2016_Service Agreement_with covers web

Home & Community Care
CLIENT SERVICE AGREEMENT
Working Together, Our Mutual
Commitment to Quality Care
A division of the Yúustway Health Services Department

Yúustway Health Services
“Taking Care of Each Other”

HOME & COMMUNITY CARE
CLIENT SERVICE AGREEMENT
Table of Contents
Introduction: ............................................... 4
Understanding the Process ................................... 5
Accountability / Reporting .................................... 6
Work Assignments .......................................... 8
Money / Gifts .............................................. 8
Environment / Health and Safety .............................10
Travel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Household Duties ..........................................14
Confidentiality. ............................................16
Yúustway Health Services Department
Unit 9A, 380 Welch Street,
West Vancouver, V7P 0A7
Phone: 604-982-0332
Fax: 604-982-0372
Toll Free: 1-877-628-2288
www.squamish.net/services/health.htm
September 28, 2016 9:47 AM

INTRODUCTION:
The Home & Community Care Division (H&CC) of Yúustway Health
Services Department is committed to providing quality care and homemaking
services to the Squamish Nation community. With that in
mind, we are providing you and your family with information regarding
the procedures and communications that help us provide you with the best
possible care.
2

UNDERSTANDING THE PROCESS:
Now that your assessment has been completed by our H&CC Assessment
Nurse, it has been determined that you are in need of home care service.
H&CC will commence this service in accordance with your assessment.
We will prepare a service schedule and assign a Worker(s) to provide your
care as per your assessment. We also wish to inform you that the service
time you have been assigned does include 10 minutes of travel time for the
Worker(s) to travel to and from their next assignment. We will make every
effort to provide the service time that best meets your needs but there may
be times that either Workers or times of service may change due to staffing
resources.
In order to avoid confusion about roles and responsibilities
and to strive to achieve the best possible communication
about your care, we feel it is important to share these procedures
and confirm our mutual agreement about how we will
work together.
We have organized this booklet in a way
that helps to clarify both what our
employees responsibilities are in
your care and also to confirm
what we will need from you
– because we know that
you are the most important
contributor to your
own healing, health and
wellness.
3
September 28, 2016 9:47 AM

SERVICES
SERVICES PROVIDED:
Squamish Nation Home & Community Care Offers different types of in
home care to meet the needs of your health.
Services
Home Making
We’ll help you set achievable goals to
improve your health & independence
Caring Companionship
Meal Preparation
Homemaking
Personal Care
Alzheimer’s & Dementia Support
●
●
●
●
Caregiver Relief/Respite Care
Nursing Care
End-of-Life Care
Foot Care
Elders 65+with Diabetes and other
conditions
September 28, 2016 9:47 AM
4

Acute/Chronic
Stay comfortable and safe in your own
home. Medication reminders and daily
living services.
●
●
●
●
●
●
Palliative/Respite
Daily end-of-life care. A qualified
caregiver ensures attentive caring
●
●
●
●
●
●
●
●
●
5
September 28, 2016 9:47 AM

CLIENT RESPONSIBILITY
What we need from you:
• Please call the H&CC office if the Worker does not arrive, arrives late
and/or leaves early form a scheduled visit without calling in to the
office.
• You will be asked to sign the back of the Worker’s time sheet at the
end of each service visit, please ensure start and end time is correct.
• At least 24 hours in advance, you must call the H&CC Office if you
will not be home during a scheduled service visit.
• If you are not home for a service visit and fail to provide notice to our
office on three occurrences, service will be put on hold until you call
our office.
• Clients do not receive service if they are not present in the home during
the service visit.
• Please report any and all concerns to the H&CC office regarding
service. Your input is important to us!
The Worker may need to report concerns regarding your medical
condition to the H&CC Manager, Nurse Assessor or
Emergency response team
September 28, 2016 9:47 AM
6

ACCOUNTABILITY AND REPORTING
Accountability and good reporting ensures a high standard of
service provision and also allows H&CC to plan ahead.
WORKER RESPONSIBILITY
What you can expect from our Worker:
• Worker should advise the office immediately if you are not at home
for service.
• Worker will not provide service if you are not present in the home.
• Worker will ensure that you sign the back of the time sheet at the
end of each service visit and will not request Clients to sign prior to
service or on a different day.
• Time sheets are due before 4:00 pm Thursday or Wednesday if
prior to a Stat holiday weekend (end of workday, the week after
pay day).
• The Worker must read the care plan at each visit.
• The Worker must check off all tasks completed on Flow Sheet in the
Client Binder at the end of each service visit.
• The Worker should report any and all concerns to the H&CC office
regarding a client’s condition and service visits.
7
September 28, 2016 9:47 AM

CLIENT RESPONSIBILITY
What we need from you:
Clients will not have immediate or core family, who are H&CC
employees, scheduled to provide home care services.
IMMEDIATE FAMILY MEMBERS INCLUDE:
• PARENTS/GRANDPARENTS
• SIBLINGS
• SPOUSE
• CHILDREN
• Please do not request assistance from a Worker to complete any
financial transactions or complete any forms.
• If grocery shopping assistance is needed, this should be included in
your care plan and you should get a receipt from the Worker and
receive the correct change.
• Please do not offer gifts to the Worker
without reporting this offer to the office in advance.
• Do not lend money to workers or enter into a private financial relationship
with the workers.
September 28, 2016 9:47 AM
8

WORK ASSIGNMENTS
We strive to provide quality service to members of the community
by assigning Workers that are best suited to provide the care needed.
WORKER RESPONSIBILITY
What you can expect from our Worker:
Workers will not be scheduled to provide home care service to immediate
or core family members as outlined in Squamish Nation Human
Resources Policy.
IMMEDIATE FAMILY MEMBERS INCLUDE:
• PARENTS/GRANDPARENTS
• SIBLINGS
• SPOUSE
• CHILDREN
MONEY / GIFTS
To maintain the integrity of our staff and avoid any misunderstanding.
• Workers are not permitted to handle any money for you. If
grocery shopping is on the care plan, a receipt with appropriate
change must be produced to the Client.
• Workers are not permitted to borrow money from clients or enter
into a private financial relationship with clients.
• Workers should not ask for any household items under any circumstances
– even if they feel/think that the item is no longer needed by you.
• If a gift is offered to the Worker, this should be reported to the office.
9
September 28, 2016 9:47 AM

CLIENT RESPONSIBILITY
What we need from you:
• Clients will allow the worker to conduct a Home Environmental
Safety Screen and report any concerns.
• Confine any animals you have during the time of service.
• Workers are not responsible for cleaning up after animals; this
includes cleaning the litter box.
• Clients are requested not to smoke during the scheduled service time.
• Clients are not permitted to use recreational drugs or alcohol during
the scheduled service visit. Service will be put on hold to ensure
worker safety.
• Clients should not request the Worker to do outdoor chores or
gardening.
• Clients should not request the Workers lift or move heavy objects or
furniture while providing service.
• Clients should not request the Workers to wash walls or drapery
unless specified on the care plan.
• Clients should not request that Workers wash interior or exterior
windows.
September 28, 2016 9:47 AM
10

ENVIRONMENT/HEALTH AND SAFETY
Our goal is to ensure the safety of both the Clients and the Workers
while working in the Client’s home Our motto is “No one gets hurt.”
WORKER RESPONSIBILITY
What you can expect from our Worker:
• Workers will conduct a Home Environmental Safety screen and
report any concerns.
• Workers will report any unsafe conditions noted in your home.
• Workers will use proper hand washing practices.
• Workers are not permitted to smoke in your home, or use drugs or
alcohol.
• Workers are expected to develop safe work habits.
• Workers must wear closed heel and toe shoes while providing service.
• Workers will take care to clean their shoes prior to entry into your
home.
• Workers will not do outdoor chores or gardening for you.
• Workers will ensure the interior walkways of your home as well as the
area at the entrance way is clear of clutter and will not cause you to
risk falling.
• Workers are permitted to spot wash wall areas around light switches
and door knobs to sanitize but not required to wash walls.
11
September 28, 2016 9:47 AM

CLIENT RESPONSIBILITY
What we need from you:
• Please do not ask the Worker to drive you on any errands.
• Please do not drive the Worker in your own vehicle.
• You may ask the Worker to assist to make any travel arrangements for
medical appointments through the Health Services Department.
• Please make a request to the H&CC office if there is a need for the
Worker to accompany you to a medical appointment. Proper
arrangements may be made, if appropriate.
September 28, 2016 9:47 AM
12

TRAVEL
H&CC staff will be happy to assist you with travel arrangement if
needed.
WORKER RESPONSIBILITY
What you can expect from our Worker:
• The Worker is not, under any circumstances, permitted to drive you
to do errands or to appointments.
• The Worker is not permitted to ride in your car to do errands or
attend appointments.
• The Worker may assist you to arrange transportation to medical
appointments through the Health Services Department
• The Worker must report any request to accompany you to a medical
appointment as soon as they have knowledge of this request.
13
September 28, 2016 9:47 AM

CLIENT RESPONSIBILITY
What we need from you:
• If there are family members living with you, they are responsible for
doing their own laundry, dishes, picking up and tidying the home as
well as doing errands and shopping for you.
• The Assessment Nurse may assign special tasks that are important for
your health and safety and add them to the care plan.
• Please refer to the care plan for all tasks that have been assigned to the
Worker.
September 28, 2016 9:47 AM
14

HOUSEHOLD DUTIES
H&CC staff is in your home to provide quality service to you as the Client. If there
are others in your homes that need assistance, please don’t hesitate to let us know.
WORKER RESPONSIBILITY
What you can expect from our Worker:
• The Worker is responsible for tasks listed on the care plan for you
only.
• The Worker will not clean up after family members living in the
home with you.
• The Worker will not do the dishes of family members who live in
your home. The Worker will only do the dishes related to meal
preparation during the time of scheduled service for you only.
• If you live on your own and need assistance with groceries, the
Worker may pick up groceries only once per week but this must be in
the care plan.
15
September 28, 2016 9:47 AM

CLIENT RESPONSIBILITY
What we need from you:
• Please do not ask the Worker for information about other Clients or
Workers.
• You are welcome to call the H&CC office to discuss any questions or
concerns you may have regarding service or H&CC staff. Please do
not share your concerns regarding one Worker with another, please
call the H&CC office.
• All Client information is kept confidential and secure in the Health
Services Department office.
September 28, 2016 9:47 AM
16

CONFIDENTIALITY
We are honoured to provide service to you and will always strive to
earn your trust.
WORKER RESPONSIBILITY
What you can expect from our Worker:
• Workers will guard your information and will not provide
information to you about other Clients or Workers.
• Workers will not discuss their schedules or the service other Clients
are receiving with anyone.
• Workers will not discuss any personal employment related concerns
with Clients or other Workers. Please contact the H&CC office.
• All employee personal information is kept confidential.
• All H&CC employees have signed and are bound by the Squamish
Nation Confidentiality Agreement.
17
September 28, 2016 9:47 AM

Nurse/Manager Visit Log
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
18

Nurse/Manager Visit Log
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
19

Nurse/Manager Visit Log
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
20

Yúustway Health Services
“Taking Care of Each Other”

Home & Community Care
CLIENT SERVICE AGREEMENT
Working Together, Our Mutual
Commitment to Quality Care
Yúustway Health Services
“Taking Care of Each Other”
Yúustway Health Services Department
Unit 9A, 380 Welch Street,
West Vancouver, V7P 0A7
Phone: 604-982-0332
Fax: 604-982-0372
Toll Free: 1-877-628-2288
www.squamish.net/services/health.htm