Annual Report


CHIMO YOUTH & FAMILY SERVICES INC.
2015/16 ANNUAL REPORT

Vision

Service excellence in the delivery of children’s mental health services

Mission

Strengthen the ability of children and youth to effectively deal with and/or resolve their mental health challenges, building resiliency for the future.  Strengthen caregivers’ understanding, skill base and ability to guide and support their children.

Values

Respect, integrity, transparency, innovation and professional excellence

2015/16 Board of Directors

Doug Murphy   President

Allan Mountford   Vice President

Kate Farnell   Secretary/Treasurer

Marcy Finn   Director

John Baldry   Director

Cindy Mount   Director

2015 to 2020 Strategic Plan

Service Capacity

  • Innovative use of technology
  • Improved professional work space
  • Improved staff recruitment, retention and training
  • Innovation in service delivery
  • Improved community awareness of Chimo services
  • Improved intake process
  • Improved rural service delivery
  • Balance between the needs of clients in service and those on waiting lists
  • Enhanced external partnerships

 

Quality Assurance

  • Clear strategies to gather feedback including the use of youth and parent engagement and a vertical slice/360 feedback
  • Thoughtful approach to vendor selection and service provider performance
  • Enhanced understanding and use of performance management
  • Internal relationships based on respect and transparency, clear and timely communication and the demonstration of appreciation
  • Professional development that responds to the changing needs and requirements of clients, staff, Board and governing legislation

Executive Director’s Report

Children’s mental health in Ontario is under the proverbial microscope and in the midst of significant review and possible change making agency planning a challenge.  There are many unknown outcome details. 

The Lead Agency process is now underway and Chimo, with its cross-jurisdictional responsibilities, is involved in two and possibly three service area planning discussions.

The Expert Panel on Residential Services has filed a 147 page report that in very broad strokes suggests the need for greater agency accountability with the establishment of a MCYS “inspectorate” that would take residential licensing to a new level including unannounced visits.  The report also notes that the panel saw little difference between group care and residential treatment.  There is much more in the report and no reference to the need for a financial investment in residential treatment.

The Auditor General’s value for money audit of children’s mental health continues.  We hear the inquiry has included a strong focus on residential services.  Agencies audited to date include Kinark, Youthdale and Vanier in London and now the Children’s Centre in Thunder Bay.

We are also moving to full proclamation of the Psychotherapy Act perhaps by April 2017 specifically the definition of the act of therapy itself.  The Act has been proclaimed except for this critical definition.

There is a common thread through all of this:

  • All core services must be available in each service area.
  • They must be easily accessible ideally with no wait times.
  • Services, especially therapy, must be delivered by staff and supervisors registered in one of the five colleges regulating psychotherapy.  Counselling will not be regulated. 
  • Residential services must have a strong treatment focus.  

All of this with MCYS indicating there will be no new funding for children’s mental health.  Resolution will fall to lead and individual agencies.

All of this sounds daunting.  However we cannot move to a place of fear and become immobilized.  Any reluctance to respond appropriately will simply lead to more challenges.  As we move through this period of transformation, I encourage all staff to ask questions.  Please don’t assume the answers and please realize all of this is not going to go away if we wait long enough.  We must respond individually, in our program teams and as a staff group positively and proactively.  No doubt we will make missteps along the way.  We will learn and move forward.

There to be an opportunity here to make a difference in the lives of children, youth and their families and an opportunity to bolster our own personal growth.  Fasten your seat belts and enjoy the ride.

Service Delivery

By Region Served:

  Clients   % of total
Durham 96 15.8
CKL 466 76.6
Northumberland 4 0.7
Peterborough 12 2
Haliburton 5 0.8
Simcoe 16 2.6
York 9 1.5
Total 608 100%

 

By Program:   

Adventure Quest – Teresa Rye Supervisor

During this fiscal year the Adventure Quest program has had the opportunity to serve 14 clients within the school months. During the summer, we had the opportunity to serve 6 clients for a condensed version of Adventure Quest combining both SNAP as well as social skills programming. In the fall of 2015, we welcomed Stacey Gudmundsson to the Adventure Quest team. She is covering a maternity leave for Ashley Kulla.  Transportation and parent involvement remain our biggest challenges in the program.

 

Balsam Lane Residential Treatment – Vanessa Rowland Supervisor

In this past year we have 14 clients served at the girl’s residence, with consistently 7-8 clients at a time.  Given the challenging behaviours of some of these clients, not all were able to remain in the program to complete their treatment.  At these times, workers have managed to support other clients to meet their treatment goals in order to be successfully discharged from the program or stay on track with their individualized treatment plans.  This has shown true dedication to the team at Balsam Lane, as it has been a difficult year.

Throughout this, clients and staff have still been able to enjoy many hands-on learning experiences to enhance their residential placements.  Some of these include work at Abby Gardens and a local horse farm, going skiing and snowshoeing, as well as volunteering at last year’s fundraiser in partnership with Giant Tiger.  They have also produced some beautiful artwork through pottery lessons and made quilts and sleepwear thanks to Mr. Holness’ (TLDSB teacher) desire to enhance the classroom experience.

This year we have introduced a new client incentive program called STEAM Bucks, which stands for Success, Trust, Empathy, Acceptance and Meaningful relationships.  The idea behind the program is to encourage clients to go beyond the typical expectations of their treatment goals in one or more of these areas.  So far they have responded well to this.  

 

Community Programs – Stephanie Anderson Supervisor

Intake

The intake process based on both internal and external antidotal reports went through a significant change in September 2015. For clients living in the City of Kawartha Lakes or clients living in Haliburton, Northumberland or Peterborough they can call our main line at the office and select two to make a referral for services. Clients living in the Durham region due to there being three children’s mental health agencies providing services in this region still need to contact central intake initially to make a referral. Once we receive a referral the family is contacted, the intake process is explained and their initial session is booked.

Previously clients had one intake meeting however, now clients receive up to four intake meetings roughly over the course of six to eight weeks for non-intensive services. This allows for families to feel more comfortable with workers and provide us with more information on which to make decisions as to which service will be the most beneficial to clients. Now sessions often involve meeting with parents and children separately, if there are behavioral issues at school we do a classroom observation to provide parents and/or adolescents with some recommendations/strategies that they utilize while they are on the waitlist for longer term supports.  Once the intake is completed the worker then brings the information gathered to the multidisciplinary team to discuss who in the agency can best provide services to support the individual or family to make the changes that lead to a referral. This new process also allows families to gain an understanding of the commitment required to successfully participate in longer term services. To date we have received very positive feedback from both our community partners and parents regarding this shift. We are looking at doing a more formal review of the shift in the near future.

 

Crisis

We have received some new funding from the Ministry related to providing crisis services at the Boys and Girls Club of Kawartha Lakes. Lisa Hall began attending the Youth Warehouse program in April 2016 on Thursdays in the afterschool hours and Julie Sine will start attending the club one day a week in the summer to provide crisis support to individual attending the clubs summer programing and then move to attending the Youth Warehouse in the fall one evening a week. As the program is new we have had limited referrals but anticipate an increase as youth become familiar and comfortable with our staff. We continue to provide crisis support through our now 30-day crisis response program which can be accessed Monday to Friday 9am to 5pm by calling the crisis line. Between May 2015 and May 2016 we provided some form of crisis support to 62 individual/families.

 

Family Skills Building and Support

Due to maternity leaves our two family skills building workers were not available to take the lead this year in the Family Skills Building groups that have been run which has meant that our clinical workers have needed to step in and assist in fulfilling this role. We were able to run an adolescent family skills building group towards the end of the 2015 school year which was successful. In September we ran an 8-12 Family Skills Building group with a companion Lego group. In January 2016 we successfully ran a 0-7 Family Skills Building group. Due to the area where participants lived all groups were run in Lindsay this year. We attempted to run an Adolescent Family Skills Building group in North Durham however do to clients declining this group did not proceed and a second 8-12 Family Skills group was offered at the office. Between May 2015 and May 2016, 31 families were offered or participated in the Family Skills Building groups. The Family Skills Building groups continue to allow clients to access services sooner and to receive support from other parents who are experiencing similar behaviors with their children.

Due to work schedules we have had more families chose to participate in our in office Family Skills Building program this year as shift work often makes it challenging for families to commit to weekly groups even for ten weeks. Again due to maternity leaves many of these files have been picked by a clinical worker. We currently have six clients waiting for this service.

 

Groups

We have run five Lego based social skill groups between May 2015 and May 2016 reducing our Lego waitlist from over thirty clients to nine clients. Lego continues to be one of the most popularly requested groups that we offer. We have run two Stop Now and Plan groups a psychoeducation anger management group out of the office. Also well we have run one Drama based social skills group for adolescents this year as well.

 

Counseling Therapy

We have experienced some staffing changes in the individuals providing counseling and therapy services in the last year. We currently have two clinical workers joining the team on a contract basis. Ruth-Ellen Baker who started in October 2015 and will be with us until October 2016 and work three days a week as well as Leah Reinhartz who works five days a week and joined us in November 2015 and will be with us until the end of July 2016. These individuals have allowed us to reduce our individual therapy waitlist to five to six months in duration. We currently have less than 20 clients waiting for this service.

Play Therapy continues to be a sought after service which we offer. Despite Julie Sine needing to dedicate half of her time to the Family Skills Building program in order to maintain quality and continuity in that program with maternity leaves we have been able to maintain our waitlist with clients only waiting a year for this service which has been this historical level for this program even when we had one clinical worker primarily dedicated to this program/service.

We had a masters level placement student join up from January 2016 until August 2016. Diana has been taking on intake clients, co-facilitating groups providing service to a few crisis and brief clients as well as some longer term individual therapy and play therapy clients. I continue to enjoy and find it mutually beneficial to have maters level placement students join us from the Yorkville program. While we have had some enquiries from other maters level programs these programs were not able to make a commitment to Chimo and our clients which was felt to be in the best interest of our clients and agency.

While the multidisciplinary team has experienced a number of staff changes in the last year there remains a commitment to supporting each other in providing the agencies clients with the highest level of service that we can.

 

Day Treatment Program and Mental Health School Worker – Brenda Stewart

Since the last Annual General Meeting; the day treatment program that was located at SA Cawker in Port Perry was moved to Sunderland Public School in August 2015.  The students have transitioned well to the new location despite the longer bus ride to and from their homes. Having the two elementary programs located on the same site has provided the programs an opportunity to share resources; participate in the physical education program together and if possible combine programs in case of illness of teacher or CYW. Our students have been successfully integrated into classes at Sunderland Public School for various amounts of time. We have five elementary students that have successfully completed the programs. Two are returning to their home schools, one is graduating to high school and the other two are moving to ME classes located in Cannington.

The plan for the elementary programs for September 2016 is for one program to provide service for the Primary/Junior students, while the other service for Junior/Intermediate students.

At Brock High School the enrollment in the day treatment program continues to be low, three full time students. Part of this is due to low enrollment at the school and some resistance of families accessing mental health services for the youth and family. We currently have five reverse integrated students for one to two periods per day for academic support; it gives the family and youth an opportunity to see what we have to offer. Two of those students and their families have made referrals for full time placement in September 2016. We have two students being successfully discharged from the program in June 2016.

We started off the school year at Uxbridge Secondary School with a full complement of students. One student and family left the program after the first semester. Out of the remaining students one left the program prematurely due to the family situation. We were able to support her to access the Durham Alternative Secondary School Program, two will be successfully discharged and two students will return for September 2016.

Often at our program reviews the Chimo Consulting Psychiatrist provides praise to the team as some of the students in our programs not only had multiple mental health diagnoses but also severe learning difficulties which required creative planning in order to meet their academic and treatment needs.  That truly speaks to the successful partnership we have with our program teachers from Grove School.

The Mental Health Worker who provides services to the elementary schools in North Durham.  She works with the Durham District School Board and the Durham Catholic School Board. This school year she has worked at Cartwright Public School in Blackstock, McCaskill Mills Public School in Cannington; Holy Family Catholic School in Beaverton and Immaculate Catholic School in Port Perry.  She has implemented Fun Friends and Friends for Life groups as well as provide brief counselling to individual students that have be recommended by the school administration and or the school social worker. We have also provided a group at another school in Brock Township that the school board identified were in need of some immediate intervention.  We continue to receive positive responses from the community and the school board in regards to this service being provided in North Durham.

The Return Ticket Program is still located in a mall in Port Perry. This year we have had one student that was expelled from the School Board full time in the program. The child and youth worker provides individual and or family counselling.  The goal is for the student to earn his ticket so he can return to his home school. The CYW also supports the Durham Alternative Secondary School students with their academics and provides the Life Skills component of the program. 

 

School Intervention Team CKL – Teresa Rye Supervisor

This team of dynamic staff members continued to provide a variety of supports to students in both the public and separate school boards. Supports include individual counselling, group interventions and family support where needed.  Services were made available at LCVI, IE Weldon, Fenelon Falls and Central Senior again this year. We also returned to St Thomas Aquinas to support students as well as St Dominic’s Elementary School. This year we able to provide our supports to the following Public Elementary Schools; King Albert, Mariposa, Dr. George Hall, Park View and Leslie Frost.

We were fortunate to have Megan Jilesen join the team in September to cover Tina Harrington while on maternity leave.

Chimo continues to value our partnerships with our local school boards and we look forward to continued growth and working together to meet the needs of children, youth and their families in our community.

 

Sprucehill Residential Treatment – Ian Flaherty Supervisor

Here at Sprucehill the later months of 2015 leading into 2016 have been some challenging times with some difficult clients. The staff group have done their best to remain client focused and positive.  With the nice weather on the way the boys are looking forward to mountain bike season (minus the black flies) and will be taking part in at least 3 races at Hardwood Hills. Since the beginning of the 2014 school year the boys along with the staff group have been working on a farm in Minden. During their time there they have help pick vegetables, plant new crops, etc. Through this experience the boys are learning what hard work is and are able to gain a school credit for their hard work (exploring the work place).

Although this has been a challenging time I feel the staff have helped the clients make many positive gains toward their treatment goals and should be applauded for that!

 

Trillium House Residential Treatment – Shauntana Holmes Supervisor

The Trillium Program has gone through many changes over the past year. With changes with the program supervisor and staffing it has shifted quite a bit. With these changes many positive gains have been seen with the client. He has shown more independence and responsibility than in the past. The staff have done a great job accepting the changes and providing their feedback and ideas on how to improve the program and the delivery of care to the client. There is a positive feeling with the staff as they embrace the skills they poses and apply each day. As a result of their skills and knowledge of the client they have been able to alter and implement new plans that support him as he grows within the program and better prepare him for adulthood.

 

Wintergreen Respite – Trish Agnew Supervisor

In this fiscal year, Wintergreen had approximately 76 open files.  There were 16 new referrals in the year, five of which didn’t attend respite before being closed.  We could not accommodate two of those five referrals while the other three did not proceed further in the process for a variety of reasons beyond Wintergreen’s control.  There were 38 file closures in total for the year this includes the five that were mentioned above, eight of those discharges were a result of the youth aging out of the program and 11 were a result of the youth being placed outside the home either into a treatment programs or into long term out of home placements, five moved out of area and the reminding nine discharges were made in consultation with coordinators and/or families as service was no longer needed or desired. 

As a result of ongoing inflationary costs a full time staff was laid off.  This had an impact on the number of clients served and resulted in the program putting a hold on processing any new referrals. Processing new referrals will resumed in April 2016.

Despite the impact that this had on the program and the staff group, I must acknowledge the supervisor and the staff for their unwavering dedication to the children and youth that come to Wintergreen and their ability to pull together as a team to provide quality care.  

 

Youth Mental Health Court Worker:

Our Youth Mental Health Court worker which is only .25 of a position provides essential support to young person’s experiencing trouble with the law and experiencing mental health concerns. In this fiscal year, this worker received 4 referrals from the Crown Attorney’s office to help youth find mental health supports in the community in hopes of diverting away from criminal charges.  Of the four referrals, three were successful in this process.  While this number may appear low, in talking with our Ministry Program Supervisor, numbers throughout the Province are low in general. Our worker attends all scheduled Youth Court dates to provide support to any youth that may need assistance with the court process as well as accepting referrals that maybe diverted in the City of Kawartha Lakes.

 

TAPP-C (The Arson Prevention Program for Children):

There were seven referrals made for TAPP-C assessment this fiscal year.  One was rated moderate to high risk for future fire involvement, four were rated moderate risk for future fire involvement, two rated low.  Unfortunately parent follow through with local Fire Departments has been low for the fire safety and other education components, with only three families completing the program.  Of the seven referrals four either were or have become connected to services at Chimo. 

 

Chimo’s Quality Assurance and Continuous Improvement Policy

Chimo will maintain a commitment to the quality of services provided to the community through a variety of processes to promote continuous improvement.

The Board through the Executive Director will ensure that there are defined processes to promote quality, improvement and address any issues of quality that may be identified.

A Quality Assurance Report will be provided to the Board annually. It will include a summary of all quality assurance activities, any actions taken for continuous improvement and recommendations for future activities.

 

Ongoing Internal Quality Assurance Processes

Chimo’s Management Team acts as the Quality Assurance Team overseeing various activities related to continuous improvement and through the Quality Assurance Lead documents any actions taken that relate to Quality Assurance activities, whether they are led by QAT or externally through the Canadian Centre for Accreditation and MCYS licensing processes as examples.

The following information provides a summary of Quality Assurance activities that occurred in 2015 as per policy and offers recommendations for 2016.

 

Consumer Feedback

Client Satisfaction Questionnaires were reviewed and data compiled from these surveys completed as clients complete the intake process and are discharged from services.

The review points to the need to refine/change the questions posed to more effectively tease out areas where improvements made be needed. Supervisors are reviewing their respective feedback forms. 

Currently, feedback is overwhelmingly positive with little to no constructive input for how the process of case management could improve.  Also, we want to hear from more voices in the entire process.  We want to build a feedback process that links the client, caregiver and case worker’s feedback adding community worker and teachers where possible to achieve a broader perspective.  That work is in progress for 2016.

YouthREX and the Centre for Excellence are providing training and added facilitation to the process.

 

Strategic Planning

As part of the community consultation to update the Strategic Plan, email surveys were sent out to community/school contacts specifically regarding Chimo’s presence and impact in the community.  Community partners see Chimo staff to be ‘good’, responsive to client needs, providing quality services and able to work within time limitations.  Some respondents in larger organizations like school boards commented they had limited information or understanding about Chimo and its services.  The distribution of future communications may need to go to senior levels of these organizations or any future survey may need to be focused on those in these larger organizations who routinely work with Chimo directly.

We will be launching Chimo’s new website in 2016 and revising our brochures.  Once completed brochures will be sent out to all community partners and contacts at all levels within those organizations.

 

Complaints and Serious Occurrences

Other indicators of service quality include formal client complaints and serious occurrence reports that must be submitted to the Ministry within 24 hours of their occurrence.

We have not had any formal complaints in 2015.

We had the typical number of serious occurrences in 2015.  The occurrences tend to focus on a small number of residential clients who present behavior that requires interventions to ensure their safety and the safety of other clients, staff and property.  A debriefing is completed after each incident with the client and the residential team to determine how the incident may have been managed differently.

An annual report is submitted to the Ministry each calendar year.

 

Performance Evaluations

All staff members participate in an annual performance review.  Collectively the reviews identify training needs and the need for program improvements.

The location of Chimo and particularly the location of the residential programs limit our ability to attract and retain qualified staff.  This is an ongoing challenge that is further complicated with the proclamation of the Psychotherapy Act.

The definition of qualified will now rooted in law with regulated practices being managed by the five colleges that regulate the act of “therapy”.  While the move to college regulation is beneficial, the transition may be difficult.

Management of the implementation of the Act is a work in progress.  Not all of the parameters are known at this time however preliminary planning has begun based on what is known now. 

Our goal is to manage the change with the least disruption to clients and staff.

 

File Audits and Supervisions

Client files are audited as part of the supervisory process and formally on closure following the requirements of the Canadian Centre for Accreditation.

 

Licensing and Accreditation

All four of Chimo’s residential programs and residences are licensed annually by the Ministry of Child and Youth Services.  The entire agency is accredited every four years.  The current accreditation ends September 2018.

 

Financial Audit

Our financial audit took place in May 2016 conducted by Collins Barrow.  There were no issues of concern for the agency.  A full report can be found in the financial offices of Chimo’s head office in Lindsay.

 

Service Delivery Challenges

Chimo’s service area is spread out geographically with transportation often creating barriers to services. For this reason the new family service model has been rolled out in three locations, Beaverton, Lindsay and Fenelon Falls to assist in addressing transportation issues.

We continue to experience families who have been encouraged by other agencies to access our services but who can be challenging to engage as they are often only willing to accept service in limited ways.  

The new College of Psychotherapy and the Psychotherapy Act will impact our service delivery and individual worker’s scope of practice within the field of children’s mental health.  We are continuing to understand how this will impact service delivery and the staff in the years to come.

Community Participation

CKL/County of Haliburton Children’s Planning Table and two associated sub committees

Four Counties Collaborative and two associated sub committees

Durham Children and Youth Planning Network and two associated sub committees

Durham Collaborative and one associated sub committee

CKL/Haliburton High Risk Planning Group

Lindsay Executive Directors Group

DRAP/Rap 4Counties

Central Intake

Threat Assessment in both Durham and CKL

TAPP-C

Memorandum of Understandings

Trillium Lakelands School Board

Peterborough Victoria Northumberland Clarington Catholic School Board

Durham District School Board

Durham Catholic School Board

Walk-in Clinic Durham (multi agency initiative)

Kinark Youth and Family Services

Boys and Girls Club of Lindsay

Durham Crisis Service (multi-agency initiative)

Four County Collaborative

Durham Collaborative

SNAP – Children’s Development Institute