Dilectus Madeira

internal regulation

INTERNAL REGULATION

Chapter I

Purpose / Scope and Objectives

Article 1

Purpose

1. The Residential Assisted Living ASSICOM, Funchal, hereinafter called DILECTUS, aims to inform the rights and duties of the legal representatives of the Company and its clients as well as to promote active cooperation between both parties, in order to ensure the fulfilment of the Company’s objectives.

2. DILECTUS is a private company which aims to coordinate Assisted Residences for the elderly and public in general, whose purpose is to provide services to its clients.

Article 2

Scope

1. DILECTUS aims to welcome clients with or without special needs on a permanent or temporary basis, aiming the accomplishment of its clients’ satisfaction, admitted of their own free will to live within our premises and surrounding community.

2. The admission process can be initiated by the client him/herself, family members, carers or legal guardians with specific credentials for such a purpose if the client’s ability is diminished.

3. Individualized Care Plans shall be provided by the Assisting Doctor and by the Head Nurse to diagnosis and create a plan for each client to promote and encourage the client’s autonomy and/or minimize adverse effects of the client’s emotional and physical needs, if applicable, in order to provide the maximum satisfaction of the client’s daily activities.

Article 3

Objectives

1. Ensure full satisfaction of the client’s daily activities: accommodation, meals/personalized diet, care planning and health treatment.

2. Promote the continuation of good relationship with the client’s family members, friends, neighbours and fellow clients.

3. Ensure and respect autonomy, individuality, privacy, and free expression of opinion.

4. To monitor and guarantee the client’s social inclusion and permit the continued practice of his/hers religious beliefs.

5. Promote social interaction, self-esteem and security.

6. Contribute to the aging process, fully accepted as a natural part of life.

Article 4

Principle values

Principal values in the activities undertaken by DILECTUS:

a) Humane caring: ensure respect for human dignity, concerning all and every aspect of the client’s privacy, giving priority to the confidentiality of the client’s medical records;

b) Ethics: ensure the implementation of all professional ethics from the different professional providers in contact with the client;

c) Quality and efficiency: promote high quality and maximum efficiency in all practices;

d) Family members’ cooperation: encourage and facilitate family members’ involvement as a crucial factor for the client’s adaptation and continuing improvement;

e) Transparency: always act with accuracy and transparency enabling DILECTUS’ objectives;

f) Responsibility: promote a culture of accountability, ensuring directors and employees working at DILECTUS, work in compliance with the internal rules and procedures, being answerable for their actions to DILECTUS’ Management.

Article 5

Accommodation

DILECTUS has 80 beds, in single and double rooms, from which 18 are, in principle, for Assignment of Right to Use and Lifelong.

Chapter II

Admission

Article 6

General Terms of Admission

1. Admission’s terms and conditions are applicable:

a) if there is vacancy at DILECTUS;

b) if the candidature meets the approval of DILECTUS’ Management;

2. and upon Client’s proposal addressed to DILECTUS’ Management and shall meet the following criteria:

a) express willingness to be admitted according to Article 2 above;

b) at the time of admission the client is not suffering from any contagious or infectious disease and/or mental disorders which could threaten the DILECTUS residents’ stability.

Article 7

Admittance Procedure

1. The admission request shall be with written consent of the client/ family member/carer/legal guardians, as applicable.

2. After submission to the Clinical Director of DILECTUS a meeting shall be held with the client/family member/carer/legal guardian, and an Application Form shall be filled in accordingly.

3. The application process shall be submitted upon presentation of the following documents:

a) Registration Form duly filled in by the client/family member/carer/legal guardian, as applicable.

b) photocopies of the following documents:

Identity card / Passport;

Fiscal card;

National Health Service card;

Social Security card, ADSE or other health subsystem card;

Family member/carer/legal guardian’s ID and proof of residence for contact purposes.

4. In the Admittance Procedure, the following information shall be provided to the candidate:

a) Terms and Conditions;

b) Opening hours of all service units;

c) Registration Form;

d) and the list of documents required together with the registration form;

5. if there is a vacancy, the admission may be made immediately upon the Management’s approval.

Article 8

Admission Procedures

At the time of admission the following procedures shall be carefully observed:

1. Completion and signature of an accommodation contract and the provision of services between DILECTUS and the client /family member/carer/legal guardian, where both parties’ rights and duties are specified, including the monthly fee, according to DILECTUS Terms and Conditions.

2. Presentation of all documents mentioned in the preceding article and attached photocopies of those that possibly are already outdated or expired, within 30 days of the registration date.

3. Medical report attesting the absence of infectious disease and/or mental disorders according to Article 6, paragraph 2 (b).

4. Medical report with the Client’s medical history.

5. Family member/carer/legal guardian’s ID, residence card or proof of residence and Fiscal card according to Article 7 paragraph 3 (b).

6. Drawing up list of all property and possessions brought by the client to DILECTUS premises, and delivered into its custody, which must be signed by all parties involved in the client’s admission contract.

Article 9

Monthly Fee

1. At the time of admission, clients shall provide a deposit of a financial guarantee equivalent to the amount of the monthly fee.

2. For stays longer than six months, clients shall be required to pay an admission fee equivalent to two monthly fees.

3. The monthly fee shall be paid by the 10th day of each month to ensure the continuation of the contract.

4. All additional services which are not included in the monthly fee shall be listed in a separate Invoice/Receipt and paid by the 10th day of each month.

5. If the client passes away in the first half of the month, the monthly fee should correspond to half; if the death occurs after this period, the monthly fee shall be paid in full.

6. The monthly fee includes all services referred in Article 10.

7. The value of the monthly fee can be altered, provided it is approved by the Management and shall be communicated to the client/ family member/carer/legal guardian, as applicable, at least 180 days in advance.

8. If payment of the monthly fee is delayed for more than 30 days, DILECTUS can suspend or revoke the contract.

Article 10

Services included in the Monthly Fee

The monthly fee includes the following services:

a) accommodation;

b) meals in the dining room;

c) personal assistance with Daily Living Activities (getting up, going to bed, going to the bathroom, getting dressed, getting undressed, help with feeding if required and other similar basic needs);

d) promote autonomous physical activities;

e) promote and develop socio-cultural/leisure activities;

f) personal laundry;

g) hygiene and comfort care;

h) medical and nursing basic health care, i.e. meet basic needs: appropriate diet and hydration and assistance with prescribed medication and administration of injections and simple bandaging, if required;

i) manage prescription medication and its acquisition upon request;

j) At client’s costs, provide transport to hospitals and other health services on his/hers request and eventual accompaniment by a DILECTUS’ employee;

k) use of the gym;

l) use the swimming pool (when available);

m) TV and Wi-Fi basic package in the bedrooms;

n) use of all common areas.

Article 11

Services not included in the Monthly Fee

1. The following services are not included in the monthly fee:

a) private phone calls, and any other phone calls of value added tax;

b) beauty treatments (hairdresser, manicure, pedicure, massage);

c) medication;

d) diagnostic tests, treatment and specialist appointments, serum therapy, bandage, except simple bandaging, provision of oxygen and any other regular medical procedure;

e) special care, namely physiotherapy, physiatry, rehabilitation and related services;

f) incontinence pads and similar;

g) dry cleaning and hand washing for personal laundry;

h) à la carte meals and bar expenses or any other facilities not referred to in Article 10 above;

i) activity classes, not included in Article 10 above;

j) high speed internet access and specific TV channels in the bedrooms;

k) room service for meals except when residents are bedridden.

Article 12

Special Contracts

Clients can contract more personalized arrangements regarding accommodation and assistance on a permanent or temporary basis. Contracts must reflect each client’s specific situation.

Article 13

Client’s Integration

1. The client’s integration process, normally takes about 4 weeks after admission. A successful integration is particularly important for long-term residents. During this period of time special attention will be given to relationship issues, between the Client and the DILECTUS Team and fellow residents always respecting the client’s individuality.

2. On the first day of admission, the DILECTUS’ Technical or his substitute will be present in order to develop an Individualized Care Plan for the new resident.

3. After admission, an Individual File for the client shall be opened, the data of which is confidential and restricted.

Article 14

Services Provided by DILECTUS

The services referred to in this document shall be provided inside DILECTUS premises, 24 hours a day without interruption:

a) accommodation, meals, hygiene and other needed services to provide a good quality of life to the client;

b) medical monitoring, if needed, as well as nursing care assured by Nurses working inside DILECTUS’ facilities;

c) accompany the client outside DILECTUS’ premises to acquire goods and services, whenever it is deemed necessary, provided the client has no family members or if family members are not available for the said purpose;

d) accommodation will be in single or double bedrooms, duly equipped for the purpose;

e) besides its permanent residents, DILECTUS can provide temporary residence to clients who need to stay for short periods of time (ex.: family´s vacation periods, respite care, temporary illness, convalescence, etc.);

f) five daily meals shall be provided, or more if duly prescribed, within the schedules that are posted in the Restaurant, Lounge and Reception;

g) the menus posted weekly can be altered whenever needed.

Article 15

Healthcare

Medical Appointments, Nursing, Physiotherapy, Rehabilitation and any other similar service shall take place in the appropriate places and according to the timetable displayed in the Reception and Nursing Room.

Article 16

Visits

1. Visits by family members or friends shall take place at the Reception, Lounge or in the bedroom, if single occupation, or if the resident is bedridden, visits shall occur within the schedule posted at the Reception and Lounge.

2. Outside these hours visits shall only be permitted in specific cases and if authorized by the Management or the DILECTUS’ technical team.

3. visitors can have meals in the Dining Room, whenever they want, provided that they are requested in advance and payment made separately.

Article 17

Outings

1. Group outings are the responsibility of DILECTUS’ Leisure Manager, who organizes the activities in which clients can participate, as well as their family members, providing that there are places available in the means of transport used.

2. Some outings are free and others shall be paid for by the client. All outings are optional.

3. During the group outings, clients shall always be accompanied by the DILECTUS’ Leisure Manager and, if necessary, by other DILECTUS’ collaborators.

4. If the client does not have ability to choose to participate in outings an authorization from the family member /carer/legal guardian will be required.

Chapter III

Rights and Duties

Article 18

Rights of DILECTUS

The rights of DILECTUS are:

a) require fulfilment of the Company’s Incorporation by both clients and collaborators;

b) amend the Company’s Internal Regulation whenever DILECTUS Management deem necessary;

c) conclude a contract between DILECTUS and the client/ family member/carer/legal guardian, as applicable;

d) determine the monthly fee and its updates;

e) debit the client’s account for services not included in the agreed monthly fee;

f) revoke the contract if the client does not comply with the Terms and Conditions laid down by DILECTUS:

g) ensure due respect to the DILECTUS’ staff on duty.

Article 19

Duties of DILECTUS

The duties of DILECTUS are:

a) provide all appropriate care to meet the clients’ needs, according to the contract, in order to promote and maintain the client’s autonomy and independence;

b) provide balanced nourishment tailored, as much as possible, to the client’s normal eating habits and personal tastes according to medical advice;

c) promote good healthy environment which will encourage a harmonious ambiance between the residents whilst simultaneously safeguarding the clients’ privacy;

d) promote social and cultural activities encouraging residents to participate in order to maintain their physical and mental abilities;

e) provide a pleasant , comfortable and humane environment;

f) guarantee services necessary for the well being of the clients, notably good hygiene, concerning meals and laundry;

g) provide medical and nursing routine care on the premises, except in the case of a medical emergency when clients may need to be transferred to an adequate medical unit;

h) provide paid rehabilitation services (ex: physiotherapy) to aid the recovery, stabilization and the minimization of pathological symptoms;

i) promote the continuation of good relationship with the clients family members, fellow residents and DILECTUS staff;

j) permit the continuous practice of his/hers religious beliefs or in the event of the client’s inability, at the request of the family;

k) inform the family member/carer/ legal guardian at a time of ill health or in case of an accident or emergency;

l) organize an Individualized Care Plan for the client and provide its implementation, evaluation and adjustment;

m) ensure all clients’ data confidentiality;

n) ensure the quality and the running of the services provided.

Article 20

Client’s rights

The rights of the client are:

a) accommodation and services/care required to meet client’s needs, taking into consideration the client’s autonomy and independence;

b) quality of life and a pleasant, comfortable and humane environment;

c) receive adequate support for any physical/mental limitations, if any;

d) be treated with courtesy and respect taking into consideration the client’s privacy within his/her own space, including personal correspondence;

e) check, correct and update personal data in the client’s file;

f) carry out periodic evaluation of care services;

g) confidentiality of personal data in the client’s file;

h) be fully informed about his/hers accommodation issues and the provision of services;

i) consider DILECTUS as his/hers own home, providing the possibility of having his personal belongings and items of greater emotional value (even furniture), within the room (if single occupation), with authorization of DILECTUS Management.

j) citizenship;

k) religious assistance whenever requested;

l) receive visits within the established timetable;

m) be free to express his/her own opinions and participate actively in the activities organized by DILECTUS, whenever possible;

n) submit complaints and suggestions;

o) use DILECTUS’ telephone, with privacy, whenever necessary, upon payment of the calls made;

p) receive a copy of DILECTUS Terms and Conditions and of its amendments, whenever they occur;

q) participate in recreational activities, according to the cClient’s interests and abilities.

Article 21

Obligations of the Client

The obligations of the client are:

a) comply with the present Company Incorporation, and with the decisions concerning the functioning of DILECTUS;

b) pay the monthly fee agreed and other expenditure;

c) contribute for the maintenance and the appropriate use of DILECTUS’ premises, both private and common areas;

d) contribute for an healthy social cohesion inside DILECTUS, including the respect for the individuality and privacy of all residents;

e) communicate within fifteen days before terminating the contract with DILECTUS, if not respected DILECTUS have the right to levy a penalty to pay the current monthly fee and/or the following monthly fee, as applicable;

f) take all meals in the Restaurant, unless illness or physical disability is verified;

g) do not use lamps, stoves or any other similar equipment, matches, lighters or any kind of weapons, sharp and blunt instruments, inside DILECTUS’ premises, including the rooms.

h) do not store or cook any type of food within the bedrooms and DILECTUS’ common areas;

i) do not have medication without knowledge of DILECTUS Management and Clinical Directorate, or receive them from their families or legal guardians. Medication should, in principle, be stored by the Head Nurse of DILECTUS, in appropriate location, and will only be administered if previously prescribed by the assisting doctor or a by the DILECTUS doctor who may assist the client in an emergency situation;

j) provide to the DILECTUS Clinical Directorate any medication prescribed by the assisting doctor as well as updated medical reports and the client’s clinical history;

Article 22

Liability

Clients/family members/ carers or legal guardians shall be civilly liable for damages caused intentionally or unintentionally to DILECTUS premises or to other residents.

After evaluation, any damages shall be repaired immediately through a reimbursement or payment in the following monthly fee.

Article 23

Client’s absence from the premises

1. Clients may leave DILECTUS on a daily basis, whenever they wish, however absences must be communicated to the Technical Director, or to his substitute.

2. If the client does not have ability to decide his/hers absences, a written authorization from the family member/carer/legal guardian will be required.

3. DILECTUS may revoke the contract if there are unjustified absences over 30 days.

4. During the period of absence, the client/family members, carers or legal guardians assume full responsibility for what might happen abnormally outside DILECTUS premises.

5. When client fails to appear at meals or not overnight at DILECTUS’ premises, without notice, absence shall be immediately communicated to his family member/carer/legal guardian as well as to the local police authorities, being the family member/carer/legal guardian, if any, responsible to execute all necessary requirements to locate him/her.

6. In case there is a temporary compulsory absence or the client’s voluntary absence for a period less than 45 days during the year, DILECTUS shall maintain the client’s bedroom.

7. In both cases referred to in the previous paragraph, a discount of 20% will be deducted from the monthly fee. This discount shall be deducted according to the number of absences.

8. If absences exceed 45 days annually, DILECTUS shall decide whether to extend what is referred in paragraph 7 or cancel the contract.

Article 24

Death of a resident

1. In case of death, the family member/carer/legal guardian shall be responsible for the funeral expenses.

2. If the family member/carer/legal guardian had not expressed preference for any funeral agent, DILECTUS shall contract an undertaker and the funeral expenses are the full responsibility of the deceased’s family member/carer/legal guardian.

3. After the death, the deceased personal belongings and assets shall be delivered to the family member/carer/legal guardian upon signature of a document which proves receipt.

4. If not otherwise stated by the client before death, the deceased personal belongings and assets shall revert to DILECTUS if not claimed by the family member/carer/legal guardian within ninety days after the resident’s death.

Chapter IV

Board of Directors

Article 25

The Technical Director

1. The Technical Director is responsible for the management and operations of DILECTUS, being responsible, before the Board of Directors for the same.

2. The Technical Director should be substituted during his/her absences and impediment, by another colleague, appointed by himself/herself to the Board of Directors.

3. The Technical Director should be a Medical Graduate (specialized in Geriatrics or Internal Medicine), or in Nursing Graduate with at least 5 years professional experience and / or in the field of Geriatrics, or a Graduate in Social and Human Sciences with at least five years of professional experience, or any other academic graduation qualified for this position.

Article 26

Technical Director’s responsibilities

1. Management:

a) assist and support the Board of Directors;

b) create conditions to ensure a good and healthy environment to Clients, concerning their privacy, autonomy and participation within the limits of their physical and cognitive abilities;

c) manage outsourcing contracts essential for the proper functioning of DILECTUS, namely Catering and Nursing.

d) Promote meetings with DILECTUS professional team, paying particular attention to interpersonal relationships in order to avoid conflicts of any kind and promote the self-esteem to everyone working within DILECTUS’ facilities.

e) promote training courses according to particular interests and needs, in order to improve the quality of services provided by DILECTUS;

f) promote and allow clients’ participation, listening to their opinions and requests;

g) supervise and authorize or draw up the staff’s working hours;

h) analyze the professionals’ qualifications at the time of admission;

i) propose the purchase of equipment and carry out necessary works;

j) manage staff annual’ appraisals;

k) request the drawing up of the annual leave schedule;

l) promote and create conditions for the client’ inclusion at DILECTUS; encourage and motivate health professionals for such purpose;

m) attend the clients’ admission, and make himself / herself known in courtesy visits;

n) supervise and require information and updates of each client’s individual files; require chronological records concerning all nursing interventions or that of any other health professional.

o) implement security measures outside DILECTUS’ premises, regarding client’s safety, which should be duly made known to the Leisure Manager and to the Head Nurse, arranging their transport and monitoring, whenever necessary;

Article 27

The General Manager

1. The General Manager is responsible for supervising DILECTUS’ general operation.

2. The General Manager reports directly to the Technical Director.

Article 28

General Manager’s responsibilities

1. Management:

a) promote and manage DILECTUS’ general operation reporting directly to the Technical Director;

b) administer the daily accounts and explain it clearly through the Company’s accounts;

c) manage the administrative and financial issues of the Company and ensure that the accounts are promptly forwarded to the accounting company;

d) propose training courses according to particular interests and needs, in order to improve the quality of services provided by DILECTUS;

e) propose the admission of professional staff when necessary;

f) propose the hiring of staff;

g) draw up the annual leave schedule;

2. Entertainment and Activities:

a) draw up a Six Monthly Plan of activities together with other technical and the clients themselves;

b) encourage the organization of activities open to the community, promoting a social interaction;

c) promote the involvement of the clients in DILECTUS’ daily life, in particular inside DILECTUS’ common areas.

Article 29

The Administrative and Reception staff

The Administrative and Reception Staff shall respond to the General Manager.

1. Perform the following functions:

a) meet clients and general public;

b) answer phones calls, and those from the bedridden clients and of any other DILECTUS client;

c) collaborate with the accounting company, organise/deliver/post all the accounting documents;

d) general administrative work;

e) filing;

f) deliver the wages receipts;

g) submit payments to suppliers;

h) be responsible for staff attendance records file.

Article 30

The Clinical Director

The Clinical Director is a Doctor qualified for this position.

Chapter V

Other Technical Expertise and Services

Article 31

Nurses and Auxiliary Nurses

Nurses and Auxiliary Nurses shall work at DILECTUS through an outsourcing company, ENFERLAR, with its head office based at DILECTUS’ premises, with the obligation to report to the Technical Director. 18

Article 32

Nurses

1. Will be responsible for:

a) The Regulations of the Nurses Professional Practice Decree-Law No. 161, of 4th September 1996, amended by Decree-Law No. 104, of 21st April 1998;

b) The provisions in the National Statute of Registered Nursing;

2. Main Functions:

2.1. The Head Nurse is responsible for the DILECTUS Clients’ Individualized Care Plan and for the supervision and coordination of the nurses who work at DILECTUS premises.

2.2. The Nursing Staff is responsible for:

a) receiving DILECTUS’ clients;

b) participate actively in the clients’ integration;

c) assisting in care planning according to the criteria defined by the Head Nurse;

d) make the link between the health care team providing clients care and giving support to their family members/ carers/ legal guardian;

e) advise, supervise and plan all nursing assistance intervention;

f) participate and promote internal training, including nursing auxiliary training.

Article 33

Auxiliary Nurses

Main Duties:

a) perform hygiene and comfort to the DILECTUS’ clients, according to the clients’ Individualized Care Plans planned by the Head Nurse;

b) fully assist DILECTUS’ clients during meals whenever necessary;

c) perform any other tasks required by the Head Nurse.

Article 34

Cleaning staff

The cleaning services are responsibility of the company ENFERLAR already mentioned above.

Cleaning staff main duties:

a) keep clean, disinfected and tidy DILECTUS’ premises, except the kitchen, dining room and the bar;

b) collect, distribute and store all laundry;

Article 35

Kitchen Staff

The Kitchen staff is responsible for the preparation, distribution and conditioning of meals, as well as the acquisition and handling of all food stuffs which is outsourced to the company GERTAL, based at DILECTUS premises, reporting to the Technical Director

The Kitchen staff is responsible for:

a) prepare the meals according to the doctor or nutritionist requirements;

b) conditioning and distribute the meals prepared inside DILECTUS or provided from the outside;

c) prepare breakfast, snacks and any other light meals;

d) be responsible for cleaning the kitchen, food preparation area, dining room and bar;

e) acquire the necessary food;

f) administer, manage and organize the pantry.

Chapter VI

Complaints and Suggestions

Article 36

Handling Complaints / Suggestions

DILECTUS has suitable criteria for receiving complaints and/or suggestions of its clients and the necessary means for the clarification and resolution of any issues, informing the complainant of the outcome of the process.

Article 37

Complaints Book

Under the Portuguese legislation, DILECTUS has a Complaints Book which may be requested at any time.

Article 38

Cases not covered within the Internal Regulation

Any cases not stated within this document shall be ruled by the current Portuguese law, by DILECTUS’ Management decisions, overseen by the General Directorate of Social Welfare and Services’ regulatory guidelines and/or any other relevant Health, Hygiene, Safety and Social Welfare rules under the Portuguese Law.

Article 39

Internal Regulation and Amendments

1. The Internal Regulation shall be valid from the date of its approval.

2. The Internal Regulation may be altered whenever the Directors of DILECTUS deem necessary.

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