When making a left turn (U.S.) on a two-lane road, I look back, signal, look back again, and if safe, I move to the center of the lane. I signal again to announce my turn. Sometimes I repeat my signal if a newcomer needs to know what I'm doing.

When making a left turn on a multiple-lane road, I do the same thing as above, except I that I must cross more lanes to do so.
Usually in this situation, there is a left-turn lane, where I take up position prior to turning.

If I want to avoid a bad intersection, I might plot a detour around it on some side street.