WHO IS ACCREDITED?

Private Organization Accreditation

Germaine Lawrence is a residential treatment center for girls ages 12-18 with complex behavioral, psychological and learning challenges.   Girls live at our programs while receiving special education, individual, family and group therapy; psychiatric and primary medical care; and a wide variety of therapeutic activities and interventions.
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VOLUNTEER TESTIMONIAL

Harry Hunter, MSW, MBA, Ph.D.

Volunteer Roles: Peer Reviewer; Team Leader

Peer Reviewer for the month of January 2013, Dr. Hunter has been volunteering for COA since 2005, conducting five site reviews.
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Purpose

Children, youth, and adults who participate in Services for Individuals with Developmental Disabilities achieve full integration and inclusion in the mainstream, make choices, exert control over their lives, and fully participate in, and contribute to, their communities.

CA-DDS 5: Service Philosophy and Intervention

The program is guided by a service philosophy that:

  1. serves as the basis for how the program will meet the needs of individuals and their families; and
  2. guides the development and implementation of services, interventions, and activities based on the program goals and the best available evidence of service effectiveness.

Interpretation: A program model or logic model can be a useful tool to help staff think systematically about how the program can make a measurable difference by drawing a clear connection between the service population’s needs, available resources, program activities and interventions, program outputs, and desired outcomes.

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.,  
  • Minor inconsistencies and not yet fully developed practices are noted, however, these do not significantly impact service quality; or
  • Written service philosophy needs improvement or clarification; or
  • Procedures need strengthening; or
  • With few exceptions procedures are understood by staff and are being used; or
  • Proper documentation is the norm and any issues with individual staff members are being addressed through performance evaluations (CA-HR 6.02) and training (CA-TS 2.03); or
  • In a few rare instances required consent was not obtained; or
  • Monitoring procedures need minor clarification; or
  • With few exceptions the policy on prohibited interventions is understood by staff, or the written policy needs minor clarification.
3
Practice requires significant improvement, as noted in the ratings for the Practice standards. Service quality or program functioning may be compromised; e.g.,
  • The written service philosophy needs significant improvement; or
  • Procedures and/or case record documentation need significant strengthening; or
  • Procedures are not well-understood or used appropriately; or
  • Documentation is inconsistent or in in some instances is missing and no corrective action has not been initiated; or
  • Required consent is often not obtained; or
  • A few personnel who are employing non-traditional or unconventional interventions have not completed training, as required; or
  • There are gaps in monitoring of interventions, as required; or
  • Policy on prohibited interventions does not include at least one of the required elements; or
  • Service philosophy is not clearly related to expressed mission or programs of the organization; or
  • One of the Fundamental Practice Standards received a rating of 3 or 4.
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.,
  • There is no written service philosophy; or
  • There are no written policy or procedures, or procedures are clearly inadequate or not being used; or
  • Documentation is routinely incomplete and/or missing; or  
  • 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
    • Include service philosophy in the Narrative
    • Policies for prohibited interventions
    • Procedures for use of non-traditional or unconventional practices
    • Table of contents of training curricula
    • Procedures for use of interventions that limit movement, diminish sensory experience, limit personal freedom, or cause personal discomfort
    • Documentation of training
    • Interview:
      1. Program director
      2. Relevant personnel
      3. Individuals served
    • Review case records

  • CA-DDS 5.01

    The service philosophy:

    1. promotes meaningful participation, inclusion, and self-determination;
    2. provides a basis for the implementation of strengths-based, person-centred activities and interventions; and
    3. safeguards the emotional, physical, and psychological well-being of the individual.

  • FP
    CA-DDS 5.02

    If the organization permits the use of service modalities and interventions it defines as non-traditional or unconventional, it:

    1. explains any benefits, risks, side effects, and alternatives to the individual;
    2. obtains the written, informed consent of the individual;
    3. ensures that personnel receive sufficient training and/or obtain certification when it is available; and
    4. monitors the use and effectiveness of such interventions.

    Interpretation: Examples of non-traditional and unconventional service modalities or interventions include, but are not limited to: hypnosis, acupuncture, and modalities or interventions that involve physical contact, such as massage therapy.

    NA The organization does not permit non-traditional or unconventional modalities or interventions.


  • FP
    CA-DDS 5.03

    Organization policy prohibits:

    1. corporal punishment;
    2. the use of aversive stimuli;
    3. interventions that involve withholding nutrition or hydration, or that inflict physical or psychological pain;
    4. the use of demeaning, shaming or degrading language or activities;
    5. unnecessarily punitive restrictions including cancellation of visits as a disciplinary action;
    6. forced physical exercise to eliminate behaviours;
    7. punitive work assignments;
    8. punishment by peers;
    9. group punishment or discipline for individual behaviour; and
    10. unwarranted use of invasive procedures or activities as a disciplinary measure.

  • FP
    CA-DDS 5.04

    If the organization uses interventions that limit physical movement, diminish sensory experience, restrict personal freedoms, or cause personal discomfort, such interventions are implemented only when:

    1. the organization can document its reasons for believing that the intervention will be beneficial to the person served;
    2. the individual or his or her guardian has been fully informed about the risks and benefits of the intervention and has consented to it;
    3. the intervention is prescribed by a qualified medial practitioner or recommended by an interdisciplinary team;
    4. the organization periodically reviews the continued need for and effectiveness of the treatment or intervention; and
    5. the intervention is not used as a substitute for appropriate staffing patterns, for the convenience of staff, or as punishment.

    Interpretation: Examples of such treatments and interventions are use of splints or poseys to prevent self-injury, use of visual or auditory screens to reduce stimulation, use of distasteful substances, textures, or activities as a consequence for behaviour.

    NA The organization does not use interventions that limit physical movement, diminish sensory experience, restrict personal freedoms, or cause personal discomfort.


  • FP
    CA-DDS 5.05

    An intervention is discontinued immediately if it produces adverse side effects, or is deemed unacceptable according to prevailing professional standards.