Standards for Canadian organizations

2020 Edition

Home Care and Support Services (CA-HCS) 2: Personnel

Program personnel have the competency and support needed to provide services and meet the needs of persons served.

Interpretation

Competency can be demonstrated through education, training, or experience. Support can be provided through supervision or other learning activities to improve understanding or skill development in specific areas.
2020 Edition

Currently viewing: HOME CARE AND SUPPORT SERVICES (CA-HCS)

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Purpose

Individuals who receive Home Care and Support Services obtain a maximum level of independence, functioning, and health, and extend the time it is possible to live safely at home and in the community.
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
  • Table of contents of training curricula
  • Procedures for providing in-home supervision
  • Procedures or other documentation relevant to continuity of care and case assignment
  • Health evaluation procedures
  • Sample job descriptions from across relevant job categories
  • Training curricula
  • Documentation tracking staff completion of required trainings and/or competencies
  • Caseload size requirements set by policy, regulation, or contract, when applicable
  • Documentation of current caseload size per worker 
  • Supervisor coverage schedules for the previous six months
  • Interviews may include:
    1. Program director
    2. Relevant personnel
  • Review personnel files

CA-HCS 2.01

Care providers meet provincial requirements, and have the competency needed to:
  1. provide services to the population served;
  2. read, understand, and carry out written and verbal care plan directions;
  3. exercise good judgement and tact in responding to an individual’s suggestions and preferences;
  4. work as a member of a care team including contributing observations and recommendations at care plan conferences or to supervisors;
  5. meet the training requirements for the position and services performed; and
  6. work in a client-centered service delivery environment.
Examples: Provincial law may specify minimum age or education requirements, mandatory criminal background checks and fingerprinting, and grounds for disqualification for employment related to prior experience working with vulnerable populations. Additionally, provincial requirements for these positions may include passing a written examination. In some provinces, these occupations are open to individuals with no formal training, and on the job training is usually provided.

CA-HCS 2.02

Personnel who conduct client screening, level of care assessments and periodic re-assessments, care management and coordination, and supervision of care providers are qualified by:
  1. a bachelor's degree in a related human services field;
  2. a minimum of two years of experience working with the service population; and
  3. demonstrated competence providing care decisions for in-home service delivery.

CA-HCS 2.03

Supervisors of care providers also have:
  1. formal training in supervision; and/or
  2. on-the-job supervisory training for the first three months of service as a supervisor.

CA-HCS 2.04

All care providers are trained on, or demonstrate competency in:
  1. maintaining a clean, safe, and healthy home environment;
  2. reading and recording vital signs;
  3. supporting self administration of medication in accordance with organization procedures, when applicable;
  4. communicating client information, needs, and status;
  5. observing and documenting client status and care or service provided;
  6. following universal precautions and basic infection control procedures; 
  7. adapting to a range of in-home care circumstances; and
  8. providing aid with activities of daily living.

Interpretation

Elements b and f apply to personal care aides only.  

Interpretation

Assistance with self-administered medications has a high possibility for error, representing a risk for the client and the organization. As such, personnel should have the competency needed to provide an appropriate level of assistance with self-administered medication when they will be assisting with that task.

CA-HCS 2.05

Individuals providing personal care aide services receive a minimum of 40 hours of training instruction.

Interpretation

Training hours do not need to be completed before the care provider begins providing services.
NA The organization provides homemaker services only.

CA-HCS 2.06

Individuals providing homemaker services receive a minimum of 8 hours of training instruction.

Interpretation

Training hours do not need to be completed before the care provider begins providing services.
NA The organization provides personal care aide services only.

CA-HCS 2.07

All care providers receive continuing in-service education following completion of initial training requirements to ensure personnel are confident in their ability to provide quality support and assistance.

CA-HCS 2.08

Employee workloads support the achievement of client outcomes and are regularly reviewed.
Examples: Factors that may be considered when determining employee workloads include, but are not limited to:
  1. the qualifications and competencies of care providers and supervisors;
  2. case complexity;
  3. case status and progress toward achievement of desired outcomes;
  4. length and strength of the worker-client relationship;
  5. whether services are provided by multiple providers;
  6. ability of care providers to meet the individual’s or family’s needs; and
  7. relevant cultural and religious factors.

CA-HCS 2.09

Care providers have access to a supervisor or other professional at all times while on duty, and have the support of a supervisor who visits the individual’s home.
Note: See CA-HCS 7.01 for timeframes for supervisory home visits.

CA-HCS 2.10

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 care providers.

Fundamental Practice

CA-HCS 2.11

Prior to providing personal care aide services, care providers receive a health evaluation to determine their ability to perform the essential functions of the job, with or without reasonable accommodation.
NA The organization provides homemaker services only.
Examples: Evaluating the ability of personnel to perform the essential functions of the job may include checking that the individual is capable of lifting 50 pounds and climbing stairs.