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Residents' Handbook

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Care conferences are multidisciplinary meetings held within 6 weeks of admission and annually thereafter to review the Resident’s care plan.

On admission, the RN Supervisor will develop an initial plan of care. Within the first 6 weeks aler the Resident is admitted to Cassellholme, the Resident Services Coordinator will arrange a Care Conference to meet with the family and Resident to evaluate the initial plan of care.

All available information is reviewed at this time, including social history, diagnosis, expectations of the Resident’s family, outside community interests, POA, Advanced Care Directive (ACD) documents and contacts. The care plan is then reviewed and updated.

The Resident Services Coordinator will contact the Resident, family and the interdisciplinary staff to arrange a date and time for each conference.

A Care Conference may be required more frequently depending on Resident needs or as required. Families may also call the Resident Services Coordinator or a member of our registered staff to request a Care Conference. Should you be unable to attend the care conference, a telephone conference can be arranged.

Families are able to request a meeting with the team at any time. They are encouraged to contact someone if they have an issue right away and not wait for their annual meeting. Teleconference, Skype and FaceTime are also available for holding a care conference.

Planning for each Resident’s care is coordinated by the Interdisciplinary Health Care Team. This team is made up of the Resident’s physician, nurses, direct care and behavioural support staff, nutrition & food services, housekeeping, activities, pastoral personnel, therapists and Resident services coordinator.

As members of the Interdisciplinary Team, all staff at Cassellholme are committed to enhancing the quality of life for Residents.

Residents are assessed on a quarterly basis using the Resident Assessment Instrument – Minimum Data Set (RAI- MDS 2.0). If there is a significant change in care or hospitalization, Residents will be reassessed more frequently.

Resident health cards should be kept at Cassellholme at the Nursing Station, so that in the event a Resident has to go to the hospital or to an appointment, the card can be sent with the Resident. Change of address, lost, damaged, and expired cards will be maintained by Cassellholme staff.

Cassellholme maintains a qualified, organized program of nursing and personal support services for the home to meet the assessed needs of the Residents.

Nursing and personal support services staff are available 24 hours a day, 7 days a week.

Personal Support Workers (PSW’s) provide services to assist with the activities of daily living, including personal hygiene services, and includes supervision in carrying out those activities.

Registered Practical Nurses (R.P.N.’s) are responsible for the administration of prescribed medications, treatments and other professional nursing duties, within their scope of practice.

Registered Nurse (R.N.) Supervisors are responsible to carry out other professional nursing duties, within their scope of practice. At least one registered nurse is on duty and present in the home at all times. Any visitor or Resident may request, through any staff, to meet with the R.N.

The nursing staff work closely with North Bay’s medical community. Residents have the option of retaining their own family physician, if the physician has a contract with Cassellholme, or will have the Home’s Medical Director assume responsibility for medical care and treatment.

All medications must be ordered by a doctor and filled by staff from our contracted, accredited pharmacy. Only Registered Nurses and Registered Practical Nurses will administer medications.

Medications cannot be kept at the bedside.

All medications brought in by a Resident at the time of admission will be reconciled by the nurse and orders obtained from the Medical Director or the Resident’s physician.

Medications brought into Cassellholme will be returned back to the family for disposal. Medications will be re-ordered by the registered staff from the pharmacy.

Any supplements or herbal remedies will be re-ordered only at the discretion of the Medical Director and must be supplied by the pharmacy. Any medications brought into the home by the Resident or family will not be administered.

Residents/family/POA will incur all costs associated with ordering and receiving supplemental medications and/or herbal remedies, or medications not covered by ODB. Pharmacy will notify Residents/POA of all associated costs.

Staff will inform Residents/family/POA of when a new doctor’s order is received. The Resident/ family/POA will have the right to consent or refuse consent to start the new order. The Resident is responsible for any harm, damage or injury to himself/herself or others occurring as a result of the Resident refusing medication, treatments or other medical orders including the use of restraints.

Information can be requested from the pharmacy concerning risks and benefits of any medication prescribed.

Use of the alcohol-based hand sanitizer is strongly encouraged on entry and exit of the building. Sanitizer units are located at the elevators, Nursing Stations, hallways, Resident rooms and at the main entrance. Residents who feel unwell are asked to inform the nurse immediately.

In an effort to control the spread of infection and protect the health of our Residents, if a visitor is feeling sick, we ask that he or she reschedule their visit. If there are a number of Residents who are ill, Cassellholme works with the North Bay Parry Sound District Health Unit and takes appropriate actions to reduce the spread of infection. An illness “Outbreak” may be declared. This may require the cancellation of home-wide activities and restrictions on visiting.

Notices of the presence of certain infections will be posted on all entrance doors, Cassellholme’s Website and a recorded announcement when calling Cassellholme to inform visitors of illness outbreaks and restrictions on visiting.

All Residents, family and visitors are expected to be cooperative with the recommended changes during outbreaks. Changes are put in place to prevent the spread of disease.

When a Resident becomes ill (eg. cold, influenza, diarrhea, vomiting, shingles, or any other illness that can be transmitted), additional precautions (also known as isolation) are put in place. Signage will be posted on the door of the Resident’s room, along with gloves, gowns, masks and goggles.

Visitors should check with the nursing staff before entering the room to ensure they understand what precautions are required. It is expected that Residents and visitors cooperate with the additional precautions to prevent the transmission of infection.

In order to protect Residents from infections, staff are trained to follow the 4 moments of hand hygiene. We encourage Residents and visitors to do the same.

Immunizations such as flu shots (Influenza Vaccine) and pneumonia shots (Pneumovax) are offered to Residents. Residents, family and friends are strongly encouraged to get an annual flu shot.

Cassellholme has a limited supply of wheelchairs, walkers and geriatric chairs for short-term use only.

Cassellholme walkers, wheelchairs and geriatric chairs are loaned to Residents, under the following circumstances:

    1. On a trial basis, so the Resident may try the equipment prior to purchase
    2. As a loaner, to be used when the Resident’s own equipment is being repaired
    3. As a trainer, when the equipment has been identified as being needed for only a short period of time

Because of the different sizes and options available in walkers and chairs, a specifically prescribed assistive device is best for the Resident’s comfort. Residents who need equipment for long-term use are required to be assessed and purchase their own equipment, chair or walker specifically designed for them. The assessment is arranged by Cassellholme’s registered staff and done by an occupational therapist, through CCAC.

When Residents require equipment such as wheelchairs or specialized seating, the contract  for services is between the Resident and this company.

The Ontario Assistive Devices Program is currently available to help those who qualify, with the purchase of equipment. In order to utilize this program, an assessment by a physiotherapist / occupational therapist is required and additional charges may apply to the Resident.

If a Resident’s equipment requires repair, this can be arranged through Cassellholme staff. The repair will be completed by an outside provider at the expense of the Resident.

Physiotherapy helps strengthen muscles, keep joints flexible and maintain well-being. Exercises such as walking, range of motion, weight training and balance exercises can help to enhance quality of life.

All Residents receive an assessment upon admission to determine if physiotherapy is required. Referrals can be made to the physiotherapist, CCAC occupational therapist or CCAC speech & swallowing therapist if there is a significant change in a Resident’s condition.

The Home provides physiotherapy services through a Physio Provider at no charge to Residents.

A Nursing Rehab/Restorative Nurse works with external and internal health care providers to develop individual rehab therapy programs for Residents who have had a significant change in their condition. The clinical services staff will receive a specific nursing rehab care plan and will deliver the rehab as directed.

A Falls Prevention Program actively monitors Residents who are identified as having a history of falls. Care plans for these Residents include specific interventions to reduce falls and a specific nursing restorative and/or physiotherapy program for qualifying Residents.

Every new Resident has a foot care assessment done when they arrive. Basic foot care then becomes part of their routine on bath days, as required. This includes simple measures like: looking for any changes, infection, injury or other problems, plus gentle care of the skin and nails.

Diabetic Residents are encouraged to have an advanced foot care provider, such as a chiropodist, podiatrist or a qualified registered nurse. There is usually a fee for this service. The Resident, or their Power of Attorney [POA] must book the care and pay the provider directly. Payments can't be made from the Resident Trust Account.

Call 705-474-4250 for more information - Associate Director of Care [ext. 232] or Director of Care [ext. 243].


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