Standards for public agencies

2020 Edition

Home Care and Support Services (PA-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 (PA-HCS)

VIEW THE STANDARDS

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
Full Implementation, Outstanding Performance
A rating of (1) indicates that the agency's practices fully meet the standard and reflect a high level of capacity.  
  • All elements or requirements outlined in the standard are evident in practice, with rare or no exceptions: exceptions do not impact service quality or agency performance. 
2
Substantial Implementation, Good Performance
A rating of (2) indicates that an agency's infrastructure and practices are basically sound but there is room for improvement.
  • The majority of the standards requirements have been met and the basic framework required by the standard has been implemented. 
  • Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality or agency performance.
3

Partial Implementation, Concerning Performance
A rating of (3) indicates that the agency's observed infrastructure and/or practices require significant improvement.  

  • The agency has not implemented the basic framework of the standard but instead has in place only part of this framework.  
  • Omissions or exceptions to the practices outlined in the standard occur regularly, or practices are implemented in a cursory or haphazard manner.  
  • Service quality or agency functioning may be compromised.  
  • Capacity is at a basic level.
4
Unsatisfactory Implementation or Performance
A rating of (4) indicates that implementation of the standard is minimal or there is no evidence of implementation at all.  
  • The agency’s observed service delivery infrastructure and practices are weak or non-existent; or show signs of neglect, stagnation, or deterioration.
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

PA-HCS 2.01

Care providers meet state 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 judgment 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: State 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, state requirements for these positions may include passing a written examination. In some states, these occupations are open to individuals with no formal training, and on the job training is usually provided.

PA-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.

PA-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.

PA-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 agency 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 agency. 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.

PA-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 agency provides homemaker services only.

PA-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 agency provides personal care aide services only.

PA-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.

PA-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.

PA-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 PA-HCS 7.01 for timeframes for supervisory home visits.

PA-HCS 2.10

The agency minimizes the number of workers assigned to the individual over the course of their contact with the agency 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

PA-HCS 2.11

Prior to providing personal care aide services, care providers receive a health evaluation that meets state requirements to determine their ability to perform the essential functions of the job, with or without reasonable accommodation.
NA The agency 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.