Standards for Canadian organizations

2020 Edition

Residential Treatment Services (CA-RTX) 6: Service Planning and Monitoring

Residents and their families participate in the development and ongoing review of a comprehensive service plan that is the basis for delivery of appropriate services and supports.

Interpretation

While a service plan may conform to a uniform format, plan content should be individualized through collaboration with the resident and, as appropriate, a parent, guardian, and/or legal advocate based on service needs and program model. Level of family involvement in the service planning process will vary by resident and/or program model.
2020 Edition

Currently viewing: RESIDENTIAL TREATMENT SERVICES (CA-RTX)

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Purpose

Residential Treatment Services provide individualized therapeutic interventions and a range of services, including education for residents to increase productive and pro-social behaviour, improve functioning and well-being, and return to a stable living arrangement 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.,
  • Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality; or
  • Procedures need strengthening; or
  • With few exceptions, procedures are understood by staff and are being used; or
  • For the most part, established timeframes are met; or
  • Proper documentation is the norm and any issues with individual staff members are being addressed through performance evaluations and training; or
  • In a few instances, client or staff signatures are missing and/or not dated; or
  • With few exceptions, staff work with persons served, when appropriate, to help them receive needed support, access services, mediate barriers, etc.; or
  • Active client participation occurs to a considerable extent.
3
Practice requires significant improvement, as noted in the ratings for the Practice Standards. Service quality or program functioning may be compromised; e.g.,
  • Procedures and/or case record documentation need significant strengthening; or
  • Procedures are not well-understood or used appropriately; or
  • Timeframes are often missed; or
  • In several instances, client or staff signatures are missing and/or not dated; or
  • Quarterly reviews are not being done consistently; or
  • Level of care for some clients is clearly inappropriate; or
  • Service planning is often done without full client participation; or
  • Appropriate family involvement is not documented; or  
  • Documentation is routinely incomplete and/or missing; or
  • Individual staff members work with persons served, when appropriate, to help them receive needed support, access services, mediate barriers, etc., but this is the exception.
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.,
  • No written procedures, or procedures are clearly inadequate or not being used; or 
  • Documentation is routinely incomplete and/or missing.  
Self-Study EvidenceOn-Site EvidenceOn-Site Activities
  • Service planning and monitoring procedures
No On-Site Evidence
  • Interviews may include:
    1. Program director
    2. Relevant personnel
    3. Residents and their families
  • Review case records

CA-RTX 6.01

Residents participate in the development of an initial service plan within one week of admission and a comprehensive service plan within 30 days.
NA The organization only operates a crisis stabilization unit, short-term diagnostic centre or detoxification program.
Note: Service planning timeframes for crisis stabilization units are addressed in CA-RTX 13.04.

CA-RTX 6.02

A comprehensive, assessment-based service plan is developed with the full participation of the resident, and their family when appropriate, and includes:
  1. agreed upon goals, desired outcomes, and timeframes for achieving them;
  2. services and supports to be provided, and by whom;
  3. procedures for expedited service planning when crisis or urgent need is identified; and
  4. the resident’s and/or legal guardian’s signature.

Interpretation

Safety concerns for victims of human trafficking often do not end when they are admitted to residential settings. The organization should work with the victim to develop a safety plan that focuses on increasing physical safety by securing needed documents, property, and services; maintaining the residence’s location in confidence or restricting access by certain individuals; and linking efficiently to law enforcement, if needed. Psychological safety should also be prioritized as the emotional effects of trauma – mistrust, anxiety, and depression – can be persistent and overwhelming for victims.
Examples: When working with victims of trauma, the organization can facilitate the development of realistic goals in an empowering and trauma-informed manner by building rapport, establishing trust, and promoting physical and psychological safety.

CA-RTX 6.03

The service plan includes:
  1. specific treatment modalities to be used, appropriate to the cultural perspective and competencies of the individual; and
  2. the estimated length of treatments and stay.

CA-RTX 6.04

The worker and a supervisor, or a clinical, service, or peer team, review the case quarterly, or more frequently depending on the needs of the resident, to assess:
  1. service plan implementation;
  2. progress toward achieving service goals and desired outcomes; and
  3. the continuing appropriateness of the agreed upon service goals.

Interpretation

When experienced workers are conducting reviews of their own cases, the worker’s supervisor must review a sample of the worker’s evaluations as per the requirements of the standard.
NA The organization only operates a crisis stabilization unit, short-term diagnostic center, or detoxification program.
Examples: Service plans may be reviewed more frequently for young children, individuals with specialized care needs, and as acute needs and contractual requirements dictate. Timeframes for service plan reviews may be adjusted depending upon, for example: issues and needs of persons receiving services; changes in residents’ life situations or psychological conditions; frequency and intensity of services provided; and frequency of contact with informal caregivers and cooperating providers.

CA-RTX 6.05

The worker and resident, and his or her family when appropriate:
  1. review progress toward achievement of agreed upon service goals; and
  2. sign revisions to service goals and plans.

Interpretation

For children and youth, family members and/or legal guardians should always be involved in case conferences and advised of ongoing progress.
NA The organization only operates a crisis stabilization unit, short-term diagnostic center, or detoxification program.