Standards for private organizations

2020 Edition

Adult Foster Care (AFC) 2: Personnel

Personnel have the competency and support needed to provide services and meet the needs of persons served.
2020 Edition

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Purpose

 Adult Foster Care (AFC) programs support community-based living arrangements for adults in need of long term-services and supports, matching them with in-home caregivers.
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; or
  • Supervisors provide additional support and oversight, as needed, to the few staff without the listed qualifications; or 
  • Most staff who do not meet educational requirements are seeking to obtain them; or 
  • With few exceptions, staff have received required training, including applicable specialized training; or
  • Training curricula are not fully developed or lack depth; or
  • Training documentation is consistently maintained and kept up-to-date with some exceptions; or
  • A substantial number of supervisors meet the requirements of the standard, and the organization provides training and/or consultation to improve competencies when needed; or
  • With few exceptions, caseload sizes are consistently maintained as required by the standards or as required by internal policy when caseload has not been set by a standard; or
  • Workloads are such that staff can effectively accomplish their assigned tasks and provide quality services and are adjusted as necessary; or
  • 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.,
  • A significant number of staff (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; or
  • 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; or 
  • Supervisors do not typically provide additional support and oversight to staff without the listed qualifications; or
  • A significant number of staff have not received required training, including applicable specialized training; or
  • Training documentation is poorly maintained; or
  • 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; or
  • There are numerous instances where caseload sizes exceed the standards' requirements or the requirements of internal policy when a caseload size is not set by the standard; or
  • Workloads are excessive, and the integrity of the service may be compromised; 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.
Self-Study EvidenceOn-Site EvidenceOn-Site Activities
  • Procedures or other documentation relevant to continuity of care and case assignment
  • Table of contents of training curricula
  • Documentation tracking staff completion of required trainings and/or competencies
  • Sample job descriptions from across relevant job categories
  • Training curricula
  • Caseload size requirements set by policy, regulation, or contract, when applicable
  • Documentation of current caseload size per worker
  • Interviews may include:
    1. Program director
    2. Relevant personnel
  • Review personnel files

 

AFC 2.01

Care managers are qualified by: 
  1. a bachelor’s degree in a human service field and experience in direct services;
  2. an associate’s degree in a human service field and two years’ experience in direct services; or
  3. five years experience in direct services.

 

AFC 2.02

Supervisors or program managers are qualified by: 
  1. an advanced degree in social work or a comparable human service field and a minimum of two years’ experience in direct services;
  2. a bachelor’s degree in a human service field and five years’ experience in direct services; and/or
  3. licensure as a registered nurse and a minimum of two years’ experience in direct services.

 
Fundamental Practice

AFC 2.03

There is adequate nursing staff, including licensed registered nurses, to meet the needs of the service population.

Interpretation

What constitutes adequate nursing differs from state to state based on the ability to delegate nursing tasks. For states that don’t allow delegation of duties, there will be a higher need for nursing staff. Nursing staff do not necessarily live within the home, but are able to meet with the family with the needed frequency.
NA Responsibilities related to nursing staff are provided by another organization as documented in policy and/or through contract.

 

AFC 2.04

Direct service staff are trained on, or demonstrate competency in the following: 
  1. special needs related to working with the identified service population;
  2. signs of abuse or neglect;
  3. advance directives;
  4. coordinating services as part of a team;
  5. disaster relief resources, planning, and procedures.
Examples: In regards to element (a), examples of special needs may include, but are not limited to, individuals with disabilities, Alzheimer’s disease, behavioural health conditions, cognitive impairment, and older adults. These populations are susceptible to suicidal ideation which is often missed due to what is considered to be atypical presentation, therefore training related to people with special needs should include how to recognize symptoms of depression

 

AFC 2.05

A supervisor or care manager is available to provide support 24/7.

 

AFC 2.06

The organization minimizes the number of workers assigned to the individual over the course of their contact with the organization by:
  1. assigning a worker at intake or early in the contact; and
  2. avoiding the arbitrary or indiscriminate reassignment of direct service personnel.

 
Fundamental Practice

AFC 2.07

Case load sizes are sufficiently small to support the achievement of client outcomes and allow for: 
  1. a flexible response when problems arise in a placement;
  2. a schedule of regular contact, including in-person visits; and
  3. responsiveness to the differing needs of individuals and caregivers.
Examples: Examples of factors that may be considered when determining employee workloads include, but are not limited to:
  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 persons served.