkler systems activate during an earthquake.

Put breakables or hea= vy objects on bottom shelves always as good practice.

Tall heavy furniture,= which could topple, such as bookcases, china cabinets or wall units, must be secu= red.

All water heaters and appliance, which could move enough to rupture gas or electricity lines shou= ld be secured.

Hanging plants and he= avy picture frames or mirrors (especially over beds) should be secured or moved= .

Cabinet doors should = have latches to hold closed during shaking. Keep them closed. =

Flammable or hazardous liquids such as paints, pest sprays or some cleaning products must be kept = in the garage or outside shed.

B.C. Housing and Kard= el will check chimneys, roofs, walls, and foundations for structural condition after the earthquake.

Emergency food, water= , First Aid Kit, and other supplies are available in each home and program near the exit for quick removal.

During the Shaking:=

Don’t panic. Do= not attempt to assist others until the shaking stops.

If indoors, stay ther= e. Get under a desk or table.

Drop to your knees an= d cover your head and neck with your hands.

If outdoors, get into= an open area, away from trees, buildings, walls, overhand structures and power line= s.

If driving, pull the = van to the side of the road and stop. Avoid overpasses or power lines. Stay as low= as possible and remain inside until the shaking is over.

If in a crowded publi= c place, do not rush for the doors. Move away from display shelves containing objects that may fall.

Doors may jam closed = during an earthquake. Don’t kick them open as this may do more damage. Use a window to access a room; or exit the building.

After the Shaking S= tops:

Stay Calm. Expect aftershocks. Count to 60 out loud to assist other people in the home to localize to the sound of your voice and to know others are safe. Assist peo= ple in the home and staff members as necessary. Call *911 if emergency services= are urgently required. Account for all people and staff. Inspect all rooms and leave doors open. Keep everyone away from windows and exterior walls. =

Check yourself first = for injuries. Help those around you and provide first aid. Do not move seriously injured individuals unless they are in immediate danger. =

Hunt for hazards. Che= ck for fires, gas and water leaks, broken electrical wiring or sewage lines. If you suspect there is damage, turn utility off at the source. If there is no dam= age, do not turn off gas. Clear hallways and evacuation routes of hazards.<= /o:p>

If you smell gas, dou= se all fires, do not use matches, candles, etc. and do not operate electrical switches. Open windows leave the building and shut off gas valve. Report the leak to authorities.

Check the building fo= r cracks and damage, including roof, chimneys and foundation. If you suspect there is damage, turn off all the utilities and leave the building for the safe area= .

If possible, stay wit= hin the home with the people supported rather than go to a public reception area, w= hich would be chaotic for people supported. All homes have a partner home nearby= ; if possible, get to this home if you must evacuate.

Check food and water supplies. Emergency water may be obtained from water heaters, melted ice cu= bes, toilet tanks and canned vegetables.

Do not use BBQ’= s, camp stoves or unvented heaters indoors.

Do not flush toilet u= ntil you are sure the sewage lines have not been damaged. Put a garbage bag into the toilet, or use the bucket that is kept with the earthquake supplies.

Do not use the teleph= one unless there is a severe injury or fire.

Turn on your portable= radio for instructions and news reports. Have a sticker that identifies the local radio station for emergency information. Cooperate fully with public safety officials.

Do not use your vehic= le unless there is an emergency. Keep the street clear for emergency vehicles.=

Be prepared for after= shocks.

If everyone in the ho= me is safe, put out the green sign for Search and Rescue; if assistance is urgent= ly required, put out the red sign.

The first phones to be reconnected will be pay phones and no coins will be required. One person sh= ould phone the out of province contact number Signature Association for Community Living: Grande Prairie (780) 532-8430 business hours, (780) 518-1469 for evenings, weekends and holidays and inform them of the status of the people supported and staff.

In a Vehicle:<= /o:p>

If you are driving, p= ull over to the side of the road and stop. Attempt to avoid stopping on or under an overpass, near power lines, signs, billboards and/or buildings. Stay inside= the vehicle until the shaking is over. Lie down on the floorboard or on the seat inside the automobile and cover your head and neck.

Evacuation:

Leave the building and prevent access if:

The building has coll= apsed partially or completely;

There is obvious and = severe damage to primary structural supports, or other signs of distress;

There are large ground fissures or massive ground movement near the building.

4.I. 1 c): Snow Storms

Though rare, Victoria has had snowstorms that have closed down roads in places for up to three days. This= has resulted in staff members being unable to come to work or leave the work si= te. Staff members within walking distance of one of our homes are requested to contact the group home and be prepared to provide back up support in an emergency to that home and staff. Day programs would not operate and the ma= nager would be responsible for informing families as soon as it is evident that a major storm front is coming. Err on the side of caution. =

All homes must have a= back up of three days supplies of food and medication at all times. In an emergency, pharmacists are linked and the homes closest pharmacist would be able to arrange short-term medications until the disaster was finished. =

4.I. 1 d): Utility Failures

Each home is equipped= with emergency lighting that goes on automatically for 20 minutes. This allows s= taff members enough time to get out the three-day camp light from the disaster supplies. The camp light is checked at quarterly inspections.

All homes that have electrical medical equipment must have back up manual equipment in case of = an emergency.

All employees must sh= utdown computers during a power failure. A power surge, which can occur after powe= r is restored, can damage a computer.

For heat, some of the= homes have fireplaces that may assist in an emergency. Back up wood supply must be kept available. Candles and extra blankets are available in all homes. Cand= les must never be left unattended. In the case of long-term power outages, the homes staff and people supported should go to the nearest partner homes that still have power. Large plastic bags are good conservers of body heat. Do n= ot place over head. All homes have “Magic Heat” in their emergency kits with instructions.

The vans could be use= d as a warm place in the short term if necessary. Run the motor occasionally to wa= rm up the vehicle. Be sure to open the window slightly for circulation. Use extreme caution not to run the motor if snow is blocking the exhaust pipe. =

4.I. 1= e): Medical Emergencies

All Kardel staff memb= ers are trained in First Aid/CPR for Adult Residential Care.

Emergencies

For serious injuries = and illness, staff must use appropriate first aid, call or have someone phone 9= 11 for an ambulance,

Notify the manager/PI= C as soon as practicable,

Notify the doctors of= the people served, or in the case of staff members, the emergency contact numbe= r on file.

Employees are encoura= ged to err on the side of safety in calling for medical assistance.

If there is adequate = coverage in the home to meet the needs of the other people supported, one employee should accompany the person in the ambulance.

If a staff member is = too ill to continue duties, notify the manager for them to arrange additional cover= age if necessary.

The Kardel Client Pro= file and Transfer Form should be taken to the hospital with a copy of the most recent Medication Administration Record. Hospital Admission Procedure

The manager/PIC or de= signate is responsible for notifying relatives and Community Living Services (CLBC) staff.

Back up medical advic= e is available for people registered with Health Services for Community Living. = HSCL Nurses may be reached from 8:00 A.M. to 12:00 P.M. (numbers posted by Phone= in homes) and through the emergency department at Royal Jubilee Hospital from 12:00= P.M. to 8:00 A.M. HSCL Nurses should be informed of hospital admissions.

4.I. 1 f) Violent, Aggression or other Threatening Situations

Individual plans are = in place for all people that have a history of violent or aggressive behaviours. Incidents are reported on critical incidence forms. Training on responding = to people with difficult behaviours is available during orientation.

All incidents of thre= ats, intimidation, harassment and violence from staff members will not be tolera= ted and should be reported to the manager for follow up.

During an escalating = situation, keep it easy, low key, simple, direct, explicit, accepting while still givi= ng the safety, security and guidance.

Do not engage in angry, verbal outbursts. <= o:p>

Keep verbal interactions and directions sim= ple, clear, using a minimum of words.

Do not provoke a person in a rage.

Keep a safe distance away if possible.

Speak in a firm, calm voice.

Plan a safe route of escape if necessary i.= e. stand by an exit door.

Policy Group:    &nbs= p;      Health and Safety

Revised:         &= nbsp;       March 2009

Reference:     &= nbsp;          Developm= ental Disabilities Mental Health Team January 1991

4.I. 1 g): Sentinel Events

A sentinel event is an unexpected occurrence involving risk of death or serious physical or psychological injury, or the risk thereof. The phrase, “or the risk thereof” includes any process variation for which an occurrence would carry a significant chance of a serious adverse outcome. A sentinel event requires immediate action and response. Responses would be coordinated by t= he Manager, or in their absence, the longest serving staff member in the home. The first goal is always safety and prevention of loss of life. Current direction wou= ld be given community wide and CFAX, (AM 1070) which has an agreement to broad= cast for emergencies.

E.G.: Terrorism: in <= st1:State w:st=3D"on">British Columbia= there have been a number of identified alleged targets: BC Ferries (transportatio= n). In the event of an act or terrorism or suspected act of terrorism we will follow official government and law enforcement regulations (Canadian Human rights and Anti Terrorism Act) and directions.

<= /span>

4.I. 1 h): BioHazardous incidents are defined as the release of any hazardous gas, vapour, liquid or other material into the atmosphere or environment that co= uld pose an immediate threat to persons or property and/or has caused a threat = to life, property or the environment.

Emergency Procedure: =

Notify Poison Control Centre 1 800 567-8911 and/or B.C. Gas (Terasen) for gas emergencies as required 1 = 800 663 9911

Evacuate immediately. Ensure all occupants are accounted for.

Evacuate upwind of vapours.

Every chemical on Kar= del property must have a readily available Material Safety Date Sheet (MSDS) th= at provides handling procedures and emergency response measures in the OH&S/WHMIS Manual. Workplace Hazardous Materials Information System (WH= MIS) legislation confirms employees have the right to know the chemical identity= of “controlled products” (hazardous materials) in the workplace and the precautions that are necessary to work with them. WHMIS has three aspec= ts: 1: labelling of containers, 2: MSDS sheets and 3: worker training. All work= ers receive work site-specific training during orientation to WHMIS, during in = home orientation and generic training during Central Orientation.

It is imperative that= all employees read product labels in order to be alerted to the hazards and safe procedures necessary. It is the employer’s responsibility to ensure t= hat all employees are trained on the use of WHMIS procedures by the Manager. Any employee not using the proper procedures for handling hazardous materials a= nd substances may be subject to disciplinary action.

All poisonous, flamma= ble, or combustible material/substances are to be stored in a safe manner as soon as they come on site. The Manager is responsible for ensuring that the people = in the home/program either:

a)&n= bsp;     understand = the danger of poisonous, flammable, or combustible products; or

b)&n= bsp;     are able to access the storage place of substances that pose potential risk.=

Storage: <= /span>

1: Commonly used household cleaners a= nd chemicals that are potentially dangerous to those who are unaware of the dangers, must be stored in a locked area. Such products include bleach, ammonia, Windex etc.

2: Commonly used prod= ucts such as dish soap, laundry soap, foot powders etc. may be stored in an unlo= cked cupboard or box, that makes the product not visible, if the people living in the home:

= a)&n= bsp;     understand = that these products are dangerous if ingested or

= b)&n= bsp;     cannot acce= ss the storage area without assistance.

= c)&n= bsp;     Have no his= tory of ingesting products

3: All poisonous, fla= mmable, or combustible materials must be kept in a locked area in a separate buildi= ng (i.e. shed). Such products include propane, paint, and pesticides.

4: Combustible materials/substances (e.g. oily or paint filled rags, paint thinner, turpentine, etc.) must be stored in a sealed, airtight container, away from= any heat source.

5: The Manger ensures= all products are properly labeled.

6: Carry out periodic= checks of the home/program to ensure that any/all materials or substances that have potential risk to persons served (e.g. nail polish remover) are properly labeled and stored. Many commercially packaged products have Risk Warnings = on the label.

Transportation/Dispos= al:

All compressed gases (specifically propane), flammable/combustible materials and oxidizing mater= ials must be transported in a manner which prevents free movement, the possibili= ty of spillage/leakage, or access by the people supported. When disposing of flammable/combustible or oxidizing materials, contact local municipality for disposal site information. Do not dispose of in regular garbage containers = or in sewage/drainage system. With compressed gases, old cylinders/tanks shoul= d be “bled” away form heat, to remove any residual gas and the empty tank taken to supplier for disposal. Valves must be turned off when not in = use. Check regularly for deterioration and replace as needed. =

Policy Group:    = ;            &n= bsp;          Health and Safety

Issued:     = ;            &n= bsp;            = ;        May 2002

Revised:    &nbs= p;            &= nbsp;           &nbs= p;     October 2006; January 2009

Reference:    &n= bsp;            = ;            &n= bsp;         &= nbsp;       Worker’s Compensation Act/Regulations, WHMIS

        =             &nb= sp;         Community Living Servi= ces Collective Agreement, Article 22.1

      =             &nb= sp;            = Licensing bulletin January 2009 “Storage of Hazardous Products”

4.I. 1 i): Lightning

Stay updated on weath= er

Get inside the house = or large building

Avoid the use of tele= phone

Avoid the use of or t= ouching plumbing fixtures

Do not stand under tr= ees or telephone poles

Avoid projecting your= self above surrounding landscape i.e. , standing on a hilltop<= /p>
Get off open waters, = cars, or other metal equipment

Stay away from wire f= ences, clotheslines, metal pipes and rails.

If in a group in the = open, spread out, keeping several yards apart.

If caught outside and= you feel your hair stand on end…lightning may be about to strike. Drop to your knees and bend forward. Place hands on knees. Do not lie flat on the ground.

4.I. 1 j): Missing People=

In the event of a mis= sing person:

Carry out a search of= the home/program and immediate surrounding area (5 minutes). Ensure that the ot= her people in the home have adequate support during this time.

Telephone Search and = Rescue for assistance.

Telephone the Police = through the local detachment number to report the missing person as well as the PhoenixCrisis Response Team for additional assistance if required.

Contact the Manager/P= IC, or if not available, program coordinator or CEO to arrange for relief and/ or emergency back up staff members.

Search and Rescue:         &= nbsp;           &nbs= p;                 =           Linda Hillard: 888-8587

Police: Local Detachm= ent:        &= nbsp;                    =           ________________

Home/Program Manager:=         &= nbsp;                    =           Home Telephone: ________________

Director of projects and Quality Assurance: &n= bsp;           Kar= en Van Rheenen: 250 477-9156

CEO:        &= nbsp;              &= nbsp;           &nbs= p;           =             &nb= sp;         Karl Egner: 250 721-4097

Phoenix Crisis Response Team           &nbs= p;       360-2111

Director of Human Resources and Finance        = Cathy Elford: 250 744-8= 850

Have the Profile and = transfer form complete with current information and recent picture on file at all ti= mes.

Write down the descri= ption of clothing at the time of disappearance.

The manager/PIC is to= inform family/caregiver as soon as appropriate. The Incident Report should be forwarded to licensing, Community Living Services and central office as soo= n as practicable (within 24 hours).

4.I. 1 k): Suicide: Prevention and Response

Where a person suppor= ted has a history of suicide attempts or threatening suicide, a health and safety p= lan will be written to ensure all staff members are familiar with the warning signs, risks and methods for intervention. Any attempted suicide is a reportable incident under the community care facilities act. Staff members would use the same protocols as for medical emergencies if warranted. Any sudden changes in behaviour should be reported in progress notes to ensure = the team picks up on early warning signs so that appropriate professional assistance may be arranged as required.

Common warning signs = include:

Signs and symptoms of depression: Depressed= mood; (feeling sad, blue or hopeless; irritability; reduced interest in almo= st all activities; significant weight gain or loss, insomnia or too much sleep, too much or too little motor activity, fatigue or loss of energ= y, feelings of worthlessness or guilt, reduced ability to concentrate or think, difficulty making decisions, recurrent thoughts of death)<= /o:p>

Repeated expression of hopelessness, helple= ssness or desperation

Expressions of interest in committing suici= de

Having a suicide plan

Loss of interest in friends, hobbies or previously enjoyed activities

Giving away prized possessions or putting a= ffairs in order

Telling final wishes to someone<= /span>

A change in personality or mood<= /span>

A change in appearance
Failure to recover from a loss or crisis

Refusing to eat, drink or take medications<= o:p>

Policy Group:    &nbs= p;      Health and Safety

Issued:     = ;            &n= bsp;    October 2006

Reference:         &= nbsp;      Mosby’s Canadian Textbook for= the Support Worker

4.I. 1 l): Ts= unami:

Risk is small, but real in coastal communities such as Port Alberni. Tsunami Alerts may be iss= ues for vulnerable areas and for specific time periods. In he event a distant tsunami is known to threaten any of BC, Tsunami Orders may be issues for specific areas and specific time periods. When the threat is over, Tsunami All-Clear is issued.

If you hear a tsunami bulletin follow instructions immediately. In the case of= an alert, move pesticides and other dangerous goods from low lying areas. In the case of a Tsunami evacuation order, move to higher ground (greater than 20 metres or 60 feet above the t= ide line). Stay tuned to your radio. Follow the instructions of all emergency officials. In the first 24 hours use the telephone only to report life-threatening emergencies. Do not go to the beach to watch. Take emergen= cy supplies with you to higher ground. If you are in a vehicle, move to higher ground. The van log contains the listings of other group homes in the region that are wheelchair accessible, and a safe haven.

If you receive a tsunami order to leave your home:

Turn off the gas, power and water to the home/program

Lock the doors;

Move to safe ground inland or above 20 m elevation.

Know where you are to evacuate to in the event of a tsunami. <= /p>

Policy Group:    = ;            &n= bsp;          Health and Safety

Issued:     = ;            &n= bsp;            = ;        December 2007

Reference:    &n= bsp;            = ;            &n= bsp; BC Provincial Emergency Program; Telus Phone book: p. 23

4.I. 1 m): We= apons: Use or possession

Anything capable of c= ausing damage, even psychologically, can be referred to as= a weapon. A weapon is a tool used to apply or threaten to apply force. No weapons may be used or present within the homes/= programs operated by Kardel. Weapons banned would include items such as guns, pepper spray, clubs, projectiles, or knifes for intimidation or any weapon within = the meaning of Canada’s criminal code. Staff members hired to provide supportive living or community integration are not to enter a home where there is a known presence of weap= ons. If staff members suspect illegal weapons on a premise, the informati= on should be brought forward to the manager for relaying to the police. <= /o:p>

Policy Group:    = ;            &n= bsp;          Health and Safety

Issued:     = ;            &n= bsp;            = ;        December 2007

Revised:    &nbs= p;            &= nbsp;           &nbs= p;     June 2009

Reference:    &n= bsp;            = ;            &n= bsp; BC Provincial Emergency Program; Telus Phone book: p. 23;

      =             &nb= sp;            =             &nb= sp;    Residential Care Regulations #24 of Community Care and Assisted Living Act

4.I.2: Emergency Drills and safety education for= the People we support

Kardel works with the= people we support to teach them about management of emergency issues, taking into consideration their cognitive ability and prior experience. Upon intake, new consumers are instructed on escape routes and fire drills. Staff members explain procedures pertaining to emergencies in plain language and at an appropriate level of comprehension. Pictures are used where appropriate. Pe= ople supported may be included in emergency drills and included on the drill tracking form. (Cross reference: 4.F.1)

4.J. Hospital Admission Procedures =

The manager/PIC is responsible for informing the CLBC analyst re: hospital admissions, central office and the HSCL nurse where applicable.

4.J. 1: Planned Admission to Hospital= :

The home manager/PIC = will determine through patient information, the unit where the person supported = will be admitted.

The home manager/PIC = contacts the hospital social worker for the unit via their pager or through switchbo= ard in situations where there will be the requirement for staffing exceptional = to existing staffing levels.

The patient is assess= ed to establish the need for group home staff members to stay with the patient by= the unit manager or designate or unit social worker in conjunction with the gro= up home manager.

The unit social worker informed of person’s care requirements for activities of daily living i.e. mealtime assistance, toileting, grooming, mobility; and exceptional ne= eds i.e. behavioural issues (screaming, aggression, wandering etc.), monitoring= requirements, augmentative and alternative communication; safety concerns i.e. inability = to pull a cord to call for help, dysphagia etc.

VGH:             =             &nb= sp; 727-4212 or

RJH:             =             &nb= sp;   370-8000 or

Saanich Peninsula:   &n= bsp;     652-3911

The unit social worke= r must reassess the person for support required greater than 4 days.

Hospital staff members complete the Form “Authorization for Staff to Support Adults with Developmental Disabilities”. See Forms. He/she notifies the group home manager.=

The manager/PIC arran= ges the care required.

Nursing staff members document the presence of group home caregiver in the progress notes. <= /o:p>

If families are avail= able and wish to be on site for a portion of the day, and are able to provide the activities of daily living support, that may be taken into consideration as part of the staffing plan.

Upon patient discharg= e, the home manager sends the completed “Authorization for Staff to Support Adults with Developmental Disabilities” to Kardel Finance and Administration, for them to fax an invoice and a copy of the authorization = form to the Health Records Department where patient was admitted. Accounting invoices indicating rate of pay, number of hours (manager provides this information) and the total costs.

Health Records provid= es verification of service and LOS (length of stay)

Health Records comple= tes authorization form and forwards to the Director with signing authority for = cost centre.

Director or designate= signs invoice and sends to Accounts Payable Department.

Accounts Payable Depa= rtment reimburses Kardel.

4.J. 2: Emergency Admissions to Hospital:

Determine through pat= ient information, the unit where the person supported is being admitted.

Request the unit soci= al worker, unit manager or designate contact you as soon as possible if a need= for group home staffing exists.

Manager/staff members exercise judgment based on the needs of the person supported re: staff cove= rage while in hospital and ensure adequate support from the group home is arrang= ed.

Proceed as above.

Staff Member’s = Role while supporting a person in hospital:

Hospital staff perfor= ms the acute care roles

Group home staff perf= orms the regular activities of daily living support that are part of their job description within the home.

Exceptions may be neg= otiated with the nurse/staff in the best interest of the person supported. For exam= ple, the nurse may oversee the group home staff member administering the person's routine medications when the person will not accept the meds from a strange= r.

4.J.3: Exceptional Considerations:

The hospitals have a = patient care coordinator who deals with more global issues. They may be contacted through the switchboard in situations such as:

Example 1: Two of the people supported are in hospital at the same time and having them in the same room would save staff= ing costs, the patient care coordinator would be contacted to assist with making these arrangements.

Example 2: The person= becomes agitated with noise and may scream. A request could be made through the pat= ient care coordinator to have access to the grief room to decrease stimulation.<= o:p>

Policy:     = ;            &n= bsp;   Health and Safety

Issued:     = ;            &n= bsp;    April 2002

Revised: June 2003; Ma= y 2007

Reference: &= nbsp;           &nbs= p; Vancouver Island Health Authority; Process for Authorization and Documentation of Caregiver Support: Adults with Developme= ntal Disabilities

4.K: Death of a Person Supported

4.K. 1: Un= expected Death:

Immediately call for = police and ambulance, and then contact the Regional Coroner 1 877 741-3707. Licensed facilities are required to report all deaths to the licensing officer. If it is after hours or on the weekend, leave a message on the machine of the licensing officer.

Contact the manager/P= IC of the home or in their absence, the Director of Programs and Quality Assurance. The manager or des= ignate will inform the family members and the analyst. The phone numbers for above= are posted by the phone on the yellow sheet and updated as required by the manager/PIC.

4.K. 2: Anticipated Home Deaths:

The coroner does not = need to be notified of an anticipated home death from natural causes, unless there = are concerns regarding the cause of death. Police do not need to be called when= a death is the expected outcome of a progressive illness. Ambulance services and/or 911 should not be contacted when the death was expected. The funeral home may be contacted directly once pronouncement of death has occurred.

A plan of care should be in place for a home death and it includes:

The names and numbers= of the health care professionals who will pronounce death: Physicians, registered nurses and LPN’s are allowed to pronounce death.

The B.C. Funeral Asso= ciation recommends that the family not wait longer than 4 to 6 hours after a death = has occurred to have the pronouncement of death.

The name and number o= f the funeral home to be contacted for transportation of the deceased.=

BC: Ministry of Healt= h form “No Cardiopulmonary Resuscitation” available from office or Pro= duct Distribution.

The Field Manual on D= eath and Dying is available in each home/program operated by Kardel and should be consulted for additional information.

4.K. 3: Duties after the Death:

The family members an= d CLBC analyst must be informed within (2) hours of the death. When the death occu= rs outside of normal Ministry working hours, service providers are to follow t= he CLBC regional protocols for reporting after hour emergencies: Victoria 310-= 1234 or the number on the answering machine at 250 952-4067.

In the event of a dea= th occurring on a weekend, the service provider is to contact the HSCL Medical Consultant, Dr. Ameet Parikh, if there would be more than 24 hours between = the death and the following work day. This will allow for timely consultation between the Medical Consultant and the local Coroner. Dr. Parikh’s Ce= ll number is 778-837-4462. Linda Verheegan R.N. completes the reviews on death= s, answers questions about health care consent and liaises with HSCL and should be contacted during work hours at 250 387-5858 to report deaths. Dr. Parikh and Ms. Verheegan work together to ensure due diligence for health services for people served by CLBC.

Within 12 hours of th= e death, the service provider must complete and submit the CLBC Mortality Information Summary (updated copy available in the forms book and on the forms disk) to= the analyst. In licensed facilities, in addition to completing and submitting t= he CLBC Mortality Information Summary, the service provider must complete a licensing reportable incident form to the licensing officer and to the anal= yst.

As service providers,= we cooperate with the local Coroner and local Licensing Officer (for licensed facilities) in providing factual information for their review and

investigation of the unexpected death. The service provider will participate in the CLBC debrief= ing process where the Doctor reviews all the circumstances surrounding the death and, as required, follows up on identified areas of concern in respect to t= he safety and well being of other adults with developmental disabilities invol= ved in the agency’s services and programs.

The manager/PIC is to= arrange ASAP debriefing for the staff members and other people residing in the home with Island Loss Clinic at 592-3138, hospice, Community Support Team counselors, or another appropriate agency knowledgeable about issues of gri= ef. In consultation with the family members, managers/PICs arrange to inform friends of the deceased, (including volunteers, former and current staff members, friends, advocates etc.) of the death and answer their questions. = Also inform the involved professionals i.e. HSCL staff, Doctors, Dentist etc. as well as the Medical Services Plan.

The manager/PIC will facilitate regular staff attendance the day of debriefing, if at all possib= le. However, attendance is voluntary and not paid time.

The manager/PIC will = inform the employment assistance worker and make adjustments to B.C. Benefits as necessary. The Income Tax Bur= eau is informed of the death. Inform the public trustee if they are involved with = the person. Notify the person’s bank and accounting at the office if the person has funds in trust for settling the account.

All binder and file information should be forwarded to Director of Programs and Quality Assuran= ce at Central office for appropriate storage. Inform the pharmacy and cancel medications. Arrangements should be made with the family for the dispositio= n of the person’s belongings.

4.K. 4: Memorial Service:

If the family chooses= to have the memorial service in the home, the manager/PIC would facilitate the proc= ess as much as possible to make it respectful, and meaningful, for the family, staff members and friends. The manager/PIC would be responsible for making arrangements in consultation with the family ensuring assistance is provide= d as required for issues such as arranging clergy, issuing invitations, order of service, luncheon afterwards etc.

Policy Group:    = ;              &= nbsp;       Health and Safety

Issued      = ;            &n= bsp;            = ;        September 1998

Revised:     &nb= sp;            =         &= nbsp;       September 2000, March 2002, July 2003; November 2008; July 2009

Reference:     &= nbsp;           &nbs= p;            &= nbsp; Coroner’s Act

4.L.: Annual competency based training

4.L.1: Overview:

As part of Kardel safety month in April, all Managers = are required to hold a meeting to provide competency based training. Sign off is required for all staff members and should be kept in the occupational health and safety file. If staff members are unable to attend, they should be prov= ided with the written materials and quizzed on the materials prior to signing off completion of this requirement.

4.L.2: Health and Safety Practices: <= /span>

Universal precautions are reviewed as part of annual evaluation

Lifts and Transfers are reviewed as part of annual evaluation

Managers are to ensure all evaluations are up to date.

4.L.3: Unsafe Environmental Factors:<= /span>

Review the quarterly OH&S worksite inspection form with all staff members= to ensure awareness of requirements to keep a safe work place.

4.L.4: Emergency Procedures:

Review the yellow Emergency procedure sheet

4.L.5: Evacuation Procedures:

Cathy to complete

4.L. 6: Identification and Reporting of Critical Incidents:

·  &n= bsp;       4.C. Reporting of critical incidents.........= ...........................................................................= ............................... 8

·      =     4.C. 1: Lice= nsed Programs: Reportable Incidents to Vancouver Island Health Authority (VIHA).............= ......... 8

·      =     4.C. 2: Lice= nsed Homes: Reportable Incidents t= o CLBC ....................................= ................................................ 8=

·      =     4.C. 3: Other Programs: Reportable Incident= s..........................................= ............................................................ 9<= /o:p>

·      =     4.C. 4: Minor Incidents or Injuries relating to Person Supported.................................................................= ........ 9

·      =     4.C. 5: Vehi= cle and Property Damage.................= ...........................................................................= ........................ 10

·      =     4.C. 6: Annu= al Review..............................= ...........................................................................= .................................. 10

·      =     4.C. 7: Work Related Staff Injuries..............= ...........................................................................= ............................... 10

·      =     4.C. 8: WCB = Forms..........................................= ...........................................................................= .......................... 11

·      =     4.C. 9: Acci= dent Investigation Report................= ...........................................................................= ........................ 11

4.L. 7: Medication Management:

Written test from the Medication DVD; (review with CQI committee)

4.L.8: Reducing Physical Risks:

Physical Assistance Procedures reviewed

4.M: Release of a Person Supported<= /span>

4.M.1: Overview

When a person is in the care of Kardel by contract, it is our responsibility to protect the person in our care and ensure their safety. <= /p>
Hence, staff must ensure that when a person arrives to take a person supported out, that they are assured of the safety of the person.

4.M. 2: Restrictions or prohibition by a court order or an order under an enactm= ent

Staff members may not allow a person restricted or prohibited by a court order or= an order under an enactment to take a person supported from the home. The order will be on the file. If the situation appears volatile, police should be contacted to enforce the order and ensure the person is off the property and does not pose threat. In situations where no threat exists, assistance shou= ld be sought from the Manager, and in their absence, Directors. Emergency Phone Numbers are at each site.

4.M. 3: Health , safet= y or dignity risks

Staff members are not = to release a person supported to anyone who they assess may pose a risk at that time to the health, safety or dignity of the person. For example, if a fami= ly member arrives to take out a person supported and they are drunk and drivin= g, the staff member should not release the person. If the situation appears volatile, police should be contacted. If not, the Manager should be contact= ed.

CLBC analyst for Kardel may also be involved as CLBC is the authority for investigating and enforcing Part 3 of the adult guardianship act which prov= ides the legal authority for ensuring that adults who may require protection from abuse, neglect or self-neglect have access to timely response and support. =

4.M.4: Form Part 6: 78 Residential Care Regulations: Release of a person supported=

As part of our admissions process and updated as required, a form is kept on e= ach person’s supported binder section 1 that provides consent in writing = from the person supported or their parent or representative to whom the person m= ay be released.

Policy:     = ;            &n= bsp;   Health and Safety

Issued:     = ;            &n= bsp;    July 2010

Reference: &= nbsp;           &nbs= p; Residential Care Regulations: Community Care and Assisted Living Act Part 6: 78 e)=

4.A. 1: Overview

Home/Program &nb= sp; Supp= lier of Service &nb= sp; = Annual maintenance

4.A. 5: Health Services for Community = Living (HSCL) Nursing Back Up

4.A. 6: Working Alone

4.C.3: Hillside= , Futues Club, Individual Support Network, Home Share: Reportable Incidents

4.C.4: Minor Incidents or Injuries rel= ating to Person Supported

4.C.8: WCB Forms

4.D. 1: Infection Control and Universal Precautions (Standard Precautions)

4.D.2: Influenza Immunization and Cont= rol of Influenza Outbreaks

4.D. 3: Communicable Diseases

4.D. 4: Staff Responsibility for Repor= ting Infectious Conditions

This is considered = an outbreak

4.E. 2: Human Bites: First Aid

4.E. 3: Hot and Cold Compresses

4.E. 4: Emergency Survival Kits and Fi= rst Aid Kits

4.E. 5: Essential Information for all = Staff Members

4.E. 6: Managing Medical Situations for People Supported:

4.F. 2: Fire Evacuation Procedures

4.G. 1: Wh= en evacuation is appropriate

4.G. 2: Complete evacuation for the ph= ysical facility

4.G. 3: The safety of evacuees

4.G. 4: Accounting for all persons

4.G. 6: Em= ergency Notification of Authorities

4.H. 2: Emergency: Adaptive Equipment<= o:p>

4.H. 3: Emergency Medical and Health Information

4.H. 4: Emergency Service Plans

4.H. 5: Emergency Personal Possessions=

4.H. 7: Emergency: Communication Headquarters during a Disaster

4.H. 9: Emergency Phone Numbers

4.I. 1 c): Snow Storms

4.I. 1 d): Utility Failures

Emergencies

4.I. 1 i): Lightning

4.J. Hospital Admission Procedures =

4.K: Death of a Person Supported

4.K. 1: Un= expected Death:

Section 4: Health and Safety