A. PROVIDE A RESPECTFUL ENVIRONMENT
It is the philosophy of Kokua to provide clients with the most supportive environment possible, physically, socially and emotionally. Keeping in mind that the clients’ homes are their own personal space, clients should feel safe and at liberty to be themselves when in their own home.
B. ENCOURAGE AUTONOMY
Difficult behavior will be at a minimum in an environment that supports and encourages:
- Personal autonomy, including the right to make choices regarding one’s own personal space.
- The right to free expression, including the right to express affection, anger, disappointment, or disagreement with staff or roommates. Free expression also includes the availability of any alternative means needed to communicate, i.e. communication devices or staff trained in facilitated communication.
- Friendships with family and peers and the ever present opportunities to make new friends and community affiliations.
- New learning. All individuals have the ability to learn throughout their life span and should have the opportunity to take measured risks and even to experience failure in the pursuit of learning.
C. POSITIVE BEHAVIOR SUPPORT PLANS
Any time a client consistently exhibits behavior that is seriously troubling to others, does not recognize the rights of roommates, presents a danger to self or others or takes medication for a mental illness or behavior issue, a Functional Assessment of the behavior should be done and Positive Behavior Support Plan should be developed.
The purpose of a Positive Behavior Support Plan is to:
- Identify, in a non-judgmental manner, why the behavior is occurring and what the client may be trying to communicate through the behavior.
- Identify what legitimate needs of the client are not being met. Meeting these needs may eliminate the behavior.
- Examine the environment for factors that may be contributing to the behavior.
- Examine the routine, demeanor and techniques of staff that may be contributing to the behavior.
- Examine the client’s behavior to see if it represents a lack of interpersonal, coping or communication skills. If necessary, develop a plan to teach the client a more effective, socially appropriate way of meeting their need.
- As much as possible, involve the client in the process of developing the Positive Behavior Support Plan.
D. NEGATIVE CONSEQUENCES ARE FORBIDDEN
Kokua staff are not to use “consequences” or “punishments” of any sort in response to the behavior of a client. Kokua staff are also forbidden to withhold any activities from a client in order to gain compliance. Punishment of a client is in violation of DD Policy 5.14 and may result in disciplinary action up to and including termination.
The preferred method of dealing with confrontation is to try to redirect the assailant. If a client is extremely upset, however, he or she may not be receptive to redirection. Be careful not to approach too closely when a client is in a highly emotional state.
If a staff person experiences client behavior that is abusive or assaultive of staff, the staff person should move himself or herself to an area of safety.
F. HANDLING PHYSICAL AGGRESSION
If all methods of redirecting behaviors have failed, and a client has become assaultive to staff or other clients, the following procedures should be implemented:
- Invite the client to leave the common area.
- If the client will not leave the common area, employees and other clients should leave to summon assistance.
- You will call law enforcement authorities and inform them of the client’s choice to be physically aggressive.
- You will use the On-Call Procedure to inform Kokua On-call Staff of the incident.
- An incident report must be filed regarding the entire episode before the end of the shift in which the incident occurred. The incident must also be reflected in the log and progress notes. It is mandatory that these entries be as accurate as possible.