We are all closely watching the number of COVID cases as they spike
across the province and we imagine that many of you are wondering
what that means for CHIRS - our staff and our clients.
Our Senior Management team and the COVID Implementation Committee
continue to monitor the situation daily. If only there was a
magic formula that would tell us that, if the numbers are above or
below a certain point, we should respond a certain way. But
there isn't. So for now we have to base our decisions
on what our health experts are recommending. This week the
Medical Officer of Heath told everyone to once again limit our risk
factors. Based on that and other recommendations and on the
rising numbers over the weekend, we have made the decision to scale
back on some supports and practices and hold steady on others where
we feel we can continue to do so safely.
are the key decisions based on our discussions today:
protocols are changing. Visits will once again be limited
to outdoors only, close to the residence, employing all the safety
protocols that we have been following (socially distanced, outside,
with masks). That means no more visits to family homes or
community outings to restaurants, patios, or indoor public venues
with families or friends. Under very specific circumstances
there may be some exceptions to these restrictions.
community outings will be re-evaluated to assess whether they are
safe and necessary. We are NOT restricting all community
outings because clients cannot be expected to stay in their
residences indefinitely. But we are asking that the frequency
of outings be limited and, in some cases, reduced and that the
location and type of outing be carefully considered for risk, always
seeking the safest options available.
to restaurants and patios and indoor public venues will be
discontinued for the time being. There is a higher
inherent risk in these settings and there are safer alternatives.
We recognize this puts additional pressure on staff to keep clients
engaged in meaningful activity so we will continue to investigate
opportunities to assist with this (e.g., additional recreational
social activity opportunities and perhaps having small cohorted
supports at Head Office for some clients).
Community Outreach Services
supports must be re-evaluated at this time. We are NOT
restricting all in-person supports but we need to constantly be
evaluating the risk and the need and looking for the safest
options. If the risk is high and the need is low, the support
should be discontinued for now. On the other hand, supports
can likely continue where the risk is low and the need is there.
Staff are being asked to work with clients and families to make a
plan and help them prepare for the possibility of another lockdown.
outings to restaurants and patios and indoor public venues will
be discontinued for the time being.
weather stays good, supports will happen outdoors as much as
possible. We live in Canada and we know that winter is coming,
but for now we'll take advantage of the pleasant fall weather, put
on a sweater, and keep supports outside. As for what happens
when it gets cold - for now we don't have an answer. It's
hard to predict where will be next week, let alone in December.
can still be used to take clients to medical and other important
appointments, maintaining all the safety protocols we have already
put in place. However, we will be driving clients in CHIRS'
vehicles only when there is a client NEED to get somewhere and when
staff driving them is the safest option, as we know being with
someone in a car is a higher risk activity.
about Head Office?
If staff can
effectively complete their work from home, they will continue to do
Staff can come
in to Head Office when necessary and we will continue with all the
safety precautions that are currently in place. This includes
restricting the number of people on site on any given day.
well and keep safe. We will get through this!
are so encouraged to see the progress that Ontario and Toronto have
been making in recent weeks in response to the COVID-19 pandemic. There
was 1 case
reported in Toronto the other day, just 1! That is such a relief to
all of us who have been watching those counts on a daily basis. We
thought this might be a good time to give you a bit of an update about
what has been going on here at CHIRS - at a time
when we are feeling some optimism.
have had a few more clients return to their homes at Aldebrain, St.
Georges, and Finch Residence and the staff have done an amazing job of
settle into the new reality. Things don't look quite the way that they
did back in March, when these clients left to stay with family
members. There are new rules, different programming, and even some new
staff. For some clients it's been a bit of an adjustment,
but we are working through it with them. The Behaviour Therapists and
the teams are also conducting intensive community safety assessments as
we start to support clients getting back to community activities such as
going to the bank or the grocery store or
even considering getting a haircut.
Outreach teams have also started to resume in-person supports to
clients living in the community. We have taken a methodical approach to
a client's need for in-person support, the potential risks for our
staff and clients, and opportunities to mitigate the risks. In some
ways, it has been like starting over with service planning. Often the
way we provide support or even the type of support
being requested have changed dramatically. But we are very happy to be
re-engaging face-to-face with our clients (even if it is only the eyes
we can see). In addition to changing the way support is provided, you
will notice that staff will be arriving with
masks and they will be conducting Point of Care Assessments before every visit.
A Point of Care Assessment is a
tool that staff will use each time they visit to assess the risk of
exposure, the type of support needed, and what precautions are needed to
protect themselves and the client.
continue to offer more than 30 ADS programs through Zoom every week and
this has allowed us to stay connected to our clients and to reach new
who weren't able to travel to Head Office for programs. Probably the
number one question we are asked is "when will the Club re-open?"
do not yet have a confirmed date but our plan is to hold steady until
at least the end of September. This will allow Toronto to, hopefully,
have a successful
transition into Stage 3 and will allow us to see the impact of schools
re-opening in September. Even then programs and services will not
operate like they did before the pandemic. We will, however, start
trialing certain in-person activities when it is safe
to do so and where physical distancing can be readily incorporated.
have been returning to Head Office in a limited and staggered way but
it is not the same here without our clients. We are missing you all a
deal. Thank you again for your patience and your support. While we
are seeing some hopeful signs, we will continue to keep client and staff
safety at the forefront of our planning and will move forward with
Staff continue to self-screen before entering a CHIRS site and have
been instructed not come to work if experiencing any of the known
symptoms of COVID-19. Site users must wear surgical masks while in
client units and common areas of a CHIRS site; the mask can be
removed only when an individual is in an enclosed office, by
themselves. Signage has been posted limiting the number of people
using common spaces at any one time. Congregate spaces like the
kitchens will be the last to open up. At the Head Office, we
have instituted a building schedule and are permitting a maximum
number of staff at any one time on each level, with social distancing
protocols still in place.
Management has developed a plan for a staged return based on priority
need for being on site, the premise of which is start small and
increase our bubbles as we go. Each team will provide a
proposed plan for who needs to be on site and when. Senior
Management will review these and make decisions based on a safe
density. As the province opens, we will look at what is
reasonable with respect to finding the right balance between working
on site and from home.
have started the slow process of bringing residential clients back to
their CHIRS homes. We are prioritizing returns based on client
need and family need. We are carefully considering the support
needs of the clients returning and evaluating any potential risks of
bringing them back into the congregate setting.
number of our residential staff are on leaves based on personal
medical concerns or on the provincial emergency order to limit staff
to one employer; we therefore have to consider our capacity to
support each client safely.
are asking clients and families about any potential exposure risks
they may have had while living in the community and are requiring
that clients be tested for COVID-19 and receive a negative result
within 24 hours of returning to the residence.
addition, we are working to support residential clients as they start
to re-access community services. We have developed assessment
and education protocols to support some clients to return to
important community outings, such as banking and elective or
non-urgent medical procedures.
The Community Facilitators have been continuing to provide support to
their clients throughout the pandemic. Wherever possible that
has been remote support over the phone or through Zoom, but many have
also been providing direct, face-to-face essential support based on
the needs of their clients.
are starting to ramp up in-person support. For some clients,
needs may have changed and we may feel that the in-person support is
now essential for some of those clients. But we are also starting to
look at returning to those supports that are important but may not
have met the threshold of essential. Staff are feeling more
confident that the protocols are in place in the community to ensure
their safety as they resume those services. Staff are very
eager to get back to providing the support their clients need.
have developed a needs assessment to help prioritize resumption of
service and a Point-of- Care assessment that staff will use to
evaluate and mitigate potential risks.
Clinical groups are continuing through Zoom. We are offering
Positive Psychology, SUBI (Substance Use and Brain Injury), DBT
(Dialectal Behaviour Therapy) and Mindfulness groups. We have
also launched a new Women's Group.
STOP Clinic will be resuming smoking cessation intervention this
week. Appointments will be provided through Zoom and Nicotine
Replacement Therapy products will be delivered to client's homes.
Day Services continues to provide multiple Zoom programs (over 35 per
week) and are adding new programs and connecting with other agencies
to pool resources. The Club and in-person social
recreation groups will be the last to re-open; we have not yet made
any concrete plans for those services to resume.
are working on a quote to upgrade our phone system to a VOIP system
so that our phone system can more effectively handle our mobile
PPE remains a priority; fortunately, our PPE situation is stable at
this point and we have months of supplies for most items. We have
also been successful in obtaining face shields from the Ministry
supply when we could not source our own at a reasonable price. We
are in discussions with Ontario Health trying to arrange mobile
COVID-19 testing for our staff and clients.
CHIRS has been focusing its resources on client and staff safety. To
date, we have had no confirmed cases of COVID-19 at CHIRS. As the
COVID-19 situation evolves, we modify our safeguards based on often
daily directives from the Ministry of Health in order to stem the
transmission of COVID-19. We monitor our Personal Protective
Equipment (PPE) supplies, update signage and active screening of
clients and staff, and implement isolation and infection prevention
protocols. Here are some highlights...
sites are closed to the public, phone calls coming into the main
CHIRS number continue to be answered remotely by our Reception
person; we have developed new processes for connecting callers to
the appropriate staff and these processes seem to be working very
staff have been enabled to work from home, reducing their possible
exposure to COVID-19 as well as the exposure to their co-workers and
We keep our
staff informed of changes in health directives. For staff that must
come to a CHIRS site, we continue to emphasize the necessity for
social distancing, screening, and good hand hygiene.
instituted active surveillance at all 3 of our sites. When anyone
arrives at any of our 3 sites, they complete a COVID-19 screening,
which includes answering questions to assess symptoms and to assess
potential COVID-19 exposure; staff also take their temperature.
increased the level of disinfection of commonly used surfaces at
help deal with the effects of stress, our clinical team has made
online and in person resources available to help staff maintain
their mental health and eligible staff continue to have access to
resources through the CHIRS benefits provider.
our residential settings...
Some of our
residential clients are staying with family. With fewer clients on
site, we need fewer staff on site... and when we reduce the number
of people on site we limit client and staff exposure.
actively screened every day.
monitored and screened twice per day for symptoms of COVID-19.
a precaution, staff are wearing surgical masks throughout their
shifts, in conjunction with frequent hand washing and the use of
gloves, gowns, and goggles when needed.
is available at all of our sites. We have a good supply and monitor
our inventory daily.
have been very creative and resourceful in helping clients to
understand what is going on and to cope with new routines. Their
creativity has also helped clients be meaningfully occupied during
day service and community activities...
community-based staff have been providing case management services
via telephone and the internet; this has been a great way to help
clients stay connected while limiting their exposure to the virus.
staff have been meeting with clients through virtual means,
including convening virtual groups.
services staff have been safely producing and delivering boxed meals
and food hampers to clients in need. When available, other needed
supplies are added to these hampers - things like cleaning
supplies, toilet paper, and recreational materials.
developed creative virtual programming, some of which is so
successful and appreciated that we plan to continue it after the
pandemic has abated.
Wellness Committee continues to be active in collecting and sharing
resources that support staff to stay physically, mentally,
emotionally, and spiritually well.
Our senior management staff and Board of Directors...
COVID-19 Implementation Team are in contact with each other daily,
responding quickly to new developments and directives.
personnel continues to be in regular contact with staff who are
self-isolating; many of them have already returned to work after
obeying directives for those who returned from travel outside the
country or for those who were not feeling well.
Management team distributes a daily update to staff and the CHIRS
Board of Directors, summarizing the day's key events and
information, as well as resources to support CHIRS staff and their
updates keep staff informed and connected, but they don't allow
for interaction. The response? A CHIRS Town Hall via the ZOOM
meeting platform. We hosted 2 pilots and were so pleased with the
staff involvement that we are planning additional sessions.
The CHIRS Board
of Directors are in regular and close contact with the Executive
Director regarding Ministry directives and other important material;
in additional ways they support the safe and effective functioning
of the organization.
are so encouraged by how well our clients have observed the "stay
at home" protocol; their efforts not only keep them safe, but
contribute to the safety of the wider community.
thank our families for their patience and understanding in
not visiting the residence; we know how difficult that is and how
much restraint must be employed.
We also thank
the families that were able to take their CHIRS client/family member
home; we know that having them there can be a comfort and it helps
our efforts to manage the situation.
received many donations of food supplies for our hampers being
distributed to clients in need and recreation materials for clients
isolating at home, often without access to the Internet. We have
also received monetary donations to support our work. We thank all
of those individuals and businesses; your donations have helped to
make a difficult situation more manageable.
have received so many well wishes and positive feedback from
families and friends of our clients...
CHIRS has been magnificent and I'm so very
grateful. The phone calls are great, and the food basket is eagerly
anticipated and enjoyed thoroughly. Also a great chance to see the
deliverer in person!
My son is responding well to the blitz of support that he is
receiving from you and the other staff. So: THANK YOU!!
CHIRS has been effective in quickly enabling
staff to work remotely with the necessary tools to be productive...
What is amazing is how in such a short period the staff has adapted
to the new world. Not only are staff helping clients adjust and
cope while they are dealing with their own anxiety and facing the
real potential of compromising their own health... CHIRS has been
proactive at recognizing that limiting contact is critical... So many
staff are long time employees and really do know the clients so
understand what will work for each. A priority has been
limiting TV and the negative news loop which raises anxiety...
clients are now doing a daily stretch and relaxation session.
For our family, staff are supporting daily FaceTime calls so that we
can include our pets to entertain our family member... On these
calls I can see he is happy and relaxed and for a guy who doesn't
like to be locked down this is very comforting. We know this
has everything to do with his being in a supportive and understanding
We thank them all for those encouraging words.
We are so very proud of our staff and know that they are doing a
remarkable job...and when we hear those same compliments from others,
it feels very good.
is a link to what the Ontario government is doing to stem the
transmission of COVID-19. You can check there any time for the most
In response to the emerging situation with COVID-19, CHIRS is making some temporary changes to programming:
- The CHIRS Clubhouse is closed until further notice
- All community programs are cancelled until further notice
- Outreach clients can connect with staff by phone instead of in person. If you need medically necessary or essential outreach support, please contact your primary worker to discuss options.
- No new admissions to any CHIRS service
- Residential outings are cancelled, unless medically necessary
- Visits to CHIRS Residences should be avoided. If you need to visit a CHIRS Residence for any reason please contact a Service Coordinator or Manager before doing so
- The Neuropsychology Clinic will be closed until further notice. If you have an Assessment scheduled with the clinic or an appointment scheduled with Dr. Lemsky, Dr. Busse, or Dr. Bolshin someone will be in touch to make a plan.
Over the last few weeks we have been closely monitoring and responding to the situation surrounding COVID-19 and we felt, at this time, it was necessary to enact the next stage of our pandemic plan. We always take Infection and Prevention and hand hygiene very seriously because we want to help keep everyone as healthy as possible. It is apparent that this new virus is spreading quickly and we want to do our part to keep our clients and those in our community healthy and to help slow down the spread of the illness.
Our staff are still available to help you. Please feel free to contact your worker or any CHIRS staff by phone if you need to speak with someone.
This was a difficult decision to make as we did not want to disrupt services to our clients and families but everyone's health and safety is our primary concern and we wanted to act with the utmost precaution.
Thank you for your understanding.
If you would like any additional information please see Public Health Agency of Canada's report "Community-based measures to mitigate the spread of coronavirus disease (COVID-19) in Canada".
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