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Appendix 6: Sample Policies adapted from the Austin Hospital (NSW) Policies

Employer Home Visit and Staff Security Risk Assessment Form

Home Visit Rating: ______

Date: ______

1. Visit to proceed
2. Conditional service - refer to A. B. C. D. E. F.
3. Unacceptable risk

The home visit will not proceed until all identified risks have been addressed, reducing risk to an acceptable level

Date of 1st home visit:	Melways Ref
Patient UR		D.O.B.
Name
Address No. Street Suburb	__ __ __ Patient’s usual address Yes / No Details:
Telephone Home Work Mobile	__ __ __ Mobile Coverage Yes / No
Nominated Contact person / NOK	Name __ Phone no. __
Name of staff member completing form.	Signature		Dept		Today’s Date (form completed)

QUESTION	YES	NO	ACTION
Has the occupant consented to the home visit/assessment?			Offer alternative avenue of service

A. ACCOMMODATION – please tick

• House
• Flat / Unit
• High Rise Complex
  • Floor or Level
  • Lift
  • Stairs
• Aged Care Facility
  • Specify __
• Residential care Unit
• Other __

B. ACCESS TO PROPERTY

QUESTION	YES	NO	ACTION
Is the house visible from the street? Is it remote? Are there high fences?			Obtain specific directions &/or location
Is the house number visible from the street/road? Day & night?			Temporary sign. Investigate further.
Is there close vehicle access to the house?			Consider risks associated with difficult vehicle access situations
Is there easy and clear 24 hour access to the house via the driveway?			Can someone meet the health care worker at car?
Will the gate be easily opened at the time of the visit?			Make practicable arrangements
Which door is used for entry? Front Side Back			Assess the access for risks
Is the pathway leading to the entry In good condition? Are there slippery steps?			See Manager
Will someone be able to open door?			Specify Other Arrangements
Do we need to negotiate an alarm/lock up system?			Please list instructions

C. LIGHTING

QUESTION	YES	NO	ACTION
Is there operational external lighting? Porch? Driveway?			If yes – inform patient that light MUST be left on in poor light. If no – discuss with Manager re provision of service.

D. OCCUPANTS

QUESTION	YES	NO	ACTION
Is the patient the sole occupant?			List other occupants
Are these occupants or visitors likely to come and go during the visit?			If yes – inquire who will be there?
Will this impinge on security, delivery or treatment of the patient?			If so, ask to reschedule visit
Are there any firearms in the house?			If so, are they securely locked away?
Is there significant alcohol or drug consumption from a patient / occupant / visitor that home visit staff should be aware of.			If so, please advise -Type: -Quantity: -Time of Day: Advise the patient that if at any stage a home visit staff member feels uncomfortable or threatened, the patient needs to be aware that the home visit service will be withdrawn.
Does the occupant/s have a history of aggressive / offensive behaviour?			If so, see Manager

E. ANIMALS

QUESTION	YES	NO	ACTION
Does the patient have any animals? Type _____
Can the animal be restrained or isolated during the healthcare worker’s visit?			Place elsewhere
Are there any dogs that will bark when staff are entering the property?
Will the animal be in the front garden?			Place elsewhere
Do we need to phone ahead of time to allow for removal of animals?

F. HISTORY - Please use patient file or other assessments for details.

Please ask discreet questions only

QUESTION	YES	NO	ACTION
Are there any medical conditions that may impact on the patient’s health?			If so, please list

Are there any other aspects that may impose a security risk?

Home Visit Staff Security Orientation Checklist

NB This orientation checklist must be completed in conjunction with the Home Visit Risk Assessment Policy and Procedure.

1. SUPERVISOR/ MANAGER RESPONSIBILITY

Prior to undertaking a home visit, it is essential for the manager/supervisor to establish a file containing:	Checklist
Personal contact details of staff member
Sitting and standing photo of staff member - to be kept in department
Physical description of staff member
Contact name and number of Next Of Kin

2. PRIOR TO STAFF LEAVING THE EMPLOYER FOR HOME VISIT

Collect as much information about the client to assess potential risks
Contact the client and explain your role and purpose of home visit
Complete the Home Visits Staff Security Risk Assessment Form second staff member or hired security to accompany staff on visit alternative service to be delivered If service is not provided, this needs to be documented and communicated to the client if service provision has been discussed with the client. If a letter has been sent to the client a copy should be sent to the Director of the service
Explain the number of people that may be attending the home visit with you
Organise a day and time for the home visit If possible, avoid visits out of working hours

2.1 On day of visit, record information in your department on:

Name of visiting staff member(s)
Name of patient / client
UR number
Address and phone number of destination
Departure time
Expected time of return
Car type and registration number
Mobile phone number that staff can be contacted on
Ring the client if you are likely to be delayed.

2.2 Take only personal items of identification with you

Identification badge
Licence
Mobile phone
Torch and batteries
Personal alarm
Avoid taking a diary that may contain personal information about staff worker or family members

2.3 Turn on the mobile phone and ensure:

It is fully charged
Contains pre-programmed emergency numbers, i.e 000
Identify whether the mobile has reception in the area you are visiting. If not take a GSM phone

2.4 Ensure the car contains:

Recent street directory (country or metro depending on trip details)
Mobile phone charger
Hands-free kit for mobile if determined by the manager to be necessary for business purposes
Fire blanket
Adequate petrol /petrol card Fill up when car contains ¼ tank petrol

3.0 IN-VEHICLE SAFETY

3.1 Before driving the car

Keep car and house keys separate and do not label them with your name or address.
Be aware of weather and road conditions and have adequate maps
Have accurate directions to the street, building, and apartment. If the area is unfamiliar to you, check with a colleague for more detailed information. Always know exactly where you are going.
Always keep in the glove box, a torch, pen, paper and coins for emergency calls.
When possible, avoid parking in deserted, poorly-lit areas.
Prior to entering the vehicle check inside for people, especially the rear
Approach car with keys in hand and disarm alarm when close to the vehicle. If possible, use keyless remote that opens only the front drivers car door rather than opening all doors of the vehicle
If strangers are around the car, do not approach the vehicle

3.2 Driving the car:

Once inside, lock all doors and roll up windows to within 3cm of the top
Be wary of strangers approaching your car while you are stationary. Stay in gear and be prepared to sound the horn or drive away if threatened.
Be alert at all times for potentially dangerous situations. If asked for help stay in the vehicle and use the mobile phone. When travelling never pick up hitchhikers. If annoyed by another driver, or think you are being followed, keep driving and drive to a place where people are visible, for example, petrol station, shop, or police station. Obtain the registration number and report incident to police as soon as possible.
Only use the phone when necessary and use the car kit only.
If the hospital car breaks down or you are involved in an accident, follow the procedure in the glove box. Upon return to the hospital complete an incident form

3.3 Leaving the car:

Always remove the key from the ignition and lock up. Valuables should be out of sight, as should any papers with your name and address.
Never hide a spare key in the car.
Park the car in the street or if you have to assist the client into the home or take equipment, then park the car in the driveway
In the evening, park the car as close as possible to a well lit area
Don’t get out of the car immediately - take a look around and make mental notes about areas that could present a risk.

3.4 If Caught in a Bushfire (Australia)

Do not leave the car
Park in a cleared area
Ensure windows are up and vents closed, turn air conditioning off
Cover yourself with a woollen blanket and clothing
Put the hazard lights and headlights on and keep the engine running
Crouch below window level
Wait until fire front passes
In the event of a bushfire, do not continue to drive into the fire zone, but do a “U” turn to safety if the road conditions permit you to do so

4.0 WHILST CONDUCTING HOME VISIT

After knocking on the door, stand to one side and not in a position where opening the screen door can trap you.

4.1 Do not enter the premises if:

No-one answers the door and it is unusual for them not to do so
The door is left open
Evidence of a break-in
There are conflicts/arguments or extraordinary noises coming from the home
The client does not know who you are and why you are there
The person answering the door gives any cause for concern, make an excuse and do not go in.
The client is alcohol or drug impaired. If so, do not enter – terminate the visit and return another time, with security if necessary

4.2 Upon entering the premises:

Follow the client into the home – never walk ahead of the client
Choose carefully where you sit – identify potential escape routes. Try to maintain a position closest to exits and escape routes.
Be alert for items that may pose a risk, such as walking sticks or kitchen knives
Treat clients courteously - remember you are a guest in their home
Avoid reacting to home e.g. smells, surroundings, untidiness
Do not spread belongings around so that if you need to leave quickly, you don’t need to collect your belongings
Contact supervisor/manager if expected delay greater than 30 minutes

4.3 Remain alert to sudden changes in client’s mood. Does the client:

Indicate a heightened level of anxiety or depression?
Have hostile or aggressive body language?
Complain about the provision of services?
Refuse to cooperate?
Display suicidal tendencies or cries for help?
Have rapid breathing, clenched fists/teeth, appear restless or talk loudly?
Swear excessively or use sexually explicit language?
Disregard organisational policies and procedures?
Make verbal threats?

4.4 If the client becomes aggressive, abusive or sexually suggestive:

Stay calm and don’t panic
Leave as quickly as possible – suggest you have something for the client in your car
If you are unable to remove yourself from the situation, attempt to diffuse the situation
Prepare to hit the speed dial on the mobile – contact the police

5. UPON RETUNING TO CMDHB HEALTH

Ensure there is adequate petrol in the car for the next staff member
Ensure mobile is fully charged
Sign in and record time of return
Return car keys and mobile

5.1 If incident occurs during home visit:

Report incident to manager / supervisor
Access First Aid or medical assistance if necessary
Complete Incident Report
Access to critical incident debriefing and counselling
Seek advice regarding Workcover
Notify police if appropriate

6.0 FAILURE OF STAFF TO RETURN FROM HOME VISIT

If the staff member is half an hour later than their expected return time:

6.1 Department manager / supervisor needs to:

Contact staff member via mobile number
If staff does not answer the mobile, contact the clients listed for home visits to establish if staff member arrived or time left the premises
If staff member still not contactable, contact police and provide description and relevant details of missing staff member. Photos and personal description should be made available to police.
Contact staff Executive via CMDHB switch board
Notify CMDHB Security department
Contact staff member’s Next Of Kin
Use Missing Home Visit Staff Member Action Sheet (Appendix 3).
Complete the incident report form.

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