WHO IS ACCREDITED?

Private Organization Accreditation

Sweetser, a Maine non-profit agency operating since 1828, provides comprehensive mental and behavioral health and substance abuse treatment services. Statewide, it serves around 15,000 consumers a year, including children, adults, and families in outpatient, office-based, and residential settings.
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ORGANIZATION TESTIMONIAL

Brewer-Porch Children's Center

James W. Thompson, Executive Director

The COA standards as applied to the operations at Brewer-Porch Children’s Center at The University of Alabama has given the administration an opportunity to examine best practice and improve the quality of care provided to clients.
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Purpose

Individuals who participate regularly in Adult Day Services achieve and maintain an optimal level of well-being, functioning and health, and remain in their preferred community residence.

AD 12: Personnel

Program personnel have the education, training, experience, and skills needed to provide Adult Day Services.

Rating Indicators
1
All elements or requirements outlined in the standard are evident in practice, as indicated by full implementation of the practices outlined in the Practice standards.
2
Practices are basically sound but there is room for improvement, as noted in the ratings for the Practice standards; e.g.,  
  • With some exceptions, staff (direct service providers, supervisors, and program managers) possess the required qualifications, including: education, experience, training, skills, temperament, etc., but the integrity of the service is not compromised.
    • Supervisors provide additional support and oversight, as needed, to staff without the listed qualifications.
    • Most staff who do not meet educational requirements are seeking to obtain them.
  • With some exceptions staff have received required training, including applicable specialized training.
    • Training curricula are not fully developed or lack depth.
    • A few personnel have not yet received required training.
    • Training documentation is consistently maintained and kept up-to-date with some exceptions.
  • A substantial number of supervisors meet the requirements of the standard, and the organization provides training and/or consultation to improve competencies.
    • Supervisors provide structure and support in relation to service outcomes, organizational culture and staff retention.
  • With a few exceptions caseload sizes are consistently maintained as required by the standards.
  • Workloads are such that staff can effectively accomplish their assigned tasks and provide quality services, and are adjusted as necessary in accord with established workload procedures.
    • Procedures need strengthening.
    • With few exceptions procedures are understood by staff and are being used.
  • With a few exceptions specialized staff are retained as required and possess the required qualifications.
  • Specialized services are obtained as required by the standards.
3
Practice requires significant improvement, as noted in the ratings for the Practice standards.  Service quality or program functioning may be compromised; e.g.,
  • One of the Fundamental Practice Standards received a rating of 3 or 4.
  • A significant number of staff, e.g., direct service providers, supervisors, and program managers, do not possess the required qualifications, including: education, experience, training, skills, temperament, etc.; and as a result the integrity of the service may be compromised.
    • Job descriptions typically do not reflect the requirements of the standards, and/or hiring practices do not document efforts to hire staff with required qualifications when vacancies occur.
    • Supervisors do not typically provide additional support and oversight to staff without the listed qualifications.
  • A significant number of staff have not received required training, including applicable specialized training.
    • Training documentation is poorly maintained.
  • A significant number of supervisors do not meet the requirements of the standard, and the organization makes little effort to provide training and/or consultation to improve competencies.
  • There are numerous instances where caseload sizes exceed the standards' requirements.
  • Workloads are excessive and the integrity of the service may be compromised. 
    • Procedures need significant strengthening; or
    • Procedures are not well-understood or used appropriately; or
  • Specialized staff are typically not retained as required and/or many do not possess the required qualifications; or
  • Specialized services are infrequently obtained as required by the standards.
4
Implementation of the standard is minimal or there is no evidence of implementation at all, as noted in the ratings for the Practice standards; e.g.,

?For example:
  • Two or more Fundamental Practice Standards received a rating of 3 or 4.

Table of Evidence

Self-Study Evidence On-Site Evidence On-Site Activities
    • Program staffing chart that includes lines of supervision
    • List of program personnel that includes:
      1. name;
      2. title;
      3. degree held and/or other credentials;
      4. FTE or volunteer;
      5. length of service at the organization;
      6. time in current position
    • Table of contents of training curricula
    • Procedures and criteria used for assigning and evaluating workload
    • Training curricula
    • Documentation of training
    • Job descriptions
    • Verify employment or contract of recreational therapist, nurse, and other necessary professionals
    • Interview:
      1. Supervisors
      2. Relevant personnel
    • Review personnel files

  • AD 12.01

    Personnel:

    1. are qualified by training, skill, and experience to meet the psychosocial and medical needs of care recipients; and
    2. possess the personal characteristics and temperament suitable for working with adults with special needs.

  • AD 12.02

    Day services providers are able to:

    1. communicate effectively with family members;
    2. identify changes in service recipient functioning;
    3. identify unmet service needs; and
    4. appreciate the cultural background, heritage, and identity of service recipients.

  • AD 12.03

    All direct service personnel receive ongoing training and supervision in the following areas, as appropriate to the services provided:

    1. methods of engagement;
    2. crisis prevention and intervention techniques;
    3. identification of medical needs or problems;
    4. the organization’s plans for handling medical or psychiatric emergencies;
    5. knowledge of public assistance programs, eligibility requirements, and benefits;
    6. skills in case advocacy;
    7. use of community resources and knowledge of the community service delivery system;
    8. use of adaptive equipment, such as braces and wheelchairs;
    9. providing personal care; and
    10. specific skills necessary to serve the target population.

  • AD 12.04

    Personnel who lead or facilitate group activities have relevant training or experience.


  • FP
    AD 12.05

    Direct service staff maintain current certification in first aid and CPR.


  • AD 12.06

    A recreational therapist is on staff or available for consultation.


  • AD 12.07

    Day programs with a health focus employ an RN or LPN.

    NA The program does not have a health focus.


  • AD 12.08

    A full-time program director or administrator is available at each site who is qualified as a registered nurse or holds a bachelor’s degree in a human service field and has relevant coursework or experience.

    Interpretation: If qualified directors or administrators are not employed full-time at every site, a qualified director or administrator oversees a limited number of sites.


  • FP
    AD 12.09

    An organization that serves a high percentage of multiply handicapped or frail individuals obtains the specialized services of dieticians, nurses, physicians, and physical and/or occupational therapists for consultation, evaluation, or training.

    Interpretation: If specialized services are provided off-site, support and transportation are arranged.

    NA The organization does not serve a high percentage of handicapped or frail individuals.


  • AD 12.10

    Employee workloads support the achievement of client outcomes, are regularly reviewed, and are based on an assessment of the following:

    1. the qualifications, competencies, and experience of the worker, including the level of supervision needed;
    2. the work and time required to accomplish assigned tasks and job responsibilities; and
    3. service volume, accounting for assessed level of needs of new and current clients and referrals.
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