Diets
Where do you locate the specialized diet plan?
Care Plan Tab in Therap
Shelby shows up for shift at 7am and around 10am Jason asks to go on a ride. Shelby tells Jason we can't go for a ride today because I don't have the gas to go anywhere.
This is a red flag statement and also is considered a rights restriction as you are restricting his right to the community.
Josh is asking staff to go for a car ride. Staff say Joshua car ride in one hour yes? Josh responds yes. An hour and a half later Josh says car ride. Staff then responds with we won't be going on a car ride today I don't have a car.
The first part of this is not a rights restriction and it would be considered a delay which is allowable but denying him access to a community outing is a rights restriction.
Jason is on a soft mechanical diet. Should you be sitting next to him while he is eating?
Yes
When is documentation expected to be completed?
Documentation should be completed prior to leaving the ISL at the end of your shift.
What is the correct size for bite size diet?
Dime size
Are these red flag statements, "Its not allowed", "Its our policy", "This is how I was taught"
All of these are red flag statements and can end in an abuse or neglect accusation.
David wakes up and wants breakfast. Staff says I will make you pancakes in a moment. David says I don't want pancakes I want eggs and bacon. Staff says today we are having pancakes (there is bacon and eggs in the house). David gets mad and throws his tablet across the room and goes to punch staff.
Denying David his right to have what kind of food he prefers is a rights restriction.
David starts to move furniture and items around the house and you feel like he is just causing a disruption so you loudly tell him to stop moving things around. You continue to yell at him and say if you move anything else you can't have lunch.
This is a form of verbal abuse. You are yelling at David and telling him he can't have a basic need because he is moving things around his home.
You leave the ISL for the day and complete your intensive note but do not complete any outcomes. Have you properly finished your shift?
No because outcomes are a part of documentation and a requirement when completing Therap documentation.
Levi is making breakfast for Jason, David, and Joshua. Levi decides to make smoked sausage, scrambled eggs, and toast. How should this be prepared for Jason?
The smoked sausage should be cut into small pieces or shredded. The toast should be buttered generously and cut into small pieces. It would be best to make a gravy for the sausage so it can become more tender.
David went on an outing with Clay. When they returned David had an accident in the car. Clay and David went inside and Clay said to Levi in front of David, "He just peed in my car and I am not going to take him out anymore because he is doing it on purpose."
This is a red flag statement even if it is out of frustration. We should not be having these conversations in front of clients. If there is a concern bring it up to your supervisor. Not only does this statement raise red flags, you are also setting yourself up for an abuse allegation as well as a rights restriction.
Jason had a behavior which ended in property damage. Later he is at baseline and has a good rest of his day and asks to go to the park. Staff denies because he had a behavior earlier.
This is a rights restriction. You cannot deny Jason an outing because of something that happened earlier.
You come into the ISL and you are scheduled for a 14 hour shift. David starts to obsess over going on an outing. You say David can we just have a good day today I am on a 14 hour shift and I just want to have a good day.
This ties into the arcs mission statement which is to support individuals with disabilities in directing their own lives as valued members of the community. If you are just assuming bad behaviors will happen you are holding prior incidents against him and he will always feel you don't care about him.
You did not submit your Therap documentation and your supervisor reaches out to you to get it completed. What is the appropriate timeframe to respond to your supervisor.
You have one business day to respond to your supervisor however when you have not completed documentation if you do not get it completed you ASAP you will receive a counseling as it is a policy.
If a client is on a bite size or soft mechanical diet it is okay to give them peanut butter?
No a client on either diet should not have peanut butter as it is a choking risk.
Joshua has breakfast at 9 am and it seems that he is still hungry at 9:30. Joshua asks staff for cottage cheese. Ashley says Joshua snack at 10 am yes? Joshua says yes and when the alarm sounds at 10 am he is allowed to choose whether he wants cottage cheese or chips. He choose chips.
This is not a red flag statement as you are not denying Joshua access to a snack you are just redirecting him to the schedule that is in place for mealtimes.
Saturday afternoon and your favorite team is playing David wants to watch Trains and you turn on the game instead of allowing David to watch his trains.
This is a rights restriction it is his home and you cannot decide to watch something you want over what they would like.
Your supervisor gives you a directive stating "Mileage is to be completed every outing and before you leave the ISL." You take Joshua to Wonders of Wildlife, grab lunch, and go to the park. You leave for the day and do not record your mileage.
This is insubordination. You will receive a counseling for questioning your supervisors directives or disobeying them.
If 3 days have passed and you still have not submitted your documentation what does that mean?
Per the documentation schedule you have voluntarily resigned from The Arc of the Ozarks
Jason comes out for breakfast and you ask him if he wants to eat what you have already prepared pancakes. Jason refuses but states he is hungry. You offer him scrambled eggs and yogurt or pineapple and peanut butter oatmeal. Are these good options to provide Jason?
Pancakes with syrup would have been a good option. But once peanut butter and pineapple were introduced it became an unsafe food choice for Jason. Though scrambled eggs and yogurt were a safe choice we should never offer an unsafe choice with it.
Joshua, David, and Jason go to a BBQ for another client. When it is time to head home Joshua starts to walk towards the road and despite staff trying to redirect him to the car he just won't get in the car. Staff try multiple times to get Joshua into the car and Joshua is scratching, trying to bite, and hurt the staff. Staff grab Joshua and force him into the car(not MANDT approved) and tell each other it is "for his own good". When arriving back at the ISL staff agree they will no longer take Joshua out "for his own good."
This is a red flag statement. You are not only forcing Josh into the car in a way that isn't approved by the agency you are saying he doesn't deserve to go into the community anymore because he had a bad outing.
New furniture got purchased with Jason's funds. Jason comes to lay on the couch and staff tell him he is not allowed to lay on the couch until he takes a shower. Jason says he doesn't want to take a shower right now staff continue to not allow Jason to lay on the couch.
This is a rights restriction. The furniture belongs to the client and he is allowed to lay or sit on when he wants.
A staff member is wearing clothes that may not be appropriate for work. You start to discuss this information with other staff members but never bring it up to your direct supervisor.
This is a violation of an expectation set in the home. Starting gossip and continuing it is not a healthy environment for the clients and can cause behaviors for the guys towards staff.
What documentation is required to be completed before you leave the ISL from your shift?
Name at least 6
Intensive, Outcomes, Body Checks, Bed Checks(overnights), Shift Change Checklist (which includes PSA counting, ensuring your staff has completed their documentation, and chromebook is charged or plugged in and present), pharmacy control sheet signed off on properly, back of bubble packs signed properly, MAR documentation completed thoroughly, all receipts uploaded