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1. Remark 1 2 Remark 2 2 May choose more than one items as applicable BRO DAA SNA Post Held HX 1Z HM RN HE Qualification f 1 Educational Level 2 Special Training 3 Other Training EN 5 HW REAL ZAE FERNER PAIR CW a OT an Al HER ZH B1 gE C SESS PT Y DT 228 A2 VE B2 Sac SW ae AW DER A3 4 B3 MAREAS A4 15 B4 HEEE AW may include a cook domestic servant driver AS BLAS SPL EM BS HIER gardener watchman welfare work or clerk BAL fir see B6 Sa A E B7 TRATH ATE WITFERXE Et SUR AUB Remark 3 74 Total weekly working hours of every staff should be reported for checking compliance with the licensing requirement Information of relief staff should not be recorded on this Staff Employment Record LEIA FA HLT PE gt DEA EE I A FERFERNINER gt BEAT gt AH CE ek le ack gt 1 Please copy front page for insufficient spacing Each page should be signed together with agency chop SUE ATE AR gt cA ATE ERR BS it ERED gt 2 An operator shall inform the Director in writing within 14 days of any change in the employment of a home manager Aut EES UA EE
2. Abdomen Urogenital E ARREA Skin RE please specify name of disease if any and if there is condition like bedsore etc CUESTA gt AAA ER Foot Ex Eye HERA please specify name of disease if any e g cataract MUERE gt AAA CUA AS Ear Fh Others Ef Annex 11 5 2 Code of Practice for Residential Care Homes Elderly Persons Part IV Functional Assessment Please tick where appropriate GUD FREBSENEE ALABAMA DE Vision with without normal unable to read unable to see lights only HH corrective E newspaper print watch TV devices AN ESN ARA El AREA ER FE un DBEST Hearing with without normal difficult to difficult to cannot m hearing aid IE communicate with communicat
3. Code of Practice for Residential Care Homes Elderly Persons Annex 82 Template Name of Residential Care Home for the Elderly Staff Duty Roster month year Name Post Daily No of 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Working Daily Hours Working Hours Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon e g XXX Ancillary 7am 7pm 12 worker Remarks Y On duty O On leave S Sick leave N Night shift For change of working hours or half day leave please specify in the box es as appropriate Annex 8 2 1 Code of Practice for Residential Care Homes Elderly Persons Annex 8 3 Template Name of Residential Care Home for the Elderly Staff Attendance Record Date day month year On duty Staff Off duty Staff Name Post Remarks time signature time signature E Staff on duty at night should fill in the off duty time on the following day Please specify the following conditions in Remarks 1 The staff is a relief staff 2 The staff is required to work outside the home during on duty hours please specify time location work nature and name of resident concerned if applicable Certified and signed by Home Manager Name o
4. Annex 8 5 1 Code of Practice for Residential Care Homes Elderly Persons Name HKID No Condition of resident after treatment Hospitalised name of hospital _ Not applicable Follow up action including the case and systematic enhancement measures Note For residents who have fallen particularly when head injuries are suspected or obvious injuries and unstable mental state are observed they must be given medical care or sent to the hospital immediately Signature of informant Name Post Date Please put a V in the appropriate box and delete as appropriate Annex 8 5 2 Code of Practice for Residential Care Homes Elderly Persons Annex 8 6 Significant Incident Report To be submitted to LORCHE within three days From name Name of Contact of RCHE responsible person telephone no To Inspector Licensing Office of Residential Care Homes for the Elderly LORCHE of Social Welfare Department Fax no 2574 4176 3106 3058 Hotline 2961 7211 2834 7414 Date of incident Date telephone report made Type of special incident please V as appropriate and provide relevant information of the incident on the supplementary sheet or submit a customised report with relevant information together with this form to facilitate follow up action and statistical consolidation by LORCHE 1 Incident of unusual death severe accident resulting in death of resident 1 1
5. n RCHEs must keep the information of drugs of the residents that passed to community pharmacies including the drugs name dosage formulation the number of pills and the frequency of medication Keep the samples or photos of the drugs as far as possible to facilitate the checking of blistered drugs returned by community pharmacies Updated drug records of the residents should also be kept properly Check the drugs carefully during each handing over of drugs 0 No matter in whatever signature format RCHEs must be able to immediately provide accurate and unchangeable records of drug preparation and distribution which include the signatures of staff responsible for preparing checking and distributing drugs for checking by inspectors during the inspection RCHEs are also responsible for keeping the past drug records of the residents for reference Licensing Office of Residential Care Homes for the Elderly Social Welfare Department Formulated in October 2010 Revised in November 2012 By the Working Group on Drug Safety in RCHEs Annex 11 1 4 Code of Practice for Residential Care Homes Elderly Persons I ID ID Annex 11 2 Template Confirmation Letter Request for Patent Non prescription Drugs Resident s Name Date of Birth Sex Information of the requested patent non prescription drugs Route of Drug Name Source Purpose of treat Administration 1 2 3 Resident s Confirmation I
6. Should protect the resident s privacy throughout the task Expose the resident s body as little as possible and keep him her in a comfortable posture Talk to the resident at bath time keep a caring attitude and be considerate Check the water temperature before starting to bathe Check and assess the body and skin condition of the resident Be aware of any change on the resident s body If the resident is feeling unwell stop bathing immediately Fold the towel into a towel mitten Apply soap lotion or soap to the towel mitten and gently rub and clean the body Rinse well with clear water and pat the area dry with a towel Clean the eyes face neck arms and hands chest abdomen legs feet back hip and the private area at last Apply skin lotion to dry areas for protecting and moisturising the skin Dress the resident Aftercare work Help the resident to lie flat in a comfortable position Gather and clean all the supplies before putting them back in the original position Wash your hands after the task Record report and follow up on any abnormality found during the task Washing Hair in Bed Preparations and aftercare work Same as those for Bed Bath Steps for washing hair in bed Identify the resident Introduce yourself to the resident and tell him her that you are going to help him her to wash hair in bed If necessary give time for the resident to empty the bowels or bladder so that he she will fe
7. month year Leaving Class Form Degree Achieved month year Completed copies to beattached k Training on care for the elderly attended Name of Course s Date of Enrolment Date of Completion Official Certificate Achieved Annex 10 1 2 Code of Practice for Residential Care Homes Elderly Persons Restricted Personal Data 1 Details of working experience in residential care homes for the elderly Name of Home s Post Held Date of Date of Leaving Commencement month year month year 3 I attach herewith the following documents to this application a photocopy of my Hong Kong Identity Card b one recent full face photograph with my name written on the back for producing the certificate and should be the same as that affixed above c photocopies of certificate and or testimonial of educational attainment and completion of Health Worker Training Course 4 The contents of this application are true and complete to the best of my knowledge and belief Signature of applicant Date Annex 10 1 3 Code of Practice for Residential Care Homes Elderly Persons C 1 Annex 11 1 Working Guidelines for Residential Care Homes for the Elderly Days in advance Drug Pre packing System Introduction Residential care homes for the elderly RCHEs must formulate and carry out appropriate safety measures before adopting the Days in advance Drug Pr
8. Template revised in 2010 1 Has abnormal mental condition and or abnormal behaviour injuring disturbing others please specify 2 Unable to maintain a proper seating posture weak in back and loin muscles hemiplegia 3 Risk of fall unsteady gait unsteady sitting posture fall during hospitalisation under the influence of drugs confusion wandering self injuring behaviour please specify joint degeneration visual hearing impairment other risks of fall please specify other reasons for being unable to maintain a proper seating posture please specify 4 Resident has history of taking out his her medical devices taking off his her personal items feeding tube gastric tube urinary drainage catheter oxygen tubing or mask colostomy bag diaper or clothes others please specify II Assessment 1 The RCHE has tried other possible alternatives which suit the needs of the resident please refer to paragraph 11 7 2 of the Code of Practice for Residential Care Homes
9. Collapse _ Increased heart beat _ Severe chest pain _ Others _ Not applicable Unsafe behaviour of resident _ Unsafe movement _ Did not use proper aids _ Did not seek help __ Others _ Not applicable Environmental Personal factors _ Slippery uneven floor _ Insufficient lighting _ Movement of furniture e g unlocked wheelchair commode chair _ Obstruction of articles _ Length of trousers being too long _ Problem of shoes _ Clashed by others _ Others _ Not applicable Details Follow up action of the accident Date of follow up action Time Check Vital signs Blood pressure mmHg Pulse min Breaths min Body temperature Level of consciousness Alert _ Confused _ Unconscious Limb movement _ Normal _ Abnormal _ Lefthand _ Righthand _ Leftleg _ Rightleg Details Injury _ No skin damage _ Skin damage _ Bruises location _ Fracture location _ Others Immediate treatment _ Wound dressing _ Others _ Not applicable Medical arrangement _ Visit by medical practitioner _ Out patient clinic _ Accident amp Emergency Department _ Not applicable Ambulance Time of calling an ambulance Time of arrival Time of departure Name of hospital to which the resident is conveyed Informing family members relatives para 8 6 2 f of the Code of Practice Time Name His her relationship with the resident Name of informing staff Post
10. staff members should pay attention to the food and other things brought in by visitors and follow the working guidelines as follows D Handling of Food Brought in 1 The home manager should provide family members of every new resident with a copy of the Notice to Visitors on Bringing in Food and explain the details to them If visitors are found bringing in food for residents they should be advised to ask the nurse health worker on duty first to decide whether the food is suitable for the residents If the visitor wants to share the food he she brings in with other residents give the food to the nurse health worker on duty for processing before arranging to share with other residents If the food brought in by the visitor cannot be arranged for consumption by the resident immediately give the food to the nurse health worker on duty for proper storage to ensure good hygiene and freshness The nurse health worker should assess if the food brought in is suitable for the resident before arranging for consumption If the food is not suitable for the resident the nurse health worker should explain it to the visitor or resident and advise the visitor to take it away after the visit For residents with special dietary needs a tag for special dietary care can be displayed at the prominent area around their beds to indicate their special care needs Food brought in by visitors should be checked and properly handled by the nurs
11. surname first Chinese HKIC No 11 Mr Miss Ms English surname first Chinese HKIC No iv Mr Miss Ms English surname first Chinese HKIC No continue on a separate sheet if necessary For completion if the operator is a corporate body i Name of the company English 11 Name of the company Chinese Annex 3 1 4 Code of Practice for Residential Care Homes Elderly Persons Section IV Particulars of the Non governmental Organisation for completion if the RCHE is a subvented or self financing non profit making establishment 1 Name of the organisation English 2 Name of the organisation Chinese Section V A For Completion if the Applicant is an Individual see Note a 1 Full name of the applicant English must be the same as shown on HKIC Mr Miss Ms Surname first 2 Full name of the applicant Chinese must be the same as shown on HKIC 3 HKIC No 4 Residential address Flat Room Floor Block Name of Building Number and Name of Street Estate District Hong Kong Kowloon New Territories 5 Correspondence address if different from d Flat Room Floor Block Name of Building Number and Name of Street Estate District Hong Kong Kowloon New Territories 6 I select the residential adddress correspondence address as the address to be shown on the Licence Item 3 b of the Licence refers please tick as appropriate
12. the back should remain tilted against the surface at 30 degrees Support the back and protect the knee with a pillow Pressure relieving products e g pressure relief or ripple bed ankle and heel protector pressure relief cushion etc can be used to protect localised parts under pressure When sitting place the feet on foot rests for support Pressure relief cushions may be used as appropriate but round cushions with a hollow centre such as doughnut shaped cushions should not be used Keep proper records of changing positions for residents in accordance with the requirements set out in paragraph 11 2 1 d of Chapter 11 Avoidance of Shearing and Frictional Forces 2 1 2 2 A proper sitting posture should be maintained to prevent sliding While a resident is in a semi reclining position the tilt angle of the bed should not exceed 30 degrees Annex 11 12 3 Code of Practice for Residential Care Homes Elderly Persons updated in September 2014 2 3 In moving a resident including changing his her position sufficient manpower should be arranged for transfer and lifting with proper skills and use ancillary tools as necessary to reduce the shearing and frictional forces 2 4 Keep the clothing and bed linen of the residents flat and wrinkle free and remove any debris from the bed Ankle and heel protectors may also be used Skin Care and Incontinence Management 3 1 Avoid massaging areas over bony prominence
13. www swd gov hk Home gt Public Services gt Family and Child Welfare gt List of Services gt Services for Prevention and Handling of Elder Abuse gt Procedural Guidelines for Handling Elder Abuse Cases Revised August 2006 Annex 8 9 1 Code of Practice for Residential Care Homes Elderly Persons Annex 8 10 Handling of Personal Data Residential care homes for the elderly RCHEs must comply with the requirements of the Personal Data Privacy Ordinance Cap 486 the Ordinance when handling personal data of staff residents and other persons The Privacy Commissioner for Personal Data PCPD issues codes of practice guidelines and information leaflets on handling of personal data based on the requirements of the Ordinance from time to time relevant information can be downloaded from PCPD s website http www pcpd org hk _ RCHEs should comply with the guidelines for protection of personal data privacy Some of the good practices for handling personal data are listed as follows for reference by RCHEs 1 post the Personal Data Collection Statement at prominent locations for reference by the data subject and the provider 2 check and update personal data regularly with the data subject provider 3 set a retention period of personal data and dispose of the data based on the period 4 review the procedures regularly to ensure that personal data are kept properly 5 provide the staff with regular training
14. 7 Telephone No Residence Office 8 Position held by the applicant in the RCHE if applicable Annex 3 1 5 Code of Practice for Residential Care Homes Elderly Persons Section V B For Completion if the Applicant is a Corporate Body Non governmental Organisation 1 Name of the company non governmental organisation English 2 Name of the company non governmental organisation Chinese 3 Business Registration Number if applicable 4 Certificate of Incorporation Number if applicable 5 Address of the company non governmental organisation Flat Room Floor Block Name of Building Number and Name of Street Estate District Hong Kong Kowloon New Territories 6 Telephone number 7 Name of the responsible person of the company non governmental organisation Mr Miss Ms English surname first Chinese 8 Position of the responsible person held in the company non governmental organisation Section VI Declaration of applicant representative of applicant I declare that a the information I have given on this application form is true and correct to the best of my knowledge and belief and b the operation keeping management or other control measures of the RCHE referred to in Section II above are under my continuous and personal supervision Signature of applicant Date representative of applicant Company Organisation chop if applicable Please
15. Elderly Persons N Date of Results of Assessment Remar Other Attempted Alternatives Please put a tick in the appropriate box E N Effective Ineffective ks Seeking medical advice to find out any possible cause leading to emotional problem or confusion and handling the situation accordingly Discussed with medical practitioners if there is a need to adjust medications Requesting visits and assistance from family members Requesting assessment and seeking advice from clinical psychologists physiotherapists occupational therapists social workers Using appropriate chair cushion or other accessories Improving the environment and furniture to provide a safe comfort and familiar living environment Providing leisure and diversionary activities Talking to the resident more often to build a harmonious and mutual trust relationship Regular observation and inspection by nursing staff Adjusting the daily care and toileting arrangement to meet special needs of the resident Others please specify a b 2 Proposed Type of Restraints safety vests seat belts soft ties soft cloth gloves mittens wrist restraints non slippery trousers non slippery stripes others please specify 3 Restraints will be applied to the resident under the following conditions sitting on the chair lying down on the bed sitting on the chair and lying down on the bed 4 Proposed Period of
16. Resident s name have requested Name of the Residential Care Home for the Elderly this RCHE to give the said drugs to me Any adverse effects which may cause will be at my own risk Resident s signature Date This column can be left blank if the resident is not able to sign due to cognitive impairment Confirmation by the Resident s Family Member Guarantor I Name am a family member guarantor of Resident s name I have requested this RCHE to give the aforementioned drugs to the said resident Any adverse effects which may cause will be at my own risk Signature Date Relationship with the resident Annex 11 2 1 Code of Practice for Residential Care Homes Elderly Persons IV Confirmation by the RCHE Concerned In response to the request made by the said resident and or his her family member guarantor to this RCHE for giving patent non prescription drugs to the said resident our nursing health care staff have reminded the said resident and or his her family member guarantor of the potential adverse effects of the drugs and have also consulted a registered medical practitioner Name of Hospital clinic who has not objected confirmed that the drugs can be taken by the said resident Signature of Signature of nurse supervisor health worker Name of Name of nurse supervisor health worker Date Date Remarks A If the said resident suffers from any adverse effects
17. S a Name Company in English Name Company in Chinese Hr AAA GOL EA AAA COL b Address Str 4 The person company named in paragraph 3 above is authorized to operate keep manage or otherwise have control of a residential care home of the following type BIS A E Aa ERS N BE EHER DCE IT Fi BEINE 5 This licence is valid for months effective from the date of issue to cover the period from to inclusive ARRE AE Ie ARA WH gt E S IE HEMA TAN gt 6 This licence is issued subject to the following conditions ARRA TIRA 1 7 This licence may be cancelled or suspended in exercise of the powers vested in me under Section 10 of the Residential Care Homes Elderly Persons Ordinance in the event of a breach of or a failure to perform any of the conditions set out in paragraph 6 above EA 226 Bote SAREE TI ERRADA gt RATE ZERRI SR LORRI TAAIE gt BEE a AR Date HH Director of Social Welfare Hong Kong Special Administrative Region DERIO AER WARNING E Licensing of a residential care home does not release the operator or any other person from compliance with any requirement of the Buildings Ordinance C
18. Unused drugs of individual residents have been removed from that resident s medicine drawer or drug storage compartment Drugs pending disposal have been kept separately 2 Observation of the Environment for Drug Preparation a b Lighting is adequate The environment for drug preparation is quiet and free from disturbance Annex 11 4 1 Al ada u a Ve al ar al Da a a dEl da E ao AEREO DOS Z o HE E Er aia a dal AAA Code of Practice for Residential Care Homes Elderly Persons c d Desktop is clean and tidy with sufficient space for placing necessary articles Workbench is at appropriate height 3 Checking the Tools for Drug Preparation and Distribution a b c d e f g Mortar and pestle are not made of wood or stone should be made of porcelain Medicine cups and boxes and tools for crushing pills are clean and dry Medicine cups or boxes are made of non fragile plastic materials Medicine cups or boxes have tight covers which do not easily loosen out Medicine cups or boxes have enough capacity to store drugs Separate medicine cups and boxes are provided for each resident The name of individual resident and the time for distributing drugs to the resident are clearly marked on medicine cups and boxes 4 Checking Drug Records a b c d Maintain a complete drug record for each resident including the residents personal Drug Record and th
19. after taking the aforementioned drugs he she should stop taking them immediately and consult a registered medical practitioner B The confirmation letter will have to be updated should there be any changes in the drugs listed in I C The drugs listed in I have to be marked in the said resident s Drug Record which will be given to the said resident for reference when consulting a registered medical practitioner Please delete where appropriate Annex 11 2 2 Code of Practice for Residential Care Homes Elderly Persons D ID ID Annex 11 3 Template Consent Form for Self storage and Self administration of Drugs Resident s Name Date of Birth Sex Information of drugs for self storage and self administration Drug Name Source Route of Administration e g oral or external 1 2 3 4 Confirmation by the Resident and His Her Family Member Guarantor JE Resident s name hereby request to store and administer the aforementioned drugs by myself I am well aware of the medical practitioner s instructions and will administer the drugs on schedule I will also store the drugs in a safe and locked cabinet box to prevent other residents from taking them by mistake Name of the Residential Care Home for the Elderly this RCHE will not be held responsible for any physical discomfort or other problems I may suffer for administering the drugs on my own Resident s Signature of witn
20. delete as appropriate Annex 3 1 6 Code of Practice for Residential Care Homes Elderly Persons Note a b c Applicant Individual s refers to natural person s Representative of applicant refers to a person who completes this application form on behalf of a corporate body non governmental organisation The applicant representative of applicant should send the orginal copy of a completed application form together with the following documents by hand or by registered post to LORCHE at Room 2354 23 F Wu Chung House 213 Queen s Road East Wan Chai Hong Kong 1 2 3 4 5 6 7 8 9 10 1 12 photocopy of the Hong Kong Identity Card of the applicant applicable to application made by an individual photocopy of Certificate of Incorporation issued by the Registrar of Companies applicable to application made by a corporate body certified copy of Business Registration Application issued by the Commissioner of Inland Revenue applicable to applications of private RCHEs photocopy of the Business Registration Certificate issued by the Commissioner of Inland Revenue applicable to applications of private RCHEs staff employment record of RCHE photocopy of the tenancy agreement of the RCHE premises applicable to rented RCHE premises photocopy of the deed of assignment of the RCHE premises applicable to self owned RCHE premises 4 sets of
21. e Stay calm e Remind yourself that the emotion and behaviour of the resident are the manifestation of their underlying disease e Be diversified in tackling the emotional and behavioural problem To consider the causes of the behaviour Do not treat a demented resident like a child Avoid arguing with the resident To seek consensus from relevant parties on consistent management approach To refer the resident with serious problem or without any improvement for professional assistance treatment 2 Communication Skills e Be patient and encouraging Pay attention to the emotion and feelings behind the resident s words Speak in short phrases Speak slowly in a calm and peaceful tone Use body language to complement verbal communications 3 Attitudes and Methods to Deal with Different Emotional and Behavioural Problems 3 1 Depression e Stay alert to depressive symptoms e Take the initiative to talk to the resident and show your care e Encourage the resident to take part in activities 3 2 Suspicion e Avoid argument accusation and direct invalidation of the resident s feelings e Propose other possible explanations 3 3 Overreaction e Avoid argument e Minimum use of restraint e Allow time and space for the resident to adjust his her emotion 3 4 Wandering e Provide regular activities in daytime e Ifthe resident insists on going out avoid argument and accompany him her 3 5 Aggressive Behaviour e Stay calm and comfort th
22. mark to get the exact dosage of medicine Be attentive and do not talk to others or handle other matters while distributing drugs Do not let other residents pass the drugs while distributing drugs Do not just put the drugs beside the resident s bed or on the dining table and leave while distributing drugs Annex 11 4 3 LJ LJ E LJ LO EJE Yes LJ 5 Ll EE ARETES Els ala ae er als Code of Practice for Residential Care Homes Elderly Persons h 0 k Ensure that the drugs for residents using nasogastric tubes can be crushed into pieces or dissolved in water A medical practitioner must be consulted as soon as possible if there are drugs which cannot be crushed into pieces or dissolved in water Where the drugs for residents using nasogastric tubes need to be dissolved in water do not crush them into pieces After assisting the resident take drugs check the medicine cup to ensure that no drug is left in the cup and check that the resident has swallowed the drugs Documented immediately in case of refusal to take drugs Sign in the Medication Administration Record immediately after distributing drugs Never sign in advance 8 Observation of Staff Members Drug Feeding Procedures a b If the residents need to take more than one kind of drugs at the same time the staff will feed them with the drugs one by one After giving out drugs to a resident using a nasogastric tube rin
23. packaging and how they are used must meet international certification standards to ensure quality and safety Principles RCHEs must observe the following principles when adopting the System I Workflow and Code of Practice a There must be a set of comprehensive working procedures for days in advance drug pre packing Compile a timetable and a flow chart for conducting a review not less than once every year and keep relevant records accordingly b The manual or operational guidelines provided by the supplier of the System concerned should be followed as far as possible c There should be adequate space for drug preparation which should be kept clean and tidy at all times It should also be separately located in a specific room or area inside the RCHE d After drug preparation properly clean up the working space for drug preparation No drugs drug packs and other tools for preparing and packing drugs shall be left behind Annex 11 1 1 Code of Practice for Residential Care Homes Elderly Persons II Operating Staff e f g h Unless there is continuous monitoring and management by pharmacists no drugs shall be prepared and kept inside multi dosage drug packs more than seven days in advance If the System is adopted for drug preparation drugs can be prepared up to seven more days in advance apart from the unpacked drug packs currently in use No staff member shall prepare drugs for more than one
24. prevent residents from falling e g arrange for and assist them in regular toileting to reduce their sudden need to go to the toilet on their own and thus reducing the chance of falling e Should not use restraints to restrict residents movement e Explain calmly the purpose of the medical treatment Comfort the emotional resident Cooperate with the family promote residents knowledge of the medical treatment and gain their understanding Appropriate care and effective communication can alleviate residents unnecessary fear Appendix 11 7 3 1 Code of Practice for Residential Care Homes Elderly Persons Appendix 11 7 4 Never Make the Following Mistakes When Applying Restraints 1 Never use a particular type of restraints method of applying restraints or change the type of restraints method of applying restraints period of applying restraints without the prior written consent from registered medical practitioners nurses health workers or other professional carers or according to the instruction of the residents family members 2 To allow quick removal and prevent the restraints from hindering the escape of the residents in case of emergency never use restraints with locking devices 3 To allow quick removal and prevent the restraints from hindering the escape of the residents in case of emergency never fix the restraints to two or more different objects for example do not fix the restraints to the cha
25. sought either at the time of admission or as it becomes necessary and should be properly documented According to Section 16 of the Residential Care Homes Elderly Persons Regulation a comprehensive and up to date recording system should be set up and maintained for possessions or property stored or kept on behalf of every resident by the RCHE including the identification document bank passbook ATM card pocket money medical follow up card etc Such records should be properly kept in the RCHE and should be ready for the inspection of the Licensing Office of Residential Care Homes for the Elderly LORCHE at any time The templates for such records are as follows Authorisation for Custody of Property Template 1 Acknowledgement of Receipt of Properties Put under Custody Template 2 Record Form for Custody Collection of Properties Template 3 Record of Resident s Bank Account Balances Template 4 and Record of Deposits and Withdrawals of Resident s Pocket Money Template 5 VVVVV Operators and staff of RCHEs are prohibited to use or withdraw money from the bank accounts of residents for paying home fees and other charges unless it is so agreed and authorised in writing by the residents and the guardian guarantor family members relatives A proper monitoring mechanism must be established and implemented to avoid misuse of or dispute over such accounts please see para 17 for the monitoring mechanism The following mon
26. to ensure that they are familiar with the requirements of the Ordinance as well as the institutional policy and practice on personal data and 6 formulate guidelines on collecting keeping using and handling person data as well as on data access correction request for the compliance of staff the guidelines should be circulated among the staff regularly e g half yearly to ensure their compliance Annex 8 10 1 Code of Practice for Residential Care Homes Elderly Persons Restricted Personal Data Annex 10 1 RESIDENTIAL CARE HOMES ELDERLY PERSONS REGULATION Application for Registration as a Health Worker photograph of applicant to be affixed here Attention In accordance with Section 5 of the Residential Care Homes Elderly Persons Regulation the Social Welfare Department has established and maintained the Register of Health Workers for inspection by the public free of charge All persons included in this Register are persons registered as health workers according to Section 6 2 of the Regulation for the purposes of employment at a residential care home Any person who collects the personal data of the health workers as included in this Register for direct marketing purposes may contravene the use limitation requirement of the Personal Data Privacy Ordinance Complaints by health workers about such use of data for marketing purpose can be addressed to the Office of the Privacy Commissioner for Personal Data The Li
27. worker to prepare drugs and check drugs each procedure must be carried out separately Strict implementation of the three checks and five rights procedures three checks procedure e first check when taking out drugs from the drug storage cabinet e second check before taking out drugs e third check before putting drugs back into the drug storage cabinet five rights procedure e first right name of the resident second right name and dosage form of drugs third right drug dosage fourth right frequency and time of administration fifth right route of administration Check clearly the prepared drugs once again according to the Medication Administration Record and the information on the drug labels Sign in the appropriate space of the Medication Administration Record after checking drugs 7 Observation of Staff Members Drug Distribution Procedures a b c d e g Carry out the five rights procedures once again while distributing drugs to ensure that the drugs are consistent with the information in the Medication Administration Record Crush the drugs into pieces only before distributing drugs and the resident s name must be marked on the medicine cup Clean the drug crushing splitting tool thoroughly each time after use and before using it to crush split the drugs of another resident Use oral syringe medicine spoons or medicine cups with level
28. Applying Restraints 1 When the attempted alternatives have been assessed to be effective no restraints should be used The use of restraints may be considered only when the attempted alternatives have been assessed to be ineffective Appendix 11 7 2 1 Code of Practice for Residential Care Homes Elderly Persons 5 Date of Next Assessment According to paragraph 8 5 2 e iv of the Code of Practice for Residential Care Homes Elderly Persons assessment shall be made half yearly Name of Nurse Health Worker Signature Date dd mm yyyy Name of Home Manager Signature Date dd mm yyyy III Doctor s Comment L Agree to the use of restraint on the above resident as suggested in parts 2 3 and 4 in D above L Disagree to the use of restraint on the above resident Remarks Doctor s name Signature Date dd mm yyyy IV Resident s Intention I Resident s name after being clearly explained by staff doctor of the RCHE the reasons for using restraint type of restraint to be used period for the restraint to be used short term and long term impacts that may be caused by the use of restraint see Special Notes below and other alternatives that have been exhausted and their effectiveness hereby agree disagree to the use of restraint as suggested in parts 2 3 and 4 in II above Resident s signature Date dd mm yyyy For completion if the re
29. CHE Chinese 3 Address of the RCHE please state in detail the address which should tally with the Business Registration Certificate Business Registration Application and Demand Note for Rate Flat Room Floor Block Name of Building Number and Name of Street Estate and or Number of Lot District Hong Kong Kowloon New Territories SWD 603 Revised Annex 3 1 1 Code of Practice for Residential Care Homes Elderly Persons 4 5 6 7 8 9 10 1 Telephone No Fax No Email address if applicable Number of floors of the building occupied by RCHE floor s Number of units of the building occupied by RCHE unit s Financing nature of the RCHE please tick as appropriate Subvented Self financing and non profit making Private Contract Home Others please specify Type of the RCHE please refer to Chapter 2 of the Code of Practice for classification of RCHEs and tick as appropriate acare and attention home anaged home aself care hostel The premises of RCHE is please tick as appropriate and provide documentary proof specified in Note c 6 and 7 on page 7 below aself owned property arented premises partly self owned and partly rented self owned unit s rented unit s Annex 3 1 2 Code of Practice for Residential Care Homes Elderly Persons 12 13 14 15 16 17 Maximum capacit
30. Code of Practice for Residential Care Homes Elderly Persons Annexes Code of Practice for Residential Care Homes Elderly Persons Annex 3 1 RESIDENTIAL CARE HOMES ELDERLY PERSONS ORDINANCE APPLICATION FOR A LICENCE Please read Chapter 3 of the Code of Practice for Residential Care Homes Elderly Persons Code of Practice and the note on pages 7 and 8 of this application form before submission Applicant N representative of applicant Y should complete Sections I IL III or IV V A or V B and VI in Chinese or English The completed application form together with the required documents and plans should be sent to the Licensing Office of Residential Care Homes for the Elderly LORCHE by hand or by registered post 3 Should there be any changes to the information contained therein the applicant is required to inform LORCHE in writing at the earliest possible time For enquiries please contact LORCHE at 2961 7211 or 2834 7414 Section I Please tick as appropriate Application is hereby made for a Licence under Section 8 1 of the Residential Care Homes Elderly Persons Ordinance Application is hereby made for a renewal of Licence under Section 9 of the Residential Care Homes Elderly Persons Ordinance LORCHE No Existing Licence No Section II Particulars of the Residential Care Home for the Elderly RCHE Applying for a Licence 1 Name of the RCHE English 2 Name of the R
31. E gt HERA 14 AAD AL SR gt 3 A home manager shall at least once every 3 months inform the Director in writing of any change in the list of staff employed by an operator E E AERA ie A WARNING Any person who furnishes any information which is false in a material particular and which he knows or reasonably ought to know is false in such particular shall be guilty of an offence under Section 21 6 c of the Residential Care Homes Elderly Persons Ordinance The supply of such false information may also prejudice the application of licence licence renewal eo TE ER E 21 6 oR gt ES AER RUTA HS EA SET EN DER gt TEA EAU Oe Er HR RR A AA o AN gt Annex 3 2 2 Code of Practice for Residential Care Homes Elderly Persons Annex 3 3 Guidance Notes on Submission of Floor Plans of Residential Care Homes for the Elderly RCHEs Para 3 2 2 h of Chapter 3 of the Code of Practice for Residential Care Homes Elderly Persons Code of Practice 1 Nam
32. English Name in Chinese Sex HKIC No Daily Working Time 42 630 2 CHX KERN SE Date of Current Post ya FERTH please enter commencement of Held Ola Working a alphabet and full Current Employment ERA Hours per week nn number including FRA please enter El On duty Off duty ti i the last digit i u 7 E ease enter the Surname First Name Surname First Name M F blade i dd mm yyyy the pe SELFI ee E code as provided in wE x 4E x i ZE E LANE HIF are Please see JEK Fel Sonne F remark 2 j o i Rie uit example l m remark 3 GAJIH TA a BEBE OHE p AH FE EFR FFIR EE oe FEMA Et 1 1 2003 AIR MF NSININININININI INININ SINI Annex 3 2 1 Code of Practice for Residential Care Homes Elderly Persons aR Supplementary Information Post fr Number A Post HZ Number A Total staff no 44 Remark f
33. L Accident in residential care home for the elderly RCHE and the resident died after being taken to hospital please select a following category as appropriate a LJ Fall b LI Choke c LU Others please specify 1 2 L Suicide in RCHE and the resident died after being taken to hospital lt applicable to 1 1 and 1 2 gt Police inspection at the home a O Yes b O No Media reporting a O Yes b O No 1 3 L Receiving a summons issued by the Coroner s Court to attend the inquest to give evidence please attach a photocopy of the summons and provide details of incident on supplementary sheets 1 4 L Others please specify 2 Missing of resident requiring police assistance 2 1 O Inside RCHE 22 L During activities outside RCHE please select a following category as appropriate a L Spending holidays athome b LJ Going out on his her own c O Activities organised by RCHE lt Applicable to 2 1 and 2 2 gt LJ Resident found date L Resident not yet found starting from the date of missing to the date of reporting after missing for a total of days 2 3 With medical history of dementia a L Yes b O No 3 Confirmed Suspected cases of abuse of residents by staff in RCHE 3 1 L Negligent care of the elderly resulting in his her injury requiring medical treatment 3 2 L Physical abuse battering 3 3 L Sexual abuse indecent assault 3 4 L Embezzling or obtaining m
34. al Care Homes Elderly Persons Ordinance The supply of such false information may also prejudice the application and an existing licence 2 Under section 6 of the Residential Care Homes Elderly Persons Ordinance any person who on any occasion operates keeps manages or otherwise has control of an unlicensed RCHE commits an offence and is liable to a fine at level six and imprisonment for two years and to a fine of 10 000 for each day during which the offence continues Annex 3 1 8 Code of Practice for Residential Care Homes Elderly Persons Home Name Staff Employment Record Hx fe H Eu gk Annex 3 2 HENA Home Nature ZEEE Subvented HL self financing HAAS L Home Address please tick one AY cum HA private 4 Fee ey contract 8 0 Telephone an Date of Reporting DD MM YYYY H H k HHH Name and Signature Status Operator Home Manager Enrollment EA CAMEO Bit RSA EE Bed no Agency Chop gency p CARL E ze BB Name in
35. ame Date Please delete as appropriate Annex 8 6 2 Code of Practice for Residential Care Homes Elderly Persons Annex 8 6 Supplementary sheet Significant Incident Report Date of incident Time of incident 1 Information of the resident concerned Name Age Sex Medical history 2 Details of the special incident 3 Immediate and or follow up actions taken by RCHE Annex 8 6 3 Code of Practice for Residential Care Homes Elderly Persons Annex 8 7 Template Death Record Name of HKIC No Sex Age Date and where Date and place Cause of death and Remarks resident hospitalised of death source of information Please refer to para 8 6 2 h and 11 2 1 e of the Code of Practice for Residential Care Homes Elderly Persons for details Annex 8 7 1 Code of Practice for Residential Care Homes Elderly Persons Annex 8 8 Template Name of Residential Care Home for the Elderly Record of Complaint Date of complaint Time Place Form of complaint L Verbal L Telephone L Written L Others please specify Complaint items please put a Y in the appropriate box es may choose more than one item C Service activity arrangement L Food quality LI Staff attitude L Administrative management Name of complainan
36. ap 123 or any other Ordinance relating to the premises nor does it in any way affect or modify any agreement or covenant relating to any premises in which the residential care home is operated EE bre SG AR gt ARTES BE AMA BARS CESE B123 KEH EARRA ae PAR I LE gt IAE Si EE AAA BAI EE fel SAI FR EE E gt SWD 605 Revised Annex 3 4 1 Code of Practice for Residential Care Homes Elderly Persons RESIDENTIAL CARE HOMES ELDERLY PERSONS ORDINANCE Hz x E z Ir Bil LORCHE Number Chapter 459 Laws of Hong Kong pon Hee g RY BE RAAPI O O Licence Number hat HR am Sir Licence of Residential Care Home for the Elderly Continuation Z Be We ROA 6 This licence is issued subject to the following conditions ARRA TIRA Continued from front page 4H 4 ag Date HA Director of Social Welfare Hong Kong Special Administrative Region SER HELE tah ee WARNING E Licensing of a residential care home does not release the operator or any other person from compliance with any requirement of the Buildings Ordinance Cap 123 or any other Ordinance relating to the premis
37. ately Prepare drugs according to the latest information listed in the residents Medication Administration Record Check the information indicated on the labels of drug packets against the Medication Administration Record when taking out drugs from the drug storage cabinet first checking Check the information indicated on the labels of drug packets against the Medication Administration Record before taking out drugs from drug packets second checking Annex 11 4 2 Oo OF 00 0000 oF O O Ej E El ag Oo 00 cod dos Oo O0 OF Oo O DO OOOO az U O Code of Practice for Residential Care Homes Elderly Persons i 0 k I Sign in the appropriate space of the Medication Administration Record immediately after preparing drugs Check the information indicated on the labels of drug packets against the Medication Administration Record before putting the drugs back into the compartments inside the drug storage cabinet third checking Tidy up and clean all the tools for drug preparation Lock the drug storage cabinet after drugs preparation and putting the drugs back into the drug storage cabinet 6 Observation of Staff Members Drug Checking Procedures a b c d Drug preparing and drug checking must be separately carried out by at lease two staff members designated to handle drugs nurses or health workers If it is necessary for the same staff member a nurse or a health
38. ath brush and towel in advance Put on plastic apron and water boots Help the resident to take off clothing Be careful not to twist the resident s joint or injure his her skin and use a towel or thicker garment to cover his her shoulder and back to avoid catching a cold Help the resident to go to the bathroom Use a shower chair if necessary At least two personal care workers are required for holding and lifting heavy or infirm residents Close the bathroom door or put a screen curtain in front of the bathroom door to provide privacy for the resident At Bath Time The Personal Care Worker is required to wash his her hand first and remove all the hand and wrist accessories to ensure the safety of the resident Help the resident take off his her underwear Prepare for water with suitable temperature and check the water temperature with inner elbow Ask the resident if he she feels comfortable and make adjustments as necessary Rinse the whole body of the resident Apply soap lotion or soap to the resident when he she feels warm Encourage him her to rub the body and wash the private parts on his her own If the resident lacks self care ability clean his her whole body with a bath brush sponge small towel Should use the smooth part of the bath brush to wash delicate areas such as the genital and rectal areas Pay attention to folds of skin and less exposed areas such as the underarm webbing between fingers the groin etc througho
39. be released for observation The observation should cover the following aspects blood circulation skin condition respiratory conditions degree of consciousness whether the restraint is displaced loosened degree of tightness personal hygiene of the resident resident s emotional condition 2 Physical restraints should be released at intervals to allow movement and exercise Remark codes N The restrained parts have been released for observation and all the aspects observed are normal P Abnormal signs are identified please inform the nurse health worker immediately for follow up actions and the observations should be recorded appropriately S Suspension of the use of physical restraint Countersign Nurse health worker home manager must conduct continuous monitoring and random checks to see whether the staffs have observed the correct procedures in applying physical restraint to a resident and then countersign in the countersign box as confirmation Random check shall be conducted at least once a day Date Observation i Remarks Signature Countersign i Remarks Signature Countersign Time Remarks Signature Countersign i Remarks Signature Countersign time Tam 9am 9am llam llam lpm lpm 3pm 3pm 5pm Spm 7pm 7pm 9pm 9pm 11pm llpm lam lam 3am 3am 5am Sam 7am Date Observation i R
40. cabinet is used solely for storing drugs of the residents The drug storage cabinet is kept in a secure and safe place The drug storage cabinet is locked and the keys are kept by staff member s designated to handle drugs The residents names and bed numbers are clearly affixed to the medicine drawers or drug storage compartments No gap is found between the medicine drawers or drug storage compartments There is sufficient storage space in the medicine drawers for keeping drugs of individual residents Oral drugs have been kept separately from other types of pharmaceutical preparations i topical drugs ointments and creams eye drops and suppositories ii spray on inhalers iii injectable medication Drugs of each resident including PRN drugs have been properly arranged and are kept separately in a fixed compartment inside the drug storage cabinet The various kinds of drugs kept inside the drug storage compartments are stored in separate drug bottles or original drug packets For the drug containers kept inside the drug storage compartments each and every drug bottle box or packet is clearly labelled The refrigerator designated for drug storage is maintained at a temperature of 2 8 C if applicable No food or other items are kept at shelves in the refrigerator designated for drug storage if applicable The refrigerator designated for drug storage or medicine boxes kept in the refrigerator are locked if applicable
41. cautions should be given to them so as to avoid misunderstanding and gain support and cooperation from the families Continued Assessment and Close Monitoring Assessment must be conducted on a regular basis at least half yearly or according to changing conditions of the resident to re evaluate the need for continual restraint changing the type of restraints and or rescheduling the time for applying restraints When the resident no longer displays dangerous behaviour or when other non restrictive alternatives can achieve the same effect restraints should be ceased immediately A monitoring mechanism must be established for nurses health workers home manager to oversee the application of restraints in the home The monitoring mechanism aims to ensure that the staff concerned have observed proper procedures in applying restraint to a resident Nurses health workers home manager must conduct regular checks on the condition of every resident under restraint and the observation record at least once a day to monitor on an ongoing basis staff s compliance with proper procedures in applying restraint to aresident The observation record should be countersigned by the nurse health worker home manager concerned after checking Annex 11 7 8 Code of Practice for Residential Care Homes Elderly Persons Appendix 11 7 1 Adverse Effects that may be Caused by the Use of Restraints which should thus be avoided 1 The use of restraints wil
42. censing Office of Residential Care Homes for Persons with Disabilities may access the data of registered health workers in accordance with Chapter 613 of Residential Care Homes Persons with Disabilities Ordinance Enquiries Telephone Number of Applicant s correspondence address Health Worker Registration 2961 7264 or 2961 7265 Application form should be sent to Licensing Office of Residential Care Homes for the Elderly Social Welfare Department Room 2354 23 F Wu Chung House 213 Queen s Road East Wan Chai Hong Kong Daytime contact telephone number l I forward the following particulars of myself for application for registration as a Health Worker under Regulation 6 1 of the Residential Care Homes Elderly Persons Regulation 2 Personal particulars a Name English Please provide in BLOCK LETTERS Chinese b Sex CJ Male U Female Annex 10 1 1 Code of Practice for Residential Care Homes Elderly Persons Restricted Personal Data c HKIC No d Date of birth e Residential address f Correspondence address if different from e g Telephone no residential Telephone no mobile h Means of contact O Email LJ Post may choose both i Email address Qj Particulars of educational only information of secondary and above attainment education is required Name of School s Date of Entry Date of Highest Certificate Diploma
43. e EAN OE TES 2 ER ____ HKIC No Hospital Clinic Ref No Brea ES i Er Br o II History of Major Illnesses 1 Any history of major illnesses operations Yes No H DERREIRA A Ree FI A NE If yes please specify the diagnosis UWA gt AA 2 a Any evidence of infectious or contagious disease Yes No AERA BAR iE If yes please specify UA 4 En b Any further investigation or treatment required Yes No FES Fs BEEZ ER ERE CTR FE E If yes please specify and also state hospital clinic attended and reference number AR AIDA ERN a i SAMA A R 3 Past psychiatric history if any including the diagnosis period and whether regular following treatment is required ARBIA RAER gt AE ee ARENA 4 Detail of present medication if any ATAR Se gt AREA RAR AD Annex 11 5 1 Code of Practice for Residential Care Homes Elderly Persons Part III Physical Examination PDA AER Blood pressure MER Pulse DE Body Weight General HEEE Cardiovascular System ARA Respiratory System FIR AG Central Nervous System FEIR AK Musculo skeletal BLE
44. e Medication Administration Record Conduct random checks of the personal Drug Record and the Medication Administration Record of the residents on a regular basis to ensure that the information contained in these two records is consistent with each other Staff members are able to as early as possible update the drug records of the residents after they are given newly prescribed drugs or upon the instructions from the medical practitioner to change the prescriptions Staff members contact the hospital wards clinics or hospital pharmacy departments concerned by phone in case of doubt and where necessary if there is no label on the drug packet contact community pharmacies or pharmaceutical firms to confirm the name and dosage of the drugs so as to ensure that the residents take the right drugs in the right dosage and record the relevant information 5 Observation of Staff Members Drug Preparation Procedures a b c d e f g h Tools for drug preparation are clean and dry before use Wash hands with liquid soap and water and dry them with clean and disposable paper towel before preparing drugs Do not take out drugs directly with hands from drug packets Use medicine spoons or other appropriate tools instead Use a pill splitter to cut the pills where necessary Staff members are attentive when preparing drugs They are not distracted by other duties and do not leave their post indiscrimin
45. e Have serious respiratory disease f Have shortness of breath or phlegm choking g Can normally take food unassisted but there is a sudden deterioration in health condition h Have other feeding problems Preparation Before Feeding a Environment Ensure that the eating area is well ventilated with adequate lighting and free from distractions so as to enhance residents concentration Annex 13 1 1 Code of Practice for Residential Care Homes Elderly Persons b c d Feeding Utensils i 11 iii iv v Ensure the utensils are clean use non slip utensils and check if they are safe Choose appropriate feeding utensils for residents e g fork or spoon instead of chopsticks Use smaller spoons to control feeding amount each time and minimise the risk of choking Use straws or specially designed cups to control the amount and flow of fluids during drinking Consult occupational therapist if necessary for advice on the choice of feeding aids e g spoons and forks with enlarged handles adapted chopsticks bowl with a raised curved lip etc Preparation for RCHE Staff 1 Gi iii iv v vi Maintain good personal hygiene wash hands with soap before feeding residents Assist residents in hand washing before every meal for maintaining good hygiene so that they can eat comfortably in a relaxed manner Perform oral care for residents before meals to stimulate appetite if
46. e Homes for the Elderly Annex 11 11 4 Code of Practice for Residential Care Homes Elderly Persons updated in September 2014 Annex 11 12 Working Guidelines for Residential Care Homes for the Elderly RCHEs Prevention and Care of Pressure Ulcers A Introduction Residents in RCHEs who suffer from illnesses or deterioration of physical functioning are prone to pressure ulcers caused by prolonged sitting or lying which may further affect their health Staff of RCHEs should provide residents with proper personal and nursing care take measures to prevent pressure ulcers and seek advice from health care professionals as soon as pressure ulcers are detected B Know more about pressure ulcers 1 Definition Pressure ulcers also known as bedsores refer to ulcers or death of tissue caused by lack of nutrition supply to skin muscle or even deep tissue due to obstructed blood flow as a result of persistent pressure on localised parts of skin or soft tissue without regular pressure relief 2 Causes 2 1 2 2 2 3 2 4 2 5 Pressure Prolonged contact of and pressure on bony prominences against a surface e g mattress chair without regular pressure relief Shearing force Sliding down of the resident due to unsteady sitting posture or improper ways of moving the resident or changing his her lying position may cause friction to his her skin and thus abrasion to his her bony prominence leading to injuries
47. e and restraints should only be used when all other alternative have been exhausted The use of restraints should be the last resort instead of the first option Moreover restraints should only be used under exceptional circumstances when the well being of the resident and or other residents is jeopardised The use of restraints should not be regarded as a usual practice The dignity and privacy of the residents must always be taken into consideration when using restraints Residential care homes for the elderly RCHEs should never use restraints as punishment or as a substitute for caring of the residents or for the convenience of the staff The use of chemical restraints is prohibited in the absence of advice from a registered medical practitioner Chemical restraints refer to the use of medications for the purpose of restraint Response to medication vary from people to people Drug overdose may result in serious complications If a registered medical practitioner prescribes drugs with chemical restraint effects close monitoring of the residents conditions is required RCHEs may consider it necessary to use restraints to limit residents movement for the following reasons a to prevent residents from injuring themselves or others b to prevent residents from falling and or c to prevent residents from removing medical equipment urinary bags urinary drainage catheters feeding tubes diapers or clothes Annex 11 7 1 C
48. e feeding bottle bag with liquid food and fill up the tubing of the feeding bottle bag Clear out the air and connect feeding bottle bag to the RT tube Set the appropriate flow rate to regulate a slow and steady flow of the liquid food into the stomach Feeding should not be administered too rapidly Never use excessive force to avoid hurting the gastric mucosa 6 During feeding the resident must be closely monitored In case of abnormality such as persistent coughing vomiting cyanosis abnormal respiration etc stop feeding immediately Seek medical advice or send the resident to the A amp E 7 After feeding flush the RT tube with 50 100ml of water to avoid its being blocked by residues 8 Remove the feeding bottle bag and the tube Place the plastic cap back to the port of the RT tube 9 Wash hands E What to Do after Feeding 1 Residents Remain in the position of feeding for around half an hour to one hour to avoid the liquid inside the stomach getting into the respiratory tract and causing aspiration pneumonia 2 Feeding tools Every resident should have his her own feeding tools individually After each use feeding funnels and tubing connecting tubes must be rinsed with water individually and air dried before being put into covered containers Feeding funnels must be cleaned and disinfected daily Please refer to the user manual for suggested cleaning or disinfecting procedures Feeding bags and tubing conn
49. e g wandering c physical abilities and activities of daily living e g being prone to falls frequently or d potential harm to self and others e g self injuring behaviours or violence against others removing medical equipment etc Noe A guardian refers to a person appointed by the Guardianship Board and thus with legal status accorded Note A guarantor refers to a relative or non relative of the resident who voluntarily involves in handling various matters for the resident including applications for admission to and discharging from RCHE discussion of care plans and payment of fees etc without legal status accorded Annex 11 7 2 Code of Practice for Residential Care Homes Elderly Persons 2 Alternatives a b c d e f Alternative methods other than the use of restraints must be adopted as far as practicable The use of restraints should only be considered when these alternatives are confirmed as ineffective Remove triggers that may agitate the resident leading to the need for restraint It is recommended to adopt the following measures to provide a safe environment such as i removing sharp edged furniture ii providing signage for guiding the residents to rooms ii assisting the residents to wear suitable footwear and use appropriate walking aids iv providing good lighting v implementing a bed chair checking system to ensure safety of the re
50. e health worker on duty before arranging for the resident s consumption I Handling of Other Things Brought in 1 If a visitor is found or suspected of bringing in any restricted article or sharp object staff should report to the home manager or supervisor immediately Advise the visitor to surrender the suspected items for inspection If the item is confirmed to be a restricted article or sharp object advise the visitor to take it away from the Home as soon as possible Pay attention to visitors abnormal behaviour If any dangerous act is found stop it immediately and or report to the home manager or supervisor and or consider seeking help from the police Annex 13 2 1 Code of Practice for Residential Care Homes Elderly Persons Annex 13 2 Template Notice to Visitors on Bringing in Food To protect the safety and health of residents please note the followings when you bring in food to visit our residents 1 Please make sure the food you bring in is suitable for consumption of the resident according to his her health condition and chewing ability You are advised to ask the nurse health worker on duty every time you bring in food if you are not sure if the food is suitable for the resident For residents with special dietary needs a tag for special dietary care will be displayed at the prominent area around their beds If you bring in food for a resident who is in need of special dietary care plea
51. e of RCHE in Chinese and English address in Chinese and English and the 2 4 sets of layout plans of RCHE should be submitted 6 sets for RCHE situated in premises under or divested by the Housing Authority Each plan should be duly signed by the applicant applicable to application made by an individual or stamped with the company organisation chop if the application is made by a company or an organisation date of submission should be clearly written on each plan 3 Each plan should be drawn to the scale of 1 100 or 1 50 For part plan the scale of 1 20 is also acceptable 4 5 The area of the home to be licensed should be demarcated in red on the plan The following items should be clearly stated the abutting streets lanes adjoining common area including lift lobbies escape staircases protected lobbies common corridors and the use of various parts or areas of the premises Detailed measurements in metric of all rooms corridors passages etc should also be indicated 6 Calculation of the area of all rooms passages corridors etc should be correctly indicated on separate plans 7 The total net floor area of the proposed RCHE premises should be indicated please refer to paragraph 6 2 of Chapter 6 of the Code of Practice 8 The position of all columns load bearing walls fire resisting walls new and existing fire rated doors new and existing fire alarm panels exit s
52. e packing System the System to avoid or minimise potential risks as far as possible The working guidelines aim to provide RCHEs with relevant information and recommendations to help home operators and their staff to understand the characteristics of the System and the principles that must be observed when adopting the System However the working guidelines are only supplementary to and do not supplant any requirements practices under the Code of Practice for Residential Care Homes Elderly Persons Code of Practice and the Operational Manual on Drug Management in RCHEs the Manual 2007 If in doubt the requirements under the Code of Practice and the Manual 2007 should prevail Definition The System adopted in RCHEs refers to the method of storing the residents drugs in well sealed device or blister packs in which packages with for example paperboard polythene or aluminium foil as under layer are needed so that drugs can be safely and properly sealed The method of drug storage in packs refers to the sorting out of drugs to be taken by providing individual residents with suitable packs drug packs or boxes and allocating the drugs properly to drug compartments for different dates and time slots before sealing Drugs are taken out by puncturing the paperboard aluminium foil or polythene at the bottom of the corresponding positions when use Given the requirements for drug quality assurance the materials tools and designs of drug
53. e resident e Have the resident stay at the spot 3 6 Repetition of Same Action or Words e To divert the resident with light conversation topics or activities e Arrange simple activities Annex 11 8 1 Code of Practice for Residential Care Homes Elderly Persons Annex 11 9 Hot Weather 1 According to Section 24 of the Residential Care Homes Elderly Persons Regulation and para 4 9 1 of the Code of Practice for Residential Care Homes for the Elderly Code of Practice residential care home for the elderly RCHE shall be adequately ventilated at all times Para 7 2 of the Code of Practice also stipulates that every RCHE should install a sufficient number of electric fans and or air conditioners to maintain sufficient ventilation and a comfortable room temperature 2 Hydration of residents should be ensured y adequate fluid intakes including water soup and juicy fruits Meals for frail elders should be arranged and provided according to the doctor s instructions 3 Avoid elderly residents staying under direct sunlight or poorly ventilated area Avoid strenuous exercise in hot weather 4 Elderly residents should be assisted to put on thin light coloured and loose fitting clothing They should be reminded to put on a hat or open an umbrella to avoid direct sunlight when they go out 5 Elderly residents should constantly be reminded to take enough rest and avoid over exertion 6 Avoid sudden change of enviro
54. e to implement preventive measures to prevent the occurrence of pressure ulcers in other unaffected areas etc Pressure Ulcers Wound Management 2 1 2 2 2 3 For Stage I Pressure Ulcers Keep the affected area clean and dry Apply lotion or skin protectant for the resident as advised by health care practitioners or use appropriate dressing for protection as advised Closely monitor the condition of pressure ulcers For pressure ulcers without improvement presented with signs of infection or deterioration or the condition of the resident has worsened seek advice from health care practitioners or arrange medical treatment as soon as possible For Stage II Pressure Ulcers Manage wounds as advised by health care practitioners including wound cleansing use of appropriate dressing lotion and dressing products and the frequency of changing dressing etc Closely monitor the condition of pressure ulcers For pressure ulcers without improvement presented with signs of infection or deterioration or the condition of the resident has worsened inform health care practitioners or arrange medical treatment as soon as possible For Stage III or Stage IV Pressure Ulcers The pressure ulcers may require relatively complicated medical or care procedures Staff in RCHEs shall report the wound condition to health care practitioners or arrange medical Annex 11 12 5 Code of Practice for Residential Care Homes Elderly Persons
55. e with communicate E 5 ARA normal voice loud voice with loud Diaes T TAMRE DE AA fast voice DEE TBE DA AA TEAS at ah AY ta Ft AR BE Mental normal mildly moderately seriously state alert disturbed disturbed disturbed EA IER Ei RG FE Sz DBE HEZA REZANE mild moderate severe dementia dementia dementia REAT PRERE BERIT Mobility independent self ambilatory always need bedridden EEE TEH 4 with walking aid personal escort EME or wheelchair INES o BHT a EE Continence normal occasional frequent urine uncontrolled PIBE IE urine or or faecal soiling incontinence faecal soiling K A MER ERE TER K A MEERA HE Speech able to express need time to express need clues to communicate sae REE eee AER FAFA RE A D L independent No supervision or assistance needed in all A PRRI daily activities including bathing dressing 558 toileting transfer continence and feeding CEA gt FK A BEN AMES h Be HRT Seis E occasional assistance Need assistance in bathing and supervision in BARAR other activities CESR m I EDEN A Annex 11 5 3 Code of Practice for Residential Care Homes Elderly Persons frequent assistance Need su
56. ecting tubes should be changed daily Syringes for feeding should be thoroughly cleaned and changed regularly 3 Feeding liquid food Unopened liquid food should be kept in a cool place and away from direct sunlight Once the liquid food is opened mark down the date and time of opening The liquid food must be sealed and refrigerated at an appropriate temperature It must be used within 24 hours 4 Records The time of feeding the amount of gastric contents and the types and amounts of food fed should be recorded The responsible staff should monitor and keep record of the intake of liquid or fluid in and the output of urine out and take note of any fluid imbalance Monitor closely also whether there is the presence of irregular gastric contents or other signs of allergy Annex 11 11 3 Code of Practice for Residential Care Homes Elderly Persons updated in September 2013 F Never Make the Following Mistakes when Feeding 1 Sedat areas If the RT tube slips out staff other than medical practitioners or nurses must not re insert the RT tube on their own Do not feed the resident if it is uncertain whether the feeding tube is positioned correctly Re extract the gastric contents and test again after a while Do not push in the food by force to avoid hurting the gastric mucosa Do not feed too fast to avoid causing digestive discomfort When feeding residents with medicine do not mix it with the food t
57. ed residents from assault a conduct regular inspection of rooms sleeping accommodations corridors and other public areas and record accordingly inspection should preferably be conducted at least once every two hours Staff must pay special attention to the condition of restrained residents during the inspection Once they detect that a resident has been assaulted or at the risk of being assaulted they must report and follow up on the case immediately b the room or sleeping accommodation of the restrained resident should be as close as possible to the nurse station office to facilitate ready observation of their condition and provision of support c the room or sleeping accommodation of the restrained resident should be kept as far as possible from the accommodation designated for the opposite sex to ensure privacy and minimise the risk of assault d install closed circuit televisions or fisheye mirrors for surveillance of public corridors or accesses in the home so that staff can keep a more watchful eye on the condition of residents and Annex 11 7 7 Code of Practice for Residential Care Homes Elderly Persons F e promote residents awareness of self protection and vigilance against assault and encourage them to seek help from staff when in need Precautions adopted by the home to protect restrained residents from assault should be clearly explained to families of the residents or information on such pre
58. el clean and comfortable Talk to the resident at bath time keep a caring attitude and respect his her privacy Help the resident to lie flat in a comfortable position Remove the pillow Place cotton balls in the ears to prevent water from getting inside Check and assess the condition of the resident s skull bone scalp and hair Check the water temperature and use the hair rinsing basin to wash the resident s hair in bed Ask if he she is comfortable with the water temperature Clean and condition the hair with shampoo and hair conditioner Gently massage his her scalp and avoid using your fingernails to scratch and hurt the scalp Be aware of any change on his her body and keep him her in a comfortable posture If the resident is feeling unwell stop washing the hair immediately Report the incident for follow up Rinse well Remove the hair rinsing basin from the bed and take out the cotton balls that were placed in the ears Pat the hair dry with a towel 10 Blow dry and brush the hair Annex 11 6 4 Code of Practice for Residential Care Homes Elderly Persons A Annex 11 7 Notes on Correct Use of Restraints General Principles of Least Restraint Restraints refer to purposely made devices to limit a resident s movement so as to minimise harm to self and or other residents As restraints may cause long term harm to a resident s health see Appendix 11 7 1 the use of restraints must be avoided as far as possibl
59. emarks Signature Countersign i Remarks Signature Countersign Time Remarks Signature Countersign i Remarks Signature Countersign time Tam Jam 9am llam llam Ipm lpm 3pm 3pm 5pm Spm 7pm 7pm 9pm 9pm 11pm llpm lam lam 3am 3am 5am Sam 7am Date Observation Time Remarks Signature Countersign Time Remarks Signature Countersign fTime Remarks Signature Countersign Time Remarks Signature Countersign time Tam 9am 9am llam llam lpm lpm 3pm 3pm 5pm Spm 7pm 7pm 9pm 9pm 11pm llpm lam lam 3am 3am 5am Sam 7am Date Observation Time Remarks Signature Countersign Time Remarks Signature Countersign Time Remarks Signature Countersign Time Remarks Signature Countersign time Tam 9am 9am llam llam lpm lpm 3pm 3pm 5pm Spm 7pm 7pm 9pm 9pm 11pm llpm lam lam 3am 3am 5am Sam 7am Appendix 11 7 5 1 Code of Practice for Residential Care Homes Elderly Persons Annex 11 8 Care for Demented Elderly Residents in Residential Care Homes for the Elderly Dealing with Emotional and Behavioural Problems 1 Basic Principles
60. emperature for prevention of hypothermia and influenza Consult medical advice if necessary and make arrangements for the resident to attend medical consultation with the visiting registered medical practitioner or send the resident to the medical institution for treatment Annex 11 10 1 Code of Practice for Residential Care Homes Elderly Persons updated in September 2013 B C Annex 11 11 Working Guidelines for Residential Care Homes for the Elderly RCHEs Guidelines for Feeding with Ryle s Tubes RT Introduction When caring for residents who are not able to take in food orally and need to be fed with RT tubes due to illness or physical impairment RCHE staff shall follow the following working guidelines in order to ensure that proper care is exercised in the use of RT tubes Basic Principles 1 RT tubes should only be used for treatment purpose or when warranted in the circumstances of the residents medical condition The use of RT tubes must be approved by a registered medical practitioner RT tubes should be inserted and changed regularly by a registered or enrolled nurse The type of milk amounts intervals and frequency of feeding should be scheduled in accordance with the advice of registered medical practitioners dietitians The use of RT tubes should be reviewed regularly Medical advice from a registered medical practitioner should be sought to determine if continual use is required Pr
61. ence e g singing social groups outdoor walk etc Such activities are to focus on enhancing their social and motor abilities Encourage family members to visit residents more frequently to show their care and support Provide a safe comfortable and familiar daily life setting for the residents to promote a sense of belonging e g posting residents daily photos at their bedside using appropriate signage to indicate the positions of different rooms etc 3 Unable to maintain proper sitting posture Understand the reasons for the resident s inability to maintain a correct sitting posture e g weak back and lower back muscles the chair being too high etc Consider using a more suitable chair seat cushion or other devices e g wheelchair with high back support or special cushion to improve sitting posture When necessary staff may seek medical professionals advice arrange for sitting posture assessment provide muscle strengthening exercises and choose appropriate assistive devices 4 Fall easily 5 Resist to receive necessary medical treatment Consult medical professionals e g medical practitioners nurses physiotherapists occupational therapists podiatrists social workers etc Identify the root of the problem by comprehensive assessments of health condition intelligence self care abilities assistive devices home settings etc Choose proper furniture and adopt proper measures to
62. ents to talk while eating Pay attention to any signs of coughing or increased sputum while residents are eating Do not pat residents on their backs or let them drink water while they are coughing Stop feeding if coughing persists Pay attention to any signs of swallowing difficulties e g coughing dribbling reflux of food into the nose or difficulties in swallowing food Observe residents pace of eating In case of choking keep calm and enlist a staff with a valid First Aid Certificate to apply appropriate first aid treatment as soon as possible Send the resident concerned to hospital immediately where necessary Record details of the incident for future follow up and review Annex 13 1 3 Code of Practice for Residential Care Homes Elderly Persons 5 xi Ensure adequate fluid intake for residents who need feeding assistance at regular intervals to prevent dehydration xii RCHE staff should not perform other duties while feeding residents Nor should they walk away without ensuring the safety of residents while feeding them g After Care 1 After feeding help residents rinse their mouths clean their dentures or perform oral care to prevent food being left in their mouths which may easily cause choking Wipe their mouths with wet towels to maintain good personal hygiene 11 Remove feeding utensils aprons and serviettes etc Let the residents rest comfortably ii Avoid lying down the residents right af
63. eparations Before Feeding 1 Staff Hand hygiene should be observed Wash hands thoroughly with soap and clear water or use alcohol based hand rubs to disinfect hands Residents Oral and nasal hygiene should be observed Oral care and checks should be carried out for residents at least three times daily Change the fixation tape of the RT tube as necessary and make sure it is securely fixed in place Residents should be placed in an upright or a semi sitting position at 30 to 45 degrees Equipment 3 1 Liquid food Check the expiry date and find out whether the food is spoiled Double check the type amount and concentration of the liquid food Annex 11 11 1 Code of Practice for Residential Care Homes Elderly Persons updated in September 2013 D 4 Normally liquid food does not need to be heated so that the nutritional quality will not be affected If necessary follow the instructions of the food manufacturer to prepare the food to the right temperature and If necessary separate liquids from solids with a sieve before feeding to prevent the RT tube from being blocked 3 2 Equipment for testing the position of the RT tube A feeding syringe of 10 20ml pH indicator and A clean container for gastric contents 3 3 Utensils for feeding A measuring cup A cup of warm water A covered feeding bottle bag and A feeding syringe of 20 50ml Surroundings Brightly lit Equipment must be ke
64. ependent on others and cannot bathe on their own Residents should be arranged for a shower tub bath bed bath or hair washing in bed according to their health conditions m Schedule and frequency of bath and bath time should be arranged according to individual circumstances Talk to the resident at bath time keep a caring attitude be considerate and respect his her privacy Be aware of any change on the resident s body If the resident is feeling unwell stop bathing and handle as appropriate Remind residents to press the emergency call bell in the bathroom in case of emergency Annex 11 6 1 Code of Practice for Residential Care Homes Elderly Persons 4 5 Ensure the safety of the resident at bath time to avoid causing burns or catching a cold Preparations before Bathing Introduce yourself to the resident and tell him her that you are going to help him her with a bath Observe the mental and physical conditions of the resident and decide if he she is suitable for a bath In case of doubt the supervisor should be consulted immediately If the resident rejects to take a bath it is necessary to understand the reasons and consult the supervisor Switch on the water heater exhaust fan bathroom light and heater if necessary Close the door windows and curtains in the room bathroom to keep the room temperature Consult the resident on the choice of clothing to change into Gather soap lotion or soap b
65. es nor does it in any way affect or modify any agreement or covenant relating to any premises in which the residential care home is operated EE TES GR gt WEAR RS BE AMA TAR CESE AB KEH AE ae PVR IN LE gt IAE NER EE bee ee A A BARNEH GA IIR EE fa MEK gt SWD 605A Annex 3 4 2 Code of Practice for Residential Care Homes Elderly Persons Annex 5 1 Checklist for Submissions of Fire Safety and Fire Precaution Measures Para 5 4 and 5 5 of Chapter 5 of the Code of Practice for Residential Care Homes Elderly Persons D New or Expanded RCHE 1 General fire service installations and equipment applicable to floor area of less than 230 m i Fire Service Installation Plan FSV314A Fire Service Installation Plan for Prescribed Commercial Premises Specified Commercial Buildings FSI 314B Fire Service Installation Plan for Composite Building Domestic Building FSI 314C as appropriate including relevant fire service plan s with the stamp of the Fire Services Department FSD and subsequent reply NP 317 from the Director of Fire Services DFS 11 Existing Certificate of Fire Service Installations and Equipment FS 251 if applicable iii New Certificate of Fire Service Installations and Equipment FS 251 iv Proof of direct line connection to fire de
66. essing signature family member guarantor Date Name of witnessing family member guarantor Relationship with the resident Date Assessment by This RCHE In response to the said resident having requested to store and administer the aforementioned drugs by himself herself this RCHE has made the following assessment Assessment Yes No Remarks The said resident fully understands the medical practitioner s instructions and is capable of administering the drugs on schedule Annex 11 3 1 Code of Practice for Residential Care Homes Elderly Persons Assessment Yes No Remarks This RCHE or the said resident s family members provides the said resident with lockable cabinets boxes to store the drugs Residents near the said resident may take someone else s drugs by mistake due to cognitive impairment RCHE The drugs listed in 1 is suitable to be stored and administered by the said resident himself herself e g drugs that have to be stored in the refrigerator or dangerous psychotropic drugs have to be stored by this Upon the assessment above this RCHE agrees disagrees to hand over the drugs listed in 1 to the said resident for self storage and self administration Signature of assessing Signature of staff member supervisor Name and post of Name of assessing staff member supervisor Date of assessment Date Please delete
67. f Home Manager Date Annex 8 3 1 Code of Practice for Residential Care Homes Elderly Persons Annex 8 4 Template Name of Residential Care Home for the Elderly RCHE Staff Outdoor Duty Record Time of Date Name Post Time of _ Staff returning to _ Staff Details of outdoor work outdoor work signature RCHE signature Note 1 Please provide details of outdoor work e g purchasing grocery supplies for RCHE purchasing xxx for resident xxx escorting resident xxx to attend follow up medical appointment at xxx hospital obtaining medicine on behalf of resident xxx from xxx hospital delivering diapers to resident xxx at xxx hospital etc Annex 8 4 1 Code of Practice for Residential Care Homes Elderly Persons Annex 8 5 Name HKID No Accident Report Name of resident Sex Age Bed no Date of accident Time Location Sitting room Dining room _ Corridor _ Toilet _ Bathroom _ Bedside _ Others Happening of accident Para 8 6 2 f and 11 2 1 e of the Code of Practice for Residential Care Homes Elderly Persons Code of Practice Activity of resident Lyingdown Standing _ Walking _ Getting out of going to bed _ Transferring to bed chair commode chair shower chair _ Feeding _ Grooming _ Dressing _ Toileting _ Bathing _ Others Illness of resident _ Lower limb weakness Jointpain Dizziness
68. f of RCHEs should understand and assess the physical and mental condition self care ability and daily living skills of their residents Staff of RCHEs should respect the personal choice and unique bathing habits of their residents while maintaining their safety and health 1 Purposes of Helping Residents to Bathe to help the residents to clean themselves up to observe and assess the residents body condition to keep skin clean and hygienic and to maintain the residents health to prevent infection and bed sore to exercise the muscles and stimulate blood flow through bathing to boost the residents spirits to make the residents more comfortable to maintain pleasing appearance of the residents and to promote interpersonal relationship and self esteem and to enhance communication and reinforce the feeling of being cared of and of mutual trust through small talks with the residents at bath time 2 Assessment of Residents Health and Bathing Details residents health condition including medical history skin condition the ability of large and small muscles residents bathing habits and details including their ability bathing time frequency and method choice of bath products and residents awareness of bath safety 3 Bathing Arrangement Residents with self care ability should be encouraged to bathe on their own RCHEs should help those in need and clean the bodies of residents who are totally d
69. family members relatives must be obtained and reviewed at least half yearly Safe Application of Restraints A registered medical practitioner should be consulted on the type and design of the restraint to be used to ensure that the application of restraints will not cause discomfort abrasions or physical injury to the residents The type size and material of restraints must be suitable and in good condition so as to minimise possible discomfort and danger to the residents as far as possible e g various sizes of safety vest should be available so as to suit the individual need of the residents Staff must read carefully the product manual or application procedures approved by the RCHE prior to the use of restraints Staff must also comply with Annex 11 7 4 Code of Practice for Residential Care Homes Elderly Persons 10 approved procedures or instructions of medical professionals when using the restraints When applying restraint staff must remove all articles from residents or within their reach which may cause injury to the residents such as pen keys etc to prevent accidents Restraints must be used with due care to avoid the residents getting injured accidentally e g to provide better protection thick padding or matting should be added to soft ties on the resident s wrists for the purpose of restricting his her upper limb movement Never use restraints with locking devices or fix the restraints t
70. gs Formulate procedures of drug delivery and collection with community pharmacies and keep clear records of drug delivery and collection Formulate procedures and frequency of random checks on packed drugs and keep clear records of random checks Annex 11 1 3 Code of Practice for Residential Care Homes Elderly Persons f Appropriate procedures for drug distribution should be formulated for use of the System g There should be guidelines for handling drug near misses incidents contingency plans and notification mechanism h Set up a monitoring mechanism to ensure that community pharmacies meet the requirements of service agreements RCHEs should seek legal advice on their own on details of agreements between RCHEs and community pharmacies i Establish a mechanism for maintaining close and effective communication with community pharmacies 1 2 Communication Mechanism j Community pharmacies must provide contact details of the pharmacists on duty 1 3 Responsibility k In case of medication incidents pharmacists of community pharmacies may have to take the professional responsibility while RCHEs may also be held responsible for negligence or inadequacies in monitoring and management IH Requirements for Records 1 RCHEs have the responsibility to keep the Medical Administration Record of each resident m RCHEs also have the responsibility to retain the past drug records of the residents for reference
71. he admission agreement in particular those in relation to collection refund of payment to the residents and their guardian guarantor family members relatives at the time of admission The admission agreement must be signed by RCHE and the resident guardian guarantor family members relatives for confirmation The resident guardian guarantor family members relatives who sign s on the admission agreement should have sufficient cognitive ability to state that he she they understand and accept the contents and conditions in the agreement Any revision including the introduction of payable items shall be effective only after being signed and confirmed by the RCHE and the resident guardian guarantor family members relatives The home s arrangement in the case of the resident guardian guarantor family members relatives disagreeing with the home s proposed fee adjustment should also be stated in the admission agreement RCHE should provide the resident guardian guarantor family members relatives with a copy of the signed admission agreement for their retention Upon receipt of payment RCHE must immediately issue an official receipt bearing the name and or business chop of the RCHE to the resident guardian guarantor family members relatives that indicates clearly the payer date of payment payee items of payment payment period and amount paid RCHE should properly keep records of different payments made by the residents amounts paid by the RCHE
72. hroom The bathroom should be brightly lit Clear all water puddles immediately and keep the floor dry as far as practicable Wear slip proof rubber soled shoes Install assistive devices in the bathroom such as handrails non slip mat shower chair etc Always lock the legs in position when using a portable shower chair The resident should keep a correct sitting posture to prevent slips and falls Install an adjustable shower head holder so that the resident can turn the stopcock conveniently without twisting the body The door sill outside the bathroom must not be too high m Never place any small mat outside the bathroom door Bed Bath Suitable for residents that are bedbound with hunched back or cannot sit still The caregiver can wash such residents in bed to keep him her clean and comfortable Steps for bed bath ae O a mw Preparations Wash your hands first Gather all the necessary supplies Ensure the room is brightly lit and warm Protect the resident s privacy Adjust the height of the bed or sit down to avoid bending your waist Steps for bed bath Identify the resident Introduce yourself to the resident and tell him her that you are going to help him her with a bath Annex 11 6 3 Code of Practice for Residential Care Homes Elderly Persons Ze gt 9 If necessary give time for the resident to empty the bowels or bladder so that he she will feel clean and comfortable
73. igns windows parapets height and materials must be specified partitions bedspace arrangement bedspace numbering sanitary fitments gates extract fans air conditioning units gas stoves electric gas water heaters false ceiling artificial lighting and mechanical ventilating systems raised floors if applicable and all other fixture and fittings should be clearly indicated and annotated 9 10 Number and location of gas stoves type of gas in use and location of LPG chamber if applicable should be indicated The headrooms under ceilings the ceiling structure or suspended false ceilings and beams of all parts of the RCHE premises measuring vertically from the floor should be indicated Annex 3 3 1 Code of Practice for Residential Care Homes Elderly Persons 11 Walls should be indicated by double lines 12 The configuration and layout of the RCHE premises shown in the plans should tally with the actual situation 13 The operator is required to submit 4 sets of revised layout plans to the Licensing Office of Residential Care Homes for the Elderly for information and comment 6 sets for RCHE situated in premises under or divested by the Housing Authority whenever there is any change of the home layout or re arrangement of the bedspaces Parts where revisions have been made should be coloured on the revised layout plans to show the difference as compared with the previously acce
74. ir and the bed at the same time 4 Never leave the residents before ensuring that the restraints have been properly and securely tied 5 To prevent residents from being hurt when the bed rails are pulled up and down never fix the restraints to any movable bed rails 6 To prevent accidents from happening when residents are trying to damage the restraints never let the restrained residents touch any dangerous articles such as scissors knives nail clippers cigarette lighters and matches 7 Never use restraints that are made of improper materials for example materials that are too hard too soft or impervious Appendix 11 7 4 1 Code of Practice for Residential Care Homes Elderly Persons Appendix 11 7 5 Template revised in 2010 Observation Record of Residents under Restraint dd mm yyyy To dd mm yyyy Condition of the resident should be reviewed at least once every 2 hours while under restraint Name of the Residential Care Home for the Elderly Name of the Resident Room Bed Number __ The type of physical restraints used O safety vest Ol seat belt I soft ties soft cloth 0 gloves mittens DJ wrist restraints O non slippery trousers non slippery stripes DJ others please specify Period of applying physical restraints O whole day JO only in the daytime from to____ Ol only at night from __to___ O others please specify Observations notes 1 The restrained parts of the resident must
75. itoring mechanism must be established and implemented to avoid misuse of or dispute over money in resident s bank accounts a If the resident is in good mental condition being able to understand and manage personal financial matters he she may if he she so wishes authorise the RCHE to withdraw bank savings for paying the home fees and other charges on his her behalf while the RCHE must keep a record of the authorisation letter The letter of authorisation must be signed by the resident staff concerned of the RCHE and a witness who should be the guarantor family members relatives if there are such persons The RCHE should formulate guidelines and operational procedures as appropriate including keeping a complete and up to date record by a designated management supervisory staff The RCHE must also establish and strictly implement a proper monitoring mechanism the accounts bills and receipts etc are to be checked by the home operator regularly These records and accounts shall be made available for inspection at any time by the residents family members inspectors of LORCHE the respective caseworker and SWD staff concerned Annex 8 1 3 Code of Practice for Residential Care Homes Elderly Persons 16 b If the guardian guarantor family members relatives who is are responsible c for handling the personal financial matters of the resident is are not able to pay the home fees in person for any reasons the resident m
76. l confine one to a seating or lying down position for a long period of time thus significantly reducing a resident s mobility and joint movement and resulting in muscular atrophy 2 Residents bones may become brittle and fragile due to the reduction of weight bearing activities 3 Residents may develop lower limbs oedema due to reduced function of the blood vascular system 4 Restrained residents may have negative emotions such as anger shame fear helplessness distress etc 5 Residents may become bad tempered and anxious or even have depressive tendency as a result of long term use of restraints 6 Restrained residents may become frailer and have mental infirmity They may fall and hurt themselves as a result 7 Some residents resist restraints very much and may harm themselves or fall when they try to get rid of the restraints 8 As residents mobility is restricted they have fewer chances to talk to or get along with other people thus affecting their social well being Appendix 11 7 1 1 Code of Practice for Residential Care Homes Elderly Persons Date of last assessment on the application of restraints Name of Residential Care Home for the Elderly RCHE Name of Resident Sex __ Date of Birth Room and or Bed No I Problems of the Resident Please put a tick in the appropriate box May choose more than one Pre application Assessment Record and Consent for Applying Restraints Appendix 11 7 2
77. layout plans of the RCHE 6 sets for RCHEs situated in premises under or divested by the Housing Authority for requirements on layout plans please refer to Annex 3 3 of the Code of Practice photocopy of the fire service installation plan and relevant documents please refer to paragraphs 5 4 and 5 5 of Chapter 5 and Annex 5 1 of the Code of Practice For use of the location premises for operation of RCHE subject to the planning permission from the Town Planning Board the applicant representative of applicant should submit proof of the planning permission to LORCHE For operation of RCHE in the subject premises violating the land lease conditions the applicant representative of applicant should submit a waiver issued by the Lands Department to LORCHE as a proof of waiving of the land lease conditions Upon receipt of the above required documents and if all of them are in order under general circumstances LORCHE will take 8 weeks to complete processing an application for a licence and issue the licence Annex 3 1 7 Code of Practice for Residential Care Homes Elderly Persons WARNING 1 Any person who in or in connection with this application makes any statement or furnishes any information whether such statement be oral or written which is false in any material particular and which he or she knows or reasonably ought to know is false in such particular shall be guilty of an offence under section 21 6 a of the Residenti
78. llow up measures for the elderly as appropriate so as to ensure their safety and well being For detailed procedures of handling elder abuse cases in RCHEs reference could be drawn to the Procedures for Handling Institutional Abuse of Elders in Chapter 9 of the Guidelines 2 RCHEs should charge fees and handle residents properties in accordance with the Guidelines on Collection of Fees and Charges and Handling of Elderly Residents Properties to protect residents from financial abuse 3 RCHEs should submit a Significant Incident Report to LORCHE within three days if there is a suspected elder abuse or elder abuse incident occurred in RCHEs 4 RCHEs should keep documents of elder abuse cases properly including the Significant Incident Report Log Book health record of residents and correspondence with government departments and or other organisations etc to facilitate inspection and follow up action 5 To identify elder abuse cases as early as possible and provide appropriate services to the abused elders notices on how to make reports complaints must be displayed at the prominent locations of RCHEs to inform the staff elderly residents their family members or other persons of the channels for reporting cases of suspected elder abuse Note 1 Forms of elder abuse include physical abuse psychological abuse neglect financial abuse abandonment and sexual abuse Note 2 The Guidelines had been uploaded to SWD s website
79. me for the Elderly Authorisation for Custody of Properties I name HKIC no resident of your RCHE the guardian guarantor family member relative of your resident name of resident hereby authorise you to keep the following items in custody on my the resident s behalf O Hong Kong Identity Card O Medical follow up card O Medical waiver O Bank passbook Bank account no 1 2 3 Pocket money Name chop o Oo O Others Please specify Signed or fingerprinted by the resident guardian guarantor family member relative Name of the resident guardian guarantor family member relative Signed by staff in charge Name post of staff in charge Signed by witnessing staff Name post of witnessing staff Date Please delete as appropriate Note Please tick the appropriate box If the resident is cognitively incapable this acknowledgement should be signed by his guardian guarantor family member relative Annex 8 1 Template 1 1 Code of Practice for Residential Care Homes Elderly Persons Annex 8 1 Template 2 Name of Residential Care Home for the Elderly Acknowledgement of Receipt of Properties Put under Custody I name HKIC no resident of your RCHE the guardian guarantor family member relative of your resident name of resident after checking the record with your RCHE on date acknowledge receipt of the following items previou
80. needed Assess residents chewing and swallowing abilities Give appropriate assistances if needed Communicate with residents before feeding so as to let them know that it is meal time Adopt a warm and caring attitude in explaining the feeding procedures to facilitate residents understanding and cooperation As for demented residents discuss the menu with them to enhance their cognition and stimulate their interest in food For residents with visual impairment guide them along by informing them the food types and positions of food and utensils to enhance their confidence in self feeding Choice of Food i Gi iii Individual s food preference religions and health status of individuals should be taken into consideration during preparation of meals e g diabetic low salt or vegetarian diet etc Choose food that is safe and easy to swallow Change menus regularly and choose nutritious food to stimulate appetite and ensure that resident s nutritious needs are met Prepare food according to individuals abilities e g provide puree porridge or fluid diet where necessary Remove the bones and skin of meat Cut meat and vegetables into small pieces for easy chewing and to prevent choking Annex 13 1 2 Code of Practice for Residential Care Homes Elderly Persons e iv Avoid food which are sticky and difficult to chew of swallow so as to prevent choking e g konjac jellies glutinous rice balls glu
81. ng of the residents lower limbs may occur due to reduced blood circulation Restrained residents may have negative emotions such as anger shame fear helplessness distress etc Residents may become bad tempered and anxious or even have depressive mood as a result of long term use of restraints Restrained residents may become more frail and apathetic They may fall and hurt themselves more easily Some residents resist restraints very much and may harm themselves or fall when they try to get rid of the restraints As residents mobility is restricted they have fewer chances to talk to or get along with other people thus affecting their social well being End Appendix 11 7 2 2 Code of Practice for Residential Care Homes Elderly Persons Appendix 11 7 3 Recommendations of Possible Approaches other than Restraints Resident s Condition Suggested Approach 1 Mentally confused 2 Demented elderly with wandering behaviour Consult a medical practitioner to identify the reasons for mental confusion e g hypoglycemia drug overdose drug reactions etc and take proper medication Communicate with the family and understand the underlying causes of the resident s wandering behaviour Maintain the resident s living habits and set regular daily routines e g regular toilet time mealtime exercise etc Arrange for leisure and physical activities within residents ability range according to their prefer
82. nmental temperature that may affect elderly residents physical health 7 Should an elderly resident fall ill arrangement should be made for him her to undergo medical consultation immediately Annex 11 9 1 Code of Practice for Residential Care Homes Elderly Persons Annex 11 10 Cold Spell Precautions 1 According to Section 24 of the Residential Care Homes Elderly Persons Regulation and para 4 9 1 of the Code of Practice for Residential Care Homes for the Elderly Code of Practice every residential care home for the elderly must be adequately heated lighted and ventilated Para 7 2 and 7 4 of the Code of Practice stipulates that heaters meeting general safety standard must be installed when necessary 2 Ensure that every resident has sufficient clothing such as hat mittens or gloves socks quilt blanket etc 3 Provide adequate and nutritious food to residents so that they can have sufficient calories intake Hot meals and hot drinks should be provided to residents in cold weather 4 Arrangements should be made for residents to perform appropriate exercise for production of heat thereby raising the body temperature and achieving better fitness 5 Enhance the health care and daily care for residents in particular those with chronic diseases by measuring and recording health condition data such as blood pressure pulse body temperature etc Special attention should be paid to their change in body t
83. o be fed Pour in warm water before and after feeding the residents with medicine to avoid blockage of tubes by the medicine In cases where choking vomiting or shortness of breath appears do not continue feeding as it may be a symptom of wrong flow of liquid into the respiratory tract G Points to Note 1 2 The test result of the pH value may be affected by the food and the medicine fed RCHEs should maintain close liaison with the families of the residents to let them know clearly about the residents conditions and if necessary discuss with them the plans of providing assistance in feeding the residents The weights of the residents should be measured regularly to monitor their weight conditions If the residents are found to be under nourished health care practitioners should be consulted as soon as possible so as to take appropriate follow up actions Syringes should be disposed of in accordance with the Waste Disposal Ordinance Cap 354 and its subsidiary legislation the Waste Disposal Clinical Waste General Regulation RCHEs should make reference to the guidelines and any subsequent amendments issued by the Department of Health the Hospital Authority and or the Licensing Office of RCHEs in carrying out the relevant healthcare procedures Social Welfare Department Licensing Office of Residential Care Homes for the Elderly September 2013 Compiled by the Task Group on Health and Care Services of Residential Car
84. o two or more different objects e g not to fix the restraint to a chair and a bed simultaneously to allow quick removal of the restraints and prevent hindering the escape of the residents in case of emergency When applying restraints methods allowing speedy removal such as reef knots must be used so that the restraint can be removed by the staff promptly in case of a fire or emergency Restraints must be applied with an appropriate degree of tightness Do not apply the restraints too tightly to avoid affecting blood circulation to the restrained areas As a general principle the knot of restraint must be tied in such a way that leaves space for one to two fingers to insert into However staff must use judgement according to the body parts to be restrained the resident s physical conditions susceptibility to swelling special reaction etc Restraints should be applied and secured properly to ensure safety and comfort of the residents with allowance for change of position e g Restraints should be fixed and tied at the lateral sides of the bed frame wheelchair geriatric chair or chair with armrests and a wide heavy base To prevent residents from being hurt when the bed tails are pulled up and down never fix the restraints to any movable bed rails If bone prominence such as wrists are to be restrained soft pad must be used to cover the skin in touch with the tie for protection against abrasion Other body parts under the pres
85. ode of Practice for Residential Care Homes Elderly Persons 6 If restraints are used a the dignity and privacy of the residents must be respected with close attention of the safety and comfort of the residents concerned and b the minimum level of restraints or arrangement must be adopted The restraints must be used for the minimum of time and must not be used longer than necessary 7 Restraints shall only be used by the home manager nurse in charge or health worker in charge with prior written consent obtained from a registered medical practitioner and the resident and or his her guardian guarantor N family members relatives When consulting a registered medical practitioner staff of RCHEs must explain clearly to him her about the reasons leading to the needs of restraints including the residents behaviour and health conditions B Procedures to be Observed in Applying Restraints 1 Assessment 1 1 Nurses or health workers must assess in detail the individual conditions of the residents and consider the contributing factors that place the residents at risk leading to the application of restraints They must also record the reasons for using the intended restraints alternative attempted the type of restraint to be used and the time of application The assessment may include one or more of the following items a emotional condition e g confusion disorientation etc b persistent disturbing behaviours
86. of Practice for Residential Care Homes Elderly Persons 11 Letter of Compliance issued by the Ventilation Division of FSD Fixed Electrical Installation Work Work Completion Certificate Form WR1 Photocopy of Fuel Gas Installation Work Certificate of Compliance Certificate of Completion and documentary proof of registered gas contractors and gas installers Emergency evacuation plan Polyurethane PU foam i Test reports 11 Invoices from manufacturers suppliers 10 111 Goods labels Certificate of Fire Service Installations and Equipment FS 251 for use of accepted fire retardant solution if applicable ID Renewal of Licence 1 Certificate of Fire Service Installations and Equipment FS 251 of the RCHE Eg Certificate of Fire Service Installations and Equipment FS 251 for sprinkler system and or hose reel system of building if applicable 3 Annual Inspection Certificate AIC of Ventilating System if applicable 4 Latest fire drill report 5 Pages 1 and 2 of Electrical Installation Work Work Completion Certificate Form WR1 Periodic Test Certificate Form WR2 6 Documentary proof of annual inspection of fuel gas installations if applicable and registered gas contractors and gas installers Annex 5 1 2 Code of Practice for Residential Care Homes Elderly Persons Annex 8 1 Guidelines on Collection of Fees and Charge
87. of Practice for Residential Care Homes Elderly Persons Annex 13 1 Working Guidelines for the Staff of Residential Care Homes on Feeding Assistance to Frail Elderly Residents 1 Introduction 2 3 4 Residents in residential care homes for the elderly RCHEs with chronic illness or impaired mobility may suffer from various degrees of feeding problems thus affecting their health condition and quality of life It is therefore important for RCHE staff to provide appropriate assistance according to frail resident s individual needs to enable them to regain confidence in self feeding and enjoy eating RCHE staff should be patient and caring when taking care of residents incapable of self care The following information is extracted from the elderly health service webpage of the Department of Health and the address is http www info gov hk elderly english healthinfo elderly feeding e htm Objectives a To maintain a healthy diet and balanced nutrition b To prevent choking c To minimise residents dependence on RCHE staff by improving their self care abilities d To improve resident s quality of life Residents Who May Need Feeding Assistance a Weak in upper limbs or low mobility of upper limbs b Not suitable to take food unassisted due to cognitive impairment or mood disturbances c Not suitable to take food unassisted due to serious visual impairment d Have swallowing difficulties
88. on Smallpox Streptococcus suis infection Tetanus Typhoid fever Typhus and other rickettsial diseases Viral haemorrhagic fever Viral hepatitis West Nile Virus Infection Whooping cough Yellow fever Tuberculosis Annex 12 1 2 Code of Practice for Residential Care Homes Elderly Persons Annex 12 2 Appendix K Suspected Outbreak of Infectious Disease in RCHE NOTIFICATION FORM To Central Notification Office CENO Centre for Health Protection Fax 2477 2770 cc Licensing Office of Residential Care Homes for the Elderly Fax 2574 4176 3106 3058 Community Geriatric Assessment Team CGAT If applicable Fax NOTE To enable prompt investigation and control of infectious disease outbreak please call CENO by phone Tel 2477 2772 before sending fax notification Name of RCHE Address of RCHE Contact person Post Tek Total no of residents Total no of staff Fax No of sick residents No admitted into hospital No of sick staff No admitted into hospital Common symptoms O Fever O Sore throat May tick multiple O Cough O Running nose items O Diarrhoea O Vomiting O Skin rash O Blisters on hand foot O Oral ulcers O Others Please specify Suspected infectious disease Reported by Name Telephone No Signature Fax on Guidelines on Prevention of Infectious Diseases in RCHEs Annex 12 2 1 Code
89. on the residents behalf receipts etc RCHE can encourage residents to pay home fee by autopay Residents receiving CSSA payment or their appointee are obliged to keep proper management of the CSSA payment received for paying home fees and other charges In case of non payment of home fees and other charges by the residents receiving CSSA payment or their appointee RCHE may contact relevant staff of the field unit of SWD which will then recover and deduct the overpayment or proceed with other appropriate arrangements RCHEs should inform the residents and the guardian guarantor family members relatives in writing of any proposed increase in fees or charges for any service or goods including monetary adjustment due to inflation or change of residents health conditions at least 30 days prior to the effective date RCHEs are forbidden to draw on the long term supplement and or the additional standard rate payments if applicable granted to CSSA recipients for subsiding their home fees Written consent and authorisation should be sought from the resident and the guardian guarantor family members relatives for possessions or property stored or Annex 8 1 2 Code of Practice for Residential Care Homes Elderly Persons 13 14 15 held on behalf of every resident by the RCHE including the identification document bank passbook ATM card pocket money medical follow up card etc Such consent and authorisation should be
90. oney possessions of resident fraudulently by staff 3 5 L Others please specify lt Applicable to 3 1 to 3 5 gt Reported to the police a OYes b O No c L Others please specify To be continued Annex 8 6 1 Code of Practice for Residential Care Homes Elderly Persons E 2 4 Dispute inside RCHE requiring police assistance a LJ Between residents b Ll Between resident and staff c LJ Between staff and visitor d LJ Between staff e L Between resident and visitor f L Others please specify 5 Serious drug incident a Residents admitted to hospital for examination or treatment after taking the wrong drugs b LJ Residents admitted to hospital for examination or treatment after missing a dose or an overdose c LI Residents admitted to hospital for examination or treatment after taking proprietary Chinese western medicine 6 Serious clinical incident Please elaborate 7 Major incident in RCHE affecting its daily operation for at least 24 consecutive hours a L Suspended fresh water supply b LI Suspended flushing water supply c LI Power suspension d U Fire e LJ Landslip flood other natural disasters and accidents f LI Building defects 8 LJ Other categories please specify The guardian guarantor family members relatives or contact person name of the resident has have been informed a LI Yes date and time b O No Signature Post N
91. or the guardian guarantor family member relative who has authorised RCHE to withdraw money from the bank account on his her behalf Name of resident HKIC no Bank account no Date Deposit amount Withdrawal amount Balance Signed by appointer Signed by staff in charge Signed by witnessing staff Note An appointer refers to the resident or his her guardian guarantor family member relative Please state the purpose for the deposit withdrawal Annex 8 1 Template 4 1 Code of Practice for Residential Care Homes Elderly Persons Annex 8 1 Template 5 Name of Residential Care Home for the Elderly Record of Deposits and Withdrawals of Resident s Pocket Money Applicable to resident or the guardian guarantor family member relative who has authorised RCHE to keep and use the resident s pocket money on his her behalf Name of resident HKIC no Bed no Date Deposit Withdrawal Balance Summary Signed by Signed by Signed by appointer staff in charge witnessing staff An appointer refers to the resident or his her guardian guarantor family member relative Annex 8 1 Template 5 1
92. pervision or assistance in bathing and AQ Fe ee BS not more than 4 in other activities IE AS SS EXE totally dependent HEBER Part V Comments PUED Hat 1 Self care Hostel JEREZ EI In general resident is capable of high degree of self care HR Kar gt EX A ies A KARA 2 Home for the Aged FERHZ EN In general resident can observe personal hygiene but need help and guidance for performing household duties fQKa gt FEA ABETI PREP TE gt 8 FE oP Je LETS as Se ese 3 Care and Attention Home HERE bt In general resident is generally weak in health or suffering from functional disability and requires constant help in meal dressing up and toilet etc but not requires constant and intensive professional nursing care fx Kar gt EX AY PER LE gt KAKA LAME IRERR FK HET E gt ARR SI EEE Re 4 Other Eftr Signature Date SE HEH Doctor s Name Hospital Clinic FEER Bor Doctor s Chop BEN Annex 11 5 4 Code of Practice for Residential Care Homes Elderly Persons Annex 11 6 Template Working Guidelines for the Staff of Residential Care Homes for the Elderly RCHEs Bathing Skills Keeping the body clean is the basic physical need of everybody As such bathing is an important part in the daily routine of every resident and helping residents to bathe is an important duty of RCHEs Since every resident has developed a unique habit and preference through decades of experience staf
93. plans and notification mechanism Set up a mechanism for staff training in days in advance drug pre packing and assess the knowledge and skills of the staff on a regular basis VI Requirements for Records q 1 Clear and complete drug records of the residents should be kept and updated regularly In case of any update of drugs drug records must be updated and printed out for keeping in the files of the residents It must be noted that RCHEs which procure services of days in advance drug pre packing provided by community pharmacies are still responsible for drug incidents due to negligence or inadequacies in monitoring and management and they should observe the following principles I Transfer of Personal Data and Drugs a b Procurement of services from community pharmacies involves personal data and drugs of the residents and must be operated in accordance with the requirements of the Personal Data Privacy Ordinance such as informing the residents in advance and obtaining consent from them and or their family guardians and requiring community pharmacies to adopt appropriate measures to prevent leakage of personal data of the residents Establish service agreements with community pharmacies II Service Agreements 1 1 Terms of Agreements c d e It is required that pharmacists are responsible for coordinating monitoring and reviewing the whole process of preparing packing and handing over of dru
94. pt clean Feeding Procedures and Care gt Wash hands Clean the resident s oral cavity Check the graduation of the RT tube to see if it is correctly positioned displaced or coiled in the oral cavity Ensure that the RT tube is fixed with plastic tape Confirm the position of the RT tube 4 1 Remove or open the plastic cap of the RT tube Attach a 10 20ml feeding syringe to the port and slowly inject 10 20ml of air into the RT tube Withdraw gastric contents gently and test its acidity with the pH indicator If the pH value is 5 5 or less the RT tube is correctly placed and feeding can be commenced If gastric contents cannot be withdrawn 4 2 4 3 Try changing the resident s position e g to a side lying position Inject 10 20ml of air into the RT tube and obtain gastric contents again after 15 30 minutes and Using pH indicator to obtain pH reading provides a more accurate and objective testing result Medical advice should be sought in case no gastric contents can be obtained after repeated attempts of the procedures position of the RT tube cannot be confirmed or the RT tube is suspected to be dislocated Observe the colour texture and volume of the gastric contents after they are withdrawn In case of any abnormality stop feeding and seek medical advice or send the resident to the A amp E Annex 11 11 2 Code of Practice for Residential Care Homes Elderly Persons updated in September 2013 5 Fill th
95. pted ones 14 Where necessary e g complicated drawings requiring professional knowledge the applicant should appoint a professional to prepare the plans Annex 3 3 2 Code of Practice for Residential Care Homes Elderly Persons Annex 3 4 RESIDENTIAL CARE HOMES ELDERLY PERSONS ORDINANCE Ho A Be G Bil LORCHE Number Chapter 459 Laws of Hong Kong pon He plz RY BE BAA PI 4S 9 Licence Number hat HS Am ai Licence of Residential Care Home for the Elderly Z ZEER 1 This licence is issued under Part IV Section of the Residential Care Homes Elderly Persons Ordinance in respect of the undermentioned residential care home a Pa AR AERP SBIVEDES ERE Se LR 2 Particulars of residential care home ZEA a Name in English Name in Chinese Z EXX Ate EX b i Address of home ZE NH 11 Premises where home may be operated nee ee AT as more particularly shown and described on Plan Number___________ deposited with and approved by me Fre ia SLA ral Als He aXe RUPE AS SA gt MAA gt c Maximum number of persons that the residential care home is capable of accommodating Ere TULANE N ER 3 Particulars of person company to whom which this licence is issued in respect of the above residential care home ER FIZERA E
96. resident at the same time Drugs of other residents shall not be placed within the working area for drug preparation Preparing and checking of drugs must be separately performed by at least two qualified staff members i e nurses health workers dispensers pharmacists or medical practitioners according to the procedures set out in Chapter 2 5 of the Manual Since drugs in different compartments may mix together during the sealing process the staff concerned should as far as possible check the drugs before the sealing procedure and must check the drugs again after sealing Medical practitioners pharmacists or nurses of RCHEs may revise this procedure as appropriate according to the actual operation However RCHEs must in this connection put in place a set of comprehensive working guidelines and monitoring mechanism to ensure the accuracy of drug preparation Unpacking and changing the drugs sealed inside packs may carry some degree of risk and hence should be avoided as far as possible When the prescribed drugs of the residents are changed or the sealed drugs have to be unpacked due to other circumstances two qualified staff members of RCHEs must prepare and check all the drugs again according to the procedures set out in 1 II g above before sealing the drugs III Information i 0 Information on the drug packs should be automatically generated by the software of the computer database to avoid mis match of information du
97. ring the process The upper part of the drug packs must contain the information of the resident including the name bed number identity card number showing only the alphabet and the first three numbers or other identity document number the commencement date of the drug packs the time intervals of drug intake and the photo of the resident The drug packs must contain information on drug intake including the drugs name dosage formulation the number of pills and the frequency of medication It is even better to have drug descriptions e g colours shapes and marks etc The information of the drugs to be taken including the drugs name dosage and number of pills should be clearly indicated in each time interval of drug intake Annex 11 1 2 Code of Practice for Residential Care Homes Elderly Persons 2 IV Requirements for Storage and Recycling of Materials k 1 Store properly the drugs prepared drug packs and other tools for preparing and packing drugs Blister packs and other packing materials must not be reused to avoid contamination of drugs V Monitoring System m n 0 p Appropriate procedures for drug distribution should be formulated for the System Designated staff should be responsible for the coordination of monitoring and reviewing the whole process of preparing checking and distributing drugs There should be guidelines for handling drug near misses incidents contingency
98. s especially for areas exhibiting a sign of skin redness 3 2 Keep the skin of residents clean dry and moisturised Timely change of diapers and wet clothing and bed linen Application of lotion and skin protectant for residents as advised by the health care practitioners 3 3 Check the skin of residents daily with special attention paid to the areas over bony prominences Check for early signs of pressure ulcers Adequate Nutrition Intake 4 1 Refer to Chapter 13 Nutrition and Diet 4 2 A feeding regimen including the type of milk amount time and intervals of feeding should be prepared for residents with feeding tubes in accordance with Paragraph 11 8 g of Chapter 11 D Handling Pressure Ulcers 1 If pressure ulcers have occurred regardless of the stage staff in RCHEs shall follow the care and management instructions as advised by health care practitioners and allied health professionals e g dietitian occupational therapist physiotherapist etc including Avoid persistent pressure on the affected areas Avoid massaging the affected areas Annex 11 12 4 Code of Practice for Residential Care Homes Elderly Persons updated in September 2014 2 Closely monitor the other parts of the body to look for signs of pressure ulcers Properly record the development of pressure ulcers to facilitate the formulation of appropriate care plans by the staff and heath care practitioners Continu
99. s and Handling of Elderly Residents Properties in Residential Care Homes for the Elderly RCHEs The operator and the home manager in handling the collection of fees and charges and residents properties must strictly adhere to the requirements set out in the Code of Practice for RCHEs and the guidelines as follows 1 2 3 Note 1 A Note 2 A RCHE shall explicitly specify the amount that is amount per month per time per item in HK dollar of home fees and other charge items including services or products and have a list of charges setting out clearly all the charge items charging criteria and the actual amount unit cost RCHEs are strictly prohibited from adopting a pricing method without specifying the actual amounts such as charging the total Comprehensive Social Security Assistance CSSA including Residential Care Supplement payment as the home fee charging a fee equivalent to the CSSA amount etc Clear lists of charges shall be displayed in prominent places in RCHE to facilitate access of residents family members and other people Before residents are admitted RCHE must give the list of fees and charges to the residents their guardian N guarantor family members relatives and clearly explain to them the charging details RCHE should state the following clearly in the admission agreement a rules governing RCHE charges b home fees payable by residents i e the amo
100. se take the food to the nurse health worker on duty for proper processing before arranging for consumption of the resident If the food is not suitable for the resident the nurse health worker will advise you to take 1t away after the visit If you want to share the food you bring in with other residents please give it to the nurse health worker on duty for proper processing before arranging to share with other residents Annex 13 2 2
101. se the tube thoroughly with warm water to clear drugs adhered inside 9 Drug Review El El O O Yes Bigs 0 03 Yes No a Conduct regular drug review O b The drug review is conducted by a nurse or health worker of the RCHE O L c Results and follow up actions of the drug review are recorded clearly and C filed for reference 10 Risk Management Report of Drugs if applicable Yes No a In the event of drug near misses or incidents the Home Manager conducts C timely investigations takes follow up actions and completes the Drug Risk Management Report b Where the residents need to be hospitalised for medical treatment as a result _ of drug incidents the responsible officer of the RCHE uses the Special Incident Report together with the Drug Risk Management Report to report the incident to the Licensing Office of Residential Care Homes for the Elderly of the Social Welfare Department as soon as possible Remarks Name of Checking Officer Signature of Checking Officer Post of Checking Officer Date of Signature Formulated by the Working Group on Drug Safety in RCHEs November 2009 Annex 11 4 4 Code of Practice for Residential Care Homes Elderly Persons Annex 11 5 Medical Examination Form for Residents in Residential Care Homes for the Elderly Z E bi tAm RRA GEHE Part I Particulars of Resident A PERR Name Sex Ag
102. sident is cognitive impairment I E guardian guarantor famil y member relative visiting doctor of Resident s name hereby witness that the resident cannot sign the consent due to cognitive impairment Witness Signature Relationship with the Resident Date dd mm yyyy V Guardian Guarantor Family member Relative s Intention I guardian guarantor family member relative visiting doctor of Resident s name after being clearly explained by staff doctor of the home the reasons for using restraint type of restraint to be used period for the restraint to be used short term and long term impacts that may be caused by the use of restraint see Special Notes below and other alternatives that have been exhausted and their effectiveness hereby agree disagree to the use of restraint as suggested in parts 2 3 and 4 in II above Witness Signature Relationship with the Resident Date dd mm yyyy Please delete as appropriate Special Notes Adverse impacts that may be caused by the use of restraint The use of such should 1 e AED therefore be avoided as far as possible The use of restraints will confine one to a seating or lying down position for a long period of time thus significantly reducing a resident s mobility and joint movement and resulting in muscular contracture Residents bones may become brittle and liable to fracture due to the reduction of weight bearing activities Swelli
103. sidents vi ensuring appropriate seating positioning for the residents on wheelchair and vii applying brakes to all movable objects e g beds wheelchairs commode etc Give more attention to the residents who may injure themselves or others at times of unstable emotions Provide leisure and diversionary activities or Promote sports activities e g organising exercise groups and assisted walking activities etc Annex 11 7 3 Code of Practice for Residential Care Homes Elderly Persons 3 C g See Appendix 11 7 3 for recommendations of other alternatives to the use of restraints Intervention Plan a b c d Explain to the resident and or his her guardian guarantor family members relatives and registered medical practitioner in detail about the reasons for applying restraints alternative attempted and the outcome Explain to the resident and or his her guardian guarantor family members relatives in detail about the purpose and procedures of applying restraints with the positive outcome and possible adverse impact highlighted The residents may choose to apply restraints if they consider that restraints can enhance security and safety Determine which type of restraints should be less restrictive for the residents as far as possible e g seat belt of a wheelchair e Written consent of a registered medical practitioner and or the resident his her guardian guarantor
104. sly put under your custody by me the resident Signed or fingerprinted by the resident guardian guarantor family member relative Name of the resident guardian guarantor family member relative Signed by staff in charge Name post of staff in charge Signed by witnessing staff Name post of witnessing staff Date Please delete as appropriate Note Please tick the appropriate box If the resident is cognitively incapable this acknowledgement should be signed by his guardian guarantor family member relative Annex 8 1 Template 2 1 Code of Practice for Residential Care Homes Elderly Persons Name of Residential Care Home for the Elderly Record Form for Custody Collection of Properties Annex 8 1 Template 3 Name of resident HKIC no Bed no Item of Date of Name of Name of Name of Date of Collecting Name of staff Name of Note property custody appointer receiving staff witnessing Collection of person returning the witnessing under custody staff property property staff An appointer refers to the resident or his her guardian guarantor family member relative Annex 8 1 Template 3 1 Code of Practice for Residential Care Homes Elderly Persons Annex 8 1 Template 4 Name of Residential Care Home for the Elderly Record of Resident s Bank Account Balances Applicable to resident
105. sore development 4 1 Stage I Intact skin with non blanchable redness of a localised area The sensation and the temperature of the affected skin may differ from normal skin 4 2 Stage II Injuries to the epidermis or dermis Skin loss or blisters occur oozing fluid may be found No slough is found 4 3 Stage III Full thickness skin loss with subcutaneous tissue injury fat may be visible but bone tendon or muscle is not visible or directly palpable Slough undermining or tunneling may occur The depth of the wound varies with the affected area Annex 11 12 2 Code of Practice for Residential Care Homes Elderly Persons updated in September 2014 C 4 4 Stage IV Full thickness skin loss Subcutaneous tissue is completely damaged and bone tendon or muscle is visible or directly palpable Slough eschar undermining or tunneling may occur Prevention of pressure ulcers 1 Relieve or reduce pressure 1 1 1 2 1 3 1 4 1 5 1 6 Encourage self reliant residents to increase physical activities for position change Assist residents in need to change their lying positions at least every two hours In addition sitting time should not be longer than two hours so as to avoid persistent pressure on a certain part of the body Supine lying position and lateral position should be adopted interchangeably to reduce pressure on localised parts of the body For lateral position
106. sure of restraint should also be covered by soft pad Annex 11 7 5 Code of Practice for Residential Care Homes Elderly Persons 11 12 13 14 15 16 D Round the clock use of restraints must be avoided as far as possible The restraints should be removed at appropriate times to allow relaxation and body movement of the resident Help the resident change position and carry out skincare on restrained body parts Once contaminated or wet the restraint must be changed immediately to prevent skin problems Residents with restraints must be assisted to change position regularly to prevent pressure ulcers caused by persistent pressure on the body Restrained residents must be assisted to maintain comfortable posture Their limbs should be kept slightly bent and maintain mobility Assist the resident with range of motion exercises regularly to prevent muscle contracture and ankylosis Close attention must be given to the resident concerned during the use of restraints and the resident should be placed in sight of the staff as far as practicable Measures must also be taken to prevent blocking of blood circulation and respiratory difficulty of the user due to displacement of the restraint Check and record the condition of the restrained resident at least once every two hours and the record must be signed by the staff concerned The purpose of checking is to assess whether there is a need to continue with the use of res
107. t Contact address Contact telephone no Details of Complaint LI LI O Personal care service L Fee charging Environmental hygiene O Facilities Others please specify resident family member staff others Complaint handling and investigation result Follow up work and or improvement Name of responsible staff Name of home manager Signature Signature Date Date Annex 8 8 1 Code of Practice for Residential Care Homes Elderly Persons Annex 8 9 Guidelines for Handling Elder Abuse Cases in Residential Care Homes for the Elderly Residential care homes for the elderly RCHEs have the responsibility to protect the elderly from any forms of abuse The Licensing Office of Residential Care Homes for the Elderly LORCHE of the Social Welfare Department SWD provides the following guidelines for handling suspected elder abuse cases in RCHEs Operators home managers of RCHEs should read this Guideline and the relevant guidelines carefully and provide their staff with clear operational guidelines on protecting the elderly from abuse 1 RCHEs should in accordance with the Procedural Guidelines for Handling Elder Abuse Cases Revised August 2006 5 the Guidelines issued by SWD seriously investigate and handle suspected elder abuse cases and refer the cases to social workers for follow up actions and professional assessment to formulate welfare plans and various fo
108. tection system v Compatibility proof of the control box of fire detection system and the detectors installed vi Calculation of back up battery capacity of fire detection system vii Checklist for the Inspection of Fire Detection System FSD Circular Letter No 1 2004 viii Certification of fire resistant cable 2 Fire service installations and equipment to be installed apart from Item 1 above applicable to floor area of less than 230 m i FSV314A FSI 314B FSI 314C as appropriate including plan s of sprinkler system and or hose reel system with the stamp of FSD and subsequent reply NP 317 from DFS li For newly installed sprinkler and or hose reel system a notification letter and a Fire Services Certificate FS 161 issued by DFS as well as a No Objection Letter on use of water issued by the Director of Water Supplies should be submitted 111 New Certificate of Fire Service Installations and Equipment FS 251 3 Certificate of Fire Service Installations and Equipment FS 251 for emergency back up generator if applicable 4 Certificate of Fire Service Installations and Equipment FS 251 for ventilation air conditioning control system if applicable 5 Ventilating system if applicable 1 As fitted drawings of the ventilating system To be submitted to the Ventilation Division of FSD via SWD for further processing Annex 5 1 1 Code
109. ter feeding Remain sitting in upright position for at least 20 to 30 minutes to prevent aspiration iv For residents who are particularly frail observe them regularly after feeding e g their mental state and signs of aspiration and choking Consult a doctor as soon as possible in case of problems Communication and Cooperation with Relatives and Friends of Residents A multi pronged approach should be adopted to improve the feeding problems of residents It includes enhancing the physiological and psychological well being of residents strengthening their physical and self care ability and providing them with aids For this approach to work comprehensive assessment by and tender care of RCHE staff are needed but the love and care of residents relatives and friends are equally important RCHEs should therefore maintain close contact and discussion with residents relatives to improve feeding of residents where necessary and encourage them to visit residents more frequently or accompany or assist feeding residents directly to motivate residents and rebuild residents confidence in eating Co compiled by the Social Welfare Department the Department of Health and the Hospital Authority April 2009 Annex 13 1 4 Code of Practice for Residential Care Homes Elderly Persons Annex 13 2 Template Working Guidelines for Staff Handling of Food and Other Things Brought in by Visitors To protect residents safety and health
110. tinous rice dumplings Chinese New Year puddings beef omasums and beef tendons Cut them into smaller pieces before serving and remind residents to be careful when eating RCHEs should avoid providing such kind of food to residents with swallowing difficulties Preparation for Residents i Gi Assist residents in wearing dentures if required Proper positioning is important to safe swallowing Back support should be provided to ensure that residents are sitting comfortably in an upright position The seats should be adjusted to suitable height Safety Tips on Feeding G Gi iii iv v vi vii viii ix x Ensure that resident is fully alert during feeding Ensure proper positioning of the resident Sitting with head slightly flexed and chin down which reduces the risk of choking Serve food at the right temperature Avoid serving food which is too hot or having uneven temperature to prevent residents from scalding Avoid serving food which is too cold as it may spoil the appetite of residents or cause discomfort Observe residents pace of eating and give them appropriate assistance Do not hurry them Do not rush or feed too much food at one time Feed another mouthful of food only after residents have finished chewing and swallowing or checking there is no food inside their mouths If residents refuse to eat try to find out the reason and patiently encourage them to eat Do not allow resid
111. to the skin and deep tissue Frictional force Repeated friction of the skin against a surface may cause injuries Scraps on the bed creases of bed sheet or plastic sheet etc may also create friction thus causing injuries to the skin of the resident Moisture Excessive moisture from excrement urine or sweat softens the outer layer of the skin making it prone to injuries Other factors Annex 11 12 1 Code of Practice for Residential Care Homes Elderly Persons updated in September 2014 Slow recovery of body tissue owing to malnutrition and insufficient protein Chronic illnesses e g diabetes stroke etc Inability to feel pressure and change position on one s own due to reduced sensation in the skin Reduced blood flow to tissue caused by diseases like heart disease anaemia etc that increase the risk of pressure sore development or Ageing and degeneration reduced sensitivity to temperature and pain fragile skin nerves and blood vessels of the elderly that increase the risk of injury 3 Body parts most prone to pressure ulcers Pressure ulcers generally occur over bony prominences For supine lying position pressure ulcers occur over the occipital bone spine sacrum scapula ankle and heel While for lateral position they occur over the anklebone medial and lateral malleoli elbow hip shoulder and ear 4 Classification and symptoms In general there are four stages of pressure
112. traint depending on the resident s prevailing behavioural conditions and reactions See Appendix 11 7 4 for mistakes that must not be made when applying restraints Observation During the application of a restraint to a resident observe check and record his her blood circulation skin condition breathing condition and level of restraint at least once every two hours and observe the following carefully a the condition of the restrained body part by removing the restraint b ifthe restraint has been dislocated or loosened Annex 11 7 6 Code of Practice for Residential Care Homes Elderly Persons E c the resident s toileting needs and personal hygiene d if the resident is taking sufficient water and nutrition and e the resident s emotional and psychological response for example if there is any sign of resistance depression abnormal emotional condition etc Record the condition of each restrained resident immediately after performing observation and check Sign the record for confirmation and If there is any abnormal condition of the resident report immediately to the home manager nurse or health worker for inspection and assessment of the condition Arrange for timely medical consultation if necessary Protecting Restrained Residents from Assault Appropriate precautions including but not limited to the following must be in place based on the actual circumstances of the home to protect restrain
113. unt per month in HK dollar and the specific amounts i e the amount per month per visit per service per item in HK dollar for items of payable fees for different services goods e g transportation fees for attending medical appointment escort fees for attending medical treatment dressing charges diaper fees nutritional milk product charges air conditioning fees and the detailed information on such charges c arrangement for collecting deposit d deadline for payment and arrangement for handling overdue payment e arrangement for home fee for residents with long term in patient treatment f arrangement for collection refund of payment for discharge e g leaving the RCHE death etc including the home fee deposit other paid fees non refundable fees and processes and procedures for refund of payment and g arrangement for fee adjustment etc guardian refers to a person appointed by the Guardianship Board and thus with legal status accorded guarantor refers to a relative or non relative of the resident who voluntarily involves in handling various matters for the resident including applications for admission to and discharging from RCHE discussion of care plans and payment of fees etc without legal status accorded Annex 8 1 1 Code of Practice for Residential Care Homes Elderly Persons 4 5 6 7 8 9 10 11 12 RCHEs are required to explain clearly all the terms in t
114. updated in September 2014 treatment for follow up actions as soon as possible in addition to assisting health care practitioners in wound management E Points to Note 1 Deterioration in pressure ulcers may cause severe complications including osteomyelitis septicaemia etc which may pose health risks to residents Therefore RCHEs should take measures for needy residents as early as possible to prevent the occurrence of pressure ulcers 2 RCHEs should continuously monitor the skin condition of residents and upon identifying any pressure ulcers take early follow up action and seek advice from health care practitioners as soon as possible 3 RCHEs should maintain close contact with the families of the residents with a view to ensuring that they understand the physical condition of the residents and where necessary discussing with them the plan for prevention and management of pressure ulcers 4 RCHEs should carry out the relevant nursing procedures as advised by the Hospital Authority staff or registered medical practitioners with regard to the personal health and care needs of the residents September 2014 Licensing Office of Residential Care Homes for the Elderly Social Welfare Department Prepared by Task Group on Health and Care Services of Residential Care Homes for the Elderly Annex 11 12 6 Code of Practice for Residential Care Homes Elderly Persons A List of Notifiable Infectious Diseases The follo
115. ust have a good mental condition he she they may sign an authorisation for any person who is being trusted or the RCHE to do so If RCHE is appointed the RCHE concerned must implement the authorisation procedure and monitoring mechanism as mentioned in a The authorisation letter must be signed by the resident s guardian guarantor family members relatives staff of the RCHE concerned and a witness If the resident is certified by a registered medical practitioner as mentally unfit or a mentally incapacitated person and is incapable of managing personal financial matters operators and staff of the RCHE are strictly prohibited to withdraw any bank savings to pay the home fees and other charges on behalf of the resident The RCHE should request the resident s guardian guarantor family members relatives or the respective caseworker to arrange for an appointee to handle matters relating to the home fees and other charges RCHE should refer to the chapter on Basic Knowledge on Elder Abuse in the Procedural Guidelines for Handling Elder Abuse Cases Revised August 2006 to protect residents against financial abuse RCHE should also refer to Guidelines for Handling Elder Abuse Cases in RCHE in Annex 8 9 for proper handling of cases involving financial abuse of residents to safeguard their properties Annex 8 1 4 Code of Practice for Residential Care Homes Elderly Persons Annex 8 1 Template 1 Name of Residential Care Ho
116. ut the bathing process Maintain a caring attitude to ask the need of the resident throughout the bathing task Be aware of the skin health condition and behavioural reaction In case of any abnormality the nurse health worker should be informed for follow up Should use a large towel to pat the body dry after washing and check if folds of skin and less exposed areas are dry Annex 11 6 2 Code of Practice for Residential Care Homes Elderly Persons 6 7 8 Apply skin lotion according to the needs of individuals Assist the resident to wear clean clothes in the bathroom or curtained area in the room Assist the resident to return to his her room and settle down in a suitable area Assist the resident to groom and put on shoes and socks etc Prevent Scalding Caused by Bathing Adjust water temperature by turning on cold water first and then hot water Check the water temperature before starting to bathe m Never add hot water into the bath or suddenly increase the flow of hot water through the shower head to avoid scalding caused by overheated water pouring on the resident Install a thermostat on the water heater for a stable water temperature control Avoid using the kettle to boil water for bathing because it is easy to cause splash from the kettle during transportation Instead a thermostat water heater should be installed in the bathroom to minimise the risk of accident Prevent Slipping in the Bat
117. where appropriate Remarks A The assessing staff member has to be either a nurse or a health worker B The RCHE concerned is required to carry out re assessments regularly not less than once every half a year and update invalidate the consent form under any of the following circumstances La The said resident family member guarantor has requested that the drugs will no longer be stored or administered by himself herself The said resident s cognitive or drug handling ability has deteriorated Changes in the condition of residents nearby resulting in increased likelihood of the said resident s drugs being taken by mistake or Changes in the types of drugs for self storage and self administration C The RCHE concerned is required to complete the drug delivery and collection record which should be signed by the said resident for confirmation Annex 11 3 2 Code of Practice for Residential Care Homes Elderly Persons Annex 11 4 Checklist on Drug Safety in Residential Care Homes for the Elderly RCHEs Name of the RCHE Date of Checking 1 Observation of the Environment and Conditions in which the Drugs are Stored a b c d e g h i 0 k 1 m n 0 p q The drug storage cabinet is kept in a place without direct sunlight The environment in which the drug storage cabinet is kept is dry and cool which is suitable for storing drugs The drug storage
118. wing list of Notifiable Infectious Diseases is set out in First Schedule to the When reading this Code of Practice please check with the Centre for Health Protection of the Department of Prevention and Control of Disease Ordinance Cap 599 Health for any subsequent amendments to these provisions DO LE A 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Acute poliomyelitis Amoebic dysentery Anthrax Bacillary dysentery Botulism Chickenpox Chikungunya fever Cholera Community associated methicillin resistant Staphylococcus infection Creutzfeldt Jakob disease Dengue fever Diphtheria Enterovirus 71 infection Food poisoning Haemophilus influenzae type b infection invasive Hantavirus infection Influenza A H2 Variant Influenza A H3N2 Influenza A H5 Influenza A H7 InfluenzaA H9 Japanese encephalitis Legionnaires disease Leprosy Leptospirosis Listeriosis Malaria Measles Meningococcal infection invasive Mumps Paratyphoid fever Plague Psittacosis Q fever Rabies Annex 12 1 1 Code of Practice for Residential Care Homes Elderly Persons 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 Relapsing fever Rubella and congenital rubella syndrome Scarlet fever Severe Acute Respiratory Syndrome Severe Respiratory Disease associated with Novel Coronavirus Shiga toxin producing Escherichia coli infecti
119. y of the RCHE Existing number of beds and residents of the RCHE Existing no of beds Existing no of residents care and attention places aged home places self care places Total Net floor area of the RCHE it should be the same as marked on the layout plan submitted with this application form square meters The RCHE is please tick as appropriate aproposed service business an existing service business Date Tentative date of commencement of service business Date Month Year Does the RCHE comply with the statutory plans land lease conditions Deed of Mutual Covenant and tenancy agreement please refer to paragraph 4 2 of Chapter 4 of the Code of Practice and tick as appropriate Yes No Others please specify Monthly fee charged per resident Minimum Maximum Annex 3 1 3 Code of Practice for Residential Care Homes Elderly Persons Section II Ownership of Business for completion if the RCHE is a private establishment registered with the Inland Revenue Department according to the Business Registration Ordinance 1 Ownership of business please tick as appropriate Sole proprietorship Partnership Corporate body 2 Name of operator s For completion if the operator is a sole proprietorship or partnership i Mr Miss Ms English surname first Chinese Hong Kong Identity Card HKIC No 11 Mr Miss Ms English

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