Circle of Care

Revised:   

Date:   May 13, 2022    

• All drivers of Circle of Care vehicles and staff who drive at work using their personal vehicles, are to show proof as required that they possess a valid driver’s license
• Persons who drive Circle of Care vehicles must provide an annual copy of a valid driver license and a driver abstract as requested by Circle of Care
• Knowledge of the Highway Traffic Act

• Driver distractions
• Poor vehicle maintenance
• Dangerous road conditions
• Inclement weather
• Inexperienced or nervous drivers
• Risk of collisions
• Poor habits of other drivers sharing the roads

• Collisions resulting in injury to staff/clients, property damage, vehicle damage and/or risk of third-party liabilities
• May result in minor to critical or fatal injuries

• Circle check completed and log initialed (for Circle of Care Vehicles)
• You have your driver’s license/insurance with you while driving
• Fluid levels checked (oil, gas, brake, washer fluid level – evidence of leaks)
• Good Visibility (all snow/ice removed, no damage)
• Wipers (damaged/loose or worn)
• Tires (worn or need air)
• Emergency equipment (first aid supplies, blankets, jumper cables)
• Adjust seat and mirrors (rear and outside mirrors)
• Damaged/missing seatbelts
• Gas tank full
• Parking brake functioning
• Foot brake functioning (not spongy or squeaking)
• Clutch and gearshift smooth
• Steering – no extreme play
• Lights all working (headlights, parking lights, turn signals)
• Dash control panel (no warning lights on)

• Never drive a client in your personal vehicle
• Do not ride in a vehicle a client is driving
• Drive at the posted speed limit
• Adjust driving speed to adverse conditions
• Do not follow too close. When stopping behind another vehicle, ensure you stop far enough behind to be able to see the rear tires of the vehicle in front of you touching the road
• Always pay attention. Know where all vehicles are around you at all times
• Never dial, text, use a hand-held phone, read or look at or for anything in the car while you are driving
• Stay calm while driving. Listen to relaxing music
• Combat the warning signs of stress by getting fresh air and breathing deeply and slowly.
• Drive in a courteous and considerate manner. Give way at busy intersections and where traffic lanes merge
• Don’t compete or retaliate. If someone’s driving annoys you, don’t try to “educate them”. Leave traffic enforcement to the police
• Don’t take other driver’s mistakes personally
• Avoid honking your horn unless necessary and, if you must, tap on it lightly
• If you miss your turn, do not take short cuts. Go around the block or turn at the next street and go back
• Park in a well-lit area or under street light at night
• Check tires or walk around before getting into your car

• Report vehicle collisions to the police if there are any serious personal injuries and where significant damage to vehicle occurs
• Damage to public or private property must also be reported to the police
• Motorists involved in a collision are required to provide their name, address, driver’s licence number, licence plate number, insurance information, and the name and address of the registered owner of the vehicle to police and to any person involved in the collision
• Every driver involved in a collision must remain at the scene of the collision to offer assistance when needed especially where there are injuries
• The penalty for leaving the scene of a collision also includes seven demerit points
• For collisions that do not involve injuries or fatalities, you are required to go to a self-reporting collision centre
• Police will only attend the scene of collisions involving a fatality or serious injury, collisions involving three or more vehicles and/or the need to call an ambulance
• If there are injuries, fatalities, fuel leaks or serious vehicle damage, do not move the vehicle(s). Turn off all engines. Do not smoke, light a match or put flares near any vehicle that is leaking fuel. If there is a fire, get the people out and make sure everyone is well out of the way. If there is no danger of fire or explosion, leave injured people where they are until medical help arrives
• Call your supervisor immediately

• Prepare for the journey (check the travel route, weather, road conditions) before you leave.
• Complete circle check and vehicle maintenance (for Circle of Care vehicles)
• Adjust all mirrors and your seat

·  Training on slip, trip and fall hazards

·  Inclement weather, hazardous walking conditions, bathroom safety

·  Exposure to slippery or wet floor surfaces or poor winter weather conditions

·  Surface contaminants on floors that cause loss of traction (snow, water, grease, dirt)

·  Working in wet areas such as bath/shower rooms

·  Inappropriate footwear

·  Inappropriate behaviour such as running to catch a bus, being distracted by being on a mobile phone, rushing, not following established safe work procedures, etc.

·  Flooring with poor traction or slip resistance such as a wet bathroom floor

·  Obstructions, obstacles and trip hazards left in high traffic pathways

·  Rushing to get to a client on time or rushing when clients may be booked too close together not giving enough time to travel or trying to reach the client at the scheduled time, particularly when the weather is poor

·  Bruises and contusions

·  Strains and sprains

·  Fractures

·  Be aware of surroundings always in client home and office

·  Take extra care when walking in poor weather & leave early to get to your first client to avoid rushing

·  Do not rush or run especially when trying to catch a bus

·  Roll up loose rugs at a client home

·  Ensure the necessary bathing equipment is available for you to assist the client safely. If no equipment is available or the client refuses to use it, the PSW should do a sponge bath

·  If client appointments are booked too close together notify your Service Coordinator that you are rushing in inclement weather. Tell the Coordinator the client names & let them know why you are late

·  Ensure loose floor mats do not pose a slip or trip hazard & pick up or remove when providing care. Ask client if you can move them & put them back after

·  Clean up spills when they happen

·  Keep walking areas free of clutter, furniture. If client home is cluttered and poses a hazard, contact your Supervisor to help identify corrective actions with client and/or family members

·  Report all hazards to your supervisor

·  Avoid running or rushing to get to the next client appointment

·  Use proper positioning when assisting a client on stairs

·  Ensure there is safe access to a client’s home. Do not try to walk through dangerous conditions where there is construction or take short cuts

Good Body Mechanics

Safe Operating Procedures

Revised:   May 2018

·  Not aware of or using safe body mechanics

·  Not practicing correct body mechanics, working too quickly or trying to reach away from your body

·  Risk of MSD injuries when good body mechanics are not used

·  Strains and sprains from using poor body mechanics

·  If there is a second caregiver, check that they know what they need to do to assist

·  If there is assistive devices (lifts, walkers or slings) know how to use them and position them properly so you are ready to use them without reaching or pulling the client

·  Maintain your physical wellbeing. Stretch, strengthen your abdominal muscles

·  Ensure you take time to rest between tasks that are repetitive

·  Get enough sleep (6- 8 hours each night)

·  Take time to de-stress and relax

·  Report changes in your client’s condition to your Supervisor

·  In the event that a transfer requires 2 persons (as per care plan) & a 2^nd person is not present, DO NOT attempt to transfer alone

·  Modify care to ensure your safety

·  If you are being asked to do something that you feel is not safe, call your Coordinator or the CSS

·  If the client transfers are difficult or become more hazardous contact the Nurse (CSS) to request that an OT or PT come to assess

·  Know each step of the task

·  Plan ahead to reduce the need to take short cuts

·  Know your client and their abilities. Ask them to help you wherever possible. Communicate to client exactly what you are doing

·  Keep you back in the neutral position (bend at the hips and/or knees)

·  Keep a wide base of support (plant your feet at least shoulder width apart)

·  Keep people & objects as close to your body as possible (holding heavier objects away from your body takes more effort and puts more stress on the muscles)

·  Do not twist when carrying, pushing or crouching. Move or change your feet to point them in the direction you are going

·  Tighten your abdominal muscles when lifting or when starting to push

·  If you are working with another person, keep up communication so both parties know what to expect

·  Use a standing kneel lift to reach or assist clients across a bed. Stand close the bed. Place one knee on the side of the bed, tighten the abdominal muscles and reach or assist a client to turn

·  Reduce the load and divide it into smaller weights whenever possible

·  Sleep on your back or side as opposed to your stomach

·  If needed, place a pillow under your knees (for back sleeping) or between your knees if on your side

·  Keep a neutral head posture, keeping your head directly over your neck with the chin tucked in slightly. Keep the ears over your shoulder

Circle of Care

Revised:   

Date:        April 2012

·      All Personal Support Workers

·      Fundamental education on cognitive deficits

• Safe Management

·      Inappropriate behaviour towards caregivers

·      Unprovoked or sudden actions by resident during care

·      Resident becomes resistive to care and display responsive behaviours such as biting, spitting, kicking, grabbing, punching, and/or scratching of employee who tries to provide or assist with care

·      Resident shows verbally abusive behaviour towards staff during care

• Behaviours that challenge the skills, resources and safety of the Caregiver

·      Bruises, scratches and contusions

·      Strains and sprains

·      Fractures

• Emotional trauma

• None

• Caregivers

• None

·      Assess and gauge receptiveness of client prior to approaching to determine temperament and mood at that time

·      Stand at the front door before entering the room and introduce yourself

·      Try to find out any established triggers for behaviours

·      Review the care plan, and assessment history for the client to learn about their preferences, temperament, dislikes, former occupation and hobbies

·      Take opportunities to speak to family members if possible to learn more about the client’s likes and dislikes

·      Do not rush or force client

·      Continually gauge temperament and be aware of changes or early warning signs that may indicate escalating behaviour such as clenched fist(s), silence, changes in facial expression or any other changes from normal behaviour

·      Understand the unique ways that are specific to each client and assess any changes, stopping or re-directing your behaviour to reduce or eliminate what is triggering the different behaviour

• Ensure the clients who require heightened monitoring for behaviours, are identified

·      Seek medical attention if needed

• Notify supervisor

·      Re-assess each client before each encounter, ask for permission and explain what you would like the client to do

·      Understand that the client may not recognize you or understand your communication or language and may have forgotten how you fit into their life

·      When entering a room, introduce yourself, use eye contact and gestures. For example, if you need to assist the client to get up, raise your hands in a gesture. When talking, speak slowly and allow for silences so the resident can process the information

·      You should know if the client is currently on a tranquilizer or any other medication that has a sedating effect, to help you understand that they may be slower than usual or not as attentive

·      Break the task into individual steps and explain what you are doing and what will be happening next. Prepare them for the experience so they can prepare for each sensation such as a warm bath or a wet cloth

·      Offer verbal reassurance when things are going well, using a soft voice and tone. Try not to speak in monotones without any expression

·      Avoid reacting with adverse facial expressions or words and tone of voice when something goes wrong. This could escalate a situation

• When the client is at extreme agitation and overwhelmed you may need to STOP, leave them in a safe environment and re-approach later. When you return, use a different approach

• None

• None

Circle of Care

·            Personal safety concerns and associated injuries

·         Injury from exposure to unknown hazards because of work in unfamiliar areas/homes

·         Assault, various injuries as a result of aggressive acts

·            Cuts, bruises, fractures, emotional trauma

·         Assess the home environment for risks prior to beginning work

·         For all new client areas analyze the safest route to take/ensure buses run at times you need access

·         Ensure cell phone is accessible and charged

·         Familiarize yourself with any new areas

·         Plan the safest route to and from the client’s home

·         Know emergency numbers & program them into your phone

·         Know the local transit route

·         Do not give clients personal phone numbers. Use call block

·         Dress conservatively. Wear appropriate footwear.

·         Wear light colored clothing for evening visits.

·         Use elevator safety tips. Do not get on the elevator 1^st if you are uncomfortable or do not get on if someone is there who you do not feel comfortable with

·         If using public transit sit in designated safety areas. If empty sit close to the driver.

·         Stay alert and mindful of surroundings.

·         Keep to well-lit routes & well-traveled streets.  Do not take short cuts.

·         Walk briskly and with purpose. When possible keep hands free.

·         Walk against flow of traffic. Never wear headphones or text message while walking

·         Do not walk through a crowd or engage in conversation with strangers

·         Avoid using public phones and ATM machines in unfamiliar areas

·         If someone tries to rob you give up your property

·         If you are being followed in your car drive to the nearest ‘safe’ building

·         If you think you are being followed walking, cross the street, walk to the nearest open store or restaurant

·         Never allow someone to force you into a vehicle. Fight back. Roll under your vehicle if possible.

·         Keep vehicle in good running order

·         Check your car before getting in

·         Have your keys in hand

·         Know where to park your vehicle.  Park in well-lit areas.

·         Never enter a home not scheduled for a visit.

·         Exercise care in hallways, elevators and
stairwells.

·         Stick to the center of the hallway in an apartment building.  In an emergency, knock on as many doors as possible and yell “FIRE”.

·         Do not enter a home if there is a visible threat to your safety

·            If you are in immediate danger, call 911

·            Notify your supervisor immediately

·            If you seek medical attention notify your supervisor

Circle of Care

Revised:  New

Date:  May 2018    

Training and Competency

·  Infection Prevention and Control Practices

·   Exposure to potentially infectious organisms

·  Exposure to unknown potentially infectious products, materials, surfaces and blood and body fluids

·   Occupational illnesses and disease

·   Risk of cross contamination exposing employees and clients to illness causing organisms

·   Non-latex, no powder disposable gloves

·   Fluid resistant face masks (when there is a risk of spraying or splashing into the face)

·   N95 fitted respirator (when there is exposure to airborne pathogens)

·   Fluid resistant gown (where there is a risk of spraying or splashing potentially infectious microorganisms onto clothing & only as instructed by Circle of Care)

·   Safety glasses (if there is a risk of spraying or splashing of infectious microorganisms where client is sick with frequent coughing, sneezing)

·   All PPE for biological hazards except safety glasses are one time use only and are to be disposed of immediately after use

·   Safety glasses are to be disinfected using hand sanitizer or alcohol wipe)

·  Do not wear an N95 unless it has been fit tested and approved for use

·  Ensure all PPE is kept in a clean dry area protected from dust and humidity

·   Seek medical attention if needed

·   Notify supervisor

·  COC willcommunicate information on clients where enhanced precautions necessary

·  Read the care plan or contact your CSS if you have any concerns Use routine precautions (wash hands before & after contact) for all persons and before preparing, handling or serving food, after servicing or cleaning potentially contaminated equipment or materials, when handling soiled linen, after personal body functions (using the toilet, blowing your nose, smoking, etc.)

·  Use proper hand washing sequence and wash hands for 10 – 15 seconds

·  Verify what if any PPE are required prior to performing personal care

·  Use an alcohol-based hand sanitizer as an added precaution during outbreaks or when caring for a person who has a communicable illness

·  Keep nails short and clean

·  Follow the policy on staying home if you are sick with frequent coughing, fever or diarrhea

·  Report all concerns of potential infections to your Coordinator or CSS

·  Get vaccinated to protect yourself and those you care for