Skip to content | Skip to institutional links

Common menu bar links

Institutional links

Current Subject
- First Nations, Inuit & Aboriginal Health
- Reports & Publications
Explore...
Proactive Disclosure

Proactive Disclosure

First Nations, Inuit and Aboriginal Health

Print |

Need Larger Text? |

First Nations and Inuit Home and Community Care Policies Template Manual

Saint Elizabeth Health Care 2000

Help on accessing alternative formats, such as Portable Document Format (PDF), Microsoft Word and PowerPoint (PPT) files, can be obtained in the alternate format help section.

(PDF Version - 3 200 K)

Introduction
Use of the Manuals
Standards and Policies
- The Value of Standards and Policies
- Standards, Policies and Procedures: Definitions
Background
- First Nations and Inuit Home and Community Care Program
- Program Roles and Responsibilities
  - Communities
  - Federal Government
Future Activity
- Tips for Customizing Standards and Policies to Meet the Needs of Your Community
- Preparing for Accreditation
Part 1: The Organization
Part 2: Scope of Services
Part 3: Client Care
Part 4: Human Resources
Part 5: Quality
Part 6: Operations
Part 7: Health and Safety
Part 8: Clinical/Service Delivery
Selected Clinical Protocols are provided as examples of this section.
Part 9: Supports for Using this Manual
- References
- Glossary of Terms

Introduction

Use of the Manuals

Development Process of the Template Manuals

The standards and policies templates, which appear in these First Nations and Inuit Home and Community Care Program Standards and Policies Template Manuals, have been developed with the assistance, input and direction of the Working Group for Standards, Scope of Practice, Liability and Training. This Working Group then provided its recommendation and a copy of the draft standards and policies template manuals to the National Steering Committee for their review and approval. A list of the Working Group members appears at the end of this introduction.

In addition to the direction provided directly by the Working Group and the Committee, input from First Nations and Inuit communities was sought during the development of the manuals. This input provided feedback from the perspective of those who will be using the manuals, and with the fresh eyes of people who were not involved in the manuals' development. The manuals have been created as living documents. They should be revisited and revised on an ongoing basis, and it is hoped that First Nations and Inuit communities will share their own customized standards and policies to enlarge the pool of information, examples and tools to support the success of the First Nations and Inuit Home and Community Care Program.

Intent of the Template Manuals

These First Nations and Inuit Home and Community Care Program Standards and Policies Template Manuals provide examples and templates on which local communities can build their own standards and policies manuals. The manuals are intended to be used as tools to support the development of customized standards and policies to address the specific needs of each community and its First Nations and Inuit Home and Community Care Program.

The manuals do not reflect mandatory practice. Instead they are building blocks, or a starting point, that communities can use to help them in the process of creating their own tools for their individual Programs and community needs.

Graphic from Resource Kit

Suggested Use of the Manuals

It is suggested that the manuals be used during the development of your community's First Nations and Inuit Home and Community Care Program to help you more easily develop standards and policies to shape the procedures and tools you will need for a successful Program. You may choose to use these templates for a while before modifying them to more effectively meet your own Program and community needs.

These templates and the customized standards, policies, procedures and tools that you create will serve as guidelines for staff to ensure:

Quality
Client and family satisfaction
Work satisfaction
Fairness
Sustainability and effectiveness of your Program

These tools will also support ongoing capacity building and help in the regular evaluation and ongoing improvement of the Program.

It is suggested that the standards, policies and procedures that your community uses should be reviewed every year. These template manuals can be used as a resource during this process. They can provide useful suggestions as to how your existing standards and policies might be revised and improved to meet the changing needs in your community and in your Program.

It is important to note that standards and policy development is an ongoing activity that will make the actual delivery of Program services much easier, more consistent and efficient, and with the assurance of quality, fairness and client satisfaction.

As well, these standards and policies template manuals will be helpful if you choose to participate in the accreditation process in the future.

Notes When Using the Manuals

To make the manuals easier to use, a number of features have been included in their design:

Cross references of policies to related standards
Use of symbols to quickly and easily reference standards and policies sections (the symbols used here are only examples and communities are encouraged to create and/or select symbols that reflect their community and its Program). Another way to provide easy reference is to colour code each section of the manuals.
A comprehensive glossary which appears at the back of each manual to provide definitions of key words that are identified by italics throughout the manual
A listing of references which also appears at the back of each manual to provide additional resources to help you in developing your own standards, policies and procedures
A flow chart that visually describes the contents of the two manuals and how the materials, including suggested procedures, link
References to sample tools that can be used as examples on which to build customized tools to support policies and procedures

An Explanation of the Formats Used for the Standard and Policy Templates

The various parts of the format used for the standard and policy templates are explained on the following pages. You may want to read them before reading the standards and policies templates so that you have a better understanding of the flow of each format and the purpose of each section within these formats.

Symbol for easy reference to main standards sections (communities can customize symbols)

An Explanation of the Format Used for the Standards Template

First Nations and Inuit Home and Community Care Program
Standards Template Manual
Community Logo

Section: Refers to major heading in the manual, for reference to related standards
Community Name

Standard: Provides specific standard name
Standard Number: XXXX

Approval: A signature (or signatures) here will confirm that this standard has been reviewed and approved, and is to be used. These signatures reflect the review process and include community leadership.

Date: This date helps you to be sure that this is the most recent version of the standard

Standard

This text provides the key statement of the standard. The rest of the information that you will find in the template builds and supports this key statement.

Process Steps

This section provides suggestions for activities to achieve the standard. Not all of them may be appropriate for your program or community; however, they should help you to identify what you can be doing to achieve the standard.

Symbol for easy reference to main standards sections (communities can customize symbols)

Evaluative Criteria

It is important to evaluate the effectiveness of the activities to determine if they are helping you to achieve the standard. This list describes some suggestions to help you identify the activities that you need.

Challenges to Consider

This section lists the challenges that you may face as you work to achieve the standard. It is important to consider these challenges so that you are prepared for the difficulties that may arise.

Suggested Policy References

This section lists policies that you can find in the policies template manual to help you achieve the standard in practice. Clip art is used to help find the related sections of the policies template manual more easily.

Some Suggested References

In addition to the related policies, there are other materials that will be useful in understanding and shaping this standard for your own community's needs. These references are listed here and more detailed information is provided at the end of each manual so that you can find the documents you want to reference.

Review Process:

It is important to review standards regularly to ensure that they are still effective. As well as monitoring how well they are being achieved, it is important to be sure they are updated as services and communities' needs may be changing. The review process includes the participation of community leadership.

Dates:

Recording the dates of the review process will be a reminder to review standards on an annual basis, or more often if changes occur.

Symbol for easy reference to main standards sections (communities can customize symbols)

Top of Page

An Explanation of the Format Used for the Policies Template

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part: Refers to major heading in the manual, for reference to related policies
Community Name

Policy: Provides specific policy name
Policy Number: XXXX

Approval: A signature (or signatures) here will confirm that this policy has been reviewed and approved, and is to be used. These signatures reflect the review process and include community leadership.

Date: This date helps you to be sure that this is the most recent version of the policy

Policy

This text provides the key points of the policy. The rest of the information that you will find in the template builds and supports these key statements.

Policy Rationale

This section highlights the reason(s) for having the policy. It reflects the related standard(s) and may, sometimes, be the actual standard(s).

Policy Details

This section provides details about the most important part of the policy to reinforce the message and helps to ensure the successful application of the policy in day-to-day practices.

Symbol for easy reference to main policy sections (communities can customize symbols)

Process Guidelines

This section expands on the policy and provides information to be considered in processes and in practice. If this information is used as the base to build these processes, it is likely that the policy will be achieved.

Performance Measurement Suggestions

This table offers suggested ways to determine how well the policy is being achieved in day-to-day practice, related processes and procedures. These measures provide a base on which to monitor success and progress.

Related Standards

This section lists standards that will help to understand this policy, and also uses the symbols to more easily guide you to the related sections in the standards template manual.

Some Suggested References

In addition to the related standards, there are other materials that will be useful in understanding and shaping this policy for your own community's needs. These references are listed here and more detailed information is provided at the end of each manual so that you can find the documents you want to reference.

Review Process:

It is important to review policies regularly to ensure that they are still effective. As well as monitoring how well they are being applied in practice, it is important to be sure they are updated as services and communities' needs may be changing. The review process includes the participation of community leadership.

Dates:

Recording the dates of the review process will be a reminder to review policies on an annual basis, or more often if changes occur.

Symbol for easy reference to main policy sections (communities can customize symbols)

Each community is responsible for developing and putting in place their own procedures. These procedures need to outline the practical steps to be taken to carry out the process guidelines for this policy.

Suggested Procedures

This section suggests procedures that should be used to practice the policy described in day-to-day practice. As well, it lists suggested tools that will help to effectively develop and use the procedures that are recommended.

Symbol for easy reference to main policy sections (communities can customize symbols)

Standards and Policies

The Value of Standards and Policies

For Individuals and Families

Community members who are receiving services, or whose family members are receiving services, are likely to feel more secure and comfortable knowing that providers are guided in their work by standards and policies designed to promote client rights, client satisfaction, fairness, quality of care, appropriate training and work satisfaction.

Clients and families have the responsibility of understanding why standards and policies are in place and how they can ensure appropriate care, equitable access to services, and client rights.

For Communities

Communities as a whole are likely to benefit from standards and policies that help to ensure the sustainability and effectiveness of the First Nations and Inuit Home and Community Care Program. The standards and policies encourage ongoing program evaluation, quality improvement, cost effectiveness and client satisfaction. Therefore, they help to ensure the success, sustainability and necessary capacity building to support the First Nations and Inuit Home and Community Care Program in the future. In addition, this experience in program development, implementation and evaluation provides an excellent base of experience and wisdom as the community continues to develop programs in health and other services in the future.

Community leadership, the political body of the community, has the responsibility of receiving, understanding, and approving the standards and policies for the delivery of the Program. Community leadership provides overall direction in this way, rather than becoming involved in the day-to-day operations of the Program.

Standards and policies provide the community leadership with the tools necessary to respond to requests and complaints from community members. They provide the basis for decision-making and conflict resolution.

For Program Staff

Standards, policies, procedures and tools provide clear direction and enable Program staff to conduct their tasks and activities with confidence, effectiveness and efficiency. In addition to improving quality and client satisfaction, staff will likely experience greater work satisfaction. The environment in which they work will reflect values of respect, ongoing learning and staff development.

Program management has the responsibility of implementing the approved policies and ensuring adherence at all times, and of monitoring, reviewing and updating them on a regular basis. Program staff are responsible for knowing the policies and adhering to them in their daily activities. Both Program management and staff participate in the review and revision of policies.

Graphic from Resource Kit

Standards, Policies and Procedures: Definitions

The following definitions from the 1999 Canadian Council on Health Services Accreditation AIM (Achieving Improved Measurement) Standards help to clarify and explain the differences and relationship of standards, policies and procedures.

The Goal:

A Standard is defined as the "desired and achievable level of performance against which actual performance can be compared".

The "What":

A Policy is "a written statement that clearly indicates the position and values of the organization on a given subject". A policy identifies what needs to be done to achieve the standard.

The "How":

A Procedure is a "written set of instructions that describe the approved and recommended steps for a particular act or sequence of acts". A procedure outlines how the policy will be carried out in day-to-day practice.

Standards, policies and procedures must all link together to ensure success of any program. Procedures are based on policies that enable standards to be achieved. Procedures are the most practical, in that they reflect the day-to-day practice that reflects the policies of the Program. The policies template manual suggests procedures and tools that should be developed at the practical level. The following chart identifies the connection of standards, policies and procedures:

The following chart identifies the connection of standards, policies and procedures

Background

The First Nations and Inuit Home and Community Care Program

The First Nations and Inuit Home and Community Care Program The Federal Government is committed to improving the health and well being of First Nations and Inuit and in February 1999 funding of the First Nations and Inuit Home and Community Care Program was approved. Autonomy and control of health programs and resources by local First Nations and Inuit communities are inherent components of the planning of this Program. The intent of the Program is to ensure that First Nations and Inuit are provided with quality care in their own homes and communities.

A Joint Health Canada/DIAND/First Nations/Inuit Working Group was formed to develop a framework for the First Nations and Inuit Home and Community Care Program. The Program is based on accepted home care principles and is flexible and adaptable to cultural values and to the individual needs of First Nations and Inuit communities. The need for an increased focus on community-based home care programs and services to support and maximize independence of First Nations and Inuit in their own communities is an essential component of the framework.

The First Nations and Inuit Home and Community Care Program is committed to building capacity within the communities served through assessment and evaluation of the needs of its people and the community as a whole. Where possible a comprehensive continuum of services will be available in First Nations and Inuit communities.

The First Nations and Inuit Home and Community Care Program will collaborate and partner with other providers to deliver care to clients and families in their home setting. Where services exist, duplication of services will not occur.

Graphic from Resource Kit

Individuals and families will participate in care delivery, individual rights will be respected, traditions and culture will be respected, and the client will have the choice to accept or refuse services.

The Accountability Framework for the First Nations and Inuit Home and Community Care Program is to be used in the development of the standards, policy and procedure manuals for the program.

A Planning Resource Kit has been provided to each First Nations and Inuit community to support the planning development of the First Nations and Inuit Home and Community Care Program at the local level. To further assist communities in the development, implementation and ongoing evaluation of their Programs, Home and Community Care Program Standards and Policies Template Manuals have been created.

Program Roles and Responsibilities

Communities

Communities will:

Plan and deliver home and community care services
Monitor and maintain the quality of services
Ensure training requirements are met
Maintain performance accountability to community members and the Federal Government
Maintain liability and malpractice insurance, delegation of responsibility
Collaborate with the Federal Government on the development and maintenance of appropriate First Nations and Inuit home and community care standards of care and practice

Federal Government

The Federal Government will:

Provide funding resources and ensure appropriate financial arrangements with First Nations and Inuit to facilitate the implementation and maintenance of the First Nations and Inuit Home and Community Care Program
Ensure that appropriate authorities have been secured for the implementation of services
Provide various technical, professional and capacity building supports which are developed in collaboration with and mutually agreed to by First Nations and Inuit
Work in partnership with First Nations and Inuit on the development and maintenance of appropriate First Nations and Inuit home and community care standards of care and practice

Graphic from Resource Kit

Future Activity

Tips for Customizing Standards and Policies to Meet the Needs of Your Community

It is suggested that you review and consider the standards and policies templates as you develop your Program. The templates can then be tailored for the specific needs of your community and the services your Program will be providing.

Specific factors to think about when developing Program standards and policies include:

your community's infrastructure
related programs, services and resources
linkages with other communities

In customizing standards and policies, the following tips are recommended:

The process for development, review, revision and approval of standards and policies needs to be clearly documented and understood by everyone. The process may involve a standards and policies committee, a home and community care advisory committee, a health management team, or some combination so that representation of all appropriate input is included. Community leadership needs to be included in the process and this can occur in a number of ways, ie as part of the team, or with a designate or designates who can make recommendations to the leadership for their consideration and approval.
Include all members of the Program team in the development of standards and policies, and their ongoing review and revision.
Evaluate each standard and policy template as it applies to your community and to your Program and services.
Build flexibility into the manuals that you create so that standards and policies can easily be moved, added and revised. For example, the standards and policies can be kept in three-ring binders so pages can be easily changed. Instead of page numbering the entire document, use reference numbers for policies and standards. You may also want to page number each of these standards and policies, for example, policy 5.4 could be page numbered as 5.4 page 1, 5.4 page 2, etc.
Use symbols or colour code sections of the manuals to make referencing easier. The symbols used in the templates are only offered as an example, and communities are urged to select their own symbols that better reflect each specific community and its Program. Local artists could be invited to create the symbols, or they may be selected from existing artwork and graphics.
Procedures and supporting tools should be developed to reflect practical ways of implementing and achieving the policies and standards that you have identified.
All standards, policies, procedures and tools should be reviewed on an annual basis and revised, as necessary.

Preparing for Accreditation

As communities establish their individual First Nations and Inuit Home and Community Care Programs, they may choose to participate in the accreditation process. Accreditation will provide a measure of the quality of the Program, and help the community to identify current strengths and areas that may require additional effort to improve the Program and its management.

The standards and policies template manuals have been designed to reflect the practices that should be implemented to achieve accreditation. It is important to consider the goal of accreditation at the time you create your Program standards and policies. Otherwise, it may be necessary to rework the standards and policies in the future so that they reflect the requirements to achieve accreditation.

Members of the Working Group for Standards, Scope of Practice, Liability and Training

Todd Armstrong Pauktuutit Ottawa, ON

Rhonda Blood Canadian Council on Health Services Accreditation Ottawa, ON

Janet Brewster Inuit Tapisariat of Canada Ottawa, ON

Elsa Cheeseman Baker Lake Hospice Baker Lake, NV

Linda Deer Kahnawake, QC

Alma Favel-King Assembly of First Nations Ottawa, ON

Deborah Greyeyes Bonnyville, AB

Mabel Horton Manitoba Keewatinowii Okimakanak Thompson, MB

Michele Landry Union of Nova Scotia Indians Sydney, NS

Donna Loft Chiefs of Ontario Marysville, ON

Francis Macklin Health Canada Winnipeg, MB

Maria MacNaughton Health Canada Ottawa, ON

Tracy Scott Anishinaabe Mino-Ayaawin Winnipeg, MB

Edna Stevens Health Canada Winnipeg, MB

Carol Trudeau North Shore Tribal Council Massey, ON

Helen Verhovsek Health Canada Ottawa, ON

Heather Young Health Canada Edmonton, AB

Part 1: The Organization

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 1: The Organization Community Name

Policy: Mission and Vision
Policy Number: 1.1

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program clearly defines, in writing, the mission and the vision for the Program. These statements are developed to reflect the Program and community values and beliefs, as well as the needs of the community. The community and its leadership are actively involved in the development and regular review of the Program mission and vision.

Policy Rationale

The mission and vision give the Program a foundation and a sense of direction for its program development and service delivery.

Policy Details

The Program mission and vision statements guide all future planning and decision making regarding home and community care services.

The mission and vision are used to:

Set the objectives of the community needs assessment
Establish the goals and objectives of the Program
Develop the service delivery, training and capital plans
Develop the Program policies and procedures
Provide the basis for decision making within the Program

Process Guidelines

The following statements are useful considerations when defining the mission:

The First Nations and Inuit Home and Community Care Program provides comprehensive home care services that are holistic and meet the physical, emotional, spiritual, health and social needs of the people and communities served.

The client's rights to culturally appropriate care and traditions, individual choice, independence and self--care are supported and respected.

Care is accessible and equitable to those who need it at home, in their communities, where support of family and friends is promoted. Family involvement in care delivery is encouraged, supported and respected.

The First Nation and Inuit Home and Community Care Program is enhanced by local control of the planning and delivery of care.

The following are considerations when developing the vision: The First Nations and Inuit Home and Community Care Program will provide community based health care that is:

Client-centred
Unique to the culture and caring tradition of the community
Comprehensive but not a duplication of services
Equitable and accessible to those who need services
Supportive of the family and community
Supportive of self-care and maximizing independence
Flexible and adaptable to the community health needs

The mission and vision will be carefully explained to all staff during orientation at the time they are hired, and will be reviewed periodically to ensure that all staff understand and are able to demonstrate the meaning of the mission and vision in all that they do.

The mission and vision will be reviewed annually to ensure that they fit appropriately with the changing needs of the community, and that they continue to reflect the values of the community and its leadership.

Any revisions to the mission and/or vision will be noted in writing and explained and shared with Program staff, clients, families, community leadership and the community as a whole.

Performance Measurement Suggestions

Indicator: This information is to be developed by communities as they work with their Programs. For an example of the kind of measures that should be identified, refer to the Hiring Policy template.

Formula:

Related Standards

1.1 Community Needs Assessment
1.2 Development and Achievement of the Vision
1.3 Capacity Building
1.4 Resource Management
4.4 Partnerships/Community Linkages

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: Program Criteria, 1, 3A, 5
Draft Liability Documents: May, section 2.2; June, pgs 6-12

CCHSA AIM Standards, 1999 -- Leadership and Partnerships
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Each community is responsible for developing and putting in place their own procedures. These procedures need to outline the practical steps to be taken to carry out the process guidelines for this policy.

Suggested Procedures

Procedure to ensure an annual review of the mission and vision, which includes input from clients, family, staff and the community.
Procedure for communication of the mission and vision to clients, families, staff and the community.

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 1: The Organization
Community Name

Policy: Values and Beliefs
Policy Number: 1.2

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program provides services that are based on the values and beliefs of the Program and of the community. These values and beliefs shape the mission, vision, goals and objectives of the Program; the Program services; and the manner in which services are delivered.

Policy Rationale

To ensure that cultural norms, individual rights and respect for human dignity guide the Program in the development and delivery of services.

Policy Details

The values and beliefs of the Program are developed with input from the community, and in partnership with the community leadership. They are communicated with the community to ensure an understanding of the Program's philosophy, in addition to its services, within the community.

Process Guidelines

The First Nations and Inuit Home and Community Care Program:

Supports life at home as long as possible
Respects the individual's right to choice, including acceptance of the right to refuse care
Promotes independence of people in the community to care for themselves, to the extent possible, and encourages the support and involvement of family and friends in the client's care
Respects the cultural and traditional health methods of the community
Promotes a holistic model of care
Recognizes that community members are a valuable resource for the delivery and management of care in the community
Promotes home care services that are available in the community
Ensures that home care services are coordinated with other services and programs
Promotes services that respond to the health and social needs of the community
Promotes services that are equitable to those provided to other Canadians

The Program's values and beliefs are reviewed annually. They serve as the basis for evaluating the mission, vision, goals and objectives to ensure their fit with the community needs and with the community's values.

Performance Measurement Suggestions

Formula:

Related Standards

1.1 Community Needs Assessment
1.2 Development and Achievement of the Vision
1.3 Capacity Building
1.4 Resource Management
3.6 Ethical Issues
4.4 Partnerships/Community Linkages

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: Program Criteria, 1, 3A

CCHSA AIM Standards, 1999 -- Leadership and Partnerships, Home Care Services
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Suggested Procedures

Procedure to conduct an annual review of the Program values and beliefs, which includes input from clients, family, staff and the community.

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 1: The Organization
Community Name

Policy: Goals and Objectives
Policy Number: 1.3

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program has clearly defined goals and objectives that are based on the mission, vision, values and beliefs of the Program, and of the community. The goals and objectives will help the Program to achieve sustainability and the community to build capacity.

Policy Rationale

Goals and objectives provide a focus for Program services, processes and activities, and a framework for evaluation to ensure and sustain quality services in the community.

Policy Details

The First Nations and Inuit Home and Community Care Program is established to provide services to community members of all ages, in their own community. Allocation of services is based on need and ensures that services are provided for as long as required, to the fullest extent possible.

Process Guidelines

The First Nations and Inuit Home and Community Care Program:

Builds capacity to develop and deliver home care services in the community by:
- Hiring community members to deliver the program, whenever possible
- Providing Program staff with a clear orientation at the time of hiring, and ongoing training and education, as required, to ensure that staff can adjust to new needs and approaches
- Teaching family members and significant others to assist with required care
Provides a single point of entry to a continuum of services that are comprehensive and are under the control of the Program, including:
- Nursing care services
- Personal care services
- Home support
- In-Home respite
- Linkages with other community services and programs
- Access to medical equipment and supplies
- Access to medication
Provides services that are culturally sensitive and that respect the traditional and contemporary ways of healing through:
- Assessment of individual need for services
- Respect for choice, including the right to refuse services
- Promotion of independence at home by encouraging and supporting self-care
- Client participation in the development of a plan of care
- Support for the involvement of family and friends in providing care and support to clients
- Provision of services when family and friends cannot provide care and support to clients
- Prevention or delay of admission to hospital or other facilitybased care
Coordinates and links the Program with existing community programs and services to prevent duplication by:
- Promoting use of existing programs and services by the client
- Developing a list of community programs and services to be used as a staff resource
- Educating staff on how to access other community programs and services
- Participating in local planning and coordination of home care services
Ensures that the Program has established standards, policies and procedures to enable services to be equitable to those provided to other Canadians through:
- The development of Program standards, policies and procedures that reflect the community's specific needs and resources
- Reference to the Canadian Council on Health Services Accreditation AIM Standards, 1999
- Reference to professional practice standards and guidelines
- Reference to relevant federal, provincial and territorial Legislation
- Reference to DIAND/FNIHB Home and Community Care Directives

The Program goals and objectives are evaluated on an annual basis to determine how well they have been achieved. As well, the fit of the goals and objectives with the needs and values of the community is also reviewed. Goals and objectives are revised, in writing and as required, to achieve a better fit with the changing needs.

Performance Measurement Suggestions

Formula:

Related Standards

1.1 Community Needs Assessment
1.2 Development and Achievement of the Vision
1.3 Capacity Building
1.4 Contract Management
4.4 Partnerships/Community Linkages
6.1 Information Needs
6.2 Data Collection and Reporting
6.3 Analysis and Evaluation

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: Program Criteria, 1, 2, 3A
Draft Liability Documents: May, sections 2 to 2.7; June, pgs 6-12

CCHSA AIM Standards, 1999 -- Leadership and Partnerships
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Suggested Procedures

Procedure to conduct an annual review of the goals and objectives, which includes input from clients, family, staff and the community.
Procedure to promote local recruitment and retention.

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 1: The Organization
Community Name

Policy: Organizational Structure
Policy Number: 1.4

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program has a clear organizational structure that is designed to achieve the mission, vision, goals and objectives of the Program, while respecting the values and beliefs of the Program and of the community. This organizational structure is approved in writing and supported by the community leadership.

Policy Rationale

To ensure there are clear lines of authority and accountability in the administration and delivery of Program services in the community.

Policy Detail

The First Nations and Inuit Home and Community Care Program organizational structure clearly defines the responsibilities and reporting relationships of all staff.

The Program structure supports and ensures the achievement of the following management activities, and ensures a clear explanation of who has accountability and responsibility for each activity:

Governance and management of the Program
Program planning and development, and service delivery
Monitoring, evaluation and improvements of Program services and processes
Recruitment, hiring, training, coordination, supervision, and ongoing development of staff
Provision of the professional expertise required to develop and deliver the Program
Accountability for the liability, malpractice and delegation of responsibility
Negotiation with the federal government for technical, professional and financial support
Development and maintenance of Program standards of practice
Coordination of Program services with other community programs and services and the promotion of building good working relationships
Preparation and communication of reports to the community leadership and others, as required
Provision of supplies, equipment and medications required for services to properly be delivered

The Program management structure is also accountable to work in partnership with the community leadership, and, if appropriate, the federal government, to ensure that:

The appropriate resources are secured to implement the Program
Adequate funding is allocated to the Program
Standards and practices are in place for the Program
Appropriate reporting mechanisms for the Program are established

Process Guidelines

Specific positions within the Program's organizational structure have responsibility and accountability for the following, and this responsibility is clearly understood by all staff:

Hiring of staff and handling of all human resource issues
Supervision of staff, including supervision in clients' homes
Administration of the budget and other financial responsibilities
Delivery of Program services, with specific explanation when particular skills and certification may be required
Administration and management of client records, staff records, financial information, and other related operations activities
Collection and management of information for evaluation and reporting purposes, including monitoring of program indicators and client and staff satisfaction
Communications within the Program and with the community and other organizations

Staff clearly understand the Program's organizational structure, the roles and responsibilities of all staff, lines of communication, and who to go to for specific issues. A complete explanation of the structure and reporting is provided during orientation, and through ongoing training and education sessions, as required. When there is a change in any reporting process or in the structure, staff are informed of the change immediately.

The roles and responsibilities of any contracted workers, including those with other programs and services in the community, are included in the Program's organizational structure, and these workers have a clear understanding of the structure and reporting processes.

A Program organizational chart details the lines of authority, reporting, and supervision, and illustrates staff relationships in the structure.

Performance Measurement Suggestions

Formula

Related Standards

1.1 Community Needs Assessment
1.3 Capacity Building
5.4 Education, Training and Development
5.5 Quality of Work Life
6.1 Information Needs
6.2 Data Collection and Reporting
6.5 Program Changes and Improvements

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: Program Criteria, 1 and 3A
Draft Liability Documents: May, sections 2 to 2.5; June, pgs 6-12

CCHSA AIM Standards, 1999 -- Leadership and Partnerships
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Suggested Procedures

Procedure to develop written job descriptions for all Program positions. These job descriptions include an explanation of reporting relationships, authority and accountability.
Suggested tools:
- Sample job descriptions
Procedure to develop and regularly review a Program organizational chart.
Suggested tools:
- Sample organizational chart

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 1: The Organization
Community Name

Policy: Roles and Responsibilities: Client and Family
Policy Number: 1.5.1

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program encourages individuals and families to maintain independence and self-care at home for as long as they are able. When a person is unable to care for oneself, family and friends are encouraged to provide support to the client. The First Nations and Inuit Home and Community Care Program will assist with care when the client, family and friends are unable to meet the client's care needs. The Program does not replace the support of family and friends.

The client's right to choice is respected.

Clients and families have the responsibility of understanding why standards and policies are in place and how they can ensure appropriate care, equitable access to services, and client rights.

Policy Rationale

The involvement of the client, family and community is essential to the plan of care in order to achieve goals of independence and self-care, and also to help people remain at home.

Policy Details

The following statements suggest the importance of the role of clients and families:

The rights of individuals to accept or refuse services are respected.
Individuals and family and friends who participate as caregivers are considered part of the care team.
Individuals are involved in the development and implementation of their care plan, to the fullest extent possible.
Education of the client and family is included in the services provided and self-care, to the fullest extent possible, is encouraged.
The role of the family and friends in providing support to the client at home is encouraged, respected and supported to the fullest extent possible.
Cultural and traditional healing practices are respected.
All care that is delivered is based on assessment of the client's need for services.
Verbal or written informed client consent to care is obtained prior to delivery of services.
Maintaining the client at home prevents unnecessary admission to hospital and other facilities.
When the need for care exceeds the care that can be provided at home in the community setting the client will be assessed for admission to a hospital or other appropriate facility. Clients will be involved in the decision for future care to the fullest extent possible.

Process Guidelines

Program processes and services are mindful of the role of clients and families and ensure that:

Assessment of the client's need for care or treatment will occur prior to acceptance for home care services
Acceptance by the client and family caregiver(s) of care or treatment, including acceptance of the role of the client and family in that care, will be documented on the client record
All clients give verbal or written informed consent to treatment or care
Clients are encouraged, educated and supported to perform selfcare where at all possible and appropriate
Families are encouraged, educated and supported to assist with care where at all possible and appropriate

Performance Measurement Suggestions

Formula:

Related Standards

1.1 Community Needs Assessment
3.2 Continuity of Services
3.4 Obtaining Consent
3.5 Client Rights
3.7 Confidentiality
4.5 Partnerships/Community Linkages

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: Program Criteria, 1, 2, 3A
Draft Liability Documents: May, sections 3.13, 4.3; June, pgs 12-13

CCHSA AIM Standards, 1999 -- Home Care Services, Leadership and Partnerships
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process: Dates:

Suggested Procedures

Procedure for assessment of the need for services.
Suggested tools:
- Assessment form
Procedure for communication of client rights and responsibilities.
Procedure to obtain informed client consent.
Suggested tools:
- Consent form
Procedure for documentation of care on the client record, which includes identification of role of the client and self-care goals, as well as role of the family and family caregiver goals.

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 1: The Organization
Community Name

Policy: Roles and Responsibilities: The Community and Its Leadership
Policy Number: 1.5.2

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program encourages and supports the community's role in providing input and assistance to Program planning, evaluation and improvement.

Community leadership, the political body of the community, has the responsibility of receiving, understanding and approving the standards and policies for the delivery of the Program. Community leadership provides overall direction in this way, rather than becoming involved in the day-to-day operations of the Program. Community leadership can use the standards and policies as tools to respond to requests and complaints from community members. These tools provide the basis for decision-making and conflict resolution.

Policy Rationale

To ensure the involvement of the community in planning and evaluating Program services to meet the community's health needs.

Policy Details

The community, through its leadership, is responsible to ensure that a continuum of health and social services, based on the broad determinants of health, is available to its members. Collaboration among community agencies, organizations and individuals is necessary to prevent duplication of services. The community encourages the traditional healing and holistic culture of its members. The role of the family as caregiver and supporter is respected.

Community members are part of the governing body of the First Nations and Inuit Home and Community Care Program. The community, through its leadership, is responsible for the autonomy and control of the Program and is responsible to supervise and monitor the effectiveness of the Program. The Program fits well with the mission, vision and values of the community. The community will assess and determine the resources available to support the Program.

Communication between the community and the Home Care Program staff will assist in providing feedback and evaluation of services/programs delivered.

Process Guidelines

The community, through the community leadership, is responsible for data collection and management of information about the community, including preparation and submission of reports as required. The community will complete an initial assessment and evaluation of the community's health care needs. It provides feedback to the Program staff about the results of this initial assessment and evaluation.

Community members form part of the First Nations and Inuit Home and Community Care Program planning and leadership structures. For example, the community may establish a home and community care advisory committee.

The community will regularly evaluate the effectiveness of the Program.

Performance Measurement Suggestions

Formula:

Related Standards

1.1 Community Needs Assessment
3.2 Continuity of Services
3.4 Obtaining Consent
3.5 Client Rights
3.7 Confidentiality
4.6 Partnerships/Community Linkages

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: 1, 2, 3A
Draft Liability Documents: May, sections 2 and 2.1; June, pgs 7-12

CCHSA AIM Standards, 1999 -- Leadership and Partnerships
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Suggested Procedures

Procedure for the initial and regular assessment, monitoring and evaluation of community health care needs and gaps in service.
Procedure for orientation of community members involved directly in Program leadership.
Suggested tools:
- Orientation package for community members

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 1: The Organization
Community Name

Policy: Roles and Responsibilities: Service Providers
Policy Number: 1.5.3

Approval:
Date:

Policy

Service providers, whether Program staff or on contract, are accountable and responsible to deliver safe, effective care to clients of the First Nations and Inuit Home and Community Care Program.

Program staff are responsible for knowing the standards and policies and adhering to them in their daily activities. Program staff participate in the review and revision of policies.

Policy Rationale

To ensure that the quality of services provided is consistent with Program, legislative and professional standards of care.

Policy Details

All Program service providers:

Operate efficiently and economically, according to established guidelines
Provide services that meet legal requirements and standards of practice, and are consistent with Program standards, policies and procedures
Determine the urgency of need for services by screening clients according to consistent, predetermined assessment, and ongoing monitoring of these criteria
Access other community programs and services for clients, as appropriate
Regularly monitor the quality of Program services delivered to clients
Collect, record and report quality indicators to Program management
Participate in Program planning, implementation and evaluation
Recommend new services based on identified community needs
Participate in local community planning and coordination of services, as appropriate, and work with the community to improve community health
Provide education to the community members about Programs services that are available

Process Guidelines

All Program service providers:

Consult with the health care team about care needs
Discuss with the clients and families the programs and services that are available
Respond in a timely way for delivery of care
Provide continuity in care
Treat clients with respect
Protect the privacy of clients and maintain confidentiality of all information gathered about clients
Obtain informed consent from clients prior to delivery of care
Provide access to after-hours care, or alternative arrangements for after-hours care, should the need arise
Teach and support self-care of clients
Maintain the independence of clients to the fullest extent possible
Encourage, teach and support care provided by families
Ensure care delivered to clients is supervised, as determined by Program management
Try to prevent unnecessary admissions to hospitals and other facilities, whenever possible
Conduct home visits to review the service plan of care
Encourage hospital or other facility care when necessary
Report and record care delivered using the appropriate forms

Performance Measurement Suggestions

Formula:

Related Standards

1.1 Community Needs Assessment
3.2 Continuity of Services
3.4 Obtaining Consent
3.5 Client Rights
3.7 Confidentiality

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: 1, 2, 3A
Draft Liability Documents: May, sections 2 to 2.9, 2.13, 2,14, 3.7 to 3.21; June, pgs 6-15, 19-27

CCHSA AIM Standards, 1999 -- Leadership and Partnerships, Home
Care Services
Professional Practice Standards
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Suggested Procedures

Procedure for reporting service delivery.
Suggested tools:
• Client record
Procedure for performance management.
Procedure for measuring indicators for quality of care.

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 1: The Organization
Community Name

Policy: Roles and Responsibilities: Program Management
Policy Number: 1.5.4

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program management staff are accountable and responsible for the development, delivery, evaluation and administration of the Program and its services.

Program management has the responsibility of implementing the approved policies and ensuring adherence at all times, and of monitoring, reviewing and updating policies on a regular basis. Program management participates, with the staff, in the review and revision of policies on a regular basis.

Policy Rationale

To ensure that services delivered are effective and cost efficient, and consider client care needs in relation to broad health issues of the community.

Policy Details

Accountability and responsibility for the program includes:

Monitoring the achievement of the goals and objectives of the Program
Delivering the Program and services effectively, efficiently and with a client-centred approach
Monitoring the delivery of the Program and services
Ensuring equitable access to the services
Ensuring confidentiality of information concerning clients and staff
Ensuring that essential Program elements and Program standards are maintained, and that Program policies are followed
Ensuring that staff have the necessary knowledge, skills and ability required to achieve the standards and work within policy guidelines
Maintaining sound accounting principles and practices
Providing a written annual report to the community leadership

Process Guidelines

The following activities are supported through processes and procedures:

An annual review and evaluation of the goals and objectives of the Program is conducted and any gaps in services are identified
An annual assessment of the level of services provided, and how these services are meeting the needs of the community, is conducted
The satisfaction of Program clients is assessed on a regular basis
An annual review of the policies and practices regarding confidentiality of information is conducted to ensure that client and staff information is being kept confidential and secure, ie auditing client records, interviewing clients and staff
All financial transactions are recorded
An annual audit of all financial transactions is conducted
Data is recorded and reported, as required by legislation and the needs of the community, for objectively-based evaluation and reporting of the Program
The Program is effectively managed and delivered, with continuous effort to improve policies, processes, procedures, and the services themselves, within the fiscal responsibilities
Program staff are supported, coached and counselled to promote their development and ongoing learning

Performance Measurement Suggestions

Formula:

Related Standards

1.1 Community Needs Assessment
3,2 Continuity of Services
3.4 Obtaining Consent
3.5 Client Rights
3.7 Confidentiality
4.4 Partnerships/Community
Linkages

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: Program Criteria, 1, 2, 3A
Draft Liability Documents: May, sections 2, 2.1, 2.13-2.15, 3.11, 3.18, 3.19, 4.1, 4.9-4.15; June, pgs 6-12, 25-34

CCHSA AIM Standards, 1999 -- Leadership and Partnerships, Home Care Services, Information Management
Canadian Health Record Association, Code of Practice and
Principles and Guidelines for Access to and Release of Health
Information
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Suggested Procedures

Procedure to assess client satisfaction with the delivery of the Program and its services.
Suggested tools:
- Client feedback form
- Interview guide
Procedure to obtain feedback from clients and staff about information in their records.
Suggested tools:
- Interview guide(s)
Procedure to audit access to services.
Suggested tools:
- Audit guide
Procedure to audit client records.
Suggested tools:
- Audit guide
Procedure to record and audit all financial transactions.
Suggested tools:
- Audit guide
- Financial transaction recording form
- Expense form
- Mileage record
- Hours of work record
Procedures for reporting guidelines for financial information and the annual report.
Suggested tools:
- Financial information reporting sample outline
- Annual Report Summary sample outline

Part 2: Scope of Services

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 2: Scope of Services Community Name

Policy: Services
Policy Number: 2.1

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program provides health care services to community members with an assessed need for services.

These services are delivered by qualified health providers, are sensitive to the unique cultural traditions of the client and community, are accessible and effective, and are equitable to those received by other Canadians.

Policy Rationale

To ensure that the needs of Program clients are safely met in the community in which they live.

Policy Details

The First Nations and Inuit Home and Community Care Program service delivery is designed to meet the assessed needs of eligible members of the community.

The Program is structured in two levels: the Essential Service Elements and the Supportive Service Elements. The basic level of service that is provided to the community is contained in the Essential Service Elements. This level of service must be present before the Program can consider implementing any of the Supportive Service Elements. The First Nations and Inuit Home and Community Care Program includes and does not duplicate appropriate elements of service delivery, which existed before the establishment of this Program.

Prior to implementing elements of the First Nations and Inuit Home and Community Care Program, the community is required to complete a detailed community needs assessment to avoid duplication of existing services.

Essential Service Elements include:

Detailed client assessments, completed by health professionals (Registered Nurses):
- to gather information on clients' need for service, their support networks, and the appropriateness of services available
Case management processes that provide:
- ongoing evaluation of appropriateness, effectiveness and eligibility for care
- linkages to other services both inside and outside of the community
Professional nursing services encompassing;
- direct care to eligible clients
- health teaching to clients, families, community members, and staff
- supervision of direct care providers who are not regulated health providers, such as home health aides
Personal and home support services encompassing:
- direct personal care to eligible clients, such as bathing, grooming, transferring, and dressing
- household management/maintenance, such as housekeeping, laundry, shopping, and meal preparation
In-home respite services
Access to required medical equipment, medical supplies and specialized medicines that are necessary for the effective provision of care
Operational processes for:
- Records management
- Data collection
- Quality programming

During the community needs assessment process, communities may have identified needs that are not fully addressed by the essential services elements. In these cases, and based on identified and measurable needs, the First Nations and Inuit Home and Community Care Program may choose to provide some or all of the supportive service elements, once the essential service elements are met.

The supportive service elements may include:

Rehabilitation and therapy services, such as physiotherapy, occupational therapy
Institutional respite care, such as temporary nursing home facility placement
Adult day care programs
Meal programs
In-home mental health services
Independent living supports
In-home palliative care
Social services related to continuing care issues
Health promotion, wellness and fitness education, such as diabetes prevention education

Process Guidelines

The delivery of accessible, equitable, comprehensive and culturally sensitive health services through the First Nations and Inuit Home and Community Care Program is dependent on:

A comprehensive formal community needs assessment prior to the start of service delivery, then ongoing on a regular basis
Regular community surveys to determine the effectiveness of services delivered through the Program
Regular informal assessment of the community needs at community gatherings, educational offerings and other such events
Community involvement in all aspects of service planning
Formal planning by Program staff with community leadership to determine the financial ability to provide essential service elements and, in some communities, supportive service elements

Performance Measurement Suggestions

Formula:

Related Standards

1.1 Community Needs Assessment
3.1 Services Delivery
3.2 Continuity of Services
3.3 Health Promotion, Disease Prevention and Protection Services
6.1 Information Needs

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: All sections
Draft Liability Documents: May, sections 2.2, 5.9, 5.19; June, pgs 6-7

CCHSA AIM Standards, 1999 -- Home Care Services
Professional Practice Standards
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Suggested Procedures

Procedure for communication of the Program activities, services and progress towards implementation, within the community and with the community leadership.
Suggested tools:
- Standard communication form for providing an update of activities on a regular basis (could include number of clients served, services that have been implemented to date, specific information about eligibility and process for client assessment)
Procedure for regularly evaluating the essential services of the Program to ensure that they are being delivered according to established standards and policies, and also to identify improvements to the services.
Procedure for supervisor to regularly monitor first-hand and evaluate the non-regulated workers' activities in the home.

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 2: Scope of Services
Community Name

Policy: Service Delivery Model
Policy Number: 2.2

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program provides health care services to eligible First Nations/Inuit community members.

These services are provided to the community through one or all of the following models:

Directly by the community
Cooperatively with other First Nations or Inuit community(ies)
Through a regional organization, such as a Tribal Council or an Inuit Regional Association
Through a purchase/contract agreement with an established agency/provider

Policy Rationale

To ensure that services are delivered in the most efficient and cost-effective way, and that the services reflect the needs of the community.

Policy Details

The service delivery model chosen by the community is influenced by:

Information gathered through the community needs assessment process
Services currently provided in the community
Emerging needs for service
Trends developing locally and regionally
Capacity and size of the community
Population
Human resources available
Financial resources available
Infrastructure
Physical
Technological
Environmental
Comprehensiveness of existing programs (to avoid duplication)

Regardless of the service delivery model chosen, the community is required to provide the essential services outlined in the First Nations and Inuit Home and Community Care Program.

The model selected meets the community needs identified through the community needs assessment process. Considerations regarding the different models include:

1. Services provided directly by the community

Administration of the program is at the local level and may be more responsive to emerging trends and needs in the community
There are opportunities for development of human resources and capacity within the community
Funding is injected into the community, rather than outside to another community or agency
There is the opportunity to develop and/or improve on the community infrastructure through the Program

2. Cooperatively with other First Nations or Inuit community(ies)

Administration of the program is shared with other community(ies), which provides for increased communication, cooperation and exchange of knowledge and learnings. Also, shared administration means shared responsibility for the Program.
There are opportunities for development of human resources and capacity between/among the community(ies)
Funding is injected into the communities, creating the potential opportunities for individual communities to develop specialized programs based on their particular community needs assessments
There is an opportunity for communities to cooperatively build their infrastructure and gradually develop autonomous programs
Cost effectiveness is possible through economies of scale

3. Through a regional organization, such as a Tribal Council, or Inuit Regional Association

The entire administrative function is at the regional level
Communities have the benefit of increased health services to community members without the administrative responsibilities
Cost effectiveness is possible through economies of scale

4. Through a purchase/contract agreement with an established agency/provider

The administrative function is provided by the agency providing service
Communities have the benefit of increased health services to community members without the administrative responsibilities

Process Guidelines

The development and delivery of accessible, equitable, comprehensive and culturally sensitive health services through the First Nations and Inuit Home and Community Care Program is the desired outcome with all of the models of service delivery outlined. The processes for determining which model is appropriate for the community, initially and on an ongoing basis, include:

A detailed community needs assessment process
Fiscal or financial planning activities
A detailed overview of services currently provided in the community to avoid duplication of services
Community involvement as a regular part of ongoing planning and needs assessment activities
Determination of the willingness and/or appropriateness of shared responsibility with other communities
Investigation of the existence of providers willing and able to provide the required services to the community

Performance Measurement Suggestions

Formula:

Related Standards

1.1 Community Needs Assessment
1.5 Contract Management
2.1 Program Management
3.1 Services Delivery
3.2 Continuity of Services
4.4 Partnerships/Community Linkages

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: Program Criteria, 1, 3A
Draft Liability Documents: May, sections 1.3.4-1.3.7, 2.2, 2.4-4.9, 4.10, 4.13, 4.14; June, pgs 6-12, 16, 30-33

CCHSA AIM Standards, 1999 -- Leadership and Partnerships
Professional Practice Standards
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Suggested Procedures

Procedure for developing and maintaining an inventory of services and resources available:
- Within the community
- In other communities
Procedure for developing and maintaining an inventory of service providers.
Procedure for regularly monitoring the adherence to contracts and evaluating the services provided by service agencies.
Suggested tools:
- Sample contract for service provision

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 2: Scope of Services
Community Name

Policy: Access to Services
Policy Number: 2.3

Approval:
Date:

Policy

All community members, who are assessed as eligible for services through the First Nations and Inuit Home and Community Care Program, will have access to comprehensive health services that are respectful of the unique cultural traditions of the client and the community. The Program services are effective and equitable to those services received by other Canadians.

Policy Rationale

To ensure eligible clients, families and communities obtain services based on predetermined criteria and need.

Policy Details

The First Nations and Inuit Home and Community Care Program staff and management must ensure that community members have full access to essential services provided by the Program. The essential services provided to the communities are outlined in the Scope of Services policy.

Staff and clients must clearly understand the services that are provided to the community through the First Nations and Inuit Home and Community Care Program. Components of the Program that need to be clearly understood by all are:

Eligibility Criteria

Recipients must:
- Be First Nations or Inuit
- Be a resident of a First Nations reserve, Inuit settlement or First Nations community North of 60
- Have an assessed need for one or more essential services
- Be able to have service provided with reasonable safety to the client, the family caregiver, and the staff, and within the standards, policies and regulations for service practice

Service Priorities

Priorities must be determined by each community, however a basic principle is that the community members with the greatest need will have a greater need for service.
A suggested plan for priorities is, in order of highest priority first:
- Community members at risk for entry to a long term care facility, acute care facility or hospice facility
- Community members being discharged from any of the above mentioned facilities to their home/community
- Community members with an acute illness
- Community members requiring ongoing assistance with Activities of Daily Living to remain independent
- Community members who are providing care to a loved one or community member and require relief to be able to continue in their responsibility
- Terminally ill community members who choose to die at home

Service Mix provided

Each community is required to provide the essential service elements, which include professional nursing, home support and personal care services, in-home respite, medical equipment and supplies, and specialized pharmaceuticals.
Each community, based on the completed community needs assessment, will determine whether there is a need and available resources for any of the supportive care services, including rehabilitation services, adult day care programs, meal programs, mental health services in home, palliative care, social services related to continuing care issues and/or health promotion, wellness and fitness education.

Eligibility Exclusions

Community members who are not First Nations or Inuit, unless community leadership decides otherwise (people who may be eligible may include teachers, RCMP, and non-community members married to community members)
First Nations and Inuit who do not reside on a First Nations reserve, Inuit settlement or First Nations community North of 60
Community members who require a level of service not provided through the First Nations and Inuit Home and Community Care Program, such as institutional long term care for clients requiring 24 hour care
Community members who require services, but where the services cannot be provided with reasonable assurance of the safety of the client, the caregiver, and Program staff

Process Guidelines

The First Nations and Inuit Home and Community Care Program has a well-defined process in place to ensure all staff and clients of the Program fully understand the services provided and the appropriate procedure for accessing the required services. This process includes:

An education program directed to the entire community that provides information on:

The purpose of the First Nations and Inuit Home and Community Care Program
The Program's mission, vision, values and beliefs
The essential services provided through the Program
The supportive service elements provided (if any) through the Program
The delivery model through which services will be provided
Entry to service information, including
- The telephone number of the Program administration
- The address of the administrative offices where the Program is situated
- The name of the person(s) involved in the case management/intake function
Eligibility criteria and exclusions determined by the First Nations and Inuit Home and Community Care Program and the community
Service priorities determined by the community
An orientation for all new staff that includes information about the access to the various service components, with specific education on service eligibility and service priority.
A pamphlet/hand-out for all clients assessed for services through the First Nations and Inuit Home and Community Care Program that provides detailed information on the Program, the eligibility criteria, the service mix offered in the community, and the appropriate access information.

Performance Measurement Suggestions

Formula:

Related Standards

2.2 Risk Management
3.1 Services Delivery
3.5 Client Rights
5.4 Education, Training and Development

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: Program Criteria, 3A, 5
Draft Liability Documents: May, sections 4.1-4.13, 6.8; June, pgs 22, 28

CCHSA AIM Standards, 1999 -- Home Care Services
Professional Practice Standards
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Suggested Procedures

Procedure for assessing eligibility and for notification to clients assessed as ineligible.
Suggested tools:
- Written list of eligibility criteria and guidelines
- Client assessment tool
- Form for tracking decisions for ineligibility
Procedure for tracking clients eligible for services but who are refused, and the reasons for this refusal.
Suggested tools:
- Form for tracking refusals of eligible clients
Procedure for client appeal process, including clearly defined mechanisms, within the community and externally, for the appeal process.

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 2: Scope of Services
Community Name

Policy: Appeal Process
Policy Number: 2.4

Approval:
Date:

Policy

All community members assessed for services through the First Nations and Inuit Home and Community Care Program have the right to appeal any decision made by any representative of the Program with regards to:

Their eligibility to receive services
The level of service that they have been assessed to receive
The type of services that they have been assessed to receive
The urgency of the need for services
Their ineligibility to receive services
The mix of services provided by the First Nations and Inuit Home and Community Care Program

Policy Rationale

To ensure that clients and staff are aware of the processes to follow when a client feels there has been an unfair, inequitable or inappropriate allocation of service.

Policy Details

The First Nations and Inuit Home and Community Care Program makes every effort to resolve issues that clients have at the level of the direct care provider/assessor/case manager when ever possible. When resolution of issues at this level are not possible, the client is advised of the formal appeal process that may be initiated for resolution of the issue.

This process includes mechanisms both within and outside of the community. The external mechanism is used when appeals cannot be settled within the community to the satisfaction of the client.

The First Nations and Inuit Home and Community Care Program provides education to all staff at orientation and through regular training sessions on the client's right to appeal decisions made by Program staff.

The First Nations and Inuit Home and Community Care Program staff advise the client at the time of admission of the client's rights under the Program. These rights include the right to appeal decisions made by Program staff.

Clients are instructed on the procedure to follow when appealing a decision made by First Nations and Inuit Home and Community Care Program staff.

Process Guidelines

The First Nations and Inuit Home and Community Care Program has a well-defined appeal process, in writing and with the approval of the community leadership, which is understood by both clients and staff. This includes but is not limited to:

An orientation for all new staff that includes information about the procedure to follow when a client appeals a decision about any aspect of their assessment or of the First Nations and Inuit Home and Community Care Program
A client assessment process that includes education to the client about client rights, particularly the right to appeal care decisions
All appeals are forwarded to an appeals committee that is made up of impartial and/or uninvolved members of the community/Program, or the community leadership. Should the appeal not be resolved to the satisfaction of the client, the client has the right to take the appeal outside of the community, as documented and agreed upon in the appeals process.
All appeals are fully documented and clients are fully involved and informed through every stage of the process
Information on appeals that are filed is documented to record occurrences for quality monitoring processes

Performance Measurement Suggestions

Formula:

Related Standards

2.2 Risk Management
3.1 Services Delivery
3.5 Client Rights
5.4 Education, Training and Development

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: Program Criteria, 3A, 5
Draft Liability Documents: May, sections 4.1-4.13, 6.8; June, pgs 22, 28

CCHSA AIM Standards, 1999 -- Home Care Services
Professional Practice Standards
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Suggested Procedures

Procedure for assessing eligibility and for notification to clients assessed as ineligible.
Suggested tools:
- Written list of eligibility criteria and guidelines
- Client assessment tool
- Form for tracking decisions for ineligibility
Procedure for tracking clients eligible for services but who are refused, and the reasons for this refusal.
Suggested tools:
- Form for tracking refusals of eligible clients
Procedure for client appeal process, including clearly defined mechanisms, within the community and externally, for the appeal process.
Procedure for admission that includes a clear understanding, by clients and their family caregivers, of their rights, services to be provided, and the process for appeal.

Part 3: Client Care

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 3: Client Services Community Name

Policy: Client Rights
Policy Number: 3.1

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program recognizes and is committed to processes and policies that respect individual and community rights of First Nations and Inuit people. Embedded in these rights are the principles of equity, access, independence and informed client consent. All services provided by the Program support the rights of community members to receive holistic and community-based care. These rights are protected and promoted by the First Nations and Inuit Home and Community Care Program.

Policy Rationale

To ensure that staff are educated about and respectful of client's rights when delivering services.

Policy Details

At a minimum, the First Nations and Inuit Home and Community Care Program expects that all Program staff will ensure that clients and their families are:

Cared for in a manner that is respectful of their culture, traditional values and beliefs, and lifestyle
Cared for by trained, competent staff
Free from abuse, exploitation, discrimination and neglect
Provided with information which supports their right to make informed decisions and personal choices
Respected for their informed choice to refuse service and/or to live at risk
Involved in all aspects of care planning and service delivery
Guaranteed that personal information gathered by Program staff is protected as private and confidential, to the fullest extent possible. Information is not shared with providers outside of the Program unless the client has provided informed consent. The client is also aware that certain situations may require information to be shared without consent, including information related to criminal matters, as requested by court authorities.
Informed about how to:
- express concerns with the quality of service
- appeal a decision made by an assessor
- complain regarding any aspect of the service provided

Process Guidelines

The First Nations and Inuit Home and Community Care Program ensures that the detailed rights listed above are supported through ongoing assessment, education and evaluation of:

The clients' and families' understanding of their rights
The providers' understanding of client rights
The ability of clients and families to exercise their rights as detailed
The providers' understanding of the confidential nature of client information
The clients' ability to express concerns and to make complaints and appeals
The responsiveness of the Program

Performance Measurement Suggestions

Formula:

Related Standards

3.1 Services Delivery
3.2 Continuity of Services
3.4 Obtaining Consent
3.5 Client Rights
3.6 Ethical Issues
3.7 Confidentiality
6.4 Information Exchange

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: 3A, 5
Draft Liability Documents: May, sections 5 -- 5.20; June pgs 22, 29, 35

CCHSA AIM Standards, 1999 -- Home Care Services
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Suggested Procedures

Procedure for communicating client rights and responsibilities.
Procedure for obtaining verbal and/or written informed client consent.
Procedure for assessing eligibility and for notification to clients assessed as ineligible.
Suggested tools:
- Written list of eligibility criteria and guidelines
- Form for tracking decisions for ineligibility

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 3: Client Services
Community Name

Policy: Client Confidentiality and Privacy
Policy Number: 3.2

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program is respectful of, and committed to maintaining the confidentiality of all client information gathered by staff or sent as referral from other programs and services.

Policy Rationale

To ensure that client information is protected.

Policy Details

All staff of the First Nations and Inuit Home and Community Care Program must be educated regarding confidentiality of client information. This education is provided at the initial orientation and periodic training sessions on an ongoing basis.

All clients are provided with information about their rights during their admission to the First Nations and Inuit Home and Community Care Program. One of these rights is the right to have their privacy protected by the staff. Clients are informed of the need to share information with other health care providers (such as hospital and long term care facilities) to ensure optimum care; however, clients also understand that they have the right not to share information. Confidentiality of all client information is maintained through a variety of processes and procedures, which may include:

Client information is stored in a secure location that is accessible to authorized individuals only. This storage policy applies to information that is currently being used, as well as information that is being stored
Client information that is being transmitted for any reason must be done so in a secure manner
When legislation allows, client information is disposed of in a secure manner
Informed client consent is obtained before any information is shared with health providers who are not employed by the First Nations and Inuit Home and Community Care Program
Any release of client information must be authorized by the client or their substitute decision maker when appropriate, except in circumstances beyond the control of the Program, such as requests of court authorities
The client or their substitute decision maker must authorize, in writing, the release of client information to any other interested parties, such as the media, research facilities, and lawyers. Exceptions to this policy are only allowed when the release of information is required by an official request using Federal/Provincial/Territorial court documents.

All staff and clients are educated regarding the appropriate reporting process for any breach of the confidentiality policy.

Process Guidelines

The First Nations and Inuit Home and Community Care Program has a well-defined process for all aspects of the confidentiality of client information policy. This includes, but is not limited to:

An orientation for all new staff that includes information about the importance of maintaining client confidentiality. Staff are advised that some challenges they may face in maintaining confidentiality may be:
- Small, intimate communities
- Extended family connections between clients, or between a particular client and Program staff providing direct services to the client
- Co-workers that may be, or are related to clients receiving care
A client assessment process which includes education to the client on their rights, including their right to have their privacy maintained
Incidents of breaches in client confidentiality, suspected or actual, are documented as occurrences for quality purposes, are fully investigated by Program management, and, when appropriate, are addressed with the employee involved through progressive discipline procedures
Detailed instructions are provided to staff and clients for reporting potential or/and actual breach of confidentiality situations when they occur.

Performance Measurement Suggestions

Formula:

Related Standards

3.5 Client Rights
3.7 Confidentiality
6.2 Data Collection and Reporting
6.6 Confidentiality of Information

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: 1, 2, 3A, 4
Draft Liability Documents: May, sections 3.3, 3.21, 4.9, 6-6.8; June, pgs 22, 37-39

CCHSA AIM Standards, 1999 -- Home Care Services
Canadian Health Record Association, Code of Practice and
Principles and Guidelines for Access to and Release of Health Information
Professional Practice Standards
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Suggested Procedures

Procedure for both staff and clients and community members to follow when reporting a breach of client confidentiality to Program management.
Procedure for reporting any suspected or confirmed violations of the confidentiality policy (to be included as part of the occurrence reporting procedure).
Procedure for progressive discipline of staff, when appropriate, for violations of the policy.
Procedure for reporting breaches of client confidentiality involving regulated health professionals, when appropriate, to professional colleges and governing bodies.
Procedure for obtaining informed client consent to share information with other providers, when necessary.

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 3: Client Services
Community Name

Policy: Consent to Treatment
Policy Number: 3.3

Approval:
Date:

Policy

All clients of the First Nations and Inuit Home and Community Care Program will provide informed consent to the treatment/service plan before any treatment or service is initiated.

Policy Rationale

To ensure that clients are aware of the risks and benefits of treatment and services, and the consequences of declining treatment or services.

Policy Details

All staff of the First Nations and Inuit Home and Community Care Program are responsible to ensure that clients are giving informed consent to the planned treatment/service. This includes clients that are new or returning to the First Nations and Inuit Home and Community Care Program, as well as those clients who are currently receiving Program services.

All staff of the First Nations and Inuit Home and Community Care Program are required to ensure that the client's informed consent is documented in the client record. Staff are also required to ensure informed client consent forms are updated as circumstances change, such as changes in the client's condition, or a change in the client's wishes.

In order to obtain informed consent from the client, all staff must consider:

The capacity/ability of the client to understand the nature of the treatment/services being proposed
Literacy challenges the client may face
Language requirements of the client
Cultural needs of the client

Process Guidelines

The First Nations and Inuit Home and Community Care Program ensures that all staff are educated about the nature of informed consent. Education includes the type of information that staff must provide to the client. Examples include:

The nature of the treatment/services being proposed including potential/possible risks and side effects
Possible/probable consequences should the client refuse to give consent
How the proposed treatment/services will positively influence the client
Options to the proposed treatment/services that the client may wish to consider

The First Nations and Inuit Home and Community Care Program educates all staff about the client's right to withdraw consent or to refuse consent to a proposed treatment/services. Staff are also educated about their responsibilities in such a circumstance. These include:

The requirement to respect the right of the client to refuse or withdraw consent
The need to immediately notify other members of the health care team of the client's decision (such as physician, clinic staff, or nurse practitioner)
The responsibility to assist the client to explore options/community linkages/alternative treatments that are in accordance with their wishes
The requirement to document the reasons for withdrawing consent or refusing services

Performance Measurement Suggestions

Formula:

Related Standards

3.4 Obtaining Consent
3.5 Client Rights
3.6 Ethical Issues
3.7 Confidentiality
6.5 Program Changes and Improvements

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: 1, 4
Draft Liability Documents: May, sections 5.1-5.20; June, pgs 24, 34-37

Review Process:
Dates:

Suggested Procedures

Procedure for obtaining and documenting informed client consent.
Procedure for assessing the competency of clients to give informed client consent.
Procedure for obtaining informed consent from a substitute decision maker.

Part 4: Human Resources

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 4: Human Resources Community Name

Policy: Equal Opportunity
Policy Number: 4.1

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program recruits and hires individuals in all positions within the Program according to well-defined recruitment criteria that comply with relevant Federal and/or Provincial/Territorial legislative requirements and individual community practices.

The First Nations and Inuit Home and Community Care Program will, however, state a preference for qualified First Nations or Inuit applicants.

Policy Rationale

To ensure a fair and equitable process for recruitment that reflects the culture and languages of the community, as well as the skills and abilities of applicants.

Policy Details

The First Nations and Inuit Home and Community Care Program will first attempt to recruit within the community and/or the local area for all available positions.

New staff will be recruited and hired without any consideration of the applicant's:

race or religion
color or ethnic origin
gender or age
ancestry, place of origin or citizenship
sexual orientation
record of offences
marital status or family status
physical, mental or social challenges

as defined and interpreted by the Provincial/Territorial and Federal courts, excepting the stated preference for qualified First Nations or Inuit applicants.

The statements listed above regarding equal opportunity in recruitment and hiring apply consistently to all decisions made about ongoing employment, training, compensation and promotion of staff within the First Nations and Inuit Home and Community Care Program.

Process Guidelines

The First Nations and Inuit Home and Community Care Program will ensure that the processes in place for recruitment and hiring of new staff to the Program meet the legislative requirements through:

The use of a standard application form that
- gathers information relevant to the position and
- details the education and experience of the applicant as is relevant to the position
Standardized interview questions that evaluate the
knowledge and training of the applicant relevant to the
position
Standardized weighting method of all interview questions
The ongoing, annual evaluation of staff against well
developed, written job descriptions
Ongoing evaluation of all procedures related to hiring,
training and promotion of Program staff to ensure that the
procedures comply with the relevant legislation
Documentation related to any violation of this policy and the
resulting actions

Performance Measurement Suggestions

Indicator: This information is to be developed by communities as they work with their Programs. For an example of the kind of measures that should be identified, refer to the Hiring Policy template.

Formula:

Related Standards

1.3 Capacity Building
3.6 Ethical Issues
5.2 Recruitment and Retention
5.5 Quality of Work Life

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: Program Criteria, 3A, 4
Draft Liability Documents:

CCHSA AIM Standards, 1999
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Recommended Procedures

Procedure for the hiring request and authorization to be used in the creation of new positions and replacement of staff who have left the Program
Suggested tools:
- Hiring request with cost analysis
Procedure for recruitment that details the steps in the process, including posting of the position within the community, as well as to the broader, local area
Suggested tools:
- Application form
- Standardized interview questionnaire
- Skills checklist (for direct care staff)
- Reference check form
- Hiring notice

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 4: Human Resources
Community Name

Policy: Human Rights
Policy Number: 4.2

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program policies, procedures and standards comply with all of the legislation pertaining to human rights.

Policy Rationale

To ensure processes are in place to deal with issues of discrimination, harassment and equal treatment.

Policy Details

The First Nations and Inuit Home and Community Care Program monitors behaviours of staff/clients/community members for prohibited practices that include:

Discrimination based on:
- race or religion
- colour or ethnic origin
- gender or age
- ancestry, place of origin or citizenship
- sexual orientation
- record of offences
- marital status or family status
- physical, mental or social challenges
- medical history/condition
Harassment of staff/clients/community members by staff/clients/community members based on:
- race or religion
- colour or ethnic origin
- gender or age
- ancestry, place of origin or citizenship
- sexual orientation
- record of offences
- marital status or family status
- physical, mental or social challenges
- medical history/condition
Harassment of staff/clients/community members by staff/clients/community members which is sexual in nature, including verbal and physical sexual intimidation, requests for sexual acts and sexually specific comments and advances When the First Nations and Inuit Home and Community Care Program discovers behaviour that suggests discrimination or harassment, the Management of the Program will take immediate steps to investigate and correct the behaviour, as required.

Process Guidelines

The First Nations and Inuit Home and Community Care Program will ensure that all employees/clients/community members are educated about the principles contained in the relevant human rights legislation through:

A detailed orientation process for new staff and volunteers that provides information about human rights
A client hand-out and verbal explanation during the initial client contact which details the client's rights and responsibilities
A process for investigating individual complaints of discrimination and harassment which includes corrective action planning
A process for monitoring complaints and corrective actions to identify issues, improvements and trends
Annual training and education sessions for staff/clients/community members about the principles, goals and practical application of human rights legislation

Performance Measurement Suggestions

Formula:

Related Standards

3.6 Ethical Issues
5.2 Recruitment and Retention
5.5 Quality of Work Life

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: 1, 3A, 4
Draft Liability Documents:

CCHSA AIM Standards, 1999
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Recommended Procedures

Procedure for the investigation and resolution of harassment and/or discrimination complaints
Suggested tools:
- Occurrence report with section for harassment/discrimination

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 4: Human Resources
Community Name

Policy: Ethics
Policy Number: 4.3

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program will have a well-developed code of ethics that is understood and practiced by all staff.

Clients will be provided with full information about the code of ethics and how to report violations of the code.

Policy Rationale

To ensure the respect of client's rights. To ensure client's rights are reflective of the culture of the community and supported by the appropriate professional bodies. To ensure the respect of staff rights.

Policy Details

The code of ethics, developed with input from the community, will provide clients and staff with guidelines to follow when dealing with ethical issues. Some examples of ethical issues may include, but are not limited to:

clients' right to choose to live at risk
clients' right to refuse services
clients' offering of gifts to service providers
violations of the rights of clients
discrimination
harassment
unprofessional actions (i.e. making personal telephone calls when at a clients' home, discussing other clients, borrowing money from clients)
staff's right to refuse to provide services when at risk
Conflict of interest guidelines
Appropriate dress
Use of alcohol or drugs or other illegal substances

Process Guidelines

The code of ethics will be reflective of the culture and values of the First Nations and Inuit Home and Community Care Program and of the community. Each community must therefore:

invite community participation in the development of the code of ethics through formal and informal gatherings
ensure that elders are consulted
review regularly the code of ethics and make updates as necessary to reflect changing community values

All staff and clients must clearly understand the code of ethics, its importance to the community and its relationship to the delivery of services under the First Nations and Inuit Home and Community Care Program policies. Management of the Program must therefore:

educate all new staff at orientation about the importance of the code of ethics and its relationship to the culture and values of the community
regularly review the code of ethics with staff through training and educating sessions
regularly evaluate all staff during performance appraisals about how well they respect and work within the code of ethics
investigate, document and take immediate corrective actions for any complaints of violations of the code of ethics
report violations of the code of ethics as an occurrence, which then forms part of the ongoing quality improvement process

Performance Measurement Suggestions

Formula:

Related Standards

3.5 Client Rights
3.6 Ethical Issues
5.2 Recruitment and Retention
5.5 Quality of Work Life

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: Program Criteria, 1, 2, 3A, 4
Draft Liability Documents:

CCHSA AIM Standards, 1999
Canadian Health Record Association, Code of Practice and
Principles and Guidelines for Access to and Release of Health Information
Professional Practice Standards
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Recommended Procedures

Development of a written code of ethics
Suggested tools:
- Written code of ethics
Procedure for reporting violations of the code of ethics (to be incorporated into the occurrence reporting procedure)
Suggested tools:
- Occurrence report
Procedure for assessing risk
Suggested tools:
- Risk assessment form
Annual review and revision, as required, of the code of ethics, with input from the community and staff

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 4: Human Resources
Community Name

Policy: Harassment
Policy Number: 4.4

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program has zero tolerance for any form of harassment of clients and/or staff. Harassment includes but is not limited to:

Physical threats, bullying and/or aggressive actions or pressures
Verbal cruelty and/or threats
Sexually inappropriate actions and suggestions
Financial abuse and manipulation
Discriminatory actions based on:
- Race or religion
- Colour or ethnic origin
- Gender or age
- Ancestry, place of origin or citizenship
- Sexual orientation
- Record of offences
- Marital or family status
- Physical, mental or social challenges

Policy Rationale

To ensure the protection of human rights for clients and staff.

Policy Details

The First Nations and Inuit Home and Community Care Program educates all staff about the harassment policy.

The First Nations and Inuit Home and Community Care Program educates all clients about the harassment policy.

Staff and clients are educated about how to report violations to the harassment policy.

Process Guidelines

The First Nations and Inuit Home and Community Care Program has a well-defined process for all aspects of the harassment policy. This includes, but is not limited to:

An orientation program that includes information about the harassment policy for all new staff
An initial client assessment process that includes education of the client on their rights, including their right to have harassment-free service
An occurrence reporting system that includes documentation of harassment as an inappropriate incident
Directions for clients and staff to follow when reporting harassment, including reassurance that they will not be punished for coming forward

Performance Measurement Suggestions

Formula:

Related Standards

3.6 Ethical Issues
5.2 Recruitment and Retention
5.5 Quality of Work Life

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: 3A, 4
Draft Liability Documents:

CCHSA AIM Standards, 1999
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Recommended Procedures

Procedure for reporting violations of the harassment policy as part of the occurrence reporting process
Suggested tools:
a. Occurrence report
Procedure for linking with appropriate services (i.e. police, counselling) when harassment of clients and/or staff occurs
Procedure for discipline of staff, as appropriate, when violations of the harassment policy occur
Procedure for stopping and/or changing services to clients when violations of the harassment policy occur

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 4: Human Resources
Community Name

Policy: Recruitment
Policy Number: 4.5

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program, through a formal and periodic community needs assessment process, evaluates regularly the on-going ability of the Program to respond to changing needs and trends in the community. This dynamic assessment process, and the analysis of the findings, provides the Program management with guidance in the area of staff recruitment.

The First Nations and Inuit Home and Community Care Program has a planned approach to effectively attract qualified, appropriate candidates for staff recruitment to meet the needs of the Program now, and as it is expected to develop in the future.

Policy Rationale

To ensure the availability of qualified, trained staff to meet the needs of clients.

Policy Details

The community needs assessment gathers information from clients, family members, Program staff and the wider community. This information is assembled and analyzed to provide the management of the First Nations and Inuit Home and Community Care Program with current information on service delivery, changing needs and developing trends. Using this information, the Program management examines the current staffing mix, with a specific focus on staff's experience, training and education. This review is then used to determine the appropriateness of the current staff for current and future Program needs.

When gaps in staffing are identified, the management of the First Nations and Inuit Home and Community Care Program will immediately submit a recruitment request to the community leadership, if required. The request will detail the identified need/trend/gap and the number and qualifications of new staff required to be recruited.

When authorized, the management of the First Nations and Inuit Home and Community Care Program will proceed to recruit appropriate candidates and hire the required staff.

Process Guidelines

A formal community needs assessment is completed regularly, at a minimum, by the management of the First Nations and Inuit Home and Community Care Program. All personal client information gathered by the community needs assessment is considered confidential, and is used only for the purposes of identifying community needs, developing trends and determining required staffing levels.

All recruitment requests and decisions are based on quantitative data and are related to community needs.

The recruitment process should include the following:

Identifying staffing gaps through a community needs assessment
Completing a request for staff form which details:
- The number of staff required
- The qualifications of these staff
- The specific needs to be met with these staff
Upon approval of the request, determining how to best meet the need. Factors to consider in this decision include:
- The availability of qualified, appropriate candidates for recruitment
- Funding considerations
- Extensiveness of the need
Promoting the new staff opportunities in a way that is likely to attract appropriate candidates

Some options the First Nations and Inuit Home and Community Care Program has are to:

Hire direct to the Program
Develop a co-operative program relationship with another First Nations/Inuit community or communities
Contract with an existing provider in the broader community

Performance Measurement Suggestions

Formula:

Related Standards

1.3 Capacity Building
1.4 Resource Management
5.1 Planning
5.2 Recruitment and Retention
5.4 Education, Training and Development
5.5 Quality of Work Life

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: Program Criteria, 2, 3A, 4
Draft Liability Documents:

CCHSA AIM Standards, 1999
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Recommended Procedures

Procedure for completing a community needs assessment with a focus on staffing requirements and staff qualifications
Procedure for determining the appropriate staff mix
Procedure for determining the appropriate response to identified gaps in staffing
Procedure for contracting with existing service providers, if required
Suggested tools:
- Sample contract for service provision
Procedure for co-operative service agreements with other First Nations/Inuit communities, if required
Suggested tools:
- Sample service agreement
Procedure for advertising/posting authorized new positions
Suggested tools:
- Sample advertisement/notice

Part 4: Human Resources

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 4: Human Resources Community Name

Policy: Hiring Policy Number: 4.6

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program attempts to hire qualified individuals for all positions within the Program according to well-developed job descriptions.

The recruitment and hiring processes meet the terms of all relevant Federal and/or Provincial/Territorial legislative requirements for human rights, equal opportunity and criminal checks.

The First Nations and Inuit Home and Community Care Program prefers to hire qualified First Nations or Inuit applicants to all positions within the Program.

Policy Rationale

To ensure a fair, equitable and consistent practice throughout the organization in relation to recruitment and reduce the risk of hiring unqualified staff.

Policy Details

The First Nations and Inuit Home and Community Care Program will develop job descriptions for all positions within the Program. All job descriptions will include the following headings:

General Overview of the Position
Specific Duties including:
- Reporting structure
- Responsibilities
- Accountabilities
- Authority
Qualifications including:
- Related experience
- Relevant education and training
- Specific clinical training/certification when required

Process Guidelines

The First Nations and Inuit Home and Community Care Program will ensure that job descriptions for all positions are relevant and current through an annual review and revision process.

All new positions created through growth in, or expansion of, the essential and/or other services provided by the First Nations and Inuit Home and Community Care Program will have a formal job description created before hiring is undertaken.

Successful new employees to the First Nations and Inuit Home and Community Care Program will be oriented to the Program only when management has completed the hiring process. This hiring process includes:

Completion by the applicant of a detailed application form that gathers information related to the job description. This information includes the applicant's:
- Previous related experience
- Relevant basic education
- On-going specialized training received
- Relevant professional references
- Signature of applicant for permission to check references
- Availability for work (ie start-date, days, hours)
- Specific skills, including clinical skills, as appropriate
- Available transportation
A formal interview with the management of the First Nations and Inuit Home and Community Care Program. This interview is designed to gather information on the knowledge and training of the applicant relevant to the job description.
A review by management of all references with specific attention to the ability of the applicant to meet the specified responsibilities and accountabilities of the position
A formal, written offer of employment to the applicant who has successfully completed the first three parts of the process. The offer of employment contains information (not necessarily complete information) about:
- The position title
- The hours of work (full-time/part-time/casual)
- The reporting structure
- The salary and benefits expected
- Standard deductions
- Start date
- The probationary period
- Occupational health requirements (vaccinations/medical certificates)
The return of the signed offer of employment by the applicant.

Performance Measurement Suggestions

Indicator: Proportion of staff hired from First Nations or Inuit Communities
Formula: # of First Nations or Inuit staff hired in the year. Total # of staff hired in the year

Indicator: Staff turnover rates
Formula: # of staff terminated in the year. Total # of staff. * Exclude retirement if analyzing turnover rates based on performance and quality of work life

Indicator: Completeness of the personnel file
Formula: # of incomplete staff files. Total # of files audited. * For example, look for signed application, two references, interview documentation, etc.

Indicator: Accuracy of the job description
Formula: # of staff who think that their job description is accurate. Total # of staff surveyed

Related Standards

1.3 Capacity Building
1.4 Resource Management
5.1 Planning
5.2 Recruitment and Retention
5.4 Education, Training and Development
5.5 Quality of Work Life

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: Program Criteria, 2, 3A, 4
Draft Liability Documents:

CCHSA AIM Standards, 1999
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Recommended Procedures

Procedure for recruitment
Suggested tools:
- Staffing needs analysis
- Recruitment strategy
Procedure for hiring
Suggested tools:
- Application form
- Interview guide
- Reference check guide
- Written offer template
- Occupational Health Requirements list
Development of job descriptions for all positions
Suggested tools:
- Job description template
Annual review and revision of job descriptions

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 4: Human Resources Community Name

Policy: Employment Relationship Policy Number: 4.7

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program has a written statement of employment with each employee. This statement is signed by the employee and outlines the conditions of employment.

Policy Rationale

To ensure an understanding of the employee of the terms under which the employee has accepted a position and to reduce the risk of misunderstanding of conditions of employment.

Policy Details

The First Nations and Inuit Home and Community Care Program management staff will determine the number and type of employees required to deliver home care services.

Employees will be classified as:

Full-time
Part-time
Casual
Contract workers

Where applicable employees may be part of a collective bargaining unit and the terms and conditions of employment are clearly outlined through joint management/staff/union negotiations.

The number and type of staff required will be based on:

The type of programs/services offered
The budgeted amount of money allocated to staffing
The ability to recruit staff to the program
The number of projected client referrals per year
Projected volume of visits per month

Labour code legislation is used to determine hours of work of employees.

The Program agrees to provide work to the employees.

The employees will be available to work as per the conditions at the time of hiring.

The Program has a duty to pay the agreed upon wages and salary to each employee.

The Program management is responsible for the health and safety of employees.

The employee agrees to perform the job to the best of his/her capability, knowledge and skill.

Process Guidelines

The First Nations and Inuit Home and Community Care Program will recruit staff according to the identified number and type of staff required to provide the services.
There will be a written procedure defining the hours of work for each classification of employee.
There will a written procedure listing the requirements for the position at the time of hiring.
Full-time employees will be required to make a commitment to work approximately 37.5-40 hours per week.
Part-time employees will be required to make a commitment to work on a pre-determined basis (less than full-time hours).
Casual employees will provide for relief of full-time and part-time staff.
Contract employees will work for a specific period of time.
Each employee will receive a contract that outlines the terms and conditions of employment which includes:
- Rate of pay
- Hours of work based on status, ie full-time, part-time, casual
- Holiday and sick time benefits
- Parental rights
- Optional benefits
- Legislated deductions
- Any guaranteed work agreements
- Maximum hours to work in one week
- The rights of the Program to give due notice to the employee for termination of employment, and the associated pay in lieu of work at termination.

Performance Measurement Suggestions

Formula:

Related Standards

4.1 Health and Safety
5.1 Planning
5.2 Recruitment and Retention
5.3 Evaluating Performance
5.5 Quality of Work Life

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: 3A, 4
Draft Liability Documents:

CCHSA AIM Standards, 1999
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Recommended Procedures

Procedure to determine the hours of work per employment category.
Procedure to determine the staffing required to perform various jobs/functions.
Suggested tools:
- A tool to calculate the number and type of full-time equivalent staff required to perform each job/function
Procedure for identifying the requirements for the position at the time of hiring.
Procedure for developing and reviewing of each staff member's employment contract at the time of hiring, to be sure the new staff member is clear about the conditions of employment.
Suggested tools:
- Sample employment contract
Procedure for reviewing the employment contracts on a regular basis to ensure they are accurate, up-to-date and reflect any changes to employment conditions and requirements.

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 4: Human Resources Community Name

Policy: Performance Management Policy Number: 4.8

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program will have an organized way of:

setting expectations and goals
monitoring performance
assessing performance of individuals and groups
providing positive feedback

The Program will look at what tasks and activities need to be done, why they need to be done and how well they should be done. The Program will clearly outline the accountability and responsibility of individual employees and groups.

Policy Rationale

To ensure clinical competence, that the standards of the Program are being met and that there is a forum to identify professional development needs and opportunities for staff.

Policy Details

The performance management processes will:

Use written job descriptions that identify expectations, goals, and responsibilities
Use performance assessment tools
Select indicators to measure performance
Monitor indicators continuously
Compare performance to the standards and policies set
Provide feedback to individuals and groups
Conduct a performance assessment prior to the completion of each employee's probationary period
Annually assess performance
Increase capacity building through ongoing training and staff development
Respond to changes to the First Nations and Inuit Home and Community Care Program by adjusting the performance management processes and the tools that are used on a timely basis

Process Guidelines

The First Nations and Inuit Home and Community Care Program will ensure that the processes are in place to measure and enhance performance and comply with legislative and professional requirements through:

Development of written job descriptions for each position
Implementation of a performance assessment system
Assessment of performance by the senior person and other appropriate methods, such as self evaluation and peer evaluation
Assessment of performance based on the job description
Documentation and signing of the assessment form by the supervisor and employee at the time of assessment
Improving the way the work is completed based on feedback
Providing positive feedback to individuals and groups for work that contributes to the mission and vision of the Program

Performance Measurement Suggestions

Formula:

Related Standards

1.2 Development of the Vision
1.3 Capacity Building
5.2 Recruitment and Retention
5.3 Evaluating Performance
5.4 Education, Training and Development
5.5 Quality of Work Life

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: Program Criteria, 3A, 4
Draft Liability Documents:

CCHSA AIM Standards, 1999
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Recommended Procedures

Procedure for ongoing training and development of individuals and groups
Suggested tools:
- Orientation checklist
- Record for ongoing training and development
Procedure for evaluation of performance which includes:
- Assessment at key times during probationary period
- Assessment at one year of employment as legislated
  Suggested tools:
  - Written job descriptions
  - Evaluation forms to match job descriptions
Procedure for monitoring, documenting and recording of indicators.
Suggested tools:
- tools to monitor indicators

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 4: Human Resources Community Name

Policy: Disciplinary Process Policy Number: 4.9

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program will immediately investigate all concerns of:

Professional misconduct
Negligence
Unethical behaviour
Violation of confidentiality
Performance issues, ie false reporting

The disciplinary process will be implemented where appropriate until investigation of the incident is completed.

Policy Rationale

To ensure a fair and equitable process that protects the clients, supports the staff, and reduces the risk to the Program.

Policy Details

Program management is responsible and accountable for the liability protection related to delivery of care in the program.
All high-risk situations will be reported immediately to the appropriate authorities.
Program management will investigate immediately all high-risk concerns identified.
All high-risk situations will be recorded and tracked by Program management.
Program management will assess the level of risk and will determine if discipline is appropriate to the situation.
Professional standards of practice will be used to guide disciplinary actions where appropriate.
All steps of the disciplinary process will be outlined in a written procedure and may include:
- Verbal criticism
- Written warning, with the warning placed in the employee's file
- Suspension from work, with or without pay as determined in advance, until investigation of the incident is completed
- Suspension following investigation, as deemed appropriate, with or without pay as determined in advance
- Discharge for sound reason
The discipline will be implemented
- Immediately
- Without warning
- Consistently
- Impersonally
Legal consult will be requested where appropriate.
When discharge is the course of action, the appropriate professional authorities will be notified.

Process Guidelines

The First Nations and Inuit Home and Community Care Program will have a written procedure that outlines the steps to be taken in progressive discipline which include:
- Informal discussion to be held with staff member regarding behaviour and expectations
- Formal interview that identifies further expectations
- The course of action to be taken
- Review of behaviour and performance expectations
The incident will be recorded and reported on an incident form.
Where appropriate, discussion about the incident will occur with all appropriate community team members while maintaining confidentiality of the employee.
A record of all discussions will be completed by Program management and will be kept on file for future reference. The staff person involved must be aware of everything that is documented and that the information will appear in the personnel file. All incidents and anecdotes are to be dated and signed by Program management and the staff person involved, and the staff person has the right to add written comments.
Discipline implemented will relate to the potential level of harm caused to the client, family, other staff, the community and the Program.
The past record of the employee will be reviewed to ensure that the discipline is appropriate to the situation.
All staff will be oriented to the expected behaviour and job requirements at the time of hiring.

Performance Measurement Suggestions

Formula:

Related Standards

3.6 Ethical Issues
3.7 Confidentiality
5.4 Education, Training and Development
5.5 Quality of Work Life
6.6 Confidentiality of Information

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: 4
Draft Liability Documents:

CCHSA AIM Standards, 1999
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Recommended Procedures

Procedure for progressive discipline, including monitoring and reviewing the progress of the employee on a timely basis.
Suggested tools:
- Form outlining progressive discipline and dates for implementation, review and decision as to next steps
- Sample letter of warning
Procedure for tracking incidents and appropriate discipline.
Suggested tools:
- Tool to record and track the response to each incident, including disciplinary actions taken
Procedure for identifying situations for suspension with and without pay to be used as reference when incidents occur.

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 4: Human Resources Community Name

Policy: Confidentiality Policy Number: 4.10

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program will respect and maintain the confidentiality of all staff information. Any breach of staff confidentiality may result in serious action, up to and including termination from employment.

Policy Rationale

To ensure the security of staff information regarding salary, medical information, licensing, insurance and performance.

Policy Details

The First Nations and Inuit Home and Community Care Program insures confidentiality of staff information by practising the following:

Information on staff personnel records must be kept confidential
Information must be protected from loss or accidental destruction
All staff information will be kept in a secure location with restricted access
Care and caution must be used to protect printed or written information from unauthorized use or abuse
All staff information must be shredded and discarded in a secure manner
All staff information sent by fax or email must be sent through a secure/confidential site
Written consent must be obtained prior to the release of confidential information
A clear process exists for the release of confidential information to people and organizations, i.e. release of information to lawyers, banks, media, etc.

Process Guidelines

All staff must be oriented to the legal requirements of confidentiality.

Professional standards of practice will be used as a guideline where applicable.

Education of staff will include:

Policy on confidentiality
Examples of situations where confidentiality must be maintained
Examples of situations where information may be shared when verbal consent of the staff is obtained
Examples of situations where information may be shared when written consent of the staff is obtained
Examples of situations where information may be shared with management without consent of the staff
Procedure to discard confidential information
Procedure to maintain security and confidentiality of information when faxing or emailing sensitive information
Consequences of breach of confidentiality

Performance Measurement Suggestions

Formula:

Related Standards

3.6 Ethical Issues
3.7 Confidentiality
5.2 Recruitment and Retention
5.3 Evaluating Performance
5.5 Quality of Work Life
6.2 Data Collection and Reporting
6.4 Information Exchange
6.6 Confidentiality of Information

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: Program Criteria, 2, 4, 5
Draft Liability Documents:

CCHSA AIM Standards, 1999
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Recommended Procedures

Procedure for release of information.
Procedure for obtaining informed consent.
Suggested tools:
- Consent form for informed consent release of information
Procedure for discarding confidential information.
Procedure for faxing and emailing confidential information.
Procedure for storing confidential staff information.

Part 4: Human Resources

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 4: Human Resources Community Name

Policy: Orientation Policy Number: 4.11

Approval:
Date:

Policy

All employees working with the First Nations and Inuit Home and Community Care Program will complete a formal orientation to the organization, the Program and the services offered.

Policy Rationale

To ensure staff are knowledgeable about the organization and the Program, with consistent application of standards, policies and procedures.

Policy Details

The First Nations and Inuit Home and Community Care Program will provide a formal orientation to all new staff within the first week of hire to ensure that staff are aware of the following:

The organization and the Program, including:
- Mission and vision
- Values and beliefs
- Goals and objectives
- Organizational structure
- Roles and responsibilities of clients and families, providers, the community and First Nations and Inuit Health Branch
Scope and services of the Program
Client care policies, including confidentiality of information, continuity of services
Human resources policies
Quality management policies
Standards and expectations of the Program
Standards of practice
Job description, role and responsibilities
Relevant legislation requirements
Community health and safety measures
Community resources and linkages to other programs available to support the Program

Process Guidelines

All staff will attend a formal orientation program within one week of hire.
There will be a formal written orientation program.
An orientation package will be developed to include certification packages for special skills and knowledge.
Dates and times of orientation will be documented and kept on the employee's file.
All staff will complete an orientation checklist.
There will be an annual review and update of the orientation program.
Changes will be made to orientation based on evaluation of the orientation program.
Ongoing education, training and development will be provided for staff.

Performance Measurement Suggestions

Formula:

Related Standards

1.2 Development of the Vision
1.3 Capacity Building
1.4 Resource Management
3.1 Services Delivery
3.2 Continuity of Services
3.5 Client Rights
3.6 Ethical Issues
3.7 Confidentiality
4.1 Health and Safety
4.2 Equipment and Materials
4.5 Emergency and Disaster Planning
5.1 Planning
5.2 Recruitment and Retention
5.4 Education, Training and Development
5.5 Quality of Work Life
6.1 Information Needs
6.2 Data Collection and Reporting
6.6 Confidentiality of Information

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: 3A, 4, 5
Draft Liability Documents:

CCHSA AIM Standards, 1999
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Recommended Procedures

Develop a formal written program of orientation.
Suggested tools:
- Orientation checklist
- Orientation program outline
Procedure to regularly evaluate the orientation program.
Suggested tools:
- Evaluation tool
Use other tools as practical examples during orientation, i.e. job description, policy manual, standards manual, and the First Nations and Inuit Home and Community Care Program Planning Resource Kit.

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 4: Human Resources Community Name

Policy: Training and Development Policy Number: 4.12

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program recognizes and values that learning is life long. The Program ensures that ongoing training and development of staff occurs. The Program recognizes that training and staff development are an integral part of capacity building.

Ongoing training and development may include:

Formal programs provided by colleges, universities and other certified training organizations
Distance education programs
Short term programs
Certification programs
Individual learning
Committee participation
Workshops
Seminars
Mentorship/preceptorship programs

Policy Rationale

To ensure resources are allocated to the development of staff to enhance services to clients. These resources include allocation for orientation, ongoing training as identified, and support for performance management.

Policy Details

Ongoing training and development of staff in the First Nations and Inuit Home and Community Care Program is supported to:

Improve and upgrade the knowledge and skills of staff
Educate staff about:
- Changes in the way care is to be delivered
- Changes in policy/procedure
- Changes to the program and services provided based on community needs assessment
- Legislation changes that affect the program
- Management of information
Build staff clinical, management, interpersonal, problem solving and decision making skills through ongoing coaching and counselling
Carry out quality improvement activities
Observe practice to ensure safety of care delivered
Improve work satisfaction of staff and client satisfaction

Process Guidelines

Ongoing training and development of staff will include:

Holding formal meetings with staff to provide updates of information about the Program/services/legislation requirements. Appropriate written materials will be provided to support this information sharing.
Developing a package of educational materials to support skill and knowledge development.
Identifying courses and seminars that will meet educational needs.
Developing and implementing individual staff training and development plans.
Annually assessing staff learning needs and using these to develop and revise individual staff training and development plans.
Encouraging staff to document ongoing training and education.
Observing clinical practice to ensure safety, work satisfaction, and client and family satisfaction.
Documentation of assessments of clinical practice.
Demonstrating skills that require certification.

Performance Measurement Suggestions

Formula:

Related Standards

1.3 Capacity Building
1.4 Resource Management
3.1 Services Delivery
4.1 Health and Safety
4.2 Equipment and Materials
4.5 Emergency and Disaster Planning
5.1 Planning
5.2 Recruitment and Retention
5.3 Evaluating Performance
5.4 Education, Training and Development
5.5 Quality of Work Life
6.1 Information Needs
6.2 Data Collection and Reporting

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: 3A, 4, 5
Draft Liability Documents:

CCHSA AIM Standards, 1999
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Recommended Procedures

Process to annually assess learning needs of the staff at a group level and at an individual level.
Suggested tools:
- Staff learning needs assessment tool
Process to design, implement, evaluate and revise individual staff training and development plans.
Suggested tools:
- Training and development plan template
- Training and education record to be used for individual staff (and retained in staff personnel files)
Process to ensure periodic, timely information sharing with staff and to arrange for training sessions to address the group learning needs.
Development of checklists and self-tests for use with the certification packages.

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 4: Human Resources Community Name

Policy: Employee Relations Policy Number: 4.13

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program management team agrees that staff will be valued and respected. The organization believes in a positive, sharing environment that is free from unwelcome comments or harassment.

Policy Rationale

To ensure consistent, open communication that enhances quality of work life, supports staff development, and facilitates improvement activities in the Program.

Policy Details

The Human Rights Code of Canada will be used to guide human resource practices.
The staff are a valuable resource to the First Nations and Inuit Home and Community Care Program and the delivery of its services.
The culture and traditions of staff will be respected.

Process Guidelines

Human Resource policies and practices will be reviewed and explained during orientation, ongoing evaluations, and other appropriate training and staff development sessions. The Human Resource policies and practices include:
- Respect of the individual and for one another
- Open, honest communication
- An environment that uses humor, when appropriate
- Freedom from harassment
All new staff will participate in a formal orientation process.
Culture and traditions of staff will be shared at orientation and at appropriate staff development sessions. Respect for these cultures and traditions will be demonstrated in all interactions with staff. There will be an understanding that client needs must be met even when community cultural and traditional events occur. This may mean that not all staff may be given the time off to take part.
All staff will be encouraged to freely voice their opinions and beliefs to management.
There will be a procedure for staff to use when employee relations are not effective.
The procedure will be discussed with staff to ensure it is understood.

Performance Measurement Suggestions

Formula:

Related Standards

5.1 Planning
5.2 Recruitment and Retention
5.3 Evaluating Performance
5.4 Education, Training and Development
5.6 Quality of Work Life

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: 3A, 4
Draft Liability Documents:

CCHSA AIM Standards, 1999
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Recommended Procedures

Procedure for the steps to be taken when employee relations are not effective.
Procedure for the steps to take if harassment occurs.

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 4: Human Resources Community Name

Policy: Grievances Policy Number: 4.14

Approval:
Date:

Policy

Staff working with the First Nations and Inuit Home and Community Care Program will have a process to address differences in understanding, importance, direction and breach of practice. The management team and staff will work together to resolve concerns.

Policy Rationale

To ensure processes are in place to prevent staff discrimination, harassment and unfair practice.

Policy Details

The First Nations and Inuit Home and Community Care Program believes that:
- Working together in harmony to discuss concerns and develop solutions is essential to the effective functioning of the program
- Staff satisfaction with the organization is important to the success of care delivery
- Staff are a valuable resource
Individuals have rights, including the right to complain, which are identified and protected under Federal and Provincial/Territorial legislation.
When agreement cannot be reached a procedure is needed for staff to follow to address and resolve concerns.

Process Guidelines

Staff will have a forum to address concerns, for example, staff meetings.
All concerns/differences will be verbally discussed with the management staff in a timely way.
Unresolved differences will be noted in writing and a copy will be given to the management staff within a clearly defined time period.
Management staff will have a clearly defined time period in which to respond to the concern.
If unresolved to the satisfaction of the employee, the written concern will be submitted to the Program/community leadership. If necessary, there is a process in place to go outside of the community for appeal.
The Program/community leadership will respond to the written concern within a clearly defined time period.
The Program/community leadership will discuss the concern with the staff and management team and will mediate a solution where possible.
Documentation about all grievances will be maintained
Staff will have access to an appeal process if he/she disagrees with the proposed solution.
During orientation, the policy on grievances will be explained and ensure that it is understood by all new staff.
There will be a written grievance procedure.
Clearly defined time frames must be strictly followed.

Performance Measurement Suggestions

Formula:

Related Standards

5.2 Recruitment and Retention
5.3 Evaluating Performance
5.4 Education, Training and Development
5.5 Quality of Work Life

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: 4
Draft Liability Documents:

CCHSA AIM Standards, 1999
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Recommended Procedures

Procedure for the handling of grievances.
Suggested tools:
- Form to track responses to concerns identified by staff to ensure time frames are being followed
Procedure for the appeal process, including a mechanism for going outside of the community, should resolution not be achieved at the community level.
Procedure for monitoring grievances, the process, and the satisfaction of staff with the process and outcomes.

Part 4: Human Resources

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 4: Human Resources Community Name

Policy: Conflict of Interest Policy Number: 4.15

Approval:
Date:

Policy

All employees of the First Nations and Inuit Home and Community Care Program are responsible to their clients, the Program and their co-workers to perform their duties at all times in a professional and ethical manner which is at all times sensitive to potential conflict of interest issues.

Policy Rationale

To prevent the taking advantage of clients, and to reduce the risk to the Program in relation to contract management, human resources management and services delivery.

Policy Details

The First Nations and Inuit Home and Community Care Program provides education to all staff at orientation and through regular staff training and development sessions on conflict of interest.

The First Nations and Inuit Home and Community Care Program staff advise the client at admission of their rights under the program.

These rights include the right to receive qualified health care that is free from conflict of interest behaviours and behaviours that take advantage of situations and clients.

Staff are advised that some, but not all, of the issues which may be considered to be in conflict of interest are:

Taking advantage of the professional relationship with any client in any manner which results in personal gain for the employee or their family/friends
Entering into an employment relationship with another health services provider which infringes on the employment relationship with the First Nations and Inuit Home and Community Care Program unless such a relationship has been disclosed and authorized by the Program
Agreeing to provide qualified health services to any client where there is a personal/familial relationship, unless such a relationship has been disclosed to the First Nations and Inuit Home and Community Care Program and has been reviewed and authorized

Staff and clients are provided with information on how to report potential/actual conflict of interest situations.

Process Guidelines

The First Nations and Inuit Home and Community Care Program has a well-defined process for all aspects of the conflict of interest policy. This includes but is not limited to:

The orientation of new staff includes information about conflict of interest situations. A variety of methods are used to demonstrate potential conflict of interest. These methods may include case study and role-play scenarios.
A client assessment process which includes education to the client on their rights, including their right to qualified and ethical care.
Incidents of conflict of interest issues are documented as occurrences or quality purposes, and are fully investigated by the Management of the First Nations and Inuit Home and Community Care Program. When appropriate, these occurrences are addressed with the employee through progressive discipline procedures.
Detailed instructions for staff and clients are provided for reporting potential conflict of interest situations.

Performance Measurement Suggestions

Formula:

Related Standards

1.5 Contract Management
3.5 Client Rights
3.6 Ethical Issues
5.2 Recruitment and Retention
5.5 Quality of Work Life

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: Program Criteria, 4
Draft Liability Documents:

CCHSA AIM Standards, 1999
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Recommended Procedures

Procedure for staff to follow when declaring a potential conflict of interest to Program management.
Procedure for reporting any suspected or confirmed violations of the conflict of interest policy (to be included in the occurrence reporting procedure).
Procedure for progressive discipline of staff, when appropriate, for violations of the policy.
Procedure for reporting conflict of interest involving regulated health providers to professional colleges or other appropriate organizations, when appropriate.

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Section: Human Resources Community Name

Standard: Compensation Standard Number: 4.16

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program will provide to employees a competitive compensation package that supports the:

Mission statement
Vision statement
Values of the Program
Program organizational chart
Job descriptions
Human resources policies
Number of people employed by the Program

The compensation package will be designed to improve morale, retain employees, and link pay to performance and it will provide a complete compensation package.

Policy Rationale

To ensure consistent application of compensation packages that support recruitment and retention issues, professional development, and skills, education and performance of staff.

Policy Details

The person responsible for human resources in the Program will oversee the compensation package.
Program management will review the financial costs of the compensation package with Program leadership and/or community leadership, as appropriate, on a regular basis.
The appropriate authorities will give approval of the compensation package.
The compensation package will be fair to all staff within the Program and competitive with other programs and similar opportunities within the community.
Salaries will be assessed and determined by the:
- Job description
- Job function
- Program organizational chart
- Skill and knowledge required for the job
- Completion of an assessment of similar jobs and the rate of pay externally
- Performance management system
The compensation package will include options for:
- Additional benefits
The compensation package will be reassessed annually.
Employment contracts will be given to employees outlining the details of the compensation package.
A signed copy of the contract will be kept on the employee's file.
Program management will track, monitor and evaluate the compensation package on a regular basis.
Program management will develop job descriptions for each category of worker.
Employees will be paid on a regular basis (ie every two weeks) and the pay schedule will be strictly followed.
Only deductions required by law will be made from the payroll, ie Canada Pension Plan, Unemployment Insurance, Income Tax.

Process Guidelines

The First Nations and Inuit Home and Community Care Program management will provide a list of compensation options to the Program leadership and/or community leadership for approval. The list includes:
- Base pay rates for all categories of workers
- The option of annual incentives based on pay for performance, if the Program so chooses
- Other benefits options including
  - Health and dental benefits
  - Life and accidental death
  - Disability benefits
  - Group pension plan
  - Registered retirement savings plan
  - Life insurance
  - Vision coverage
  - Mileage reimbursement, with the rate of pay per Kilometre to be set by the Program
Predetermined rates for staff to pay to participate in the above optional benefit plans, if offered by the Program, will be established.
The Program's contribution to the benefit packages it offers will be identified.
There will be set dates for employees to decide whether or not to participate in the optional benefits package, if offered by the Program.
Other compensation options available to employees will be identified and may include:
- Flexible work hours
- Job sharing
- Wellness programs
- Child and Elder care
- Educational assistance plans
- Conditions where meals will be paid
- Payment of professional memberships
- Individual and team cash incentives
- Bonuses in the form of cash
- Non cash incentives available to staff for recognition of excellence, ie gift certificates
Conditions of work will be detailed in a procedure which includes:
- Hours of work
- Scheduling of work
- Payment of overtime hours for all staff except Program management
- Pay rate differences for hours worked during the evening or night.
- Unpaid lunches and paid coffee breaks
All staff will be made aware of optional benefits and how to request these benefits at orientation.
A performance management system will be implemented and explained to all staff at the time they are hired.

Performance Measurement Suggestions

Formula:

Related Standards

1.2 Development of the Vision
5.1 Planning
5.2 Recruitment and Retention
5.5 Quality of Work Life

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: 3A, 4
Draft Liability Documents:

CCHSA AIM Standards, 1999
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Recommended Procedures

Procedure for determining base rates of pay.
Suggested tools:
- Job descriptions
- Form listing all jobs and pay ranges for each
Procedure for detailing optional benefit plans, length of service required to enter plans, and costs to employees and the Program.
Suggested tools:
- Form outlining the benefits, requirements and costs, with noted review dates and signatures of approval
Procedure for outlining the conditions of work.
Suggested tools:
- Sample employee contract that includes all conditions of work
Procedure for mileage reimbursement.
Suggested tools:
- Form for recording mileage request for reimbursement
Procedure for regularly tracking, monitoring and evaluating the costs of the compensation package.

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Section: Human Resources Community Name

Standard: Benefits Standard Number: 4.17

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program will Provide a benefit package to management and staff employees' that meets the minimum Federal/Provincial/Territorial labour legislative requirements.

Policy Rationale

To ensure that there are consistent practices across the Program regarding benefits and that staff are aware of this entitlement.

Policy Details

There are mandatory minimum requirements for employers to provide to employees as benefits of their employment, as listed below:
- Vacation
- Statutory holidays
- Sick leave
- Bereavement leave
- Pregnancy leave
- Paternity leave
Additional benefits, such as fasting leave, ceremonial days, and court leave, may be provided as determined by the Program and the community.
There will be written procedures outlining the benefit package available to employees and the length of service required prior to receiving benefits.
All staff will be provided with a written contract outlining the benefit package.
All staff will be provided with orientation to the benefit package at the time they are hired.
The human resource staff/management staff will be responsible for regularly reviewing the mandatory benefit requirements.

Process Guidelines

The First Nations and Inuit Home and Community Care Program will provide staff with a copy of the benefits provided by the Program at the time they are hired.
Discussion of the benefit plan will be covered in orientation and will include review of mandatory entitlements, as set out be legislation, including the following:

Vacation Pay Entitlements:

Vacation pay will be 2 weeks after one year of service or 4% in lieu of vacation time.
Vacation pay will be 3 weeks after six years of service or 6% in lieu of vacation time.
Vacation time accumulated must be taken within 10 months after the year of service.

Statutory Holiday Entitlement

All employees will be entitled to the following statutory holidays:
- New Years Day
- Good Friday
- Easter Monday
- Victoria Day
- Canada Day
- Labour Day
- Thanksgiving Day
- Remembrance Day
- Christmas Day
- Boxing Day
- Civic Holiday
- Tribal Day(s)
When an employee works on a statutory holiday the employee will be paid time and one half for all hours worked.
Community leadership will determine tribal/ceremonial day(s).
When the holiday falls on a weekend the following Monday will be observed as the statutory holiday.

Sick Leave Benefits

All full time employees will be entitled to sick leave pay at a predetermined rate per month, usually 1 day.
Part time employees will be entitled to sick leave as a percentage in lieu of hours worked.
Sick leave will be equal to 7.5 hours.
Leave without pay may be granted when sick days have been used.
Illness must be reported immediately to the management staff.
Staff will bring in a medical certificate when illness is for more than 3 consecutive days.
Employment insurance benefits can be used to supplement pay when longer-term illness occurs.
Sick leave benefits will not be paid on resignation of the employee.
Sick leave will not exceed a predetermined number of days per year.

Compassionate Leave Benefits

Employees who have worked 10 days will be eligible for compassionate leave.
Leaves of absence without pay will be supported.
Program management will approve leaves of absence.
Compassionate leave will not exceed a predetermined number of days per year.

Bereavement Leave Requests

Employees who have completed 3 months of service will be entitled to a minimum of 3 days of bereavement leave immediately following the death of an immediate family member.
Immediate family member includes father in law and mother in law, and any other relative with whom the employee resides.
Bereavement leave will be granted to staff when death of an immediate next of kin occurs.
Discretion can be used by the Program to grant unpaid bereavement days for employees who have not completed 3 months of service, or for those who claim to have a close relationship with the deceased.

Maternity/Paternity Leave Requests

An employee must work 6 months with the Program prior to being entitled to maternity leave.
Maternity leave after 6 months of service is 17 weeks.
The total combined time granted by law for maternity/paternity leave is 24 weeks.
The Program may decide to extend the request for leave on an individual basis however, consistency in management practice must occur.
The employee must give a written application for leave of absence and 4 weeks prior to maternity leave.
the employee will provide a medical note stating that the employee is pregnant and the estimated date of delivery.
Maternity leave can occur 11 weeks prior to delivery and no longer than 17 weeks after the birth of the child.
Up to 2 weeks of sick leave time can be used prior to maternity leave.

Optional Benefits:

All other benefits listed below may be individually offered by the Program through an independent insurance company as part of the compensation package and may include:
- Health and dental coverage
- Life and accidental death coverage
- Disability coverage
- Group pension plans Employee Assistance Plans
- Registered Retirement Savings plans
- Life insurance
- Vision care

Performance Measurement Suggestions

Formula:

Related Standards

5.2 Recruitment and Retention
5.5 Quality of Work Life

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: 3A, 4
Draft Liability Documents:

CCHSA AIM Standards, 1999
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Recommended Procedures

Procedure to detail each employee benefit.
Procedure to monitor and track length of service of employees.
Procedure to track hours of service, to determine benefit entitlements.
Suggested tools:
- Form to record hours of service and keep track of total hours to date of employment
Procedure to monitor and track sick days.
Procedure to monitor requests, approvals and use of vacation time.
Suggested tools:
- Vacation request form
Procedure to monitor requests and approvals for leaves of absence.
Suggested tools:
- Request for leave of absence form

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Section: Human Resources Community Name

Standard: Termination Standard Number: 4.18

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program has a formal and fair process for terminations, both voluntary and involuntary, that is understood by all staff, and followed by all Program management.

Policy Rationale

To ensure that all legislative requirements are met with respect to voluntary and involuntary terminations and to reduce the risk of grievance and litigation.

Policy Details

There are four separate categories of termination that Program management will be required to address. They are:

1. Voluntary Termination (resignation)

The First Nations and Inuit Home and Community Care Program will require a specified notice of resignation, prepared in writing
In cases where the employee fails to resign, and the Program has not been in contact with the employee for a specified period of time, the employee shall be considered as having resigned

2. Retirement

The First Nations and Inuit Home and Community Care Program adheres to all relevant Federal and Provincial/Territorial legislative requirements regarding retirement
The First Nations and Inuit Home and Community Care Program will have a stated retirement age
All employees approaching retirement will be notified of their status in a timely fashion
Program management and the employee will determine the date for retirement. The appropriate termination notice and government documentation will be completed in a timely way

3. Reduction in the workforce (layoff)

Employees of the First Nations and Inuit Home and Community Care Program will be subject to layoff provisions when there is a reduction in the demand for services, or/and a reduction in funding available
Employees who will be subject to layoff will be notified of their status in a timely manner, preferably one month, so that they are able to begin the search for alternate employment
Program management will ensure that all employees who are laid off are provided with a current evaluation of their performance and are offered references where applicable
Employees laid off will receive severance pay in accordance with federal and provincial/territorial legislation

4. Dismissal (involuntary termination)

Employees of the First Nations and Inuit Home and Community Care Program will be dismissed under the following categories:
i. During the probationary period
- When there is documented reason to believe that the employee will be unable to fulfill the responsibilities of the position
ii. As the final stage in the disciplinary process
- Termination can occur after verbal and/or written warnings, or as a first step in serious violations of the policies and standards of the First Nations and Inuit Home and Community Care Program
Employees who are dismissed by Program management will be notified in writing of their status and severance will be paid to the employee according to the relevant federal and provincial/territorial legislation
Termination decisions will be made solely with regard to the employee's job performance and not with regard to any factors which are prohibited by human rights legislation

In each of the categories, it is essential that a notice of termination and appropriate Government notification be completed. In all cases, First Nations and Inuit Home and Community Care Program property and supplies must be returned to the Program before final payments in salary, severance and travel expenses will be made to the employee.

Process Guidelines

All employees will be informed of the termination policy and the requirement for written notice of resignation
All employees will be informed of the progressive discipline policy
Any employee who is disciplined, either verbally or in writing, by Program management will be advised that further violations of policies and standards may progress to termination and will have the termination policy provided to them
All employees who are involuntarily terminated have the right to appeal their termination to the Program and/or community leadership and have the right to have the decision of the Program and/or community leadership on the appeal explained to them. As well, they have the right to go outside the community, using the external appeal mechanism that is in place for grievances and appeals, should the matter not be resolved to their satisfaction or understanding.
All terminations are to be handled confidentially; however, employees who are dismissed must be advised that future requests for references will be responded to with information about the termination
Terminations for cause will/may be reported to the respective professional college or other regulatory body
Termination interviews may be conducted following voluntary termination to identify areas for Program improvement

Performance Measurement Suggestions

Formula:

Related Standards

3.6 Ethical Issues
3.7 Confidentiality
5.2 Recruitment and Retention
5.5 Quality of Work Life
6.6 Confidentiality of Information

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: 4
Draft Liability Documents:

Review Process:
Dates:

Recommended Procedures

Procedure for progressive discipline, including suspension with and without pay
Suggested tools:
- Progressive discipline form
Procedure for appeal
Procedure for return of equipment, supplies and any other Program property
Documentation procedure
Suggested tools:
- Termination form
- No contact letter

Part 5: Quality

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 5: Quality Community Name

Policy: Quality Planning Policy Number: 5.1

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program has a quality program that is used for strategic and operational planning of the Program. The quality program includes:

Assigning a senior person to the role of quality leader (a role that may be shared with other programs in the community)
Developing of a philosophy of continuous quality improvement
Allocating resources to the development of the quality program
Developing quality program goals, objectives, and scope that fit with the Program's mission and vision
Reviewing the literature and research about other quality program models, benchmarks and best practices
Education of staff

Policy Rationale

To ensure that processes are in place to monitor performance indicators and evaluate the efficiency and effectiveness of Program services and processes.

Policy Details

Assessing the level of consistency in quality across the Program's activities is very important to future strategic and operational planning. Quality information is used to plan future services and for appropriate budget development and resource allocation.

Resources are used efficiently and effectively to improve the quality of services delivered by the Program. Removing barriers allows improvement in the Program's performance.

Quality improvement activities of all aspects of the Program are coordinated with the monitoring of performance indicators. Relationships developed with other local service providers are important to address community needs and to coordinate care delivery. Advocating on behalf of clients for program development and identifying the potential of such development in other health and social services are effective ways to improve clients' quality of life.

Standards of practice are used as the minimum practice requirements for delivery of Program services, where appropriate. Training and development of staff is an integral component of the quality program.

Process Guidelines

Processes for quality planning should include, but not be limited to:

Implementing a continuous quality improvement program
Involving key stakeholders in the quality planning process
Assessing high risk, high volume and potential problem situations regularly
Providing all staff with an orientation and ongoing training and education about the quality program, and the role of all staff in achieving the quality goals
Developing an annual quality improvement plan
Maintaining relevant quality improvement resource materials
Developing policies, processes and procedures for Program services to achieve quality objectives
Evaluating the quality program regularly
Involving clients and families in the evaluation of care and services
Regularly reviewing and analyzing quality reports and trends by Program management
Communicating results of reports and trends in quality to staff, clients, families, community leadership and authorities, as appropriate
Involving staff in quality improvement initiatives
Demonstrating a customer-focused behaviour and attitude by all Program staff
Demonstrating the outcome of continuous quality improvements through implementation of new services and Program improvements
Responding to Program development in a timely way
Developing tools to assist with measurement of quality indicators

Performance Measurement Suggestions

Formula:

Related Standards

1.1 Community Needs Assessment
1.2 Development and Achievement of the Vision
2.1 Program Management
2.2 Risk Management
3.1 Services Delivery
3.3 Health Promotion, Disease Prevention and Protection Services
4.1 Health and Safety
4.4 Partnerships/Community Linkages
4.5 Emergency and Disaster Planning
5.1 Planning
5.5 Quality of Work Life
6.1 Information Needs
6.2 Data Collection and Reporting
6.5 Program Changes and Improvements

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: All sections
Draft Liability Documents: May, section 2.2

Occupational Health and Safety Act
CCHSA AIM Standards, 1999 -- All Standards
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Suggested Procedures

Procedure for developing and enhancing the Program plan, mission, vision and values.
Procedure for developing and enhancing the quality improvement plan.
Procedure for establishing accountability for quality planning.
Procedure for obtaining client, family and staff input on the Program's services and their delivery, processes, and satisfaction with the Program.
Procedure for identifying, monitoring, and recording key indicators and reporting on the changes that have occurred from one year to another, and, as appropriate, from one quarter to another.
Suggested tools:
- List of key indicators in clinical, financial, human resources and quality areas
- Tool to measure indicators on a regular basis for comparison purposes over time

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 5: Quality Community Name

Policy: Quality Monitoring Policy Number: 5.2

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program staff are accountable and responsible for monitoring performance indicators that measure both clinical and administrative structures, processes and outcomes.

Policy Rationale

To ensure that continuous quality improvement activities are regularly conducted for ongoing Program development.

Policy Details

Clinical services and processes promote positive client outcomes and client satisfaction with Program services and their delivery. These services and processes meet contract obligations, legislation, standards of practice and best practices.

Administrative programs and processes support the Program services and their delivery, and meet legislative and reporting requirements. Research and best practices are used to improve services and processes.

Program staff will participate in the analysis and evaluation of services and processes. Management staff are responsible for implementing quality monitoring and tracking trends in quality reports, as well as implementing a process to monitor incidents and track concerns. Changes in services and processes are communicated to all staff.

Process Guidelines

Clinical indicators to monitor process, structure and outcomes I include:

Measurement of outcomes of service delivery according to standards of practice
Client satisfaction with services
Evaluation of clinical practice, policies and procedures
Evaluation of Program scope, goals, objectives

Clinical indicators are measured using some or all of the following methods:

Client satisfaction tools
Client surveys
Informal interviews with clients, families, staff, other providers and community members
Incident monitoring
Manual chart audits
Electronic data audits, if applicable
Direct observation of clinical practice

Administrative indicators to monitor process, structure and outcomes of program delivery include:

Financial indicators such as:
- Overtime, paid hours, comparison of direct service hours to indirect service hours
Human resource indicators such as:
- Orientation and training costs, recruitment costs, competency training costs
- Evaluation of each programs goals and objectives

All staff receive an orientation and ongoing training and education regarding the quality monitoring process. Particularly, changes that occur in services, policies, processes and procedures are highlighted during these sessions.

There is a process for monitoring successes on a regular, timely basis. The quality report system tracks trends in indicators. These indicators are selected to measure the performance of each specific service and process. Quality monitoring reports are submitted regularly to the appropriate authorities as required.

Investigation of all problems, issues or concerns identified through the incident monitoring process occurs immediately. Timeliness of response to concerns is closely monitored to ensure appropriate responses and response times. Documentation of quality monitoring activities is kept on file for a specified period of time. Program services and processes are reviewed and evaluated regularly, from both clinical and administrative views.

Performance Measurement Suggestions

Formula:

Related Standards

1.4 Resource Management
1.5 Contract Management
2.1 Program Management
2.2 Risk Management
3.1 Services Delivery
3.2 Continuity of Services
3.3 Health Promotion, Disease Prevention and Protection Services
3.4 Obtaining Consent
3.5 Client Rights
3.7 Confidentiality
4.1 Health and Safety
4.2 Equipment and Materials
4.3 Building/Physical Space
4.4 Partnerships/Community Linkages
5.1 Planning
5.2 Recruitment and Retention
5.4 Education, Training and Development
5.5 Quality of Work Life
All of Section 6: Information Management

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: All sections
Draft Liability Documents: May, sections 2.2, 2.6, 3.4, 3.13, 3.18, 4 to 4.14

Occupational Health and Safety Act
CCHSA AIM Standards, 1999 -- All Standards
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Suggested Procedures

Procedure for outlining the type and frequency of quality monitoring activities and reports.
Procedure for incident monitoring.
Procedure for obtaining client, family and staff input on the Program's services and their delivery, processes, and satisfaction with the Program.
Procedure for identifying, monitoring, and recording key indicators and reporting on the changes that have occurred from one year to another, and, as appropriate, from one quarter to another. Suggested tools:
- List of key indicators in clinical, financial, human resources and quality areas
- Tool to measure indicators on a regular basis for comparison purposes over time

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 5: Quality Community Name

Policy: Quality Improvement Policy Number: 5.3

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program promotes a philosophy of continuous quality improvement throughout the organization.

Policy Rationale

To ensure that continuous quality improvement activities are conducted for ongoing Program development, process improvement and the reduction of risk to clients, families, staff, and the Program.

Policy Details

The Program's vision and activities promote a culture of continuous quality improvement. Program management is accountable to establish a quality improvement program with identified goals, objectives, and scope. Quality improvement to programs/processes is achieved by using benchmarks, best practices and reviews of the literature. Regular analysis and evaluation of quality improvements occurs. Quality improvement activities can assist in reallocation of resources.

At the time of hiring, staff receive orientation regarding the philosophy of continuous quality improvement and are involved in quality improvement activities. Education and training of staff about continuous quality improvement activities is provided regularly to promote the philosophy.

Quality improvement activities are coordinated with other service providers, programs and services in the community and other First Nations and Inuit Home and Community Care Programs.

Communication of quality improvement initiatives to staff, other community-based programs and services, community leadership and funders is the responsibility of Program management.

Process Guidelines

Quality improvement processes will be guided by the following:

Coaching, counseling, mentoring and development of staff about continuous quality improvement activities is a key activity of Program management
Benchmarks and best practices are adapted into Program practices and processes
Clients, families, the community and staff are involved in decision making about quality improvement activities
Identification of areas for improvement in services and processes occurs regularly
Analysis of changes and improvements occurs
Evaluation of the effectiveness of quality improvement activities regularly occurs
Communication about changes to services and processes is timely

Performance Measurement Suggestions

Formula:

Related Standards

1.3 Capacity Building
2.1 Program Management
2.2 Risk Management
3.1 Services Delivery
3.5 Client Rights
3.7 Confidentiality
4.1 Health and Safety
4.4 Partnerships/Community Linkages
All of Section 6: Information Management

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: All sections
Draft Liability Documents: May, sections 2.2, 2.4, 2.5, 4.1 to 4.19; June, pgs 4-12, 30-31

CCHSA AIM Standards, 1999 -- All Standards
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Suggested Procedures

Procedure for outlining and monitoring quality improvement monitoring activities and results.
Suggested tools:
- Tracking tool for quality improvement activities
- Evaluation tool for quality improvement activities
Procedure for monitoring Program and Program services results.
Procedure for communicating quality improvement activities and results.
Suggested tools:
- Communication tool for quality improvement activities (ie newsletter, information sheet)
Procedure to detail accountability of quality improvement activities.

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 5: Quality Community Name

Policy: Risk Management Policy Number: 5.4

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program has a clearly defined, coordinated system of incident monitoring that is used to assess, analyze, report, evaluate and improve quality.

Policy Rationale

To ensure that risk issues related to clients, families, staff and Program liability are addressed in a timely and effective way.

Policy Details

At a minimum, the First Nations and Inuit Home and Community Care Program has clear processes and procedures for reporting incidents and ensures that:

The responsibilities of Program management and staff are clearly defined in writing
All staff receive ongoing education and training about incident monitoring
All staff are involved in incident monitoring
Potential hazards and risks are minimized wherever the client receives service
All incidents are reported within 24 hours from the time they occur
Response to incidents and undesirable events occur in a timely way
Ongoing monitoring, analysis and evaluation of incidents are important activities within the Program
Results of improvements are communicated effectively Process Requirements

The First Nations and Inuit Home and Community Care Program ensures that there is:

Completion of an incident monitoring form within 24 hours of the event
Investigation and identification of the cause of incidents and undesirable events
Recording of incidents and undesirable events on the client's record, including the management of each incident or event
Ongoing monitoring and evaluation of incidents
Ongoing collection and analysis of data over time
Ongoing identification of high-risk clients and client groups and areas of potential risk in processes and practices

Performance Measurement Suggestions

Formula:

Related Standards

1.4 Resource Management
1.5 Contract Management
2.1 Program Management
2.2 Risk Management
3.1 Services Delivery
3.3 Health Promotion, Disease Prevention and Protection Services
4.1 Health and Safety
4.2 Equipment and Materials
4.3 Building/Physical Space
4.5 Emergency and Disaster Planning
5.3 Evaluating Performance
5.4 Education, Training and Development
6.1 Information Needs
6.2 Data Collection and Reporting
6.4 Information Exchange
6.5 Program Changes and Improvements
6.6 Confidentiality and Security

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: All sections
Draft Liability Documents: Entire May document and entire June document

CCHSA AIM Standards, 1999 -- All Standards
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Suggested Procedures

1. Procedure for reporting, recording and handling incidents and complaints, with a specific procedure for high-risk complaints.
Suggested tools:
- Incident report form
Procedure for identifying and classifying low, medium and high risk situations.
Suggested tools:
- Guidelines for low, medium and high risk situations
Procedure for investigating risk issues, including the course of action to be taken by the Program and the staff and Program management roles in that action.
Procedure for communication of risk issues.
Procedure for tracking incidents and appropriate discipline.
Suggested tools:
- Tool to record and track the response to each incident, including disciplinary actions taken
Procedure for progressive discipline, including monitoring and reviewing the progress of the employee on a timely basis.
Suggested tools:
- Form outlining progressive discipline and dates for implementation, review and decision as to next steps
- Sample letter of warning
Procedure for forwarding incident reports to appropriate people.
Procedure for securing and keeping incident reports for a specified period of time.

Part 6: Operations

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 6: Operations Community Name

Policy: Program Management Policy Number: 6.1

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program has a management system for the Program that ensures that the services delivered to the community:

Are approved of and supported by the community leadership
Are responsive to changing needs and demographics
Support the mission, vision and goals identified by the community and First Nations and Inuit Home and Community Care Program staff
Are equal to those received by other Canadians
Are fiscally responsible and financially sustainable
Meet the standards for service delivery and quality programming
Do not duplicate services that were available in the community prior to the establishment of the First Nations and Inuit Home and Community Care Program
Achieve a continuum of care with other services offered in the local area, with other First Nations and Inuit communities, and with non-Aboriginal communities, as appropriate

Policy Rationale

To ensure that the Program and its services are regularly evaluated in order to provide quality care that meets the health needs of the community.

Policy Details

Management of the First Nations and Inuit Home and Community Care Program involves:

Internal management processes/systems
Financial management
- Fiscal efficiency analysis
- Financial reporting
- Funding/resource allocation applications and analysis
- Annual reports
Human resource management
- Staffing needs analysis
- Recruitment and retention strategies
- Compensation and benefit decisions
- Ongoing training and development planning
Quality management
- Risk management
- Occurrence/Incident reporting and analysis
- Quality improvement activities/planning for ongoing Program and services changes and improvements
Resource/capacity management
- Management of funding allotments
- Capacity building analysis
Service delivery management
- Management of the essential service elements of the Program:
  - Case Management
  - Client Assessment
  - Home Care Nursing
  - Home Support Services
  - In-Home Respite
  - Medical Supplies and Equipment
  - Data/Information Systems and Records Management
Physical space/equipment/materials management
Examination of the physical location of the Program offices
- Regular maintenance of equipment and materials
- Tracking and analysis of safety audits
Information management
Management of external relationships, partnerships and contracts, including:
- Linkages with health and social services outside of the First Nations and Inuit Home and Community Care Program
- Contract management, as required, for communities that choose to purchase services and for the purchase of equipment, supplies, etc.
- Management of partnerships with other First Nations and Inuit communities
- Management of relationships with funding agencies

Process Guidelines

The First Nations and Inuit Home and Community Care Program has a well-defined process in place for the management of internal and external relationships that will ensure the responsiveness and success of the Program. This process includes but is not limited to:

Clear and specific job descriptions for managers within the First Nations and Inuit Home and Community Care Program. These job descriptions outline responsibilities, authority and accountabilities associated with each position.
The development of an organizational chart that is specific to the community and its First Nations and Inuit Home and Community Care Program. This chart defines the individuals who are accountable for the Management function within the Program and has the approval of the community leadership. • A planning process, which prepares the community for the implementation and ongoing management of the First Nations and Inuit Home and Community Care Program that includes:
- Identification of community leadership responsibility
- Development, with community input, of the mission, vision, values and goals of the First Nations and Inuit Home and Community Care Program
- Community needs assessment
- Evaluation of the Program's delivery of services to examine:
  - Appropriateness
  - Effectiveness
  - Efficiency
  - Timeliness
  - Ability to address identified community needs
- Financial planning
- Development of evaluation criteria
- Regular reporting process
- Identification of potential partners and referral sources
Identification and listing of existing services, including other community resources and programs, and programs and services provided outside of the community
A formal review process of all contract agreements and partnerships
A process for annual evaluation of the First Nations and Inuit Home and Community Care Program

Performance Measurement Suggestions

Formula:

Related Standards

1.1 Community Needs Assessment
1.3 Capacity Building
1.4 Resource Management
3.1 Services Delivery
3.2 Continuity of Services
3.7 Confidentiality
4.2 Equipment and Materials
4.3 Building/Physical Space
4.4 Partnerships/Community Linkages
5.2 Recruitment and Retention
5.3 Evaluating Performance
6.1 Information Needs
6.2 Data Collection and Reporting
6.3 Analysis and Evaluation
6.5 Program Changes and Improvements

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: All sections
Draft Liability Documents: May, sections 2 to 2.9; June, pgs 6-12

CCHSA AIM Standards, 1999 -- Leadership and Partnerships, Home Care Services
Professional Practice Standards
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Suggested Procedures

Procedure for reporting, recording and handling incidents and complaints, with a specific procedure for high-risk complaints.
Suggested tools:
- Incident report form
Procedure for conducting a Program evaluation each year.
Suggested tools:
- Information guide, to ensure the necessary information is collected
- Report guide, to ensure the most important aspects of the Program, its strengths and its weaknesses, are considered
Procedure for identifying, monitoring, and recording key indicators and reporting on the changes that have occurred from one year to another, and, as appropriate, from one quarter to another.
Suggested tools:
- List of key indicators in clinical, financial, human resources, and quality areas
- Tool to measure indicators on a regular basis for comparison purposes
Procedure for completing a community needs assessment and annually reviewing this assessment to identify any changes that suggest a need to adjust the Program to be more responsive.
Procedure for managing contracts for services, equipment and materials.
Suggested tools:
- Sample contracts for service provision and for equipment and materials purchases
Procedures for interviewing and discussing client, family, community and staff satisfaction with the Program.
Suggested tools:
- Objective questions regarding the program, service delivery, staff competency and attitude, and other key aspects of the Program

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 6: Operations Community Name

Policy: Record Management Policy Number: 6.2

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program has a record management system that:

Protects client and staff information
Assists quality monitoring activities
Provides data for planning activities
Conforms to relevant Federal/Provincial/Territorial legislation

Policy Rationale

To ensure that all records, including client information, staff information and financial information, are confidentially maintained and stored.

Policy Details

The First Nations and Inuit Home and Community Care Program management of records ensures the security, efficient use and appropriateness of:

Client care records, including:
- Client assessments
- Case management files
- Ongoing client information and notes written by staff providing direct services, which may be kept in the home and/or in the Program office
Financial records, including:
- Income and expense records
- Program funding applications/approvals/allotments
- Data pertaining to annual reporting
Inventory records for medical supplies, equipment and medications
Human resource records, including:
- Income and expense records
- Payroll records
- Staff files
  - Active
  - Terminated
Contracts/partnership agreements/cooperative service delivery agreements
Quality management records
- Client satisfaction data
- Community needs assessment data
- Occurrence reporting and tracking

Process Guidelines

All First Nations and Inuit Home and Community Care Program services have a process that ensures the security, efficient use and appropriateness of all records relating to the Program through:

Recruiting appropriately trained and experienced staff to Program management positions
Educating all staff in the responsibilities of their positions as they pertain to record management
Educating all staff to procedures regarding the release of information, storage of files, destruction of files, use of quality monitoring data, and data gathered through the community needs assessment process
Monitoring legislative requirements for records management to determine the need for changes in policy or direction
Documenting any incidents of inappropriate use/release/destruction/loss of records for quality monitoring purpose
Storing all records listed above in secure locations with access available only to approved staff

Performance Measurement Suggestions

Formula:

Related Standards

1.1 Community Needs Assessment
3.7 Confidentiality
6.1 Information Needs
6.2 Data Collection and Reporting
6,4 Information Exchange
6.4 Program Changes and Improvements

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: Program Criteria and sections 1, 2, 3A, 4, and 5
Draft Liability Documents: May, sections 6 to 6.8; June, pgs 7-10, 37- 39

CCHSA AIM Standards, 1999 -- Information Management,
Leadership and Partnerships
Professional Practice Standards
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Suggested Procedures

Procedure for the release of information.
Suggested tools:
- Consent form for informed consent release of information
Procedure for storing confidential client, staff, contract and financial information.
Procedure for discarding confidential information.
Procedure for determining access to information.
Procedure for gathering, recording, and reporting quality monitoring data.
Procedure for the use of data gathered through the community needs assessment process.
Procedure for development and distribution of reports about the Program.
Suggested tools:
- Sample report outline to ensure the most useful information is collected, analyzed and shared appropriately
Procedure for faxing and e-mailing confidential information.

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 6: Operations Community Name

Policy: Communications Policy Number: 6.3

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program ensures that all communications (verbal and written, within the Program, to other programs and services, the community, the media, government, and others) are:

Delivered by the appropriate Program manager or community leader
Accurate
Consistent with the goals of the First Nations and Inuit Home and Community Care Program
Consistent with policies regarding confidentiality of client and staff information
Respectful of community values and traditions

Policy Rationale

To ensure that there is senior accountability for all information shared inside and outside the Program, and that all information fits with the mission, vision, values and goals of the Program.

Policy Details

The First Nations and Inuit Home and Community Care Program appoints either the Program manager or another senior person as the Program spokesperson. This individual will be responsible for:

Ensuring that staff are informed of all Program, policy and process changes relevant to their responsibilities in the Program
Ensuring that community members are informed about the Program and the services available
Ensuring that all information being supplied to the media, government, community partners and other First Nations and Inuit communities is accurate and current
Ensuring that only appropriate information is released
Ensuring that information shared or released does not violate confidentiality policies for client and/or staff information
Receiving all incoming requests for information
Responding to all media requests for information or, when appropriate, referring the media to the others, either within the Program or to other programs, services or the community leadership
Preparing for and assisting in the delivery of the Program's annual report, by:
- Ensuring that the community is involved
- Ensuring that information included in the annual report is accurate
- Ensuring that appropriate government, media, community partners, and others are included in the distribution of the report and any other related activities
Monitoring information prepared and delivered by other communities delivering First Nation and Inuit Home and Community Care Program services and partnering with them, when appropriate, to explore shared trends in data analysis and quality improvement

Process Guidelines

The First Nations and Inuit Home and Community Care Program has a well-defined process for handling information that may include but is not limited to:

All internal information that is being prepared for delivery to staff or/and clients is checked for its accuracy by at least two other Program staff (senior staff if possible) before release
All requests for information from external sources are documented in a communication record and forwarded to the Program spokesperson for response
All information being prepared for external release, including written reports and updates for government funding agencies, is checked for accuracy by at least one other Program staff and a member of the community leadership
Information released to the general community is approved by the community leadership and the First Nations and Inuit Home and Community Care Program management before release
The annual report is checked for accuracy and relevance by the community leadership and the First Nations and Inuit Home and Community Care Program management

All staff is fully aware of the communications policy of the Program and refers all information requests to the Program spokesperson. This understanding begins during orientation and is reinforced during ongoing training sessions. Staff are also fully aware of any information released to media and other external sources in a timely way.

Performance Measurement Suggestions

Formula:

Related Standards

1.1 Community Needs Assessment
3.7 Confidentiality
6.4 Information Exchange
6.5 Program Changes and Improvements
6.6 Confidentiality of Information

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: Program criteria, sections 1, 2, 3A and 4
Draft Liability Documents: May, sections 3.2.1, 4.9, 6.5; June, pgs 7- 13, 22, and 28

CCHSA AIM Standards, 1999 -- Leadership and Partnerships, Information Management
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Suggested Procedures

Procedure for the release of information (including client, staff or Program information).
Suggested tools:
- Consent form for informed consent for release of information
Procedure for processing communication requests from outside sources, including the recording of the request, the response and any follow-up required. A specific procedure that is more detailed exists for processing media requests.
Suggested tools:
- Communication log
Procedure for communication of mission, vision, values and goals to community and staff.
Procedure for preparing and sharing the Program annual report.

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 6: Operations Community Name

Policy: Annual Program Summary Policy Number: 6.4

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program prepares an annual report and submits this report, as required, to the community leadership and the appropriate government agency.

Policy Rationale

To ensure that Program services are regularly evaluated and carefully planned, based on the trending of data, and that there are quality improvement activities concerning service delivery, resource management, fiscal management, and other activities of the Program.

Policy Details

The First Nations and Inuit Home and Community Care Program prepares the annual summary of activities throughout the year. Information is collected on a monthly basis, and is pulled together at the end of the year to provide the annual summary of activities. The annual summary provides the community leadership and the government funding agency with an analysis of:

The previous year's activities
The strengths and weaknesses of the Program
Recommendations for on-going development of the Program

Information appearing in the annual report may include but is not limited to:

Data related to community needs assessment activities
Trending of incidents and related actions
Quality improvement activities
Educational opportunities for staff
Data related to community complaints
Any pending legal issues
Evaluation of the confidentiality of client and staff information
Human resources statistics including:
- Turnover
- Recruitment and retention challenges/successes
- Specific training gaps
- Workforce data, such as RN/LPN ratio, supportive care qualifications, rehabilitation staff (if applicable), administrative and management needs
Service delivery information
- Service volumes provided
- Efficiency of service
- Costs of services provided
- Services required and not provided
- Waiting lists
- Linkages with other services, providers and agencies required to deliver continuum of care to community
Accreditation progress and/or activities, if applicable
Recommendations for further development and/or the contracting of current services provided, and for the addition of any new services

Process Guidelines

The First Nations and Inuit Home and Community Care Program prepares for the annual Program summary throughout the year by ensuring that there is a process for the collection of relevant data and information.

The First Nations and Inuit Home and Community Care Program regularly evaluates community response to services provided through the Program. This evaluation is achieved through:

Community needs assessment activities
Client satisfaction analysis
Complaints analysis
Incident analysis
Review of the Program's mission and vision statements

The data gathered through this process forms the basis for recommendations for further development of the First Nations and Inuit Home and Community Care Program.

The First Nations and Inuit Home and Community Care Program designates, within the Program, an individual/position that is responsible for the collection, summarizing and reporting of relevant information. This individual ensures the accuracy of all information prior to the release of the annual summary.

Performance Measurement Suggestions

Formula:

Related Standards

1.1 Community Needs Assessment
1.2 Development and Achievement of the Vision
2.2 Risk Management
3.7 Confidentiality
5.1 Planning
5.2 Recruitment and Retention
5.4 Education, Training and Development
6.2 Data Collection and Reporting
6.3 Analysis and Evaluation
6.4 Information Exchange
6.5 Program Changes and Improvements

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: Program Criteria, Sections 2, 3A, 4 and 5
Draft Liability Documents: May, sections 1.3.1, 1.3.2, 1.3.3, 2,2; June, pgs 6-12, 27

CCHSA AIM Standards, 1999 -- Leadership and Partnerships
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Suggested Procedures

Procedure for identifying, monitoring, and recording key indicators and reporting on the changes that have occurred from one year to another, and, as appropriate, from one quarter to another.
Suggested tools:
- List of key indicators in clinical, financial, human resources and quality areas
- Tool to measure indicators on a regular basis for comparison purposes over time
Procedure for completing a community needs assessment and annually reviewing this assessment to identify any changes that suggest a need to adjust the Program to be more responsive.
Procedure for preparing the annual report, including an outline of the report information, a review process, and a time line to ensure it is ready and can be reviewed before it is shared.
Procedure for the communication of the Program summary results.

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 6: Operations Community Name

Policy: Financial Management Policy Number: 6.5

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program has a financial management system that ensures all aspects of the Program are fiscally responsible and financially sustainable.

Policy Rationale

To ensure fiscal accountability in the delivery of all Program services.

Policy Details

Responsible financial management of the First Nations and Inuit Home and Community Care Program includes but is not limited to:

An annual budget and financial forecasting report which outline projected expenses and funding expectations
An analysis of key Program costs and recommendations for cost reductions (i.e. human resources, medical and office supplies, communications equipment, overhead, etc.)
An analysis of financial indicators and recommendations for overall expense reductions (i.e. travel time expenses, training and in-service expenses, recruitment expenses, etc.)
Monthly reports to community leadership and government funders on financial status of the First Nations and Inuit Home and Community Care Program
Capacity building requirements and associated funding applications and cost outlines
Written contracts are in place and regularly reviewed for the purchase of services and equipment

Process Guidelines

The First Nations and Inuit Home and Community Care Program has a well-defined process in place for the financial management of the Program. This includes but is not limited to:

A clearly defined position within the Program that is assigned overall responsibility for the financial management of the Program, to the extent that this activity is managed within the Program. The individual with this accountability must have experience in financial analysis and budgeting.
Clear and specific job descriptions that detail all positions with accountability for financial data analysis and spending authority.
A budgeting process that involves the staff, management and community leadership associated with the First Nations and Inuit Home and Community Care Program
Compiling an annual report for the community leadership and appropriate government agency

Performance Measurement Suggestions

Formula:

Related Standards

1.1 Community Needs Assessment
1.3 Capacity Building
1.4 Resource Management
1.5 Contract Management
4.3 Building/Physical Space
4.4 Partnerships/Community Linkages
6.1 Information Needs
6.3 Analysis and Evaluation
6.4 Information Exchange
6.6 Program Changes and Improvements

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: Program Criteria and sections 2, 3A, and 4
Draft Liability Documents: May, sections 2.2 to 2.15; June, pgs 6-13

CCHSA AIM Standards, 1999 -- Leadership and Partnerships
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Suggested Procedures

Procedure for preparing payroll on a regular, timely basis.
Procedure for managing accounts receivable and accounts payable.
Procedure for reconciling bank statements.
Procedure for preparing the annual capital budget.
Suggested tools:
- Capital budget outline
Procedure for preparing the annual operating budget.
Suggested tools:
- Operating budget outline
Procedure for the submission and reimbursement of expenses incurred by staff.
Suggested tools:
- List of expenses and guidelines for reimbursement
- Expense reimbursement form
Procedure for monitoring variances in the budget to actual financial performance.
Procedure to ensure the confidentiality of information.

Part 7: Health and Safety

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 7: Health and Safety Community Name

Policy: Hazardous Waste Management Policy Number: 7.1

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program will ensure safe handling, storage, use and disposal of hazardous wastes and materials according to government legislation and/or community regulations. Hazardous wastes and materials include:

Body fluids and blood
Blood products
Sharps disposal including blades, syringes, needles
Equipment
Solutions commonly used in the home

Policy Rationale

To provide a healthy environment for clients and staff, and ensure measures are in place for the safe use, storage and disposal of hazardous wastes and materials.

Policy Details

All hazardous wastes and materials will be handled, stored, used and disposed of safely according to relevant government policies and relevant provincial, federal and territorial legislation. The standards set by the Occupational Health Safety Act and the Environmental Health and Safety Act of Canada will be used as key references for determining the handling, storage, use and disposal of hazardous waste materials and products.

Staff of the First Nations and Inuit Home and Community Care Program will not transport hazardous wastes or materials. All staff will be familiar with the Occupational Health and Safety Act (including WHMIS guidelines) and a copy of the Act is readily available to them at all times.

Process Guidelines

The First Nations and Inuit Home and Community Care Program will have written procedures for safe handling, storage, use and disposal of hazardous wastes and materials.

All staff will receive orientation, education and training on:

Occupational Health and Safety Act guidelines
WHMIS guidelines and labels
Universal precautions
Proper cleaning of contaminated equipment
Proper handling, storage, use and disposal of hazardous wastes and materials

Employees will protect the safety of themselves, their clients and families through:

Use of universal precautions
Proper handling, storage, use and disposal of hazardous wastes and materials
Adequate amounts of protective supplies, ie gloves, masks, sharps disposal containers

Employees will teach clients and families about proper methods of handling, storing, using and disposing of hazardous wastes and materials and will ensure that they have adequate supplies for same.

Employees will assess the client's home environment for safety hazards.

There will be an information package developed for WHMIS education for staff to be used during orientation and ongoing training sessions.

Performance Measurement Suggestions

Formula:

Related Standards

3.1 Services Delivery
3.3 Health Promotion, Disease Prevention and Protection Services
4.1 Health and Safety
4.2 Equipment and Materials
4.3 Building/Physical Space

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: Program Criteria, Sections 2, 4 and 5
Draft Liability Documents: May, section 4; June, pgs 9-10, 27-28

Environmental Health and Safety Act
Occupational Health and Safety Act
CCHSA AIM Standards, 1999: Environment
WHMIS
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Suggested Procedures

Procedures for safe handling, storage, use and disposal of specific hazardous wastes and materials.
Suggested tools:
- Checklist on WHMIS guidelines to be used during orientation and also in ongoing training sessions, as required
Procedure on Universal Precautions.
Procedure for proper cleaning of contaminated equipment.
Suggested tools:
- Checklist of various steps for proper cleaning of specific kinds of equipment

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 7: Health and Safety Community Name

Policy: Disaster Response Policy Number: 7.2

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program has a clear plan, in writing, which outlines the responses of the Program and its staff to disasters that may occur in the community. This plan is part of the community's disaster plan and is complementary to it.

Types of disasters may include:

Fires
Natural disasters
Threats of violence
Chemical spills
Power failures
Bomb threats

Policy Rationale

To ensure there is a coordinated plan to deal calmly, effectively and quickly with emergencies and disasters.

Policy Details

The plan promotes the protection and safety of Program clients, families and staff. The Occupational Health and Safety Act of Canada is used as a reference for the development of the plan.

The plan:

Identifies who is responsible to initiate and coordinate a disaster response for the Program
Outlines the policies, processes and procedures to be followed for various types of disasters
Includes the Program's role in working with community leadership and others in the community on activities related to disaster response
Identifies the orientation, education and training required by staff to ensure they are able to effectively respond in disaster situations
Outlines how to access client lists in a disaster situation
Explains how to set priorities regarding the care needs of clients and families during a disaster
Identifies ways of protecting and transporting client records during a disaster
Clearly describes a process to quickly access properly qualified staff in response to a disaster
Identifies ways to communicate with clients, with staff and with others in the community, should a disaster occur
Identifies physical space requirements for an emergency response situation

Process Guidelines

There are written processes and procedures to guide staff in their response to each type of disaster listed above.

Processes and procedures related to the types of disaster that may occur and the roles and responsibilities of staff during any disaster are reviewed and explained during orientation and other training sessions.

A process that details each staff responsibility outlines the process for contacting one another and clients of the Program, in the event of a disaster. This process utilizes a fan-out approach, in which each staff member contacts a certain number of people who, in turn, contact another certain number of people, so that the contact is multiplying in its impact.

Planned disaster exercises are carried out by the Program and the community on a regular basis. These exercises provide an opportunity to test and evaluate the effectiveness of the written policies, processes and procedures related to disaster planning. Key information regarding these exercises is documented, including an evaluation of the response. This material is kept on file for purposes of accreditation and feedback concerning areas for improvement is provided to staff.

Performance Measurement Suggestions

Formula:

Related Standards

3.1 Services Delivery
3.2 Health Promotion, Disease Prevention and Protection Services
4.1 Health and Safety
4.3 Building/Physical Space
4.4 Partnerships/Community Linkages
4.5 Emergency and Disaster Planning

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: Sections 2 and 4
Draft Liability Documents: May, sections 1.3.6, 2.4, 2.5, 3.3, and 4 to 4.15; June, pgs 9-10, 22, 25, and 28

Occupational Health and Safety Act
CCHSA AIM Standards, 1999 -- Environment
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Suggested Procedures

Specific procedures to guide staff in responding to fires, natural disasters, threats of violence, chemical spills, power failures, and bomb threats.
Suggested tools:
- Checklists outlining the steps and tasks to consider for each specific type of disaster
Procedure for identifying clients at risk, and setting priorities regarding clients and their needs for service during a disaster.
Suggested tools:
- Form for listing priority clients and their care needs during a disaster
Procedures for security and transportation of client records during a disaster.
Procedure for communication with staff and clients, including call lists for each staff.
Procedure for recording and evaluating disaster practice exercises.
Suggested tools:
- Report format to record necessary information and notes on effectiveness of the plan in practice
Procedure for evacuation of clients who are at risk and, if necessary, for staff.
Procedure for identifying community resources that can be shared during times of disaster.
Suggested tools:
- List of community resources

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 7: Health and Safety Community Name

Policy: Fire and Evacuation Policy Number: 7.3

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program has a written fire and evacuation plan that outlines the steps to be taken by staff in the event of a fire and/or evacuation.

Policy Rationale

To ensure there is a coordinated plan to deal quickly and effectively in the event of the need for evacuation.

Policy Details

The safety of clients, families and staff will be promoted through use of a written fire and evacuation plan. The plan will be coordinated with the local community fire authority. In fact, the authority may assist in the development of the plan and related processes and procedures. Program management will ensure compliance of the plan with any fire codes and regulations.

All fire safety concerns identified by staff will be reported immediately to Program management. All concerns will be documented.

The fire and evacuation plan will identify the following and should be developed with input from the community fire authority:

Frequency and documentation of workplace safety inspections
Frequency and documentation of inspection of the physical structure where the Program staff are located
Frequency and documentation of inspection of fire extinguisher equipment used on the premises
Frequency and documentation of fire and/or evacuation drills
Who is responsible to initiate the fire and evacuation plan
Education and training of staff about their responsibilities in the event of a fire and/or evacuation
Floor plan of the office space
List of the items kept at the First Aid Station and its location
Who is in charge of inspecting the First Aid Station
List of hazardous products that are kept in the office space

Process Guidelines

During orientation, all staff will be made fully aware of the fire and evacuation plan. This orientation will include an explanation of:

The procedure to be followed in the event of a fire and/or evacuation occurring in a client's home, a school, or the Program office
How practice drills and exercises will be reported and recorded
How fire safety concerns will be reported, recorded and monitored for any trends
Staff responsibility in initiating a fire and/or evacuation response
Use of fire extinguishing equipment
Types of fire extinguishing equipment located in the Program office
Identification of hazardous products, including the use of WHMIS labels and MSDS sheets

Regular fire and evacuation practice exercises will be carried out in partnership with the community fire authority. In fact, the authority may assist in the development of the plan and related processes and procedures.

Reports will be completed to record these activities and they will be reviewed on a regular basis to identify any changes that should be made to the fire and evacuation plan.

Performance Measurement Suggestions

Formula:

Related Standards

3.1 Services Delivery
3.3 Health Promotion, Disease Prevention and Protection Services
4.1 Health and Safety
4.3 Building/Physical Space
4.4 Partnerships/Community Linkages
4.5 Emergency and Disaster Planning

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: Sections 2 and 4
Draft Liability Documents: May, sections 2.3-2.6; June, pgs 7-10

CCHSA AIM Standards, 1999 -- Environment
Fire and Safety Act
Hazardous Products Act of Canada
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Suggested Procedures

Procedure for evacuation of clients, family members and staff. There may be two specific procedures for clients: one for those at risk and another for those who are not at risk.
Procedure for fire drills and evacuation practice exercises.
Suggested tools:
- Report for recording fire drills and evacuation exercises
- Tool for tracking trends of fire drills and evacuation exercises
Procedure for safety inspections.
Suggested tools:
- Form for completing safety inspections and monitoring their frequency
Procedure for communication with staff and clients, including contact lists for each staff.
Procedure for identifying clients at risk.
Suggested tools:
- Form for listing priority clients who may be at risk
Procedure for identifying community resources that can be shared during times of fire and evacuation.
Suggested tools:
- List of community resources
Procedure for security of client records during a fire and/or evacuation.
Procedure to define access to client records in the event of a fire and/or evacuation.

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 7: Health and Safety Community Name

Policy: Incident Reporting Policy Number: 7.4

Approval:
Date:

Policy

All First Nations and Inuit Home and Community Care Program staff incidents will be reported, recorded and investigated promptly.

Policy Rationale

To ensure appropriate attention to staff incidents and the identification of risk issues for staff; to identify areas for improvement by monitoring, tracking and evaluating these incidents.

Policy Details

All employees working with the First Nations and Inuit Home and Community Care Program will receive prompt medical treatment for an injury or incident.

Employees are required to notify Program management of any incident within 24 hours.

Program management will investigate the incident and report it to the Worker's Compensation Board within the designated time guidelines and using the appropriate forms. Where appropriate, a course of action will be identified as per legislative requirements. Program management may face legal and financial consequences for incidents that are not reported.

Program management will collect information on the types of incidents and trends. All incidents will be reviewed on a regular basis or at least quarterly.

Process Guidelines

During orientation, all staff will be made aware of:

The processes and procedures related to incidents and incident reporting, as well as health and safety monitoring
Types of incidents that should be reported
The time frames in which incidents must be reported
Any protective devices that are required for specific tasks

On going training programs will be held for staff to review incident reporting practices/changes in legislation.

All incidents are reported and recorded using an incident reporting form. These forms are always completed in ink. Permanent records of any incidents will be kept on each staff person's file.

All employees who experience an incident will be assessed for early return to work. Modified work programs will be offered to staff who are injured on the job.

Program management staff should establish a committee to oversee health and safety issues as per legislative requirements. It may be most effective to establish this committee in partnership with other health and social services programs.

Performance Measurement Suggestions

Formula:

Related Standards

3.3 Health Promotion, Disease Prevention and Protection Services
4.1 Health and Safety
4.2 Equipment and Materials
4.5 Emergency and Disaster Planning
6.4 Information Exchange

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: Sections 3A, 4 and 5
Draft Liability Documents: May, section 6.2, 6.3; June, pgs 9-10, 38

Canada Labour Code
Occupational Health and Safety Act
CCHSA AIM Standards, 1999 -- Environment
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Suggested Procedures

Procedure for reporting incidents to Program management
Procedure for recording and monitoring incidents.
Suggested tools:
- Incident reporting form
- Tool to track incidents by type and degree of seriousness
Procedure for reporting incidents to appropriate legislative bodies.
Suggested tools:
- Incident reporting form, with space to record reporting and follow-up
Procedure for quality improvement and risk prevention as a result of monitoring and reviewing incidents.
Procedure for qualifying for a leave of absence.
Suggested tools:
- Form for recording leaves of absence, including reason, length of leave, and any modified work arrangements upon return
Procedure for qualifying for and establishing a modified work program, in case of injury.
Suggested tools:
- Form for recording details of the modified work program, including reason, length of time modified program should be in place, and progress achieved in returning to a full work program

Part 7: Health and Safety

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 7: Health and Safety Community Name

Policy: Liability Protection Policy Number: 7.5

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program carries the required amount of liability insurance and has a written liability protection plan that identifies when formal written contracts are required.

All staff employed with the First Nations and Inuit Home and Community Care Program and who are required to drive their own vehicle carry vehicle liability coverage in the amount of $1,000,000, Or more, and must also have a current, valid driver's licence

Policy Rationale

To ensure that processes are in place for ethical and legally sound contract management, including financial protection for Unforeseen or inappropriate conduct staff, which may result in legal action.

Policy Details

Program management is legally responsible and accountable for the liability of all contracted services and the financial security of the Program. Program management provides a safe physical environment for the Program.

Formal written contracts outlining all terms and conditions are prepared for:

Any services provided to other programs and organizations
Student placements
All research activities
All employees of the Program
All consultant services and any other purchased services related to the Program

The liability protection plan details who is responsible to initiate written contracts for the First Nations and Inuit Home and Community Care Program. All contracts are regularly reviewed to ensure compliance with legislation requirements. Legal consult will be obtained as necessary to review contracts.

The liability protection plan outlines the types of liability protection provided to:

The Program
Employees
Partner organizations and programs
The client, in the event of violation of legislation, practice, and client care, and from individual employees

All incidents of concern will be immediately documented and assessed and a plan of action will be identified. Legal consult may be necessary when incidents of concern are identified.

Process Guidelines

All staff receive an individual contract of employment that outlines the details of the requirements of the Program.

Program contracts and agreements include a clear detailing of the:

Responsibility of the Program
Requirements of the contract
Definition of contracted services
Obligations to the Program
Basis of payment

All staff are provided with an orientation that includes an explanation and clear understanding of:

Reporting and recording of liability concerns
Recognition of potential liability problems
The consequences of no action when liability problems are identified
The responsibility to provide the Program with annual proof of vehicle liability coverage in the amount of $ 1,000,000, or more, if required to use one's own vehicle to provide services
A copy of valid, current driver's licences must be on file for all staff required to drive in order to deliver services

Ongoing education and training of staff are provided when changes in practice are necessary.

The First Nations and Inuit Home and Community Care Program reports and records liability concerns.

Program management communicates to staff regarding changes of practice that may result from investigation of a liability concern.

Performance Measurement Suggestions

Formula:

Related Standards

1.5 Contract Management
3.1 Services Delivery
3.2 Health Promotion, Disease Prevention and Protection Services
4.1 Health and Safety
4.2 Equipment and Materials
4.3 Building/Physical Space
5.1 Planning
5.5 Quality of Work Life

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: Program Criteria, Sections 2, 3A, 4 and 5
Draft Liability Documents: May, sections 2.13, 2.14, 3.4, 3.11, 3.17 and 4.12 -- 4.15; June, pgs 7-12, 16-17, 21, 25, 30-34

CCHSA AIM Standards, 1999 -- Leadership and Partnerships
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Suggested Procedures

Procedure to guide the content of written contracts and service agreements.
Suggested tools:
- Sample contracts and service agreements for standard wording and layout
Procedure for reporting and recording of liability concerns.
Suggested tools:
- Form for reporting liability concerns, including follow-up activity
Procedure for validating staff vehicle liability.
Suggested tools:
- Personnel record that includes recording of vehicle liability, if required, and annual updating to ensure liability information is still valid
Procedure for conducting criminal reference checks.
Procedure for the regular review of insurance coverage.

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 7: Health and Safety Community Name

Policy: Negligence Policy Number: 7.6

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program accepts responsibility to ensure that the competence of all management and staff involved with the Program has been assessed and, where appropriate, additional skills and training have been provided.

Policy Rationale

To ensure the delivery of safe client care through the effective recruitment and training of competent human resources.

Policy Details

The First Nations and Inuit Home and Community Care Program strives to protect clients, families and staff through detailed hiring practices and appropriate education and training. Program management is responsible to ensure that the public will be protected from any violation of conduct, including false reporting.

Program management has proven skills and training to supervise staff.

All employees are required to show proof of their education and training, including certification where appropriate, at the time they are hired.

References of all staff are checked prior to hire. When appropriate, criminal records may be obtained for staff working with the program.

The conduct of all staff is professional at all times. Any violation of conduct and the course of action to be taken is documented and reported to the appropriate authorities immediately. All complaints will be investigated thoroughly.

Due diligence is demonstrated when a question of negligence occurs. Legal consult will be requested, where appropriate, to review and advise Program management on necessary actions when a situation of negligence occurs.

Process Guidelines

Orientation of staff includes an explanation of:

Expectations regarding the staff's code of conduct
Certification requirements for specific skills
Responsibility of staff to practice competently
Requirements to maintain competence and/or certification in skills
Performance review expectations
The process for reporting, recording and handling a violation of conduct
Consequences that may result of a violation of conduct

Ongoing training and development is provided for staff who require certification of skills. Professional standards of practice are discussed, as appropriate.

Regular reviews of staff performance and practice occur and training and development plans are discussed at that time.

The Human Rights Code will be followed at all times.

Performance Measurement Suggestions

Formula:

Related Standards

3.1 Services Delivery
3.3 Health Promotion, Disease Prevention and Protection Services
4.1 Health and Safety
5.2 Recruitment and Retention
6.4 Information Exchange

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: Program Criteria and Sections 2, 3A, 4 and 5
Draft Liability Documents: May, section 4 to 4.15; June, pgs 7-12, 28- 29.

CCHSA AIM Standards, 1999 -- Leadership and Partnerships, Human Resources
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Suggested Procedures

Procedure for conducting checks of references, certifications, and education and training, as well as criminal checks, as required.
Suggested tools:
- Checklist for obtaining information about and checking references, certifications, education and training and conducting criminal checks, as required
Procedure for annually reviewing certifications, education and training, and any other updates of information for personnel files.
Suggested tools:
- Update checklist for information about references, certifications, education and training, and criminal checks, as required, to be kept in individual personnel files
Procedure for annually completing staff performance reviews.
Suggested tools:
- Performance review process guideline
Procedure for securing personnel files and access to personnel files.
Procedure for identifying ongoing education, training and development required and for tracking the progress of training plans and staff training sessions.
Suggested tools:
- Update checklist to record information about current individual staff education and training, to be kept in individual personnel files
Procedure for reporting, recording and handling complaints, with a specific procedure for high-risk complaints.
Suggested tools:
- Incident report form
Procedure to guide Program management when violation of conduct occurs.
Suggested tool:
- Form to record information about the violation, consequences and follow-up required

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 7: Health and Safety Community Name

Policy: Client Abuse Policy Number: 7.7

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program has a strict policy of zero tolerance for client abuse by health care workers. The Program accepts accountability and responsibility for Recording and reporting situations of suspected client abuse.

Policy Rationale

To ensure staff have a clear understanding of the seriousness of any client abuse caused by the staff and the consequences that may result. These consequences may range from limited measures with the start of the disciplinary process to more severe actions, up to and including termination.

Policy Details

Program management has a moral responsibility to protect clients at all times from any form of client abuse. The First Nations and Inuit Home and Community Care Program uses professional standards of practice where appropriate to guide client/provider relationships.

All cases of suspected client abuse by Program staff are to be reported immediately to Program management and to the appropriate authorities. Reporting of client abuse follows legislative standards. All cases of suspected client abuse are to be investigated immediately. Program management is responsible for recording, monitoring and tracking all cases of client abuse by Program staff.

Education is provided to all staff on the client/ provider relationship to ensure that they know about proper conduct and the consequences of a violation of that relationship.

Process Guidelines

During orientation and ongoing training sessions, the First Nations and Inuit Home and Community Care Program educates and trains all staff about:

The types of client abuse, how to detect client abuse and how to assess the suspected degree of client abuse
The legal requirements to record and report client abuse and the steps to take when a situation of client abuse is suspected
Treatment for the various types of client abuse
Consequences of a violation of the client/provider relationship related to client abuse

A team approach will be used to assess suspected cases of client abuse by Program staff. Other community services may be used to assist with management of client abuse and to provide a social network for the client where appropriate.

Where appropriate, a written, informed consent from the client will be obtained to report the suspected case of abuse.

The Program is reviewed on a regular basis and changes are made, as required, to reflect changes to legislation or health care practices.

Performance Measurement Suggestions

Formula:

Related Standards

3.1 Services Delivery
3.2 Health Promotion, Disease Prevention and Protection Services
3.5 Client Rights
3.6 Ethical Issues
3.7 Confidentiality
4.1 Health and Safety
6.2 Data Collection and Reporting

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: 4
Draft Liability Documents: May, section 3, 3.1, 3.3, 3.11, 3.13, 3.17, 3.20; June, pgs 15, 22.

CCHSA AIM Standards, 1999 -- Human Resources
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Suggested Procedures

Procedure for reporting, recording and handling complaints, with a specific procedure for high-risk complaints.
Suggested tools:
- Incident report form
Procedure for reporting, recording and handling suspected client abuse.
Suggested tools:
- Incident report form
- Client consent form
Procedure to guide Program management when client abuse occurs.
Suggested tools:
- Form to record information about the situation, consequences, and follow-up required, as well as the process for reporting the occurrence to the appropriate authorities
Procedure to determine and implement disciplinary processes.
Suggested tools:
- Form for individual personnel records that indicates the reason for discipline, the disciplinary plan, and any follow-up required
Procedure for handling gifts and donations that clients wish to make to individual staff and to the Program.

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 7: Health and Safety Community Name

Policy: Infection Control Policy Number: 7.8

Approval:
Date:

Policy

The First Nations and Inuit Home and Community Care Program uses infection control principles and practices in care delivery in order to reduce the risk of infection to clients, families, staff, and the entire community.

Policy Rationale

To ensure that staff and clients are protected against infectious diseases and infections.

Policy Details

Hiring practices are designed to reduce the risk of infection and the spread of disease. All staff provide a record of current immunization status at the time of hiring. Written reports of medical examinations of staff must be provided within a period of time after being hired.

Immunization of staff is required where exposure to high-risk infections exist, such as Hepatitis B and Tuberculosis. Consents forms are obtained from staff prior to any immunization. All staff exposed to high risk infections and communicable diseases are screened immediately.

Program management complete an investigation of any incidents. All cases of exposure to high-risk infections and communicable diseases are reported to the appropriate health authorities, and, if necessary, to community leadership. Incidents will be reviewed and analyzed by Program management to identify ways to improve care delivery and reduce risk of infection to clients, families and staff.

Process Guidelines

Orientation of First Nations and Inuit Home and Community Care Program staff includes an explanation of:

Infection control principles and practices that include:
- Hand washing techniques
- Aseptic techniques
- Use of personal protective equipment
- Care and cleaning of equipment
- Supplies required for universal precautions
- Disposal of blood and body fluids
- Needle use and disposal
- Types of infections in the community
- Accidental spills
Identification and isolation of infectious diseases
Care of clients with infectious diseases
Reporting and recording of infectious diseases
Reporting and recording of staff incidents of exposure to infectious diseases
Environmental assessment of client access to safe drinking water, disposal of waste products and safe food management
Client/family teaching about infection control Training and education of staff about infection control practices is conducted on an ongoing basis.

All staff use universal precautions when providing direct care. Staff are provided with the necessary personal protective equipment to prevent exposure to infectious diseases

The health status of all staff is monitored on a regular basis. Records of any staff exposure to infectious diseases are maintained in the individual staff personnel files.

Program management follows the Occupational Health and Safety Act guidelines for infection control.

All hazardous wastes must be properly labeled, handled and discarded.

Any buildings or other physical space used for the Program meet legislated safety requirements.

Performance Measurement Suggestions

Formula:

Related Standards

3.1 Services Delivery
3.3 Health Promotion, Disease Prevention and Protection Services
4.1 Health and Safety
4.2 Equipment and Materials
4.3 Building/Physical Space
4.5 Emergency and Disaster Planning
5.5 Quality of Work Life

Some Suggested References

The First Nations and Inuit Home and Community Care Planning Resource Kit: Sections 3A, 4
Draft Liability Documents: May, section 5.9; June, pgs 6-9, 28

CCHSA AIM Standards, 1999 -- Environment
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives

Review Process:
Dates:

Suggested Procedures

Procedure for universal precautions.
Procedures for care of specific infectious diseases (ie chickenpox, hepatitis, HIV, etc.).
Procedure for monitoring immunization status of staff on a regular basis.
Procedure for handling situations of employee exposure to infectious disease.
Procedure for special precautions to be taken by pregnant employees who are working in situations that may expose them to infectious diseases.
Procedure for handling accidental spills.
Procedure for handling needle stick injuries.
Procedure for sharps disposal.
Procedure for communication with local authorities regarding exposure to high-risk infections and communicable diseases.

Part 8: Clinical/Service Delivery

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 8: Clinical/Service Delivery Community Name

Protocol: Death in the Home Protocol Number: PROT 8.1

Approval:
Date:

Purpose:

To respect the client's and family wishes regarding death at home, to the fullest extent possible. To ensure appropriate protocols are in place for unexpected death in the home.

Guidelines:

When a client chooses to die at home:

An assessment of the client's condition, the family and caregiver support, and the client's wishes regarding resuscitation and dying at home is conducted by Program staff to determine if the client's wishes can be achieved.
Following the assessment, Program staff conduct ongoing review and discussion with the client and family to identify any changes in the client's wishes, the ability of the family to manage and support death at home, and any changes in the client's condition and care requirements. In case the family is unable to support death in the home, a contingency plan that is mutually agreeable is developed.
The relationship with the physician needs to be strong to ensure required support is provided, including pain and symptom management, on-call availability, home visits if required, and signing of the death certificate.
At all times, the client's and family's wishes are respected; and, should these wishes change at any time, they are acted upon immediately; communicated to the rest of the care team, including the physician; and documented in the client record.
Program staff are aware of those situations that require notification of a coroner and act accordingly and in a manner that provides the least intrusion and upset to the family.

When an unexpected death occurs:

The Program staff notify the attending physician to pronounce death, determine cause and issue the death certificate. Program staff are aware of correct protocol, ie ensuring that the body is not moved until cause of death has been determined.
At all times through this process, Program staff assist the family to the fullest extent possible to ensure that they experience the least intrusion and upset possible, and to help them cope with their grief and sense of loss.

Review Process:
Dates:

Suggested Procedures and Tools

Procedure for signing of medical certificate by the attending physician, other physician or coroner to minimize the impact on the family.

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 8: Clinical/Service Delivery Community Name

Protocol: DNR (Do Not Resuscitate) Protocol Number: PROT 8.2

Approval:
Date:

Purpose:

To ensure the client's wishes, or those of a substitute decision maker, are clearly identified and documented.

Guidelines:

If already identified by other health providers (ie prior to referral) the client's wishes regarding resuscitation are confirmed and communicated to all Program staff and other members of the care team in the community.
During client assessment, or as appropriate, client wishes, or those of a substitute decision maker, are identified and documented in the client record.
These wishes are revisited periodically and as a client's condition changes.
An informed client consent regarding resuscitation wishes is signed and included in the client record.
Clients and caregivers are educated to ensure they understand CPR actions and the probable outcomes.
Any request to reverse the client's original wishes, at anytime, is immediately documented and communicated to the rest of the care team.
When there are differences in client and family wishes, the client's wishes will be followed. Program staff will help the family to understand these wishes, as appropriate.

Review Process:
Dates:

Suggested Procedures and Tools

Procedure for documenting client wishes regarding resuscitation.
Suggested tools:
a. Incident report form
Procedure for communicating the client wishes, and any changes in these wishes, to the rest of the care team.

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 8: Clinical/Service Delivery Community Name

Protocol: First Dose Medication Administration Protocol Number: PROT 8.3

Approval:
Date:

Purpose:

To ensure quality client care and minimize client and staff risk for administration of first dose medications in the home.

Guidelines:

Medications considered safe for administration in the community setting for both clients and staff are clearly identified. Similarly, medications considered unsafe that should be excluded from administration in the community are clearly identified. These medications are frequently reviewed and the list revised to reflect latest best practice.
Program orientation includes training related to first dose medications and treatment of adverse reactions.
Registered nurses, who are Program staff or providing services on behalf of the Program, have the necessary skills and certifications to be administering first dose medications. They also have the skill, equipment and supplies to detect and manage adverse reactions.
Prior to administration of first does medications, the client is assessed and the following client information is obtained:
- History of reactions to medications
- Any drug allergies
- Current medications
- Other pertinent client information, ie weight, vital signs
The home environment is also assessed to determine the ease of accessing emergency services, if required (ie telephone, road access).
Prior to administration, staff are prepared for adverse reactions and any treatment that may be required.
Clients are monitored by Program staff during administration and for an appropriate period following administration to detect any adverse reactions.
A family member or caregiver is available to monitor the client's condition for an appropriate period following administration and knows what to do in the event of an adverse reaction.
Clients and caregivers understand potential adverse reactions, how to detect symptoms, and how to access Program staff and emergency services.
Emergency services are provided in the area and available in case of an adverse reaction.
The referring physician agrees that the client is at low risk of an adverse reaction, and is advised of any such reaction.
Any adverse reactions and required treatment are fully documented in the client's record.

Review Process: Dates:

Suggested Procedures and Tools

Procedure for identifying and approving medications to be administered in the community.
Suggested tools:
a. Approved medications list
b. List of medications excluded from administration in the community
Procedure for client and environment assessment.
Suggested tools:
- Assessment form
Procedure for education of client and caregiver(s) regarding potential adverse reactions, symptoms, and appropriate action.
Suggested tools:
- Informed client consent form
Procedure for identifying equipment, supplies and medications required for adverse reactions.

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 8: Clinical/Service Delivery Community Name

Protocol: General Medications Administration Protocol Number: PROT 8.4

Approval:
Date:

Purpose:

To ensure quality client care and the safe administration of
medications in the home.

Guidelines:

Medications considered safe for administration in the community setting for both clients and staff are clearly identified. Similarly, medications considered unsafe that should be excluded from administration in the community are clearly identified. These medications are frequently reviewed and the list revised to reflect latest best practice.
Program orientation includes assessment of staff knowledge in medications and their skills in administering medications and identifying and treating adverse reactions.
Registered nurses and registered practical nurses, who are Program staff or providing services on behalf of the Program,
have the necessary skills and certifications to be reviewing, administering or pre-pouring medications, in accordance with their scope of practice. They also have the skill, equipment and supplies to detect and manage adverse reactions.
Prior to administration of medications, the client is assessed and the following client information is obtained:
- History of reactions to medications
- Any drug allergies
- Current medications
- Other pertinent client information, ie weight, vital signs
Prior to administration, staff have a thorough understanding of the medication, its benefits, side effects, and potential reactions with other medications the client is taking; and are prepared for adverse reactions and any treatment that may
be required.
Concerns that staff may have regarding medication appropriateness and its administration are raised with Program management, including supervisors. Attending physicians are then consulted and the concerns are discussed. Appropriate procedures are in place for documenting any decisions that differ from those of the attending physician.
Clients are monitored by Program staff during administration to detect any adverse reactions.
Clients and caregivers understand all aspects of the medication, including dose, frequency, benefits, potential risks and adverse reactions, and how to access Program staff and emergency services in the event of an adverse reaction.
All medication administration, any adverse reactions and required treatment, and any medication errors are fully documented in the client's record. Attending physicians are advised of any irregularities, including adverse reactions and medication errors.
Clients and caregivers are educated in self-administration, and coaching and support are provided as required to promote self-administration.
Clients provide informed consent to medication administration and this consent is included in the client record.
Appropriate Program staff (ie registered nurses) evaluate the outcomes achieved by the medication.

Review Process:
Dates:

Suggested Procedures and Tools

Procedure for identifying and approving medications to be administered in the community.
Suggested tools:
a. Approved medications list
b. List of medications excluded from administration in the community
Procedure for client and environment assessment.
Suggested tools:
- Assessment form
Procedure for education of client and caregiver(s) regarding medications, their benefits, potential adverse reactions, symptoms, and appropriate action.
Suggested tools:
- Informed client consent form

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 8: Clinical/Service Delivery Community Name

Protocol: Oxygen Management Protocol Number: PROT 8.5

Approval:
Date:

Purpose:

To promote client, family and staff safety when oxygen and oxygen equipment is involved in client care.

Guidelines:

Safe storage practices are followed within the Program, and clients and families are educated about safe storage practices and the risks involved if these practices are not followed.
Safe transportation practices are followed within the Program and clients and families are educated about safe transportation practices and the risks involved if these practices are not followed.
All risks related to the operation of oxygen in the home, including sources of heat, flame, combustion (ie aerosols), and grease, are identified, discussed with clients and families, and reduced to the fullest extent possible. Any risk situations that remain are documented and Program management is notified.
The risks of smoking near the oxygen and equipment or while the oxygen is on are discussed with the client and family to be sure they understand the dangers of such action.
If clients choose to smoke in an unsafe manner (ie too close to the equipment, or while the oxygen is on), Program staff should discuss the issues with clients and families to ensure they understand the dangers. If they still choose to continue to smoke, Program staff should document the client record, leave the home for their own safety, and advise Program management of the situation.
All equipment should be carefully checked on a regular, frequent basis to ensure that it is functioning correctly and has not been altered. If it appears to have been tampered with, or is not functioning properly, the supplier should be contacted.

Review Process:
Dates:

Suggested Procedures and Tools

Procedure for monitoring maintenance of oxygen equipment on a regular basis.
Procedure for documenting unsafe practices, including the appropriate notification of Program management and other care team members, including the physician.

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 8: Clinical/Service Delivery Community Name

Protocol: Workplace Safety Protocol Number: PROT 8.6

Approval:
Date:

Purpose:

To minimize risk to staff while at work, whether at the Program offices, in clients' homes, or traveling.

Guidelines:

All Program staff have the right to work in a safe environment. Potential risks in the home and community care environment are different than those in a facility environment. Program staff should be able to identify risk situations and respond as safely as possible. The Program places a high priority on workplace safety and the safety of its staff.
Program staff should be aware of and be able to address the following risk situations:
- Physical threat, abuse or assault
- Verbal abuse
- Sexual harassment or assault
- Aggressive behaviour
- Substance abuse and related behaviour
- Physical environment risks, such as unsafe structures (ie stairs, floors), vicious or threatening animals, and exposure to smoke
- Communicable diseases
Clients and families have a responsibility to provide a safe environment for Program staff. Although they may choose to live at risk, their choice should not put others at risk, nor should their lives be in danger.
When traveling to and from clients, Program staff should practice the following:
- Use main roads and walkways whenever possible and avoid poorly lit, seldom traveled areas
- Check the vehicle before getting in to be sure no one is in the back seat. If the drive's seat tilted forward, it will be easier to see into the back seat area
- Do not pick up strangers
- If vehicle trouble is experienced, stay in the car and do not accept rides from strangers. Lock the doors and use the horn to signal for help
- Be alert to people who may be following the vehicle. If anything appears to be suspicious, drive to the police or community office, or to other buildings that you know are occupied so that you are not alone
When visiting clients that may put staff at risk, the following precautions should be emphasized:
- Make the visit with another provider
- Make the visit with police or security personnel
- Schedule the visit to minimize the risk as much as possible, ie visit when other family members will be there (if there is a fear of being alone with the client)
- Stay out of the kitchen if a client or family member appears dangerous or unstable
- If it is necessary to go upstairs, follow the client instead of going up the stairs first
- Do not confront clients; instead, negotiate and suggest as a way to resolve issues. Treat all clients with respect and in a non-judgmental manner.
- Do not antagonize verbally abusive clients; speak softly, advise that other appointments are scheduled, staff are aware of the schedule and expected arrival times, and use common sense to find ways to leave as soon as possible
- Immediately leave if the client or caregiver behaves in a threatening manner, is dressed inappropriately, is under the influence of a substance, or if illegal activity is suspected
- Be sure that other Program staff know of scheduled visits and any situations that are considered risky
- Consider providing services in a safer location, such as a health centre
If an incident occurs, once safe, be sure to document the incident with as much detail as possible. If an assault or threat has occurred, or if illegal activity is suspected, contact the police. Be sure to advise Program management and the immediate supervisor of any incidents or suspected risk to staff safety.
When working at the office after hours or alone, be sure that appropriate safety precautions are taken, such as notifying any security, locking exit doors, and following instincts and common sense.

Review Process:
Dates:

Suggested Procedures and Tools

Procedure for reporting incidents, including workplace risk.
Procedure for withdrawal of services.

Top of Page

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

Part 8: Clinical/Service Delivery Community Name

Protocol: Withdrawal of Services Protocol Number: PROT 8.7

Approval:
Date:

Purpose:

To minimize risk to clients, families and staff when situations are considered to be unsafe and Program services should be withdrawn.

Guidelines:

Unsafe situations include those circumstances that put clients and families at risk, or staff at risk. Examples include the following:
- Cognitive impairment of a client that puts the client and others at risk (ie risk of a fire)
- Physical, verbal or sexual abuse of staff
After ensuring the client's safety to the fullest extent possible, and their own safety if they are at risk, Program staff notify Program management immediately about any unsafe situations. The attending physician and other members of the care team are also notified of the situation. It may be useful to discuss the situation as a team.
Program staff and/or management may then contact the family to determine how the situation may best be handled. Family members may help to rectify the situation, or they may be part of the cause of the situation.
Program management may also meet with the care team, including service providers from other programs, to identify possible solutions.
An alternative solution will be sought in order to continue to provide care to the client whenever possible. If the client or family refuse to participate in this alternative, it may be necessary to withdraw services. If withdrawal is the only choice, clients and families will be given a period of notice so that they can make alternative arrangements. Program management will notify the client, family, physician and other care team members about the withdrawal of services.
The withdrawal notice, rationale for the action, and any steps taken prior to withdrawing services will all be documented in the client record.
In cases where Program staff are at risk, services will be withdrawn immediately, without notice. If the situation warrants, police will be notified and legal action may be taken.

Review Process:
Dates:

Suggested Procedures and Tools

Procedure for reporting incidents, including unsafe situations and withdrawal of services.
Procedure for documenting and communicating with the client and family, including the process of seeking alternative solutions and the actual withdrawal of services if this becomes necessary. Suggested tools:
- Standard letter of agreement
- Standard letter for notification of withdrawal of services, with copy to physician

Part 9: Supports for Using this Manual

References

The following resources are referenced in the standards and policies and may be of value as you create and revise your own documents. The list is not exhaustive and serves as a starting point. It is also valuable to link with other Programs and communities to learn more about what they have developed.

The First Nations and Inuit Home and Community Care Draft Liability Documents
The First Nations and Inuit Home and Community Care Planning Resource Kit
The First Nations and Inuit Home and Community Care Website
Bill C54, Personal Information Protection and Electronic Documents Act
Canada Labour Code
Canadian Council on Health Services Accreditation (CCHSA) AIM Standards, 1999
CCHSA Draft Quality Dimensions & Descriptors, 1998
Canadian Health Records Association, Code of Practice and Principles and Guidelines for Access to and Release of Health Information
Canadian Institute for Health Information
Canadian Nurses Association, National Code of Ethics
Colleges and Universities for ethics issues in data collection
Community Workload Increase System population figures
CQI Network Website
DIAND Population Figures
DIAND/FNIHB Home and Community Care Directives
Environmental Health and Safety Act
Fire and Safety Act
First Nations and Inuit Regional Health Survey
Hazardous Products Act of Canada
Human Resources Development Canada, Labour Sector Study in Nursing, in progress; Labour Sector Study in Home Care, pending
International Counsel of Nurses, International Code of Nursing Ethics
National Association for Health Care Quality, www.cphq.org
Occupational Health and Safety Act of Canada
Professional Standards of Practice, including those of nursing and licensed practical nursing associations, home support associations, such as the Ontario Community Support Association, and other provincial and territorial associations
Provincial/Territorial and Federal Legislation
Registered Nurses Act, by jurisdiction
Rozovsky, Lorne, Canadian Law of Consent to Treatment, 2^nd edition
Statistics Canada
WHMIS

Glossary

Accountability:

The responsibility for a particular outcome, service or program. Tasks within a service or program can be delegated but the responsibility cannot.

Advanced Directives:

Also referred to as living wills, a written set of instructions given by a competent client in the event that the individual will not be able to communicate care and treatment wishes due to illness, injury or impaired cognition. Advanced directives can include instructions about financial affairs, health care, legal issues, etc.

Advocacy:

Specific actions that show support for a client's or group's concerns.

Allocation of Resources:

See Resource Allocation

Anonymity:

An unknown source of information.

Auditing:

A systematic review of processes and documentation. Audits are most often done at year-end for financial data or conducted in an ongoing way as a quality improvement activity for client data.

Benchmarks:

Comparing the evaluative results of organizational programs and services to other programs and services (often external to the organization) that are perceived to have achieved excellence. This comparison assumes common similarities between programs and client populations.

Benefit(s):

Additional non-salary compensation such as paid vacation, paid sick days, pension plans, etc. Benefits also include group insurance, such as medical or dental coverage.

Best Practices:

Processes that have been proven to be very successful in achieving desired outcomes.

Care Plan:

A written document of the interventions required to achieve a particular goal. Care plans are developed based on client assessments and the identification of needs, and are regularly evaluated to measure their success or failure.

Capital:

Expenditures are not associated with operating costs (such as salaries, supplies). Examples of capital expenditures include the purchase of computers or office furniture. Capital is usually associated with expenditures over a particular dollar limit, ie any expenditure over $500 or $1000 dollars.

Certification(s)

A mandatory annual membership with a professional college or association that sets the standards of practice, such as the College of Nurses.
An internal process of education for staff to ensure knowledge and competence in performing advanced skills. This process might include a learning package, self-test, lecture, demonstration and/or return demonstration, etc.

Client Assessments:

A systematic process to evaluate the physical, emotional, social and spiritual needs of clients. The client assessment will help determine the amount and level of care required and the goals and outcomes of service.

Client Satisfaction Surveys:

A process to gather information on the clientA process to gather information on the client' service, and whether the service has met expectations and needs. Client surveys can be done in writing or verbally, either while the client is receiving services, or after being discharged.

Clinical Outcome(s):

The results achieved after a particular treatment or service has been provided to a client or group of clients.

Community Needs Assessment:

A process that gathers information to identify the characteristics and potential needs of a particular population. This information will guide the development of new programs and services. Assessments are most often done through the analysis of demographic data and surveys.

Conflict of Interest:

Examples of conflicts of interests include activities that interfere with performance or responsibilities, solicitation or acceptance of money or gifts from clients, and competing for services provided by the organization. These conflicts place an individual in a compromising position because personal and organizational interests are not aligned.

Contract Management:

Processes to monitor the effectiveness and the ability to achieve the terms and conditions agreed to in a particular contract. This might be done through occurrence monitoring, quarterly or annual reports, or monthly variance analysis.

Compensation:

The amount of salary and benefits paid to an employee.

Competencies:

The skills and knowledge necessary to fulfil the requirements of a particular position within the organization. Competencies can be clinical, managerial or administrative.

Continuity of Care/Continuum of Care:

A seamless transition of services to meet the needs of a client or group of clients. A seamless transition is achieved through internal and external service integration and coordination.

Criteria:

Guidelines that facilitate making a decision. For example some of the criteria for admission to the program might be valid demonstrated need, the availability of physician's orders, and a safe home environment.

Demographics:

Data used to describe a particular community or population, such as analysis based on language, age, disease trends, income levels, etc.

Determinants of Health:

Demographic, genetic, and other environmental factors that influence the well being of people in their community. Examples of such factors include income levels, size and characteristics of the community, education, access to services, and family history.

Discrimination:

The unfair or inequitable treatment of one individual or group of individuals. The basis for some discriminatory practices could include age, race, or religion.

Diversity:

Characteristics that are unique to individuals or populations, such as language, culture and religion.

Ethics:

Guides behaviour that is morally acceptable. Used as standards of conduct for most professional organizations.

Evaluation:

Processes used to determine the degree of success or failure of a program, service or procedure. The criteria/tools used in the evaluation are usually developed prior to initiating the program, service or procedure.

Exit Interviews:

A face-to-face meeting between the manager and the employee at the time the employment relationship ends. This meeting is to identify reasons for leaving the organization, thus providing some information regarding strengths and areas for improvement for the organization as perceived by the terminating employee.

Focus Groups:

Meetings conducted with select groups of people (such as clients, family caregivers, staff, community members). These meetings use a framework for guiding discussion to obtain input from the various participants regarding certain issues.

Goals:

Statements that identify the ambitions of the organization, program, service, or individual and guide activities to achieve those ambitions. An organizational goal might be "To enhance community health care through the development of new home and community services".

Health Status:

A measurement of the state of well being of a client, community or population that includes physical, emotional, social and spiritual needs.

Holistic:

A philosophy of care that encompasses the physical, emotional, social and spiritual needs of clients in addition to the symptoms of a disease.

Impaired Mental Capacity:

A predetermined condition that inhibits a person's ability to make informed decisions. Conditions that cause impaired mental capacity might be age, Alzheimer's disease, or mental illness.

Incidents:

An occurrence or action that is considered out of the ordinary and may have a negative impact on the client, staff, community or organization. Incidents should always be measured in terms of the degree of risk.

Indicator(s):

A measurement that can be used to determine the degree of success or failure in achieving desired outcomes. Indicators can be applied to all areas of the organization such as clinical (ie, is the wound smaller in size? ); financial (ie, travel time, km per visit, productivity); and human resources (ie, staff turnover rate ).

Informed Client Consent:

Giving voluntary permission for a treatment or service after all details and risks of the treatment or service and the consequences of declining or refusing the treatment or service have been explained. To obtain informed consent it is assumed that the client is competent to understand the information. If the client is not competent then a substitute decision maker must be used to gain consent.

Job Descriptions:

Detailed, written outlines of specific functions, responsibilities and reporting lines in an organization. All management, clinical and support staff require job descriptions to guide behaviour and measure performance.

Living Will:

Also known as advanced directives, a written set of instructions given by a competent client in the event that the person becomes unable to communicate wishes due to illness, injury or impaired cognition. An example of the content of a living will might include orders not to resuscitate or use mechanical devices to prolong life.

Mission/Mission Statement:

A written statement that identifies the customers, stakeholders and goals of the organization and guides the policy development.

Orientation:

A process that familiarizes staff with the mission, vision, values, programs, services, policies and procedures of the organization. Orientation may include a period of time for preceptorship (the shadowing of the new employee with an experienced employee).

Performance Review/Performance Evaluation:

A written description of the knowledge, skills and professional behaviours of the staff that includes strengths, weaknesses, and a plan for improvement. Performance reviews are most often completed annually and at the end of the probationary period.

Quality:

The degree to which the expectations and needs of clients, staff, funders, communities, and the organization are met.

Quality Improvement:

An organizational philosophy that guides the analysis of information to identify trends and make changes in processes/procedures. These changes enhance programs and services to meet client/community needs, reduce organizational risk, improve efficiencies and improve the work environment.

Recruitment:

The process used to attract, inform and select qualified individuals to meet the human resource needs of the organization. Recruitment strategies include local advertising, job fairs, and referrals for existing staff and others.

Reference(s):

A written or verbal verification of the employment and/or performance of a current or previous employee. Permission from the employee must be obtained prior to the release of any information.

Referral and Intake:

The process of client identification and eligibility for a particular program or service.

Resource Allocation:

The identification of the human resource needs and staff utilization. This is often stated as full time equivalents (FTEs) and includes full time and part time staff.

Retention:

The ability of an organization to keep staff from pursuing employment elsewhere. Some retention strategies include professional development opportunities, promotions within the organization, and increased compensation related to skill level.

Risk:

The measurement of the potential harm that may come to clients, the community, staff or the organization. Risk is most often measured as low, medium, or high.

Stewardship:

To act on behalf of others, in this case the community, to ensure that resources, both financial and human, are used effectively and efficiently

Self-care:

The ability of a client to safely do the tasks associated with activities of daily living and health maintenance. Such activities might be cooking, cleaning, shopping, attending appointments, as well as managing some of their own health care, such as monitoring their condition, managing their own medications, etc.

Substitute Decision Maker:

A person identified by the client to make decisions in the event that the client lacks the ability to do this for him/herself. This process is usually confirmed in writing.

Termination:

A process where by the employment relationship is ended due to dismissal with cause, retirement, reduction of workforce or resignation. All terminations should be done in writing.

Value/Value Statement:

A written statement of the beliefs of an organization that guide the development of programs and services.

Variance Analysis:

An examination of the reasons for not meeting a particular target or outcome. The results of the examination guide improvement activities.

Vision/Vision Statement:

A written statement that provides direction for the organization and guides the development of the strategic goals.

Common menu bar links

Institutional links

Current Subject

Explore...

Proactive Disclosure

First Nations and Inuit Home and Community Care Policies Template Manual

Table of Contents

Introduction

Use of the Manuals

Development Process of the Template Manuals

Intent of the Template Manuals

Suggested Use of the Manuals

Notes When Using the Manuals

An Explanation of the Formats Used for the Standard and Policy Templates

Standards and Policies

The Value of Standards and Policies

Standards, Policies and Procedures: Definitions

Background

The First Nations and Inuit Home and Community Care Program

Program Roles and Responsibilities

Future Activity

Tips for Customizing Standards and Policies to Meet the Needs of Your Community

Preparing for Accreditation

Members of the Working Group for Standards, Scope of Practice, Liability and Training

Part 1: The Organization

First Nations and Inuit Home and Community Care Program Policies Template Manual Community Logo

Part 1: The Organization Community Name

First Nations and Inuit Home and Community Care Program Policies Template Manual Community Logo

First Nations and Inuit Home and Community Care Program Policies Template Manual Community Logo

First Nations and Inuit Home and Community Care Program Policies Template Manual Community Logo

First Nations and Inuit Home and Community Care Program Policies Template Manual Community Logo

First Nations and Inuit Home and Community Care Program Policies Template Manual Community Logo

First Nations and Inuit Home and Community Care Program Policies Template Manual Community Logo

First Nations and Inuit Home and Community Care Program Policies Template Manual Community Logo

Part 2: Scope of Services

First Nations and Inuit Home and Community Care Program Policies Template Manual Community Logo

Part 2: Scope of Services Community Name

First Nations and Inuit Home and Community Care Program Policies Template Manual Community Logo

First Nations and Inuit Home and Community Care Program Policies Template Manual Community Logo

First Nations and Inuit Home and Community Care Program Policies Template Manual Community Logo

Part 3: Client Care

First Nations and Inuit Home and Community Care Program Policies Template Manual Community Logo

Part 3: Client Services Community Name

First Nations and Inuit Home and Community Care Program Policies Template Manual Community Logo

First Nations and Inuit Home and Community Care Program Policies Template Manual Community Logo

Performance Measurement Suggestions

Part 4: Human Resources

First Nations and Inuit Home and Community Care Program Policies Template Manual Community Logo

Part 4: Human Resources Community Name

First Nations and Inuit Home and Community Care Program Policies Template Manual Community Logo

First Nations and Inuit Home and Community Care Program Policies Template Manual Community Logo

First Nations and Inuit Home and Community Care Program Policies Template Manual Community Logo

First Nations and Inuit Home and Community Care Program Policies Template Manual Community Logo

Part 4: Human Resources

First Nations and Inuit Home and Community Care Program Policies Template Manual Community Logo

Part 4: Human Resources Community Name

Policy: Hiring Policy Number: 4.6

First Nations and Inuit Home and Community Care Program Policies Template Manual Community Logo

Part 4: Human Resources Community Name

Policy: Employment Relationship Policy Number: 4.7

First Nations and Inuit Home and Community Care Program Policies Template Manual Community Logo

Part 4: Human Resources Community Name

Policy: Performance Management Policy Number: 4.8

First Nations and Inuit Home and Community Care Program Policies Template Manual Community Logo

Part 4: Human Resources Community Name

Policy: Disciplinary Process Policy Number: 4.9

First Nations and Inuit Home and Community Care Program Policies Template Manual Community Logo

Part 4: Human Resources Community Name

Policy: Confidentiality Policy Number: 4.10

Part 4: Human Resources

First Nations and Inuit Home and Community Care Program Policies Template Manual Community Logo

Part 4: Human Resources Community Name

Policy: Orientation Policy Number: 4.11

First Nations and Inuit Home and Community Care Program Policies Template Manual Community Logo

Part 4: Human Resources Community Name

Policy: Training and Development Policy Number: 4.12

First Nations and Inuit Home and Community Care Program Policies Template Manual Community Logo

Part 4: Human Resources Community Name

Policy: Employee Relations Policy Number: 4.13

First Nations and Inuit Home and Community Care Program Policies Template Manual Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo

First Nations and Inuit Home and Community Care Program
Policies Template Manual
Community Logo