Home Visitor SAFETY

Washington State Home Visiting

Summit

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Pamela S. Williams

PCHP State Model Lead

Thrive Washington

Early Learning. Every Child. Our Future.

Learning Objectives

1. Participants will learn what safety procedures should be in place of before and during a visit.

2. Participants will learn strategies on how to address their safety concerns.

3. Participants will learn how other agencies handle safety concerns and what policies they have in place.

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Four cornerstones of safety for home visits

Awareness Assessment

Attitude Action

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Cornerstone

Awareness Recognize the value of

taking steps to ensure your health and safety.

Know your agency’s policy for home visit safety.

Be aware of the environment around you, from the weather and the neighborhood, to the client's mood and home environment.

Know when it is mandatory for visiting staff to postpone or immediately leave a visit.

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Self-Awareness Know thyself

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Q: How do I handle the challenges of being a home visitor? I feel like I am taking all the family's problems home

with me. I am worried about getting burned out.

A: If you sense that you are becoming burned out, seek the support of your supervisor. The first step is to

recognize the signs of stress and burnout. Your frustrations, worry, or distress should not get to a level that

interferes with your job or your life outside of work. Try to identify the supports that would help you: informal

peer support to talk openly about the challenges of your work; validation from your supervisor about the work

you do; in-depth consultation on specific issues; access to mental health professionals; or time off to rest and

recuperate from the demands of your job. The more proactive you are in meeting your own needs, the better you

will be able to meet the needs of children and families.

Taken from Home Visitor's Handbook : Head Start Home-Based Program Option

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Q: Some of the homes I visit are in rough and extremely remote neighborhoods. I am afraid to go there. I have been wondering if I am

just not cut out for this work.

Talk with your supervisor about your discomfort and try to determine what you find threatening. Carefully examine exactly what it is that is making you feel uncomfortable, In some cases, your

concern might be about things you witness—drug deals, fist fights, or vandalism.

Perhaps you sense a feeling of vulnerability when you drive long distances on a deserted road after dark. In other cases, your discomfort might be less obvious and rooted in the unfamiliar. If you are

working in diverse communities, it is not unusual to feel some discomfort until you become familiar with the community and culture. Examine your own beliefs and attitudes and educate

yourself about cultural differences.

Ultimately, your safety is your first priority, and it is of equal concern to your program administrators. Identify the things you can do to protect yourself. If your agency does not have a protocol for

dealing with safety issues, your first step might be to approach your supervisor to develop one. For example, perhaps you would feel comfortable if you had a cell phone with you and a telephone

number where your supervisor or other support person was readily available should you need assistance. Or perhaps, in some neighborhoods, home visitors should go on home visits in teams,

never alone. Your local police department might be able to provide crime-prevention training or self-defense classes. The police may also provide additional police protection if they are aware that

you are in the community In addition, you can enlist the families' support in protecting your safety. They often can tell you what you need to know to travel safely in the neighborhood, for example,

what streets to avoid, locations of safer places to park, or the safest time of day to visit.

Taken from Home Visitor's Handbook : Head Start Home-Based Program Option

Setting Boundaries

Boundaries set the tone for the professional relationship. They are important. Spend a few moments thinking about the kinds of boundaries you would set up for both yourself and for your clients.

Important considerations for boundary settings include the following questions:

When you’ve set a limit, how do you maintain that limit?

Do you make exceptions?

In what situations are you willing to bend the rules?

Observation and conversation with peers and supervisors help home visitors define ways to best maintain boundaries. Talk with your supervisor about how best to maintain boundaries.

Awareness

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Cornerstone

Assessment

Evaluate risk factors before, during and immediately after your home visit.

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Car check list

Item Yes

No

Copy of car ownership in glove compartment

Copy of driver’s license in glove compartment or on person

Copy of valid car insurance for business in glove compartment

List of emergency numbers in glove compartment

Gas tank more than half full

Windshield wiper fluid topped off and spare container in trunk

Snow tires on in the winter

Small first aid kit in the trunk

Area maps in the car

Solar or wool blanket in the trunk

Non-perishable food, such as granola bars and water

“Help! Call the police” sign under foot mat in car

Assessment – Prior to visit

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Car check list Assessment - Day of Visit

Item Yes

No

Leave your purse in the car

Ensure items are in your trunk and not visible on your car seat or front dash

Copy of valid car insurance for business in glove compartment

List of emergency numbers in glove compartment

Gas tank more than half full

Windshield wiper fluid topped off and spare container in trunk

Snow tires on in the winter

Small first aid kit in the trunk

Area maps in the car

Solar or wool blanket in the trunk

Non-perishable food, such as granola bars and water

“Help! Call the police” sign under foot mat in car

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Entrance into a home Using this safety assessment form helps to develop and sharpen your "safety lens." This can help you recognize more hazards and the speed at which you can spot them.

Item Yes

No

Visibility of entrance and exit screened by trees, bushes or fences

Building structural y unsound, for instance with loose brick, siding, broken or absent window panes

Clutter, accumulated garbage

Poor lighting for entrance, steps and walkways

Broken, steep, rotting or narrow steps to the building

Inadequate handrails, or lack of handrails, for safe use Of stairs to the home

Ice/snow on walkway and or driveway

Leaves and branches scattered on walkway

Uneven or slippery walkways

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Things to consider

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Animal Hazards

Many people have animals. Some friendly some not so friendly. Its always a good idea to check this when talking to the client on intake or when planning the first home visit.

Watch for clues: If you are unsure if there are animals in the residence look for signs

that may warn you of the presence of an animal.

Be vigilant: These are not your pet's, you have no idea on how they will behave.

Know safety procedures if you are going to be near an unfamiliar animal.

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Communicable Diseases & Health Hazards

Use a common sense approach if you feel there is a health hazard present.

One of the best and easiest methods of preventing the spread of communicable diseases is to wash your hands frequently and thoroughly.

Coming and in and out of homes and being in contact with many families throughout the week increases chance of spread of communicable disease between staff and families.

Helpful Reminders:

Know agency procedures

Hand washing is critical

Know when to protect yourself

Watch for Lice

Airborne & Fluid surface contamination

Assessment

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Drugs & Chemical Hazards

Some signs of drugs or hazardous chemicals in a home are more obvious than others. If you get a feeling that things are not right then trust your instincts to know when to leave or to ask for help.

Know agency procedures

Recognize hazards

Know when to get help or leave

Reporting issues

Assessment

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Washington: Substance Abuse Statistics • Alcohol only 20.9% • Alcohol w/secondary drug 25.9% • Cocaine (smoked) 5.5% • Cocaine (other route) 2.3% • Marijuana 17.0% • Meth 14.5%

Weapons

One can assume that every home may have a weapon of some kind in it. And that every client can access a weapon.

It is important to pay attention to the client for signs that they are becoming more agitated or that a situation is starting to escalate.

It is best to keep the client talking and encourage them to engage you in a discussion to help calm the situation however you should be ready to leave or ask for help if you feel this situation is out of control or the client has crossed over boundaries that you have established.

Assessment

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Do you have set policies for…?

Cars

Entrance into a home

Animal Hazards

Communicable Diseases & Health Hazards

Drugs & Chemical Hazards

Weapons Cars

Entrance into a home

Animal Hazards

Communicable Diseases & Health Hazards

Drugs & Chemical Hazards

Weapons

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Attitude

Everyone has a different attitude about health, safety, parenting, race and culture. Are you aware of your own? If so, do you understand how your attitudes and believes influences what you will notice and how you will react to it?

Health , safety, parenting, race and cultural attitudes can range from not being concerned at all to being excessively concerned about it. If you have a high tolerance for risk or are significantly restricting your activities from constant fear, it is important to actively work toward having a more balanced attitude in this area.

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Cornerstone

Self -Reflection

Self-Awareness and reflection is being familiar with questions about how you respond to these difficult questions related to client interaction.

Understanding yourself will help you set up limits and boundaries for interactions with clients.

Self - awareness is a construct that is a compilation of several concepts with which you are likely quite familiar. These concepts include boundaries and limit setting behavior, communication, feelings, intuition, problem solving skills, and power.

These concepts are not particularly challenging when you are working with a motivated client. However, as you work with difficult or unmotivated clients these concepts become much more challenging.

Attitude

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Leave your stuff at the door

Understanding Limits

Being aware of your own feelings and responses is critical in working with families in difficult circumstances.

We all have situations that trigger responses within ourselves.

It is our responsibility professionally to monitor ourselves closely and work on our own issues sometimes with the help of reflection and reflective supervision.

There will always be situations in which you are more comfortable, but learning to manage the more uncomfortable situations will make you better professionally and personally. This may mean reading books, journaling, or even working with a counselor.

Attitude

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Ask yourself the following questions

How will I feel if a client does not complete program activities?

Is it OK for client to raise their voice at me?

Is it OK for a me to continue with a visit when a client is dealing with domestic violence?

Is it OK for me to continue working with an uncommitted client?

Is it OK for a client to lie to me?

How would I feel having to work with a client whose home is extremely dirty?

How would I feel having to work with a family abusing alcohol or using drugs?

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Cornerstone

Action

Be accountable for your safety. Take charge, before, during and immediately after your home visit. Plan ahead. If you sense a client or the client’s environment is unsafe, remove yourself from the situation and inform your supervisor.

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Before the Visit

Always let someone know where you are going

Review intake form for possible concerns of violence or substance abuse

Mentally rehearse the visit and what you need to accomplish.

Don’t wear excessive jewelry and dress appropriately.

Take your ID with you, but do not wear your ID cord around your neck

Wear comfortable shoes with low or no heels.

Carry a cell phone with you, when possible

Action

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Approaching the House

Be aware of your surroundings.

Park your vehicle in a way that you can make a quick exit, if necessary.

Do not block anyone’s s parking space.

Lock valuables in the trunk of your vehicle.

Action

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During the visit

Be aware of the exits from the home.

If possible, keep yourself between the client and the door.

Sit near an exit or facing the hallway so you can view hall and bedrooms.

Use non-threatening body language and remain calm and polite.

Respect the client’s home and their emotions.

Listen to your instincts and feelings.

Do not touch the family pet.

Be cautious and use common sense.

Leave if you feel threatened or if you notice unlawful or peculiar behavior.

Report your concerns to your supervisor or police when necessary.

Action

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Physical Appearance

Clothing can do several things make a statement about our personality, background and any affiliations we may have.

Those very things can work against us when dressing for safety. Consider the following statements regarding various items of clothing:

Religious or political symbols - cautious wear

Jewelry - avoid flashy jewelry that may make you a target

Long hair - wear it up to prevent it from being used against you

Shoes - should be comfortable and protect the feet.

Ties & Scarves - use clip on ties that cannot present a choking danger

Action

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Just in case

Make sure your vehicle is in good running condition and has enough gas.

When possible, back your vehicle into parking spaces.

Keep a flashlight and a first aid kit in your vehicle.

Don’t reveal too much personal information about yourself or your family. Use first name only except on business cards or signed papers that must be left with the family. Use only business or public phones to prevent identification of personal phones with caller I.D.

Action

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Policies

If you don’t feel safe, what should I do?

Who do you call first, second, or third?

When do you call?

If you are hurt on the job, what do you do?

Can I change my visitation schedule without notifying anyone?

Are the families we serve informed of the agency’s safety policies?

Action

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Sample Protocol

A home visitor is expected to postpone or immediately terminate a visit when they think their health and safety are at risk or when:

You are verbally or physically threatened with violence

You are asked to leave

The client or family member demonstrates signs of alcohol intoxication or drug influence.

You perceive sexual advances

The building or location poses a risk to your health and safety

The client or others present have an airborne transmittable disease, such as influenza

You have an airborne transmittable disease

An animal threatens your safety and the client refuses to contain the animal in another room while you are there

Someone is exhibiting irrational behaviors or questionable mental health

You are exposed to visually threatening or sexual gestures, such as a client answering the door partially clothed , or sent written suggestive material, such as letters or photos

You feel unsafe or threatened

Action

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Emergency Information

Emergency Police (non-emergency) Fire (non-emergency) Supervisor Ambulance Taxi company Towing company Your car's service garage Traffic report station Weather Info. Roadside Assistance

Action

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Information and phone numbers your supervisor should have

Next-of-kin (work telephone #)

Next-of-kin (home telephone )

Your family physician

Other medical Issues, such as diabetes, Medic Alert Bracelet, etc.?

Some phone numbers you should have for the communities you are serving

This presentation was adapted from

BE SAFE: A guide to home visits and off-site activities from Providence Healthcare

http://giic.rgps.on.ca/files/Be%20Safe%20Guide%20to%20Home%20Visits%20from%20Providence%20Healthcare.pdf

Home Visitor's Handbook: For the Head Start Home-Based Program Option

https://eclkc.ohs.acf.hhs.gov/hslc/hs/resources/ECLKC_Bookstore/PDFs/05F613A8CC15D89DAFE1D1568DB0719A.pdf

HOME VISITOR SAFETY: MIECHV Program Training Module

http://healthandwelfare.idaho.gov/Portals/0/Children/HomeVisiting/Home%20Visitor%20Safety%20Training.pdf

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Contact Information

Pamela Williams, M.S.

Parent-Child Home Program

Washington State Model Lead

Thrive Washington

pam@thrivewa.org

p 206.621.5555 | f 206.652.0761

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