Safety
Can you conduct an in-home visit with a minor without the presence of another non-staff adult?
No. Must have non-staff adult present during home visitation. AND Must inform service partners/family of this PRIOR to first home visit so non-staff adult will be present.
What are items to review with SP and/or guardian to plan the in-home meeting?
Determine date & time of visit.
Determine duration of visit: What are the issues to be addressed or action steps to be completed?
Have the attendees or participant(s) to be included in the meeting been discussed and agreed upon? Any specifics on who shouldn’t be in attendance (i.e., friends, or other non-essential persons)? If so, is the client or their representative aware of any restrictions prior to arrival?
Has the client been informed and agreed to comply with any requirements regarding the visit?
Have you conducted a pre-assessment to determine risk/safety factors?
Have you conducted location research with the client?
Any other stated or conveyed requirements for the client to be aware of (pets secured, private meeting space for confidentiality, etc)?
Should we wear SDYS logos to a home visit?
Staff/volunteers should not wear clothing with an SDYS logo, or their SDYS ID badge, to the home visit.
What are home visits and why are home visits important?
Home visitation is a model of service delivery in which clinicians, case managers and/or volunteers enter the home of a Service Partner to provide home-based therapy, behavioral support, intake and assessment, or other services as defined by the Program. Home visitation does not include transporting a Service Partner to or from a home, or providing services to a Service Partner in a non-residential community setting.
Trauma informed to meet a client where they are at
Learn significant information about a client and their family (environmental observations)
Ability to practice cultural competency to displace respect and dignity for family
How do you transport information to and from SDYS site and the SP's home?
Transportation of Protected Health Information (PHI) and any personally identifiable information (PII) should be limited to what is necessary for the home visit. All PHI/PII should be transported in a lock box and returned to the program office as soon as possible after the conclusion of the visit. PHI/PII should not be taken home by staff or volunteers unless special approval is granted by the Program Manager and/or Director of Services on a case by case basis.
What should you do if you get to an assessment and the minor is without a non-staff adult?
If there are no non-staff adults present or available during the scheduled home visit, SDYS Staff/volunteers should ensure the safety of the Service Partner and conduct the visit outside of the home, or, with consent from a parent/guardian, transport to a community location in public view.
If there are no non-staff adults present and SDYS Staff or volunteers are concerned about safety and/or boundary violation, staff/volunteers should contact their Program Manager and/or Clinical Supervisor to consult regarding appropriate steps to address the safety concern. Safety concerns and related consultation should always be documented in progress or collateral notes.
What are some risk factors to assess for in a pre-assessment safety meeting (prior to scheduling meeting)?
Assess possible risk factors pertaining to the Service Partner and members of the household, including: history of violence, substance use, severity of mental illness, probation/parole, pets in the home, feeling safe in home/neighborhood, place to park. If any concerns arise, speak with program manager before scheduling meeting.
What are some car safety tips for an in-home visit?
Drive around the block before parking to be aware of your surroundings. When possible, do not park directly in front of the home, to protect your car and self from being a target for vandalism or other risk factors.
Staff/volunteers should have their car keys out and available when coming to and from the home.
What should you be paying attention to during a home visit?
Surroundings: exits, where you are in relation to the exit, doors, dangerous items in view, animal care, safety concerns (poor house keeping or excessive debris-hoarding, or physical disrepair-exposed electrical wire, flooring, stairs, visible water damage)
Time: how much time has elapsed and do you need to inform supervisor that session is running late
How should you maintain safety on the way back to your vehicle?
Situate yourself and any materials you have to keep one or both hands free while walking back to your vehicle. Have any emergency equipment accessible while in transit. Before leaving the location, do a brief visual observation along your route of egress. If possible, observe the path to your vehicle to observe existing conditions and surroundings. Are any unknown persons loitering nearby? Have weather conditions changed? Has ambient lighting changed? Once you have ascertained that conditions are acceptable, proceed to your vehicle.
Do you need another non-staff adult present with meeting in-home with an adult (18+)?
No
When discussing where their home is located, what are some important questions to ask?
Type of location (residential/commercial); single family residence, multi-unit (apartment/condo); mobile or manufactured home.
Security (controlled access to units and/or parking area, camera surveillance, guard or patrol service or security illumination).
Is the client location visible from the street?
Changes in elevation between street and visitation site (stairs, steps, elevators, ramps).
Is the visitation location in a known “high crime” neighborhood?
Estimated distance to travel from parking location to visitation site. Are there multiple routes to access visitation site? Does the route include any egress through closed or covered areas with limited or minimal visibility?
Are there any significant safety concerns along the path of egress to the visitation location (cracked or buckled walkways or pavement, standing water, missing or damaged handrails or other conditions that inhibit pedestrian access or egress.
What do you do if you arrive to the home and go to text the program manager and realize you have no cell phone service?
Always ensure that you have a charged cell phone available and accessible throughout the visit. If you do not have cell phone service, drive to a location where it is safe to communicate this to your Program Manager and/or Clinical Supervisor.
What are some boundaries to maintain during the home visit?
If, upon arrival or at any time during the home visit, staff or volunteers continue to have significant safety concerns, they are encouraged to “trust their gut” and reschedule the time or location of the meeting. Staff/volunteers are permitted to leave a home visit if they are concerned for their personal safety.
When possible, try to conduct activities during the meeting in open area with direct access to exit points and maintain a vantage point so you can see who enters or exits the area during the course of the meeting.
Maintain all possessions and materials with you at all times
Maintaining appropriate distance between self and Service Partner, leaving bedroom doors open during private conversations, etc. Do not complete a home visit with someone who is inappropriately dressed or making sexual innuendos or advances. Do not complete a home visit with someone who is under the influence of drugs or alcohol.
What do you do if you feel like you are being followed?
If, upon leaving the home visit, you feel you are being followed, call the police and drive to the nearest police station, or the parking lot of a well-lit open business. Do not exit the vehicle until it is safe to do so.
What do you do if you and program manager determine that a home visit is not appropriate with a certain SP?
If it is determined that a home visit is not appropriate for a particular non-minor Service Partner, SDYS Staff/volunteers should work with their Program Manager and the Service Partner to determine whether another coworker should be present or an alternative meeting location should be utilized, such as the SDYS office or a public setting.
When planning a home visit with a program manager, what types of things would need to be agreed upon before scheduling a session?
Confirm how you will communicate your arrival, departure, and any safety concerns.
Communicate expected length of appointment
Communicate address of home visit
If staff does not contact PM within 15 minutes of expected arrival or departure, PM should attempt to contact staff/volunteer. If they are unable to reach them, then staff/volunteer’s emergency contact.
If you have done your safety/location assessment, are there concerns about the home visit?
Who do you contact when you arrive to the SP's home?
If possible, contact the client by phone to alert them to your arrival and confirm that all appropriate attendees are available and that any pre-conditions have been met.
If conditions appear to acceptable and you are ready to make your approach, text message or call your supervisor to record and transmit arrival time.
What are some cultural considerations of home visits?
Service Partners and their families may attempt to include you in natural family rhythms while you are present in the home, including drinks, snacks and meals. Staff/volunteers should consult with Program Managers and/or Clinical Supervisors regarding this special circumstance in advance of home visits and should only consider participation in meal time when not doing so would be culturally disrespectful and damaging to the therapeutic relationship.
Are we allowed to leave a home visit at any time?
In the event that the home visit becomes unsafe due to Service Partner, family or collateral intent to physically harm staff/volunteer, SDYS staff/volunteer should exit the home as soon as possible and immediately inform their Program Manager and Clinical Supervisor, following all safety protocol.
When do you first assess for safety and/or boundary concerns?
Before the meeting
How will the program manager know details about a home visit?
Which is a more safe approach when a staff is approaching a SP's home?
A. Staff is carrying lockbox in one hand, their coffee in the other hand, have their bag over their shoulder, cell phone in their bag, and keys in their back pocket.
B. Staff carrying bag and lockbox over one shoulder. Phone phone and keys are in their right hand. Coffee is left in the car.
Organize and condense all materials that can be carried on one hand or on a shoulder strap to free both hands.
Carry any emergency items (cell phone, whistle, keys or fob, small flash light) in an accessible pocket for quick and easy access.
Depending on weather conditions, time of day, make sure to don any protective gear before leaving your vehicle.
Step carefully if using stairs, test handrails to make sure they’re secure.
What are steps to take when you arrive at the front door?
Confirm the location at the door and that the anticipated attendees are present.
Confirm that agreed upon conditions have been complied with.
This would be a good time to use an agreed method (sending confirmation text or similar action) that you are at the site and beginning the meeting. Convey your estimation of time needed to complete the visit to your contact. These actions will convey that you are in touch with peers.
What do you do in the event of a crisis during a home visit? What about a life-threating emergency?
In the event of a crisis situation during a home visit (i.e. Service Partner/family expresses suicidal or homicidal ideation, or Service Partner/family become emotionally dysregulated), SDYS staff/volunteers should use Crisis Intervention training to attempt to de-escalate the situation and provide support to the Service Partner and/or their family.
In the event of a life-threatening emergency, SDYS Staff/volunteers should initiate contact to 9-1-1 and request PERT; if PERT is not available, staff/volunteers should request a PERT-trained officer, then immediately consult with their Program Manager and/or Clinical Supervisor. SDYS staff/volunteers should follow Program Manager and Clinical Supervisor direction regarding next steps, which may include safety planning, awaiting arrival of emergency services, or leaving the home. SDYS staff and volunteers should NEVER use physical restraints on a Service Partner or their family.
All crisis or emergency situations that arise during home visitation should be documented in progress or collateral notes and should be addressed during Treatment Team meetings.