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

Orange County Government, Youth & Family Services Division

Rodney J. Hrobar Sr., LMHC, CPP, Quality Assurance Manager

As the lead agency in Orange County, providing the safety net for children and families, it is reassuring that our clients can be confident that their needs will be addressed in accordance with the most stringent standards of public, as well as private, accountability as monitored and reviewed by the Council on Accreditation. 
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Purpose

Group Living Services allow individuals who need additional support to regain, maintain, and improve life skills and functioning in a safe, stable, community-based living arrangement.

GLS 19: Personnel

Personnel have the education, training, experience, skills, and supervision that is needed to work with the residents in care and involved families.

Note: For additional standards guidance on the use of non-employee personnel, please refer to Volunteers, Interns, and Consultants: Applicability of COA Standards to Non-Employee Personnel – Private, Public, Canadian.

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
    • Job descriptions
    • 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
    • Documentation of training
    • Information and/or data describing staff turnover
    • Interview:
      1. Supervisors
      2. Personnel
    • Review personnel files

  • GLS 19.01

    Residential counselors, house parents, adult care, and/or youth care workers have:
    1. a bachelor’s degree or are actively and continuously pursuing a degree;
    2. knowledge and understanding of organizational mission and values; 
    3. the personal characteristics and experience to collaborate with and provide appropriate care to residents and their families, gain their respect, guide their development, manage a home effectively, and participate in the overall treatment program;
    4. the ability to provide services in a culturally and linguistically competent manner;
    5. the temperament to work with, and care for, children, youth, adults, or families with special needs, as appropriate; 
    6. up-to-date certification in first aid and CPR; and
    7. adequate and continuous training and supervision.

    Interpretation: Competency can be demonstrated through education, training, or experience. The elements of the standard will be considered together in order to provide a rating. Demonstrated competence in elements (b), (c), and (d) with appropriate supervision and specialized training can compensate for a lack of a bachelor’s degree.

    Interpretation: Experience per element (c) can include lived experience as residential programs can have peer support specialists, youth advocates, mentors, and/or family advocates on staff.

    Research Note: Having the personal characteristics, experience, and temperament to work with and provide appropriate care for residents is vital to group living services practice. Literature indicated residents, when asked at discharge, invariably responded that their relationship with their worker had the greatest impact on their treatment.


  • GLS 19.02

    The clinical or program director is qualified by:
    1. an advanced degree in social work or a comparable human service field and two years of relevant experience; or
    2. a bachelor’s degree in social work or a comparable human service field and four or more years of relevant experience.


  • FP
    GLS 19.03

    Depending on resident needs, qualified professionals and specialists provide services and support related to the following:
    1. mental health;
    2. substance use;
    3. medicine and dentistry;
    4. prenatal and postnatal health care, and the developmental needs of children;
    5. prenatal and postpartum depression screenings and care;
    6. nursing;
    7. education;
    8. physical and developmental disabilities;
    9. speech, occupational and physical therapy;
    10. recreation and expressive therapy;
    11. nutrition; and/or
    12. religion and spirituality.


  • GLS 19.04

    Direct service personnel demonstrate experience or receive training and education on:
    1. engagement with residents, including building trust and establishing rapport;
    2. engaging and partnering with families and significant others;
    3. recognizing trauma and coping mechanisms, and providing trauma-informed care;
    4. the definitions of human trafficking (both labor and sex trafficking) and sexual exploitation, and identifying potential victims;
    5. protocols for responding to residents who run away;
    6. interventions for addressing the acute needs of victims of trauma; and
    7. collaborating with local law enforcement.

    Interpretation: In relation to element (c), direct service personnel should be trained to recognize and respond therapeutically to manifestations of trauma, such as mood instability, acting out behaviors, and hyper-vigilance. 


  • GLS 19.05

    Personnel who conduct assessments are qualified by training, skill, and experience and are able to recognize individuals and families with special needs.


  • GLS 19.06

    Supervisors demonstrate a commitment to providing structure and support to direct staff to:
    1. address and reduce stress, anxiety, and secondary traumatic stress; 
    2. create an atmosphere of problem-solving and learning;
    3. build and maintain morale;
    4. reinforce the organizational values and clinical practices in family-based treatment; 
    5. provide constructive ways to approach difficult situations with clients; and 
    6. facilitate regular feedback, growth opportunities, and a structure for ongoing communication and collaboration.

    Interpretation: Supervision is an important determinant of child and family outcomes, organizational culture, and staff retention.

    Research Note: Secondary traumatic stress (STS) – distress that results from being exposed to the traumatic stories of others – and vicarious trauma (VT) – internal changes in the perception of self due to chronic exposure to traumatic material – have a significant impact on direct care workers and supervisors.  STS has been linked to increased absenteeism among employees, high staff turnover, and decreased compliance with organizational requirements. The impact of VT can exceed organizational function and negatively influence an individual’s sense of trust, safety, control, and esteem. 

    In order to promote workforce well-being, organizations should implement policies that address and help prevent stress-related problems. Strategies to reduce the adverse effects of STS and VT include: helping staff identify and manage the difficulties associated with their respective positions; promoting self-care and well-being through policies and communications with personnel; offering positive coping skills and stress management training; and providing adequate supervision and staff coverage.

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