WHO IS ACCREDITED?

Private Organization Accreditation

CSS Healthcare Services provides Community based health services to the young, the elderly and to Individuals with Developmental Disability. Founded in 1997, we have the ability to offer a variety of quality community-based services to our clients, which has greatly contributed to our growth and success.
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VOLUNTEER TESTIMONIAL

Judy Kay, LCSW

Volunteer Roles: Peer Reviewer; Team Leader

In administration for 22 of 24 years at Child Saving Institute, a COA-accredited not-for-profit child welfare agency in Omaha, Nebraska. Retired approximately two years ago, I moved to Tucson, Arizona, where I advocate for children's rights as a Court Appointed Special Advocate (CASA) volunteer to three young children.
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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.

DDS 10: Personnel

Direct support personnel are trained and able to provide services, supports, and other forms of direct assistance.

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
    • Caseload size, per worker, for the past six months, and procedures or criteria used to assign and evaluate caseloads
    • Training curricula
    • Documentation of training
    • Job descriptions
    • Interview:
      1. Supervisors
      2. Personnel
    • Review personnel files

  • DDS 10.01

    Direct support personnel have a high school degree or equivalent and are trained and competent in:

    1. establishing rapport with individuals served;
    2. interaction and communication techniques;
    3. implementation of person-centered service plans;
    4. implementing the principles of self-determination and inclusion;
    5. de-escalation techniques in relation to this population;
    6. use of assistive technology;
    7. teaching ADLs; and
    8. recognizing and addressing abuse, neglect, and exploitation.

    Update:

    • Revised Standard - 05/07/18
      Element e) was added.

  • DDS 10.02

    Direct support personnel or service coordinators receive training or demonstrate competency in:

    1. advocating on behalf of individuals served;
    2. coordinating services within a team;
    3. knowledge of community programs and how to access services;
    4. building bridges between the individual and the community; and
    5. knowledge of public assistance programs, eligibility requirements, and benefits.

  • DDS 10.03

    Training can include, as appropriate to the service and needs of individuals served:

    1. positive behavioral supports;
    2. assisted dining techniques and good nutrition;
    3. lifting and transfer techniques;
    4. safe transportation techniques;
    5. health related supports; and
    6. medication administration.

    Update:

    • Revised Standard - 05/07/18
      An element regarding management of behavior was removed. 

  • FP
    DDS 10.04

    Direct support personnel receive training in CPR, basic first aid, and universal precautions.


  • DDS 10.05

    Caseload size and case assignments are sufficiently small to permit direct support personnel to respond flexibly to the differing needs of individuals served and their families, and are are assessed and adjusted according to:

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

  • DDS 10.06

    Organizations that permit the use of interventions that limit physical movement, diminish sensory experience, restrict personal freedoms, or cause personal discomfort as part of behavior management, train and evaluate their staff regularly on:

    1. the proper and safe use of these interventions;
    2. the potential for re-traumatization; and
    3. individuals’ treatment plans that outline specifically how these interventions may be used.

    Update:

    • Added Standard - 05/07/18

    Interpretation: In regards to elements (a) and (b), “regularly trained” refers to at least annually if not more frequently. Staff should be trained on all individuals’ treatment plans and the specific parameters of their intervention prior to working with them.

    NA The organization does not permit the use of interventions that limit physical movement, diminish sensory experience, restrict personal freedoms, or cause personal discomfort as part of behavior management.

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