The 519 Church Street Community Centre Crisis Intervention and Service Restrictions Policy and Procedures CONTENTS 1. Policy a. b. c. d.
Purpose The 519 Mission and Values Policy Statement Definition of Crisis and Crisis Intervention
2. Procedure a. b. c. d. e. f. g. h. i. j.
Supporting Participants and Avoiding Crisis Length of Service Restrictions Discretion Regarding Service Restrictions Staff Roles What we can do in a situation Debriefing Appeal Process Confidentiality and Anonymity Progressive Appeals Process Documentation Requirements
3. General Policy and Procedure Information a. b. c. d. e. f. g. h. i. j.
Management Responsibilities for this Policy Board Responsibilities for this Policy Applicability Policy Expectations Policy Source Policy inputs Publication Review and Revision History Related Policies Appendices
POLICY Purpose This policy applies to community members, neighbours, volunteers and staff to create a safe environment in the Centre, to define standards of acceptable behaviour within and around the Centre, and to ensure that there is a clear policy and process to deal with individuals who engage in disruptive, harassing or violent behaviour.
The 519 Mission Statement The 519 Community Centre is a meeting place and focal point for the creative enhancement of a vibrant healthy downtown community. We respond creatively and passionately to the needs of the local neighbourhood and the broader LGBT communities by providing resources and opportunities to foster self-determination, civic engagement, and community enrichment through social recreation, volunteerism, arts and culture, and community participation.
The 519 Values Statement The 519 believes we must: ⋅ Recognize and celebrate our diversity and our history ⋅ Respect and value the principles of equity, inclusion and the dignity of all ⋅ Provide programs and services within an anti-oppression social justice framework ⋅ Ensure we are secular and non-partisan ⋅ Fearlessly act with integrity, creativity and vision
Policy Statement The 519 Community Centre is committed to working with its employees to provide a safe work environment. The 519 will not tolerate any acts of violence and will take all reasonable and practical measures to prevent violence and protect employees from acts of violence. Some people who use the Centre may at times present challenging behaviours. All staff and relevant volunteers of the Centre are expected to: • •
Treat people with dignity and respect during the course of our duties; Use appropriate non-violent crisis intervention techniques when dealing with difficult situations involving community members in order to de-escalate and address
•
disruptive behaviours; Work collaboratively to assist each other in managing difficult or crisis situations.
It is unacceptable under any circumstances to assault community members, neighbours, staff or volunteers of The 519 Community Centre. It is unacceptable to use physical intervention as a means to manage situations with community members. When staff or volunteers are physically threatened or attacked, retreat to safety is the first appropriate course of action. In all cases of threats or acts of physical violence, 911 should be called at the earliest possible moment.
Definition of Crisis and Crisis Intervention Crisis situations often arise when an individual has come to a point where their usual coping skills are no longer functioning in the situation. Behaviour related to crisis situations may include one person or a group of people and may be manifested in different ways including: • • • • •
Verbal harassment (racist, sexist, homophobic, transphobic, etc) of staff, volunteers or other participants Under the influence of alcohol, drugs or mood altering substances in the building, where the individual’s behaviour may become disruptive to the program, members of the public, staff or volunteers Symptoms of serious physical or mental illness Violence or threats of violence Vandalism, theft or property damage
Crisis intervention involves staff using de-escalation techniques in a team approach to bring the situation to a manageable level. Staff present at a crisis are involved in the crisis. It is incumbent upon all parties to be aware of their role and the proper actions to encourage and facilitate de-escalation. Staff are expected to work as a team and ensure the safety of volunteers, staff and other members who may be present. Volunteers, participants and members of the public are not expected to intervene in crisis situations. They may on occasion be asked to seek emergency personnel assistance and/or provide witness statements.
PROCEDURES Supporting Participants and Avoiding Crisis Staff are expected to work collaboratively with their team members to foster an atmosphere, at all times, of friendly, respectful and helpful service. Check in with coworkers and volunteers at the beginning of each shift. Mutual support in the work environment and an understanding of personal triggers enables and supports staff to handle crisis situations proactively and successfully. Staff have the responsibility to proactively reduce the intensity and number of crisis situations. By engaging in conversations and activities with participants and by monitoring behaviour between participants, staff will be aware of and respond to difficulties as a way to de-escalate or avert crisis situations. Positive intervention prior to escalation can prevent a crisis situations in most cases.
Staff Roles Anyone who is present during a crisis is involved in the crisis, whether they are the first responder, 2nd responder, back up or witness. The first responder • is the lead person and makes decisions about how to proceed • uses appropriate crisis intervention and de-escalation techniques (See next section: What we can do in a situation) • begins dealing with a crisis • ideally this person will write the incident report The second responder • is the second person who arrives at the situation and is the main backup person • uses appropriate crisis intervention and de-escalation techniques (See next section: What we can do in a situation) • stands back and evaluates the situation • is specifically available to the first person to assist (if asked) • uses eye contact and other visual cues to communicate with the first responder, if necessary. • watches the situation and calls 911 if necessary • may include their perspective in an incident report • analyzes the situation • if the first responder seems to be having difficulty the second responder may offer
assistance by saying “Can I help?” This leaves an opening for the first responder to ask for help and/or back off Additional back up staff • uses appropriate crisis intervention and de-escalation techniques (See next section: What we can do in a situation) • ensure that members of the public and volunteers keep a safe distance and do not get involved. • create the sense of a barrier by standing near staircases and hallways leading into other parts of the building so that the path of least resistance is to the nearest exit. • create an open space between the individual causing the crisis and the nearest exit • may include their perspective in an incident report Every staff person present • is a witness • uses appropriate crisis intervention and de-escalation techniques (See next section: What we can do in a situation) • should not get involved more than the above, unless the first responder asks them for help. • to many people directly involved may escalate the situation. • if there is a previous relationship with the instigator of the crisis, or if the first or second responder is triggered, then these responders should ask for assistance from other staff present.
What we can do in a situation Helpful • Speak in a calm, unhurried voice - move slowly • Be aware of your own physical safety • Make gestures that mirror your comments for example, nodding your head to demonstrate that you are listening • Slowly move to a safer space if appropriate • Face the individual, but slightly at an angle or sideways so as not to appear threatening • Keep your arms unfolded • Keep your gestures slow • Keep a calm expression • Be aware of how you are feeling: is your heart pounding? are you talking really fast, are you scared? angry?
• • • • •
What tools do you have to calm yourself? Is there another staff that can take your place so you can back away from the situation? Leave the person space to exit, so they don't feel cornered Find out their name if possible, so you can call them by name Communicate with other staff Separate people who are arguing by having other staff invite participants in the argument to different areas. Staff can ask the participant for their perspective on the situation.
Not so helpful • Talking to someone with your arms folded • Standing too close to the person • Touching the person • Frowning, angry expressions • Talking in a loud voice • Waving your arms, making fast gestures • Making judgements or comments about the person • Asking too many questions may escalate the situation Things you might say: • Give them a chance to talk before you begin problem solving, for example, you could say "I'd like to hear from your end what's happening" or “Please tell me what’s going on for you.” • Say what you see happening - let them know you've noticed.; for example "Looks like you're having some trouble settling this, can I help?" • Offer information about what is expected and state what needs to happen, for example "as staff it's my job to help maintain a safe comfortable space and I need to let you know that what you are doing is not okay here.”
Debriefing After a crisis incident, there should be an interdepartmental debriefing and for serious crisis situations organizational debriefing. Sometimes a debriefing a day or two after an incident can bring out more responses. Who should attend a debriefing? • Staff who were present at the incident • Anyone who has been affected/traumatized by the incident (volunteers, members of the public) may be invited to an additional debriefing
Useful questions include: • How did it go? • How did each person feel about how we handled it? • Was there something we could have done differently? • How did we work together as a team? • Was the decision to call/not call 911 or the non-emergency police appropriate? • During debriefing, it is appropriate for staff to say what worked and what didn’t • All staff, including casual and relief staff are invited to discuss incidents with a view to improving our teamwork and the effectiveness of our responses • Use the attached debriefing form (in development) to report on the debriefing to all concerned. For serious incidents involving many staff or a 72 hour service restriction, a more formal debriefing session with a manager will be arranged. Volunteers who were present at an incident but not directly intervening may be stressed or traumatized by the incident. Staff supervisors are to debrief with volunteers and ensure that they are supported. All serious incidents involving staff safety will be referred to the Joint Occupational Health and Safety Committee and the Conduct Incident Committee for further review that may include changes to policies and procedures, staff training, etc.
Appeal Process When a community member receives a service restriction they are entitled to appeal the decision. Appeals must be in writing. When individuals indicate that they want to appeal a decision made by The 519, staff are expected to support them to complete the Complaint/Appeal Form, subject to safety considerations. Support may take place over the phone or with two staff present to ensure safety. Support may include verifying what the individual wrote, completing the form based on the individual’s dictation, or arranging translation service for the individual. Staff are also expected to support individuals with appeals by explaining the Appeals Process. See the Complaints and Appeals Policy for complete details. To make an appeal, means to ask the organization to review the circumstances and / or the decision in order to have the decision reconsidered, changed or reversed. Current or former participants may appeal decisions The 519 makes that they perceive as
being adverse to them (appeals should be made within 6 months of the decision). People may bring an advocate when making an appeal. Grounds for appeal include but are not limited to: service restrictions non-admission to a program readmission conditions In most cases, The 519 accepts appeals only from the individual affected by the decision being appealed, though we support the right of individuals to be supported in the appeal process by workers and/or participant advocates.
Confidentiality and Anonymity Confidentiality refers to keeping personal and / or medical details of a crisis private. The 519 respects confidentiality and only the people directly involved in a crisis and/or who need to know for the purposes of their safe work environment will have access to personal information unless in the case of violence or potential violence. Then staff will be informed so that they are fully aware of any risk.
Progressive Appeals Process Individuals have the right to take their appeal to progressively higher levels within The 519 if they feel the issue has not been satisfactorily resolved. The levels are: 1. Coordinators 2. Managers 3. Executive Director A Coordinator deals with appeals initially. If an appeal of a service restriction of 6 months or less is escalated to the Executive Director, the Executive Director’s decision on the matter is final. If the service restriction is indefinite in length, it may be appealed to the Board of Directors. 4. Board of Directors If an appeal is escalated to the Board of Directors, the Board’s decision on the matter is final. If they are still dissatisfied they may make a complaint to the City of Toronto Ombudsman.
DOCUMENTATION REQUIREMENTS
The following documentation is required for all incidents, complaints and appeals: 1. Incident Report Form – An incident report must be completed before the end of the shift for all time outs, calls to emergency services and/or the police. In most cases the form should be completed by the first responder. 2. Accuracy – Staff must ensure that reports accurately reflect what took place. It is a violation of MFIPPA to collect, record, distribute or store inaccurate information and/or reports. In order to ensure accuracy, incident reports should be written as soon as possible after the incident. The second responder and other staff involved may also be involved in writing the report. Multiple reports may be written in the case of a complex incident. 3. Confidentiality - Use initials to identify the participants that need to be protected for the purposes of confidentiality – using full names for participants who need to be identified for safety purposes is acceptable. 4. Distribution – the incident report is forwarded to the Crisis Management Team, appropriate staff, managers, and the Executive Director with attention to the provisions in the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA). 5. Filing – a copy of each incident report is to be filed date sequentially (most recent incident is placed on top at the front desk in the Emergency / Incident Binder. 6. Follow up – All incident reports will be reviewed at the next management team meeting and the Conduct Incident Committee. 7. Follow up – The Crisis Intervention Working Group will continue meeting on a monthly basis to review incident reports, identify trends and make recommendations. It may be called upon to schedule a special meeting to discuss and review more serious incidents or direct staff teams/individual staff for more training if the practices is not in line with the policy. 8. Municipal Freedom of Information Privacy Protection Act (MFIPPA) – All document creation and retention must be in compliance with MFIPPA. 9. Follow up – Serious incidents as defined in Provincial Health and Safety Legislation
will be forwarded to the Joint Occupational Health and Safety Committee, the Conduct Incident Committee and to the attention of senior management. 10. Complaints and appeals – See the complaints policy and procedure for details on documentation regarding complaints and appeals. 11. Debriefing Form (in development) – The debriefing form is to be used for all debriefing sessions.
GENERAL POLICY AND PROCEDURES INFORMATION Management Responsibilities for this Policy a. Analysis of Complaints and Appeals – The Conduct Incident Working Group will conduct a quarterly review of all incident reports in order to determine if there are patterns and ongoing issues that need to be addressed (see terms of reference for that committee). b. Health and Safety Committee –serious incidents involving staff safety/concerns will be referred to the Health and Safety Committee and the Conduct Intervention Committee. These incidents would involve violence against staff including sexual harassment, staff injuries, weapons, and death threats. c. The Executive Director will report semi-annually (based on the Conduct Incident Committee analysis) to the Strategic Planning and Program Planning and Human Resources Committees of the Board, summarizing the number, subject matter and severity of incidents. d. Orientation – Managers will orient new staff to this document, its policy and practices. e. Ongoing Practice Sessions – The Conduct Incident Committee will develop a role playing exercise which will be available at operations meetings or other staff team meetings at various times in the year. f. Training – Formal crisis intervention training will be conducted on a regular basis as resources permit. New staff and staff who have not participated in the training in the past three years are required to attend the training.
Board Responsibilities for this Policy a. Approval – This policy has been reviewed by the Strategic Planning and Program and Human Resources Committees of Board in order to ensure that it is consistent with The 519’s Mission and Vision. The Human Resources Committee presented this policy to
the Board for approval. The same review and approval procedure will be followed for updates.
b. Incidents and Incident Resolution as a Valuable Source of Information – The Board is responsible to ensure that The 519’s policies are consistent with The 519’s Mission, Vision, and Values, and that our services are producing the intended outcomes. The Board uses the information gathered through tracking incidents to review policies and current and future services.
Applicability This policy applies to:
All employees Contractors People attending programs at The 519 All front-line and management staff Board of Directors Volunteers General Public
Policy Expectations The 519 expects that this policy will support our goal to ensure that our services are responsive and accessible for participants while maintaining a safe and welcoming community centre for community members, staff, volunteers and neighbours. The 519 will help staff follow this policy by: keeping the policy, procedures and task outlines updated providing orientation and training on this policy to board, staff and volunteers holding information sessions when this policy or procedure changes training and coaching staff on how to deal with difficult behaviours and situations including policy-adherence in job descriptions The consequences of not following this policy can be harmful to The 519, staff and participants and may include, but are not limited to: putting participants, staff and volunteers in unsafe situations being in breach of The 519’s contract with its funders having funding reduced or withdrawn having services and staffing reduced progressive discipline when there is deliberate non-compliance
Policy Source This policy is based on the following documents: The 519’s mission and values statements The 519Community Centre Working With Crisis Workshop (January 31-Feb. 1 2007) by Linor David and H. R. Bremner Meetings of the Crisis Intervention Policy and Procedure Working Group, a group of staff who attended the Crisis Intervention Training in early 2007 and agreed to work through issues to create a policy and procedure. The Collective Agreement Child Welfare Act Health and Safety Act Toronto Drop In Network Good Practices Toolkit City of Toronto Hostel Services Quality Assurance policy documents
Policy Inputs Policy Development – This policy was developed by: The 519 Crisis Intervention Policy and Procedure Working Group (a cross department staff group which held meetings throughout 2007) reviewing past complaints and appeals gathering input from staff through a series of meetings gathering input and reviewing policies used in similar organizations discussing the policy with the Board’s Strategic Planning and Human Resources Committees for feedback Board Review and Approval – The Strategic Planning Committee presented this policy to the Board for review and approval. The same review and approval procedure will be followed for updates. Policy Update – In addition to regularly-scheduled reviews, reviews will be triggered when: Toronto Drop In Network standards are updated there are ongoing issues and/or a pattern of complaints that point to inadequacies or omissions, or to support and improve this policy reorganization within The 519 that affects roles, responsibilities or procedures
Publication The policy is available to anyone who has an interest in The 519 and is available as follows:
Staff Manual THE 519’s website Anyone will be given their own copy upon request A condensed version posted on bulletin boards within The 519
The Procedures are an internal document of The 519. If participants or others require assistance to be able to understand our policies, we will provide explanation, interpretation, and/or translation.
Review and Revision History Policy No. Date of Board Approval Policy Effective Date Storage Locations Updated
TBD October 2008 In practice September 2008 S:\519 Policies and Staff Orientation Manual June 2010 (workplace violence policy)
Related Policies
Complaints and Appeals Policy Workplace Violence policy Human Rights and Anti-Harassment Policy
Appendices
Service Restriction and Emergency Procedures Chart Completed Samples of Forms Crisis Intervention workbook