Policies and Procedures Document - Community Living

Transcription

Community Living-Central Huron
Policies & Procedures
The VISION of Community Living-Central Huron is:
“People live in dignity and share in all aspects of living in their community.”
The MISSION of Community Living-Central Huron is:
“Community Living-Central Huron is committed to assisting and supporting people to
achieve their goals, vision and dreams and to participate in the community through the
promotion of social inclusion.”
Distributed:
Updated/Distributed:
Novem ber, 2001
February 2003; October 2004; February 2006; July 2006; February 2007;
August 2007; July 2008; October 2009; Decem ber 2009; January 2010;
October, 2010; Novem ber 2010; May 2011; October 2011; Decem ber, 2011;
June 2012; Septem ber 2012; October 2012; Novem ber 2012; Decem ber 2012,
January 2013, March 2013, May 2013, June 2013, October 2013, Novem ber 2013,
January 2014, October 2014, Novem ber 2014, Decem ber 2014, February 2015,
May, 2015, June, 2015, Septem ber, 2015, Novem ber 2015, Decem ber 2015.
POLICIES and PROCEDURES
Table of Contents:
Page #
SECTION A: AGENCY BELIEFS:
-
Philosophy (A-001)
Guiding Principles (A-002)
Confidentiality (A-003)
Privacy (A-004)
SECTION B: BOARD GOVERNANCE:
-
-
B1 - B21
Interpretation (B-001)
Press and Media Releases (B-002)
Relationship with Law Enforcement
Agencies (B-003)
Community Involvement (B-004)
Tender (B-005)
Usage of Agency Equipment/Electronic
Communication Technologies (B-006)
Volunteer (B-007)
Purchasing and Credit (B-008)
Accessibility Policy (B-009)
Duty of Care Policy (B-010)
Code of Conduct (B-011)
SECTION C: SUPPORT SERVICES:
-
A1 - A11
C1 - C26
Individual Welfare/Rights (C-001)
Behavioural Support (C-002)
Person Supported Complaint/Feedback (C-003)
Abuse (C-004)
Use of Physical Restraints (C-005)
Serious Occurrence (C-006)
Communication Book (C-007)
Finances of People Supported (C-008)
Individual Support Policy for Persons
Supported (C-009)
Pet Ownership, Visiting Pets and
Service Animals (C-010)
Orientation for People Supported (C-011)
Medical Care for Persons Supported Policy (C-012)
Inventory, Personal Belongings of Persons
Supported (C-013)
Bathing and Showering Supervision of
Of Persons Supported Policy (C-014)
Persons Supported Food and Nutrition
Policy (C-015)
Missing Person/Unknown Whereabouts Policy (C-016)
SECTION D: HEALTH and SAFETY:
-
SECTION E:
Health and Safety Policy Statement (D-001)
Medication Policy Statement (D-002)
Emergency (D-003)
Smoking (D-004)
Dangerous Weapons and Fire Arms (D-005)
Critical Injury (D-006)
Bullying, Harassment and Workplace Violence Policy and
Procedures (D-007)
Pandemic Policy (D-008)
Preventative Maintenance Policy (D-009)
Musculoskeletal Disorders Awareness Policy (D-010)
First Aid Policy and Procedures (D-011)
Working Alone Policy (D-012)
Infection Control Policy and Procedures (D-013)
Hazard/Risk Policy and Procedures (D-014)
Health and Safety Orientation Policy (D-015)
Location Health and Safety Representatives Policy (D-016)
Ladder Safety Policy and Procedures (D-017)
Sharps Policy and Procedures (D-018)
Manual Handling Policy (D-019)
Slips, Trips and Falls Prevention Policy (D-020)
Workplace Inspection Policy (D-021)
Work Refusal Policy (D-022)
HUMAN RESOURCES/PERSONNEL
-
D1 - D79
E1 - E35
General Policy No. 2 (E-001)
Hiring Policy (E-002)
Police Record Check (E-003)
Employee Records Policy (E-004)
Employee and Volunteer Orientation Policy (E-005)
Professional Development/Training Policy (E-006)
Individual Consultation (E-007)
Employee Performance Appraisal (E-008)
Vehicle Use (E-009)
Personal Property Damage Reimbursement (E-010)
Employee Performance Standards (E-011)
Disciplinary Policy (E-012)
Sexual Harassment (E-013)
Work References (E-014)
Retirement (E-015)
Early and Safe Return to Work (E-016)
Benefit Plans (E-017)
Record Retention and Archives (E-018)
Staff Recognition (E-019)
Volunteer Recognition (E-020)
SECTION A:
AGENCY BELIEFS
Section:
Subject:
A
Philosophy
Policy Number: A-001
Total Pages:
1
Approval Date:
June 29, 1988
Revision Date(s)
May 15, 1991
PHILOSOPHY COMMUNITY LIVING-CENTRAL HURON
The goal of Community Living-Central Huron is the following:
“That people live in dignity and share in all aspects of living in their community.”
To achieve this goal, we believe that each of us is to be treated with respect and dignity, that
each of us must have the opportunity to develop our own life style; that each of us learns and
continues to learn throughout our life; that each of us needs, desires and hopes for the company
and friendship of others; that each of us have human and civil rights accorded us by law.
The means to achieve this goal are simple. People who have felt isolated and rejected must
be welcomed by the community-at-large to participate. This means becoming members of
groups, associations, clubs and churches. It means being asked to share ideas, gifts and
abilities with others. It means being included in decisions and actions that build and fortify
community life.
People who are poor need a real income, an income achieved by working for real wages. Paid
support needs to become a matter of right but can never surpass the real emotional,
psychological and financial support provided by one's family and friends.
Our role as an association is to enhance the dignity and value of all people. It is to assist people
to regain power and control over their own lives. It is to listen and respond. When we embrace
the richness of diversity, recognize the gifts we each possess and respect each others
contributions, we will, indeed, have a competent, caring community that includes all its citizens.
A.1
Section: A
Subject: Guiding Principles
Total Pages:
5
Approval Date: November 19, 1997.
Revision Date(s)
GUIDING PRINCIPLES
Preamble:
Community Living-Central Huron Board of Directors, Staff and the Membership-at-Large believe
in the dignity and worth of all individuals. Committed to the pursuit of all elements of community
life being shared among every member of society, C.L.-C.H. believes that the preservation and
protection of fundamental human rights should be strived for and adhered to. Reflective of
these ideals, the delivery of service will be provided in a fashion that is both empathetic and
empowering to assist people in a supportive, respectful and positive manner.
Overview:
This document is prepared to show the general beliefs of Community Living-Central Huron with
regards to the five most common issues encountered by the Agency’s Board of Directors, Staff,
Membership-at-Large and the people receiving service.
The Agency’s position is given on the following areas of daily concern:
a)
b)
c)
d)
e)
1.
Responsibility
Competence
Moral and Legal Standards
Confidentiality
Welfare of the Consumer
Responsibility:
C.L.-C.H. Staff are devoted to the quality of life for each and every individual. They place
the highest regard for their professional conduct and accept the responsibility for the
consequences of their actions.
a)
C.L.-C.H. recognizes the uniqueness of each person and the need for flexibility
in responding to each individual.
b)
C.L.-C.H. promotes the belief that everyone has the right to make decisions and
have control over their own lives.
c)
The Agency encourages a process that allows people to be listened to and
understood, in order for the appropriate supports to be identified and made
available.
d)
The Agency believes quality of life must include positive and supportive
environments; opportunities for community participation, inclusion and choice; and
the understanding of underlying psychological, medical and behavioural concerns
must be addressed.
A.2
2.
e)
C.L.-C.H. staff have a responsibility to protect people from abuse and harm, which
includes the responsibility of reporting such occurrences.
f)
The Agency abides by the belief of the protection of people's privacy and the
confidentiality of personal information.
g)
C.L.-C.H. will endeavour to seek information for the enhancement of knowledge
pertaining to individual needs and available resources, services both within and
apart from the Human Services field.
h)
C.L.-C.H. recognizes and respects expertise of other professions and encourages
the use of such services.
I)
C.L.-C.H. Staff accept the responsibility of avoiding relationships that may limit
their objectivity or create a conflict of interest.
j)
C.L.-C.H. acknowledges the importance of promoting a positive image of the
Agency and the people it supports.
k)
C.L.-C.H. Staff acknowledge and accept their social responsibility and will make
every effort to be alert to personal, social, organizational, financial or political
situations that may have an impact on the lives of the people receiving service.
l)
In an ongoing mutual process, C.L.-C.H. Staff will review both formal and informal
agreements with people receiving service as frequently as necessary, daily if
necessary.
m)
The Agency promotes inclusion and therefore will not participate in any public
gatherings that are exclusive to people identified as having limitations or
impairments.
n)
C.L.-C.H. Staff will follow the appropriate Agency reporting procedures when
aware of any violation to the Community Living-Central Huron Guiding Principles.
Competence:
The maintenance of high competence standards is a responsibility shared by C.L.-C.H.
Board of Directors, Staff and the Membership-at-Large in the interest of the people
receiving service, the public and the profession as a whole. C.L.-C.H. Staff recognize
the boundaries of their competence and the limitations of their service. They provide
only services and methods consistent with the Agency's philosophical statements,
policies and procedures for which they are qualified by training and experience.
a)
C.L.-C.H. Staff recognize the need for continuing education and are open to new
approaches and changes in expectations over time.
A.3
3.
4.
b)
C.L.-C.H. Staff will acknowledge when further education is necessary to develop
or enhance skills.
c)
C.L.-C.H. Staff will accurately represent their competence, education, training and
experience.
d)
The Agency recognizes differences among people, such as age, gender,
socioeconomics, sexual preferences and ethnic backgrounds. When necessary,
Staff will obtain training and experience to provide competent service.
e)
C.L.-C.H. Staff will acknowledge and respect the different job functions,
responsibilities and roles within the Agency; Staff will perform such duties
consistent to their position.
Moral and Legal Standards:
Moral and ethical standards of behaviour of the C.L.-C.H. Board of Directors, Staff and
Membership-at-Large are a personal matter to the same degree as they are for any other
citizen, except as those which may compromise the fulfilment of their Agency
responsibilities or reduce the public trust in Community Living and its Staff.
a)
C.L.-C.H. Staff are sensitive to prevailing community standards and to the
possible impact that deviation from these standards may have upon the quality
of service they provide.
b)
C.L.-C.H. Staff are aware of the possible impact of their public behaviour with
respect to their professional credibility.
c)
The Agency will not condone practices that are inhumane or that result in illegal
or unjustifiable actions. Such practices include, but are not limited to, those
based upon considerations of race, disability, age, gender, sexual preference,
religion or natural origin.
d)
C.L.-C.H. Board of Directors, Staff and Membership-at-Large will not participate
in the violation or contradiction of the legal and civil rights for people.
e)
C.L.-C.H. Staff will not exploit their professional relationship.
f)
The Agency will not condone approaches or practices towards people that are not
consistent with society's definition or interpretation of acceptable standards for all
of its citizens.
Confidentiality:
C.L.-C.H. Board of Directors, Staff and the Membership-at-Large have a primary
responsibility to respect the confidentiality of information obtained as a result of their
affiliation with Community Living-Central Huron.
A.4
5.
a)
Information to others shall be shared only with the consent of the person or the
person's legal representative, except in unusual circumstances in which not to do
so would result in clear danger to the person or to others, and when there is a
legal requirement to notify.
b)
C.L.-C.H. Staff are responsible for informing people receiving Agency services of
the limits of confidentiality.
c)
Only relevant information will be disclosed and every effort will be made to avoid
undue invasion of privacy.
d)
C.L.-C.H. Staff make provisions for maintaining confidentiality in the storage and
disposal of records.
Welfare of the Consumer:
C.L.-C.H. Board of Directors, Staff and the Membership-at-Large believe in the respect,
dignity and worth of each and every individual receiving service:
a)
The focus and loyalties of the Agency is for the welfare of the people it supports.
b)
C.L.-C.H. Staff will ensure people are provided the opportunity to access an
advocate, withstanding any conflicting affiliation.
c)
C.L.-C.H. will acknowledge any belief when the consumer is not benefiting from
Staff and/or Agency involvement.
d)
C.L.-C.H. Staff will provide people the assistance to locate alternative sources of
support/service.
e)
C.L.-C.H. Staff will fully identify the purpose and nature of their role and freely
acknowledge the participant’s freedom of choices.
f)
C.L.-C.H. Staff are cognizant of their potentially influential position and will avoid
exploiting the trust and dependency of such relationships.
g)
The Agency believes in a support system that will attempt to meet the individual
needs of those requesting service.
The intent of Community Living-Central Huron’s ‘Guiding Principles’ is to convey the Agency’s
philosophical beliefs and expectations of its role as a support provider.
To assist in the application of the ‘Guiding Principles,’ a list of questions which identify specific
areas/concerns from the five main issues, have been provided.
A.5
The following questions should be considered by all people affiliated with C.L.-C.H.
and addressed as it relates to their role with the Agency:
a)
Am I imposing my expectations, beliefs, interests onto other people?
b)
Am I clear on the Agency’s expectations and particularly my role?
c)
Am I open for change?
d)
Have I challenged my views and am I open to be challenged?
e)
Do I persuade the people to whom I provide support, to agree with my values?
f)
How do I communicate options to people and ignore my values?
g)
What is my motivation?
h)
Is my involvement serving the person or my needs more?
i)
Do I know and understand my professional boundaries?
j)
Do I respect the people I support and their choices?
k)
Do I know what the person wants for the future, who determined this and what is
being done to assist or support the person?
l)
Who decided where the person should live? If the person is not satisfied, what
can be done?
m)
What is a typical day like, would I want to trade lifestyles with the person? Why
or why not?
n)
Who is responsible for deciding the person’s routine, how are the person’s
choices, selections solicited?
o)
How is it determined what rights the person can and wants to exercise?
A.6
Section:
Subject:
A
Confidentiality
Total Pages:
2
Approval Date:
Oct. 25, 1984
Revision Date(s): May 15, 1991,
Sept. 19, 2012.
CONFIDENTIALITY POLICY
Community Living-Central Huron recognizes the right of all employees, volunteers and persons
supported to confidentiality in principle and practice. This right refers not only to written material
kept on file, but also on the verbal material given freely by an employee, volunteer or person
supported understanding such information would not be repeated.
To maintain this level of confidentiality, no information, written or verbal shall be given unless
a signed Release of Information Authorization from the employee, volunteer or person
supported accompanies such a request. The employee, volunteer or person supported is
entitled access to their file and to correct inaccurate information. To view their file, written notice
must be provided in advance to the Executive Director; the file shall be shown to them at a
mutually agreed time and in the presence of a person designated by the Executive Director. The
Supervisors, Coordinators and Executive Director shall ensure that each employee and
volunteer is aware of the Confidentiality Policy and its contents. Non-compliance with the
Confidentiality Policy is subject to discipline, up to and including dismissal from Community
Living-Central Huron’s employment and/or services.
Confidentiality can only be assured within the confines of legal limitations.
Procedure:
1.
All employees, volunteers and persons supported shall be advised of the Confidentiality
Policy immediately upon their involvement with Community Living-Central Huron. Each
employee and volunteer is required annually to sign an Oath of Confidentiality.
2.
Employees, volunteers and persons supported must give their written consent before any
information, written or verbal can be released to, or obtained from another person,
agency or institution. Each Release of Information Authorization must bear only one
specific contact, the time frame of the Release, the employee, volunteer or person
supported signature, the date and signature of a witness. Two identical authorization
forms are prepared; one for the Community Living-Central Huron file and the other to be
sent to the source requesting or being asked for information. If the information needed
pertains to a person under the age of eighteen, the parent or guardian will be requested
to sign the consent form.
3.
No confidentiality can be promised where there is a suspicion or proof of child abuse.
The law requires that all such instances must be reported to Children’s Aid Society.
Refer to the Agency’s Abuse Policy (No. C-004), with respect to specific procedures.
4.
An employee may be legally required to provide confidential information to family or
criminal courts if a subpoena is served.
A.7
5.
All employees’, volunteers’ and files of persons supported must be maintained in locked
cabinets. An employee removing a file, or any of its contents, assumes responsibility for
confidentiality and will also be responsible for returning the file/its contents immediately
after use.
6.
A signed Release of Information Authorization must be received by Community LivingCentral Huron, prior to releasing any information to another person, agency or institution.
Such Authorization must be signed by the employee, volunteer or person supported.
7.
All files and their contents will be retained and archived as per Record Retention and
Archives Policy (No. E-018) and be placed in a secure location.
8.
Should there be reason to believe that an employee, volunteer or person supported be
a danger to themselves or others, or be in violation of the law, the employee and/or
volunteer will consult their Immediate Supervisor or designate to determine the
appropriate course of action.
A.8
Section:
Subject:
A
Privacy
Total Pages:
3
Approval Date: April 21, 2004
Revision Date(s)
PRIVACY POLICY
Community Living-Central Huron is committed to protecting the privacy of people supported, staff,
volunteers, membership and donors by ensuring that personal information is handled according to
the following Privacy Policy for the collection, use and disclosure of personal information. Under
the Personal Information Protection and Electronic Documents Act (PIPEDA),organizations are
required to adhere to the ten principles of the Act. Community Living-Central Huron reserves the
right to collect, use and disclose personal information as authorized by PIPEDA. Non-compliance
with the Agency Privacy Policy is subject to discipline; up to and including dismissal from the
Agency’s employ and/or its services.
The Agency’s Confidentiality Policy recognizes the right of its employees and people receiving
supports, the right to confidentiality both in written material and verbal conversation. A signed
Release of Information must be secured from people receiving supports or employee when
information is being given or obtained. All employees, Board and Committee Members sign an
Oath of Confidentiality upon employment or volunteer commitment and annually thereafter.
The ten Principles established under the PIPEDA and how Community Living-Central Huron will
apply them are as follows:
1.
Accountability:
The person designated as the Agency’s Compliance Officer for the purposes of this policy
and applicable legislation (Personal Information Protection and Electronic Documents Act)
will be the Executive Director.
2.
Identifying Purposes:
Personal information provided to Community Living-Cental Huron will only be used for the
following purposes:
Individuals receiving Supports:
a)
determine eligibility, provide support and assistance;
b)
to comply with Ministry of Community & Social Services, Agency Service Contract,
and related government Legislation;
c)
information regarding supports and services;
d)
invitations to events; and
e)
to receive a copy of Agency newsletter, membership and other information.
Employees:
a)
to administer and provide employee benefit plans;
b)
to determine qualifications, administer and process all aspects of payroll;
c)
to participate in Agency events and employee functions;
d)
and related government Legislation;
e)
allowing contact information for general business purposes;
f)
to provide required documentation to OPSEU and OPSEU, Local 146;
g)
to provide information required for various training events; and
h)
to recruit employees.
A.9
Volunteers:
a)
to recruit volunteers;
b)
Agency By-Laws, Agency Policies and Procedures and related government
Legislation;
c)
invitations to Agency events and fund raisers;
d)
allowing contact information for general business purposes;
e)
to receive a copy of Agency Newsletter and other information; and
f)
to provide information required for various training events.
Membership:
a)
to receive a copy of the Agency Newsletter and other information;
b)
Legislation; and
c)
invitations to Agency events and fund raisers.
Donors:
a)
Legislation;
b)
invitations to Agency events; and
c)
to receive a copy of appeal letters and other fundraising events.
3.
Consent:
Community Living-Central Huron will seek permission, either verbal or written, of all people
being supported, employees, volunteers, membership and donors to consent to the
collection, use and disclosure of personal information as described in number 2 above.
4.
Limiting Collection:
Community Living-Central Huron will only collect personal information related to the
specified purposes as described in number 2 above, and information will be collected by
lawful means.
5.
Limiting Use, Disclosure and Retention:
Community Living-Central Huron will not use or disclosure information for purposes other
than those for which it has been collected, unless the individual has consented or as
required by statute or other legal requirements. Personal information will be retained only
as long as necessary for the fulfillment of those purposes.
6.
Accuracy:
Community Living-Central Huron will undertake its best efforts to ensure information it keeps
is accurate, complete and up-to-date for the purposes for which it is collected.
7.
Safeguards:
Community Living-Central Huron will keep all personal information in locked cabinets/offices
and on the computer systems which are password protected. Access is restricted to the
Compliance Officer and authorized personnel.
A.10
8.
Openness:
Community Living-Central Huron will post a copy of its Privacy Policy and make copies
available to all people supported, employees, volunteers, members and donors as
requested. Orientation to the Agency’s Privacy Policy will occur, as appropriate, with people
supported, employees, volunteers, members and donors.
9.
Individual Access:
Upon the receipt of reasonable notice, people supported, employees, volunteers, members
and donors may view the paper and electronic files maintained by Community Living-Central
Huron with their own personal information. The individual may review the information for
accuracy and completeness and request that information be amended as necessary. The
individual has the right to a copy of all documents contained in the files.
10.
Challenging Compliance:
Challenges to Community Living-Central Huron’s Privacy Policy must be made in writing to
the Compliance Officer; the Compliance Officer will respond to any such questions or
suggestions in writing.
EXCEPTIONS TO THE CONSENT AND ACCESS PRINCIPLES:
Community Living-Central Huron may collect and or use personal information without the
individual’s knowledge or consent only if:
a)
b)
c)
d)
e)
it is clearly in the individual’s best interest and consent is not available in a timely manner;
information is required to investigate a breach of an agreement or contravention of a federal
or provincial law and knowledge and consent would compromise availability and accuracy;
it is publicly available as specified in regulations;
the organization has reasonable grounds to believe the information could be useful when
investigating a contravention of a federal, provincial or foreign law and the information is
used for that investigation; and
for an emergency that threatens an individual’s life, health and safety.
Community Living-Central Huron may disclose personal information without the individual’s
knowledge or consent only to:
a)
b)
c)
d)
legal counsel representing the Agency;
collect a debt the individual owes to the Agency;
comply with a subpoena, a warrant or an Order made by a Court or other body with
appropriate jurisdiction; and
a government institution that has requested the information, identified its lawful authority and
indicates the disclosure is for the purpose of enforcing, carrying out an investigation, or
gathering intelligence relating to any federal, provincial or foreign law, or suspects that the
information relates to national security or conduct of international affairs; or is for the
purpose of administering any federal or provincial law.
A.11
SECTION B:
BOARD GOVERNANCE
Section:
Subject:
B
Interpretation
Policy Number: B-001
Total Pages: 1
Approval Date:
May 20, 1981
Revision Date(s) May 15, 1991, April 15,
1992
INTERPRETATION
a)
Association and Agency both mean Community Living-Central Huron.
b)
Board of Directors means the duly appointed Directors of the Association governing the
policies and practices of the Association.
c)
Division Coordinator or Supervisor means the employee responsible for the overall operation
of a) Employment Services b) Residential Services c) Children's Services, and d) any other
Program as designated by the Board of Directors.
d)
Full-time Employee means an employee who is guaranteed forty (40) hours per week.
e)
Part-time Employee means an employee who is guaranteed twenty (20) hours of work per
week but less than forty (40) hours per week.
f)
Occasional Employee means an employee who is not guaranteed a minimum of twenty (20)
hours work per week.
g)
Contract Employee means an employee who is hired to do a specific job for a specified
period of time.
B.1
Section:
Subject:
B
Press and Media Releases
Total Pages: 1
Approval Date: Nov. 21, 1984
Revision Date(s) May 15, 1991
PRESS AND MEDIA RELEASES
In the event that Board Members, Committee Members or Employees of Community Living-Central
Huron are approached for either press or media interviews or the Association wishes to release
written statements, the following authorization must be obtained:
a)
For Board and Committee Members, authorization from the President.
b)
For Employees of Community Living-Central Huron, authorization from the Executive
Director.
B.2
Section: B
Subject:
Relationship w ith Law
Total Pages: 1
Enforcement Agencies
Approval Date:
May 15, 1991
Revision Date(s)
RELATIONSHIP WITH LAW ENFORCEMENT AGENCIES
The Association:
a)
Supports integration of the Developmentally Handicapped into the community and
recognizes that all members of that community are subject to the same laws.
b)
Offers instruction and counselling so that the illegality of activities and the probable
consequences of those activities can be recognized and appreciated.
c)
Supports law enforcement agencies in prevention and detection of unlawful activity.
d)
Will support and assist by lawful means those persons investigated for or charged with
criminal activity with a view to enabling their proper representation and defence.
e)
Will co-operate with courts, probation and parole agencies in abiding by any sentence
imposed.
B.3
Section:
Subject:
B
Community Involvement
Total Pages:
1
Approval Date: March 15, 1989
Revision Date(s) May 15, 1991
COMMUNITY INVOLVEMENT
Staff members at Community Living-Central Huron enjoy a privileged relationship with the people
this organization supports. On occasion, a staff member may wish to hire an employee or tenant
to work for them. Written approval to do so must be obtained from the staff member's supervisor.
In such a case, a memo will be sent to their respective supervisors outlining the work required, the
expected date and hours of work, and the rate of pay.
When staff members invite employees or tenants to accompany them on vacations or outings which
involve the sharing of expenses, written approval must be obtained from the staff member's
immediate supervisor. A memo to the supervisor will be written outlining the nature and the
duration of the outing, the date, and the anticipated financial outlay. The supervisor will contact
appropriate resource people to determine if such a proposal is desirable and feasible.
As a rule, Community Living-Central Huron does not support the involvement of large numbers of
labelled people in a given public activity. When such an activity is contemplated, any staff member
who intends to involve themself should seek written approval to do so through the established lines
of communication with the Executive Director being consulted.
B.4
Section:
Subject:
B
Tenders
Total Pages:
1
Revision Date(s) May 15, 1991,
June 19, 1991, May 19, 1993, May
18, 2005
TENDER POLICY
A minimum of three potential suppliers, when possible, will be contacted for all items being
tendered. All local suppliers and services who could potentially deliver the desired goods or
services, will be given the opportunity to respond to the written tender. Local suppliers are deemed
to be those suppliers who operate within the catchment area of Community Living-Central Huron.
Also, the Finance Committee reserves the right to extend the search outside the catchment area
for specific services and/or products. Items and services to be tendered will be those expenditures
that exceed $5,000., as well as recurring services.
The Finance Committee will provide instructions to the Central Administration Staff with respect to
distributing tenders, specifically date of issue/return; opening instructions; ensuring all details are
included; seeking clarification as necessary from respondents and preparation of a written
summary. At its discretion, the Finance Committee may invite a resource person(s) to assist with
the development of the call for tenders, as well as to review tender responses. A self-addressed
envelope to Community Living-Central Huron, marked: "Attention: Finance Committee - Tender,"
will be included in the tender package. The tender process will be consistently applied to all
services and/or products.
The Finance Committee will review all tenders properly returned before the due date and make a
recommendation(s) to the Board of Directors. Lowest or any tender not necessarily accepted.
Following the motion by the Board of Directors, the Finance Committee or designate, will be
responsible for notifying in writing, the successful and unsuccessful suppliers.
The Tender Policy does not preclude the Executive Director or designate, to conduct market
surveys on various items/services on day-to-day operational products or services.
B.5
Section:
B
Subject:
Usage of Agency
Total Pages:
3
Equipment/Electronic Communication Technologies
Approval Date: Feb. 21, 2001
Revision Date(s): Oct. 16, 2013.
USAGE OF AGENCY EQUIPMENT/ELECTRONIC COMMUNICATION
TECHNOLOGIES POLICY
General:
The intent of this Policy is to provide employees of Community Living-Central Huron with guidelines
and procedures regarding the use of Agency equipment and electronic communication
technologies. As such, the primary use of Agency equipment and electronic communication
technologies is for business usage; therefore, personal use is strongly discouraged. All equipment
is the property of Community Living-Central Huron and as such, management reserves the right,
with reasonable grounds, to monitor/view all e-mail transmissions, internet history files and graphic
caches, with authorization from the Executive Director or designate. The use of equipment and
technology must be consistent with provincial and federal laws, the Agency’s Mission, Vision and
Principles. Non compliance with the Usage of Agency Equipment/Electronic communication
Technologies Policy is subject to discipline, up to and including dismissal from the Agency’s employ.
Definitions:
Agency equipment: would include, but is not limited to the fax machines, laminators, photocopiers,
TV, VCR/ DVD Player, video camera, camera, global positioning system (GPS), postal machine,
post office box, internal mail boxes, etc.
Agency telecommunication devices/systems: would include, but are not limited to computers,
telephones, internet, cell phones, laptops, ipads, iphones, ipods, walkie-talkies, etc.
Software: would include all software for all equipment listed above and operating systems.
Security Software: refers to a computer program designed to enhance information security and
unauthorized access. Similarly, the defence of computer networks is called network security.
Password(s): is a secret word or characters used by an operator to prove identity or gain access
to a resource; a password is not shared with others who are not allowed access.
Procedures:
All Agency equipment and electronic technologies will be labelled as property of Community
Living-Central Huron; the use of agency equipment and electronic technologies is a privilege
and must be treated as such;
-
Staff are required to use Agency equipment as provided for work purposes; use of similar
personal equipment and/or technology is strongly discouraged. Use of personal equipment
for work purposes requires written approval of the relevant Supervisor. The Agency will not
be liable for any damage nor has any responsibility to repair, replace or maintain any
personal equipment used by staff for work purposes;
-
All workstations and portable devices are secured with appropriate licensed security
software; Administrative Staff will ensure installation of appropriate software for security
protection;
B.6
-
All workstations and portable devices must be secured with a password; all passwords will
be registered with the Administrative Coordinator and kept confidential and will only be
accessed by other staff for emergency purposes; passwords are the property of Community
Living-Central Huron;
-
Access to various data on computers, ipads, iphones, etc. will be restricted to relevant Staff;
-
Community Living-Central Huron does or will use external resources and expertise for the
purchase, repair and maintenance of Agency owned equipment;
-
Community Living-Central Huron Administrative Staff will ensure data is backed-up on a daily
basis and kept off-site in a secure, confidential manner;
-
Information or instructions regarding accessing Agency equipment may be obtained from
your immediate Supervisor or Administration Staff.
-
The email system is provided to employees of Community Living-Central Huron to assist in
conducting business and supporting individuals; information in the email system is part of the
public record of the Agency. Email communication is to be treated in the same way as other
types of Agency correspondence and reports and will held to the same standards with
respect to appropriate contents and language.
-
The use of texting among staff is strongly discouraged for: security reasons, impersonal form
of communication, shorten and/or abbreviated language, therefore creating a source of
possible miscommunication. Should a staff utilize texting, they maybe required to submit
their cell-phone to their immediate Supervisor, who may chose to have all Agency related
information transcribed to be included with Agency records;
Unacceptable use/conduct of electronic communication technologies include but is not limited to
the following:
a)
Using the system for any illegal activity, including violation of copyright or other contracts.
This means, in part, that no pirated or self-owned computer software or hardware shall be
installed on any Community Living-Central Huron computer systems;
b)
Use the system for personal, financial or commercial gain;
c)
Degrading or disrupting equipment or system performance;
d)
Vandalizing the data of other users;
e)
Gaining unauthorized access to resources or entities;
f)
Invading the privacy of individuals;
g)
during working hours accessing via computers, ipad, cell phones, internet sites that are
unrelated to their job description/responsibilities;
h)
Adding new software programs or applications (apps) without written authorization of the
immediate supervisor or the Administrative Coordinator.
B.7(a)
i)
sending electronically or downloading Agency files, including personal information on people
supported on portable flash drives or disks without the prior written approval of their
immediate Supervisor.
j)
Sharing the access codes, changing access codes, account numbers, passwords or other
authorizations, including keys, that have been assigned to them without written authorization
from the Executive Director or designate. All staff must request in writing to the
Administrative Coordinator should they wish to change their password(s) and/or pass code.
k)
Allowing unauthorized persons access to Agency equipment/technology.
l)
Using abusive or otherwise objectionable language in either public or private messages.
m)
Purposely sending messages that are likely to result in the loss of information or disruption
to the system (ie. computer virus).
n)
Publishing Web Pages or posting links to sites without the approval of the Executive Director
or designate.
o)
Sending inappropriate messages and/or images or viewing such sites/images. These
include but are not limited to messages and or images that are racist, pornographic,
dangerous, obscene, illegal or interpreted as harassment.
p)
Sending “chain letters” or global messages or other types of communication.
All users of the internet and e-mail having access through Community Living-Central Huron
computers, facilities, offices, or network, must recognize that Community Living-Central Huron does
not accept any responsibility for the use or misuse of information acquired, as well as any situations,
issues, litigation that might arise from unauthorized use or contravention of the above rules of
conduct.
Any unacceptable use (as outlined above) of Community Living-Central Huron equipment or
electronic communication technologies will be addressed by the immediate appropriate Supervisor.
or Coordinator.
Related Policies:
- Guiding Principles (A-002)
- Confidentiality (A-003)
- Privacy (A-004)
- Purchasing and Credit Policy (B-008)
- Individual Welfare/Rights (C-001)
- Individual Support Policy for Persons Supported (C-009)
- Emergency Policy (D-003)
- Bullying, Harassment and Workplace Violence Policy and Procedures (D-007)
- Annual Workplace Maintenance Policy (D-009)
- Employee Performance Appraisals (E-008)
- Vehicle Use (E-009)
- Personal Property Damage (E-010)
- Employee Performance Standards (E-011)
- Disciplinary Policy (E-012)
B.7(b)
Section: B
Subject: Volunteer
Total Pages:
3
Approval Date: December 17, 2003
Revision Date(s): February 18, 2004,
December 19, 2012.
VOLUNTEER POLICY
Community Living-Central Huron supports and promotes the use of volunteers and student
placement programs as an integral link to the community and as part of the Agency’s
commitment to providing quality supports and services. It is recognized that volunteers make
unique contributions of time, talent and skills. Such volunteer contributions are above and
beyond supports provided through Community Living-Central Huron’s Programs; volunteers will
not replace staff, rather provide complimentary support.
The Agency recognizes two different classes of volunteers; Board/Committee Members and
individuals who provide direct supports to enhance services to individuals and/or their families.
Individuals who volunteer with Community Living-Cental Huron are expected to adhere to the
Agency’s Vision, Mission, all policies, procedures, health and safety standards and actively
perform their agreed upon duties to the best of their ability. Volunteers must undergo a Police
Record Search prior to assuming their duties (Police Record Search Policy # E-003).
The purpose of the volunteer is to augment and enrich services provided to individuals and their
families, it is not the Agency’s purpose to infringe upon or affect volunteers from other sources,
ie. Church, Friendship, Recreation, friends, family, acquaintances, etc. Recognizing that
volunteers are a valuable resource, the Agency will strive to provide meaningful assignments and
the right to full involvement and participation. Accepting the services of volunteers will be at the
discretion of the Association and in accordance with the Agency’s Volunteer Guidelines and
Procedures.
Guidelines for Use of Volunteers:
Community Living-Central Huron’s Volunteer Policy B-007 states that it supports and promotes
the use of volunteers and student placement programs. The role of volunteers is to augment and
enrich services provided by staff to individuals and their families, not replace staff, friends or
families. It is not the Agency’s intent to infringe upon or affect volunteers from other sources, ie.
Church, Friendship Club, recreational activities. There are two categories of volunteers: Board
and Committee Members and individuals who provide direct supports. Acceptance of and
termination of volunteers is at the discretion of the Agency, its Board of Directors and Senior
Management Team.
1.
RESPONSIBILITIES:
Community Living-Central Huron:
a)
endeavour to provide meaningful assignments which reflect the various abilities
and interests of both the volunteer and the individual receiving support which
adheres to the Agency’s vision, mission, goals and objectives;
b)
provide orientation and necessary training of the Agency’s policies and procedures;
ensure all required documentation throughout the assignment is completed; and
appropriate levels of supervision and regular feedback as to their performance; and
c)
provide coverage under its Commercial Insurance Policy.
B.8
Volunteer:
a)
actively perform assigned duties to the best of their ability;
b)
understand, abide by and promote the Agency’s vision, mission, goals and
objectives and adhere to the Agency’s Confidentiality and Privacy Policies, and any
other applicable policies and procedures;
c)
complete and submit all required documentation in a timely manner; and
d)
direct any questions, concerns to the appropriate Supervisor, or designate, in a
timely manner.
2.
GUIDELINES AND PROCEDURES:
a)
Board and Committee Members:
Standing Committee Chairpersons are responsible for recruiting Committee
Members for their respective Committees and reviewing the Committee’s Terms of
Reference on an annual basis, as well as holding regular meetings and ensuring a
quorum. All Committees are required to observe the Agency’s vision, mission,
policies and procedures in any recommendations to the Board of Directors. The
Vision and Mission Statements will appear as a standing item on all Board and
Committee Agendas.
The Nomination Committee, Board of Directors, is responsible for soliciting potential
nominees for election to the Board and providing a list of all nominees to the
Membership at the Annual General Meeting. Refer to By-Law No. 3, Code of
Conduct and Job Description for Board Members for further information with respect
to composition, eligibility, responsibilities, meetings, voting rights, etc.
b)
Direct Volunteers:
This category includes student placement programs and individuals recruited to
volunteer. Should an Agency employee wish to volunteer, they must not have a
‘professional’ relationship with the individual. The employee will complete a
volunteer application form and discuss with their immediate Supervisor and
Coordinator, their intention to volunteer. Guidelines and procedures are as follows:
C
C
C
C
C
recruitment may be by word of mouth, posting or advertising;
Coordinators/Senior Case Managers will advise the Executive Director of the
requirement and proposed job description; the Board of Directors may be
approached to cover the costs of paid advertising;
a written resume or “Volunteer Application Form” must be completed as well
as participation in an interview comprised of at least two of the following:
Executive Director, Coordinator, Senior Case Manager or Facilitator;
Coordinators/Senior Case Managers/Facilitators will be responsible for
assisting with recruitment, interviews, selection, screening, reference
checks, receipt of a signed Work Education Agreement or any other such
Agreement with other Volunteer Programs (if applicable), determining
specific responsibilities; orientation to the Agency including the vision,
mission, goals and objectives, Policies and Procedures document, Guiding
Principles; apprisal of other Agency related documents and information;
determining if any training is necessary, and maintaining a record of the
number of hours volunteered;
relevant, pertinent information regarding the individual receiving support will
be provided by the appropriate Supervisor, or designate;
volunteers under the age of eighteen must submit a “Volunteer Parental
Acknowledgment;”
B.9
C
C
C
the Executive Director will provide an original letter and copy to the volunteer
outlining the conditions of their volunteer assignment; the volunteer must
sign and submit the second copy to the Coordinator/Senior Case
Manager/Facilitator;
the volunteer’s immediate Supervisor must pre-approve expenses, mileage
and training, if applicable. If a volunteer is using their own personal vehicle
or an Agency vehicle to transport individuals, they must submit prior to
transporting, their driver’s licence number and a copy of their insurance
policy indicating a minimum of one million dollars third party liability; and
the volunteer’s immediate Supervisor will maintain an up-to-date file
containing pertinent information, ie. resume, Volunteer Application Form,
signed copy of Executive Director’s letter outlining the conditions of the
volunteer assignment, Volunteer Parental Acknowledgment, Oath of
Confidentiality, evaluations, references, etc.
B.10
Section:
Subject:
B
Purchasing and Credit
Total Pages:
3
Approval Date: Sept. 15, 2004
Revision Date(s) Oct. 20, 2010
PURCHASING AND CREDIT POLICY
To ensure the best use of Agency resources and that proper controls and authorizations are in
place for the Agency, people supported, staff and volunteers, all Agency purchases and expenses
must be appropriately authorized and recorded with original documentation. Should original
documentation not be available, a note of explanation must be provided and authorized by the
Supervisor. Invoices will be addressed to Community Living-Central Huron, P. O. Box 527,
Goderich, Ontario, N7A 4C7.
The Supervisor and/or the Coordinator will authorize all purchases in advance of the purchase
and will initial the receipt prior to presentation to the Office Accountant for payment. Also, each
receipt will clearly identify the item(s) purchased, which department the expense is costed, tax
information and if there is any reimbursement. All receipts will be stamped with the internal
authorization stamp and completed by each appropriate Supervisor. Purchases and expenses
include: petty cash, credit cards, pre-authorizations, charge accounts, promotions/bonus offers,
etc.
At a minimum, bi-weekly, the Office Accountant will provide to the Executive Director, all
invoices/receipts of purchases, ensuring such receipts are appropriately authorized, prior to
preparing cheques or documenting on-line payment. This is to ensure no service or interest
charges are incurred by the Agency. All Agency cheques require two signatures, as determined
annually by the Board of Directors.
Community Living-Central Huron utilizes credit cards for authorized Agency use only, this is for
the convenience of staff, volunteers and people supported. The Office Accountant will exclusively
hold, administer and reconcile the use of the Agency Credit Card. Coordinators, Senior Case
Managers and other authorized staff will have access to the Agency Credit Card for the purposes
of pre-purchasing out-of-town trips, hotel and ticket orders for people supported as well as for
other authorized Agency purchases. The Agency also has available in each Agency owned
and/or leased vehicle, a credit card for purchasing gas and other necessary items related to the
operation of the vehicle, ie. washer fluid, wiper blades.
The following procedures have been developed for use of the Agency Credit Card for the
protection of the Agency, its staff and volunteers:
a)
It is important to make arrangements to use the Agency Credit Card in advance of
anticipated usage; staff and/or volunteers using the Agency Credit Card will first complete
the Detailed Use of Credit Card Form, authorized by their Supervisor. The completed
original Detailed Use of Credit Card Form will be given to the Office Accountant, at the time
of accessing the Credit Card. Staff are required to indicate the date the card is accessed
and when it will be returned to the Office Accountant.
B.11
b)
Staff accessing the Agency Credit Card, or the Supervisor, will provide to the Office
Accountant, as soon as possible, a receipt/proof of purchase/confirmation number, etc.,
containing the completed internal authorization stamp.
c)
When the Agency Credit Card is utilized on behalf of people supported, for pre-purchasing
tickets, hotel accommodations, transportation, etc., for an upcoming holiday/outing,
payment for such purchases shall be made no later than two weeks following the booking.
In addition, currency exchanges for non-Canadian dollars will be charged once the
‘monthly’ Credit Card Statement is received; the Office Accountant will notify in writing the
appropriate individual and/or staff.
d)
It is important to ensure the HST number is included on every invoice.
e)
The Agency’s credit limit is $5,000. The outstanding balance will be paid in full upon
receipt of the statement, to ensure no interest charges.
The following procedures have been developed for use of the gas credit cards located in each
vehicle leased/owned by the Agency:
a)
Gas credit cards, are kept locked inside the Agency locked vehicle, ie. glove box, console,
at all times. Vehicle doors are locked when exiting the vehicle.
b)
Signed receipts for all purchases made with the gas credit card, along with the mileage
sheet, are submitted to the Office Accountant weekly. Supervisors are required to initial
the summary page of mileage sheets, for approval and authorization purposes.
c)
Should the gas card have bonus or rewards program offers attached to it, staff will ensure
such bonuses or rewards are credited to Community Living-Central Huron. Examples of
such bonus or rewards programs are: Air Miles, Esso Extra, Petro Points, Bonus Bucks,
etc.
The following procedures have been developed for pre-authorized purchases and credit
applications:
a)
The Executive Director and Coordinator(s) will determine which local and out-of-town
businesses/suppliers will be accessed for credit purchases on behalf of the Agency. Also,
the Executive Director and the applicable Coordinator(s) will establish which staff and or
volunteers will be authorized to make purchases on behalf of the Agency.
b)
It is necessary for the Agency, Executive Director, to provide each business with
verification and in some situations, sample signatures of staff and/or volunteers who are
authorized to purchase items on the Agency’s behalf. Examples of pre-authorized
accounts are: Wal-Mart, Zellers Inc., MicroAge Basics, Microtech Computers, H.O. Jerry
(1983) Ltd. and Ideal Supply.
B.12
c)
Receipts for all pre-authorized purchases will be signed by the staff or volunteer making
the purchase and initialled by the staff/volunteer’s immediate Supervisor. The Supervisor
will immediately provide all receipts and authorizations to the Office Accountant to ensure
no late payment fees and/or interest is charged to Community Living-Central Huron.
d)
Any bonus offers, promotions, gift certificates, credit vouchers, etc., are the property of
Community Living-Central Huron. Staff and volunteers will not keep such forms of
recognition for their own personal use.
The Agency expects that the convenience and benefit of utilizing Agency credit cards, preauthorized purchases and credit applications will be respected and used solely for the intended
purchase; any deviation will result in disciplinary action up to and including termination of
employment.
B.13
Section:
Subject:
B
Accessibility Policy
Total Pages:
4
Approval Date: Dec, 21, 2011
Revision Date(s)
ACCESSIBILITY POLICY
Community Living-Central Huron (CL-CH) is committed to conforming to all aspects of the
Accessibility for Ontarians with Disabilities Act, 2005 (AODA), Ontario Regulation 429/07
(Accessibility Standards for Customer Service) and the Ontario Human Rights Code. The Agency
will strive to ensure all locations, owned or operated by CL-CH which are accessed by the public,
provide barrier-free services, supports, environments and employment. This policy does not apply
to the homes or apartments/units where people supported live, as these are not areas the public will
be accessing for service. The Agency recognizes the key principals of accessibility are
independence, dignity, integration and equality. All employees and volunteers are expected to
actively support this policy and its procedures; non-compliance is subject to discipline, up to and
including dismissal.
Definitions:
Assistive Devices – as defined in the Guide to the Accessibility Standards for Customer Service,
is a technical aide, communication device, or medical aid modified or customized, that is used to
increase, maintain, or improve the functional abilities of people with disabilities. Examples include,
but are not limited to walkers, canes, wheelchairs, hearing aids or oxygen tanks.
Barrier – as defined in the Accessibility of Ontarians with Disabilities Act is anything that prevents
a person with a disability from fully participating in all aspects of society because of his or her
disability, including a physical barrier, an architectural barrier, information or communications barrier,
an attitudinal barrier, a technological barrier, a policy or a practice.
Disability – as defined in the Accessibility for Ontarians with Disabilities Act and the Human Rights
Code is:
-
any degree of physical disability, infirmity, malformation or disfigurement that is caused by
bodily injury, birth defect or illness and, without limiting the generality of the foregoing,
includes diabetes mellitus, epilepsy, a brain injury, any degree of paralysis, amputation, lack
of physical coordination, blindness or visual impediment, deafness or hearing impediment,
muteness or speech impediment, or physical reliance on a guide dog or other animal or on
a wheelchair or other remedial appliance or device;
-
a condition of mental impairment or developmental disability;
-
a learning disability, or a dysfunction in one or more of the processes involved in
understanding or using symbols or spoken language;
-
a mental disorder; or
-
an injury or disability for which benefits were claimed or received under the insurance plan
established under the Workplace Safety and Insurance Act, 1997.
B.14
Guide Dog – as defined in Ontario Regulation 429/07 and section one (1) of the Blind Persons
Rights Act is a dog trained as a guide for a person who is blind and having qualifications prescribed
by the regulations under the Blind Persons Rights Act.
Premises – all locations owned and operated by Community Living-Central Huron where the public
has access.
Service Animal – as defined in Ontario Regulation 429/07 is a service animal for a person with a
disability:
-
if it is readily apparent that the animal is used by the person for reasons relating to his or her
disability; or
-
if the person provides a letter from a physician or nurse confirming that the person requires
the animal for reasons relating to the disability.
Support Person – as defined in Ontario Regulation 429/07 in relation to a person with a disability,
another person who accompanies him or her in order to help with communication, mobility, personal
care or medical needs or with access to goods or services.
Procedures:
Providing Services to People with Disabilities:
Community Living-Central Huron is committed to excellence in providing supports and services to
people with disabilities and will carry out all functions and responsibilities in the following areas:
-
The services must be provided in a manner that respects and promotes dignity,
independence and integration of persons with disabilities.
-
The provision of services to persons with disabilities and others must be inclusive unless an
alternate measure is necessary, whether temporarily or on a permanent basis, to enable a
person with a disability to obtain, use or benefit from the services.
-
Persons with disabilities must be given an opportunity equal to that given to others to obtain,
use and benefit from the services.
Communication with Persons with Disabilities:
When communicating with people with disabilities, Community Living-Central Huron will do so in a
manner that will take into account their disability.
Assistive Devices:
The use of assistive devices by persons with disabilities to obtain, use or benefit from Community
Living-Central Huron’s services will be recognized unless otherwise prohibited due to health and
safety of privacy issues. In these situations, Community Living-Central Huron may offer a person
with a disability other reasonable measures to assist him or her in obtaining and using Community
Living-Central Huron’s services where applicable.
B.15
It is the responsibility of the person with a disability to ensure that his or her assistive device is
operating in a safe and controlled manner at all times.
Use of Guide Dogs and Service Animals:
Community Living-Central Huron is committed to welcoming people with disabilities who are
accompanied by a guide dog or service animal on the parts of our premises that are open to the
public and other third parties. Community Living-Central Huron will ensure that all employees and
volunteers dealing with the public are properly trained in how to interact with people with disabilities
who are accompanied by a guide dog or service animal.
Use of Support Persons:
Community Living-Central Huron is committed to welcoming people with disabilities who are
accompanied by a support person and will be allowed to enter Community Living-Central Huron’s
premises with his or her support person. At no time will a person with a disability who is
accompanied by a support person be prevented from having access to his or her support person
while on the premises. Fees will not be charged for the support person for admission to programs
or services. Where admission fees for the support person are applicable, Community Living-Central
Huron will provide advance notice of the fee.
Service Disruptions:
Community Living-Central Huron will provide notice to people with disabilities in the event of a
planned or unexpected disruption in the facilities or services used by people with disabilities. This
notice will include information about the reason for the disruption, its anticipated duration, and a
description of alternative facilities or services, if available.
The notice will be placed at applicable premises or by such other method as it is reasonable under
the circumstances. In the event of an unexpected disruption, notice will be provided as soon as
possible.
Feedback Process:
The goal of Community Living-Central Huron is to meet expectations of people who are supported
while welcoming family members and other visitors. Comments on CL-CH’s services regarding how
well those expectations are being met are welcomed and appreciated. Feedback may identify areas
that require change and encourage continuous service improvements.
Feedback regarding the provision of services to people with disabilities can be made in person, by
phone, e-mail, in writing or through the mail. A form for feedback or suggestions is attached as to
this policy for reference and is available on the Agency’s website (www.clch.ca), and at the Central
Administration Office (267 Suncoast Drive, East, Goderich). All feedback may be addressed to
Central Administration, Community Living-Central Huron; the Agency will respond to all feedback
received.
Training for Employees:
Community Living-Central Huron will provide training to all employees and volunteers who support
people with disabilities or come in contact with any other person who may access the Agency’s
premises, and all those who are involved in the in the development and approvals of customer
service policies, practices and procedure.
New and current employees will be trained by completing the Serve-ability: Transforming
Ontario’s Customer Service on-line training by accessing www.mcss.gov.on.ca/mcss/serveability/splash.html with employees signing off to indicate the training is understood and complete.
B.16
Questions Regarding the Policy:
This policy exists to achieve service excellent to customers with disabilities. If anyone has a
question about the policy, or if the purpose of the policy is not understood, an explanation will be
provided upon request. Community Living-Central Huron will provide a copy of the policy, practices
and procedures required under Ontario Regulation 429/07 upon request and a copy is also available
on the Agency’s website, www.clch.ca
If Community Living-Central Huron is requested to provide a person with a disability a document or
information, Community Living-Central Huron will take into consideration the communication needs
of the person with a disability and endeavour to provide the information to the person in a format that
takes into account the person’s disability.
B.17
Section:
Subject:
B
Duty of Care
Total Pages: 2
Approval Date:
November 19, 2014.
Revision Date(s)
DUTY OF CARE POLICY
Community Living-Central Huron believes the health and safety of its Staff, Volunteers and the
people who access Agency services is a priority. To this end, CL-CH is responsible for the
development of policies, procedures, guidelines and practices to establish a standard of reasonable
care while Staff and Volunteers perform their duties. Staff and Volunteers share in the
responsibility of Duty of Care by following all Agency policies, procedures, guidelines, reading all
information that is provided to them, obeying laws and working within ‘industry’ standards.
Definitions:
Duty of Care:
Is a requirement to act toward others in a prudent and cautious manner to avoid the risk of
reasonably foreseeable harm to oneself and others. Employers are expected to take practical
steps to safeguard their employees and volunteers against any foreseeable dangers.
Reasonable Care:
Is the standard of care a reasonable service provider would practice in a similar situation. More
specifically, what is expected of any reasonable person who performs the same duties. Factors
considered for reasonable care include:
- Agency policies, procedures and guidelines;
- Job requirements and job description;
- Preventative Measures, such as information, relevant equipment;
- Training of Staff and Volunteers;
- Laws and regulations;
- Practicalities relating to the situation;
- Needs of others in the situation;
- Current trends in the field; and
- Community values and attitudes.
Breach of Duty of Care:
When the Agency, Staff or Volunteer have not taken reasonable steps to prevent harm; risk and
liability can be increased by virtue of something done or omitted to be done that was not reasonable
in the situation.
Related policies, procedures:
Abuse (C-004)
Use of Physical Restraints (C-005)
Serious Occurrence )C-006)
Finances of People Supported (C-008)
Medical Care for Persons Supported (C-012)
Missing Person/Unknown Whereabouts (C-016)
Bathing and Showering Supervision of Persons Supported (C-014)
B.18
Related policies, procedures (cont’d):
Medication Policy (D-002)
Emergency (D-003)
Bullying, Harassment and Workplace Violence (D-007)
Pandemic (D-008)
Annual Workplace Maintenance (D-009)
Musculoskeletal Disorders Awareness (D-010)
Working Alone (D-012)
Infection Control (D-013)
Hazard/Risk (D-014)
Employee and Volunteer Orientation (E-005)
Professional Development/Training (E-006)
Vehicle Use (E-009)
Disciplinary (E-012)
Sexual Harassment (E-013)
Occupational Health and Safety Document
B.19
Section: Board Governance
Subject: Code of Conduct Policy Total Pages: 2
Approval Date: June 23, 2015
Revision Date(s)
CODE OF CONDUCT POLICY
Policy:
Community Living-Central Huron is dedicated to ensuring quality supports are provided to every
person who accesses the Agency’s services. All employees and volunteers are required to abide
by an acceptable Code of Conduct when representing the Agency and when performing their job
responsibilities. Further, Community Living-Central Huron is devoted to maintaining its reputation
for integrity and high moral standards and all employees and volunteers are required to abide by
ethical and lawful conduct.
Purpose:
To convey to employees and volunteers the conduct requirements expected as representatives
of Community Living-Central Huron when interacting with people supported, co-workers, families,
other agencies/services, and the communities in which people live and access services.
Guidelines:
All Employees and Volunteers will:
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Work in the best interests of the people supported;
Treat people with respect, compassion, dignity and fairness;
Support, promote and apply the principles of human rights, equity, dignity and respect in the
workplace;
Act fairly and objectively;
Recognize and address conflicts of interests;
Think about how our actions may impact on the people supported, co-workers, family, other
agencies/services and the community;
Exercise best judgement;
Protect the confidentiality of the information intrusted to us;
Report what we think is not in the best interests of people supported or the Agency;
Provide support services in an honest and diligent manner;
Ensure the services provided are within the limits of our knowledge, role, experience and skill
and seek the necessary assistance, when appropriate;
Adhere to statutory acts, regulations, by-laws, civil and criminal laws and never knowingly
engage in or condone any unlawful activity or attempt to circumvent the clear intention of the
law;
Maintain personal and professional growth by engaging in activities that enhance the credibility
and value of our role;
Cooperate fully and honestly for investigations of possible performance breaches; and
Maintain familiarization of Agency guidelines, policies, procedures, principles and philosophical
statements.
Responsibilities:
The Employer is responsible to have guidelines, policies, procedures, principles and philosophical
statements in place to establish what constitutes an acceptable Code of Conduct for employees
and volunteers.
B.20
It is the responsibility of every employee and volunteer to adhere to the Code of Conduct Policy
by abiding by established guidelines, policies, procedures, principles and philosophical statements
and to report all breaches of the Code of Conduct to their relevant Supervisor or designate.
The Supervisors will investigate all reports of Code of Conduct violations as soon as possible and
take appropriate steps to address any continuing risks to the health, safety and well being of all
employees, volunteers and people supported.
Non-compliance with this Policy is subject to discipline, up to and including dismissal from
Community Living-Central Huron’s employment and/or volunteer opportunity.
Related Policies and Procedures:
- Philosophy Community Living-Central Huron (A-001)
- Confidentiality Policy (A-003)
- Privacy Policy (A-004)
- Community Involvement (B-004)
- Usage of Agency Equipment/Electronic Communication Technologies Policy (B-006)
- Volunteer Policy (B-007)
- Accessibility Policy (B-009)
- Duty of Care Policy (B-010) ??
- Individual Welfare/Rights Policy (C-001)
- Behavioural Support Policy (C-002)
- Person Supported Complaint/Feedback Policy (C-003)
- Abuse Policy (C-004)
- Use of Physical Restraints Policy (C-005)
- Serious Occurrence Policy (C-006)
- Communication Book (C-007)
- Finances of People Supported (C-008)
- Pet Ownership, Visiting Pets and Service Animals (C-010)
- Orientation for People Supported (C-011)
- Medical Care for Persons Supported Policy (C-012)
- Inventory, Personal Belongings of Persons Supported Policy (C-013)
- Bathing and Showering Supervision of Persons Supported Policy (C-014)
- Persons Supported Food and Nutrition Policy (C-015)
- Health and Safety Policy Statement (D-001)
- Smoking (D-004)
- Dangerous Weapons and Fire Arms (D-005)
- Bullying, Harassment and Workplace Violence Policy and Procedures (D-007)
- General Policy NO. 2 (E-001)
- Professional Development/Training Policy (E-006)
- Individual Consultation Policy (E-007)
- Employee Performance Appraisal Policy (E-008)
- Employee Performance Standards Policy (E-011)
- Sexual Harassment Policy (E-013)
- Medication Policy and Procedures Manual
- Occupational Health and Safety Document
B.21
SECTION C:
SUPPORT SERVICES
Section:
Subject:
C
Individual W elfare/Rights
Policy Number: C-001
Total Pages:
2
Approval Date: Oct. 18, 2000
Revision Dates: May 17, 2006,
April 20, 2011, May 20, 2015
INDIVIDUAL WELFARE/RIGHTS POLICY
Community Living-Central Huron endeavours to ensure individuals supported by the Agency and
their families are aware of and exercise their rights as individuals. Notwithstanding these rights,
the safety and security of an individual will take precedence. Non-compliance with the
Individual Welfare/Rights Policy is subject to discipline, up to and including dismissal from
Community Living-Central Huron’s employment and/or volunteerism.
Persons receiving support from Community Living-Central Huron shall be made aware of their
rights and shall have the same rights as all Canadian citizens as inscribed by the legislation listed
below. It is intended that all legislation is included and is not limited to the following:
-
Canadian Charter of Human Rights and Freedoms
The Ontario Human Rights Code
The Employment Standards Act
Freedom of Privacy and Information Act (Freedom of Information and Protection of
Privacy Act)
United Nations Declaration on the Rights of Disabled Persons
The Substitute Decisions Act
The Consent to Treatment Act (Health Care Consent Act)
The Mental Health Act
Also, individuals receiving support will be protected by the Principles, Policies and Procedures
adopted by the Board of Directors of Community Living-Central Huron. Examples of such are:
Guiding Principles, Confidentiality, Privacy, Behavioural Support, Abuse, Participant
Complaint/Grievance, Finances of People Supported, Individual Support, Use of Physical
Restraints, Health & Safety and Medication.
Procedure:
The following guidelines are to be used in considering the rights and welfare of persons receiving
support. Any staff or volunteer who witnesses or has knowledge of a violation of the rights of an
individual being supported shall report the matter without delay to their immediate Supervisor or
designate. Such rights would include the:
a) right to proper medical care and physical therapy and to such education, training, and
rehabilitation to enable each individual to develop to their potential;
b) right to economic security and to a decent standard of living;
c) right to cultural, ethnic and religious beliefs;
d) right to perform productive work or to engage in any other meaningful activity;
e) right to participate in their individualized support plan(s);
f) right to protection from exploitation, abuse and degrading treatment;
g) right to due process of law;
h) right to privacy and to have such right promoted and encouraged;
i) right to social inclusion;
j) right to individual choice; and
k) right to independence.
C.1 (a)
Protocols:
To assist Staff and Volunteers with providing optimal support, as per individual needs, specific written
protocols may be necessary. It is important to consider all factors when developing protocols, such
as those listed above under Procedures (a-k). Following are areas, not all inclusive, that may require
protocols to ensure the safety, security and welfare of people supported.
a)
b)
c)
d)
e)
f)
Bathing Requirements
Support Approaches
Level of Supervision
Visual Checks
PRN Medications
Intrusive Intervention Protocol
Related Policies/Procedures:
Individual Support Policy for Persons Supported (C-009)
Orientation for People Supported (C-011)
Medical Care for Persons Supported (C-012)
Bathing and Showering Supervision of Persons Supported (C-014)
Persons Supported Food and Nutrition Policy (C-015)
Missing Person/Unknown Whereabouts Policy (C-016)
Medication Policy and Procedures Manual
Other Related Documents:
Quality Assurance Measures
Occupational Health & Safety Document
C.1(b)
Section:
Subject:
C
Behavioural Support Total Pages:
6
Revision Date(s) Feb. 19, 2003
Dec. 19, 2012, February 20, 2013,
Draft - Jan. 2016)
BEHAVIOURAL SUPPORT POLICY
Behavioural Support Position Statement:
It is the position of Community Living-Central Huron that all support strategies occur through
adherence to legal, ethical and professional standards and in accordance with the Agency's "Guiding
Principles."
Community Living-Central Huron recognizes the intrinsic importance of staff providing support to the
individuals who access the Agency's services. In addition, Community Living-Central Huron realizes
that providing support to individuals who have behavioural difficulties may at times cause feelings of
apprehension and uncertainty. In respect to this, Agency practices and procedures, such as:
gathering information about the individual and their support needs from staff, family, external support
providers and the individual; staff orientation; staff/case meetings; use of external
consultants/resources; developing individual support protocols; professional development/staff
training, and supervision will be accessed to ensure the health and safety of all individuals.
It is the Agency's view that behaviour difficulties may be the result of various factors; such as a
person's disability, environment, faulty learning process or form of communication. Therefore, the
Agency would not condone any program or other intervention, the object or result of which is
to label, stigmatize or otherwise set apart individuals served by Community Living-Central
Huron.
Reflective of the Agency's philosophy, Community Living-Central Huron has developed specific
guidelines to follow when implementing behaviour support strategies. It is anticipated these
guidelines will provide staff with guidance in determining acceptable, positive ways of supporting
people who may present difficult or challenging behaviours. While this list is not exhaustive, each
method is explained and some concrete examples and definitions are provided:
•
Challenging behaviour: Behaviour that is aggressive or injurious to self or others or that causes
property damage or both and that limits the ability of the individual to participate in daily life
activities and in the community or to learn new skills or a combination.
•
Behaviour Support Plan: Document that is based on written functional assessment of the person
that considers historical and current, biological and medical, psychological, social and
environmental factors (a bio-psycho-social model) that outlines intervention strategies designed
to focus on the development of positive behaviour, communication and adaptive skills.
•
Intrusive behaviour intervention: A procedure or action taken on a person in order to address
the person’s challenging behaviour, when the person is at risk of harming themself or others or
causing property damage.
C.2
•
Video monitoring and recording: A tool used to assist in meeting the needs of a person
when safety of the person and/or Staff may be of significant concern and/or a tool used for
a comprehensive evaluation of a person with challenging behaviour.
C
Approved Methods:
Those methods that are acceptable to use in most
circumstances.
C
Restricted Methods:
Those methods that are acceptable only in special
circumstances.
C
Prohibited Methods:Unacceptable
methods
of
dealing
with behaviour.
1. Approved Methods of Behavioural Support:
Approved methods of behavioural support are defined as any practice, intervention, or planned
method of support that is positive or constructive in nature and is geared toward promoting new
ways of understanding emotions, behaviours, difficulties, challenging situations, or reinforces
positive behaviour. It is not controlling in nature, and in no way infringes on the rights and
freedoms of the individual.
Approved and appropriate methods of support are as follows:
a)
b)
c)
d)
e)
f)
g)
h)
i)
j)
k)
l)
m)
n)
o)
C.P.I. Nonviolent Crisis intervention; a safe, non-harmful behaviour management system
designed to aid staff members in maintaining the best possible care, welfare, safety and
security for agitated or out-of-control individuals;
Positive Systems Approach;
Listening;
Compliments;
Talking to the person;
Teaching or learning components, including teaching proactive skills and communication
strategies to maximize the individual’s abilities and to minimize challenging behaviour;
Review of the individual’s living environment, including the physical space and support and
social networks, to identify possible causes of challenging behaviour and make changes
to the living environment to reduce or eliminate the causes;
Facilitating informed choices; it is important to provide choices and accept the person’s
decision and also to provide additional opportunities where appropriate. Remember that
choosing between 2 things is a dilemma, 3 is a choice;
Natural consequences: natural consequences are those which permit the person to
learn from the natural order of daily living (ie. refusing to eat is followed by hunger or
spending all your bus money is followed by walking). Logical consequences permit the
person to learn from the reality of the social order (ie. you may be avoided by your friends
for your body odour if you refuse to wash).
Role playing;
Modelling positive behaviour;
Letting persons make mistakes that are not harmful;
Changing the subject, creating a diversion, or redirecting the behaviour to a positive
activity;
Making a suggestion or respecting that the person might want to spend time alone; and
Reinforcement of positive actions.
C.3
2. Restricted Methods of Behavioural Support:
Restricted methods are defined as any practice, crisis intervention or planned procedure that
could be perceived as infringing on the right and/or freedom of movement of the individual but is
not considered a prohibited practice (see prohibited methods).
It is recognized that there may be an occasion whereas such intervention may be required to
resolve a potentially violent situation.
Restricted methods may in limited circumstances be appropriate, but only with the consent of the
individual and/or where applicable, persons acting on behalf of the individual, and after careful
planning and documentation and in consultation with the individual's support network (Agency
staff, external agencies, consultants, family) and with the approval of the relevant Supervisor and
Coordinator.
There are two types of Restricted Methods:
a)
Those requiring prior approval of the relevant Supervisor and Coordinator. These are
carefully planned methods of intervention and determined to be necessary when issues
prevent the application of a full positive systems approach.
The incident reporting procedure is to be followed by the staff involved and the Supervisor
contacted within a twenty-four (24) hour period or the first working day.
Examples of i): protective restraints (ie. helmets), token economy, the use of video
monitoring and recording, prescribed medication to assist the individual in calming.
Note:
1.
The prescribed medication used to assist an individual in calming must have a
clearly defined protocol developed by a physician as to when to administer the
medication and how the medication is to be monitored and reviewed. Further,
medication used for calming an individual is considered an intrusive
intervention and is subject to an annual review by the Review Committee.
2.
b)
All video monitoring must adhere to the principles as noted herein (#4
Individual Support Protocols/Behaviour Support Plans). CL-CH views video
monitoring and recording as an intrusive intervention and requires an annual
review by the Review Committee.
Emergency/Crisis intervention strategies that are deemed necessary by the Support
Worker to prevent serious or life threatening injury. Documentation, using the designated
form, would be required to be completed by the Support Worker within a 24 hour period
or the first working day. The Supervisor or designate or Pager would be contacted
immediately following the emergency/crisis intervention.
Example of ii): CPI Nonviolent physical intervention; used only as a last resort when a
person is a danger to self or others. It involves the use of safe, non-harmful control and
restraint positions to safely control an individual until he can regain control of his behaviour.
The individual’s family/primary support network would be notified of the use of a physical
restraint, as appropriate.
C.4
3. Prohibited Methods of Behavioural Support:
Prohibited methods are defined as methods that are commonly referred to as being aversive. They
restrict human rights and/or freedom of movement of the individual and are a direct conflict of the
Agency's "Guiding Principles." Under no circumstances will these methods be condoned.
The use of prohibited methods will result in disciplinary action which may include termination of
employment and/or legal action.
Examples of prohibited methods are:
a)
b)
c)
d)
e)
f)
g)
h)
i)
j)
k)
l)
m)
n)
o)
p)
q)
striking the person with or without a physical object;
use of unnecessary force, or threats of force (physical, verbal or emotional);
shaking, shoving, striking, spanking, or any other form of physical aggression;
punishment of a person by another person or group of people condoned or instigated by
staff (ie. removing privileges);
requiring or forcing the person to assume an uncomfortable position (ie. squatting, kneeling);
requiring or forcing the person to repeat physical movements;
interfering with, or interrupting a person's sleep;
harsh or degrading verbal remarks (ie. name calling);
deprivation of basic needs (ie. withdrawal of food, shelter, warmth);
confinement (ie. placing the person in an enclosed area that is barren of reinforcers and
from which escape is not permitted);
secure isolation - NO person is to be detained in a locked room;
noxious stimuli - a punishment procedure in which a noxious stimulus is applied (ie. lemon
juice in mouth, water mist spray in face, inhalation of aromatic ammonia);
mechanical restraint - any device or equipment which reduces freedom of movement or
exposure to stimulation. Devices and equipment, as well as those listed as approved
practices, used to protect a person with physical disabilities or self- injurious behaviour are
not considered a mechanical restraint. These include splints and helmets to prevent selfinjury as recommended by a Physician or Occupational Therapist;
contingent electric shock - a punishment procedure in which an aversive electrical stimulus
is briefly applied immediately following the occurrence of a pre-defined response;
facial screening - the practice of putting a mask over the eyes for a specific period of time
contingent upon a specified behaviour;
contingent exercise - the repeated practice of physically demanding movements contingent
on a specified behaviour;
over-correction - requiring an individual to repair any environment damage they have
caused to a state vastly improved from that which existed prior.
C.5 (a)
4. Individual Support Protocols/Behaviour Support Plans:
The following principles will be adhered to when developing Individual Support
Protocols/Behaviour Support Plans which address challenging behaviour:
•
•
•
•
•
•
•
•
•
•
•
•
•
5.
Outline positive behaviour intervention strategies and include the least intrusive and most
effective strategies possible.
Ensure strategies in the protocol/plan are designed to focus on the development of positive
behaviour, communication and adaptive skills to enable the individual to reduce, change and
overcome their challenging behaviour that may limit their potential for inclusion in the
community
All strategies will ensure the dignity of the individual is maintained throughout the process.
Within the laws of society, all people who have difficulty managing their behaviour have the
right to live in the community as valued citizens and to participate fully in community life.
All behaviour strategies developed are consistent with the core values of the Agency and
reflective of its philosophy, vision and mission statements.
Individual Support Protocol/Behaviour Support Plan principles do not relieve the individual
of ownership and responsibility for their behaviour and legal consequences.
Participation in the development and maintenance of the Individual Support
Protocol/Behaviour Support Plan will include the person and/or representative’s (ie. family,
support network)/ informed choice/consent and inclusion and such participation will be
documented in the protocol/plan.
Individual Support Protocols/Behaviour Support Plans to address challenging behaviour,
whereas the inclusion of an intrusive behaviour intervention is within the Protocol/Plan, there
must be written approval by a psychologist, a psychological associate or behaviour analyst
certified by the Behaviour Analyst Certification Board or physician.
All Staff working with individuals who have an Individual Support Protocol/Behaviour
Support Plan are required to review such Protocol/Plan at least twice in each 12 month
period.
Each Individual Support Protocol/Behaviour Support Plan will specify who is to be contacted
and updated regularly on the use of any intrusive behaviour intervention. Should an
individual not have an Individual Support Protocol/Behaviour Support Plan and an intrusive
behaviour intervention is used, pending consent of the individual, notification to the
individual’s family/primary support must occur as soon as possible. Further, the process for
initiating the development of an Individual Support Protocol/Behaviour Support Plan must
occur.
Staff will record, as soon as possible, all incidents where intrusive behaviour intervention
has been used.
Each Individual Support Protocol/Behaviour Support Plan will identify how the
intrusive intervention will be monitored and evaluated as to its effectiveness and if
cessation of the intrusive intervention is feasible.
Individual Support Protocols/Behaviour Support Plans which provide for video
monitoring will note the limitation of video monitoring to common areas.
Review Committee:
Reviewing and monitoring Individual Support Protocols/Behaviour Support Plans, which
include intrusive behaviour intervention, are considered important steps by Community
Living-Central Huron in evaluating the suitability and effectiveness of the Protocol/Plan and
ensuring it is consistent with the Agency’s vision and mission statements, as well as the
general principles of what Protocols/Plans are to achieve.
C.5(b)
Therefore, the Agency will ensure reviews are conducted on a regular basis, no less than
annually, by an independent third party review process, referred to as the Review
Committee, to:
•
•
•
Assess if the protocol/plan is ethical and appropriate to the needs of the individual, based on
professional guidelines and best practices; and
Ensure the protocol/plan is consistent with the Ministry of Community and Social Services
‘Services and Supports to Promote the Social Inclusion of Persons with Developmental
Disabilities Act, 2008' and Policy Directives for Service Agencies June 2012.
Determine the Protocol/Plan is meeting the principles outlined in CL-CH’s development of
Individual Support Protocols/Behaviour Support Plans.
The Agency will determine the membership of the independent third party Review Committee, which
may include Agency representation and must include the involvement of a clinician with experience
in supporting adults with a developmental disability who have challenging behaviours. The Review
Committee will be responsible for developing the Committee’s Terms of Reference.
All Review Committee findings and recommendations will be documented and forwarded to the
Agency. The Agency will ensure the findings and recommendations are shared with the
“professional” who approved the Protocol/Plan (ie. Psychologist, Psychological Associate, certified
Behaviour Analyst or Physician).
The Agency will review the Committee’s findings and recommendations and determine how the
findings and recommendations may be implemented.
C.5(c)
Section: C
Subject: Person Supported Complaint/
Feedback Policy
Total Pages: 3
Revision Date(s): June 20, 2012,
Oct. 17, 2012; Nov. 21, 2012
Person Supported Complaint/Feedback Policy
All persons supported by Community Living-Central Huron shall have access to a system of complaint
and feedback with respect to matters of the Agency, its staff and volunteers. A complaint/feedback
process is an important part of providing quality support that is responsive to individuals’ needs and
promotes continuous improvement in service delivery. As such, any person shall have access to the
Person Supported Complaint/Feedback Policy. Non-compliance with the Agency’s Persons
Supported Complaint/Feedback Policy is subject to discipline; up to and including dismissal from the
All persons supported through Community Living-Central Huron, as well as any person acting on
behalf of a person supported; and the general public have access to a complaint procedure that
ensures the fair and unbiased review of any complaint the individual may have. Dependent upon the
capabilities of the person supported, the Agency will ensure support is provided in lodging the
complaint, as requested.
Definitions:
“Complaint” is an expression of dissatisfaction related to the services and/or supports that are
provided by Community Living-Central Huron. A complaint may be expressed by a person supported,
or a person acting on their behalf, or by the general public, regarding the services and supports that
are provided by Community Living-Central Huron. A complaint may be made formally (such as a letter
written to the agency) or informally (such as a verbal complaint expressed to a staff person).
Community Living-Central Huron will not provide feedback on matters unrelated to the Agency or its
services and supports.
“Feedback” may be positive or negative (including complaints) and is related to the services and/or
supports that are provided by Community Living-Central Huron. Feedback may be solicited (such as
information and comments collected through a satisfaction survey or a suggestion box) or unsolicited
(such as a letter from a person or family member about services and supports). Feedback may be
formal (like the survey or letter noted above) or informal (such as a verbal complaint expressed to a
staff person).
The following is recognized as the complaint procedure utilized by Community Living-Central Huron:
a)
Persons supported should attempt to resolve the issue, if appropriate, with the person(s)
directly involved. Cases of alleged, suspected or witnessed abuse that may constitute a
criminal offence will be promptly reported to the police. If the issue is connected to a matter
of Community Living-Central Huron policy, it should be promptly directed to the appropriate
Supervisor/designate or Coordinator.
C.6(a)
b)
Upon immediate receipt of a complaint, the relevant Supervisor or designate will review the
complaint and document action(s) using the Complaint/Feedback form. All complaints will
be taken seriously; however, the Agency will not attempt to resolve complaints that have
determined to be frivolous or vexatious. The Supervisor or designate would consult with
the Coordinator and/or Executive Director if the complaint was thought to be frivolous
(trivial; insignificant; not serious) or vexatious (tending to cause annoyance, frustration or
worry).
c)
Within 2 business days of having received the initial complaint, the Supervisor or designate,
will begin the investigation by contacting (in person, telephone, email) all relevant parties
and document all findings on the Complaint/Feedback form. Should there be any conflict
of interest between the person supported and Supervisor/designate, the Coordinator or
Executive Director will determine who will investigate the complaint.
d)
Within 7 business days of having received the initial complaint, the Supervisor or designate
will have completed the investigation and have provided a written or verbal response to the
person supported, person acting on their behalf or the person making the complaint. There
may be cases where a written and verbal response will not be provided (ie. anonymous
complaint); however, a written report will always be completed by the Supervisor or
designate using the Complaint/Feedback form and copied to the Coordinator and Executive
Director.
e)
Wherever possible, the Agency shall make reasonable efforts to resolve or address the
complaint to the mutual satisfaction of both the person who has made the complaint and
the Agency. If no satisfactory solution has been agreed upon, the person can request a
meeting utilizing a Supervisor/Coordinator as facilitator. Appropriate notice of the meeting
should be given to all involved.
f)
If the issue is still unresolved, the person will be offered the option to meet with the
Executive Director in an attempt to resolve the issue/complaint.
g)
At all points of the process, the person supported has the right and should be informed they
have the right to access a Self-Advocate, the A.P.S.W., determine family involvement, the
Human Rights Commission or the Office of the Ontario Ombudsman, or any other form of
advocacy and/or representation they may choose.
h)
The Executive Director shall keep the Board of Directors informed.
i)
The Executive Director, or designate, will ensure the Ministry of Community and Social
Services is provided with all mandatory documentation.
The following is recognized as the feedback procedure utilized by Community Living-Central Huron:
a)
The relevant Supervisor, in consultation with the Coordinator and/or Executive Director shall
receive, document and review all feedback using the Complaint/Feedback form within 5
business days of receipt of the feedback.
b)
At each Senior Management Meeting the feedback will be discussed and any
recommendations, action to occur will be noted on the Complaint/Feedback form. The
Minutes will reflect the number of feedback received.
C.6(b)
c)
The Agency will solicit feedback via the Agency’s website which will be checked on a
monthly basis by the Central Administration Staff and immediately forwarded to the relevant
Supervisor or designate.
d)
The Agency may also choose to solicit feedback using other methods, such as suggestion
box, mail outs, etc.
e)
The Executive Director shall keep the Board of Directors informed.
Review:
In order to promote continuous quality improvement, the Agency will conduct a review and analysis
of the complaint and feedback received to evaluate the effectiveness of its policies and procedures,
on an annual basis. When conducting reviews, Community Living-Central Huron may also consider
the need to revise any other policies and procedures that are in place.
Risk Assessment: Community Living-Central Huron shall share information about its
complaint/feedback process, and/or about complaint/feedback, as part of the Ministry of Community
and Social Services Risk Assessment process, as requested by the Ministry.
C.6(c)
Section:
Subject:
C
Abuse
Total Pages:
11
Approval Date: Jan. 20, 1993
Revision Date(s) March 17, 1993, Jan. 21, 1998,
Dec. 19, 2012. Oct. 15, 2014, May 20, 2015
ABUSE POLICY - Prevention, Reporting and Managing
Community Living-Central Huron is devoted to the quality of life for all persons supported, employees
and volunteers by providing a safe, nurturing and respectful environment. All persons who receive
support will be treated with dignity and respect; their rights will be honoured and protected. Operating
with a zero tolerance for any type of abuse, all self-disclosures and reports will be taken seriously.
Community Living-Central Huron will not tolerate any form of abusive treatment. All reports will be
reviewed in keeping with this Policy, its procedures and all legislative requirements.
All Staff, volunteers providing direct service, persons on placement, Board of Directors and its
Committee Members and people supported will be required to receive a mandatory orientation and
annual training on the Agency’s Policy and Procedures on abuse prevention, identification and
reporting. Family/caregivers and community members may receive orientation to the Agency’s Abuse
Policy - Prevention, Reporting and Managing, as deemed appropriate.
In keeping with the Social Inclusion Act 2008, Regulation 299/10, abuse is defined as follows:
ABUSE: means action, mistreatment or behaviour that causes or is likely to cause physical injury
or psychological harm or both to a person, or results or is likely to result in significant loss or
destruction of their property, and includes neglect. In addition, the definition of abuse includes any
maltreatment, be it physical, sexual, emotional, verbal, financial or material exploitation, threats,
harassment, hate or bias motivated incidents.
FURTHER DEFINITIONS:
Physical Abuse - is assault, non-accidental injury or physical harm to a person. It includes but is
not limited to inflicting pain or any unpleasant sensation, and causing harm or injuries. Acts of assault
or threats of assault, such as hitting, slapping and burning that cause or could cause physical injury
or fear of physical injury.
Emotional Abuse - frequent criticism, insulting, threatening, degrading, humiliating, intimidation or
terrorizing of a person including verbal assaults, threats of maltreatment, harassment, humiliation or
intimidation, or failure to interact with a person or to acknowledge that person’s existence. This may
also include denying cultural or religious needs and preferences. Taking advantage of a person’s
disability to trick or manipulate for personal benefit. The persuasion to do things that are illegal or
not in the individual’s best interest.
Verbal Abuse - demeaning language, name calling or negative verbal depictions of disability or
attractiveness, unwelcomed, embarrassing, offensive, threatening or degrading to another person
are all forms of verbal abuse.
Financial or Material Exploitation - The misuse or misappropriation of someone’s financial assets
for personal gain or the use or withholding of another person’s resources by someone with whom
there is a relationship implying trust.
C.7
Neglect - a failure to provide the basic physical and emotional necessities of life. It can be willful
denial of medication, dental or medical care, therapeutic devices or other physical assistance to a
person who requires it because of age, health or disability. It can also be a failure to provide
adequate shelter, clothing, food, protection, supervision and nurturance or stimulation needed for
social, intellectual and emotional growth or well being. It can be the placement of persons at undue
risk through unsafe environments or practices thereby exposing them to the danger of physical,
mental or emotional harm.
Threats of Death or Bodily Harm - actions where a person did knowingly utter or convey a threat
to cause death or bodily harm to a person, and did so to intimidate or strike fear into a recipient of
the remarks. It is not necessary that the person making the threat intend to carry it out or be capable
of doing so. The threat need not be made directly to the intended victim. The intended victim need
not even be aware of the threat. And threats include to burn, destroy or damage real or personal
property or to kill, poison or injure an animal or bird that is the property of any person.
Sexual Abuse - any act or situation where the person supported is forced and/or coerced into any
kind of sexual contact without consent; the lack of consent is the defining feature. It is important to
note that the hierarchy makes it impossible for there to be consent between a person with a disability
and their support worker/care provider.
Harassment/Sexual Harassment - comments, conduct or gestures that are insulting, intimidating,
humiliating, malicious, degrading, offensive or discriminatory, directed toward an individual or group
of individuals. Harassment includes any form of sexual harassment. It is important to recognize that
people with disabilities do not choose to live within care and cannot often choose to leave care, the
atmosphere of respect that comes from purposefully avoiding jokes or language that others might find
distressing is important to foster.
Hate or Bias Motivated Incidents - are incidents that are motivated in whole, or in party, by the
perpetrator’s bias against a race, religion, disability, sexual orientation, ethical or national origin, age,
gender, social status or political affiliation. Incidents may include physical assault, damage to
property, bullying or insults.
Documented/Documentation - includes all writings, printed text or book of account, receipts,
recordings or note taking, documents of all kind, whether handwritten, typed, computer generated or
electronically recorded.
Subject Person - this is the person (ie. employee, direct service volunteer, persons on placement,
Board of Director or its committee member) who is alleged to have committed abuse.
Volunteer - Direct Service - includes all volunteers who under the auspices of Community LivingCentral Huron are likely to, or will find themselves alone with a person supported and in an
unsupervised capacity.
Individual/Family Member/Caregiver - includes self-employed contract worker or family members
who provide services to persons supported and families through any Programs coordinated by
Community Living-Central Huron.
Person Supported - includes all persons who are 18 years of age or older and receive support from
Community Living-Central Huron.
C.8
Ministry - includes the Ministry of Community and Social Services and the Ministry of Children and
Youth Services.
OPP - Ontario Provincial Police.
Prevention of Abuse:
The following Principles form an integral part of this Policy and will help guide the practices of the
Agency in its efforts to reduce and eliminate all forms of abuse.
•
Promote and operate from an environment of respect and safety for all persons supported,
families, Staff and volunteers;
•
Actively identify and eliminate all conditions within the organization that may foster abuse;
•
Regularly offer training/education to persons supported, Staff and volunteers, about abuse
issues; offer training/education to families and the community as appropriate;
•
Establish and maintain an expectation that all persons possess positive and valuing
attitudes towards persons with disabilities;
•
Ensure effective measures that screen qualified Staff, persons on placement, direct service
volunteers and caregivers through work references and Vulnerable Sector Checks;
•
Provide ongoing orientation, training and education on the Agency’s Abuse Policy and
related procedures;
•
Ensure that all allegations are properly documented, reported and reviewed; and
C
Annual Review of Abuse Policy by Senior Management to promote zero tolerance and
determine if Policy revision is required to prevent abuse.
Orientation, Training and Education:
All Staff, direct service volunteers, persons on placement, persons supported, the Board of Directors
and its Committee Members will be required to receive annual mandatory orientation on the Agency’s
Policy and Procedures on abuse prevention, identification and reporting. Family/caregivers and
community members may receive orientation on the Agency’s Abuse Policy as deemed appropriate.
Orientation will occur for Staff prior to working directly with persons supported and for volunteers prior
to initiating their volunteer role and annually thereafter. It is the responsibility of each person covered
under the scope of this Policy to actively participate and complete their assigned orientation, training
or education and to participate in a yearly review. Signed acknowledgements of orientation and
annual reviews will be maintained in personnel or other appropriate files.
All persons supported through services directly operated by the Agency will be provided with
education/awareness training that addresses boundaries, rights, relationships, abuse prevention and
reporting. The training will be provided within three (3) months of the commencement of services.
Training will be offered in a language and manner that is appropriate to the person(s) supported. A
refresher training will be provided annually thereafter. Acknowledgement of completion of the initial
training, annual training and any refresher training will be placed in the person’s supported file.
C.9
How Abuse May Become Known:
i)
Alleged - Reported directly to the Staff, direct care volunteer, family/caregiver by the
person supported or any other person who suspects abuse; can include disclosure made
by the person supported.
ii)
Suspected - Personal detection of unusual behaviour, events or physical signs that could
be an indication of abuse; awareness that another caregiver, family member has reason
to believe or suspects abuse; can include disclosure made by the person supported.
iii)
Witnessed - Having observed first-hand an incident where the person supported was
abused.
Additional clarifying indicators of abuse that form an integral part of this Policy are found in
Appendix A.
Reporting and Managing Abuse:
All Staff, volunteers, persons on placement, who witness or suspect abusive treatment of a person
supported is to take immediate steps to protect the person supported and to report the incident in
keeping with the following Reporting Procedures. Failure to report an alleged, suspected or
witnessed abuse may result in disciplinary action, up to and including termination of employment.
Reporting Procedures:
In all instances, the protection of the person supported is paramount. It is imperative to make sure
the person supported is safe and is provided with appropriate support. As appropriate and if required,
first aid or medical intervention should be provided as an option at this time. It is important to inform
the person supported of the risks of not seeking medical attention (ie. unattended wound, sexually
transmitted disease, evidence, etc.).
In the event of a disclosure, carefully record and document what the person says in their own words.
Do not ask any leading questions; do not initiate further review of the situation.
If necessary, take reasonable steps to:
•
If possible, separate the subject person from the person supported, as well as other
person(s) present;
•
Call 911 if Emergency Services are required;
•
Encourage the person supported not to speak to others, should the Police be contacted;
•
Protect and do not tamper with any physical or medical evidence;
•
Contact the relevant Supervisor/designate or Pager for direction as to how to proceed;
•
Document all events; and
•
Do not discuss the allegation with anyone other than to cooperate with the
Supervisor/designate, Pager, Coordinator, OPP or the Children’s Aid Society.
In an emergency situation (ie. incidents involving serious bodily harm, assaults in progress,
sexual assault, etc.), contact must first be made with 911 or the OPP, as appropriate.
C.10
Reporting Alleged, Suspected or Witnessed Abuse of Children or Youth:
If the abuse involves a child or youth who is under 16 years of age, all Staff, volunteers,
family/caregivers must themselves report the allegation directly to the local Children’s Aid Society.
DO NOT rely on anyone else to make a report. The Children’s Aid Society will determine if the police
should be contacted.
If the abuse involves a youth who is between 16 and 18 years of age, all Staff, volunteers,
family/caregivers must themselves report the allegation to the OPP.
In both instances above, once the Staff or volunteer have contacted the OPP or Children’s Aid
Society, they must then immediately contact their Supervisor/designate or Pager; all Agency internal
reporting/documentation requirements must be completed prior to leaving their shift.
Reporting Alleged, Suspected or Witnessed Abuse for Adults (over 18 years of age):
It is the responsibility of all Staff and volunteers to immediately report any alleged, witnessed or
suspected incidents of abuse to the Supervisor/designate or Pager. Once a report is made, one must
not discuss the allegation of abuse with anyone other than to cooperate directly with the
Supervisor/designate, Pager and the OPP.
i)
In an emergency situation (ie. incidents involving serious bodily harm, assaults in progress,
etc.), contact must first be made with 911 to access appropriate Emergency Services.
Advise the Supervisor/designate or Pager as soon as possible, thereafter.
ii)
If possible, separate the subject person from the person supported, as well as other
person(s) present.
iii)
Provide First Aid as necessary.
iv)
Report alleged, suspected or witnessed abuse as soon as possible to the
Supervisor/designate or Pager.
v)
The Supervisor/designate or Pager will seek clarifying information to help assess the
incident and to determine how to proceed and advise/direct the Staff or volunteer
accordingly.
Staff will document all details.
It may be necessary for the
Supervisor/designate or Pager to do a review of the incident to ascertain if there is the
possibility of abuse, which would require Police involvement. This review may include
asking the person supported and/or subject person or others, as deemed appropriate,
specific, non-leading questions, all of which will be documented. Consultation with the
relevant Coordinator or Executive Director is to occur during this process.
vi)
Should the Supervisor/designate have reason to believe that an incident of abuse of a
person supported may have occurred and it may constitute a criminal offence, the
Supervisor/designate will immediately report the incident to the OPP.
vii)
The Supervisor/designate will inform the Coordinator or the Executive Director. The
Coordinator or the Executive Director will ensure a Serious Occurrence form is completed
and forwarded to the Ministry, within the required time frame.
C.11(a)
viii)
No further review will be conducted by the Agency until the incident has been investigated
by the OPP.
ix)
Once a report is made to the OPP, the Agency and the OPP will remain in close
communication until the OPP have concluded their investigation.
Note:
In the event that an Agency Supervisor or Coordinator is the subject of the allegation or
abuse, the Executive Director, or designate will contact the OPP.
In the event that the Executive Director is the subject of the allegation or abuse, the
President, Board of Directors, will review the report and determine who will contact the
OPP. In such incidents, the President and Executive Committee will oversee the matter.
Managing Reports of Abuse:
The Agency will review all reports of abuse following completion of investigations by the OPP or other
appropriate authorities. In the event that the OPP investigation does not confirm criminal intent, the
Agency will take whatever action it deems appropriate.
i)
In all cases of alleged abuse, whether a Staff, direct service volunteer or caregiver, at
minimum they will not be permitted unsupervised contact with the individual, or may be
excused from attending work, volunteering or care giving until the OPP’s investigation or
Agency’s review has been completed. Such actions may be taken by the Agency in order
to ensure both the protection of the person supported and the subject person.
ii)
Any such action as noted above is not to be interpreted as a presumption of guilt. During
this period, the rights and the dignity of the person who is the subject of the allegations, will
be safeguarded.
iii)
The Agency will initiate disciplinary action up to and including termination in instances
where it believes evidence of abuse is sufficient to warrant such action.
iv)
In all cases, any person who has been the subject of the allegations, is charged and found
guilty of abuse will be terminated from employment and prohibited from any volunteer or
care giving position.
v)
The parent(s) or guardian(s) of the alleged victim will be kept informed of relevant events
by the Executive Director, or designate, except when the alleged victim is an adult and
specifically requests otherwise. Depending on the individual situation, the Executive
Director, or designate, may also notify other persons. As appropriate, the timing and
specifics of notification will be determined in conjunction with the OPP or other appropriate
authorities.
vi)
Consent must be obtained from the person supported before notifying others, except for
the OPP and the Children’s Aid Society.
vii)
All media contact will be managed by the Executive Director or designate.
viii)
The Executive Director or designate will notify the Board of Directors and the Ministry, and
ensure adherence to the Serious Occurrence Policy (C-006).
C.11(b)
Support to Police and Children’s Aid Society during Investigations:
The Agency will cooperate in facilitating and sharing information within their respective and regulatory
requirements or limits with the OPP and the Children’s Aid Society, for children under the age of 16
years.
Information sharing and disclosure regarding Staff, volunteers, persons supported and others
affiliated with the Agency’s services, is governed by the Municipal/Freedom of Information and
Protection of Privacy Act.
In addition, information sharing and disclosure will be guided by, at a minimum, the Child and Family
Services Act, the Services and Support to Promote the Social Inclusion of Persons with
Developmental Disabilities Act and the Agency’s Confidentiality, Access to and Disclosure of
Information Policy.
In the event the Agency is prohibited by law to release certain information, it is understood that the
OPP and/or the Children’s Aid Society may attain other relevant information only by subpoena or
search warrant.
The Executive Director or designate may provide information necessary to assist the OPP or other
authorities to understand the nature of the intellectual disability(ies) of the alleged victim. If an
Agency Staff is asked to act in an interpreter/communication support capacity, the Staff is limited
solely to interpreting what is asked, and to providing only the individual’s response to the question.
C.11( c )
In summary:
PROTOCOL FOR ABUSE or ALLEGED ABUSE:
IF YOU HEAR OF OR SUSPECT ABUSE
HERE’S WHAT TO DO ...
1.
In an Emergency situation, contact 911 to access appropriate emergency services.
Advise the Supervisor/designate or Pager as soon as possible, thereafter.
2.
If possible, separate the subject person from the person supported, and any other
person(s) present.
3.
Provide First Aid, if necessary.
4.
Report alleged, suspected or witnessed abuse as soon as possible to the
Supervisor/designate or Pager.
5.
Wait for direction from the Supervisor/designate or Page as to how to proceed.
6.
Document all events and submit such to your Supervisor/designate in a timely manner.
Refer to “Reporting Alleged, Suspected or Witnessed Abuse for Adults (over 18 years of Age” for
further details on the role of the Supervisor/designate or Pager and Community Living-Central Huron.
C.11(d)
APPENDIX A
Indicators of Abuse:
All Staff, volunteers, family/caregivers play an important role in protecting individuals from harm by
recognizing the indicators of abuse and responding accordingly. Presence of one or more indicators
does not necessarily mean that abuse has occurred, but does require ongoing vigilance and
reporting. Indicators of abuse are not always obvious. Indicators are variable, and often persons
who are familiar with individuals supported and have a positive relationship with them, are best placed
to recognize behavioural changes that may suggest abuse has occurred.
The following indicators are provided to assist in identifying abuse:
Indicators of Physical Abuse:
•
•
•
•
•
•
•
•
Disclosure by person supported
Unexplained or poorly explained injury - fractures, dislocations, sprains
Other bruising and marks may suggest that shape of object that caused it
Unexplained burns, scalds
Facial, head, neck bruising
Signs of new injury when old injury has not healed
Sleep disturbance
Changes in behaviour (out of character aggression, withdrawal, excessive compliance)
Indicators of Emotional and/or Verbal Abuse:
•
•
•
•
•
•
•
•
•
•
Extreme unusual behaviour (aggression, withdrawal, bullying, excessive
compliance)
The appearance of fear or apprehension to be near a specific person
Depression, crying
Attempted suicide
Delayed emotional or physical development
Lack of attachment to parent or caregiver
Speech disorder
Weight loss or gain
Feeling of worthlessness, extreme low self-esteem, self-abuse or self-destructive
behaviour
Indicators of Financial Abuse, Material Exploitation:
•
•
•
•
•
•
•
Unusual financial records (missing receipts, unusual receipts, accounts do not
balance)
Missing money, valuable or property
Only one person monitors person’s funds
Restricted access to or not control over personal funds or bank accounts
Forces changes to wills or other legal documents
Person stealing from others, borrowing money, begging
C.11(e)
Indicators of Neglect:
•
•
•
•
•
•
•
•
•
•
•
•
Dirty, torn clothing worn everyday
Insufficient clothing
Hunger, weight loss
Poor hygiene
Inappropriate shelter or accommodations
Unattended physical needs
Social isolation
Constant fatigue, listlessness, falling asleep
Extreme longing for company
Anxiety about being alone or abandoned
Displaying inappropriate or excessive self-comforting behaviours
Indicators of Sexual Abuse and/or Harassment:
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Existence of sexually transmitted disease(s)
Pregnancy
Stained, torn or bloody undergarments
Bruised or swollen genitalia/anal area
Sore throat - through choking or forced oral sex
Unusual or offensive odour
Wearing layers of clothing
Difficulty sleeping/increased time spent sleeping
Nightmares
Refusal to eat/increased eating
Sudden infantile behaviour (rocking, biting, sucking)
Refusal to undress/bathe
Trauma to breasts, buttocks, lower abdomen, thighs
Unexplained accumulation of money or gifts
Description of sexual activity
Inappropriate advances to others
Indicators of Threats of Death or Bodily Harm and/or Indicators of Hate or Bias Motivated
Incidents/Abuse:
•
•
•
•
•
•
•
Extreme unusual behaviour (aggression, withdrawal, excessive compliance)
Depression, crying
Sleep disturbance
Eating disorders
Social isolation
Anxiety about being alone or left unattended
Policy Review Date: September 10, 2014; April 17, 2015.
C.11(f)
Related Policies:
- Privacy (A-004)
- Press and Media Releases (B-002)
- Relationship with Law Enforcement Agencies (B-003)
- Volunteer (B-007)
- Behavioural Support (C-002)
- Person Supported Complaint/Feedback (C-003)
- Use of Physical Restraints (C-005)
- Serious Occurrence (C-006)
- Finances of People Supported (C-008)
- Medical Care of Persons Supported Policy (C-012)
- Inventory, Personal Belongings of Persons Supported (C-013)
- Missing Person/Unknown Whereabouts (C-016)
- Medication Policy Statement (D-002)
- Dangerous Weapons and Fire Arms (D-005)
- Critical Injury (D-006)
- Bullying and Workplace Violence Policy and Procedures (D-007)
- Police Record Search (E-003)
- Staff Orientation (E-005)
- Procedure for Professional Development (E-006)
- Employee Performance Appraisal (E-008)
- Employee Standards Policy (E-011)
- Record Retention and Archives (E-018)
Other Documents:
Occupational Health & Safety Document
Medication Policy & Procedures Document
C.11(g)
Section:
Subject:
C
Use of Physical Restraints
Total Pages:
3
(replaces Aggressive Behaviour Policy)
Approval Date: Jan. 20, 1993
Revision Date(s) Feb. 19, 2003, May
21, 2003; April 21, 2004; Jan. 17,
2007; Nov. 21, 2012; May 15, 2013.
USE OF PHYSICAL RESTRAINTS POLICY
1. Definitions:
“Support Worker” (with respect to the Physical Restraints Policy):
A member of Community Living-Central Huron Staff who provides direct support to a
person within their place of residence.
“Volunteer”
An unpaid individual with specific tasks, as determined by the Agency.
“Ministry”
Means the Ministry of Community & Social Services and the Ministry of Children and Youth
Services.
“Physical Restraint”
Means using a holding technique to restrict a person’s ability to move freely.
Further, the Ministry states for greater certainty, physical restraint does not include:
a)
restriction of movement, physical redirection or physical prompting, if the restriction of
movement, physical redirection or physical prompting is brief, gentle and part of a behaviour
teaching program; or
b)
the use of helmets, protective mitts or other equipment to prevent a Support Worker from
physically injuring or further injuring himself or herself.
“Mechanical Restraint”
Is a means of controlling behaviour that involves the use of devices and equipment to restrict
movement; but does not include any of the following restraints or devices:
a)
b)
c)
that are worn most of the time to prevent personal injury, such as a helmet to prevent head
injury resulting from seizures or a device to safely transport a person in a motor vehicle,
that help to position balance, such as straps to hold a person upright in a wheelchair, or
that are prescribed by a physician to aid in medical treatment, such as straps used to
prevent a person from removing an intravenous tube.
Mechanical restraints are to be used only when identified in the person supported
approved behavioural support plan.
C.12(a)
“The Nonviolent Crisis Intervention Program”
This safe, non-harmful behaviour management system is designed to aid Staff members in
maintaining the best possible care, welfare, safety and security for agitated or out-of-control person
supported even during their most violent moments.
Nonviolent Physical Crisis Intervention is used only as a last resort when a person is a danger to
self or others. It is the only physical restraint intervention sanctioned by Community Living-Central
Huron for trained Support Workers to use. Nonviolent Physical Crisis Intervention involves the use
of safe, non-harmful control and restraint positions to safely control an individual until they can
regain control of their behaviour.
2. Training and Education Requirements:
All Support Workers are required to be trained in CPI’s Nonviolent Crisis Intervention, as per
Ministry Regulations. CL-CH volunteers are restricted from using a physical restraint and therefore
training is not required. Training and ongoing education will be provided, as follows:
a)
All Support Workers will be trained in CPI’s Nonviolent Crisis Intervention Program.
b)
Newly hired Support Workers, who have not been trained in CPI Nonviolent Crisis
Intervention in the past twelve months previous to hire, will be educated on the Agency’s
Policy within the first thirty days of employment. All Staff must be trained in and
successfully complete the physical portion (Unit 8) of CPI Nonviolent Crisis Intervention
prior to carrying out a physical restraint. This training is inclusive of a review of all legislated
regulations, Ministry policies and Agency policies applying to the use of physical restraints;
c)
Documentation of initial training and annual updates will be maintained in a central binder;
d)
Support Workers must participate in a formal refresher course every six to twelve months;
all Staff will review existing regulations and policies applying to the use of physical restraints
at least annually, during their annual performance review. Only Staff who successfully
complete the physical portion (Unit 8) of the CPI Nonviolent Crisis Intervention training will
be authorized to use physical interventions; and
e)
Community Living-Central Huron, may at its own discretion, determine Support Workers’
participation in Nonviolent Crisis Intervention training at different intervals, dependent on
the needs of persons supported and/or Support Workers’ skill sets.
3. Rules Governing the Use of Physical Restraints:
Physical restraint may be carried out only for the purpose of preventing a person supported from
physically injuring or further physically injuring themself or others and only if there is a clear and
imminent risk that the person supported will physically injure or further physically injure themselves
or others. While safety is always the priority, preserving the dignity of the person supported
should also be considered. Physical restraint may never be carried out for the purpose of
punishing a person supported by the Agency. Non-physical interventions are always preferred.
A physical restraint may be carried out only after it is determined that less intrusive interventions
are or would not be effective in preventing the person supported from physical injury or further
physical injury of themself or others. Support Workers implementing the use of nonviolent physical
crisis intervention are required to follow the techniques, as per CPI’s Nonviolent Crisis Intervention
training program. Failure to follow said techniques will be grounds for disciplinary action. When
a physical restraint is carried out, it must be carried out using the least amount of
C.12(b)
force that is necessary to restrict the ability of the person supported to move freely. Physical
interventions are intended to be pain-free. During the use of physical restraint, the well-being of
the person supported being restrained must be continually monitored and assessed.
Physical restraint of a person supported must be stopped upon the earlier of the following: when
there is no longer a clear and imminent risk that the person supported will physically injure
themself or others or when there is a risk that physical restraint will endanger the health and safety
of the person supported.
4. Debriefing Process:
A debriefing process consisting of two steps will be conducted firstly with the Support Worker(s)
who performed the physical restraint. The Supervisor or designate will be responsible to initiate
and finalize the debriefing process, consistent with nonviolent crisis intervention training (ie. CPI
COPING Model).
The second step will involve the Support Worker and the person supported who was physically
restrained, ensuring the process is conducted to accommodate the psychological and emotional
needs and cognitive ability of the person supported. The debriefing will be conducted within fortyeight (48) hours after the physical restraint was carried out, or if circumstances do not permit, the
debriefing will be conducted as soon as possible after the forty-eight (48) hour period and a record
will be kept of the circumstances which prevented the debriefing process from occurring within the
forty-eight (48) hour period.
5. Reporting:
Any use of physical restraint is required to be reported to the Ministry of Community and Social
Services as a Serious Occurrence. Use of a mechanical restraint which was not in the person
supported approved behavioural support plan must also be reported to the Ministry. The
Supervisor or designate will advise the parent, guardian or emergency contact, as appropriate,
after physical restraint of a person supported. The Executive Director, or designate, will report the
use of physical intervention and/or mechanical restraint to the Ministry of Community and Social
Services within twenty-four (24) hours; the Serious Occurrence Initial Notification Report will be
submitted, followed by the Serious Occurrence Inquiry Report within seven (7) days of the Initial
Report. Support Workers will complete documentation on the designated form to be returned to
the Supervisor or designate within twenty-four (24) hours or the first working day following the use
of physical intervention.
6. Overview:
The procedure that is to occur following the use of physical intervention, should
Nonviolent Physical Crisis Intervention be implemented:
a)
Support Worker - Contact the relevant Supervisor or Pager immediately following the use
of physical restraint or mechanical restraint (if not in the person supported approved
behavioural support plan). Complete documentation using the designated form (return to
Supervisor or designate within 24 hours or the first working day following the use of physical
intervention).
b)
Supervisor or designate - Immediately contact the Executive Director or designate upon
being advised of the use of physical restraint. Conduct debriefing (CPI COPING Model).
Advise family, guardian, or emergency contact of physical intervention, as appropriate.
c)
Executive Director or designate - Report the use of physical restraint, mechanical
restraint to the Ministry of Community and Social Services within twenty-four (24) hours,
followed by the seven (7) day Serious Occurrence Inquiry Report.
C.12(c)
Section:
Subject:
C
Serious Occurrence
Total Pages:
7
Approval Date: May 20, 1992
Revision Date(s) Oct. 15, 2003,
Feb. 15, 2006, Oct. 20, 2010, May 15,
2013.
SERIOUS OCCURRENCE POLICY
Community Living-Central Huron is responsible for ensuring its services promote the health, safety and
welfare of people being supported. As part of its accountability relationship with the Ministry of
Community and Social Services and the Ministry of Children and Youth Services, referred to within this
policy as ‘Ministry,’ the Agency is required to submit information to the Ministry(ies) that demonstrates
its delivery of services is consistent with relevant legislation, regulations and/or Ministry policies. The
Ministry prescribes very specific definitions, requirements and procedures with respect to serious
occurrences.
All employees and volunteers must adhere to the proper execution of Serious Occurrence Reporting
requirements, procedures and advise their immediate Supervisor of the need for clarification or training.
Non-compliance with serious occurrence requirements and procedures is subject to discipline, up to
and including dismissal from Community Living-Central Huron’s employment.
The following procedures are requirements of all providers of services that are funded by the Ministry
to ensure a consistent process is established for the communication of serious occurrences and that
procedures are followed without exception.
SERIOUS OCCURRENCES TO BE REPORTED TO THE MINISTRY ARE DEFINED AS FOLLOWS:
1. Death: Any death of a person being supported which occurs while participating in a service.
2. Serious injury: Any serious injury to a person being supported that occurs when participating in
a service, a deciding factor to consider is whether professional medical treatment (ie. doctor or
dentist) is required. Serious injuries include:
-
any injury caused by the service provider;
a serious accidental injury, ie. sports injury, fall, burn, etc.;
a serious injury which is non-accidental, including self-inflicted, or unexplained.
medication errors resulting in an injury/illness, e.g person supported receives
wrong medication; failure to document administration of medication
3. Alleged, Witnessed or Suspected Abuse: Any alleged abuse or mistreatment of a person being
supported which occurs while participating in a service. This includes all allegations of abuse or
mistreatment against Staff, volunteers, temporary caregivers, police/court Staff, drivers providing
transportation.
Alleged, suspected or witnessed abuse of a person supported that may constitute a criminal offence,
shall be immediately reported to the police and will require an enhanced serious occurrence report
to the Ministry.
4. Missing Person: Any situation where a person being supported is missing (whereabouts unknown)
and the Service Provider considers the matter to be serious.
C.13
5. Disaster on the Premises: Any disaster on the premises where service is provided that interferes
with daily routines, e.g. flood, fire, power outage, gas leak, lock down, etc.
6. Complaint about the Operational, Physical or Safety Standards: Any complaint concerning
operational, physical or safety standards of the service considered by the Service Provider to be of
a serious nature.
7. Complaint made by or about a Person Supported: Any complaint made by or about a person
being supported, or any other serious occurrence considered by the Service Provider to be of a
serious nature (ie. person supported charged by police; inappropriate disciplinary techniques;
serious assault by person supported against Staff, peers, community members; serious assault by
non-caregiver against person supported; hospitalization considered serious by the Service Provider.
Alleged, witnessed or suspected abuse of a person supported that may constitute a criminal offence
should be immediately reported to the police and will require an enhanced serious occurrence report
to the Ministry, regardless of whether the alleged, suspected or witnessed abuse is by a person
providing services on behalf of the agency (ie. Staff, volunteer, board member) or a non-caregiver
(ie. friend, another person supported, stranger).
8. Restraint of a Person Supported: Any use of a physical restraint of a person being supported or
use of mechanical restraints not identified in the person supported approved Behaviour Support
Plan.
•
Any situation whereby “Enhanced Serious Occurrence Reporting” procedures will be followed when
emergency services are used in response to a significant incident involving a person(s) supported
and funding accessed from the Ministry, and/or the incident is likely to result in significant public or
media attention. The Executive Director/Designate will refer to the “Enhanced Serious Occurrence
Identification Tool.”
DEFINITIONS:
‘While participating in service’ shall mean when an individual being supported is receiving direct care
from Staff, volunteers, caregivers, etc., from any Agency Program.
‘Ministry’ refers to the Ministry of Community and Social Services and/or the Ministry of Children and
Youth Services.
‘Abuse’ is defined in Agency Policy No. C-004.
‘Use of Physical Restraints’ and ‘Mechanical Restraints’ are defined in Agency Policy No. C-005.
‘Challenging behaviour’ and ‘Behaviour Support Plans’ are defined in Agency Policy No. C-002
Within the parameters of the above definitions, the Executive Director or designate is responsible for
determining whether an incident is deemed to be a Serious Occurrence as defined by these procedures
and whether, therefore, it should be reported to the Ministry and the Board of Directors. Also,
clarification can be sought from Ministry personnel with respect to determining the need to report a
serious occurrence.
C.14(a)
SERIOUS OCCURRENCE RESPONSE AND REPORTING:
Actions to be taken if a serious occurrence has occurred, or is suspected, include the following:
1. The person being supported is provided with immediate medical attention as warranted.
2. Appropriate steps shall be taken to address any continuing risks to the person’s health, safety and
well-being. The health, safety and well-being of others being supported should also be considered.
3. In the event of a death of a person supported, in addition to notifying the Ministry, the Agency must
comply with the reporting requirements of the Coroner’s Act, and any other legislated requirements
from the Ministry, including the Child Death Reporting and Review Joint directive.
4. If there is reason to suspect that a person supported has been abused (and/or in need of protection,
in the case of a child), contact the Children’s Aid Society (CAS) and/or police; where the Agency
suspects any alleged, suspected or witnessed incidents of abuse of a person supported that may
constitute a criminal offence, contact police immediately.
5. The Staff or any person witnessing or having knowledge of the occurrence shall report the matter
immediately to their Supervisor or Pager or Coordinator or Executive Director, whomever is most
immediately accessible.
All persons having knowledge of the occurrence should be asked to remain on the premises until
they have been interviewed and there is no further need at this time for their presence. The Staff
who witnessed or having knowledge of the occurrence will complete and submit the necessary
Agency documentation to their Supervisor or designate prior to the end of their shift.
6. The Supervisor or Pager or Coordinator or Executive Director, whomever was initially contacted by
Staff, shall immediately begin an investigation regarding actual or alleged occurrences. The
information will form the basis of whether there has been a serious occurrence; details to include:
name and birth dates of any individuals supported; description of occurrence; allegations (if
applicable) by person being supported; date, time and place of occurrence; time occurrence
reported; reason for occurrence (if known); people involved; actions taken, current status;
notification of coroner (in cases of death), Police, CAS, parents, others, emergency contact, etc.,
as appropriate; further action recommended/proposed.
7. The Supervisor will contact the appropriate Coordinator and/or the Executive Director to review the
information submitted by Staff, details of their investigation and the “Serious and Enhanced
Serious Occurrence Reporting Guidelines” of March 2013, as provided by the Ministry. The
Executive Director or designate will determine if the occurrence corresponds to the Ministry’s
Serious Occurrence Reporting requirements.
8. Following the determination of a Serious Occurrence, the Supervisor will complete the Ministry’s
“Serious Occurrence Report,” Part 1 - Initial Notification Report (IN) and immediately provide the
original to the Executive Director or designate for approval. The Executive Director or designate will
submit the completed Serious Occurrence Report to the Ministry’s Regional Office within twenty-four
(24) hours of becoming aware of the incident and/or deems the incident to be a serious occurrence.
The Executive Director or designate may contact the Ministry by telephone or send an email for the
Initial Notification Report, if circumstances dictate (ie. there is no fax available).
C.14(b)
9. Within seven business days of submitting the Initial Notification Report (IN), complete and submit
the Inquiry Report (IR). Submit the IR within seven business days, even if information and /or actions
have yet to be completed. Include an explanation that a further follow-up report will be provided.
ENHANCED SERIOUS OCCURRENCE REPORTING:
The Executive Director will be the Designated Authority, to determine when an incident may require
“Enhanced Serious Occurrence Reporting.” Enhanced Serious Occurrence Reporting procedures
should be followed when emergency services (ie. police, fire and/or ambulance) are used in response
to a significant incident involving a person supported and/or the incident is likely to result in significant
public or media attention. The Ministry has developed an Enhanced Serious
Occurrence Identification Tool to assist the Executive Director or designate determine when an incident
may be considered enhanced. Within three (3) hours of becoming aware that an Enhanced Serious
Occurrence has occurred, the Executive Director or designate will notify by telephone or facsimile the
Ministry. The Ministry regularly provides up-to-date contact information and forms.
FOLLOW-UP REQUIREMENTS:
Any follow-up/outcome reports must be forwarded to the Ministry by the Agency. Upon review of the
Inquiry Report, the Ministry Office may request additional information or a further review by the Agency.
The Ministry also has the option of initiating its own review.
An Annual Summary and Analysis Report of all serious occurrences recorded from the previous year
period must be submitted to the Ministry using the Ministry provided Annual Summary & Analysis Report
form and within the time frame specified by the Ministry.
C.14(c)
SERIOUS OCCURRENCE STEPS & RESPONSIBILITIES SUMMARY
1. Immediate Actions
a) Staff witnessing or having
knowledge
± Health and safety of all individuals receiving support
addressed;
± Comply with the reporting requirements of the
Coroner’s Act, and any other legislated
requirements from the Ministry, including the Child
Death Reporting and Review Joint Directive;
± Notify Children’s Aid Society, as appropriate;
± Contact all other applicable parties, as required,
including police when the agency suspects any
alleged, suspected or witnessed abuse that may
constitute a criminal offence;
± Contact Supervisor/Pager/Coordinator, or Executive
Director;
± Staff to complete Agency documentation, ie.
Communique; and remain at the scene, until
interviewed or advised by Management Staff their
presence is no longer required.
b) Supervisor or Initial Management
Contact
± Gather and collate details to determine if Serious
Occurrence.
2. W ithin 3 Hours - Situations deemed
Enhanced Serious Occurrence Executive Director or designate
± Determine if the incident is an enhanced serious
occurrence;
± Submit Enhanced Serious Occurrence Initial
Notification Report (IN) to Ministry Regional Office.
3. W ithin 24 Hours
Executive Director or designate
± Initial Notification Report (IN) to Ministry Regional
Office;
± Notification of the Emergency Contact Person for an
adult with a developmental disability, if appropriate;
± For children, contact CAS and/or Police; inform parent/
guardian, as appropriate.
* Clock starts when any Staff of the
service agency becomes aware of
an incident or when the service
provider deems the incident to be
serious
4. W ithin 7 Days
± Serious Occurrence Inquiry Report (IR) submitted to
Ministry Regional Office, even if incomplete at this time.
5. Follow ing submission of ‘Serious
Occurrence Inquiry Report’
Ministry
± Service provider actions follow-up review(s)/information
update(s), as requested by Ministry Regional Office;
± Action outcome report(s) submitted to Ministry Regional
Office, as required;
± In-year monitoring of Serious Occurrence related
issues/trends.
C.14(d)
SERIOUS OCCURRENCE STEPS & RESPONSIBILITIES SUMMARY (cont’d)
6. Annually
± Annual Summary & Analysis Report submitted to Ministry
Regional Office, according to required time frame;
± W hen requested, follow-up action outcome report(s)
submitted to Ministry Regional Office.
7. Ongoing
± In-year monitoring of serious occurrence related issues;
± Conducting follow-up actions in a timely manner;
± Identifying and addressing any trends which might
indicate a need for training, support or internal Agency
policy modifications.
C.14(e)
APPENDIX A
Serious Occurrence to Enhanced Serious Occurrence Reporting
Serious Occurrence Category
For a complete definition, please refer to the
guidelines above
The incident may be enhanced if ...
1. Death of a person supported
• Suspicious circum stances or negligence could be
perceived to have contributed to the death.
2.
a)
b)
c)
• The injury is currently life-threatening
• Suspicious circum stances or negligence could be
perceived to have contributed to the cause of the injury
A serious injury to a person supported:
An injury caused by the service provider
A serious accidental injury
A serious non-accidental injury
3. Any alleged abuse of a person supported
• MCSS: In adult developm ental services, any alleged,
witnessed or suspected incident of abuse that m ay
constitute a crim inal offence shall be im m ediately reported
to the police
4. Missing Person
• The person supported age or m ental capacity m akes
him /her especially vulnerable.
• A crim e is suspected to have occurred in conjunction with
the person supported going m issing (ie. abduction, stolen
vehicle, assault on Staff).
• The service provider contacted the police and an am ber
alert or a sim ilar public awareness tactic is planned.
Note: Do not report incidents in this category as enhanced if
the incident has already been resolved (ie. m issing
person supported has returned).
5. Disaster/Disease
• The incident is a lock down relating to a serious
incident occurring in your service provider location
• The incident is an outbreak of a serious contagious
disease or virus, such as C. Difficile or SARS.
• The incident caused m ajor dam age to a service provider’s
location and will significantly disrupt the delivery of
services.
Note: Do not report incidents in this category as enhanced if
the incident has already been resolved (ie. lockdown has
been lifted).
6. A com plaint about the service provider
• The individual or group who com plained has contacted the
m edia
• A Staff m em ber has been arrested for a serious crim e that
m ay have affected persons supported
• The com plaint is about a topic that is often covered
in the m edia.
7. A com plaint m ade by or about a person
supported and any other serious
occurrences
• The incident involves serious crim inal activity on the part
of the person supported.
8. Restraint of a person supported
•
Service provider Staff applied a physical restraint
that resulted in a life-threatening injury.
C.14(f)
Section:
Subject:
C
Communication Book
Total Pages:
1
Revision Date(s)
COMMUNICATION BOOK
Community Living-Central Huron will use in all ‘residential’ and ‘day activity’ settings, a Communication
Book, which will be clearly identified as such. The purpose of the Communication Book is to share all
pertinent information with regard to program participants, as well as relay other necessary information
to Agency Staff.
To ensure information is presented in a consistent, factual, comprehensive, relevant manner, the
following guidelines will be adhered to for all Staff when entering information in the Communication
Book. Provide a summary, identifying the following areas, each shift:
a)
Concerns, issues (ie. medical, behavioural, etc.).
b)
Brief summary of participants’ involvement, activity during shift.
c)
Appointments (overview of appointment, detailed information will be entered in person’s
individual file; upcoming appointments).
d)
Changes in routine (ie. participants’ weekly outing cancelled).
e)
Note any additional information that may be of benefit to the participants and/or Staff.
The following guidelines will be adhered to for recording purposes:
a)
Information should be recorded in the Communication Book using ink. Corrections should
be made in ink by drawing one or two lines through the entry, and signed and dated by the
person making the correction.
b)
Never erase material from the Communication Book or remove pages or portions of pages.
c)
Each page of the Communication Book should be used. If blank spaces must be left, a line
should be drawn diagonally through the blank space and the line signed and dated by the
person who is making the entry after the blank space.
d)
Each entry must be dated, specifying shifts, and signed by the person completing the entry.
C.15
Section: C
Subject: Personal Finances
Total Pages: 4
Approval Date: June 18, 2008.
Revision Date(s): May 18, 2011, Sept.
15, 2015.
Procedures Revised: Nov. 21, 2012,
Sept. 15, 2015.
FINANCES OF PEOPLE SUPPORTED
Community Living-Central Huron is committed to ensuring people supported are provided with
individualized assistance with managing their own personal finances. Informed Consent must first be
obtained from the person supported or legal guardian, prior to any assistance being provided.
Assistance may include obtaining funds, budgeting, monitoring finances, support with purchases,
recording, paying bills and trusteeships. When a Staff assumes responsibility for a person’s supported
finances, they do so with the understanding that the person’s funds are spent in a manner that is
consistent with the Individual Support Plan to enable persons supported to direct their own services and
supports in a personalized way. Further, when a Staff has a dual signature or joint signature bank
account with a person supported, the Staff member does so with the full understanding and agreement
that all funds belong solely to the person supported and the Staff has no entitlement to any funds at any
time, including but not limited to bequests. Non-compliance with this policy and the detailed procedures,
“Record Keeping and Financial Accountability of Persons’ Supported Finances,” is subject to discipline
up to and including dismissal.
The following practices are included in a detailed procedure “Record Keeping and Financial
Accountability of Persons’ Supported Finances”:
-
-
-
-
-
-
Persons supported must give consent prior to the Agency providing assistance with banking and
financial matters;
Full-Time and Part-Time Support Workers, as directed by their Supervisor, may have the
responsibility of assisting a designated person(s) supported with financial record keeping; including
individual ledgers and banking records. All discrepancies will be immediately reported to the
Supervisor;
all transactions must be documented, noting the specific of the debit and/or credit; receipts are
expected to be obtained, whenever possible and are required for all purchases made with Staff
assistance;
the relevant Supervisor will reconcile banking records on a monthly basis and immediately report
any concerns to the Coordinator, Adult Services. The Coordinator, Adult Services, will provide a
report annually to the relevant Committee(s), as confirmation that an independent review of an
person’s supported finances has been conducted.
Staff will not borrow money or engage in any personal financial transactions with persons
supported;
Staff will not accept or obtain any benefit for themselves when assisting people supported with their
finances. More specifically, Staff will not utilize a personal “points card”, receive a credit voucher,
etc., when assisting supported individuals;
CL-CH Administration Staff will conduct an independent annual review/audit of the accounts of
persons’ supported by residential services and the SIL Program, as appropriate. The
appropriateness to be determined by the level of Staff involvement;
Persons supported will be provided with information on various banking services/options, such as
direct deposit, automatic transfers from individual accounts to the house account.
The Agency requires Support Workers to administer the finances of persons supported in a respectful,
efficient and responsive manner.
C.16(a)
Procedures for Record Keeping and Financial Accountability
of Persons’ Supported Finances
Review of Policy:
Community Living-Central Huron (CL-CH) believes the health, safety and well being of persons
supported is of primary concern, with one such area being finances. Therefore, CL-CH has developed
policies and procedures to address the area of finances.
Finances of Persons Supported:
The level and type of support required to assist persons supported to manage their financial resources
must be discussed and agreed upon by the person supported or legal guardian. As per the
individualized Support Plan, input may come from the person supported, family, internal and external
service providers, including the relevant Supervisor and Coordinator. Persons supported are
responsible for all of their own expenses from their own income. The designated Support Worker, which
may include the Supervisor or Coordinator, may assist with budgeting, financial planning, accounting
of the person’s supported finances, pursuing other options related to income, investigating bank account
features, assuming the role of trustee, and ensuring all transactions are recorded accurately, as per the
Agency’s policy and procedures. Agency Staff will not borrow money, nor engage in any personal
financial transactions with persons receiving support. Staff will not accept or benefit personally from any
bonus offers, promotions, points cards, gift certificates, credit vouchers, etc., when assisting persons
supported to make purchases/with their finances. Further, Agency Staff will not initiate or promote the
giving of gifts from persons supported to Staff. An annual independent review of all account
ledgers/transaction registers will be conducted by a third party followed by a report to the Quality Review
and Planning Committee. The written minutes of the Quality Review and Planning Committee will
provide notification to the Board of Directors that the third party review has occurred.
Failure to abide by the Agency’s Finances of People Supported Policy and Record Keeping and
Financial Accountability of Individuals’ Finances procedures, will result in disciplinary action, up to and
including dismissal.
Income of Persons Supported:
The most common source of income for persons receiving support is the Ontario Disability Support
Program (ODSP). Specific guidelines accompany ODSP.
Persons who receive support may also have other source of income, which can vary. Examples of other
sources of income are as follows:
-
Old Age Security
Employment Income
Ontario Works
Inheritance/Trusts
Canada Pension Plan
C.16(b)
Dual Signature Accounts:
Persons supported have the option of having a dual signature account(s) with their designated Support
Worker. The dual signature bank account option is voluntary and is typically of an educational nature
and/or as an additional security measure for the person supported. The designated Support Worker
is required to submit a completed Consent for Dual Signature Bank Account form to the appropriate
financial institution when setting up the dual signature account. A copy will also be placed in the
person’s supported file, as well as forwarded to the relevant Supervisor and Coordinator.
General Responsibilities:
- Receipts are required for all purchases made with Staff assistance and whenever possible when
Staff assistance does not occur.
- Any cash amounts locked in a person’s home will require recording of all transactions, noting the
specific of the debit/credit, date of the transaction and the balance. The written balance must be the
same as the cash balance.
- Any cash amounts locked in a person’s home will be counted at the beginning of each day shift and
the end of each evening shift, with the Staff initialling said process.
- Any discrepancies will be immediately reported and reviewed with the relevant Supervisor or
designate. Should there be any concerns or ongoing discrepancies with the cash count balances,
further safeguards or other measures as determined by the Supervisor or designate will be
implemented, such as cash counting at the beginning and end of every shift.
- Discussions and agreement with the person supported must occur for all purchases/transactions.
Designated Support Worker Responsibilities:
- All bank transactions, including interest and service charges, must be recorded in the person’s
supported account ledger/transaction register, noting the specific of the debit/credit. The
ledger/register is to balance with the person’s supported financial institution’s balance.
- All entries made to the person’s supported ledger/register will be made in pen and white out will not
be used. The date will be recorded for each entry. Pages will not be removed from persons’
supported ledgers/registers.
- Bank books will be updated at least monthly.
- The person’s supported bank account(s) will be monitored regularly to ensure the allowable asset
amount, if applicable, is not exceeded.
- Fulfill the responsibilities of the trustee, as per ODSP requirements, if applicable.
- Be familiar with the relevant guidelines, requirements which accompany the person’s supported
source(s) of income.
- All persons supported who require safekeeping of cash or any other financial item shall have such
item(s) kept in a locked location in their home. Keys to the locked location will be limited amongst
the Staff and determined by the relevant Supervisor. The relevant Supervisor will keep a spare key.
- A limited supply of pre-signed cheques and/or withdrawal slips will be left at the work locations and
will bear only one signature, the Staff signature, until the time of cashing/depositing.
- When there is more than one designated worker on an account (ie. House Account), the balancing
of the account will be rotated on a monthly basis amongst the designated workers.
- All pre-authorized bill payments and deposits will be recorded in the account ledger/register for easy
reference. Also, pre-authorized bill payments and deposits are not to be recorded in the account
ledger/register until the expense/deposit has occurred/is occurring.
- When recording errors made by Staff create an overdraft situation for the person supported, Staff
will repay the person supported for the entire cost of the overdraft expense.
- The designated worker(s) will rotate, on a monthly basis, the responsibility of ensuring there is
available petty cash, if applicable at the work location.
C.16( c )
Supervisor Responsibilities:
- The relevant Supervisor will maintain an up-to-date list of all dual signature accounts for persons
supported within their Team.
- Any discrepancies will be reported in writing to the Coordinator.
- The relevant Supervisor will review all account ledgers/transaction registers, within their Team, on
a monthly basis, which includes bank accounts, cash, petty cash and ensuring any over-draft
expense caused by the Support Worker is promptly repaid.
- When a designated Support Worker temporarily vacates their position, the Supervisor, in
consultation with the Coordinator, will determine if the Support Worker’s name will be removed from
all dual signature accounts for leaves of absence, such as: maternity/parental leaves, short term and
long term disability leaves, WSIB leaves.
- The Supervisor will ensure for all departures of employment, the designated Support Workers’ name
will be removed from all dual signature accounts.
- On an annual basis, the relevant Supervisor will ensure an independent review of all account
ledgers/transaction registers is conducted by a third party and reported to the Coordinator, Adult
Services.
Admin. Staff Responsibilities:
- Conduct an annual audit/review of all bank accounts, investments, expenditures, record books,
receipts, petty cash vouchers and any other financial records of persons supported by residential
services and SIL (as appropriate).
- Provide a written summary of the annual audit to the relevant Supervisor and copy to the
Coordinator, Adult Services.
Petty Cash Guidelines:
- The amount of petty cash should be limited. Typically, the purpose of petty cash is to purchase
lower cost, incidental house items, shared by all persons supported within the home, when unable
to go to the bank or the item is required in a prompt manner.
- The petty cash will come from the House Account or equally from the persons’ supported personal
accounts.
- Receipts are required for all purchases.
- All transactions will be recorded in the account ledger/transaction register, noting the specific
debit/credit, date of the transaction and the balance. The written balance must be the same as the
cash balance.
- Petty cash will be counted at the beginning and end of every shift, with the Staff initialling the
ledger/register each time.
- Discrepancies will be reported immediately and reviewed with the Supervisor or designate.
Related Policies:
- Service Principles
- Philosophy
(A-001)
- Employee and Volunteer Orientation (E-005)
- Privacy (A-004)
- Interpretation (B-001)
- Volunteer (B-007)
- Duty of Care Policy (B-010)
- Code of Conduct (B-011)
- Abuse (C-004)
C.16(d)
Section: C
Subject: Individual Support Policy
Total Pages:
1
Approval Date: October 21, 2009
Revision Date(s): Nov. 21, 2012.
INDIVIDUAL SUPPORT POLICY FOR PERSONS SUPPORTED
All Staff and Volunteers of Community Living-Central Huron will support people in a manner consistent
with the Agency’s Philosophy, Vision and Missions Statements, Guiding Principles, and all other Policies
and Procedures, Ministry Acts and Regulations. Agency Staff and Volunteers will be provided with a
Job Description and/or letter which will outline further details with respect to their support role. Each
Program will be responsible for ensuring an individualized Support Plan is developed, specific to the
service(s) the person supported is receiving and reviewed annually by the relevant Staff and person
supported.
All persons supported receiving accommodation support(s) from Community Living-Central Huron will
be provided with the opportunity to participate in the development of their Support Plan, which will:
a) build on the person’s supported capacity to participate in activities that promote life in the
community;
b) respect the person’s supported abilities, preferences and choices;
c) be developed in a manner that is respectful of the person’s supported interests and concerns;
d) provide for ongoing monitoring and flexibility to ensure revisions to the Plan can and will occur, as
dictated by the needs and desires of the person supported.
Non-compliance with the Agency’s Persons Support Policy is subject to discipline, up to and including
dismissal from the Agency’s employ and/or its services.
C.17
Section: C
Subject: Pet Ow nership, Visiting Pets
and Service Animals
Total Pages:
1
Approval Date:
Oct. 19, 2011
Revision Date(s):
PET OWNERSHIP, VISITING PETS AND SERVICE ANIMALS POLICY
Community Living-Central Huron recognizes that individuals supported have the right to own pets, as
pets can provide companionship and positively contribute to one’s quality of life. The Agency also
recognizes that Staff play a key role in the success of pet ownership and in utilizing pet therapy and/or
service animals. Staff will ensure that the individual’s interests in pets is reflected in their Individual
Support Plan. When individuals supported live with roommates, all individuals residing within the same
unit of the home must be in agreement of pet ownership and/or pet visiting.
a) Household Animal Companions:
A pet requires a great deal of thought by all involved due to the personal commitment to the animal’s
care and welfare, as well as the health and welfare of roommates. Staff will provide information to
individuals supported regarding responsibilities of pet ownership, such information to include:
-
the individual who wants a pet, should have the ability, desire and financial resources to properly
care for a pet;
any local by-laws associated with pet ownership;
everyone residing within the individual home unit must be in agreement;
the choice of those residing in the home rather than Staff preference;
the cost, time and quality of life associated with pets ie. nutritional and dietary needs, exercise, living
space, license fees, medications, immunizations, veterinarian appointments, cage, leash, pet
accessories such as toys, beds, etc.
b) Visiting Animals or Pet Therapy:
When it is not feasible to have a pet living in the home, but individuals supported wish to engage in
some contact with animals, other resources may be considered, such as: established Pet Therapy
resources, Humane Society, Ontario Society for the Prevention of Cruelty to Animals (SPCA),
petting zoo, pet shops, local vet clinic or informal pet visits from friends or family. Any such
arrangements will be reflected in the Individual Support Plan. When considering these alternatives
the following guidelines are to be followed to ensure the safety of individuals supported as well as
animals involved:
-
suitability of the animal/pet visiting, ie. temperament;
People supported must consent to having a pet visit them in their home and visits are not to impact
on people’s health (ie. allergies) or emotional well being (ie. fear of dogs or cats, etc.);
Consideration must be given to people’s skills in interacting with animals and reduce risks through
education, instruction and close supervision.
c) Staff Support:
Staff will ensure continuity of care through effective communication when there are changes in Staff
and report any concerns pertaining to the health and welfare of individuals supported, Staff,
volunteers and the pet to the relevant Supervisor.
C.18
Section: C
Subject: Orientation for People Supported Total Pages: 1
Approval Date:
June 20, 2012
Revision Date(s): Oct. 17, 2012
ORIENTATION FOR PEOPLE SUPPORTED
In addressing quality assurance measures which respect the promotion of social inclusion, individual
choice and independence, Community Living-Central Huron will conduct a mandatory orientation for all
individuals, and any persons acting on their behalf, when the individual begins to receive service/support
and annually thereafter.
Such orientation will include, but is not limited to, review of the following information:
•
•
•
•
•
•
•
Agency’s Vision and Mission Statements
Adult Services Organizational Structure
Service principles
Individual Welfare/Rights Policy
Person Supported Complaint/Feedback Policy
Relevant Agency handbooks, brochures
Visit(s) to the location(s), as appropriate, where support services will be
provided
C.19
Section: C
Subject: Medical Care for Persons
Supported Policy
Pages: 2
Approval Date:
Revision Dates:
Sept. 16, 2015.
Nov. 21, 2012
Dec. 19, 2012,
MEDICAL CARE FOR PERSONS SUPPORTED POLICY
Community Living-Central Huron Staff shall ensure persons receiving 24 hour support from the
Agency will receive the necessary assistance to have regular and emergency medical care. Regular
medical care shall include, but is not limited to, annual physical examinations; annual dental care or
as recommended by a dentist or dental specialist; annual eye exam or as recommended by an
optometrist or eye specialist; annual hearing tests, as appropriate for age and health status.
Documentation by Staff for all medical appointments will occur using the relevant Agency forms.
Staff will ensure the medical professional performing the annual physical will complete the required
Agency form.
Should a person supported refuse to attend any medical appointment, or receive any medical
service, as recommended by a legally qualified medical practitioner or other health professional,
documentation of such refusal will be completed on the Agency’s Medical Appointment form. Family
members and/.or support network will be advised as appropriate.
Community Living-Central Huron Staff are restricted from the following:
•
•
•
Acting as a substitute decision maker
Performing medical assessments
Providing medical treatment beyond First Aid/CPR or for which training by a
qualified professional, under the Regulated Health Professions Act, 1991, has
not been successfully obtained
Do Not Resuscitate (DNR) Orders - Trained Staff will provide First Aid/CPR to persons supported
who have DNR orders in place until qualified medical personnel arrive.
Should a person supported have a written DNR Order on file, Support Workers are to ensure it is
provided to qualified medical personnel, as appropriate.
Non-compliance with the Medical Care for Persons Supported Policy is subject to discipline, up to
and including dismissal from Community Living-Central Huron’s employment and/or services.
Related Policies:
- Philosophy
(A-001)
- Privacy (A-004)
- Accessibility Policy (B-009)
- Behavioural Support (C-002)
C.20 (a)
Related Policies (continued):
- Abuse (C-004)
- Use of Physical Restraints (C-005)
- Medication Policy Statement (D-002)
- Emergency (D-003)
- Pandemic Policy (D-008)
- First Aid Policy and Procedures (D-011)
- Infection Control Policy and Procedures (D-013)
- Hazard/Risk Policy and Procedures (D-014)
- Health and Safety Orientation Policy (D-015)
- Sharps Policy and Procedures (D-018)
- Employee and Volunteer Orientation Policy (E-005)
- Professional Development/Training Policy (E-006)
C.20(b)
Section: C
Subject: Inventory, Personal Belongings
Of Persons Supported
Total Pages:
1
INVENTORY, PERSONAL BELONGINGS OF PERSONS SUPPORTED POLICY
Community Living-Central Huron recognizes persons supported by the Agency will own personal
property and may require assistance for the care and maintenance of the personal property. Staff
will assist individuals to complete an annual inventory of assets, which may be shared with
persons supported home insurance provider. Initial inventory is completed within one month of a
person accessing Residential Services and immediately when any additional personal
property/belongings are acquired or purchased. Videotaping of personal property, in addition to a
written inventory, is acceptable. The Agency will maintain a copy of the written inventory list.
Staff will assist persons supported with the necessary care and maintenance of the personal
property, which may include accessing community services for care, maintenance or replacement
of personal property, as dictated by persons supported willingness and financial ability.
Non-compliance with the Inventory, Personal Belonging of Persons Supported Policy is subject to
discipline, up to and including dismissal from Community Living-Central Huron.
C.21
Section: C
Subject: Bathing and Show ering Supervision
Of Persons Supported Policy
Total Pages: 2
BATHING AND SHOWERING SUPERVISION OF PERSONS SUPPORTED POLICY
The health, safety and well being of persons supported by Community Living-Central Huron is a
major concern of the Agency’s Management and Board of Directors. To ensure the safety and
well being of persons supported when bathing and showering, the appropriate level of
supervision is required for all persons who receive 24 hour support by the Agency.
Agency Staff will be required to abide by Community Living-Central Huron’s Bathing and
Showering for Persons Supported Policy and Procedures. Non-compliance with the Bathing and
Showering Supervision of Persons Supported Policy is subject to discipline, up to and including
dismissal from Community Living-Central Huron.
C.22
Procedures for Bathing and Showering Supervision of Persons Supported
Review of Policy:
Community Living-Central Huron (CL-CH) believes the health, safety and well being of persons
supported is a major concern. To ensure the safety and well-being of persons supported when
bathing and showering the appropriate level of supervision is required. Therefore, CL-CH has
developed policies and procedures to address the area of bathing and showering for persons who
receive 24 hour support from the Agency.
Procedures:
•
•
•
•
•
•
•
Prior to CL-CH initiating support, the determination of bathing and showering supervision will
be discussed with the person to be supported and other significant individuals, as appropriate,
such as: family, Developmental Services Ontario (DS0), medical professionals to determine
what, if any, bathing and showering supervision is required. The area of water temperature will
be considered as part of the determination. The outcome of the determination will be
documented.
Should bathing/showering supervision be required, a bathing/showering protocol would be
developed prior to support initiation and signed by all parties who participated in the
determination, including the person supported. For water temperature protocols,
consideration to the following safeguards will occur:
The use of control valves for the water temperature not to exceed 49 degrees Celsius
(120.2 Fahrenheit)
Staff testing the water by hand, palm down, continue to immerse into water if
comfortable
Staff testing the water with a thermometer prior to person supported bathing/showering
Staff will complete the Residential Health and Safety Daily Checklist to document water
temperature. Staff are to contact their Supervisor or designate if the water temperature
exceeds 49 degrees
Bathing/showering protocols will be kept in the person supported file. Protocols will be
reviewed at orientation for newly hired Staff and reviewed by Staff on a minimum annual basis
and at any time revisions are made.
All persons supported by CL-CH will be expected to participate in a Person Directed Plan on
an annual basis. The area of bathing/showering is addressed on the Personal Plan checklist
and therefore will be reviewed, as to the level of supervision required.
Should the needs of persons supported change, an assessment will occur, as outlined in the
first bullet point. Consideration to the following areas will be given:
1. Seizure activity
2. Inability to keep head above water unsupported
3. Inability to bathe without any mechanical support
4. Inability to understand potential risks associated with bathing/showering
Respect to persons supported privacy will be given. Options, such as curtains may be used to
ensure the necessary supervision is provided and the person’s privacy is respected.
C.23
Section: C
Subject: Persons Supported Food and
Nutrition
Total Pages:
1
PERSONS SUPPORTED FOOD AND NUTRITION POLICY
Community Living-Central Huron recognizes the importance of “food and nutrition” for persons
supported through the Agency, as well as culture, diversity, medical considerations, special diets
and individual choice. Staff will be responsible for promoting and assisting persons supported to
abide by the recommendations made under Canada’s Food Guide, as per the following guidelines:
a) Persons supported will be encouraged to participate in daily meal planning and preparation of
meals;
b) Information will be provided to persons supported via Agency Staff, Public Health, Dietician or
any other Agency approved education/training tool regarding food and nutrition as per
Canada’s Food Guide;
c) Documentation of meals will take place by Staff to monitor consistency to Canada’s Food
Guide;
d) Staff will monitor safe food preparation practices;
e) Staff will monitor safe food storage practices, as per local health department regulations
Non-compliance with the Persons Supported Food and Nutrition Policy is subject to discipline, up
to and including dismissal from Community Living-Central Huron’s employment.
C.24
Section:
Subject:
C
Missing Person
Total Pages: 2
MISSING PERSON/UNKNOWN WHEREABOUTS POLICY
Community Living-Central Huron is responsible for ensuring the health, safety and welfare of people
supported, and as such has developed a policy and procedure which outlines the expectations and
responsibility of Staff and volunteers when the whereabouts of a person requiring supervision is
unknown. Staff and volunteers of Community Living-Central Huron recognize they have no legal
authority to hold any adult against their will at any time; however, documented in each Individual’s
Person-Directed Plan/Personality Profile there is a section that addresses supervision, support
required/desired. Further, there may be Individual Protocols which describe risks to individuals who
may leave the premises, work area, community location, etc. without Staff accompaniment and
elaborate on what action should occur. Non-compliance with Missing Person/Unknown Whereabouts
Policy and procedures is subject to discipline, up to and including dismissal from Community LivingCentral Huron’s employment.
Definitions:
Missing Person/Unknown Whereabouts: Any situation where a person being supported is missing
and/or their whereabouts is unknown, as per the necessary supervision described in the PersonDirected Plan/Personality Profile and per Serious Occurrence Policy.
Emergency Preparedness Binder: A location-specific binder kept at all Agency work sites, which
includes detailed information regarding individuals supported (personality profile), as well as other
relevant emergency data, (ie. floor plans, inventory listings, record of monthly fire drills, etc.); see
Policy No. D-003 (Emergency Policy).
Personality Profile: is a tool used by Community Living-Central Huron to record various
individualized information of individuals supported. Personality profiles will provide a snapshot of the
individual, such as: supervision required; medical alerts/conditions; strong likes or dislikes.
Individual Protocols: A document which provides detailed steps Staff and volunteers are to follow
for a specific situation regarding a person supported.
Person-Directed Plan: is a document utilized by the Agency to record the goals; dreams; choices
and visions of individuals supported. Staff will facilitate a process to assist individuals supported
along with their family, friends and support network for individuals to achieve their goals, vision and
dreams.
‘While participating in service’ shall mean when an individual being supported is receiving direct
care from Staff, volunteers, caregivers, etc., from any Agency Program.
‘Ministry’ refers to the Ministry of Community and Social Services and/or the Ministry of Children and
Youth Services.
“Enhanced Serious Occurrence Reporting” refers to Agency Policy No. C-006, Serious
Occurrence Policy, which describes in detail situations and reporting procedures as required by the
Ministry.
C.25
Procedures for Staff and Volunteers providing direct supports:
1. All Agency Staff and volunteers are required to participate in orientation, training and to continue
to update themselves on an ongoing basis with respect to the support needs of the individual they
are providing support to.
2. Full and part-time Staff and Supervisors are responsible to ensure that all areas of a PersonDirected Plan/Personality Profile/Individual Protocols are up-to-date at all times, ie. considerations
of risks, family/caregiver contacts, support requirements; Personal Data Sheets, etc.
3. In each situation where an individual being supported is missing and/or their whereabouts is
unknown; Staff and volunteers will refer to the individual’s Person-Directed Plan, Personality
Profile/Individual Protocols (if any) and review the individual’s vulnerability in such situations, level
of risk, and proceed accordingly.
4. Based on the details of the Person-Directed Plan, Personality Profile/Individual Protocols, and
the specific circumstances at that time, (ie. person missing from their home, Day Program, job
site, community outing, notification by a citizen, etc.), appropriate steps shall be taken to address
safety, health and well being of the individual, others being supported at that time/location and
as necessary, the community.
5. As referenced under definitions above, the Emergency Preparedness Binder is site-specific and
is kept at all Agency work locations, detailing different situations and actions. Actions may be to
check adjoining areas; solicit support of other Staff; community members; notification of
Supervisor; emergency services; family; Ministry, etc. Also, refer to Serious Occurrence Policy
(C-006) for any situation whereby “Enhanced Serious Occurrence Reporting” procedures are
required (ie. in response to a significant incident involving a person(s) supported and the incident
is likely to result in significant public or media attention).
6. Should there be a situation whereby an individual is missing/their whereabouts unknown and no
protocols are in place, Staff and/or volunteers will contact the Supervisor or designate, pager or
call 911, as appropriate.
Communication/Documentation:
Each work location has a cell phone which Staff are to carry with them, when not on-site at an
Agency location. The Supervisor will consult with the Staff and/or volunteer involved with an incident
as to when and who will contact the family/caregivers/other service providers, etc., Staff and/or
volunteer will complete appropriate documentation (ie. Communique, Serious Occurrence Reporting
form, Communication Book) within the required timeframes, as per Agency policies and procedures.
C.26
SECTION D:
HEALTH and SAFETY
Health & Safety Policies (Section D)
were reviewed by:
Name (Please print)
Title
Signature
Date
Section:
Subject:
D
Health and Safety
Policy Number: D-001
Total Pages:
2
Approval Date:
May 15, 1991
Revision Date(s): Jan. 20, 1993,
Nov. 15, 2006, Oct. 20, 2010,
Nov. 16, 2011, Sept. 19, 2012.
Dec. 17, 2014, Nov. 18, 2015.
HEALTH AND SAFETY POLICY STATEMENT
Policy:
The health, safety and well-being of all employees, volunteers and people supported is a major
concern of Community Living-Central Huron’s Management and Board of Directors. Working safely
on the job and promoting one's own good health, safety and well-being and that of others are some
of the most important responsibilities of each employee and volunteer.
Community Living-Central Huron will take every reasonable precaution for the protection of all
employees, volunteers and people supported, striving to eliminate and reduce risk of any foreseeable
hazards which may result in damage to property and personal injuries/illnesses. The Agency provides
specific orientation and training for health and safety purposes. Also, the Agency has an Early and
Safe Return to Work Policy and Program which recognizes the value of employees; and as such is
committed to the successful recovery of ill, injured and disabled employees. Every employee or
volunteer must protect their own health and safety by working in compliance with the Occupational
Health and Safety Act, its regulations and within Community Living-Central Huron’s safe work policies
and procedures.
Purpose:
This Policy and related policies and procedures have been developed to assist in implementing an
Occupational Health and Safety minded culture, acknowledging and communicating a commitment
to safety. This commitment is internal to the Agency and extends to all people during their interaction
with Community Living-Central Huron.
Responsibilities:
The Employer will ensure that every reasonable precaution is taken for the protection of employees,
volunteers and people supported. The Employer will advise employees and volunteers of the
existence of actual or potential workplace hazards and will ensure they work safely and in
accordance with the Occupational Health and Safety Act, its regulations and all applicable
Community Living-Central Huron policies and procedures.
Supervisors are responsible for ensuring employees and volunteers are aware of established safe
work policies and procedures. Every employee and volunteer will perform their job in accordance
with legislated and Community Living-Central Huron safe work practices and procedures. Noncompliance with safety standards is subject to discipline up to and including dismissal.
D.1 (a)
The Province of Ontario requires that employers abide by the Occupational Health and Safety Act
and its Regulations; therefore sets out minimum guidelines that must be in place to ensure a safe
working environment. The Ontario Ministry of Labour is committed to workplace safety and assisting
Employers in providing safe work environments. The Ministry’s Occupational Health and Safety
mandate is to set, communicate and enforce the Occupational Health and Safety Act and its
regulations. It also develops, coordinates and implements standards and strategies to prevent
workplace injuries and illnesses.
There are various organizations in place to assist Employers in achieving compliance with the Act
and preventing workplace injuries and illness. Working in conjunction with the Ministry of Labour is
the Workplace Safety and Insurance Board (WSIB). WSIB provides no-fault workers’ compensation
and promotes workplace Health and Safety. Another important part of Ontario’s safety program is
Health and Safety Ontario. This organization comprises of four Health and Safety Associations
working together to get Ontario’s workers home safely and achieve a goal of zero work-related
injuries, illness and fatalities. Community Living-Central Huron has utilized the services and supports
of the Public Services Health and Safety Association (PSHSA).
D.1(b)
Section:
Subject:
D
Medication
Total Pages:
1
Approval Date:
April 20, 1994
Revision Date(s) Dec. 01, 1995,
Dec. 15, 1999, Sept. 19, 2001
MEDICATION POLICY STATEMENT
The health, safety and well-being of the people the Agency supports is of primary concern to the the
Board of Directors. Therefore, to assist in ensuring the welfare of all individuals, Community LivingCentral Huron has developed policies and procedures which address the area of “medications.”
Employees and the Agency both share responsibilities associated with administering medications.
The Agency must establish guidelines, policies, procedures and protocols, including orientating and
training employees.
Employees are responsible for adhering to the established policies and procedures and to seek
clarification or training when needed from their immediate Supervisor.
Non-compliance with medication procedures is subject to discipline; up to and including dismissal
from Community Living-Central Huron’s employment.
In an effort to ensure medications are administered safely and responsibly, the following
procedures/guidelines will be adhered to:
1. A Support Worker will not administer prescribed or over the counter medications prior to receiving
approved training in the proper procedures relating to dispensing and recording medications as
outlined in this procedural document.
Community Living-Central Huron utilizes a variety of dispensing methods: pharmaceutical
containers for liquids and tablets; blister packs; dossettes and syringes; however, this does not
preclude the use of other dispensing methods.
2. A Supervisor or designated person will provide on-site training in administering and recording of
medications.
3. In an effort to ensure employees are familiar with the Agency’s Medication Policy and Procedures,
all new employees will be asked to complete a written questionnaire and achieve a proficiency
of 100%. The Medication Questionnaire will be administered by a Supervisor or the Coordinator
within 30 days of a Support Worker's commencement of employment with Community LivingCentral Huron.
4. It is the responsibility of the new employee to obtain valid First Aid, C.P.R. and any other required
certificates within the first 12 months of employment. Community Living-Central Huron will
compensate employees for subsequent training.
Refer to the Agency’s “Medication Policy and Procedures Manual.”
D.2
Section: D
Subject: Emergency Policy &
Preparedness
Total Pages: 6
Approval Date:
Nov. 17, 1999
Revision Date(s): Feb. 18, 2004
Jan. 20, 2010, Oct. 2010,
Sept. 19, 2012, February 20, 2013,
Oct. 15, 2014, May 20, 2015
EMERGENCY POLICY
Community Living-Central Huron recognizes the health, safety and well-being of individuals both
receiving and providing services, as an Agency priority. It is anticipated by having precautionary
measures in place, some emergencies may be lessened or possibly averted. Community LivingCentral Huron’s Emergency Preparedness Plan and Procedures for Emergency Situations will
provide clear and concise measures to coincide with area/local emergency plans. Non-compliance
with the Emergency Policy, preparedness planning and procedures for emergency situations is
subject to discipline, up to and including dismissal from Community Living-Central Huron’s
employment and/or services.
Each Agency work location will have on site, an Emergency Preparedness Binder. Staff are required
to review the Binder each month. Supervisors will maintain an up-to-date Staffing List (names, phone
numbers) of all Teams, which will identify the work locations to which Staff Members have been
orientated. The Staffing List would be accessed in the event additional Staffing was required due to
an emergency situation.
Staff, volunteers and people supported will be provided with training related to various emergency
situations. Training is provided as part of orientation and on an on-going basis, specific to the needs
of individuals supported or events that may present health, safety and well-being concerns of Staff,
volunteers and people supported.
1. An Emergency may include but is not limited to the following situations:
a)
suspicion of any illegal activity;
b)
any serious injury or illness;
c)
any abuse or mistreatment;
d)
fire;
e)
any situation where an individual supported is missing and the matter is considered
serious;
f)
pandemic (see Pandemic Policy D-008);
g)
natural disasters;
h)
critical injury; and
i)
workplace violence
2. Examples of Some Emergency Situations/Procedures:
The following chart illustrates examples of some emergency situations and lists recommended
procedures. Note, the term “contact” is defined as directly communicating with the relevant
person.
D.3
Situation
Procedure
Step 1
Procedure
Step 2
Procedure
Step 3
Abuse /
Mistreatm ent
Intervene to ensure
health, safety and
well-being
Contact
Supervisor/Pager
Polices & Procedures
(Abuse, Serious Occurrence)
Critical Injury
Provide em ergency
first aid and contact
relevant em ergency
services
Contact
Supervisor/Pager
Occupational Health & Safety
Docum ent, Policy &
Procedures (Critical Injury,
Serious Occurrence)
Death
Ensure health, safety
& well being of others
Call 911
Contact
Supervisor/Pager
Docum ent, Policies &
Procedures (Serious
Occurrence, Critical Injury)
Fire
Evacuate prem ises
Call 911
Medication Incident
Refer to Medication
Folder/File or contact
m edical and/or
em ergency options
Contact
Supervisor/Pager if
serious in nature,
or for non-m edical
em ergencies
contact
Supervisor,
designate or voice
m ail
Missing Person
Refer to Person
Directed Plan for
support needs and
individual protocol(s)
Call Police if
warranted by
support needs
Natural Disasters
Ensure health, safety,
well-being; refer to
location protocols
Contact
Supervisor/Pager
Pandem ic - as
determ ined by The
W orld Health
Organization
Refer to Pandem ic
Policy
Serious
Injury/Illness
Provide em ergency
first aid and contact
relevant em ergency
services
Suspicion of Illegal
activity
Contact
Supervisor/Pager
Docum ent
Use of Physical
Restraints
Contact
Supervisor/Pager
Policies & Procedures (Use
of Physical Restraints,
Serious Occurrence)
W orkplace
Violence
Contact em ergency
services and/or
police, as appropriate
Contact
Supervisor/
Pager
Refer to Relevant
Policy
Docum ent; Policies &
Procedures (Serious
Occurrence)
Medication Policy &
Procedures
Contact
Supervisor/
Pager
(Serious Occurrence,
Missing Person, Unknown
W hereabouts)
Docum ent
(Em ergency Policy,
Pandem ic Policy)
Contact
Supervisor/Pager
Contact
Supervisor/Pager
Docum ent; Medication Policy
& Procedures; Policies &
Procedures (Serious
Occurrence)
(W orkplace Bullying &
Violence, Em ployee
Perform ance Standards,
Behavioural Support),
Docum ent
3. For Emergency Situations in the Goderich & Clinton Areas:
911
911 is a single emergency telephone number that makes it faster and easier for anyone to reach
Police, Fire or Ambulance Emergency Services.
Your call will be answered at the Central Emergency Reporting Bureau in your municipality.
When your call is answered, the 911 operator will ask: Police, Fire or Ambulance? Indicate the
emergency service(s) you need. The operator will then forward your call to the appropriate
emergency service(s).
4. How to Proceed:
The following is intended to be used as a guideline only. Should you be unsure of proper
procedures, refer to the relevant policies already set into place (ie. Medication Policy, Abuse
Policy, Occupational Health and Safety Document), individual and location protocols or contact
your immediate Supervisor/Pager.
In the event of an emergency situation, all Staff will follow one or more of the following options
immediately:
a)
contact the relevant Emergency Service(s) via 911;
b)
ensure the required emergency community services are fully informed by providing all
pertinent information;
c)
ensure appropriate steps are taken to address any immediate and continuing health and
safety risks as per relevant Agency Policies/Procedures and individual and location
protocols;
d)
if extra Staffing is required, immediately contact appropriate Supervisor or Pager;
e)
access supplies/equipment, if needed, as per ‘Emergency Preparedness Plan’;
f)
when situation is stabilized, ensure appropriate C.L.-C.H. contact (as per attached chart)
is directly informed;
g)
provide a summary of the situation and subsequent directives in the Communication
Binder; and
h)
complete required documentation as per relevant Agency Policies/Procedures.
5. For Non-Emergency Situations in the Goderich & Clinton Areas:
Ambulance (for transfers only)
Goderich
1-800-265-1868
Clinton
1-800-265-1868
Fire Dept. (not always Staffed)
519 -524-7972
519-482-3920
Hospital
519-524-8323
519-482-3447
O.P.P.
1-888-310-1122
1-888-310-1122
CO Alarm (carbon monoxide)
519-524-4790
D.5
911
6. Emergency Preparedness Plan:
Following are the precautionary measures to be in place within all Agency locations:
a)
Community service emergency numbers such as 911 (for Police, Fire and Ambulance),
as well as phone numbers for hospital, CO Alarm Contact Number and utility services, all
of which are to be located next to the phone and/or programmed into the phone.
b)
Phone numbers of Immediate Supervisor, Pager, Agency cell phones and individuals’
supported ‘emergency contact’ number next to the phone and/or programmed into the
phone.
c)
The following supplies/equipment:
first aid kit (contents as per Occupational Health & Safety Document and First Aid
Policy);
flashlight and charged batteries;
battery powered radio and charged batteries;
photographs of utility shut-off valves, instructions as to how to shut-off;
blankets and/or sleeping bags for participants and Staff;
water supply (4 litre of water, per participant and Staff person, per day). Store
water in sealed, unbreakable containers, protected from the elements. Identify the
expiration date and replace accordingly;
supply of non-perishable, packaged or canned food and a non-electric can opener;
BBQ, Coleman stoves or other similar cooking equipment;
fire extinguisher(s);
smoke detector(s);
carbon monoxide detector(s);
additional set of vehicle keys (kept at Central Admin. Office);
candles and matches;
floor plans indicating exits;
floor plans indicating location of utility shut-off points;
land and charged cell phones (cordless/portable phones do not work when hydro
is off);
portable generators (located at designated locations);
Weatheradio or Multiband radio to advise of tornado warnings.
D.6
d)
Each Agency vehicle will have a Winter Survival Kit to be kept in the vehicle and
maintained from November 1st to May 1st, with the exception of the First Aid kit, which will
be kept in the vehicle throughout the year. Also, appropriate extra clothing and footwear
will be taken on an individual basis when travelling out of town. The following items will
be included in the Winter Survival Kit:
- Ice scraper/snowbrush
- Shovel
- Road flares or warning lights
- Gas line antifreeze
- Flashlight and batteries
- First Aid Kit (**to be in car at all times)
- Extra clothing and footwear (based on individual needs when travelling out of town)
- Blanket
- Non-perishable energy foods (ie. chocolate or granola bars, juice, soup,
bottled water with consideration to individual needs/restrictions)
- Candle and a small tin can
- Matches
e)
Emergency Preparedness Binder to include:
Index
Emergency Policy and Emergency Preparedness Plan
Relevant Staff and Volunteer contact information
Community emergency shelter addresses and phone numbers
Floor plans (to include tornado “safe space”)
List of utilities, location of fuse panel/breaker and water shut offs
Generator start-up instructions
Monthly checklist indicating review of the Emergency Binder
Information as to where to report in an emergency situation
Record of fire drills (monthly in residential locations, 4 times annually in Activity
Centre)
Record of tornado drills (1 time annually for all work locations)
Up-to-date Personal Data Sheets, Person Directed Plans, Timelines, Routines for
each person supported
Individual Inventory Lists
Evacuation Procedures/Fire Safety Plan
Individual and location specific protocols
Recent photograph of each person supported, as applicable
Resource information/section (ie. Red Cross package which includes info on
“Severe Storms”; “Emergency Preparedness Guide”; Safe food storage)
Local community Emergency Plan; County Emergency Plan
Insurance Company Name, phone number
CO alarm procedure
List of emergency supplies/equipment (ie. food, water, blankets, batteries, etc., and
where such supplies/equipment are stored)
D.7
f)
The Coordinator of Adult Services, Senior Case Managers and S.I.L. Support Workers will
retain up-to-date accessible “Emergency Assessment Checklists” for all S.I.L. participants.
The purpose of an “Emergency Checklist” is to identify each individual’s vulnerability
pertaining to an emergency situation. Personal data information will also accompany the
“Checklist.” The designated S.I.L. Support Worker will ensure the relevant emergency
information and assistance is provided.
g)
All Agency policies, procedures to be readily accessible in Policy & Procedures Binder.
h)
All Agency vehicles will include a Vehicle Inspection Report, HS-8, to be completed by all
Staff and Volunteers who access an Agency vehicle, prior to such use. The purpose of the
Vehicle Inspection Report, HS-8, is to ensure any problems/concerns with the vehicle are
identified prior to use, as well as confirming the vehicle contains all required safety
equipment (ie. first aid kit, winter survival kit). Staff and Volunteers are required to notify
their Supervisor if an Agency vehicle does not provide for a Vehicle Inspection Report, HS8.
7. Communication:
Each work location has a cell phone which Staff are to ensure is fully charged and on to enable
two way communication. Staff are required to take the work location cell phone with them when
supporting individuals in the community.
Clear, concise and timely communication to the Board of Directors; Ministry of Community &
Social Services; Coordinators; Managers; Administrative Staff; Support Staff; Individuals,
Families/Caregivers; Joint Health & Safety Committee, is imperative.
Policy Number B-002, Press and Media Releases, details communication with media. The format
and frequency of communication will be determined by the Executive Director or designate,
depending on immediate circumstances and may occur in a variety of ways: telephone, email,
memos, faxes and/or in person.
8. Post-Emergency Preparedness Plan and Procedures:
Following an emergency as defined in the Policy, Staff will undertake an evaluation of the
Emergency Plan and Procedures for Emergency Situations to determine its effectiveness and any
necessary revisions.
- Press and Media Releases (B-002)
- Relationship with Law Enforcement Agencies (B-003)
- Usage of Agency Equipment/Electronic Communication Technologies (B-006)
- Individual W elfare/Rights (C-011)
- Medical Care for Persons Supported (C-011) - Missing Person/Unknown W hereabouts Policy (C-016)
- Critical Injury (D-006)
- Pandemic Policy (D-008)
- First Aid Policy and Procedures (D-011)
- W orking Alone Policy (D-012)
- Infection Control Policy and Procedures (D-013) - Hazard/Risk Policy and Procedures (D-014)
- Personal Property Damage Reimbursement (E-013)
- Early and Safe Return to W ork (E–016)
- Benefit Plans (E-017)
- Occupational Health & Safety Document
D.8
Section: D
Subject: Smoking
Total Pages:
1
Revision Date(s): Sept. 16, 1998,
Sept. 15, 2004, Oct. 21, 2009.
SMOKING
Smoking is prohibited on and in all Agency work locations; this is inclusive of Agency owned and
leased vehicles. Also, smoking is prohibited while Staff and volunteers are supporting individuals in
their own vehicles.
Failure to comply with this Policy is subject to discipline, up to and including dismissal from the
D.9
Section:
Subject:
D
Dangerous W eapons
Total Pages: 1
Revision Date(s):
DANGEROUS WEAPONS AND FIRE ARMS
Dangerous weapons and fire arms are prohibited on or in any premises being utilized for the purpose
of this Agency's services.
D.10
Section:
Subject:
D
Critical Injury
Total Pages:
3
Revision Date(s): June 26, 2013
CRITICAL INJURY
Community Living-Central Huron will make every attempt to ensure the health, safety and well-being of
all its employees and volunteers and as such, has adopted the definitions and practices as determined
by the Occupational Health and Safety Act (OH&S Act) and Regulations, 2013, Regulation 834. NonCompliance with this Policy and Procedure is subject to discipline, up to and including dismissal from
Community Living-Central Huron employment.
Definition:
Critical injury as defined by the OH&S Act states: “critically injured” means an injury of a serious nature
that:
a)
b)
c)
d)
e)
f)
g)
places life in jeopardy;
produces unconsciousness;
results in substantial loss of blood;
involves the fracture of a leg or arm, but not a finger or a toe;
involves the amputation of a leg, arm, hand or foot, but not a finger or toe;
consists of burns to a major portion of the body; or
causes the loss of sight in an eye.
Procedures:
1. When a person is killed or critically injured, it is essential the Ministry of Labour and the Agency’s
relevant Health and Safety Location Representative be informed immediately. The Staff and/or
volunteer involved will contact their Supervisor or designate or Pager regarding the critical injury; the
Supervisor or designate will notify the relevant Health and Safety Location Representative, Ministry
of Labour and a representative of the union, that a critical injury investigation is being conducted.
2. To meet the Act’s legislative obligations where a person is killed or critically injured at the workplace,
the Agency will take steps to preserve the scene of the accident to ensure no one interferes with,
disturbs, destroys, alters or carries anything away from the scene or anything connected with the
occurrence until there is permission from the Ministry of Labour, Inspector to do so. However, the
following exceptions apply for the purpose of:
a)
b)
c)
saving a life or relieving human suffering;
maintaining an essential public utility service or public transportation system; or
preventing unnecessary damage to equipment or other property.
3. The relevant Health and Safety Location Representative and the employer will investigate serious
accidents; this investigation can be part of, or in addition to, an investigation conducted by the
Ministry of Labour. The Employer will make every effort to have at least one Certified Occupational
Health & Safety Employer Representative present for investigations. Sections 25 and 26; Section
27 and Section 26 of the OH&S Act outlines the responsibilities of the Employer, Supervisor and
Employee (Worker) respectively.
D.11
4. The Investigation Team, consisting of the relevant Health and Safety Location Representative and
a representative of the Employer will at the earliest opportunity:
a)
b)
c)
d)
e)
investigate the accident at the site;
interview witnesses;
interview co-workers and supervisory personnel as required;
review applicable policies, procedures; and
prepare a written report within forty-eight (48) hours of the death or critical injury, as attached,
of findings and recommendations to prevent a recurrence; the report will be signed by both
the Employer and the Health and Safety Location Representative.
5. Regulation 67/93, Health Care and Residential Facilities, Section 5 (1), OH&S Act sets out the
specific details that must be contained in Accident Notices and Reports. A copy of the Critical Injury
Notices and Report to the Ministry of Labour form has been included with the Policy.
6. A copy of the Critical Injury Notices and Report submitted to the Ministry of Labour shall be copied
to relevant Agency personnel, Health & Safety Location Representative and a representative of the
Union representing the employees of Community Living-Central Huron.
7. The Agency shall keep a permanent record (Employee Incident Report) of any accident, explosion
or fire involving an employee and/or volunteer that causes injury requiring medical attention but does
not disable the employee and/or volunteer from performing their usual duties and shall make such
records available to the Ministry of Labour Inspector upon request. A WSIB form 7 is required if
medical aid or lost time results.
Community Living-Central Huron is committed to working collaboratively with its Location Health and
Safety Representatives, Ministry of Labour, the Union and all employees to create a safe and healthy
workplace.
D.12
CRITICAL INJURY NOTICES AND REPORT TO THE MINISTRY OF LABOUR:
As required under Health Care and Residential Facilities Regulation Section 5 (1):
Employer’s Name
Employer’s Address
267 Suncoast Dr. E., P.O. Box 527
Goderich, Ontario
N7A 4C7
Type of Occurrence
Critical Injury G
Fatality G
Circumstance(s) of Occurrence
Bodily Injury Sustained
Description of any machinery, equipment or
procedure involved
Date, Time and Place of Occurrence
Name and Address of injured or deceased
Name and Address of all witness(s)
1.
2.
3.
Name of Hospital and Attending
Physician/Medical Professional.
Steps to Take/Taken to Prevent Recurrence
Name & Address of W orker LHSR completing
report:
Name & Address of Employer LHSR completing
report:
Signature
Signature
Date
Date
Report to be forw arded to M inistry of Labour, Union and LHSR w ithin 48 hours of the critical injury / fatality.
Ministry of Labour fax #
1-905-577-1316
Forwarded by:
Signature
Title
Forwarded to:
Ministry of Labour (MoL)
(date)
Union
(date)
LHSR
(date)
Em ployer HSR
(date)
Executive Director
(date)
Coordinator
(date)
Revis e d : Septem ber 2, 2015.
Section: D
Subject: Bullying, Harassment and
Total Pages: 8
W orkplace Violence Policy and Procedures
(Form erly Bullying and W orkplace Violence Policy and Procedures,
Approval Date:
Mar. 17, 2004
Revision Date(s): Nov. 18, 2009
Sept. 21, 2011; June 20, 2012;
January 16, 2013.
Originally W orkplace Violence Policy)
BULLYING, HARASSMENT AND WORKPLACE VIOLENCE POLICY AND PROCEDURES
Community Living-Central Huron is committed to providing a safe, respectful, healthy and supportive work
environment that is free from bullying, harassment, violence or threats of violence for all employees,
volunteers and/or people supported. This will be accomplished by providing orientation, relevant/pertinent
information, on-going education and training to be aware of risk factors and strategies to avoid/minimize
potential hazards. All Agency employees and volunteers are required to report actual or alleged incidents
of bullying, harassment or violence in the workplace. Non-compliance with this Policy and Procedure is
subject to discipline, up to and including dismissal from the Agency’s employ and/or its services.
Individuals who engage in bullying, harassment, violent or prohibited behaviour (see below) may be
removed from the premises, and may be subject to dismissal or other disciplinary action, arrest and/or
criminal prosecution. This Policy applies to all work locations including offices, work sites, vehicles, and
the community. In addition, it is important to note that bullying, harassment and workplace violence can
occur outside of work locations, yet be work related (ie. threatening and/or repeated telephone calls, emails received at home; social media).
Community Living-Central Huron provides services to people who, as a result of personal experiences, may
demonstrate disruptive and, at times aggressive/responsive behaviour. Aggressive/responsive behaviours
are those where there is no intent to cause harm; there is an underlying physiological/psychiatric condition
and/or resulting from difficulty communicating a need. Aggressive/responsive behaviour is not classified
as workplace violence as per definitions outlined in Bill 168 amendments to the Occupational Health and
Safety Act.
Goal and Objectives:
The goal of this Policy is to increase and maintain awareness and education of bullying, harassment and
workplace violence, by ensuring information, procedures and protocols to control risks or potential injury
is provided to all Staff, volunteers and/or people supported. Further objectives of the Policy are to reduce
occurrences and to comply with Occupational Health & Safety legislation. This will be accomplished
through a participatory program by the Board of Directors, management, support workers , volunteers and
people supported.
Definitions:
For purposes of this Policy:
a) Bullying, involves persistent and ongoing acts of incivility (rude behaviour) directed toward an individual
or group with the intent to harm or manipulate. Although bullying is defined as involving persistent and
ongoing acts, a single act or incident may be considered bullying, should the behaviour be egregious
(shocking, appalling, flagrant, intolerable) and involves significant physical and emotional impact on the
target. Generally, bullying is any behaviour that is unwelcome, offensive, inequitable, unsolicited or
objectionable and can be physical, psychological, verbal, sexual or racial.
D.14
b) Workplace harassment means engaging in a course of vexatious comment or conduct in a workplace
that is known or ought to be known to be unwelcomed. Workplace harassment may include bullying,
intimidating or offensive jokes or innuendoes, displaying or circulating offensive pictures or materials
or offensive or intimidating phone calls.
c) Workplace violence means exercising or attempting to exercise physical force by a person, in a
workplace that causes or could cause physical injury. Also, a statement or behaviour that is reasonable
for a worker to interpret as a threat to exercise physical force in a workplace that could cause physical
injury.
Types of Workplace Violence:
Type I.
External perpetrator (thefts, vandalism, assaults by a person with no relationship to the
workplace).
Type II.
Person Supported/Customer (physical or verbal assault of an employee by a person
supported/family member or customer).
Type III. Employee to employee (physical or verbal assault from an employee or former employee;
includes harassment, stalking and bullying).
Type IV. Domestic violence (personal relationship).
Additional Definitions Associated With Bullying, Harassment or Workplace Violence:
a) Verbal Abuse:
use of vexatious comments that are known, or that ought to be known, to be unwelcomed,
embarrassing, offensive, threatening or degrading to another person (including swearing, insults or
condescending language).
b) Threat (Verbal or Written):
a communicated intent to inflict physical or other harm on any person or to property by some unlawful
act. A direct threat is a clear and explicit communication distinctly indicating that the potential offender
intends to do harm (ie. “I am going to make you pay for what you did to me”). A conditional threat
involves a condition (ie. “If you don’t leave me alone you will regret it”). Veiled threats usually involve
body language or behaviours that leave little doubt in the mind of the victim that the perpetrator intends
to harm.
c) Physical Attacks:
any aggression resulting in a physical assault/abuse with or without the use of a weapon. Examples
include hitting, shoving, pushing, punching, biting, spitting, groping, pinching, or kicking the victim, unwelcomed displays of affection or inciting a dog to attack.
d) Psychological Abuse:
an act that provokes fear or diminishes an individual’s dignity or self-worth or that intentionally inflicts
psychological trauma on another.
D.15
e) Assault:
any intent to inflect injury on another, coupled with an apparent ability to do so; any intentional
display of force (ie. stalking that causes the victim to fear for their safety or the safety of anyone
known to them).
f) Sexual Abuse:
any unwelcomed verbal or physical advance or sexually explicit statement, such as jokes, displays
of pornographic material, pinching, brushing against, touching, patting or leering that makes a
person feel humiliated, intimidated or uncomfortable, thus interfering with work performance.
g) Sexual Assault:
the use of threat or violence to force one individual to touch, kiss, fondle or have sexual intercourse
with another.
h) Near Miss:
an act of striking out, but missing the target.
i) Poisoned Work Environment:
is characterized by an activity or behaviour, not necessarily directed at anyone in particular, that
creates a hostile or offensive workplace and threatens the physical or psychological health and
safety of employees.
j) Discrimination:
a showing of partiality or prejudice in treatment: specific action or policies directed against the
welfare of minority groups. Every person has a right to full and equal recognition and exercise of
his or her human rights and freedoms without distinction, exclusion, or preference based on race,
colour, sex, sexual orientation, civil status, religion, political convictions, language, ethnic or national
origin, social condition, or the fact that he/she is an individual with a disability, or that he/she uses
any means to palliate the handicap. Discrimination exists where such distinction, exclusion, or
preference has the effect of nullifying or impairing such a right.
k) Examples:
Although there can be no exhaustive list, examples of behaviour and impact that may signify
bullying, harassment and workplace violence include, but are not limited to:
•
•
•
•
•
•
•
•
•
•
Behaviours
insulting or derogatory remarks, gesture or actions
rude, vulgar language or gestures
malicious rumours, gossip or negative innuendo
verbal aggression and/or verbal abuse
swearing, name calling
glaring or staring
outbursts or displays of anger directed at others
targeting an individual through persistent,
unwarranted criticism
public ridicule
verbal, written or physical threats and intimidation
Impact
• undermines
• humiliates
• offends
• embarrasses
• intimidates
• frightens
• de-motivates
• demoralizes
Can cause:
• depression
•
•
•
•
•
•
•
mobbing and/or swarming
misuse of power or authority
isolation and/or exclusion from work related activities
violent (causing or attempting to cause physical
and/or emotional harm)
persistent contact, pressure of an individual or
group to participate or not participate in an activity
contrary to the individual’s preference
interference or sabotage
faultfinding or unwarranted blaming
• anxiety
• emotional distress
• physical distress
• low morale
• inability to perform work tasks
• absenteeism
• loss of productivity
• turnover
• poisoned work environment
Reporting and Investigation:
It is the responsibility of all employees and volunteers to immediately report all incidents or potential
incidents of bullying, harassment and workplace violence to their immediate Supervisor or designate
using the Workplace Hazard & Suggestion Report. Employees and volunteers have a responsibility
to promptly report to their immediate Supervisor, or designate, or pager, as appropriate, any incidents
of bullying, harassment and/or workplace violence, whether or not those involved are Community
Living-Central Huron employees.
Any employee or volunteer who follows the foregoing
policy/procedure and reports bullying, harassment and/or workplace violence will not suffer recourse.
The Supervisor will investigate the report, as soon as possible and take appropriate steps to address
any continuing risk to the health and well-being of all employees, volunteers and people supported.
Every effort will be made to treat all incidents and/or complaints of bullying, harassment and/or
workplace violence as confidential. Any information related to alleged incidents will be restricted, as
much as possible, to people directly involved in the incident. If external authorities are involved, an
employee or volunteer involved in the external investigation will be required to comply with the law.
A copy of the Workplace Hazard & Suggestion Report is provided to the relevant work location Health
and Safety Representative. The name of the individual(s) may be withheld. Employees have the option
of addressing their concerns directly to their work location Health and Safety Representative at any time
after they have first addressed with their Supervisor or designate.
D.17
What to do if you are a victim of bullying, harassment or workplace violence:
Step 1.
< Request that the specifically identified behaviour stop;
< Inform the individual the behaviour is unwanted and unwelcome;
< Document the events, complete with times, dates, location, witnesses, and details;
< Preserve any evidences, such as communications.
For situations of workplace violence where risk of physical harm is imminent, call 911.
Any situation where there is an injury or suspected injury:
< Contact the Supervisor, designate or pager the same day the injury or suspected injury occurs;
< If possible, complete an Employee Incident Report and take the WSIB package from the work
location to the health professional for completion. The WSIB package contains: Workers
Claim/Consent Form, Treatment Memorandum, Health Professional’s First Report (Form 8),
Functional Abilities Form. Copies of the WSIB package are available at the Central Admin Office
(267 Suncoast Dr. E., Goderich).
Step 2.
Should the problem persist or communicating with the accused compromises your physical or emotional
safety, seek support:
< Contact the Supervisor, designate or pager (for after hours, if necessary)and advise of the
behaviour;
< Complete a Workplace Hazard & Suggestion Report, to include the remedy sought;
< Attach/include all documentation and evidence, to date.
< Address with your Work Location Health and Safety Representative at any time after you have first
addressed with your Supervisor, if desired.
Witnesses:
What to do if you witness bullying, harassment or workplace violence:
Step 1.
< For situations of workplace violence where risk of physical harm is imminent, call 911;
< Any situation there is an injury or suspected injury, contact the Supervisor, designate or pager as
soon as possible.
Step 2.
< Report workplace violence or suspected bullying and/or harassment to the Supervisor, designate or
pager (for after hours, if necessary);
< Complete a Workplace Hazard & Suggestion Report.
Failure to report a situation of bullying, harassment and/or workplace violence will be cause for
disciplinary action, up to and including termination.
D.18
Supervisors:
What to do for reports of bullying, harassment or workplace violence:
Step 1.
< Confirm the safety and well being of all involved.
For all reports of fatalities/critical injuries, the Supervisor will immediately notify the Program Coordinator
and/or Executive Director; Ministry Of Labour, Inspector and the Work Location Health and Safety
Representative. The Supervisor will conduct an investigation with the Work Location Health and Safety
Representative as soon a possible and provide a written report, using the form as per Critical Injury
Policy D-006. If the Work Location Health and Safety Representative is unavailable, a work location
employee would be asked to participate in the investigation.
Within 48 hours, the Employer must also notify, in writing, a director of the Ministry of Labour, giving the
circumstances of the occurrence. Refer to the Occupational Health and Safety Document,
“Incident/Accident Investigation” and the Critical Injury Policy for further details.
Step 2.
< Initiate the investigation by reviewing the Workplace Hazard & Suggestion Report (s), Employee
Incident report and WSIB employer forms, if applicable;
< Seek clarification from the complainant, including how they wish to proceed; document;
< Seek clarification, if necessary, from witnesses; document.
Step 3.
< If possible and safety is not of concern, arrange to meet with the person accused of the bullying,
harassment or workplace violence. Supervisors will first consult with the Program Coordinator or
Executive Director to determine if the inclusion of a recorder is necessary for the meeting;
< Confirm the accuracy of the information contained in the Workplace Hazard & Suggestion Report (s),
Employee Incident report and WSIB employer forms;
< The Supervisor or recorder will take notes of the meeting which will be filed in the relevant CL-CH
Staff, Volunteer and/or person supported file, with a copy going to the Program Coordinator and
Executive Director.
Step 4.
< In consultation with the Program Coordinator and/or Executive Director, recommendations will be
provided and noted on the Workplace Hazard & Suggestion Report. Recommendations may include,
but are not limited to: education, training; workplace inspection; review of Agency policies,
procedures, protocols; external resources; disciplinary action, up to and including termination;
< The complainant will be apprised of the outcome of the investigation by the Supervisor or designate.
Note:
Details of any disciplinary action will not be specified on the Workplace Hazard & Suggestion Report
due to the Work Location Health and Safety Representative receiving a copy of the form(s). Should
any disciplinary action occur, a letter would be issued, as per the Agency’s Disciplinary Policy,
specifically the Progressive Disciplinary Process. In addition, should there be any criminal charges
laid, the Supervisor will include documentation of the charges and outcome of said charges in the
file of the relevant CL-CH Staff, Volunteer and/or person supported.
D.19
Roles and Responsibilities:
As with all matters relating to health and safety, responsibilities are shared among the workplace parties,
more specifically:
Employer (Sections 25 and 26, Occupational Health & Safety Act):
The Employer will:
act respectfully towards all employees, volunteers and people supported while at work and/or
participating in any work related activity;
provide awareness and education materials to all employees and volunteers to aid in the
prevention of bullying, harassment and workplace violence (ie. non-violent crises intervention
training, relevant videos, etc.);
monitor that all employees and volunteers are using safe work practices;
improve its knowledge of measures to reduce incidents of bullying, harassment and workplace
violence in all work locations; and
review reports and statistics annually with the Work Location Health and Safety
Representatives to identify work areas which may require additional education of such and
a means to reduce any potential injuries.
Supervisor (Section 27, Occupational Health & Safety Act):
The Supervisor will:
document all reports of bullying, harassment and/or workplace violence and the measures
taken to address them, using the Workplace Hazard and Suggestion Report and ensure
copies/reports are provided to the relevant Coordinator, Executive Director and the Work
Location Health and Safety Representative;
investigate all reports of bullying, harassment and workplace violence and ensure appropriate
measures are taken to safeguard employees, volunteers and people supported; the
investigating Supervisor, will also inform the employees and/or volunteers who made the
report of the outcome of the investigation;
educate employees, volunteers and people supported on the hazards and provide written
measures, protocols and procedures as required; and
lead by example (ie. always direct and perform work in a safe manner themselves).
Work Location Health and Safety Representatives:
Representatives will:
during regular inspections of the workplace inquire with employees to ensure a safe and
healthy environment;
be knowledgeable about bullying, harassment and workplace violence, as well as prevention
ideas/procedures; and
make recommendations to the Employer on how to eliminate, control or reduce hazards or
risks that increase the likelihood that employees, volunteers and people supported may be
exposed to bullying, harassment and workplace violence.
D.20(a)
Workers (Sections 28, Occupational Health & Safety Act):
Employees will:
ensure that safe work practices include procedures, protocol, education and other measures
that prevent bullying, harassment and workplace violence;
report to their Supervisor, using the Workplace Hazard & Suggestion Report, in a timely
manner, anything that may be a hazard or risk factor that could cause or contribute to bullying,
harassment and workplace violence; failure to report a situation of bullying, harassment and/or
workplace violence will be cause for disciplinary action against the Staff and/or volunteer;
understand and comply with the Agency’s Bullying, Harassment and Workplace Violence
Policy and Procedures;
inform the individual(s) engaging in bullying, harassment and/or workplace violence that a
specific identified behaviour stop and that it is unwanted and unwelcomed;
take part, when requested, in a workplace inspections to advise of any hazards or risks
associated with bullying, harassment and workplace violence; and
participate in education sessions and comply with safe work procedures.
Evaluation:
Community Living-Central Huron is committed to looking at leading indicators of bullying, harassment
and workplace violence through information gathering from employees and volunteers and providing
continuing education and awareness as necessary. Supervisors will regularly audit employees and
volunteer practices related to bullying, harassment and workplace violence, as well as review the
monthly checklist for any noted hazards and corrections. Work Location Health and Safety
Representatives will make recommendations to the Employer to identify bullying, harassment and
workplace violence issues and potential hazards, as well as monitor outcomes of strategies for
improvement.
D.20(b)
Section:
Subject:
D
Pandemic
Total Pages:
6
Approval Date:
Nov. 18, 2009
Revision Date(s)
PANDEMIC POLICY
Community Living-Central Huron is committed to providing a safe and healthy working environment for
all Staff, volunteers and people supported. The Agency will provide necessary resources to ensure
Staff, volunteers and people supported are aware of the risk factors and requirements associated with
a Pandemic, including pre, active and post-pandemic. Non-compliance with the Agency’s Pandemic
Plan is subject to discipline, up to and including dismissal from the Agency’s employ and/or its services.
1. It is important to understand the definitions of ‘influenza’ (the flu) and ‘pandemic’; attached is a
comparison chart. Briefly:
a) Influenza: is caused by a flu virus which infects the respiratory tract (nose, throat, lungs). It
usually starts suddenly and may include these symptoms: fever, muscle pain and weakness,
headache, tiredness, dry cough, sore throat, runny or stuffy nose, diarrhea and vomiting (especially
in children).
Influenza is transmitted from person to person through direct contact primarily when people who are
infected cough or sneeze and droplets come into contact with the eyes, nose or mouth of another
person. Also, influenza is indirectly transmitted when people touch contaminated hands, surfaces
or objects and then touch their face. The virus can survive on nonporous surfaces such as
doorknobs, countertops or toys for up to 48 hours. People who become infected with influenza are
able to transmit the virus for 24 hours before symptoms appear and for up to 5 days after symptoms
appear. Children can be infectious for up to 7 days after symptoms appear.
b) Pandemic: is distinguished from influenza by its scope; it becomes a worldwide epidemic, or
pandemic, when a disease spreads easily and rapidly through many countries and regions of the
world and affects a large percentage of the population where it spreads. An influenza pandemic
occurs when a new influenza “A” virus emerges to which the population has little or no immunity.
It may spread easily from person to person and may cause serious illness and death. It is not
known beforehand what age group will be most affected or what the severity will be. Pandemics
are unpredictable and can happen at any time of the year.
c) The World Health Organization: monitors the status of influenza around the world and declares
pandemic alert phases based on the number of cases and mode of the transmission of illness. At
a provincial level, the Chief Medical Officer of Health and the Commission for Emergency
Management will be jointly responsible. In Huron County, the Medical Officer of Health will confirm
when there is local pandemic activity. Also, each local municipality has an emergency plan and may
activate their plan in response to a pandemic emergency to coordinate the municipal support to the
community. Community Living-Central Huron also has an Emergency Preparedness Plan No. D003, which would be activated in conjunction with other local Emergency Plans and pandemic
activity.
D.21
2. The objectives of this Policy are to:
a)
ensure all Staff, volunteers and people supported are educated about pandemic risk factors
and prevention procedures;
b)
control infection risks through the application of controls;
c)
integrate pandemic prevention strategies in day-to-day operations;
d)
encourage Staff, volunteers and people supported to recognize this educational information
has been provided to them to utilize in the workplace, at home and in the community.
People can lower the risk of a pandemic by usual, preventative practices against a range of illnesses
that include:
a)
cover you nose and mouth when you cough or sneeze by using a tissue or coughing into
your sleeve or elbow; dispose of the tissue immediately into a garbage can;
b)
wash your hands often with soap and water, especially after you cough or sneeze; alcoholbased hand rub/sanitizer with 60 - 90% alcohol is also effective;
c)
avoid touching your eyes, nose and mouth, germs spread easily that way;
d)
do not share objects that have been in other people’s mouths, ie. drinks, water bottles; lip
products, musical instrument mouthpieces;
e)
if you get sick, stay home until you no longer have a fever and are feeling well; you should
limit your contact with others during this time to keep from infecting them;
f)
if your symptoms worsen, contact your doctor;
g)
personally speak with your medical professional about getting the annual flu shot and/or
vaccines.
The Executive Director and the Coordinator of Adult Services will work in conjunction with the
Agency’s Joint Occupational Health & Safety Committee to maintain an up-to-date Pandemic Plan.
D.22
3. What is the difference between seasonal influenza and pandemic influenza?
Seasonal Influenza
Pandemic Influenza
Occurs every winter between November
and April.
Occurs approximately 3 times every century,
ie. Spanish Flu (1918); Asian Flu (1957);
Hong Kong Flu (1968).
Peaks for a few months during the winter
and then declines.
Occurs any time during the year; comes in 2 3 waves several months apart.
Affects approximately 10 % - 20% of the
population each year.
May affect 30% of the population over the
course of the outbreak.
Most people who get seasonal flu will get
sick, but usually recover within 2 weeks.
About 50% of the people who get pandemic
flu will become ill, most will recover but it may
take a long time, and some people will die.
Some people will have immunity from
previous exposure to that strain or/and
from the annual flu vaccination.
Most people will have little or no immunity to
the new virus, therefore, more serious illness,
a greater number of deaths.
Symptoms are unpleasant, but most
people do not become seriously ill or die.
Very young, the elderly and people with
certain chronic illnesses are most at risk.
More serious infections and deaths will occur;
people of any age will be at risk.
Annual vaccination available for
protection.
No vaccine will be available at the start of the
Pandemic; one may be available after 4 - 5
months.
Affects mainly the young and very old
and people who are immunocompromised; does not usually affect
health care delivery or other essential
services.
Could affect anyone, including health care
providers and their families, as well as other
essential service workers.
D.23
4. PANDEMIC PROCEDURES FOR ADULT SERVICES:
In conjunction with Community Living-Central Huron’s Emergency Preparedness Procedures, the
information outlined below is specific to Influenza Pandemic and the operations of Adult Services.
The World Health Organization monitors the status of influenza around the world and declares
pandemic alert phases. It describes the alert phases as follows:
Phases
Description
1 and 2
No animal influenza virus circulating among domesticated or wild
animals has been reported or known to have caused infection in
humans.
3
An animal or human-animal influenza virus has caused sporadic
cases or small clusters of disease in people, but no human-tohuman transmission sufficient to sustain community-level
outbreaks.
4
Verified human to human transmission of an animal or humananimal influenza virus able to sustain community-level outbreaks.
5
The same virus as identified in phase 4 has caused sustained
community-level outbreaks in two or more countries in one World
Health Organization region.
6
In addition to the description in phase 5, the same virus has caused
sustained community-level outbreak in a least one other country in
another World Health Organization region.
Post-Peak
Period
Pandemic influenza in most countries has dropped below peak
levels.
PostPandemic
Period
Influenza activity has returned to levels as seen for seasonal
influenza in most countries.
D.24
5. Responsibilities:
Senior Case Managers:
a)
Obtain and maintain a daily update regarding the number of people supported and Staff
members who have been diagnosed with the influenza pandemic.
b)
Maintain ongoing contact with relevant, qualified health professionals, such as the Huron
County Health Unit and share important information with Staff, individuals supported and
family/caregivers. The Senior Case Manager(s) will assess and determine the most
appropriate means of communication and content to be shared with Staff, individuals
supported, families/caregivers and any other relevant individuals and/or services. Timely
Team and Staff Meetings to occur to review individual needs, site specific procedures and
Staffing concerns.
c)
Encourage people supported, Staff and volunteers to report symptoms associated with the
influenza pandemic and that they should seek advice from their health care provider
regarding such.
d)
Assess Staffing resources and adjust work schedule accordingly to ensure quality supports,
as well as health & safety of people supported, Staff and volunteers. Consideration may be
given to orientating Staff unfamiliar to work locations. Also, families/immediate caregivers
may be approached about taking their family member home.
e)
Establish Action Plans as necessary, for each work location to include, but not limited to:
delivery of groceries, medications, isolation and/or quarantine of people supported, Staff and
volunteers.
f)
Assess the need to close ‘Day Programs,’ ie. Activity Centre & Employment Support.
Families will be notified of current situation by relevant Senior Case Manager or designate.
g)
Provide necessary equipment and resources in pandemic procedures to reduce the spread
of infection for people supported, Staff and volunteers; evaluate and update monthly.
Equipment to include N95 masks, gloves, antiseptic hand wash, cleaning supplies and any
other equipment recommended by qualified health professionals.
h)
Provide training both general and site-specific on pandemic prevention, universal
precautions, communicable diseases and hazard identification. Information to include DVD “Stop the Spread,” “Infectious Disease Control” poster, pamphlets and memos.
I)
Establish cleaning practices and infection control of work location, in consultation with
qualified health professionals.
j)
Encourage safe food handling practices, proper storage of foods, handling of eating utensils,
in consultation with qualified health professionals.
D.25
5. Staff/Volunteers:
a)
Comply with any requirements, procedures and/or protocols at all times and seek clarification
as required. Staff are expected to work their scheduled shifts unless otherwise directed by
Management Staff. If there are extenuating and/or changed circumstances relating to Staff’s
health (asthma, pregnancy, illness, etc.) they must inform the relevant Senior Case Manager
immediately. A medical note may be requested when Staff are unable to work.
b)
Staff may be required to work additional shifts during an influenza pandemic and while every
effort will be made to comply with the Employment Standards Act (ESA) related to hours free
from work/hours of work, it may be necessary to rely on the exception in the ESA for
Emergency and Exceptional circumstances.
c)
Participate in mandatory training and ongoing education as determined by Community LivingCentral Huron.
d)
Report any unsafe acts, hazards, equipment shortages and/or problems or any unsafe
conditions immediately to their Supervisor and/or pager.
e)
Report any influenza pandemic symptoms to their Supervisor immediately and participate in
procedures as determined by their Supervisor.
f)
Stay home from work if sick and seek necessary medical attention.
g)
Consult your health care provider about getting the annual flu shot and/or vaccines.
h)
Provide your Supervisor with daily reports.
6. Post-Pandemic:
The following will be taken into consideration following influenza pandemic:
a)
communication and sharing of information with people supported, families/caregivers, all
Staff, volunteers, Board Members, Joint Occupational Health & Safety Committee, Medical
Officer of Health and the Ministry;
b)
continued monitoring of pandemic activity and immunization of individuals supported and/or
Staff, where appropriate;
c)
monitoring of any potential after effects of the pandemic;
d)
evaluation of pandemic response, plan and procedures; revisions to be incorporated as
necessary; and
e)
provide counselling services to individuals supported, Staff and volunteers as required.
D.26
Section:
Subject:
D
Annual W orkplace
Maintenance Policy
Total Pages:
4
Approval Date: October 20, 2010
PREVENTATIVE MAINTENANCE POLICY
Policy:
Community Living-Central Huron recognizes the importance of the health, safety and well-being of
individuals supported, employees and volunteers. Community Living-Central Huron requires that each
work location has regular and/or annual inspections and preventative maintenance schedules of all
systems, including, but not limited to plumbing, heating, cooling, electrical and fire, as well as equipment
and devices used by employees, volunteers and/or people supported. Preventative maintenance is an
important part of a healthy and safe environment for individuals supported, employees and volunteers.
Each work location will inspect identified equipment and devices and ensure maintenance is conducted
as recommended by the manufacture/supplier. Non-compliance with this Policy is subject to discipline,
up to and including dismissal.
Definition:
Preventative Maintenance is the care and servicing of equipment, systems and devices that is regularly
performed to lessen the likelihood of failure. Regular systematic inspections, tests, adjustments and
replacements will aid in the prevention of possible failures before they develop or become actual or
major failures/defects.
Purpose:
To ensure equipment, systems, devices used by individuals supported, employees and volunteers are
in safe working order and issues are detected prior to adversely affecting the health, safety and wellbeing of people supported, employees and volunteers.
Employer:
The Employer will:
-
take every precaution reasonable in the circumstances for the protection of individuals supported,
employees and volunteers;
include measures and procedures for employees and volunteers to report maintenance
issues/concerns;
provide for education and training as determined necessary for the use and maintenance of
equipment, systems and devices used by employees and volunteers.
D.27 (a)
Supervisor:
-
-
-
-
-
ensure inspection requirements, as per the Ministry of Community and Social Services are met at
each work location; such inspections include: Electrical Safety Association, annual heath, fire and
furnace inspections. The inspection records will be kept on file in the location and at the Central
Administration Office;.
be responsible for equipment, systems and items being serviced and maintained by qualified
professionals and a written record of the inspection, as well as any repairs and/or upgrades are kept
on file in the work location Emergency Binder and at the Central Administration Office;
conduct an annual inventory of equipment and devices requiring Preventative Maintenance at the
work location;
develop a Preventative Maintenance schedule, which includes the equipment, systems, devices to
be inspected, the frequency and interval at which the service must be performed and who will
perform service/maintenance for each work location. Such determination will be based on the
manufacturer’s and/or qualified professional’s recommendations;
respond promptly to any concern from an employee, volunteer or person supported pertaining to
equipment, systems, device failure or potential for failure by seeking the services of a qualified
professional;
arrange for training/education for employees and volunteers for the use of equipment, systems, as
deemed appropriate;
provide employees and volunteers, when so prescribed, written instructions as to the procedures for
the proper use of identified equipment, systems and devices;
complete monthly workplace inspections;
conduct annual Workplace Hazard/Risk Assessments using the Agency’s designated form;
ensure employees are completing all required documentation, as it relates to maintenance
equipment, systems, devices used by employees and volunteers in the workplace.
Location Health and Safety Representatives:
The Location Health and Safety Representative will:
-
-
-
comply with the requirements of the work location and procedures regarding preventative
maintenance;
participate in all training and educational programs, as determined by the Employer to be beneficial
for the area of preventative maintenance;
identify and immediately report any concerns with equipment, systems, devices used by employees,
volunteers and people supported that may be a source of danger or hazard and make
recommendations to their Supervisor by completing a Workplace Hazard and Suggestion Report;
encourage co-workers to immediately report concerns related to equipment, systems, devices used
by employees or volunteers to their Supervisor or designate using the Workplace Hazard and
Suggestion Report;
conduct and document monthly inspections of their work location and submit such to their immediate
Supervisor within the designated time frame;
review Workplace Hazard and Suggestion Reports and make written recommendations;
review Employee Incident Reports and make written recommendations and submit to Supervisor or
designate in the time frame required;
D.27(b)
-
accompany a Ministry of Labour Inspector during an inspection visit;
investigate work refusals;
investigate, when notified by the employer of a critical injury/fatality and provide a report in writing
to the Ministry of Labour, within forty-eight (48) hours, as prescribed
Employees:
The Employee will:
-
-
-
-
comply with the requirements of the work location and procedures regarding preventative
maintenance;
identify and immediately report to their Supervisor or designate any concerns with equipment,
systems, devices used by employees, volunteers and people supported by completing a Workplace
Hazard and Suggestion Report;
abide by any procedures, guidelines that have been developed by the Supervisor and/or
manufacturer and/or qualified professional with regard to the use of equipment, systems and devices
used by employees, volunteers and people supported;
participate in, when requested, workplace inspections to advise of any hazards or risks related to
equipment, systems, devices used by employees, volunteers and people supported;
seek clarification from the relevant Supervisor or designate on the use of equipment, systems and
devices used by employees, volunteers and people supported;
participate in all training and educational programs, as determined by the Employer to be beneficial
for the use of equipment, systems and devices used by employees, volunteers and people
supported;
report, in writing, to their Supervisor or designate any new equipment, systems, devices that will be
used by employees, volunteers or people supported to ensure as appropriate preventative
maintenance occurs.
It is the responsibility of all employees and volunteers to immediately report to their immediate
Supervisor or designate using the Workplace Hazard and Suggestion Report all potential risk factors for
hazards/incidents related to equipment, systems and devices used by employees, volunteers and people
supported. The Supervisor will investigate the risk/hazard as soon as possible and take appropriate
steps to address any continuing risk to the health, safety and well-being of the people supported,
employees and volunteers. The Supervisor will forward the completed Workplace Hazard and
Suggestion Report to the Location Health and Safety Representative. The Location Health & Safety
Representative will review the actions taken or recommended by the Supervisor and provide feedback
as to further actions or recommendations. Should a hazard result in a critical injury or fatality,
Supervisors, employees and Location Health and Safety Representatives will follow the Agency’s Critical
Injury Policy (#D-006).
Evaluation:
Community Living-Central Huron is committed to looking at leading indicators of workplace risks and
hazards related to the use of equipment, systems and devices used by employees, volunteers and
people supported through such methods as: information gathering (ie. Workplace Inspections, Incident
Investigations, Job Hazard Analysis), surveys, data collection (ie. Rate Group Trends) and Staff
Meetings.
D.27(c)
Supervisors will regularly audit employee and volunteer practices related to equipment, systems, devices
use through such means as: monthly, periodic work location inspections; review of Workplace Hazard
and Suggestion Reports, Incident Reports, Location Health and Safety monthly workplace inspections;
conducting annual risk assessments; completing an annual inventory of equipment/systems/devices
used by employees, volunteers and people supported; review the preventative maintenance schedules,
as prescribed. The Agency will maintain a Hazard/Risk Registry, which will be updated as necessary,
in consultation with Location Health and Safety Representatives and based on written
information/documentation received by Supervisors, employees, volunteers and the Location Health and
Safety Representatives.
Preventative Maintenance Schedule:
Supervisors of each work location will conduct an annual inventory of equipment, systems, devices used
by employees, volunteers and people supported, considered to require a preventative maintenance
schedule, with keeping in mind the “Purpose” of the “Preventative Maintenance Policy”. Once the
inventory list is established, Supervisors will develop a Preventative Maintenance Schedule, as outlined
under the roles and responsibilities of the Supervisor. The types of equipment, systems, devices to be
considered in developing the Preventative Maintenance Schedule may include but are not limited to:
•
•
•
•
•
•
•
•
•
•
fire alarm systems
items under warranty
exit and emergency lighting
fire extinguishers
Agency vehicles
ceiling lifts
portable lifts
wheelchair lifts
generators
automatic doors
Usage of Agency Equipment/Electronic Communication Technologies Policy (B-006)
Emergency Policy (D-003)
First Aid Policy & Procedure (D-011)
Health & Safety Orientation Policy (D-015)
Slips, Trips and Falls Prevention Policy (D-020)
Early and Safe Return to Work Policy (E-016)
Other Related Agency Documents:
Community Living-Central Huron’s Occupational Health and Safety Document
D.27(d)
Section: D
Subject: Musculoskeletal Disorders
Aw areness Policy
Total Pages: 2
Revision Date(s)
MUSCULOSKELETAL DISORDERS AWARENESS POLICY
Community Living-Central Huron is committed to providing employees and volunteers with a safe and
healthy workplace. This will be accomplished by focusing attention on the overall wellness and
education of employees and volunteers about the risks of musculoskeletal disorders and ways to avoid
them. All employees and volunteers are expected to actively support this policy and its procedures; noncompliance with the Musculoskeletal Disorders Awareness Policy is subject to discipline, up to an
including dismissal. The Agency’s Health & Safety Document outlines further information regarding
musculoskeletal disorders (MSD).
Definition:
A musculoskeletal disorder (MSD) is defined as an injury or disorder of the muscles, tendons, ligaments,
joints, nerves, blood vessels, or related soft tissue, which occurs over a period of time. The term MSD
is not a discrete medical diagnosis, rather an umbrella reference to various types of injuries. Causes
or aggravations of these types of injuries are found in sports, household activities, activities of daily
living, work and recreational stressors. An MSD may be referred to as:
repetitive strain injury, not a single injury or event;
cumulative trauma disorder, or
repetitive motion injury.
Examples of Musculoskeletal Disorders include:
back pain,
shoulder strains
rotator cuff syndrome
tennis elbow (lateral epicondylitis),
tendonitis, and
Goals and Objectives:
The goal of this Policy is to increase and maintain awareness and education of the growing prevalence
of musculoskeletal disorders (MSD) in the workplace for all employees and volunteers; prevention will
be the primary focus. Further objectives of the program are to reduce the number of musculoskeletal
injuries and to comply with Occupational Health & Safety legislation. This will be accomplished through
a participatory program by the Board of Directors, Management Staff, all support workers and
volunteers.
more specifically:
The Employer will:
provide awareness and education materials to all workers and volunteers to aid in the
prevention of MSD;
improve its knowledge of measures to reduce MSD in all work locations; and
review injury statistics quarterly with the Joint Occupational Health & Safety Committee to
identify work areas with MSD; education of such and a means to reduce any potential injuries.
D.28
ensure all employees and volunteers perform their tasks in a safe manner through regular
audits and making corrections as necessary;
take every reasonable precaution to protect workers and volunteers;
educate employees and volunteers on the hazards and provide written measures and
procedures as required; and
lead by example (ie. always direct and perform work in a safe manner themselves).
Joint Occupational Health and Safety Committee Representatives:
Representatives of the Joint Occupational Health and Safety Committee will:
regularly inspect the workplace to ensure a safe and healthy environment and involve
workers, as needed with inspections;
be trained on MSD and prevention ideas; and
risks that increase the likelihood that employees and/or volunteers may develop an MSD.
Workers will:
ensure that safe work practices include good ergonomics and other measures that prevent
MSD; this includes properly using all equipment provided by the Employer;
report to their Supervisor in a timely manner, anything that may be a hazard or risk factor that
could cause or contribute to an MSD;
take part, when requested, in a workplace inspection to advise of any ergonomic hazards or
risks; and
It is the responsibility of all employees and volunteers to immediately report all MSD or potential MSD
injuries to their immediate Supervisor using the Employee Incident Form. The Supervisor will investigate
the MSD or potential MSD, as soon as possible and take appropriate steps to address any continuing
risk to the health and well-being of all employees and volunteers.
Evaluation:
Community Living-Central Huron is committed to looking at leading indicators of MSD, through surveys
to employees and volunteers, and providing continuing education and awareness as necessary.
Supervisors will regularly audit employee and volunteer practices related to MSD, as well as review the
monthly checklist for any noted hazards and corrections. The Office Accountant will provide the Joint
Occupational Health & Safety Committee with a quarterly summary of all Return to Work Plans. The
Joint Occupational Health and Safety Committee will make recommendations to the Employer to identify
MSD issues and potential hazards.
D.29
Section:
Subject:
D
First Aid Policy and Procedures Total Pages:
3
Approval Date:
October 17, 2012
FIRST AID POLICY AND PROCEDURES
Community Living-Central Huron recognizes its obligation and responsibilities with regard to providing
and maintaining first aid supplies/equipment, stations, records and training employees in all work
locations and as such will meet the minimum required standards of the Workers Safety and Insurance
Board (WSIB). Work locations include Agency and personal vehicles. The Agency will comply with
Regulation 1101, under Section 3 of the Workplace Safety and Insurance Act. Employees/volunteers
that are non-compliant with the First Aid Policy and Procedures are subject to discipline, up to and
including dismissal from Community Living-Central Huron’s employment and/or services.
First Aid:
For the purpose of this Policy, first aid includes, but is not limited to: cleaning minor cuts,
scrapes/scratches; treating a minor burn, applying bandages and/or dressings, cold compress, cold
pack, ice, splint and changing a bandage or dressing as follow-up from seeking medical observation
and/or treatment.
The Employer (Agency’s) responsibilities with respect to first aid requirements includes the following:
-
providing and maintaining the appropriate size of first aid kit for each work location, and that the kit
contains all items for first aid and treatment (including personal protective equipment) as required
by Regulation 1101. Employees will be provided with orientation as to the location of the first aid
kit at each site; the kit will be kept in a location easily accessed by by all employees and/or
volunteers. Employees who use their personal vehicles for work purposes will be provided with a first
aid kit. Employees who have used first aid supplies from the Employer’s first aid kit for personal use,
are responsible for replenishing the supplies used, and at their own expense;
-
posting at each work location the WSIB poster know as “Form 82" (In Case of Injury at Work) and
furnishing and maintaining first aid kits;
-
at each work location, posting/placing in the first aid kits, copies of valid first aid certificates for all
employees that work at that location. Community Living-Central Huron requires that all employees
maintain a relevant valid first aid certificate; and all new employees must obtain certification as soon
as possible upon their employment, but in any event, within six months of their start date. A first aid
responder must have a valid first aid certificate;
-
the work location Supervisor will maintain a record of all accidents/treatment; First Aid Log Sheet,
which documents: name of injured person; the date and time of occurrence; names of witnesses; the
nature and location of personal injuries/treatment and name of first aid responder. The First Aid Log
Sheet will be reviewed, at a minimum, monthly by the Supervisor;
-
arrange for semi-annual training of the Location Health & Safety Representatives (LHSR);
D.30
-
responding in writing to all recommendations from the Location Health & Safety Representatives
(LHSR), within twenty-one (21) days of having received the written information;
-
providing a Monthly First Aid Checklist, that is to be completed by the Location Health & Safety
Representative (LHSR); the Monthly First Aid Checklist itemizes all the required first aid supplies for
that specific work location;
-
providing a Quarterly First Aid Checklist for Agency and employee vehicles; the LHSR to complete
and document the inspections for Agency vehicles. Employees who use their personal vehicles for
work purposes will complete the Quarterly First Aid Checklist and document the date of the
inspection; they will also notify their Supervisor the inspection has been completed. The Supervisor
will file the Quarterly records of the inspections.
Supervisor’s Responsibilities:
-
ensure on a monthly/quarterly basis, the site specific Health & Safety Checklists, inclusive of
vehicles, are completed, and all identified items replaced in the first aid kits;
-
review the First Aid Log Sheet and follow-up with the employee, as soon as reasonably possible,
after being notified by the employee that they have accessed the first aid kit;
-
ensure valid First Aid Certificates for employees that work in that location are posted /kept in the First
aid kit;
-
provide orientation and training for new employees and/or volunteers, regarding the health and safety
procedures at the locations they supervise, inclusive of the First aid kit; and
-
arrange for renewal of Emergency First Aid Certification.
Employee Responsibilities:
Should a new employee not have a valid First Aid Certificate upon employment, they are responsible
to obtain at their own expense, and on their own time, a First Aid Certificate within 6 months of
employment. Employees must ensure they maintain valid certification (ie. attend training) throughout
their employment with the Agency. Employees/volunteers must also:
-
know who the LHSR is for their work location;
-
immediately seek first aid treatment;
-
promptly inform their Supervisor of the injury and of the possible on-set of further injury/illness;
-
complete the First Aid Log Sheet, document accurately, the date and time of the incident; location
of injury; names of witnesses; nature and location of the injury on their person; and name of the First
Aider;
D.31
-
should they seek professional health care (Emergency, Family Doctor, Nurse Practitioner), take the
WSIB Kit with them; complete an Employee Incident Report; (copies of Employee Incident Reports
and procedures are kept at each work location);
-
complete, if necessary, a Workplace Hazard and Suggestion Report, copies of this report and
procedures are kept at each work location;
-
participate in the Agency’s Early and Safe Return to Work Policy and Procedures;
-
complete a quarterly inspection of First aid kits, located in their personal vehicles; provide a copy to
their Supervisor.
Location Health & Safety Representatives (LHSR):
At each work location a site-specific Location Health and Safety Representative has been appointed;
their responsibilities include:
-
completing monthly the Health and Safety First Aid Checklist for the location in which they work and
providing a copy of such to their immediate Supervisor. During such inspections, the LHSR will
inquire with employees and people supported about first aid, workplace hazards, etc. to ensure a
safe and healthy environment;
-
attend semi-annual training;
-
review site-specific Workplace Hazard and Suggestion Reports and make recommendations to
reduce recurrences;
-
participate in an investigation when a person is critically injured or killed at the workplace;
-
obtain information from the Employer regarding hazardous material, processes or equipment and
any workplace testing for health and safety purposes;
-
be present for any health and safety related testing in the workplace and for any work refusal
investigations;
-
provide advice and recommendations to the Employer on health and safety matters, inclusive of
training for all employees;
-
encourage co-workers to work safely and to report any hazardous or unsafe conditions immediately
to their Supervisor;
-
be available to speak with, or accompany the Ministry of Labour, should they conduct a
site/inspection tour of the workplace;
Community Living-Central Huron is committed to providing ongoing information and
awareness/education to all employees/volunteers with respect to First Aid. Supervisors will regularly
audit employees and volunteer practices related to First Aid, as well as review the monthly/quarterly
checklists. The LHSR will make recommendations to the Employer to improve the First Aid Policy and
Procedures.
D.32
FIRST AID KIT SUPPLIES
Year: 20
Location:
Residential First Aid Kit
Supplies
Jan
Supervisor/Coordinator:
Feb
Mar
Apr
May
Jun
e
July
Aug
Sep
Oct
Nov
Current edition Standard St.
John Am bulance First Aid
Manual
1 card of safety pins (12)
24 adhesive dressings,
individually wrapped (bandaids)
12 sterile gauze pads, 3" x
3"
4 rolls of 2" gauze bandage
4 rolls of 4" gauze bandage
4 sterile surgical pads,
suitable for pressure
dressing, individually
wrapped
6 triangular bandages
2 rolls of splint padding
1 roll-up splint
1 pair scissors
2 rolls of adhesive tape
Antiseptic Cream
Rubber gloves - 2 pairs
C.P.R. Respirator
Staff Signature
Revised: April, 2012.
****
First Aid Log Sheet should be included in P&P Document as it is mentioned in the above Policy.
Dec
Section:
Subject:
D
W orking Alone
Total Pages: 3
Revision Dates:
WORKING ALONE POLICY
Community Living-Central Huron is committed to providing and maintaining policies, procedures and
guidelines, which will promote a safe and healthy work environment. The Agency will take every
reasonable precaution for the protection of all employees, volunteers and people supported, striving to
eliminate/reduce risk of any potential hazards which may result in personal injuries/illnesses. Every
employee must protect their own health and safety by working in compliance with the law, following
protocols and safe work practices and procedures, as noted below with the Precautionary Measures.
Non-compliance with the Working Alone Policy and Procedures is subject to discipline up to and
including dismissal from the Agency’s employment and/or its services.
Working Alone:
The definition of “working alone” means that the employee/volunteer is the only employee/volunteer in
that work location, inclusive of being in a vehicle, or is in circumstances where the employee/volunteer
cannot be seen or heard by another worker/volunteer in the event of injury, illness or emergency.
Precautionary Measures: (Safe Work Practices)
“Precautionary measures” includes maintaining a distance that allows you to react to any movement of
another person, and by approaching others in a non-threatening, respectful manner, using positive body
language, dressing appropriately, complying with protocols of persons supported and being aware of
circumstances, triggers, responsive behaviours of persons supported; all of which are consistent with
the Nonviolent Physical Crisis Intervention (CPI) training.
Each Community Living-Central Huron work location has on-site an Emergency Preparedness Binder,
which Staff are required to review on a monthly basis and when revisions occur. Included in the
Emergency Preparedness Binder are a number of important items and information, inclusive of
evacuation procedures; floor plans; emergency numbers such as the on-call Pager, 911; individual and
location specific protocols; up-to-date Person Directed Plans; routines; etc. The location cell phone is
to be kept charged at all times, and all employees are to take the cell phone with them when they are
supporting individuals in the community.
As well, the residential locations, the Activity Centre and the Employment Support Program utilize a
Communication Book to document pertinent information regarding people supported, concerns, or issues
for incoming Staff to review as they begin their shift. Each month the Location Health & Safety
Representative (LHSR) conducts an inspection of the location in which they work. The LHSR would
document and bring to the attention of their Supervisor all workplace hazards. In addition, the work
location Supervisor conducts sporadic inspections of workplace hazards and documents monthly their
findings and corrective actions.
Staff who work out of an office location, are to record in the daily log book their whereabouts and the
expected date of their return. It is important to balance the confidentiality of people supported and the
health and safety of employees/volunteers.
D.33
Employer Responsibilities:
The Employer will:
-
-
ensure policies and procedures are developed and activated to address any identified hazards;
ensure that a risk assessment is completed at each work location;
ensure the Health & Safety Location Representative, where necessary, conducts a monthly
inspection;
provide training and orientation to Staff regarding their responsibilities, including the Health and
Safety Policy and Procedures, Emergency Policy, site-specific protocols and individual protocols of
persons supported;
provide a cell phone for the work location/Program;
provide some type of electronic personal safe guard emergency alarm/device, when necessary.
Supervisor Responsibilities:
-
-
be responsible for being aware of this policy, procedures, precautionary measures and ensuring
compliance by all employees and/or volunteers they supervise;
ensure that risk assessments are carried out at the locations they supervise and communicating in
writing any risks, policies and procedures to minimize such risks or hazards to Staff and/or
volunteers;
ensure training and orientation is provided to all employees and/or volunteers who work alone;
ensure that all investigations concerning health and safety risks of working alone are conducted
immediately and documented, following notification of such risks;
respond to Workplace Hazard and Suggestion Reports immediately; take steps to reduce or eliminate
all risks;
complete the required documentation to notify the Union of any workplace hazards;
take every reasonable precaution to respond to employees’ concerns or correct any unsafe situation;
visit the work location periodically and observe Staff working alone;
periodically each month, visit the work location to conduct a hazard inspection.
Employee Responsibilities:
The Employee will:
-
participate in orientation and follow training and education;
ensure they are aware of and follow all policies, procedures, precautionary measures and guidelines
related to working alone;
be knowledgeable about reporting procedures and reporting incidents; including the completion of
appropriate forms, as soon as possible to ensure all details are included;
immediately reporting in writing any concerns regarding health and safety to their Supervisor;
follow site specific protocols and use precautionary measures as described above;
comply with protocols/Support Plans of persons supported, being aware of circumstances, triggers,
responsive behaviours of persons supported;
record their whereabouts in the daily log book, where applicable.
Note: At any time should an employee or volunteer believe they are in imminent risk
or danger, contact 911 immediately.
D.34
It is the responsibility of all employees and volunteers to immediately report any and all risks or potential
risks of working alone to their immediate Supervisor, using the Workplace Hazard and Suggestion
Report. The Supervisor will investigate the risk(s) or potential risk(s), as soon as possible and take
appropriate steps to address any continuing risks to the health and well-being of all employees and
volunteers.
Evaluation:
Community Living-Central Huron is committed to looking at leading indicators of working alone, through
surveys to employees and volunteers, and providing education and awareness as necessary.
Supervisors will regularly audit employee and volunteer practices of working alone as well as review the
monthly checklist for any noted hazards and corrections.
D.35
Section:
Subject:
D
Infection Control Policy
Total Pages: 4
and Procedures
Approval Date: January 16, 2013.
Revision Dates:
INFECTION CONTROL POLICY AND PROCEDURES
Community Living-Central Huron is committed to providing employees and volunteers with a safe and
healthy workplace. This will be accomplished by focusing attention on the overall wellness, proper
hygiene practices and education of employees and volunteers about the risks and best practices related
to infection control in the workplace and ways to avoid them. All employees and volunteers are expected
to actively support this policy and its procedures; non-compliance with the Infection Control Policy and
Procedures is subject to discipline, up to and including dismissal.
Definitions:
Infection: the invasion and multiplication of microorganisms such as bacteria, viruses and parasites that
are not normally present within the body. An infection may show no symptoms, or symptoms may be
apparent; an infection can remain localized or it may spread throughout the body.
Hazard: any real or potential condition, practice, behaviour, act or thing that can cause injury, illness or
death.
Risk: a chance of injury or loss.
Personal Protective Equipment: clothing and equipment designed to protect an individual from injury;
for the purposes of this policy, it may be disposable gloves, alcohol-based hand sanitizer, masks, eye
wear (goggles, glasses), gown or apron to cover clothing, etc.
Universal Precautions: refers to the ongoing practice of avoiding contact with another person’s bodily
fluids, by means of wearing nonporous personal protective equipment (gloves, glasses, goggles, face
shields, masks, gowns) to minimize the risk of infection. Essentially, universal precautions are good
hygiene practices, such as hand washing, use of gloves/sanitizers and other barriers, correct handling
and disposal of needles and sharps.
Bodily Fluids: include blood, semen, vaginal secretions, oral/respiratory secretions, sputum, urine, feces,
wound drainage and any other moist body discharge.
Direct and Indirect Disease Transmission: contact transmission is the most common form of transmitting
diseases and infection. Direct contact is when there is physical contact between the infected person and
healthy person, via blood, bodily fluids; examples kissing, sexual contact, contact with oral secretions,
body lesions. Indirect contact is when the infected person coughs, sending infectious droplets into the
air; the healthy person then inhales the infectious droplets or the droplets land directly in their eyes, noise
or mouth, or the person touches a surface where the infectious droplets have landed. Droplets generally
travel between three and six feet; and when they land on commonly used objects, ie. tables, doorknobs,
telephones, and healthy people touch the contaminated object with their hands, eyes, nose, mouth they
can become infected.
D.36
Mucus Membranes: a membrane lining all body passages that come in contact with air, such as
respiratory and digestive tracts and having cells and/or glands that secrete mucus. (ie. nostrils, lips,
mouth, eyes)
Infection Control/Prevention: proper thorough hand washing is one the best methods to prevent disease
transmission along with good personal hygiene. Regular disinfection of frequently touched surfaces such
as doorknobs, handrails, computer keyboards, telephones, counter tops, etc.,is also beneficial to avoid
the spread of infection.
Examples of Hazards:
- not wearing protective equipment, eg. gloves should be worn to sort/dispose of contaminated items,
clean-up vomit, blood spills and other bodily fluids;
- improper disposal of sharps, eg. placing sharps in with ‘regular garbage’ and not utilizing the sharps
container;
- neglecting to disinfect an area that has been contacted by bodily fluids, eg. not utilizing a the proper
mixture of disinfectant (1 part chlorine bleach to 9 parts water)
- not ensuring that refrigerators are kept the proper temperate for food storage.
Prevention Procedures:
To prevent the spread of infections, the following practices should be followed: hand hygiene; personal
protective equipment and safe handling and disposal of sharps. Prevention procedures include:
- washing hands vigorously before and after contact when providing personal care to individuals
supported, after using the washroom, and before and after preparing meals;
- wearing disposable gloves for all procedures that may give exposure to mucous membranes, nonintact skin, body fluids and objects that have been in contact with the above. Change gloves before
and after each procedure and wash hands after removing the gloves.
- wearing masks and protective eye wear if there is a possibility of bodily fluids to splash skin or
mucous membranes ;
- wearing gowns or plastic aprons during procedures or circumstances where soiling may occur;
- properly using and disposing of needles or other sharp instruments; obtain clear instructions and
training specific to the person supported and dispose of needs in approved “Sharps Container,” and
- disinfecting areas exposed to disease transmission, using a mixture of 1 part chlorine bleach to 9
parts water.
Goals and Objectives:
The goal of this Policy is to increase and maintain awareness and education of infection control for all
employees and volunteers; prevention will be the primary focus. Further objectives are to reduce the
number of injuries and to comply with Occupational Health & Safety legislation. This will be
accomplished through a participatory program by the Board of Directors, Management Staff, all support
workers and volunteers.
D.37
more specifically:
The Employer will:
provide awareness and education materials to all workers and volunteers to aid in the
prevention of infection;
provide as appropriate all necessary personal protective equipment;
improve its knowledge of measures to reduce incidents of infection in all work locations; and
review statistics quarterly with the Location Health and Safety Representatives, to identify
work areas with incidents of infection; education of such and a means to reduce any potential
injuries.
ensure all employees and volunteers perform their tasks in a safe manner through regular
audits of use of personal protective equipment, proper hygiene practices and related
procedures and making corrections as necessary;
take every reasonable precaution to protect workers and volunteers;
educate employees and volunteers on the hazards and provide written measures and
procedures as required;
lead by example (ie. always direct and perform work in a safe manner themselves);
provide personal protective equipment; and
seek information from approved health care professionals regarding specific infectious control
matters and covey such information to other Staff (ie. recommended clean-up for blood spills).
Location Health and Safety Committee Representatives:
Location Health and Safety Committee Representatives will:
regularly inspect the workplace, use of personal protective equipment and proper hygiene
practices to ensure a safe and healthy environment and involve workers, as needed with
inspections;
be trained on infection control and prevention ideas; and
risks that increase the likelihood for infection of employees and/or volunteers.
Workers will:
ensure that safe work practices include prevention and protections of infections, use of
personal protective equipment, proper hygiene practices; including properly using all
equipment provided by the Employer;
report in writing to their Supervisor, in a timely manner anything that may be a hazard or risk
factor that could cause or contribute to infections;
take part, when requested, in a workplace inspection to advise of any infectious hazards or
risks; and
D.38
It is the responsibility of all employees and volunteers to immediately report all infections or potential risk
factors, hazards, injuries to their immediate Supervisor using the Employee Incident Form and /or the
Workplace Hazard & Suggestion Report. The Supervisor will investigate the incidents of infections or
potential infections, as soon as possible and take appropriate steps to address any continuing risk to the
health and well-being of all employees and volunteers.
Evaluation:
Community Living-Central Huron is committed to looking at leading indicators of infection through
surveys to employees and volunteers and providing continuing education and awareness as necessary.
Supervisors will regularly audit employee and volunteer practices related to infection control, as well as
review the monthly checklist for any noted hazards and corrections. The Location Health and Safety
Representatives will make recommendations to the Employer to identify infectious issues and potential
hazards.
D.39
Section:
Subject:
D
Health and Safety
Total Pages:
6
HAZARD/RISK POLICY AND PROCEDURES
Community Living-Central Huron promotes the health and safety of its Employees and Volunteers, and
as such, is cognizant of the Agency’s responsibility to recognize, assess, control and evaluate workplace
hazards, as per the Occupational Health and Safety Act (OH&SA) and Health Care and Residential
Facilities Regulation (Reg. 67/93), made under the OH&SA. The Agency will ensure through training of
legislative requirements, risk identification, hazard awareness, hazard management including a
hazard/risk inventory, all Employees and Volunteers are aware of their responsibilities with regard to their
safety and obligations under the OH&SA. Employees and Volunteers who are non-compliant with the
Hazard/Risk Policy and Procedures are subject to discipline, up to and including dismissal from
Community Living-Central Huron’s employment and/or services.
Definitions:
Hazard:
Any real or potential condition, practice, behaviour, act or thing that can cause injury, illness or death or
damage to or loss of equipment, property or the environment.
Hazard Awareness:
Is the practice of being able to recognize all potential hazards, assess or evaluate the hazard and
associated risks; then to control the hazard and evaluate and monitor any controls put in place. Hazard
awareness is the responsibility of all workplace parties - the Employer, Supervisors and Workers.
Risk:
A chance of injury or loss as defined as a measure of probability and severity of an adverse effect to
health, property, the environment or other things of value.
Occupational Health & Safety Act: (OH&S Act):
Provincial legislation that provides definitions; minimum standards; rights, duties and responsibilities of
all workplace parties (Employer, Supervisor and Worker); basic principles; offences and fines and several
regulations. Relevant sections of th OH&S Act: Sections 25 and 26 for Employers (CL-CH); Section 27
for Supervisors and Section 28 for Workers (Employees).
Also, the related sections of the legislation that are specific to the Location Health & Safety
Representatives are: Section 8 (11) - Powers of Representatives, in which Location Health & Safety
Representatives will obtain information from the Employer or contractor concerning conducting tests of
equipment, machines, devices, materials, chemicals, etc. for the purpose of occupational health and
safety. Location Health & Safety Representatives have the power to be consulted about and be present
at the beginning of testing of any equipment, machines, devices, materials, etc., if they believe their
presence is required to ensure valid testing procedures are used and test results are valid. Also,
Location Health & Safety Representatives can obtain information from the contractor or Employer to
identify potential or existing hazards of materials, processes, or equipment and work practices and
standards in similar or other industries of which the contractor or Employer has knowledge.
D.40
Specific to hazards and the duties of CL-CH, Section 25 of the OH&SA, describes the responsibilities
of the Employer regarding equipment, material and protective devices, taking every precaution
reasonable in the circumstances to protect Employees and Volunteers. Section 27, sets out the duties
of the Supervisor, as the person who has responsibilities over a specific workplace and the Employees
and Volunteers of that workplace. The Supervisor will advise Employees and Volunteers of the existence
of any potential or actual danger to the LH&S Representative of which they are aware, and provide
Employees and Volunteers with written instructions as to the measures and procedures to be taken for
protection and take every precaution reasonable in the circumstances for the protection of Employees
and Volunteers.
Section 28 defines the duties of the Employee with regard to reporting any hazard of which they are
aware, as well as any contraventions of the OH&SA to their Supervisor. Also, no Employee shall remove
or make ineffective any protective device required without providing an adequate temporary protective
device, as necessary or use or operate any equipment, machine, device, etc. in a manner that may
endanger themself or others or engage in any prank, contest, unnecessary running or rough or
boisterous conduct.
Sections 32.02, 32.03 and 32.06 address the issue of workplace violence and harassment and domestic
violence. The Agency’s Bullying, Harassment and Workplace Violence provides for this section of the
legislation.
Health Care and Residential Facilities Regulation (Reg. 67/93):
This Regulation applies to hospitals and laboratories, psychiatric facilities, long term care homes,
intensive support residence or supported group living residence as defined in the Services and Supports
to Promote the Social Inclusion of Persons with Developmental Disabilities Act, 2008, any facility that
provides child development services or child treatment centres, as defined in the Child and Family
Services Act and laundry facilities located in any of the facilities listed above and a plant as defined in
Ontario Regulation 219/01 that is primarily for one of, or associated with any of the facilities listed above.
Sections 8, 9 (1,2,3,4,), of this Regulation outlines the responsibilities of the Employer with regard to
work in consultation with Location Health & Safety Representatives to reduce measure and procedures
for the health and safety of Employees and that such procedures are provided in writing and are
reviewed annually, or more frequently if necessary. Sections 10 and 11, address the area of personal
protective equipment and proper use, fit, storage and fitting of such, as well as exposure to hazard that
my cause head, eye or foot injuries that prevent slips, trips and falls. Section 19 speaks to proper
ventilation system and that such systems are inspected every six months by a person who is qualified
to do so. Sections 33(1) (a,b,c) and 44(e) deal with work surfaces being free from obstructions and
hazards, cracks, accumulations of refuse, ice and snow, etc. that may endanger an Employee or
Volunteer, and that equipment be inspected before use and as recommended by the manufacturer.
Internal Responsibility System (IRS):
Is a system in an organization that encourages self-reliance from within, in which everyone has direct
responsibility for health and safety, and safety is an essential part of their job. An IRS encourages
Employers, Supervisors and Workers to show initiative to raise and resolve health and safety issues.
Location Health & Safety Representatives have a role to play by monitoring and supporting the IRS.
D.41
Examples of Hazards:
• Physical Agents: noise; temperature; vibration; radiation;
• Chemical Agents: liquids; gases; solids;
• Biological: bacteria; viruses; fungi; parasites;
• Psycho-social: work overload; boredom; violence; harassment; lack of control;
• MSD: awkward postures; repetition; high force demands; poor design of tools, equipment,
workstation; inadequate procedures for lifting, lowering, pushing, pulling, carrying loads;
• Safety: energy hazards; mechanical hazards; moving parts of machinery/equipment or processes;
working at heights; uneven or slippery ground and floor surfaces; work practices; material handling;
As the IRS states, all matters relating to health and safety, responsibilities are shared among all
workplace parties, specifically:
Employer:
The Employer will:
< abide by the Occupational Health and Safety Act and the Health Care and Residential Facilities
Regulation;
< take every precaution reasonable in the circumstances for the protection of an Employee and
Volunteer;
< provide and maintain equipment, materials and protective devices as prescribed;
< maintain an up-to-date registry of identified workplace hazards/risks;
< maintain a Workplace Violence Program Policy/Program and Workplace Harassment Policy/Program;
< assess the risks of workplace violence that may arise from the nature of the workplace, the type of
work or conditions of work and record in the Hazard/Risk Registry to the Location Health & Safety
Representative, location specific;
< advise all Employees and Volunteers of the results of the Risks of Workplace Violence Assessment,
and provide a copy of such, if the assessment is in writing;
< reassess the risks of workplace violence as often as is necessary;
< include measures and procedures for Employees and Volunteers to report incidents of workplace
harassment to their immediate Supervisor;
< establish a procedure as to how the Employer will investigate and manage incidents and complaints
of workplace harassment and violence;
< determine the necessity to complete individualized Responsive Behaviour Risk Assessments;
< ensure all hazardous materials present in the workplace are identified in the prescribed manner and
are available in English and such other languages as required;
< obtain or prepare, as may be prescribed, any expired Material Safety Data Sheets (MSDS) for all
hazardous materials present in the workplace and ensure Material Safety Data Sheets are available
in English and such other languages as required;
< ensure a hazardous material is not used, handled or stored at a workplace unless the prescribed
requirements concerning identification, Material Safety Data Sheets and employee instruction and
training are met;
< review at least once a year the Agency’s Occupational Health and Safety Policy and Procedures for
the health and safety of Employees and Volunteers and revise based on current legislation and
practice;
D.42
<
<
<
review and revise measures and procedures more frequently than annual, if the Employer and
Location Health and Safety Representatives determine necessary;
in consultation with Location Health and Safety Representatives, develop, establish and provide
training and educational programs in health and safety measures and procedures for Employees that
are relevant to the Employees’ work;
post in the workplace a copy of the Occupational Health and Safety Act and any explanatory material
prepared by the Ministry, outlining the rights, responsibilities and duties of Employees; Bullying,
Harassment and Workplace Violence Policy and Procedures.
Supervisor:
< advise Employees and Volunteers of the existence of any potential or actual danger to the health and
safety of Employees and Volunteers of which the Supervisor is aware;
< provide Employees and Volunteers, when so prescribed, written instructions as to the measures and
procedures to be taken for protection of the Employee and Volunteer;
< take every precaution reasonable in the circumstances for the protection of the Employee and
Volunteer;
< conduct annual Workplace Hazard/Risk Assessments using the Agency’s designated form;
< complete monthly workplace inspections;
< complete individualized Responsive Behaviour Risk Assessments when deemed necessary by the
Employer;
< record workplace violence data on designated forms monthly;
< ensure Employees and Volunteers work in a safe manner and with the protective devices, measures
and procedures required by the Occupational Health and Safety Act; the Health Care and Residential
Facilities Regulation and the Agency’s Health & Safety Policies and Procedures;
< instruct and train Employees and Volunteers on how to wear or use any protective clothing,
equipment or device prior to such use and at regular intervals thereafter;
< educate Employees and Volunteers on the hazards and risks and provide written measures and
procedures, as required;
< investigate all reports of health and safety hazards/risks and incidents;
< respond in writing to any written or verbal reports and provide written recommendations of
hazards/risks/incidents.
The Location Health and Safety Representatives will:
< participate in all training and educational programs, as determined by the Employer to be beneficial
for the area of hazards and risks;
< encourage co-workers to work safely and to report any hazardous or unsafe conditions immediately
to their Supervisor or designate using Workplace Hazard and Suggestion Report;
< obtain from the Employer information concerning the conducting or taking of tests of any equipment,
machine, device, article, thing, material or biological, chemical or physical agent in or about a
workplace for the purpose of occupational health and safety;
< be consulted about and be present at the beginning of testing conducted in or about the workplace
if the Location Health and Safety Representative believes his or her presence is required to ensure
that valid testing procedures are used or to ensure that the test results are valid;
D.43
<
<
<
<
<
<
<
<
obtain information from the Employer respecting the identification of potential or existing hazards of
materials, processes or equipment, and health and safety experience and work practice(s) and
standards in similar or other industries of which the Employer has knowledge;
conduct and document monthly inspections of their work location and submit such to their immediate
Supervisor within the designated time frame;
identify and report situations immediately, that may be a source of danger or hazard to Employees
and Volunteers and make recommendations to their Supervisor by completing a Workplace Hazard
& Suggestion Report;
review location Workplace Hazard and Suggestion Reports and make written recommendations;
review Incident Accident Reports and make written recommendations and submit to Supervisor or
designate in the time frame required;
investigate, when notified by the Employer of a critical injury/fatality and provide a report in writing
to the Ministry of Labour, within forty-eight (48) hours as prescribed.
Employees:
The Employees will:
< report to their Supervisor or designate, immediately, the absence of or defect in any equipment or
protective device of which the Worker is aware and which may endanger himself, herself or another
Employee or Volunteer using a Workplace Hazard and Suggestion Report;
< report to their Supervisor or designate, immediately, anything that may be a hazard or risk using a
Workplace Hazard and Suggestion Report;
< report to their Supervisor any contravention of the Occupational Health and Safety Act or Health Care
and Residential Facilities Regulation or the existence of any hazard of which the Employee or
Volunteer is aware;
< abide by safe work practices/safe operating procedures, to include but not limited to Slips, Trips &
Falls; “Client Handling;” Responsive Behaviours; Workplace Violence and Harassment; Infection
Prevention and Control and MSD.
< take part, when requested, in a workplace inspection to advise of any hazards or risks;
< participate in all training and educational programs, as determined by the Employer to be beneficial
for the area of hazards and risks.
Note: At any time should an Employee or Volunteer believe they are in imminent risk or danger,
contact 911 immediately.
It is the responsibility of all Employees and Volunteers to immediately report all potential risk factors for
hazards/incidents to their immediate Supervisor or designate using the Employee Incident Form and/or
the Workplace Hazard & Suggestion Report. The Supervisor will investigate risks/hazards/incidents as
soon as possible and take appropriate steps to address any continuing risk to the health, safety and well
being of all Employees and Volunteers. Should a hazard result in a critical injury or fatality, Supervisors,
Employees and Location Health and Safety Representatives will follow the Agency’s Critical Injury Policy
(#D-006) .
D.44
Evaluation:
hazards through such methods as information gathering (Workplace Inspections, Incident Investigations,
Job Hazard Analysis, etc), surveys, data collection (Rate Group Trends), and Staff meetings.
Supervisors will regularly audit Employee and Volunteer practices related to hazards and risks, through
such means as, monthly, periodic inspections at the work locations; documenting written reports of
workplace violence on the designated form; providing written recommendations in response to any
reports of hazards/risks; reviewing monthly work location checklists completed by Location Health and
Safety Representatives; and, completing annual workplace hazard/risk assessments. The Location
Health and Safety Representatives will provide written recommendations to the Employer when
identifying issues related to Employee hazards/risks. The Agency will maintain a Hazard/Risk Registry,
which will be updated annually in consultation with the Location Health & Safety Representatives, as
necessary, based on the written information/documentation received by Supervisors, Employees,
Volunteers and the Location Health and Safety Representatives.
• Behavioural Support Policy (C-002)
• Health and Safety Policy Statement D-001
• Emergency Policy D-003
• Smoking D-004
• Dangerous Weapons and Fire Arms D-005
• Critical Injury D-006
• Bullying, Harassment and Workplace Violence Policy and Procedures D-007
• Pandemic Policy D-008
• Annual Workplace Maintenance Policy D-009
• Musculoskeletal Disorders Awareness Policy D-010
• First Aid Policy and Procedures D-011
• Working Alone Policy D-012
• Infection Control Policy and Procedures D-013
• Sexual Harassment Policy E-013
• Early and Safe Return to Work E-016
• Community Living-Central Huron Medication Policy and Procedures Manual
• Community Living-Central Huron Occupational Health and Safety Document
D.45
Section:
Subject:
D
Health and Safety
Total Pages:
6
Approval Date: December 17, 2014.
Revision Date(s):
HEALTH and SAFETY ORIENTATION POLICY
Policy:
Community Living-Central Huron work locations may present hazards; therefore, the Agency has
implemented a Health and Safety Orientation Program to ensure that new or returning employees and
volunteers are provided with information regarding working conditions, so they may perform their job in
the safest possible manner. This orientation procedure will be used for newly hired employees, including
students, co-op placements, contract Staff and volunteers; as well as employees and volunteers
returning from periods of absence.
Purpose:
To provide guidance, direction, consistency and a checklist to ensure employees and volunteers of
Community Living-Central Huron receive complete and up-to-date information on health and safety
policies and procedures.
Responsibilities:
Community Living-Central Huron utilizes means to orientate new and returning employees and
volunteers. It is the responsibility of the employee’s or volunteer’s direct Supervisor to provide a
comprehensive orientation to Community Living-Central Huron work locations and safe work policies and
procedures. Employees and volunteers are responsible to take part in the orientation process and follow
the policies and procedures outlined during this process. Failure to participate in health and safety
orientation is subject to discipline up to and including dismissal from the Agency’s employment or to no
longer provide volunteer supports.
Definitions:
Orientation:
means an introduction/beginning for employees and volunteers to familiarize themselves with the Agency’s Philosophy, Service Principles, work practices, changed work practices,
policies, procedures, protocols, expectations and to acquaint themselves with the individuals they will
be supporting. Orientation for health and safety is inclusive of the above, but also all policies, procedures
and checklists related to safe work practices. Orientation for health and safety is conducted both on and
off-site, within the work locations and at Central Administration.
Re-Orientation: occurs when an employee has been away from their job for various reasons (ie.
Maternity/Parental; Short/Long Term Disability; WSIB; Leaves, etc.), or if changes in support
protocols/procedures occur or performance concerns arise. The relevant Coordinator and/or Supervisor
will determine the extent of re-orientation based on individual circumstances and document such reorientation on the designated re-orientation checklist.
D.46
Procedures:
Employees and/or Volunteers:
All new and/or returning employees and volunteers are required to participate in Health and Safety
Orientation; new employees and volunteers will also be given an overview of the Agency. The immediate
Supervisor of the new and/or returning employee or volunteer is responsible for health and safety
orientation. Specific and relevant health and safety information will be reviewed with them, including the
items listed below; this list is not intended to be exhaustive:
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
Health and Safety Policy Statement;
Bullying, Harassment and Workplace Violence Policy and Procedures;
An explanation of the function, operation and composition of the Committee of Location Health
and Safety Representatives;
Ministry of Labour’s “Health & Safety at Work, Prevention Starts Here”;
An overview of applicable sections of the Occupational Health and Safety Act and its
regulations;
A review of the Health and Safety responsibilities, paying particular attention to the
responsibilities of employees, volunteers and Supervisors;
Instruction on fire and emergency evacuation procedures;
Infection Control and Hazardous Substances Identification Procedures;
Working alone;
Location(s) specific Emergency Plan;
Lifting and carrying;
Ladders;
Vehicle Information Binder/Training of wheelchair lifts (automatic and manual), Q-Straints, as
applicable;
A review of Community Living-Central Huron’s RACE Tool - Hazard/Risk Registry;
Reporting procedures for injury/illness or hazards in the workplace (Workplace Hazard &
Suggestion Report);
First Aid procedures; reporting workplace and non-workplace illness and/or injuries including
claims procedures and Early and Safe Return to Work;
WHMIS training and location of MSD Sheets;
Work refusal procedures;
Personal protective equipment, including footwear;
Behavioural Support Plans and Profiles of people supported.
Health and safety orientation is ongoing; some components of this program must be presented before
the employee or volunteer begins work while others are introduced during the orientation process, and
as working conditions change. In addition to this orientation training, all locations may have specialized
training for employees or volunteers which may be unique to their job responsibilities and people they
are supporting. All training will be monitored and reviewed by the employee or volunteer’s Supervisor
and a training matrix is maintained for each employee and/or volunteer. The Health and Safety
Orientation Checklist shown as Attachment A should be used for this purpose.
D.47
The new employee or volunteer will then be given a tour of their work location(s). During this tour the
new employee or volunteer should be introduced to the Health and Safety Representative at their
location (if possible). The following will be included in the on-site training:
C
C
C
C
C
C
C
C
Showing the employee or volunteer emergency exits, fire extinguishers, Health and Safety
postings and First Aid stations;
Introducing the employee/volunteer to the individuals they will be supporting;
Introducing the employee/volunteer to co-workers;
Reviewing the specifics of the RACE Tool Hazard/Risk Registry for the job(s) the employee
or volunteer will be performing;
Fuse Panel and Water Shut Off;
Snow removal/maintenance;
Re-enforcing to the employee or volunteer, the importance of working safely, not taking
chances and asking questions concerning things of which they are unsure;
The employee or volunteer is then ready to start performing job tasks but should be closely
observed by the Supervisor or designate.
During the first few days on the job, the Supervisor will frequently discuss job responsibilities and safety
with the new employee or volunteer; this will allow the opportunity for questions and assess the need for
additional orientation.
Supervisor:
All Supervisors will receive training in Health and Safety upon beginning employment or upon being
promoted or transferred within the Agency. The employee’s direct Supervisor is responsible to ensure
this training occurs upon hire/promotion, as well as on an on-going basis, as may be required. This
training will include, but may not be limited to:
C
C
C
C
C
C
C
C
C
C
C
C
C
Occupational Health and Safety Act and its regulations with special emphasis on Health Care
and Residential Facilities and those sections relating to Supervisors;
Community Living-Central Huron Health and Safety Policies and Procedures;
Bullying, Harassment and Workplace Violence Policy and Procedures;
Supervisor’s responsibilities for Health and Safety;
Community Living-Central Huron’s RACE Tool - Hazard/Risk Registry;
Reporting procedures for injury/illness or hazards in the workplace (Workplace Hazard &
Suggestion Report);
Accident Investigations training;
Workplace Inspections training;
Work related and non-work related illness/injuries and Return to Work Policies and
Procedures;
How and when to deliver WHMIS training;
Review of operating instructions for equipment and processes;
Orientation and training requirements for employees and volunteers (as applicable) on safe
work practices;
Review of any present hazards, controls and/or precautions.
D.48
Related Policies:
Bullying, Harassment and Workplace Violence Policy and Procedures (D-007)
Infection Control and Hazardous Substances Identification Procedures (D-013)
Hazards/Risk Policy and Procedures (D-014)
Attachments:
Attachment A - Health and Safety Orientation Checklist
D.49
Complete
(Yes/No/N/A )
Tour of the work location(s)
Address
Address
Health and Safety Policy Statement
Bullying, Harassment and Workplace Violence Policy & Procedures
An explanation of the function, operation and composition of the Committee of
Location Health and Safety Representatives
Health and Safety Responsibilities
Fire and Emergency Procedures
Infection Control and Hazardous Substances Identification Procedures
General safe practices
Working Alone
Lifting and Carrying
Ladders
Personal Protective Equipment (safety glasses, protective clothing, safety
footwear)
Emergency Plan
Snow removal/maintenance
D.50
Complete
(Yes/No/N/A )
Report unsafe equipment/conditions
RACE Tool - Hazard/Risk Registry
Vehicle Information Binder/Wheelchair Lifts/Q-Straints
Reporting procedures for injury/illness or hazards in the workplace
First Aid Training
First Aid and WSIB Claims Procedures
WHMIS Training
Training for Members of the Committee of Location Health and Safety
Representatives
Acknowledgement:
By signing below, you identify that the above outlined items have been discussed, trained and a sign-off
completed where required.
Employee Signature
Date
Supervisor Signature
Date
D.51
Section:
Subject:
D
Health and Safety
Total Pages:
2
Revision Date(s):
LOCATION HEALTH and SAFETY REPRESENTATIVES POLICY
Policy:
As per the Occupational Health & Safety Act, and based on the current compliment of Staff at the various
work locations of Community Living-Central Huron, the Agency must establish and maintain a Worker
Health and Safety Representative at each location. Community Living-Central Huron has determined
it will also utilize a Committee forum for the Location Health and Safety Representatives (LHSR). The
LHSR Committee will meet at least quarterly and will act together to identify, assess, review progress
and make recommendations to improve and control health and safety in the workplace.
Purpose:
The LHSR and the Committee play an important role with health and safety in the workplace in bringing
forward concerns, stimulating awareness, promoting an atmosphere of co-operation and working with
all levels of management to improve health and safety.
Responsibilities:
Community Living-Central Huron promotes the philosophy of an internal responsibility system (IRS) for
health and safety. This is based on the principle that every individual in the workplace is responsible for
health and safety, this is inclusive of the Board of Directors, Management Staff, Support Staff and
individuals being supported.
Employer:
- Ensure that a Location Health and Safety Representative (LHSR) is appointed and maintained at
each work location.
- Ensure the name and work location of the LHSR is posted at each location.
- Provide information and training to the LHSR, as well as allow the necessary time for the LHSR to
complete their duties.
- Participate on the Committee of Location Health and Safety Representatives.
- Provide related information to the LHSR, including information on hazards identified and incidents
reported to the Employer.
- Responsible for responding to written recommendations within 21 days. Written recommendations
to include: a timetable for implementation, if the Employer agrees with the recommendation; reasons
for disagreement, if the recommendation is not acceptable; alternative resolution(s) with timetable
for implementation if the recommendation is not acceptable.
D.52
Location Health and Safety Representatives (LHSR):
- Participate in training in order to carry out the required duties.
- Participate on the Committee of Location Health and Safety Representatives.
- Conduct monthly workplace inspections by the 15th of each month, documenting all sub-standard acts
and working conditions.
- Review information on incidents occurring and provide written recommendations to their Supervisor
as needed. Written recommendations to include: nature of concern with information and justification;
recommended remedial action, listing suggested solutions and methods of implementation; date and
signature.
- Refer co-workers to the Occupational Health and Safety Act, the Agency’s Occupational Health &
Safety Policy and Procedures and safe work practices.
- Encourage co-workers to work safely and to report hazardous or unsafe conditions immediately to
their Supervisors.
- Participate in an investigation when a person is killed or critically injured at the workplace.
- Be present at the beginning of health and safety related testing in the workplace.
- Be present for, or assist in, work-refusal investigations.
- Be available to accompany a Ministry of Labour Officer on his/her inspection of the workplace.
Selection and Composition:
LHSR’s will be elected by the workers. Should a vacancy occur, the LHSR will notify the relevant
Supervisor and Union immediately. The Union, with approval from the Executive Director, will post
vacancies immediately in the relevant work location. Should the Union be unable to fill a vacancy for a
LHSR, the Employer will fill the vacancy.
Terms:
It is recommended that the LHSR fill the position for a minimum period of two years, with terms being
staggered.
Agenda/Minutes:
The Employer Representative of the Committee of LHSR’s will be responsible for the Agenda and
recording of minutes. Agenda items must be submitted to the Employer Representative at least seven
(7) days prior to the scheduled Meeting. Minutes will be dated and posted in each location, or placed
in the binders until the next meeting.
Meetings:
The Committee of the LHSR’s will meet at least quarterly, or as required, not including training.
D.53
Section:
Subject:
D
Ladder Safety Policy
and Procedures
Total Pages: 4
Approval Date:
Revision Date(s)
February 18, 2015
LADDER SAFETY POLICY and PROCEDURES
Policy:
Community Living-Central Huron is committed to ensuring a safe work environment for all employees
and volunteers. To this end, the Agency has developed procedures and included precautions to be
followed when using a ladder and for storage of a ladder. All employees and volunteers whose duties
require them to use a ladder are required to follow the responsibilities, procedures and precautions
noted below to reduce or eliminate hazards and to ensure safe work practices related to the use of
ladders. The type and height of a ladder is to be determined by the needs of each work location and
the ladder must be CSA approved. Non-compliance with this Policy and Procedures is subject to
discipline, up to an including dismissal from Community Living-Central Huron’s employment and/or
volunteer opportunity.
Purpose:
To provide proper procedures and guidelines to employees and volunteers of Community LivingCentral Huron for safe use and storage of a ladder.
To ensure compliance with relevant legislation: The Occupational Health & Safety Act, the Health Care
and Residential Facilities Regulation (O. Reg. 67/93), Sections 80 - 84, inclusive.
Responsibilities:
The Employer’s responsibility is to develop safe use and storage procedures for ladders, ensure that
all employees and volunteers are trained in use and ensure that supplied ladders are in good
condition, regularly inspected and replaced where required.
Supervisors are responsible to ensure that employees and volunteers are trained in proper use prior to
using a ladder, to include the weight capacity of the ladder. Supervisors must also ensure that ladders
are maintained in good condition, inspected regularly and properly stored.
The Location Health and Safety Representative (LHSR) is responsible to notify Management if a
ladder is being used incorrectly, to inspect all ladders on a monthly basis during workplace inspections
and to notify Management of any damage to a ladder.
Employees and volunteers are responsible for using ladders in the manner in which they were trained,
inspecting a ladder prior to use and to report any damage or defect to a ladder to their Supervisor.
Orientation:
To reduce the risk of incident or injury all new employees and volunteers will be orientated to the
Agency’s Ladder Safety Policy & Procedures.
D.54
Definitions:
Ladder: means a portable structure consisting of two sides crossed by parallel rungs, including
everything from a step stool, to a step ladder to an extension ladder. Ladders are classified by the
weight capacity (ie. Light - up to 200 lbs, Extra Heavy - up to 300 lbs, etc.). Ladders are most
commonly made out of aluminum, wood, steel and fiberglass-reinforced plastic.
Community Living-Central Huron does not require Staff or volunteers to use an extension ladder.
Step Ladder: can vary in length, should be approximately 1 meter (3 feet) shorter than the highest
point you have to reach.
Step Stool: a small step ladder which can be of various designs; however, usually consisting of one or
two steps.
Procedures:
Inspection:
Ladders shall be inspected before use; inspection to include: checking the steps; side rails;
rubber feet; fold out brackets/hinges; stability and locking mechanism. Ensure these
components are intact, not broken or bent and there are no sharp edges. The capacity of the
ladder will be posted within eye sight of the ladder or otherwise attached to the ladder.
Defective ladders will be taken out of service, tagged for disposal or repair. Ladders will only be
repaired by qualified personnel.
-
Supervisors will include inspection of ladders during their period audit of the work location.
-
Ladders are to be checked on a monthly basis by the LHSR when completing monthly
workplace inspections.
Set-up:
When setting up a ladder, ensure the fold out brackets/hinges are completely extended, pushed
down into a locked position and that the ladder is on level firm footing. A step ladder cannot be
used as a straight ladder.
-
Check for any over-head obstructions prior to climbing the ladder. Never place a ladder in front
of a door way that opens towards the ladder, unless the door has been locked to prohibit use.
Use:
Prior to using a ladder, the employer or volunteer must ensure they do not exceed the weight
capacity of the ladder.
-
Ladders must be of sufficient height to perform the work. Standing on the step second top step,
or higher, of a step ladder to perform a task is prohibited. Keep your centre of gravity between
the side rails. Keep both feet on the ladder and/or step stool.
D.55
-
Ladders must be of sufficient height to perform the work; standing on the second top step or
higher of a step ladder to perform a task is prohibited. Keep your centre of gravity between the
side rails. Keep both feet on the ladder and/or step stool.
-
Ensure appropriate footwear and that footwear is free of anything slippery. Appropriate
footwear for ladder safety includes a closed shoe (toe and heel), with no to low heel that
provides good stability.
-
To climb a ladder, face the ladder and use both hands when going up or down, and maintain a
firm grip. Always keep a three (3) point contact (two (2) hands and a foot, or two (2) feet and a
hand) on the ladder when climbing. Keep your body near the middle of the step and don’t overreach upwards or sideways when on the ladder.
-
Place a step ladder at right angles to the work, with either the front or back of the steps facing
the work.
-
Do not move a ladder horizontally while workers are on it.
-
Ensure to dismount the ladder before moving it. Dismount a ladder from the bottom rung; don’t
jump from a step ladder or slide down a step ladder.
Ladder Maintenance:
Aluminum, fiberglass and metal ladders should be cleaned with soap and water, as needed.
-
Wooden ladders should be cleaned with a mild soap and water, then dried. Wooden ladders
that have been painted shall be removed from service.
Storage and Moving Ladders:
Step ladders must always be secured to a wall or affixed structure, whether they are stored
horizontally or vertically. Horizontal storage either on the floor or hung on the wall must be
supported at 4 to 5 foot intervals; this is the same requirement for vertical storage. Step stools
may be collapsed when not in use.
-
Ladders should not be stored in areas where there is excessive heat or dampness. Also, it is
best to store ladders away from high traffic areas - people.
-
When moving a ladder, collapse the ladder, hold the middle side rail and tip slightly forward,
watching for overhead hazards and hazards at both ends.
Ladder Precautions:
To avoid accidents with portable ladders:
-
Select the right ladder for the job situation; use the ladder as it was designed to be used; do not
overload a ladder (ie. do not put more weight on a ladder than it is designed to hold);
-
Step ladders cannot be used as straight ladders;
D.56
-
Step ladders are designed for one person only;
-
Before use, inspect the condition of the ladder; do not use a ladder with damaged parts that
affect the strength of the ladder; do not alter the structure of the ladder;
-
Before use, inspect the job-site for overhead wires and obstructions;
-
Before use ensure the stability of the base of the ladder; base to be placed on a level, nonslippery solid surface. Remove material and debris away from the base of the ladder;
-
Wooden ladders should not be painted;
-
Avoid pushing or pulling step ladders from the side;
-
Do not overload a ladder beyond its weight capacity;
-
Do not leave ladders that are set-up unattended;
-
Do not climb the back of a step ladder;
-
Clean the soles of your footwear before climbing the ladder;
-
Do not work on ladders when feeling weak, sick, or dizzy or when taking medication that may
cause drowsiness;
-
Do not work on ladders covered with snow, ice, or other slippery materials;
-
Do not work on ladders in bad weather or high winds;
-
Do not use ladders, boxes, barrels, or other makeshift materials to raise your work height;
-
Step ladders must be tall enough to perform the necessary work.
Related Policies:
Duty of Care Policy (No. B-010)
Critical Injury (No. D-006)
Annual W orkplace Maintenance Policy (D-009)
Musculosketal Disorders Awareness Policy (D-010)
W orking Alone Policy (D-012)
Location Health and Safety Representative Policy (D-016)
Early and Safe Return to W ork (E-016)
D.57
Section: D
Subject: Sharps Policy & Procedure Total Pages: 6
Approval Date:
May 20, 2015.
Revision Date(s)
SHARPS POLICY & PROCEDURES
Policy:
Community Living-Central Huron is responsible to ensure the health, safety and welfare of its
employees, volunteers and people supported, and therefore will take every reasonable precaution to
eliminate risks and hazards related to the use and disposal of medical sharps, Safety Engineered
Medical Sharps (SEMS) and other sharp objects. The Agency has developed procedures, including
definitions and outlined precautions for all employees and volunteers regarding sharps. Noncompliance with this Policy and Procedures is subject to discipline, up to an including dismissal from
Purpose:
To emphasize the correct handling of all sharps, to minimize the risk of injury and/or contamination,
decrease potential hazards and to increase the awareness of safe work practices related to various
types of sharps. Also, to promote and support the health and safety of all employees, volunteers and
people supported through training on proper procedures.
A further goal of this policy and procedure is to achieve compliance with relevant legislation: The
Occupational Health & Safety Act; the Health Care and Residential Facilities Regulation (O. Reg.
67/93); and the Needle Safety Regulation (O. Reg. 474/07).
Definitions:
Sharps:
Any sharp object, edge or broken article that is capable of cutting or penetrating the skin and could
cause injury to the employee, volunteer, person supported or other persons.
Medical Sharps:
Sharp objects used for a person’s medical care, treatment or diagnosis (ie. needles, syringes, blood
lancets, auto injectors, etc.).
Safety Engineered Medical Sharps (SEMS):
Sharp medical devices or instruments designed to include safety features to help protect workers
from being cut, punctured or injured in some way:
a)
a hollow-bore needle that:
is designed to eliminate or minimize the risk of a skin puncture injury or the user,
and
is licensed as a medical device by Health Canada; or
b)
a needleless device that:
replaces a hollow-bore needle, and
is licensed as a medical device by Health Canada.
D.58
Sharp Objects:
Employees, volunteers and people supported may come in contact with various sharp objects that are
capable of cutting or penetrating the skin through everyday activity. Examples of such sharps
include, but are not limited to: knives; scissors; lids from aluminum cans; razor blades; pins; chipped
or broken tooth; broken glass; etc.
Contamination:
The definition of ‘contamination’ is within the context of this Policy (Sharps Policy & Procedures).
Contamination of a sharp shall mean that the needle, syringe, broken article that is capable of cutting
or penetrating the skin has come in contact with any other object prior to administration. For
example, contamination occurs if a needle falls on the floor, touches another object such as clothing,
blood, dirty laundry, etc. Airbourne pathogens, biological and chemical agents are also included as
contaminants. Once administered (or encountered), the sharp or broken object must be disposed
immediately into a safe container.
Community Living-Central Huron promotes the use of the Internal Responsibility System (IRS) which
is a system that encourages self-reliance from within, in which everyone has a direct responsibility for
health and safety, and safety is an essential part of their job. Location Health & Safety
Representatives (LHSR) have a role to play by monitoring and supporting the IRS. In all matters
relating to sharps, health and safety are shared among all employees and volunteers.
The Employer will:
-
-
-
-
abide by the Occupational Health and Safety Act and the Health Care and Residential Facilities
Regulations;
take every precaution reasonable in the circumstances for the protection of an employee,
volunteer and person supported related to risks and hazard with sharps;
ensure all employees have up-to-date First Aid training and encourage all volunteers to obtain
and maintain First Aid certification;
conduct a Risk Assessment to identify potential hazards related to all sharps, provide controls
and re-evaluate the hazard after the control is in place, document such on the RACE Tool Hazard/Risk Registry;
provide awareness and education to all employees and volunteers to enforce the Sharps
Policies and Procedures;
ensure appropriate training programs for the various types of sharps: medical, SEMS and other
sharp objects to aid in the prevention of illness and injury from sharps;
monitor all employees and volunteers to ensure they are using safe work practices when
handling sharps, including use, storage and disposal;
provide and maintain necessary equipment, protective devices and resources to ensure safety
for employees and volunteers, including providing approved hollow-bore needles that are
designed to eliminate or minimize risks;
ensure, as necessary, site-specific written protocols are in place related to sharps, more
specifically, when injury, punctured skin or contamination occurs due to a needle stick from a
medical sharp or a SEMS;
investigate and respond in writing to all Employee Incident Reports and Workplace Hazard &
Suggestion Reports related to injury, illness or accidents related to sharps;
D.59
-
-
review at least once a year the Agency’s Occupational Health and Safety Policy and
Procedures for the health and safety of employees and volunteers related to sharps and to
revise such as required, based on current legislation;
in consultation with Location Health and Safety Representatives, develop, establish and
provide training and educational programs related to sharps.
provide and/or arrange for training, education on the use of sharps for people supported, as
required or appropriate.
-
-
abide by the Occupational Health and Safety Act and the Health Care and Residential Facilities
Regulations;
ensure all employees and volunteers are trained in the safe use of sharps to reduce the risk of
illness, injury and exposure to blood and body fluids;
ensure all new employees and volunteers receive general and site-specific orientation to the
Sharps Policy and Procedure and all site-specific protocols related to sharps;
ensure employees have valid First Aid certification and encourage volunteers to have the
same;
include use of, storage and disposal of sharps, as part of their regular workplace audit; and
provide employees, volunteers and people supported with corrective measures as required;
develop, as required, site-specific written protocol for all aspects of medical sharps and SEMS;
such protocol to include training, proper usage techniques, precautions, storage and disposal;
ensure employees, volunteers and people supported take every reasonable precaution
including using protective devices and equipment, ensuring proper storage and disposal
procedures, as required by the Occupational Health & Safety Act; the Health Care and
Residential Facilities Regulation and the Agency’s Health & Safety Policies and Procedures;
investigate and respond to all reports of hazards, risks, safety concerns and incidents related
to the use of sharps.
The Location Health and Safety Representative will:
-
-
abide by the Occupational Health and Safety Act; the Health Care and Residential Facilities
Regulations; and the Agency’s Health & Safety Policy and Procedures;
participate in training and educational programs related to sharps, as determined by the
Employer;
in consultation with the Employer establish necessary training and educational programs
related to sharps;
immediately report all hazardous or unsafe conditions related to sharps to their Supervisor and
encourage co-workers to do the same using the Workplace Hazard and Suggestion Report;
review location Workplace Hazard and Suggestion Reports and make written
recommendations back to the Employer that will assist in eliminating, controling and reducing
hazards and risks related to sharps;
abide by site-specific written protocol for medical sharps and SEMS;
include sharps as part of the monthly workplace inspection;
investigate work refusals.
D.60
Employees will:
-
comply with the Occupational Health and Safety Act; the Health Care and Residential Facilities
Regulations and the Agency’s Health & Safety Policy and Procedures;
participate in training and educational programs related to sharps, as determined by the
Employer;
exercise safe work practices at all times with regard to the use, storage, and disposal of all
types of sharps;
immediately report to their Supervisor, using the Workplace Hazard and Suggestion Report all
concerns related to unsafe work practices related to sharps;
maintain current First Aid certification;
ensure they are aware of instructions, precautions and proper techniques when utilizing all
equipment and protective devices related to sharps;
abide by site-specific written protocol for medical sharps and SEMS;
immediately report to their Supervisor any use of non-safety engineered medical sharps which
have not been previously approved for use by the Employer;
immediately report to their Supervisor or designate, the absence of or defect in any equipment
or protective device of which the worker is aware and which may endanger themselves or
others using a Workplace Hazard and Suggestion Report;
Procedures/Precautions for Medical Sharps and SEMS:
Each work location where medical sharps and SEMS are used or otherwise present shall develop
site-specific procedures outlining the use and disposal of the products as appropriate and in keeping
with the following general provisions:
-
-
All needles and sharps shall be handled and disposed of in a manner that will not endanger the
health and safety of users or others;
it is the responsibility of the Employee to ensure appropriate handling and safe disposal of
medical sharps and SEMS;
needle-less products and products with inherent safety features shall be used when such
alternatives are available;
needles will not be recapped, bent or removed or otherwise manipulated by hand;
discard needles and syringes immediately after use, to the appropriate sharps container;
never discard sharps into bags of biological waste or regular trash;
uncapped needles or other medical sharps must not be left unattended or covered with a
towel, blanket, etc.;
all used needles; syringes; blood lancets, etc. are to be placed/dropped directly into a labeled
designated ‘”Sharps” container; this container must be labeled “bio-hazardous materials” and
the container must be large enough to hold several used sharps;
the sharps disposal container is checked regularly, to ensure it is not filled beyond capacity and
a replace container is readily available;
full sharps containers are disposed of at the designated pharmacy;
all needles and medical sharps shall be disposed of properly in appropriate sharps containers
by the person who used the device;
all sharps injuries must be immediately reported to the Supervisor or designate. Medical
attention will be sought as appropriate for such injuries.
D.61
Procedure for Sharps/Needlestick injury or Body Fluid Splash:
immediately squeeze the injured area to promote bleeding, if it is a medical or SEMS injury;
treat the wound using First Aid measures and then seek medical attention, take WSIB forms
with you when you seek medical attention;
if a body fluid splash, flush thoroughly with soap and water;
report the incident immediately to your Supervisor or designate;
Complete the Employee Incident Report; ensure completion of WSIB forms;
Contact the Administrative Coordinator, Human Resources/Finance;
Complete a Communique if person supported sustains a needle stick.
Procedure for injuries from Sharp Objects:
Depending on the nature of the injury, various factor are to be considered when an employee,
volunteer or person supported is requiring treatment. Is injury a cut, skin punctured or sharp object
embedded in the skin, etc. A minor cut may only require first aid, where if a larger object has
punctured the skin and stitches are required, immediately go to the nearest Emergency Department;
other circumstances may require contacting 911 immediately. Below are examples/considerations:
-
if the skin was punctured or cut;
if an object is protruding from the skin;
the size and type of sharp object;
the location of the injury on your body;
the force in which the injury was inflicted;
It is the responsibility of all employees and volunteers to immediately report all potential risk factors
for hazards/incidents to their immediate Supervisor or designate using the Employee Incident Form
and/or the Workplace Hazard & Suggestion Report. The Supervisor will investigate
risks/hazards/incidents as soon as possible and take appropriate steps to address any continuing risk
to the health, safety and well being of all employees, volunteers and people supported. Should a
hazard result in a critical injury or fatality, Supervisors, employees and Location Health and Safety
Representatives will follow the Agency’s Critical Injury Policy (#D-006) .
Evaluation:
Community Living-Central Huron is committed to looking at leading indicators of injuries from sharps,
through surveys to employees and volunteers, and providing continuing education and awareness as
necessary. Supervisors will regularly audit practices of employees, volunteers and people supported
to minimize the risk of injury from sharps. The Committee of Location Health and Safety
Representatives will review statistics and incidents of illness or injury due to handling of sharps.
D.62
Related Policies:
Duty of Care Policy (No. B-010)
Critical Injury (No. D-006)
Annual Workplace Maintenance Policy (D-009)
Location Health and Safety Representative Policy (D-016)
Community Living-Central Huron Medication Policy and Procedures Manual
D.63
Section: Health & Safety
Subject: Manual Handling Policy
Total Pages:
5
Approval Date:
June 23, 2015
Revision Date(s) December 16, 2015.
MANUAL HANDLING POLICY
Policy:
Community Living-Central Huron believes the safety of its employees and volunteers is of paramount
importance. Employees and volunteers must be aware of and adhere to safe, manual handling
procedures, outlined herein. Failure to abide by said Policy and Procedures may result in disciplinary
action, up to and including termination from employment.
Definition:
Manual Handling - a wide variety of activities including lifting, lowering, pushing, pulling and carrying.
Purpose:
Manual handling causes over one third of all workplace injuries, such as pain and injuries to the back,
arms, legs and joints. If the tasks associated with manual handling are not carried out appropriately,
there is a risk of injury. The Manual Handling Policy is to provide further awareness and education to
employees and volunteers with respect to procedures, protocols and guidelines associated with
manual handling.
Guidelines:
Refer to pre-established procedures, protocols for manual handling tasks;
Access qualified professionals (ie. Occupational Therapists for training and education);
Refer to Hazard/Risk Policy and Procedures, including Risk Registry;
Assess the manual handling task prior to engaging if there is not a pre-established procedure to
determine if the task can be performed in a safe manner;
Considerations for manual handling are: weight, size and shape of task; individual capability;
equipment aids available; prior experience performing task; environmental conditions; urgency
of task to be performed;
Ensure there is a safe and clear pathway to perform manual handling task;
Push versus pull;
Decrease the weight when possible;
Obtain the assistance from another person when possible;
Reduce re-handling;
Improve/enhance ergonomics;
Eliminate risky postures (bending, twisting, extreme reaches);
Reduce carrying distances;
Avoid lifting from floor level or above shoulder height; and
perform only manual handing tasks that can be easily and safely managed.
D.64
Responsibility:
Employer:
The Employer will:
-
abide by the Occupational Health and Safety Act and all other relevant legislation;
take every precaution reasonable in the circumstances for the protection of an employee and
volunteer;
provide and maintain equipment, materials and protective devices as prescribed; equipment
may include but is not limited to: mechanical ceiling, outside or van lifts, slings, transfer belts,
wheelchairs, walkers, etc.
maintain an up-to-date Registry of identified workplace hazards/risks;
assess the risks of Manual Handling that may arise from the nature of the workplace, the type
of work or conditions of work and record in the Hazard/Risk Registry, location specific;
reassess the risks of Manual Handling as often as is necessary;
include measures and procedures for employees and volunteers to report incidents of injury
related to Manual Handling to their immediate Supervisor;
establish a procedure as to how the Employer will investigate and manage incidents and
injuries from Manual Handling;
ensure all materials requiring Manual Handling present in the workplace are identified in the
prescribed manner and are available in English and such other languages as required;
Procedures for the health and safety of employees and volunteers and revise based on current
legislation and practice;
review and revise measures and procedures more frequently than annual, if the employer and
Location Health and Safety Representatives determine necessary; and
in consultation with Location Health and Safety Representatives, develop, establish and provide
training and educational programs on Manual Handling, safety measures and procedures for
employees that are relevant to employees’ work.
Supervisor:
-
advise employees and volunteers of the existence of any potential or actual danger to the
health and safety of employees and volunteers, related to Manual Handling of which the
Supervisor is aware;
provide employees and volunteers, when so prescribed, written instructions as to the measures
and procedures to be taken for protection of the employee and volunteer related to Manual
Handling;
take every precaution reasonable in the circumstances for the protection of the employee and
volunteer related to Manual Handling;
ensure regular inspections (as per manufacturer’s instructions) are completed and documented
for all mechanical lifts or assistive device products/systems;
ensure employees and volunteers work in a safe manner and with the protective devices and
equipment, measures and procedures required by the Occupational Health and Safety Act; the
Health Care and Residential Facilities Regulation and the Agency’s Health & Safety Policies
and Procedures;
D.65
-
instruct and train or arrange with qualified professionals to train/educate employees and
volunteers on how to wear or use any protective clothing, equipment or device prior to such use
and at regular intervals thereafter;
educate employees and volunteers on the hazards and risks and provide written measures and
procedures, as required for Manual Handling;
investigate all reports of health and safety hazards/risks and incidents related to Manual
Handling;
respond in writing to any written or verbal reports and provide written recommendations of
hazards/risks/incidents related to Manual Handling.
-
-
-
-
participate in all training and educational programs, as determined by the Employer to be
beneficial for the area of Manual Handling;
encourage co-workers to work safely and to report any hazardous or unsafe conditions
immediately to their Supervisor or designate using Workplace Hazard and Suggestion Report;
obtain from the Employer information concerning the conducting or taking of tests of any
equipment, machine, device, article, thing, material or biological, chemical or physical agent in
or about a workplace related to Manual Handling, for the purpose of occupational health and
safety;
be consulted about, and be present at the beginning of, testing conducted in or about the
workplace if the Representative believes his or her presence is required to ensure that valid
testing procedures are used or to ensure that the test results are valid related to Manual
Handling;
related to Manual Handling, obtain information from the Employer respecting the identification
of potential or existing hazards of materials, processes or equipment, and health and safety
experience and work practice(s) and standards in similar or other industries of which the
Employer has knowledge;
conduct and document monthly inspections of their work location and submit such to their
immediate Supervisor within the designated time frame;
identify and report situations immediately, that may be a source of danger or hazard to
employees and volunteers and make recommendations to their Supervisor by completing a
Workplace Hazard & Suggestion Report;
review location Workplace Hazard and Suggestion Reports and make written
recommendations;
review Employee Incident Reports and make written recommendations and submit to
Supervisor or designate in the time frame required;
investigate, when notified by the employer of a critical injury/fatality and provide a report in
writing to the Ministry of Labour, within forty-eight (48) hours as prescribed.
D.66
Employees:
The Employees will:
-
arrange for regular inspections (as per manufacturer’s instructions) are completed and
documented for all mechanical lift or assistive device product/system;
document and complete daily inspections of all equipment and devices used within the work
location;
report to their Supervisor or designate, immediately, the absence of or defect in any equipment
or protective device of which the worker is aware and which may endanger himself, herself or
another employee or volunteer using a Workplace Hazard & Suggestion Report;
report to their Supervisor or designate, immediately, anything that may be a hazard or risk using
a Workplace Hazard & Suggestion Report;
abide by established protocols/safe work practices/safe operating procedures, related to
Manual Handling; qualified professionals will provide training as appropriate;
take part, when requested, in a workplace inspection to advise of any hazards or risks related to
Manual Handling;
seek clarification from the relevant Supervisor or designate on manual handling related tasks
beneficial for Manual Handling.
It is the responsibility of all employees and volunteers to immediately report all potential risk factors for
hazards/incidents related to Manual Handling to their immediate Supervisor or designate using the
Employee Incident Form and/or the Workplace Hazard & Suggestion Report. The Supervisor will
investigate risks/hazards/incidents as soon as possible and take appropriate steps to address any
continuing risk to the health, safety and well being of all employees and volunteers. Should a hazard
result in a critical injury or fatality, Supervisors, employees and Location Health and Safety
Evaluation:
hazards related to Manual Handling, through such methods as information gathering (Workplace
Inspections, Incident Investigations, Job Hazard Analysis, etc), surveys, data collection (Rate Group
Trends), and Staff meetings.
Supervisors will regularly audit employee and volunteer practices related to Manual Handling through
such means as: monthly, periodic inspections at the work locations; documenting written reports on
the designated form(s); providing written recommendations in response to any reports of hazards/risks
related to Manual Handling; reviewing monthly work location checklists completed by Location Health
and Safety Representatives; and, completing annual workplace hazard/risk assessments. The
Location Health and Safety Representative (LHSR) will provide written recommendations to the
Employer when identifying issues related to Manual Handling and any risks to employees or
volunteers. The Agency will maintain a Hazard/Risk Registry, which will be updated annually in
consultation with the Location Health and Safety Representative, as necessary, based on the written
information/documentation received by Supervisors, employees, volunteers and the Location Health
and Safety Representatives.
D.67
Health and Safety Policy Statement D-001
Emergency Policy D-003
Workplace Inspection Policy (D-021)
Community Living-Central Huron Occupational Health and Safety Document.
D.68
Section:
Subject:
Health & Safety
Slips, Trips and Falls
Total Pages: 6
Revised Date: Nov. 18, 2015.
SLIPS, TRIPS and FALLS PREVENTION POLICY
Policy:
Community Living-Central Huron is committed to protecting the health, safety and well-being of its
employees, volunteers, people supported and visitors. Slips, trips and falls are among the leading
causes of injuries; therefore, it is important the Agency establish and promote practices that prevent
such injuries and provide a safe and healthy workplace. In the interest of working safely, all
employees, volunteers, people supported and visitors are required to follow all health and safety
procedures that are related to slips, trips and falls. Non-compliance with this Policy and Procedures is
subject to discipline, up to and including dismissal from Community Living-Central Huron’s
employment and/or services.
Purpose:
Eliminating and preventing all injuries from slips, trips and falls are the key goals of this Policy.
Additional goals include: reducing injuries from slips, trips and falls; increased knowledge of hazard
awareness in the workplace for the prevention of slips, trips and falls incidents and injuries and to
outline safe work practices.
Common Hazards:
The following are common hazards in the workplace and can be the cause of a slip, trip or fall:
-
slippery surfaces (oily or greasy);
seasonal slip, trip and fall hazards (snow, ice, frost, hail, sleet and rain);
wet leaves or pine needles;
missing or uneven floor tiles, boards or bricks;
spills of wet or dry substances (areas in bathroom or laundry, spilt powder laundry detergent);
changes/cracked walkway and/or floor levels and slopes;
transition of one flooring surface to another (ie. from carpet to tile floor; rough to smooth);
unsecured mats;
polished or freshly waxed floors;
open desk or file cabinet drawers;
lack of awareness of pets moving about;
unsafe use of ladders, damaged ladder steps;
poor/insufficient lighting;
debris, cables or cords in walkways;
damaged or irregular steps, no handrails;
smoke, steam or dust obscuring view;
lack of guardrails/handrails on balconies, steps;
unsuitable footwear for the job being performed/damaged footwear, shoes that are wet, muddy,
greasy or oily soles;
clutter - books, laundry, footwear, etc.
preoccupation of workers on mobile phones - talking, texting, and not paying attention to what
is in front of them.
inappropriate footwear
D.69
Definitions:
Flooring/Walking Surfaces:
Flooring/walking surfaces include floors; stairs; ramps; entrances; outside walkways and driveways.
Footwear:
To ensure that safe standards are maintained, all employees must wear safe and appropriate
footwear at all times which suits the environment and the conditions of the job. Appropriate footwear is
defined as: a proper-fitted shoe with a slip-resistant sole, low or medium heel that provides good
stability, support and foot protection. The shoe should be closed at the heel so that the foot will not
slide around. Loose fitting footwear is not appropriate at any time. In some work locations, there may
be specific recommendations where additional protection is required (ie. safety shoes). In order to
determine safe and appropriate footwear, each employee must have knowledge of the risks
associated with the job responsibilities and select footwear based on an understanding of the hazards
within the individual job tasks. Such factors include the conditions present n the work location and
weather conditions. Each employee is expected to use their professional judgement in choosing
footwear in keeping with the environment and the activities that are scheduled and/or could potentially
occur for that day including, but not limited to: pushing someone in a wheelchair; demonstrating how
to use a lawnmower; carrying groceries; walking or providing supports in wet environments or areas
with water, ice, sand, gravel or snow covered.
Guidelines to Create a Safer Working Environment:
Below is a list of guidelines that assist in creating a safer working environment to avoid injuries from
slips, trips and falls:
1.
Create Good Housekeeping Practices:
Adopt a “clean as you go” practice in daily routine by cleaning up spills and other slipping or
tripping hazards. Good housekeeping is critical; safety and housekeeping go hand in hand.
Poor housekeeping habits may result in higher incidences of injury; make proper housekeeping
part of the routine and daily performance. Good housekeeping includes: clean up spills
immediately; mark spills and wet area; mop and sweep debris from floors; remove obstacles
from walkways/keep walkways clutter free; cover cables that cross walkways; keep working
areas and walkways well lit; secure mats, rugs and carpets that do not lay flat; always close file
cabinets and storage drawers.
2.
Reduce Wet or Slippery Surfaces:
The most frequent surfaces where slips, trips and falls occur are: parking lots; sidewalks; food
preparation areas; shower stalls and floors in general. Traction on outdoor surfaces can
change considerably as weather conditions change and this can then affect indoor surfaces as
moisture is tracked in. Therefore to reduce slips, trips and falls: keep parking lots, sidewalks
and ramps in good repair; remove ice and snow, if this is not possible, refrain from using the
area until ice and snow are removed; use adhesive stripping material or anti-skid paint when
possible. For indoor surfaces use moisture-absorbent mats with backing so they will not slide
on the floor; display “Wet Floor” signs as needed; clean up spills immediately.
3.
Avoid Creating Obstacles in Aisles and Walkways:
Injuries can result from obstacles, clutter, materials and equipment in aisles, corridors,
entrances and stairwells; proper housekeeping is the most effective control measure in
avoiding slips, trips and falls. Keep all work areas; passageways; storerooms and equipment
rooms clean and orderly. Avoid stringing cords, cables or hoses across hallways. Avoid
leaving boxes, files or brief cases in the aisles; encourage safe work practices such as closing
file cabinets and drawers after use. Also conduct periodic inspections for slip, trip and fall
hazards.
D.70
4.
Create and Maintain Proper Lighting:
Poor lighting in a workplace is associated with an increase in accidents, therefore use proper
illumination in walkways; staircases; ramps; hallways; basements; patios; garages, etc. Keep
work areas well lit and clean. Upon entering a dark room, always turn on the light first and
keep areas around light switches clear and accessible. Repair light fixtures, switches and
cords immediately if they malfunction.
5.
Wear Proper Shoes:
The shoes we wear can play a big part in preventing slips and falls. The slickness of the soles
and the type of heals worn need to be evaluated to avoid slips, trips and falls. Shoelaces need
to be tied correctly. Employees are expected to wear footwear appropriate for the duties they
are performing.
6.
Individual Behaviour:
This condition can be the most difficult to control; it is human nature to let your guard down for
two or three seconds and be distracted by music, talking, pets or doing multiple activities.
Being in a hurry will result in walking too fast or running which increases the chances of a slip,
trip or a fall. Taking shortcuts, not watching where you’re going, using a cell phone, carrying
materials which obstruct your vision, wearing sunglasses in low light are common elements in
many on-the-job injuries. Each individual is responsible to stay alert, pay attention and plan
ahead.
Responsibilities:
Preventing slips, trips and falls is the responsibility of everyone in the workplace. Employers are
legally required to take every reasonable precaution to protect employees in the workplace, as well as
inform employees about any potential job hazard. Supervisors are required to inform all employees
about hazards on the job. Employees and volunteers are required to follow the policies and
procedures set out by the Employer.
Employer:
The Employer will:
-
volunteer to avoid injuries from slips, trips and falls;
provide and maintain equipment, materials and protective devices as prescribed;
assess the risks in workplace for slips, trips and falls, the type of work or conditions of work and
record in the Hazard/Risk Registry;
provide orientation and training to all employees and volunteers on the prevention of slips, trips
and falls;
include measures and procedures for employees and volunteers to report incidents of slips,
trips and falls to their immediate Supervisor;
establish a procedure as to how the employer will investigate and manage incidents and
complaints of workplace hazards related to slips, trips and falls;
ensure all hazards present in the workplace are identified in the prescribed manner and are
available in English and such other languages as required;
review and revise measures and procedures more often than annually, if the employer and the
D.71
-
provide training and educational programs related to prevention of slips, trips and falls for
employees that are relevant to the employees’ work; and
post in the workplace a copy of the Occupational Health and Safety Act and any other materials
that will assist employees and volunteers to identify hazards of slips, trips and falls and their
responsibilities and duties related to such.
Supervisor:
-
-
advise employees and volunteers with information on the existence of any potential or actual
danger and/or hazards related to slips, trips and falls and the health and safety of employees
and volunteers of which the Supervisor is aware;
provide employees and volunteers written instructions as to the measures and procedures to
be taken for protection of the employee and volunteer;
take every precaution reasonable in the circumstances for the protection of the employee and
volunteer against injuries from slips, trips and falls;
ensure employees and volunteers work in a safe manner and with the protective devices,
measures and procedures required by the Occupational Health and Safety Act; the Health Care
and Residential Facilities Regulation and the Agency’s Health & Safety Policies and
Procedures;
instruct and train employees and volunteers on the guidelines for a safe working environment
and the prevention of injuries from slips, trips and falls;
educate employees and volunteers on the hazards and risks and provide written measures and
procedures, as required;
investigate all reports of health and safety hazards/risks related to slips, trips and falls;
respond in writing to any written or verbal reports and provide written recommendations of
hazards/risks/incidents related to slips, trips and falls.
-
comply with the requirements of the work location and procedures regarding slips, trips and
falls;
beneficial for the area of hazards and risks related to slips, trips and falls;
encourage co-workers to work safely and to report any hazardous or unsafe conditions
immediately to their Supervisor or designate using a Workplace Hazard & Suggestion Report;
or about a workplace for the purpose of occupational health and safety;
be consulted about and be present at the beginning of testing conducted in or about the
testing procedures are used or to ensure that the test results are valid;
obtain information from the Employer to identify potential or existing hazards related to slips,
trips and falls;
D.72
-
identify and report situations immediately that may be a source of danger or hazard to
review Incident Accident Reports and make written recommendations and submit to Supervisor
or designate in the time frame required;
investigate when notified by the Employer of a critical injury/fatality and provide a report in
writing to the Ministry of Labour, within forty-eight (48) hours as prescribed.
Employees:
The Employees will:
-
comply with the requirements of the work location and procedures regarding slips, trips and
falls;
report to their Supervisor or designate, immediately, using a Workplace Hazard & Suggestion
Report the absence of or defect in any equipment or protective device of which the worker is
aware and which may endanger himself, herself or another employee or volunteer;
Report anything that may be a hazard or risk;
report to their Supervisor any contravention of the Occupational Health and Safety Act or
Health Care and Residential Facilities Regulation or the existence of any hazard of which the
employee or volunteer is aware;
abide by safe work practices/safe operating procedures, to include but not limited to slips, trips
and falls,
take part, when requested, in a workplace inspection to advise of any hazards or risks related
to slips, trips and falls; and
beneficial for the area of hazards and risks related to slips, trips and falls and seek any
necessary clarification.
It is the responsibility of all employees and volunteers to immediately report all potential risk factors for
hazards/incidents to their immediate Supervisor or designate using the Employee Incident Form
and/or the Workplace Hazard & Suggestion Report. The Supervisor will investigate risks/hazards
/incidents as soon as possible and take appropriate steps to address any continuing risk to the
health, safety and well being of all employees and volunteers. Should a hazard result in a critical injury
or fatality, Supervisors, employees and Location Health and Safety Representatives will follow the
Agency’s Critical Injury Policy (#D-006) .
Evaluation:
hazards of slips, trips and falls through such methods as information gathering (Workplace
Inspections, Incident Investigations, Job Hazard Analysis, etc., surveys, data collection and Staff
meetings.)
D.73
Supervisors will regularly audit employee and volunteer practices related to hazards and risks of slips,
trips and falls through such means as: monthly, periodic inspections at the work locations;
documenting unsafe work practices; providing written recommendations in response to any reports of
hazards/risks; reviewing monthly work location checklists completed by Location Health and Safety
Representatives; and, completing annual workplace hazard/risk assessments. The Location Health
and Safety Representatives will provide written recommendations to the Employer when identifying
issues related to slips, trips and falls. The Agency will maintain a Hazard/Risk Registry, which will be
updated annually in consultation with the Location Health and Safety Representatives, as necessary,
based on the written information/documentation received by Supervisors, employees, volunteers and
the Location Health and Safety Representatives.
•
Usage of Agency Equipment/Electronic Communication Technologies (B-006)
•
Volunteer (B-007)
•
Duty of Care (B-010)
•
•
Pet Ownership, Visiting Pets and Service Animals (C-010)
•
Orientation of People Supported (C-011)
•
Inventory, Personal Belongings of Persons Supported (C-013)
•
Bathing and Showering Supervision of Persons Supported Policy (C-014)
•
•
•
Critical Injury D-006
•
Annual Workplace Maintenance Policy D-009
•
Musculoskeletal Disorders Awareness Policy D-010
•
First Aid Policy and Procedures D-011
•
Working Alone Policy D-012
•
•
•
•
•
Early and Safe Return to Work E-016
•
•
•
•
Early and Safe Return to Work (-016)
•
Community Living-Central Huron Occupational Health and Safety Document
D.74
Section:
Subject:
Health & Safety
W orkplace Inspection Policy
Total Pages:
5
WORKPLACE INSPECTION POLICY
Policy:
Workplace inspections and audits are an important function in attaining a workplace that is free from
occupational injuries and illness at Community Living- Central Huron. Regular inspections and audits
will take place to monitor the effectiveness of the health and safety of people supported, employees
and volunteers. Non-compliance with this Policy is subject to discipline, up to and including dismissal.
Definitions:
Audit:
A process to examine compliance with established policies and procedures for workplace inspections.
Hazard:
Any real or potential condition, practice, behaviour, act or thing that can cause injury, illness, adverse
health effects, death or damage to or loss of equipment, property or the environment.
Occupational Injury:
Is an event that results in physical harm to an employee.
Occupational Illness:
Is a condition that results from exposure in a workplace to a hazard to the extent that normal
physiological or psychological mechanism are affected and the health of the worker is impaired.
Purpose:
This policy is intended to ensure that Community Living-Central Huron is proactive in identifying and
evaluating the safety of a workplace to reduce and eliminate hazards for the safety and protection of
people supported, employees, volunteers and the general public. The Agency will ensure that
workplace inspections are conducted to identify, record and correct any deficiencies and enforce
appropriate corrective action consistent with the Occupational Health & Safety Act.
Roles & Responsibilities:
Employer:
The Employer will:
ensure that regular monthly workplace inspections occur and are documented for each work
site, inclusive of Agency vehicles;
provide orientation and training to all employees and volunteers regarding the requirements of
effective workplace inspections and the Internal Responsibility System whereby the Employer,
Supervisor, Location Health & Safety Representatives and employees are all responsible for
workplace safety;
include measures and procedures for employees and volunteers to report unsafe acts and
conditions, as well as corrective action;
establish procedures as to how the employer will conduct workplace inspections;
D.75
-
be familiar with the relevant sections of the Ontario Health & Safety Act, Sections 25 and 26;
Duties of Employers;
review and revise measures and procedures more often than annually, if the employer and the
provide effective training and educational programs related to workplace inspections;
post in each workplace a copy of the Occupational Health and Safety Act and any other
materials that will assist employees and volunteers to identify their responsibilities and duties
related to workplace inspections.
Supervisor:
-
Procedures for the health and safety of employees and volunteers
be familiar with the relevant sections of the Occupational Health & Safety Act, Section 27,
Duties of Supervisor;
comply with the requirements of the Internal Responsibility System and be proactive with the
completion of workplace inspections;
ensure Location Health & Safety Representatives (LHSR) have training, instruction and be
familiar with proper procedures to complete effective monthly workplace inspections; such
training will take place prior to completing any inspections;
provide site-specific training, inclusive of Agency vehicles to employees and volunteers on
workplace safety to assist in the completion of monthly workplace inspections;
conduct regular workplace inspection audits inclusive of Agency vehicles, using the Agency’s
designated form;
educate and instruct employees and volunteers on a safe workplace and prevention of
occupational injury and/or illness;
investigate and resolve all reports of an unsafe workplace, ensuring controls are in place;
respond in writing to any written or verbal reports and provide written recommendations to
improve workplace safety;
seek regular input from LHSR’s and all employees to update the ‘RACE Tool - Hazard/Risk
Registry.
-
comply with the requirements of the Internal Responsibility System and be proactive with the
completion of workplace inspections;
beneficial for workplace inspections;
obtain information from the Employer to identify potential or existing occupational injury or
illness;
provide input to update the ‘RACE Tool - Hazard/Risk Registry;
encourage co-workers to work safely and to report all concerns related to hazards and/ or
occupational injury or illness immediately to their Supervisor or designate using a Workplace
Hazard & Suggestion Report;
D.76
-
or about a workplace for the purpose of occupational health and safety;
be consulted about and be present at the beginning of testing conducted in or about the
testing procedures are used or to ensure that the test results are valid;
Procedures for the health and safety of employees and volunteers;
be familiar with the Occupational Health & Safety Act;
conduct and document monthly inspections of their work location inclusive of Agency vehicles
and submit such to their immediate Supervisor within the designated time frame;
identify and report situations immediately that may be a source of hazard, occupational illness
or injury to employees and volunteers and make recommendations to their Supervisor by
completing a Workplace Hazard & Suggestion Report;
review Incident Accident Reports and make written recommendations and submit to
Employees:
The Employees will:
-
comply with the requirements of the Internal Responsibility System (IRS) by being proactive
with workplace inspections;
be familiar with the relevant sections of the Occupational Health & Safety Act, Section 28,
Duties of Workers;
beneficial for workplace inspections, inclusive of Agency vehicles;
Report any concerns related to workplace inspections;
provide input to update the ‘RACE Tool - Hazard/Risk Registry;
abide daily by safe work practices and safe operating procedures;
take part, when requested, in a workplace inspections to advise of any hazards or risks or
potential of such;
advise the relevant Location Health & Safety Representative of all workplace inspection
concerns not addressed by the Supervisor.
The Employer is responsible for ensuring regular inspections of the workplaces, inclusive of Agency
vehicles are completed. Community Living-Central Huron will provide training and information to
supervisors, employees and volunteers regarding the requirements of effective workplace
inspections. Supervisors are responsible for ensuring Location Health & Safety Representatives
(LHSR) complete workplace inspections and are trained to complete such. Training will be
documented and to be completed prior to completing any inspections. Location Health & Safety
Representatives will complete assigned workplace inspections, review inspection reports as a
Committee and assist the Employer and Supervisor in developing and implementing training and
strategies for a hazard free workplace. Employees and volunteers are required to follow the policies
and procedures set out by the Employer.
D.77
Evaluation:
Community Living-Central Huron is committed to ensuring safe workplaces and as such will provide
orientation, training and any tools necessary to conduct effective workplace inspections. The RACE
Tool - Hazard/Risk Registry will be reviewed regularly at staff meetings, to consider leading indicators
of workplace risks and hazards through such methods as information gathering (Workplace
Inspections, Vehicle Checklist, Incident Investigations, Job Hazard Analysis, etc., surveys, data
collection and Staff meetings.)
Supervisors will regularly audit employee and volunteer practices related to hazards and risks of slips,
trips and falls through such means as: monthly, periodic inspections at the work locations;
documenting unsafe work practices; providing written recommendations in response to any reports of
hazards/risks; reviewing monthly work location checklists completed by Location Health and Safety
Representatives; and, completing annual workplace hazard/risk assessments. The Location Health
and Safety Representatives will provide written recommendations to the Employer when identifying
issues concerning workplace inspections. The Agency will maintain a Hazard/Risk Registry, which
will be updated annually in consultation with the Location Health and Safety Representatives, as
necessary, based on the written information/documentation received by Supervisors, employees,
volunteers and the Location Health and Safety Representatives.
•
Usage of Agency Equipment/Electronic Communication Technologies (B-006)
•
Volunteer (B-007)
•
Duty of Care (B-010)
•
Code of Conduct (B-011)
•
•
Person Supported Complaint/Feedback (C-003)
•
•
•
Pet Ownership, Visiting Pets and Service Animals (C-010)
•
Orientation of People Supported (C-011)
•
Medical Care for Persons Supported Policy (C-012)
•
Inventory, Personal Belongings of Persons Supported (C-013)
•
Bathing and Showering Supervision of Persons Supported Policy (C-014)
•
•
Medication Policy Statement (D-002)
•
•
Smoking (D-004)
•
•
Critical Injury D-006
•
Bullying, Harassment and Workplace Violence Policy and Procedures (D007)
•
Pandemic Policy (D-008)
•
Musculoskeletal Disorders Awareness Policy D-010
•
First Aid Policy and Procedures D-011
•
Working Alone Policy D-012
•
Infection Control Policy and Procedures (D-013)
•
•
•
•
•
Sharps Policy and Procedures (D-018)
•
•
Slips, Trips and Fall Prevention Policy (D-020)
•
D.78
•
•
•
•
•
•
•
•
Vehicle Use (E-009)
Disciplinary Policy (D-012)
Early and Safe Return to Work (-016)
•
Community Living-Central Huron’s Occupational Health and Safety Document
•
Medication Procedures Document
D.79
Section:
Subject:
Health & Safety
Work Refusal Policy
Total Pages:
7
Revision Date(s):
WORK REFUSAL POLICY
Policy:
Community Living-Central Huron believes the safety of its employees and volunteers is of paramount
importance and as such will meet the requirements of the Occupational Health & Safety Act (OHSA).
The Agency emphasizes the use of the Internal Responsibility System (IRS), in which all parties have
the responsibility to control unsafe working conditions by identification and assessment of hazards;
hazard inspections, investigations and implementation of corrective actions. It is the Policy of
Community Living-Central Huron that all work refusals that are permitted under the OHSA be
conducted in compliance with the OHSA and the procedures as outlined in this Policy. Failure to
abide by said Policy and Procedure may result in disciplinary action, up to and including termination
from employment or volunteerism.
Definitions:
The Right to Refuse Work:
Employees and volunteers have the right to refuse work that they believe is dangerous to either their
own health and safety or that of another person.
Conditions in which an employee can Refuse Work:
An employee may refuse to work, if they believe that:
any equipment, machine, device or thing the employee is to use or operate is likely to
endanger themself or another employee;
the physical condition of the workplace or the part thereof in which they work or is to
work is likely to endanger them;
workplace violence is likely to endanger them; or
any equipment, machine, device or thing they use or operate or the physical condition of
the workplace or the part thereof in which they work or is to work is in contravention of
the OHSA or the regulations and such contravention is likely to endanger themself or
another employee.
Limitations on the Right to Stop Work:
Under Section 43 of the OHSA, there are several groups of employees in municipal and healthcare
sectors which have a limited right to refusing work, specifically for Community Living-Central Huron,
Section 43 (d) (ii) - “a person employed in the operation of a residential group home or other facility
for persons with behavioural or emotional problems or a physical, mental or developmental disability.”
Circumstance in which workers have limited rights are not permitted to refuse work are as follows:
(a)
when a circumstance described is inherent in the worker’s work or is a normal condition
of the worker’s employment; or
(b)
when the worker’s refusal to work would directly endanger the life, health or safety of
another person.
D.80
Purpose:
The goal of this Policy and Procedure is to ensure the prompt, effective and correct handling of work
refusals as per OHSA, Part V, Section 43 and to encourage prompt resolution of such situations.
Responsibility:
Employer:
The Employer will:
-
-
abide by the OHSA and all other relevant legislation with respect to work refusals;
comply with the OHSA, and ensure the Agency’s Work Refusal Policy and Procedure is
followed and resolved;
enforce the Work Refusal Policy and Procedure; include measures and procedures for
employees and volunteers to report incidents of work refusals to their immediate Supervisor
and establish procedures as to how the Employer will investigate and manage incidents and
injuries from work refusals;
volunteer, by assessing the risks that may arise from work refusals (ie. the workplace, the type
of work or conditions of work) and resolve such;
review and approve the Policy and Procedure in consultation with Location Health & Safety
Representatives (LHSR) annually to implement improvements as required;
in consultation with LHSR, develop, establish and provide training and educational programs
on work refusals, safety measures and procedures for employees that are relevant to
employees’ work.
Supervisor:
-
attend immediately to investigate a work refusal, whether written or verbal; record the time,
date and details of the work refusal using the Agency’s Refusal to Work Report;
be open and responsive to the employee’s or volunteer’s concern and assist them to identify
the specific problem, recognizing it is in the best interest of all workplace parties to resolve the
situation internally without having to involve the Ministry of Labour;
promote the Internal Responsibility System with all employees and volunteers;
clarify the work refusal and ensure the employee and/or volunteer is refusing unsafe work and
the document the details of the refusal;
investigate the work refusal in the presence of the LHSR, or another employee, if the LHSR is
not available;
ensure corrective action is taken as necessary and procedures implemented, follow-up;
should it be necessary to re-assign an employee to other duties, ensure the new assignment is
consistent with the work refusal requirements of the OHSA;
ensure that the employee/volunteer is not disciplined for their report of a work refusal;
complete necessary documentation related to the work refusal, corrective action,
recommendations, etc.; maintain records of all work refusals;
advise employees and volunteers of the existence of any potential or actual danger to the
health and safety of employees and volunteers, related to work refusals of which the
Supervisor is aware;
D.81
-
-
-
provide employees and volunteers, when so prescribed, written instructions as to the
measures and procedures to be taken for protection of employees and volunteers related to
work refusals;
take every precaution reasonable in the circumstances for the protection of employees and
volunteers related to work refusals such as: ensure regular inspections of equipment (as per
manufacturer’s instructions); ensure employees and volunteers work in a safe manner by
educating them on the hazards and risks; provide protective devices and equipment and
instructions on it’s proper use; conduct annual Workplace Hazard/Risk Assessments; complete
monthly workplace inspections, etc.;
comply with Ministry of Labour orders ensuring they are properly posted and other
requirements, measures and procedures required by the Occupational Health and Safety Act;
the Health Care and Residential Facilities Regulation and the Agency’s Health & Safety
Policies and Procedures;
respond in writing to any written or verbal reports of work refusals and include written
recommendations to resolve all concerns.
The Location Health and Safety Representatives (LHSR) will:
-
-
when possible, attend immediately to assist with the investigation of a work refusal, whether
written or verbal; use the Agency’s Refusal to Work Report;
be open and responsive to the employer’s assessment of the work refusal, recognizing it is in
the best interest of all workplace parties to resolve the situation internally without having to
involve the Ministry of Labour;
promote the Internal Responsibility System with all employees and volunteers and participate
in training and educational programs, as determined by the Employer to be beneficial for the
area of work refusals;
encourage co-workers to work safely and to report work refusals using the Agency’s Refusal to
Work Report;
for the purposes of work refusal, obtain from the Employer information concerning the
conducting or taking of tests of any equipment, machine, device, article, thing, material or
biological, chemical or physical agent in or about a workplace;
when possible attend the Ministry of Labour Inspector’s investigation of a work refusal; assist
to report on the situation to the employer and the Committee of LHSR;
related to work refusals obtain information from the Employer respecting the identification of
potential or existing hazards of materials, processes or equipment, and health and safety
experience and work practice(s) and standards in similar or other industries of which the
Employer has knowledge;
identify and report situations immediately that may be a source of danger or hazard to
review location Workplace Hazard & Suggestion Reports and make written recommendations;
review Employee Incident Reports and make written recommendations and submit to
ensure any MOL reports and orders are appropriately posted and in compliance with the
OHSA.
D.82
Employees:
The Employees will:
-
-
report to their Supervisor or designate, immediately, the absence of or defect in any equipment
or protective device of which the worker is aware and which may endanger himself, herself or
another employee or volunteer using a Workplace Hazard & Suggestion Report;
when they believe their health and safety is in danger, and if they chose to refuse work, they
must notify their Supervisor or designate immediately and state clearly the reason(s) for the
work refusal. Employees will complete the Refusal to Work Report immediately before or after
notifying their Supervisor or designate of the work refusal;
abide by the Agency’s Work Refusal Policy and Procedure;
observe safe work practices/safe operating procedures at all times;
comply with all Ministry of Labour orders;
take part, when requested, in workplace inspections to advise of any hazards or risks related
to work refusals;
seek clarification from the relevant Supervisor or designate on concerns with work refusals;
beneficial to avoid work refusals.
Standard Procedures:
If the situation does arise that a work refusal happens, all parties shall follow the following steps:
Right to Refuse Work:
Under the Occupational Health and Safety Act (OHSA), an employee may refuse to work where
he/she has reason to believe that:
-
A.
-
-
Any equipment, machine, device or thing he/she is to use or operate is likely to endanger
himself/herself or another employee;
The physical condition of the workplace is likely to endanger himself/herself or another
employee;
Any equipment he/she is to use, or the physical condition of the workplace, in which he/she
works is in contravention of the Occupational Health and Safety Act, and such contravention is
likely to endanger himself/herself or another employee.
First Stage Refusal:
Upon refusing to work, the employee shall promptly report the circumstances of his/her refusal
to his/her Supervisor.
The Supervisor must immediately investigate the report in the presence of the worker and a
worker representative (ie. Joint Health and Safety Committee worker member, Location Health
and Safety Representative, or a worker who because of knowledge, experience and training is
selected by a trade union that represents workers or if there is no union, is selected by the
workers to represent them).
If the worker representative contacted for a work refusal is from the Joint Health and Safety
Committee it is preferred it be a certified member.
The worker representative must be made available and must attend the investigation without
delay; and time spent by this representative is deemed to be work time, for which the person
shall be paid at his/her regular or premium rate, as may be proper.
D.83
-
Until the investigation is completed, the worker must remain in a safe place near as reasonably
possible to their workstation and be available to the employer or Supervisor for the purpose of
the investigation.
If action can be taken to resolve the complaint without need for further investigation, the
Supervisor will carry out the action and complete the “Work Refusal Form.”
During the investigation, the Supervisor must record as many details as possible regarding the
refusal, using the “Work Refusal Form.”
If the worker is satisfied with the corrective action, he can return to work and sign the “Work
Refusal Form.”
The Ministry of Labour is only called if the refusal progresses to the second stage.
B.
-
-
-
Second Stage Refusal:
If the employee is dissatisfied with the results of the investigation and has reasonable grounds
to believe that the circumstances are still such that the work continues to be dangerous, then
he/she may continue to refuse work.
Upon the continuance of the worker’s refusal to work, the worker or Supervisor or the
representative of the worker or employer shall immediately notify a Ministry of Labour
Inspector. The Management representative will conduct internal notifications as needed (ie.
employer, health and safety officer, etc.).
The Ministry of Labour Inspector will investigate the work refusal in consultation with the
employer or person representing the employer, the worker, and if there is such, the worker’s
representative.
After the investigation, the Ministry of Labour Inspector will decide whether the work being
refused is likely to endanger the employee or another person.
The Ministry of Labour Inspector’s decision will be given in writing, as soon as practicable, to
the employer, the worker and the worker’s representative.
Pending the investigation and decision of the Ministry of Labour Inspector, the worker must
remain, during the normal working hours, in a safe place that is near as reasonably possible to
their workstation and available to the Inspector for the purpose of the investigation. However,
this does not apply if the employer subject to the provisions of a collective agreement if any,
assigns the worker reasonable alternative work during the worker’s normal working hours; or
subject to OHSA Section 50, where an assignment of reasonable alternative work is not
practicable, gives other directions to the worker.
Pending the investigation, no other worker shall be assigned to the work that is being
investigated unless that worker has been advised of the other employee’s refusal and reasons
for it, in the presence of the worker representative.
The worker should sign a statement of being advised of the refusal.
Supervisors will not penalize any employee for exercising or seeking to exercise their rights
under the OHSA.
If the Ministry of Labour Inspector determines the work is unsafe, the Inspector will direct the
workplace parties (ie. order corrective actions, etc). The worker will not return to work until the
corrective actions are in place. Once compliance is achieved the worker will return to work.
If the Ministry of Labour Inspector does not consider that the work is likely to endanger, the
worker is expected to return to work. If however, no reasonable grounds exist for ongoing
refusal, the worker may be subject to disciplinary action by the Supervisor/Employer.
D.84
-
-
During the investigation the Supervisor must record all matters relating to the work refusal and
ensure these are maintained on file and provide copies to Management and the Health and
Safety Coordinator or designate and Location Health and Safety Representative or Joint
Health and Safety Committee.
When the corrective actions are achieved, the worker will return to work and sign the “Work
Refusal Form.”
It is the responsibility of all employees and volunteers to immediately report all potential risk factors
for hazards/incidents related to Manual Handling to their immediate Supervisor or designate using the
Employee Incident Form and/or the Workplace Hazard & Suggestion Report. The Supervisor will
investigate risks/hazards/incidents as soon as possible and take appropriate steps to address any
continuing risk to the health, safety and well being of all employees and volunteers. Should a hazard
result in a critical injury or fatality, Supervisors, employees and Location Health and Safety
Note:
In cases where there is limitation of a worker to refuse work, the worker must report the hazard or
unsafe circumstance to the Supervisor or designate. The Supervisor or designate will investigate the
complaint in a timely and prompt manner, as soon as safely possible and implement corrective
actions as necessary.
Evaluation:
hazards related to work refusals, through such methods as information gathering (Workplace
Inspections, Incident Investigations, Job Hazard Analysis, etc), surveys, data collection (Rate Group
Trends), and Staff meetings.
Supervisors will regularly audit employee and volunteer practices related to work refusals through
such means as, monthly, periodic inspections at the work locations; documenting written reports of
on the designated form(s); providing written recommendations in response to any reports of
hazards/risks related to work refusals; reviewing monthly work location checklists completed by
Location Health and Safety Representatives; and, completing annual workplace hazard/risk
assessments. The Location Health and Safety Representatives will provide written recommendations
to the Employer when identifying issues related to Manual Handling and any risks to employees or
volunteers. The Agency will maintain a Hazard/Risk Registry, which will be updated annually in
consultation with the Location Health and Safety Representatives, as necessary, based on the written
information/documentation received by Supervisors, employees, volunteers and the Location Health
and Safety Representatives.
CL-CH Occupational Health and Safety
Document
D.85
COMMUNITY LIVING-CENTRAL HURON
PROCEDURE FOR A WORK REFUSAL
First Stage
Employee believes work is unsafe
Employee reports refusal to his/her Supervisor or designate.
Employee may also wish to advise the LHSR.
Employee stays in a safe place.
Supervisor investigates in the presence of the employee and LHSR
Issue Resolved
Employee returns to work
Issue Not Resolved
Proceed to the Second Stage
Second Stage
The refusing worker may be offered other work
during the time of work refusal, investigation and
outcome.
W ith reasonable grounds to believe work is still
unsafe, employee continues to refuse and remains in
a safe place. Employee, LHSR or Supervisor calls
Ministry of Labour (MoL) at 1-877-202-0008
Refused work may be offered to another
employee, but Management must inform the
other employee that the offered work is the
subject of a work refusal. This must be done in
the presence of the LHSR; or an employee who
because of his/her knowledge, experience and
training is selected by the Union.
MoL Inspector investigates in presence of the employee, LHSR and Supervisor.
MoL Inspector gives decision in writing to employee, LHSR and Supervisor.
Post MoL Field Visit Reports and Orders. Changes are made if required or ordered.
Employee returns to work
D.86
SECTION E:
HUMAN RESOURCES / PERSONNEL
Section:
Subject:
E
General Policy
Policy Number: E-001
Total Pages:
1
Revision Date(s) May 15, 1991,
Sept. 19, 2001
GENERAL POLICY NO. 2
As a general policy, Community Living-Central Huron seeks to:
a)
employ the most competent available persons without regard to race, creed, sex, residence or
political affiliation;
b)
establish a clear understanding of the conditions under which each person is being employed and to
emphasize in a positive sense, the acceptable levels of performance/conduct. Standards will apply to
the entire Agency and additional standards may be established in specific work locations, depending
on the need of the individuals being supported and/or program goals; and
c)
provide working conditions and an atmosphere conducive to enabling each Staff member to
contribute to the fullest extent of his/her skill and competence; all employees will be treated with
respect and fairness.
Any subsequent change to an employee’s terms of employment shall be confirmed in writing and signed by
the employee. Each employee is responsible for reading and understanding the Agency’s Policies and
Procedures. Employees are required to sign various duplicate acknowledgments; one copy for the
employee to keep for their own records; the other will be placed in their personnel file. Any changes made
by government legislation after this printing will be followed.
E.1
Section:
Subject:
E
Hiring
Total Pages:
3
Approval Date:
April 18, 1984
Revision Date(s): May 15, 1991: June 19, 1991;
Nov. 18, 1992; May 19, 1993; March 18, 1998;
May 15, 2002, Jan. 15, 2014.
HIRING POLICY
1.
Community Living-Central Huron is committed to fair and accessible employment practices and
will accommodate the accessibility needs of people with disabilities during the recruitment and
hiring processes, as required by the Integrated Accessibility Standards (Ontario Regulation
191/11) under the Accessibility for Ontarians with Disabilities Act, 2005 (AODA).
2.
It is the responsibility of Agency Coordinators/Supervisors to notify the Executive Director, of the
need for Staff replacement or additional Staff. The Executive Director is responsible for
administrative Staff positions.
3.
Hiring of the Executive Director shall be the responsibility of the Board of Directors.
4.
The relevant Coordinator/Supervisor and/or the Executive Director will prepare the job posting
and/or advertisement.
5.
The Executive Director and the relevant Program Coordinator or designates, will determine when
a position will be posted externally, notwithstanding the terms of the Collective Agreement, as it
relates to Bargaining Unit employees. Applications in the resource file and/or a posting on the
Services Canada website, and/or other reliable websites, will be considered prior to advertising in
local newspapers. Advertisements, when used, will be placed in the following Newspapers:
Goderich Signal-Star, Clinton News-Record, The Citizen (Blyth/Brussels), the Huron Expositor and
extended to the London Free Press and the Kitchener/Waterloo Record if necessary. The
advertisement will include, "only individuals receiving an interview will be contacted."
6.
Applications will be submitted to either the relevant Coordinator/Supervisor or the Executive
Director.
7.
The Interviewing Team will consist of a minimum of three of the following: Board Member,
Executive Director; Coordinator(s) and Senior Staff. Other Staff and/or people supported may be
involved at the discretion of the Interviewing Team.
8.
The Executive Director or designate will contact references and make the Offer of Employment to
the successful candidate. Also, the Executive Director or designate will notify by telephone when
possible, and in writing, the unsuccessful candidate(s).
9.
The Executive Director will author all Letters or Conditional Letters of Employment.
10.
Board Members must not have been a Director of Community Living-Central Huron, for a period of
at least three (3) months, prior to any employment with the Agency.
11.
All resumes received by Community Living-Central Huron, will be kept in the resource file by
Central Administration for a period of six months from the date of receipt.
E.2
Hiring Procedure:
1.
The Interviewing Team will determine the number of qualified applicants to interview, establish the
date and time of the interviews, and ensure candidates are notified regarding interviews.
2.
Candidates will be provided at the time of interviews, with written information advising of the
following Agency Policies:
a)
b)
c)
Police Record Check Policy (Vulnerable Sector Check)
Vehicle Use, which includes the Third Party Insurance requirement
Reference Consent Form
As appropriate, candidates will be apprised of Union affiliation.
3.
Each set of interviews will be conducted in a consistent manner, utilizing pre-determined questions
and scenarios, both written and verbal. An Interview Record and Evaluation Form will be used by
each Member of the Interview Team, excluding a person supported if participating, to record
comments and scores. With internal interviews, Supervisors will share any relevant information
(performance strengths or concerns) with the Interview Team. All recording Members of the
Interview Team will individually rate each candidate, full results will not be discussed until final
tabulations are completed. The Interview Team will determine the successful candidate.
4.
For new hires, the Interview Team will make their recommendation for hire, pending successful
reference checks; three work related references are required by each candidate. Reference
checks will be completed using the "Employment Reference Check" form. The Executive Director
or designate will make the Offer of Employment, pending a successful Vulnerable Sector Check;
the successful interview candidate will not begin their employment with Community Living-Central
Huron until they provide the Agency with the successful Vulnerable Sector Check.
5.
If the Executive Director has not participated in the Interviewing Process, the Interviewing Team
will advise the Executive Director of their recommendation to hire, accompanied by the reference
checks, Interview Records, Letter of Application and resume. The most Senior Management Staff,
or designate, will make the Offer of Employment [or Conditional Offer of Employment- delete] to
the successful candidate.
6.
All unsuccessful candidates will be notified by the Executive Director, or designate immediately by
telephone, when possible and also in writing.
7.
All resumes and interview documentation/files for all competitions will be returned to the Central
Admin. Staff; who will then file such in a secure location.
E.3
8.
Employment for all positions will be confirmed with a Letter of Employment stating: position title,
start date if known, immediate Supervisor, starting salary, receipt of outstanding
Acknowledgements, orientation and any other special conditions and/or limitations which may
apply. The Letter will also indicate that the applicant has received a copy of and has reviewed
with their immediate Supervisor, Job Description; Agency Policies & Procedures; Oath of
Confidentiality; Guiding Principles; Medication Policy & Procedures; Health & Safety Document,
Hepatitis B Acknowledgement, etc.
9.
Two copies of the Letter of Employment will be provided to the successful candidate with a clause
indicating acceptance of employment as described. The applicant will sign and return one copy
for the Agency's personnel file. Should the successful candidate not accept the Terms of
Employment and by the specified date, the Offer of Employment will be withdrawn. Also, should
the successful candidate not meet all Conditions of Employment within the specified dates, the
Offer of Employment will be withdrawn.
10.
Any subsequent changes in the Terms of Employment shall be confirmed in writing to all
employees, this does not include changes to compensation.
Staff Changes/Information
The Executive Director will inform the Board of Directors of all hirings, Staff changes, terminations, WSIB
information, etc. This information will be made known to the Board of Directors as part of the Executive
Director's Report at the earliest regularly scheduled Board Meeting.
Related Policies:
Privacy (A-004)
Volunteer (B-007)
Bullying, Harassment and Workplace Violence Policy and Procedures (D-007)
General Policy No. 2 (E-001)
Vehicle use (E-009)
Work Place References (E-014)
Other Related Documents:
Collective Agreement, OPSEU, Local 146 - Community Living-Central Huron
E.4
Section:
Subject: Police Record Check Policy Total Pages:
2
(formerly Criminal Reference Checks)
Approval Date:
May 15, 1991
Revision Date(s): April 15, 1992,
March 18, 1998, May 17, 2006, Nov.
15, 2006, Oct. 19, 2011, June 20,
2012.
POLICE RECORD CHECK POLICY
Community Living-Central Huron is committed to ensuring the safety and well-being of people supported,
Staff and volunteers. Therefore, all persons who are offered employment with Community Living-Central
Huron, including volunteers who work directly with people the Agency supports, must undergo a Police
Record Check prior to assuming their duties. To be acceptable, the results of the Criminal Record Check
must be dated within ninety (90) days prior to the date it is received by the Agency.
When an individual applies for a position and an offer of employment or volunteerism is made, it will be
offered conditionally pending a favourable Police Record Check. Applicants seeking employment and/or
volunteer opportunities and who reside within Huron County, will provide to a designated Staff the
completed Vulnerable Sector Check; Declaration of Criminal Record, if necessary; appropriate
identifications, and payment of the fee, as determined by the Huron Detachment, Ontario Provincial
Police (OPP). The Huron OPP Detachment will only perform Police Record Checks for persons residing
within the County of Huron. In order for the Huron OPP to conduct the Check, Community Living-Central
Huron will submit the aforementioned completed, signed forms, copies of identification, along with
payment to the Huron OPP. Completed Police Record Checks will only be released to the applicant; the
Coordinator and Executive Director or designates will be responsible to follow-up with the applicant
seeking specifics/clarification of the Check. Potential employees, contract workers and volunteers who
reside outside the County of Huron will be responsible to provide the Agency with a ‘successful’ Police
Record Check; such individuals would follow the procedures, costs, etc., specific to the area in which
they reside.
Notwithstanding Section 17.0 of the Agency’s By-Law No. 3, Execution of Documents, persons in the
position of Coordinator will have specific permission to sign on behalf of the Agency, a Letter of
Authorization for a Police Record Check to be conducted. As a service to individuals/families/caregivers
involved with the Community Support for Families Program, Facilitators are given permission to sign a
Letter of Authorization for a Police Record Check for people who complete a Data Sheet for the purpose
of becoming a self-employed contract worker.
The Executive Director and President or designate will use their judgement in determining whether or not
a criminal record warrants the disqualification of any applicant and/or volunteer from a given position.
Individuals with outstanding Criminal Code convictions or charges pending for certain offenses will not be
accepted by this Agency. These offenses may include but are not limited to: physical or sexual assault;
current prohibitions or probation orders forbidding the individual to have contact with children under the
age of 14; offenses under the Child and Family Services Act relating to abuse of children; outstanding
convictions or charges pending for any offense deemed violent, theft and outstanding convictions or
charges pending for criminal driving offenses, including but not limited to impaired driving.
E.5(a)
Any fee charged by Police Forces for performing such a Check will be borne by individuals applying for
paid and contract positions. Should there be any cost associated with potential volunteers, Community
Living-Central Huron will bear this expense. Student volunteers who become involved with Community
Living-Central Huron through programs sponsored by the local Boards of Education will not be required
to undergo a Police Record Check if under the age of eighteen years. University or Community College
Co-op Students who work directly with people supported must undergo a Police Record Check.
All potential employees and/or volunteers working directly with people the Agency supports, will be asked
by Staff at the time an offer of employment or volunteerism is made if they have a criminal record. Should
the potential employee/volunteer respond that they have a criminal record, they must complete the
Declaration of Criminal Record. The OPP state the following self declarations do not include: convictions
for which a pardon has been received; Youth Convictions (YCJA) - waiting for clarification from CPIC
Audit; absolute/conditional discharges; offences where there were no convictions; provincial/municipal
offences; charges dealt with outside Canada.
*Note: Acceptable forms of identification include:
Photo: Driver’s Licence; BYID (issued by LCBO); Military Employment Card; Canadian Citizenship Card;
Indian Status Card: International Student Card: Passport; Permanent Resident Card; PAL - Possession
& Acquisition Licence; and, CNIB Card.
Non-Photo: Birth Certificate; Baptismal Certificate; Hunting Licence; Outdoors Card; Canadian Blood
Donor Card; and, Immigration Papers.
Health Cards and Social Insurance Number Cards (SIN) are not acceptable for identification purposes.
E.5(b)
Section: E
Subject: Employee Records Policy
Total Pages: 2
(Previously Personnel Records)
Approval Date:
Oct. 19, 1983
April 21, 1993; Oct. 16, 2013.
EMPLOYEE RECORDS POLICY
Community Living-Central Huron respects the privacy and confidentiality of its employees and as such
will not release information, without written consent of the employee (Release of Information),unless
required by law or as permitted under the Freedom of Information policy. Employees may not review any
documentation that would violate the confidentiality of another employee, volunteer or person supported.
The Agency shall maintain separate files for each employee related to: Personnel, Payroll and Medical.
Such files are kept confidential with only authorized personnel having access. All information maintained
in Community Living-Central Huron’s employee files are the sole property of Community Living-Central
Huron. Unauthorized removal of any documentation or information from employee files by employees or
third parties is strictly prohibited. Non-compliance with the Employee Records Policy is subject to
discipline, up to and including dismissal from the Agency’s employ.
It is the employee’s responsibility to ensure that information concerning their personal status is current at
all times. The employee will immediately advise the Administrative Coordinator of any changes to the
following: name, address, phone number(s), marital/family status, dependents, beneficiaries, etc.
Personnel File:
Employees of Community Living-Central Huron may request twice per calender year to view their
Personnel file. A request will be made to the Executive Director in writing; arrangements will be made as
soon as possible for a mutually agreeable time to view the file. Examination of a Personnel File will be in
the presence of a person designated by the Executive Director; the date and time the employee views
their file will be recorded in the Personnel file. Should an employee request a copy of any documentation
included in their Personnel file, they will pay for such copies, at the current photocopying rate.
Any former employee of Community Living-Central Huron or any third party that requests access to
information from an Agency Personnel file must provide a written request and/or authorization from the
employee and/or former employee. The request and viewing processes shall be the same as for current
employees of Community Living-Central Huron.
Individual personnel records for each Staff member shall be maintained by the Executive Director or
his/her designate. Documents contained in an employee’s Personnel file include, but are not limited to:
Resume(s); Letters of Reference/Written Reference Check; Job Application(s); signed Job
Description(s); Police Check/Vulnerable Sector Check; Signed Employment Letter(s)/ Agreement(s); all
Agency Acknowledgments, initial and annual; educational and training records/certificates; Performance
Appraisals; Disciplinary letters; Letter(s) of Counsel or Warning; summary of employment with the
Agency; Transfer Notice(s), Layoff(s) and Recall Notice(s); Letter of Resignation/ Termination; Exit
Interview Notes, as applicable and any other Severance Agreements and Releases.
E.6(a)
Payroll File:
Items contained in an employee’s Payroll file, will be any document(s)/letter(s)/ agreement(s)/notice(s)
required and related to the processing of payroll. Examples of such documents include: Letter(s) of
Employment; Record(s) of Employment; Notice(s) from Services Canada; TD1; TD10N; void cheque(s);
letters/notices/forms pertaining to benefits inclusive or Group RRSP, etc.
Medical File(s):
A ‘medical file’ may include a file for an employee of Community Living-Central Huron related to claims
and/or information from/about Workers Safety and Insurance Board (WSIB) or the Agency’s Benefit
Carrier. Examples of such information, includes: copy of Employer’s Form 7, WSIB; letter(s) from/to
WSIB and/or Agency’s Benefit Carrier regarding a claim and/or requests for additional information; copy
of Application for Short/Long Term Disability Benefits, copy of Doctors/Specialist Notes, Copy of Early &
Safe Return to Work Plans and/or forms/updates and revisions; Employee Incident Report(s).
Related Policies:
Privacy (A-004)
Staff Orientation (E-005)
Work References (E-014)
Retirement (E-015)
Record Retention and Archives (E-018)
E.6(b)
Section:
Subject:
E
Employee and Volunteer Orientation
(Formerly Staff Orientation Policy)
Total Pages:
2
Revision Date(s): March 18, 1998;
April 21, 1993; May 15, 1991, January
15, 2014, Dec. 17, 2014.
EMPLOYEE and VOLUNTEER ORIENTATION POLICY
Policy:
Community Living-Central Huron will provide orientation to all of its employees and volunteers.
The Agency believes this practice provides a significant learning opportunity to employees and
volunteers; they will receive an overview of the Agency’s Vision, Mission, Service Principles,
Philosophy, Guiding Principles, Organizational Structure, all Agency Policies and Procedures,
Health and Safety Orientation and a review of Agency expectations. Orientation or re-orientation
will also provide for specific job responsibilities as required for the employee’s or volunteer’s
position within the Agency; orientation will be documented on the appropriate checklist. The
Executive Director will be responsible for the orientation and re-orientation of Board and
Committee Members.
Purpose:
To ensure employees and volunteers are informed of the Agency’s Vision; Mission; Service
Principles; Philosophy; Guiding Principles; Policies; Procedures and Organization Structure and
how such relates to their position within the Agency.
Definitions:
New Employee: not a current employee of Community Living-Central Huron; recently hired.
Direct Volunteer: includes students and individuals who provide direct supports to people who
use the Agency’s services; direct volunteers will not replace Staff, but rather augment supports
and enrich the lives of people who use the Agency’s services.
Indirect Volunteer: may include Board and Committee Members or any individual who supports
the Agency in various capacities (ie. fundraising, community awareness events, etc.), and does
not provide direct support.
Orientation:
means an introduction/beginning for employees and volunteers to familiarize
themselves with the Agency’s philosophy; services; work practices; policies; procedures and
expectations of their position.
Initial Orientation: New employees and new direct volunteers will attend an unpaid initial Agency
orientation meeting whereby the Executive Director or relevant Coordinator will provide an
overview of the Agency’s Vision; Mission; Service Principles; Philosophy; Guiding Principles;
Organizational Structure and expectations. This orientation will be approximately one (1) hour in
length. New employees will also have the opportunity to be introduced to the Coordinator,
Finance & Human Resources. Employees will be paid for all orientation beyond the initial
orientation.
E.7(a)
The relevant Supervisor will provide new employees and direct volunteers with orientation to all
Agency Policies and Procedures, inclusive of Health and Safety; Medication Policy &
Procedures,
responsibilities of their job; as well as on-site orientation and ensure all acknowledgements are
completed, signed and returned to the Central Administration Staff.
Re-Orientation: The relevant Coordinator and/or Supervisor will determine the extent of reorientation based on individual circumstances and document such re-orientation on the
designated re-orientation checklist. Consideration for re-orientation will include but is not limited
to Leaves, (ie. Maternity/Parental; Short/Long Term Disability, WSIB), but also changes in
support protocols/procedures and performance concerns.
Related Policies:
All Agency Policies and Procedures;
-
Community Living-Central Huron Orientation Slide Presentation;
Health and Safety Orientation;
E.7(b)
Section: E
Subject: Professional Development/Training Total Pages: 2
Dec. 21/11, Dec. 19/12 , Nov. 19/14
PROFESSIONAL DEVELOPMENT/TRAINING POLICY
(Seminars, Workshops, Conferences, Internal Training)
Community Living-Central Huron recognizes the value of Staff and Volunteers participating in
professional development and training as it can positively impact on people supported, the Staff
themselves; co-workers and the Agency. The Agency, when able, may provide an incentive for
Staff to enrol in post-secondary education related to the field of developmental disabilities. Staff are
required to provide proof of successful completion to be eligible for any type of incentive.
Staff who register for professional development and/or training and fail to attend will be charged the
professional development and/or training event fee, if applicable.
Professional Development:
If a Staff or Volunteer wish to participate in professional development or a non-mandatory training
event, they will provide to their Supervisor all necessary written information, including costs. The
Supervisor will consult with the relevant Program Coordinator or Executive Director. The following
will be taken into consideration when approving participation:
a) Relevance of the professional development/training event with respect to the Staff’s
or Volunteer’s position/role and the Agency’s needs;
b) Previous opportunities to participate in professional development/training;
c) Time requirement to ensure continuous operation of services; and
d) Cost of the professional development/training, status of Program’s budget and when
appropriate, the Agency’s ability to provide an incentive.
Following approval, the Agency will pay for the following expenses:
a) Registration fee, or a portion thereof;
b) Accommodation - most cost-effective option, prior written approval must be sought from
the relevant Supervisor, in consultation with the Program Coordinator;
c) Meals - refer to Community Living-Central Huron Policy, and/or the Collective Agreement;
and
d) Transportation - as authorized by the relevant Supervisor, in consultation with the
Program Coordinator.
E.8(a)
Mandatory Training:
Orientation: Agency Staff will be provided with paid on-site orientation at each relevant work
location, whereas the relevant Supervisor or designate will ensure the Orientation Checklist is
completed. Upon hire, new Staff will be required to participate in an unpaid Agency orientation,
conducted by the Program Coordinator.
Annual Training: Agency Staff are required to participate in mandatory training, as set out in the
requirements of Quality Assurance Measures and the Occupational Health & Safety Act, (ie. Abuse;
Fire Prevention; Non-Violent Crisis Intervention; First Aid/CPR; Workplace Violence). Should a
Staff person not have valid, up-to-date training, they will be subject to discipline up to and including
dismissal from the Agency’s employment. Disciplinary measures may include Staff being removed
from the work schedule, until such time their training/certificates are updated. In addition, should
Staff fail to attend mandatory training arranged by the Agency, the Staff member may be
responsible for securing such training on their own time and cost.
Note: There is required training within the Orientation Checklist, such as: Fire Prevention; Quality
Assurance Measures; Workplace Violence Prevention; Medication training. Refer to the Orientation
Checklist for the current requirements.
Volunteers will be provided with an orientation of their role by the relevant Supervisor, Coordinator
or Executive Director. In addition, for Volunteers providing direct support, an Agency orientation will
be provided by the Program Coordinator.
First Aid/CPR: All Agency Staff are required to have an up-to-date Emergency First Aid/CPR
certificate. Should a Staff be hired and not possess a valid Emergency First Aid/CPR certificate, the
Staff will be required to obtain a certificate within the first 3 months of employment and be
responsible for the cost and training, on their own time, for the initial Emergency First Aid/CPR
certificate. For Staff who are hired and possess a current certificate, the Agency will arrange for recertification and incur the cost of training for Staff to update their Emergency First Aid/CPR
certificates for the term of the Staff’s Agency employment.
Workplace Hazardous Materials System (WHMIS): All Agency Staff are required to have annual
training in WHMIS, which the Agency will determine the training material for both the initial training
and annual refresher training.
Nonviolent Crisis Intervention (CPI): All Agency Staff who work in “group living residential
locations” where three or more people reside are required to be trained in CPI’s Nonviolent Crisis
Intervention. The Agency will provide the initial training, as well as annual refreshers. The Agency,
may at its own discretion, determine Staff who work in other locations would benefit from Nonviolent
Crisis Intervention training and subsequently such training would be provided. Reference to the
Agency’s “Use of Physical Restraints Policy” (C-005) can be made for further details regarding the
Nonviolent Crisis Intervention Program.
When a Staff member attends any professional development/training event, they will be paid for a
maximum of eight hours per day. Part-time and Occasional Workers will be paid for the number of
hours approved in advance by their Supervisor, not to exceed eight hours per day.
Following participation in a professional development/training event, the participants may be
requested by their Supervisor to submit a written report for circulation within Community LivingCentral Huron. Hand-outs and other information obtained at the event will be attached to the
circulation copy.
E.8(b)
Section:
Subject:
E
Individual Consultation
Total Pages:
1
Dec. 17, 1997
INDIVIDUAL CONSULTATION POLICY
As Employees of Community Living-Central Huron, it is an expectation of both Supervisors and
Support Workers to receive on-going information regarding job performance. The Association will
provide to all new employees orientation which will include but is not limited to: a job description;
familiarization to workplace(s); Association's Philosophy and Guiding Principles; Policies and
Procedures; Participants, etc. All employees will receive an annual performance appraisal.
It is therefore suggested, the following be considered:
a) Each Supervisor and/or Employee arrange supervision meetings when required.
b) Supervision items should be presented in a positive, constructive manner. Areas to be
discussed could include:
I)
ii)
iii)
iv)
v)
vi)
vii)
Time Management
Individual Training and Information Needs
Problem Solving
Suggestions and Recommendations
Personnel Issues
Participant and Staff issues
Brain Storming/New Ideas
c) Confidentiality would be strictly enforced. Anything mentioned is to be held confidential
unless both agree the information should be shared.
E.9
Section: E
Subject: Employee Performance Appraisal Total Pages:
1
Procedure
Revision Date(s):May 17, 2006
EMPLOYEE PERFORMANCE APPRAISAL POLICY
It is the Policy of Community Living-Central Huron that all employees must participate in regular job
performance reviews; failure to comply with this requirement is subject to disciplinary action. The
purpose of the Employee Performance Appraisal is to:
a)
b)
increase the employee’s knowledge ability and skills related to the job and to maintain a high
quality of service to people supported and their families;
provide employees with regular feedback on their performance;
c)
d)
e)
establish reliable and fair standards for performance, conduct and expectations;
assist employees in identifying and satisfying individual job and performance requirements;
and
strengthen Community Living-Central Huron’s ability as an Agency to support people to
achieve their goals, assert their rights and ensure their safety and well-being.
The procedure will consist of the completion and submission of an Employee Self-Review, input
from the immediate supervisor, co-workers and people supported. The immediate supervisor will
meet with the employee to review the Employee Performance Appraisal document and agree on
mutual goals. Both the employee and supervisor will sign the written evaluation and goals. The
employee’s signature does not necessarily indicate agreement with the Employee Performance
Appraisal, only that it has been discussed. The employee’s reasons for not agreeing with the
Appraisal will be documented on the Employee Performance Appraisal. The completed signed
Employee Performance Appraisal will be placed in the individual employee’s personnel file.
E-10
Section:
Subject:
E
Vehicle Use
Total Pages:
1
Revision Date(s): May 15, 1991; Jan. 20,
1993; May 19, 1993; Dec. 17, 1997; June
18, 2008, Dec. 19, 2012.
VEHICLE USE
All vehicles owned or leased by Community Living-Central Huron are to be used only to conduct the
business of the Agency. The use of Agency vehicles is strongly encouraged; however, on occasion,
the use of personal vehicles is unavoidable. Use of personal vehicles must be approved in advance
by the relevant Supervisor. In order to be reimbursed, Staff must provide to their Supervisor on a
monthly basis, a completed Statement of Travel Expense, detailing the destination, purpose,
number of kilometres travelled and attach any parking or meal receipts. The mileage allowance
paid for the use of personal vehicles will be reviewed on a regular basis.
The Agency utilizes a central booking system for accessing Agency vehicles. Each Agency location
has a cell phone and it is to be taken at all times when Staff are supporting individuals in a vehicle.
Each Agency vehicle contains specific information, inclusive of make, model, insurance, roadside
assistance, and documentation to be completed prior to and following each use. Eating, drinking
and smoking are prohibited in any Agency vehicle.
The relevant supervisor is responsible for the regular maintenance on Agency vehicles and
ensuring orientation to Staff and volunteers on the operation of vehicles and wheelchair lifts/ramps.
Staff and volunteers will complete a Workplace Hazard & Suggestion Report and submit it
immediately to the relevant Supervisor, should they believe the vehicle/lift to be unsafe or requires
service. In the event of inclement weather and/or poor road conditions, the driver will make the
decision, in consultation with their Supervisor, on whether or not to cancel a trip.
All Staff and volunteers of Community Living-Central Huron are required to file proof of 3rd party
liability insurance for at least two million ($2,000,000.00) dollars upon employment and on
September 1st thereafter. Staff and volunteers are also required to inform their insurance
company, they are being paid mileage compensation when using their personal vehicle for work
purposes. Staff and volunteers must maintain a valid Ontario driver’s licence and provide such
information to the Office Accountant upon hire or at the beginning of their volunteer placement.
Staff and volunteers must advise their supervisor immediately should their driver’s licence status
change.
While on Agency business, whether driving your own vehicle or an Agency vehicle, Staff and
volunteers will report accidents/emergencies immediately by calling the police/911, as appropriate.
Next, they will obtain from the other driver their name, address, phone number and insurance
company. Staff and volunteers will next report any accidents/incidents to the relevant supervisor
utilizing the Vehicle Incident Report form. Staff and volunteers are expected to ensure the safety of
themselves and their passengers at all times, ensuring seat belts are worn properly and obeying all
traffic and highway regulations. People supported should not be left unsupported in vehicles nor
should vehicles be left running and unattended for any reason. Also, keys should not be left in the
ignition and vehicle doors are to be locked when parked on or off-site. Failure to comply with the
Agency’s Vehicle Use Policy shall result in disciplinary action up to and including dismissal.
Requests from the community to use an Agency wheelchair van will be considered by the
Coordinator, Adult Services, Executive Director, and the President of the Board of Directors. If
approved and prior to the Agency supplying the vehicle, the Agency will obtain a copy of the
appropriate valid driver’s licence and provide all necessary training to the community person.
E.11
Section:
E-010
Subject:
E
Policy Number:
Personal Property Damage
Total Pages: 1
Revision Date(s): May 15, 1991
PERSONAL PROPERTY DAMAGE REIMBURSEMENT POLICY
Employees may submit claims for damaged personal property in writing to their supervisor. Claims
will be reviewed by the Board of Directors. Consideration will be given on an individual basis for
possible reimbursement.
E.12
Section:
Subject:
E
Employee Performance
Total Pages:
5
EMPLOYEE PERFORMANCE STANDARDS POLICY
Policy Statement:
Community Living-Central Huron believes all employees have the right to a workplace where the
expected standards of performance based on employee conduct and behaviour, are clearly stated
and defined, and within that, a workplace where all employees are treated with respect and fairness.
Purpose:
This Policy is intended to provide guidelines in a positive context as to what is considered to be
acceptable and unacceptable conduct and behaviour in the work environment. Employees are
expected to govern their conduct and behaviour in a manner consistent with the Policy set out
herein.
Scope:
There are four primary groups expected to benefit from establishing such a Policy:
a)
b)
c)
d)
Individuals/families receiving supports/services: the expectation of receiving consistent high
standards of supports/services in day-to-day activities;
Employees, individually and collectively:
the understanding of what is considered
acceptable and unacceptable conduct throughout the Agency in order to achieve or surpass
the desired level of performance, as well as the opportunity to improve work performance;
Community of Central Huron: the community expects that as a publically funded social
services organization, Community Living-Central Huron will be well managed and that all the
resources provided to them will be fully utilized in meeting Community Living-Central Huron’s
objectives.
Volunteers/Co-op Placements: the knowledge of expected conduct and behaviour protocol at
whichever location they are volunteering or performing a placement.
Responsibility:
Adherence to the Policy is expected from all employees, volunteers and co-op students, as they
carry out their duties and responsibilities.
Should the conduct or behaviour of an employee, volunteer or co-op student not be consistent with
the Employee Performance Standards Policy Statement of Policy and Procedure, Supervisors are
responsible for counseling employees promptly.
Acceptable Conduct and Behaviour include, but are not limited to:
a)
adherence to Agency policies, practices and procedures;
b)
competent performance of all job duties assigned;
c)
prompt and regular attendance at work;
E.13
d)
e)
f)
g)
h)
i)
courtesy to and respect for people being supported, co-workers, management, customers,
suppliers, or any other person who may have contact with Community Living-Central Huron;
wearing proper work attire and footwear during working hours, appropriate to the job being
performed;
reasonable care and control of the Agency’s property, and respect for the property of people
supported by the Agency, and that of other employees;
adherence to the spirit and intent of all legislated provisions (ie. Ontario Human Rights Code,
Employment Standards Act, Occupational Health and Safety Act, etc.) as they apply to the
working relationships of the people supported by Community Living-Central Huron;
prompt reporting of all injuries and/or illness to the employer; and
compliance with Supervisor.
Unacceptable Conduct and Behaviour Includes, but are not Limited to:
a)
gross misconduct (an act which fundamentally breaches the trust and confidence the
employer had in an employee; universal wrongdoing);
b)
loitering or loafing on related Agency work locations prior to or after scheduled shift;
c)
leaving work early without Supervisor’s or designate’s permission;
d)
using obscene, abusive language;
e)
spreading malicious gossip or rumours;
f)
g)
h)
i)
j)
k)
l)
m)
n)
o)
p)
q)
r)
s)
t)
u)
v)
w)
x)
y)
harassing, threatening, intimidating or coercing any person at any time;
horseplay or throwing objects; creating or contributing to unsanitary conditions or failure to
report witnessed conditions;
performing personal or unauthorized work while on duty;
insubordination (wilful or deliberate refusal to follow instruction(s) from a Supervisor);
breach of confidentiality, by disclosing information in any form to anyone not legally entitled or
authorized to receive such information;
personal use of Agency property/equipment without knowledge or approval of a Supervisor
or designate;
illegal conduct including the contravention of the Criminal Code, the Narcotics Control Act, the
Ontario Highway Traffic Act;
possession of guns, weapons or explosives at Agency work locations;
being under the influence or having possession of alcohol and/or any performance altering
substance while engaged in Agency business;
wilful violation of safety rules and procedures;
wilful neglect and/or mishandling of Agency equipment, machinery, property;
unsafe driving of Agency vehicles;
theft, includes unauthorized expenditures and/or falsification of Agency records;
indecency;
fighting;
poor or careless work;
sleeping while on duty (excluding designated hours of the Overnight Sleep Position);
personally accepting gifts, monies, favors or gratuities from individuals supported by
Community Living-Central Huron;
illegal work stoppage or slow down;
any abusive or disorderly conduct, or failure to report such acts; and sexual
harassment.
E.14
Failure to improve or correct unacceptable conduct or behaviour could result in disciplinary action up
to and including termination without notice or pay in lieu thereof.
General:
Community Living-Central Huron reserves the right to make additions, as deemed necessary, and
further reserves the right to deal with other acts considered detrimental to the well-being of the
Agency, people receiving services/supports, its employees, volunteers and co-op students, other
interest groups or the general public, as they relate to the activities and objectives of Community
Living-Central Huron.
E.15
General Performance Standards Guidelines
Acceptable Standard of Conduct
Unacceptable Standard of Conduct
C o m p e te n c e a n d p ro d u c tiv ity - C o m p e te n t
performance of job duties assigned and specific to
the position and any additional standards established
in specific work locations. Knowledge and application
of all CL-CH policies, practices and procedures.
Adherence to the spirit and intent of all applicable
legislation (ie. O ntario Human Rights Code,
Employment Standards Act, Occupational Health &
Safety Act).
Failure to abide by Agency policies, practices,
procedures, job description, established standards in
specific work locations, applicable legislation, and
failure to convey, promote CL-CH’s philosophy.
Prompt and regular attendance - Reporting to and
leaving the workplace according to the specified work
schedule or as otherwise required.
Failure to report to work on time; leaving the
workplace early or without Supervisory approval;
failure to report to work.
Orderly and acceptable conduct and behaviour Behaving in a manner appropriate to the workplace.
Treating the people being supported, co-workers,
management and any person who may deal with CLCH with courtesy and respect.
Behaving in an
honest, trustworthy, responsible and ethical manner.
W earing proper work attire including footwear
Fighting; horseplay; abuse; assault or threatening to
h a rm o th e rs; h a ra s sm e n t, in c lu d in g s e xu a l
harassment; endangering the well-being of others or
one’s self and any behaviour which prejudices the
Employer’s ability to operate and maintain a positive
reputation; support contrary to approved methods,
philosophy; breach of confidentiality; accepting gifts,
Substandard, incompetent and/or negligent work
performance; performing personal business when
working; sleeping on the job (excluding designated
hours for Night Sleep Position).
appropriate to the work location; reporting any
unacceptable conduct or behaviour immediately to
the relevant Supervisor or designate.
monies from clients; involvement, participation in
activities which result in a conflict of interest;
dishonesty; theft; deception; falsification of records;
fraudulent conduct and any other illegal conduct
including the contravention of the Criminal Code, the
Narcotics Control Act, the Ontario Highway Traffic Act
or any other provincial statutes while engaged in
Agency business; participation in illegal work
stoppage, strike, sit down, slowdown or any other
interference with Agency business; possession of
guns, weapons or explosives on any related Agency
work locations; being under the influence or having
possession of alcohol and/or any performance
altering substance when engaged in Agency
business; G ross M isconduct (an act which
fundamentally breaches the trust and confidence the
Employer had; universal wrong doing).
Failure to report unacceptable behaviour, conduct,
c o n tr a v e n tio n o f w o rk s ta n d a rd s , p o lic ie s ,
procedures, guidelines, Agency philosophy and
applicable legislation; loitering or loafing at Agency
work locations prior to or after scheduled shifts;
spreading gossip or rumours.
E.16
Acceptable Standard of Conduct
Unacceptable Standard of Conduct
Care, Use and Maintenance of Agency property/work
locations - Appropriate usage and maintenance of
Agency property, equipment, including all property
and equipment at work locations and personal
property of people supported by the Agency.
Failure to care for, including regular maintenance and
prompt reporting of any functional problems, damage
pertaining to property, equipment at any work
location; misuse, damage, destruction or waste of
resources and/or property of the people being
supported by CL-CH or the Agency; personal use of
Agency property, equipment, without Supervisory
approval.
Creating/contributing to unsanitary
conditions.
Compliance with Supervisor - Complying with the
direction of the Employer.
Insubordination (wilful and deliberate refusal to follow
instructions); refusal to perform work assignments;
refusal to comply with policies, procedures, statutes,
guidelines, philosophy, established standards and
applicable legislation; refusal to accept work shifts
and overtime.
E.17
Section:
Subject:
E
Disciplinary Policy
Total Pages:
3
Revision Date(s): Sept. 21, 2011
DISCIPLINARY POLICY
Policy Statement:
It is the policy of Community Living-Central Huron to be patient, fair and tolerant in the administration
of its employees, and to encourage employees to exercise self-discipline at all times in their
performance, based on individual conduct and behaviour. However, repeated, wilful or inexcusable
breaches of policies, work ethics or standard operating practices are not acceptable and shall be
dealt with in accordance with the provisions of this Statement of Policy and Procedure.
Depending on the severity of the concern and the number of past occurrences, disciplinary action
may call for any of the four corrective steps and will apply to all Community Living-Central Huron
Policies and Procedures, Principles and the Collective Agreement, as applicable.
Except for termination of employment, any step of the disciplinary procedure may be repeated more
than once, if necessary.
Purpose:
To encourage consistent, self-discipline and corrective action in the event of unacceptable conduct,
behaviour, or violations of policies, procedures or standard practices. Failure to meet these
standards will result in corrective action being taken to ensure that the Agency’s mandate is
achieved.
Scope:
This policy applies to all Community Living-Central Huron employees and volunteers.
Responsibility:
Employees are responsible for performing their work in a competent manner and displaying conduct
and behaviour that is consistent with Agency policies and practices, and those practices typically
regarded as standard in work environments. Employees are also responsible for seeking
clarification of acceptable standards, practices, policies, etc., from their Supervisor.
Supervisors are responsible for orientating, training, and counselling employees to understand the
expectations of their position and of those of the Agency. Supervisors must follow-up on all reports
of unacceptable conduct and performance concerns and will ensure, in consultation with the
Coordinator and/or Executive Director, the necessary information and training, as appropriate, is
available to Staff and volunteers to achieve the desired level of performance and/or behaviour. Each
Supervisor is responsible for ensuring employees are treated with respect and fairness.
The Executive Director is responsible for ensuring this Policy is applied objectively, promptly and
consistently to all employees and throughout all programs/divisions and to provide advice and
assistance to management throughout the discipline process and in the application of the procedures
outlined herein.
E.18
Procedure:
Community Living-Central Huron will utilize ‘Progressive Discipline,’ which calls for an increase of
disciplinary action on a step-by-step basis, where the preceding action has failed to correct the
behaviour or conduct. There are four basic steps in the application of progressive discipline;
however, in the case of gross misconduct, it may be justified to omit one or more steps.
Note:
Gross misconduct is an act which fundamentally breaches the trust and confidence the
employer had in an employee; universal wrongdoing.
Except for termination of employment, it may also be appropriate to repeat the step of progressive
discipline more than once depending on the circumstances, at the discretion of the Supervisor, in
consultation with the Coordinator and/or Executive Director.
Notwithstanding the time frames referred to in Step One through to Step Four of the ’Progressive
Discipline’ Process, extraordinary or unforeseen circumstances may alter the expectations to
complete steps in the designated time period.
Step One of the ‘Progressive Discipline’ Process:
When there has been an infraction, the employee will be verbally advised by their Supervisor or
designate after the facts giving rise to the incident become known, in an informal manner, ie.
meeting or telephone call, as follows:
a)
b)
discuss the nature of the misconduct, or the rule or standard breached;
reference to the previous discipline, if any;
c)
d)
e)
f)
g)
h)
request to provide their explanation of the circumstances;
reinforce the expected performance standard;
corrective action or change in conduct expected; it is desirable that both parties agree on the
preceding action as well as a time frame for demonstrated improvement of behaviour;
follow-up by the Supervisor;
verbal notice to the employee, a formal discipline step may be implemented if the desirable
results are not achieved within an agreed time period;
notice to the employee that although the incident has been recorded, there will be no formal
letter placed in the employee’s personnel file.
Step Two of the ‘Progressive Discipline’ Process:
When Step One, an informal discussion, has not achieved the desired performance standard, or
where a more serious infraction has occurred, a written reprimand is warranted. The Supervisor or
designate will meet with the employee to discuss the performance infraction(s) and review the
expected performance standard. Subsequently, a Letter of Counselling will be provided to the
employee, with a copy going in the employee’s personnel file, summarizing the meeting and will
include the following:
a)
b)
c)
d)
e)
f)
g)
the nature of the infraction(s), or the rule or standard breached;
the employee’s response to the performance infraction(s);
reference to previous discipline, if any;
reinforcement of the expected performance standard;
corrective action or change in conduct expected; it is desirable that both parties agree on an
action plan as well as a time frame for demonstrated improvement of behaviour;
follow-up by the Supervisor will be scheduled no later than 30 days following the date on
which the written warning and corrective action plan is issued; and
notice to the employee, the potential consequences of continued or repeated infractions.
E.19
Step Three of the ‘Progressive Discipline’ Process:
This step is implemented as a paid or unpaid suspension, of the employee from the workplace for a
specified period of time, based on the nature of the infraction(s). The Supervisor or designate will
meet to discuss the performance infraction(s) and th expected performance standard.
Subsequently, a Letter of Warning will be provided to the employee, with a copy going in the
employee’s personnel file, reviewing the meeting and the terms of the suspension; the letter will
include the following:
a)
b)
c)
d)
e)
f)
g)
h)
i)
nature of the infraction(s)/rule that has been breached or the performance standard that has
not been achieved;
the employee’s response to the performance infraction(s);
if applicable, reference to previous oral/informal or written discipline;
reinforcement of the expected performance standard;
corrective action required or the change in conduct expected from the employee;
if applicable, a time frame for demonstrated improvement;
follow-up by the Supervisor will be scheduled no later than 14 days following the date on
which the established time frame for demonstrated improvement is to occur;
notice to the employee the potential consequence of continued or repeated infraction(s); and
date(s) the paid or unpaid suspension is to be served, noting the shifts/hours.
Immediate disciplinary suspensions may also occur, without prior warnings, if the suspension is
administered because of unacceptable conduct or behaviour which demands immediate action. In
consultation with the Coordinator, if applicable, and the Executive Director, an investigation
surrounding the suspension will be conducted. The suspended employee will be notified in writing of
the result of the investigation within forty-eight hours following completion of the investigation.
Step Four of the ’Progressive Discipline’ Process:
Dismissal will occur for infractions of an extremely serious nature or when the previous steps taken
to achieve the required performance standard have failed.
The Executive Director or designate(s) will meet with the employee advising them of their dismissal,
when possible. Subsequently, a letter from the Executive Director or designate will be provided to
the employee, outlining the rationale and terms of dismissal. A copy of the dismissal letter will be
placed in the employee’s personnel file.
E.20
Section:
Subject:
E
Sexual Harassment
Total Pages:
1
Revision Date(s):
SEXUAL HARASSMENT POLICY
The Human Rights Code, 1981 provides a remedy for three common types of sexual harassment.
1. The first type is "a course of vexatious comment or conduct that is known or ought
reasonably to be known to be unwelcome" perpetrated by a person's employer, someone
acting for the employer, or a co-worker. Examples of this type of behaviour include
repeated sexual remarks, or physical contacts, that are degrading.
2. The second type of behaviour is a sexual advance or solicitation made by a person who is
in a position to grant or deny a benefit to another. This is a contravention of the Code
when the person making the solicitation or advance knows, or should know, that such
behaviour is unwelcome. Unwelcome advances from an employer to an employee are
examples of this type of behaviour.
3. A third type of prohibited behaviour occurs when a person who is in a position to grant or
deny a benefit threatens or institutes a reprisal against the person who rejected his or her
sexual advance. An example is the denying of a promotion or firing of an employee
because the employee has refused a sexual proposition.
Employees of Community Living-Central Huron who feel that they are subject to sexual harassment
may deal with such treatment through the normal grievance procedure and/or may file a complaint
with the nearest office of the Ontario Human Rights Commission.
E.21
Section:
Subject:
E
References, W ork
Total Pages:
1
Approval Date: April 15, 1992
Revision Date(s):
WORK REFERENCES POLICY
The Executive Director, in consultation with the Coordinator and/or Supervisor, will be responsible for
providing work references for current and former employees.
All potential candidates for employment must provide Community Living-Central Huron with three
work-related references.
E.22
Section:
Subject:
E
Retirement
Total Pages:
1
RETIREMENT POLICY
The Agency’s Retirement policy shall be in accordance with the Employment Standards Act, 2002.
E.23
Section: E
Subject: Early and Safe Return to W ork
Total Pages: 8
Approval Date: February 15, 2006
Revision Date(s): November 20, 2013
EARLY AND SAFE RETURN TO WORK POLICY
Community Living-Central Huron recognizes the value of employees’ early and safe return to work
and is committed to the successful recovery of ill, injured and disabled employees through an Early
and Safe Return to Work (ESRTW) Program. It is the intent of this Policy to encourage employees
to actively participate with rehabilitative employment and cooperate with the procedures of the
ESRTW Program. Non-compliance with the Agency’s ESRTW Program is subject to discipline, up
to and including dismissal. The Agency will make every attempt to ensure that all employees who
are permanently or temporarily disabled as a result of a work injury, accident, illness or disability, are
provided meaningful and productive employment through the ESRTW Program.
Community Living-Central Huron’s ESRTW Program will work towards achieving the following goals:
increasing awareness of disability issues for all employees; decreasing the number of days lost due
to absences from injuries and illnesses and thus reducing payments through wage replacement
plan(s); implementing a fair and consistent process for employees to return to work; and enabling
employees to maintain their dignity, self-worth, respect and standard of living as valued employees.
The Supervisor will design an Individualized Return to Work Plan in consultation with the employee,
the employee’s health care provider(s) and representatives of the various wage replacement plans,
and as necessary, the employee’s union representative. An Individualized Return to Work Plan will,
when possible, assist in providing suitable temporary work to accommodate work restrictions over a
specified period of time. In doing so, the Agency will make every reasonable effort to return
employees to their regular job as soon as possible; it is understood that such steps will not result in
undue hardship for the Agency.
The Agency will ensure the ESRTW Program and Individualized Return to Work Plans are in
compliance with current and future legislative requirements.
1.
Early and Safe Return to Work Program:
Purpose:
The purpose of the ESRTW Program is to provide a planned approach to assist employees in
returning to work in a safe and timely manner by minimizing barriers. The ESRTW Program is
available to all employees who are temporarily unable to perform their duties. In some
situations, employees may return to work with no lost time, when modifications and/or
accommodations can occur immediately. The ESRTW Program is designed to attain the best
performance with regard to personnel and finances, to manage benefits through various wage
replacement plan(s). As a means for an employee to safely return to their regular duties, they
must participate in the Agency’s ESRTW Program; employees upon return may or may not
require modified work with the ultimate goal of being able to return to regular duties within their
own work location as soon as possible.
Relevant co-workers will be kept informed about modified jobs being offered to recovering
employees and of temporary changes to job expectations. The Location Health & Safety
Representatives will participate in monitoring injury, return to work and work related
complaints in order to identify patterns and trends within the workplace.
E.24
2.
Definitions:
The Health Care Provider(s):
The health care provider(s) is the attending physician, physiotherapist, psychologist,
psychiatrist, occupational therapist or other member of the rehabilitation team. This
professional can provide the necessary information about the employee’s expected return to
work date; any physical restrictions that may apply upon return to work, and/or the prognosis
of an illness, injury or disability. To help prevent misunderstandings and prolonged absences,
it is essential that ongoing communication occur between the attending health care
provider(s), employee, Supervisor and Administrative Coordinator, as well as a representative
from the wage replacement plan(s).
Wage Replacement Plans:
Wage Replacement Plans may include but are not limited to:
a) Workplace Safety & Insurance Board (WSIB)
b) Agency’s Benefit Carrier: Short Term and Long Term Disability
c) Employment Insurance Act
d) Remunerations as provided for under any other private or legislated wage replacement
plans
Modified Work:
Modified work is a temporary job, task and/or function that an ill, injured or disabled employee
may perform safely without risk of re-injury, further illness, further disability or risk to others.
Modified work is developed based on the physical restrictions identified by the health care
provider(s) utilizing the Agency’s Physical Demands Analysis and Job Description for the
position, as provided by the employer. In all situations, attempts are to ensure the work will be
productive and valuable.
Modified Work Program:
A Modified Work Program is designed primarily to assist ill, injured or disabled employees to
make a safe and speedy return to their regular duties. This is a temporary measure that is
intended to bridge the gap between illness, injury or disability and a return to regular duties. A
Modified Work Program will not normally last longer than six (6) weeks. Extensions to this
period will be granted on an individual basis based on supporting medical information.
Individualized Return to Work Plan:
The Individualized Return to Work Plan (IRWP)is a written document that lays out the steps to
be taken to accommodate an employee’s temporary work restriction(s). Accommodation(s)
will recognize the unique circumstance in each case and may include, but is not limited to:
a) working fewer hours
b) taking more frequent rest breaks
c) obtaining temporary assistance from co-workers for tasks the returning employee is unable
to perform (more difficult tasks- delete)
d) job/responsibility sharing
e) physical changes to the work environment
f) assistive devices
g) assignment to another location
h) special project work
E.25
An Individualized Return to Work Plan (Appendix “A”) will be developed by the employee and
the employee’s supervisor in conjunction with the employee’s relevant health care provider(s)
and a representative from the wage replacement plan(s). The Individualized Return to Work
Plan will set-out and document the objectives of the Plan, time frames, duties/tasks, training (if
required), limitations, safety considerations, etc., for the employee to return to their regular
duties.
The Plan will also include any responsibilities of co-workers and supervisors and will regularly
document progress (Appendix “B”) towards the goal, such as returning to their regular duties.
The employer will assess the employee’s ability to perform modified work and/or return to
regular duties based on the employer’s obligation to accommodate and the needs of the
Agency. As noted above, progress will take into consideration information from the employee,
their health care professionals, needs of individuals supported, co-workers, etc.
Return to Work Survey:
Each employee following their return to work, full hours and no modifications, will complete a
Return to Work Survey; the employee’s immediate Supervisor will also complete a Return to
Work Survey. Completion of the surveys will be independent with the purpose of evaluating
the Individualized Return to Work Plan. The Return to Work Surveys will assist the Agency in
auditing its Return to Work Program.
3.
Responsibilities:
Shared Responsibility:
Returning to work is a shared responsibility primarily between the employer and the
employee and with this shared responsibility, communication and cooperation towards a
common goal is essential. Health care provider(s)s are responsible for furnishing timely
health and medical information, along with any restrictions, functional abilities information.
Representatives of the wage replacement plan(s) are responsible for management and
monitoring, providing information, education and assistance to the employee and the
employer. The Employer must respond to requests for information and file reports in a timely
manner. The Employee can control payment from wage replacement plans (WSIB or Benefit
Carrier) by providing requested information whether Doctor/Specialist reports, completed
functional abilities forms, dates of follow-up appointments, etc. in a timely manner. When such
information is delayed, payment to the employee is delayed or ended. Together, all parties
working toward a shared goal of early and safe return to work and full productivity, have the
potential to reduce the human and economic impact of workplace injuries and illness.
The Injured/Ill/Disabled Employee will:
a) get proper medical treatment immediately following any (a work-related) illness, injury or
disability, that may cause them to miss work and follow the recommendations of (their) a
qualified health care provider(s), as per ESRTW definition;
b) promptly report all illnesses, injuries or disabilities to their immediate supervisor, along with
completion of Employee Incident Report, submission of medical documentation regarding
length of time off work, expected date of return and any work restrictions;
c) cooperate with the Agency in its (an) ESRTW Program by immediately supplying all
medical information as required by WSIB, the Benefit Carrier or the Employer when
requested and complete all required medical releases;
E.26
d) follow-up with their health care provider regarding delays in processing forms, lack of
details and dates, as required by WSIB or the Benefit Carrier;
e) assist in the development of the Individualized Return to Work Plan, as contained in the
Agency’s ESRTW Program;
f) maintain frequent contact with the Agency’s Administrative Coordinator, to advise of any
changes in their condition, progress in their recovery, delays in processing forms by the
attending health care provider(s), etc;
g) continue to follow recommended medical, rehabilitation programs, etc., to assist with an
early and safe return to work;
h) obtain written clearance from the health care provider(s) to return to work, both to modified
work and/or regular duties;
i) schedule rehabilitation activities, such as physiotherapy, that will result in as little lost time
as possible from the employee’s work schedule;
i) cooperate with all parties involved and be committed to returning to their regular duties;
k) complete the Return to Work Survey and submit such to the Administrative Coordinator,
within seven days of returning to full duties, (full hours, no modifications).
The Employer will:
a) maintain absolute confidentiality and ensure compliance to the ESRTW Program;
b) upon employment, provide each employee with information of Community Living-Central
Huron’s Health and Safety Policy and Occupational Health and Safety Document. A
complete and updated copy of such documents are available at work sites, along with a
‘WSIB Kit’ and “Benefit Carrier Kit;”
c) comply with the requirements for return to work, as outlined in the attached document, as
well as the Workplace Safety and Insurance Act, 1998;
d) provide as soon as possible to the ill, injured or disabled employee with the necessary
forms and assistance in completing and submitting such to the appropriate source;
e) develop in conjunction with the worker and appropriate health care provider(s), an
Individualized Return to Work Plan;
f) maintain frequent contact with the ill, injured or disabled employee to document progress,
discuss the Modified Work Program and the Individualized Return to Work Plan; this
function is the responsibility of the Administrative Coordinator;
g) take all reasonable steps to return ill, injured or disabled employees to their regular duties
as quickly as possible;
h) accommodate to the best of its ability, modified work restrictions, functional abilities, etc.,
of the employee who is unable to return to their regular duties;
i) annually audit and review the Agency’s Early and Safe Return to Work Policy and
Program;
j) maintain an active file for each claim.
a) maintain absolute confidentiality and ensure compliance to the ESRTW Program;
b) contact or follow-up with the ill, injured or disabled employee, as appropriate and as soon
as possible, after the illness, injury or disability has been reported;
c) as applicable, conduct an accident or incident investigation;
E.27
d) develop, in consultation with the ill, injured or disabled employee, Administrative
Coordinator and health care provider(s), an Individualized Return to Work Plan and any
extensions and revisions thereafter;
e) orientate the ill, injured or disabled employee to modified work and/or return to regular
duties;
f) advise co-workers, as appropriate, of modified work restrictions, functional abilities, etc., of
the ill, injured or disabled employee;
g) assist in the collection of medical information, job information for task analysis,
development of workplace modifications; inclusive of regular jobs that can be modified;
h) monitor the ill, injured or disabled employee’s progress and complete the required forms
for documenting progress and required changes to the Individualized Return to Work Plan;
i) cooperate with the Location Health & Safety Representative and all parties involved;
j) complete a Return to Work Survey); Survey is submitted to the Administrative Coordinator.
k) complete a Return to Work Survey, within seven days of an employee’s full return to work
(full hours,no modifications), and immediately submit such to the Administrative
Coordinator.
The Administrative Coordinator will:
a) maintain absolute confidentiality and ensure compliance with the ESRTW Program;
b) cooperate with the Supervisor and the employee and WSIB and/or Benefit Carrier and any
other parties involved;
c) maintain frequent contact with the ill, injured or disabled employee, seeking such
information as any changes in their condition, progress in their recovery, delays in
processing forms by the attending health care provider, etc;
d) apprize the ill, injured or disabled employee’s immediate supervisor of the regular
communication with the worker;
e) apprize the union of ill, injured or disabled employee, as required;
f) follow-up, as required with health care provider(s), wage replacement plan(s), etc., to
ensure progress with the Individualized Return to Work Plan;
g) receive Return to Work Surveys and prepare a summary of such for the Management
Health and Safety Representative and the Executive Director;
h) review annually with the Executive Director, the results of the Agency’s ESRTW Program;
i) maintain all required records in a confidential manner.
E.28
4.
Summary:
IF YOU ARE INJURED ON THE JOB or
You are Unable to Report for Work because of Injury
HERE’S WHAT YOU DO .......
C
Immediately seek proper medical treatment.
C
Report injury to your immediate Supervisor or pager.
C
Complete and submit all relevant forms and documentation to the Agency and
representatives of the wage replacement plan(s).
C
Assist in the development of your Individualized Return to Work Plan.
C
Maintain frequent Contact with the Administrative Coordinator to report on progress,
changes in condition, etc.
C
Immediately address any delays with your health care provider in submission of
information, letters, forms, follow-up, etc.
C
Participate in your Individualized Return to Work Plan.
C
Obtain clearance from your health care provider(s) to return to work.
C
Complete Employee Return to Work Survey.
E.29(a)
5.
Steps and Responsibilities Summary:
Person
Responsibilities
Employee
- Immediately seek proper medical treatment;
- Report injury to your immediate Supervisor or pager;
- Complete and submit all relevant forms and documentation to the
Agency and wage replacement plan(s); follow -up as necessary;
- Assist and participate in the development of your Individualized Return
to W ork Plan;
- Maintain frequent contact with the Administrative Coordinator to report on
progress, changes in condition, etc.;
- Obtain clearance from your health care provider(s) to return to work
(modified and/or regular duties).
- Complete Return to W ork Survey
Supervisor
- Maintain confidentiality and ensure compliance to the Early and Safe
Return to W ork Program;
- Contact or follow -up with the employee as soon as possible, after the
injury/illness/disability, has been reported;
- Conduct an accident or incident investigation, as applicable;
- Develop, in conjunction with the employee, Administrative Coordinator and
health care provider(s), an Individualized Return to W ork Plan and any
extensions and revisions thereafter;
- Orientate injured, ill or disabled employee to modified work and/or
return to regular duties;
- Advise co-workers, as appropriate, of modified work duties,
restrictions, functional abilities, etc. of the employee;
- Assist in the collection of medical information, job information for
development of workplace modifications, and/or return to regular
duties;
- Monitor the employee’s progress and complete the required forms for
documenting progress and required changes to the Individualized Return
to W ork Plan.
- Complete Return to W ork Survey.
Administrative
Coordinator
- Maintain confidentiality and ensure compliance with the ESRTW
Program;
- Cooperate with the Location Health & Safety Representative and
parties involved, inclusive of preparing up-to-date reports;
- Maintain frequent contact with the employee regarding any changes in
their condition, progress, delays in processing forms by the attending
health care provider(s), etc.;
- Update the employee’s immediate Supervisor of employee’s progress;
- Follow -up, as required, with health care provider(s), wage replacement
plan(s), etc.;
- Prepare a summary of submitted Return to W ork Surveys; provide a copy of
such to the Management H & S Rep. and Executive Director;
- Review annually with the Executive Director, the results of the
Agency’s Early and Safe Return to W ork Program;
- Maintain all required records.
E.29(b)
Related Policies:
-
Privacy (A-004)
Volunteer (B-007)
First Aid Policy & Procedures (D-012)
Disciplinary (E-012)
E.29 ( c )
COMMUNITY LIVING-CENTRAL HURON
Return to Work Survey
This survey is to be completed by both the Supervisor and the employee independently, once the
employee has returned to work, full hours and no modifications. Please complete within 7 days of full
return to work; completed forms are given to the Administrative Coordinator.
Name of Employee:
Position:
Supervisor:
Work Locations:
Employee Off on: G WSIB Claim
G Benefit Carrier
G Other
What was the duration of time from the initial injury/illness report to return to work(full hours and duties)?
Was there any lost time? G YES
G NO
Was there any period of modified duties? G YES
What was the initial Return to Work Plan?
G Own job
G with modifications G temporary
G Other job
G with modifications G temporary
G Other, Alternative work
Was the Return to Work Plan Achieved? G Yes
Why or Why not?
G permanent
G permanent
G NO
G unknown
G unknown
G No
Comments:
What worked well in the Return to Work Plan?
What are the opportunities for improvement? (What would you change about the process if you could?)
Completed by:
Date:
Thank you for completing this survey. Confidentiality of this information will be maintained at all times. If
you have any questions, please contact the Administrative Coordinator.
Section:
Subject:
E
Benefit Plans
Total Pages:
1
Approval Date: Feb. 21, 2007
Revision Date(s): Oct. 16, 2013 and Oct.
15, 2014.
BENEFIT PLANS
Community Living-Central Huron provides various Benefit Plans for its employees. The Terms and
Conditions of the Master Plans and Policies with respect to Benefit Plans, shall govern administration,
application and eligibility to such plans. The Agency will adhere to both the Privacy and
Confidentiality Policy with respect to administering benefit plans. Non-compliance with the Benefit
Plans Policy is subject to discipline, up to and including dismissal from the Agency’s employ.
Information on benefit coverages, eligibility, costs, claims procedures, etc., are available from the
Administrative Coordinator and/or the booklet or brochure provided by the Carrier. When an employee
is off on Workers Safety and Insurance Board (WSIB) or a Short or Long Term claim through the
Benefit Carrier, the Administrative Coordinator will be the primary contact to both the employee and
WSIB/or Agency Benefit Carrier. Employees who are approved for and received Long Term Disability
Benefits (LTD Benefits) shall cease to be entitled to Extended Health Care (EHC) and Dental Care
Benefits through the Agency’s Benefit Plan, effective two (2) years from the date the employee was
approved for LTD Benefits. Employees who are approved for and received WSIB Benefits shall
cease to be entitled to Extended Health Care (EHC) and Dental Care Benefits through the Agency’s
Benefit Plan, effective two (2) years from the date of accident or injury. Also, it is the employee’s
responsibility to respond within the timeframes determined by WSIB or the Agency Benefit Carrier for
providing medical information/documentation.
The Administrative Coordinator will notify employees in writing of their eligibility for benefits and
provide all necessary enrolment cards/applications/forms to satisfy all submission time frames. It is
the responsibility of the employee to complete applications/forms and return them to the
Administrative Coordinator within the specified timeframe for eligibility.
Employees are required to contact the Administrative Coordinator to discuss their eligibility, changes
in status, change in address and the administration of the various benefits. Should an employee not
wish to participate in a Benefit Plan offered by Community Living-Central Huron, they must provide
the Agency with a letter noting the offer and refusal. Should an eligible employee decline benefits, or
if benefits are not granted by the Agency’s Benefit Carrier, Community Living-Central Huron does not
provide any salary compensation for not participating in the benefit.
Community Living-Central Huron has the authority to change the carrier of any Benefit Plans.
Related Policies:
Privacy (A-004)
Employee Records Policy (E-004)
Staff Orientation (E-005)
Retirement (E-015)
E.30
Section:
Subject:
E
Record Retention and
Archives Policy
Total Pages:
2
Approval Date: January 20, 2010
RECORD RETENTION AND ARCHIVES POLICY
This Policy refers to all documentation related to the operation of Community Living-Central Huron,
Board of Directors, as well as the supports and services provided to persons supported, Staff and
volunteers. Abiding by the Record Retention and Archives Policy, the destruction of records will
ensure compliance with all legislation and regulations with respect to the Ministry of Community &
Social Services, Employment Standards, Human Rights Code, Occupational Health & Safety Act,
Pay Equity Act, Canada Revenue Agency and other applicable requirements. Non-compliance with
the Record Retention and Archives Policy is subject to discipline, up to and including dismissal from
Information and records will be kept in a locked area. Central Administration Staff have the
responsibility of archiving and storing all documentation, information and records in a secure,
confidential manner until a contracted commercial record destruction company attends on site to
shred the stored documentation. Once the documentation has been shredded, the Agency receives
a “Certificate of Destruction.”
1.
a)
Persons Supported:
Community Living-Central Huron is required to keep a written record for each person
supported and shall retain the record for a minimum of seven years after the date the person
supported is no longer receiving service and support from CL-CH.
b)
The record will include a copy of the Application for Developmental Services and Supports;
Supports Intensity Scale (SIS) and Needs Assessment; Individual Support Plan, as well as the
person’s supported name; age; gender; address prior to admission; personal and family
history; the date and circumstances of their admission; terms of any payment arrangements;
medication administration records; medical, psychological and other similar
assessments/recommendations; and the name, address and contact information of their
parent/guardian/caregiver.
c)
When a person supported has withdrawn from service, the record will contain as much
information as possible, such as, the date and reason of the withdrawal of service,
name/contact information of relevant support services, contact information pertaining to the
individual, relevant Release of Information Forms.
d)
For persons supported currently receiving services, records to be archived will be provided to
the Central Admin. Staff for that purpose, in accordance with Section 4. Summary. Current
files will retain the most recent information that is considered necessary (ie. Orders,
assessments/reports).
E.31
2.
a)
Staff and Volunteers:
As stated in the Agency’s Personnel Records Policy (E-004), a separate file is kept for each
employee and volunteer in secure cabinets for a period of seven years after the
employee/volunteer leaves the Agency.
3.
a)
Agency Records:
Records related to the financial and legal aspects of the Agency, including such items as
banking records, mortgages, loans, securities, accounts payable, accounts receivable,
taxation, cheques, etc., must be supported by original documents. The Canada Revenue
Agency requires that such documents be archived for a period of seven years from the end of
the last taxation year.
b)
The Canadian Human Rights Act and the Ontario Pay Equity Act recommends records related
to the Pay Equity Commission and/or Human Rights Commission be kept permanently.
c)
Minutes of Staff Meetings, Nightly Inspection Checklist, Communication Book, Community
Involvement Activity Charts, fire drills, are to be kept for a period of two years.
d)
Joint Health & Safety Committee minutes, agenda, inspections, incident reports, are to be kept
for a period of ten years.
e)
The portable back-up hard drive unit containing the Agency’s financial records must be stored
in a secure manner while off site.
4.
Summary:
Information/Record
Archived
Retention in Agency
File
Persons Supported
Date the person is no longer
receiving service
7 years
Staff and Volunteers
Personnel Records
7 years
Agency
Financial, Legal
7 years
The Canadian Human Rights
Act, Ontario Pay Equity Act,
Pay Equity/Human Rights
Commission
permanently
Staff Meetings, Nightly
Inspection Checklist,
Communication Book,
Community Involvement Activity
Charts, fire drills
2 years
Joint Health & Safety
Committee Minutes, Agendas,
Inspections, Incident Reports
10 years
E.32
Section:
Subject:
E
Staff Recognition Policy
Total Pages:
1
Staff RECOGNITION
Community Living-Central Huron believes that recognizing and honouring Staff for their service to the
Agency and people it supports is an important component of a positive and productive work
environment. Each employee contributes in a variety of ways to support the Agency to achieve its
vision. Recognition should be fair, transparent, inclusive, timely and be meaningful and reflect the
preferences of the recipient.
The Board of Directors of Community Living-Central Huron will demonstrate its appreciation to Staff
by way of a Staff Recognition Program as follows:
-
acknowledging Staff for continuous years of service with a gift and/or gift certificate at 5 year
intervals, beginning with the completion of 5 continuous years of service and then every fifth
year, thereafter. A year of service is based on the Agency’s fiscal year, April 1st to March 31st.
The gift/gift certificate’s value increases at each 5 year interval between 5 and 40 years of
service as follows:
after 5 years
after 10 years
after 15 years
after 20 years
after 25 years
after 30 years
after 35 years
after 40 years
-
- value $20.;
- value $35.;
- value $50.;
- value $100.;
- value $200.;
- value $300.
- value $400., plus a gift certificate in the amount of $100., to a restaurant of
the
employee’s choice; and
- value $500., plus a gift certificate in the amount of $100., to a restaurant of
the
employee’s choice.
the presentation of the gift/gift certificate will occur as part of the Annual General Meeting and
Dinner where those Staff being recognized will be invited to the Dinner as a guest of the Board
of Directors.
Also, the Board of Directors hosts an Annual Christmas Party whereby Staff are invited and may
bring a guest.
Expressions of Sympathy/Memorial Donations:
As an expression of sympathy or memorial, the Board of Directors will send a sympathy card or make
a contribution to a charity, club, foundation, etc., as appropriate, upon the death of an employee or
their immediate family member.
E.33
Section:
Subject:
E
Volunteer Recognition Policy Total Pages:
2
Revision Date(s):
VOLUNTEER RECOGNITION
The Board of Directors of Community Living-Central Huron believes that recognizing and honouring
volunteers, direct and indirect, for their service to the Agency and people it supports is important.
Each volunteer can contribute in a variety of ways to support the Agency to achieve its vision.
Volunteers will be recognized in a timely and consistent manner.
The President of the Board, in consultation with the Executive Director, will annually review the length
of service of volunteers. The following will guide the Board of Directors with recognition to volunteers:
Board and Committee Members:
honour Board Members upon retirement from the Board, presenting them with a framed
Certificate of Appreciation; the Certificate to be signed by the President of the Board, or an
Executive Committee Member;
-
recognize Committee Members upon their retirement from the Agency, with a Letter of
Appreciation for their service and commitment;
-
for outstanding contributions, per the Agency By-Laws, acknowledge Board or Committee
Members with an Honourary Life Membership to the Agency;
-
nomination of Board and Committee Members to various provincial award programs (ie.
Ontario Volunteer Service Awards), for their continuous length of service, beginning at 5 years
and at five year intervals thereafter; and
-
Volunteer Committee Members who are not Members of Community Living-Central Huron will
receive a copy of the Agency Newsletter and will be acknowledged in the Committee’s Annual
Report to the Membership;
-
when possible, invite the local newspaper and include a photo/information in the Agency
Newsletter, to acknowledge volunteers, ensuring community recognition and appreciation for
their contributions.
Unpaid “Direct” Volunteer Recognition:
To acknowledge the contributions of volunteers, including Students who work directly with individuals
supported, the Agency will demonstrate appreciation to such individuals, depending on the length of
their involvement (weeks, months) with the Agency and their contributions. Such acknowledgments
can occur at various times throughout the year and may include: mementos of the Agency; Certificate
of Appreciation, luncheon or a gift/gift certificate, with a maximum value of $20. The student and/or
volunteer’s immediate Supervisor will initiate such recognition.
E.34
Presenter/Speaker Recognition:
From time to time, the Agency invites various presenters, speakers and/or performances for particular
functions and/or topics. Should such presenters not have a fixed charge/rate, Community LivingCentral Huron will provide recognition by way of mementos of the Agency, Certificate of Appreciation,
gift/gift certificate and/or cash donation, specific to the nature of the contribution. The Supervisor
responsible for inviting the presenter, speaker and/or performance will be responsible to initiate
appropriate recognition. All financial amounts of recognition will be approved by the applicable
Committee and forwarded to the Board of Directors for consideration.
Expressions of Sympathy/Memorial Donations:
As expressions of sympathy, the Board of Directors will send a sympathy card or make a contribution
to a charity, club, foundation, etc., as appropriate, upon the death of a person supported or their
immediate family member and a volunteer with the Agency or their immediate family member.
Also, as appropriate, the Board of Directors reserves the right to demonstrate appreciation,
remembrance and honour long-term volunteers on an individual basis and to other community
members and/or businesses who have made significant contributions to the Agency.
E.35
INDEX OF
POLICIES AND PROCEDURES
POLICY NAME
Abuse
Accessibility Policy
SECTION
C
B
PAGE(s)
7 - 11(g)
14 - 17
Bathing and Showering Supervision
Behavioural Support
Benefit Plans
Bullying, Harassment and Workplace Violence
Policy and Procedures
C
C
E
D
22 - 23
2 - 5(c)
30
14 - 20(b)
Communication Book
Community Involvement
Confidentiality
Critical Injury
C
B
A
D
15
4
7-8
11 - 13
Dangerous Weapons and Fire Arms
Disciplinary
Duty of Care
D
E
B
10
18 - 20
18 - 19
Early and Safe Return to Work
Emergency
Employee and Volunteer Orientation
Employee Performance Appraisal
Employee Performance Standards
Employee Records
E
D
E
E
E
E
24 - 29(d)
3-8
7(a) - 7(b)
10
13 - 17
6(a) - 6(b)
Finances of People Supported
First Aid Policy and Procedures
Food and Nutrition
C
D
C
16(a) - 16(d)
30 - 32
24
General Policy No. 2
Guiding Principles
E
A
1
2-6
Hiring
D
E
1
2-4
Individual Welfare/Rights
Individual Support
Individual Consultation
Infection Control Policy and Procedures
Inventory, Personal Belongings
Interpretation
C
C
E
D
C
B
1(a) - 1(b)
17
9
36 - 39
21
1
POLICY NAME
SECTION
PAGE(s)
Medical Care
Medication Policy Statement
Missing Person/Unknown Whereabouts
Musculoskeletal Disorders Awareness
C
D
C
D
20
2
25 - 26
28 - 29
Orientation for People Supported
C
19
Pandemic
Person Supported Complaint/Feedback
Persons Supported Food & Nutrition
Personal Property Damage Reimbursement
Pet Ownership, Visiting Pets and Service Animals
Philosophy
Police Record Check
Press and Media Releases
Preventative Maintenance Policy
D
C
C
E
C
A
E
B
D
21 - 26
6(a) - 6(c)
24
12
18
1
5(a) - 5(b)
2
27(a) -27(d)
Privacy
Professional Development/Training Policy
Purchasing and Credit
A
E
B
9 - 11
8(a) - 8(b)
11 - 13
Record Retention and Archives
Relationship with Law Enforcement Agencies
Retirement
E
B
E
31 - 32
3
23
Serious Occurrence
Sexual Harassment
Sharps
Slips, Trips and Falls Prevention
Smoking
Staff Orientation
Staff Recognition
C
E
D
D
D
E
E
13 - 14(f)
21
18
69 - 74
9
7
33
Tender
B
5
Usage of Agency Equipment/Electronic Communication
Technologies
B
Use of Physical Restraints
C
6 - 7(b)
12(a) - 12(c)
Vehicle Use
Volunteer
Volunteer Recognition
E
B
E
11
8 - 10
34 - 35
Work References
Working Alone Policy
Workplace Inspection Policy
E
D
D
22
33 - 35
75 - 79

Policies and Procedures Document - Community Living

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