Best Practices – Provider

Practice
Magnolia Oaks group home makes it a standard practice to be sure the group home operates and has the appearance of a private home rather than a business. Employees do not wear scrubs, business files and records are disguised in a homelike setting. All office equipment is kept in an out of the way room. All employee notices, bulletins, schedules and business aspects are virtually unnoticeable. All employees are repeatedly trained to understand they are entering someone’s home each time they come to work, and that they should treat it and the people residing there with respect and dignity.

Who Benefits? All
How? All individuals living in this home benefit by the respect and dignity with which they are treated. They are living in a home not a business venue.

Practice
A Behavior Analyst creates an easy to follow and easy to understand “Cheat Sheet” for direct care staff members to utilize when they are with individuals.

This helps all staff to follow through with what is designated on behavioral plans. These “Cheat Sheets” are laminated and kept where Direct Care staff can access and utilize them.

Who Benefits? All
How?

• The individual with consistency in trainings
• The direct care staff with easy to understand and follow directions
• The Behavior Analyst with plans that are being used and followed

• My Personal Outcomes – They have taken information from CQL, identifying each outcome and questions the staff should ask to gather information about that outcome.  At the end of each outcome they have a section that asks what they can do to provide support in this area. They have some standard suggestions, but also leave space for the individuals and staff to write ideas.
• My Rights – They have used person centered language as well as some descriptive clip art to discuss each of the rights.
• Abuse is Wrong – they have used a mixture of person centered and process language as well as descriptive clip art to discuss abuse, neglect and exploitation.
• Grievance Procedure – A one page step by step method to follow using person centered language.
• My Rights to Due Process – A mixture of person centered and process language as well as descriptive clip art to discuss the Due Process steps.

Who Benefits? Individuals
How? Currently the provider is using it with individuals who receive Residential Habilitation (RH) and Supported Living (SL) services.  They plan on expanding to all of the other services over the next year. This is an excellent way for the staff to get to know more about the individuals and learn what is really important to them, as well as to find ways to address things that individuals want to change. This is also beneficial for the individuals to be able to receive education about the topics in easy to understand language.  Individuals are able to share information with the provider that they might not discuss if not asked.

Practice
In order to ensure that staff are truly understanding the training being given, the Director of the agency developed a post questionnaire for staff to complete.  It helped the director identify whether any staff person may have missed or misinterpreted the message of the training so that additional training could occur.  The two questions were: 1) This training will help me perform my job better because….2) The most important thing that I learned during this training is….

Who Benefits? Staff
How? Ensuring that they understand the training they received in order to either improve or maintain quality supports and services.

Who Benefits? Agency Provider
How ? Helps them ensure staff understand the content of the training.

Who Benefits? Persons receiving services
How? The training staff receive will assist them in providing quality supports and services.

Practice
Providers in Area 14 formed a stakeholders group in response to the need for training in a variety of areas. They also identified the need for a provider network, more provider meetings, ongoing communication with the Area staff and mentoring. The group included providers, individuals receiving services, APD staff and Delmarva staff. The goal of receiving additional training has been initiated and provider meetings are held every 3 months, with providers taking the lead on facilitation and delivering training and education on a number of topics. Several provider networks have arisen as a result of the stakeholders efforts. Recently, a member of the group, became a liaison between the Area Steering Committee and the stakeholders group, in order to continue positive communication between the provider community, Area staff and the local steering committee.

Who Benefits? Providers
How? Providers benefit from the additional training and the opportunity to discuss and brainstorm any problem areas during provider meetings. Individuals benefit from the ongoing networking and focus on the attainment of outcomes. APD benefits from providers decreased reliance on the Area for all of their training needs. All benefit from the ongoing communication and focus on continuous improvement.

Practice
In an effort to promote self-reliance, Sumter County ARC initiated a new practice for their monthly fire drills in group homes as well as Adult Day Training. Rather than pulling the alarm and directing individuals out of the building, they place a “block exit” (model of a fire) in a different location for each drill with the expectation that residents or participants will pull the alarm. The change in procedure was announced during a routine visit from the local fire chief.

Who Benefits? Group Home residents & Adult Day Training (ADT) Participants
How ? Group Home residents & Adult Day Training (ADT) participants become self-reliant rather than looking to staff to direct their every move.

The question, “What would happen if staff were incapacitated?” is addressed and resolved.

Practice
A SLC provider works with individuals, by tapping into their particular interests, and enhancing these interests.  For example, for individuals who are interested in Painting, Art work and Poetry, the provider encourages the individuals to tap into their artistic abilities.  She travels with them to various Art Shows throughout their local communities, where they’re able to present their work and put it up for sale—from paintings, to books of poetry (which the provider works with the individuals on), etc.  Some individuals have sold some of their Art work and books of poems.  The provider has also assisted people to  develop websites, in order for them to showcase their work for potential customers.  In addition, other individuals had expressed wanting to make some extra money.  The provider assisted them to purchase gumball machines and placed them in the local APD offices, where they’re able to get some business.  This has proven to be very successful and the individuals are THRILLED!  The provider recently returned from a Mexican Cruise vacation, with a select group of individuals, who had expressed wanting to go on vacation overseas.

Who Benefits? Individuals
How? The individuals have all expressed how excited they are to be able to express themselves through different forms of personal interests.  In addition, the vacation in Mexico enabled the individuals to experience different  customs, and culture through education, exposure and experience.

Practice
People receiving services from this organization personally hand out paychecks to staff. The organization initiated the idea after attending a training by CQL (The Council on Quality and Leadership).

Additionally, a group home manager with this organization took the lead from one of the residents and renamed “House Rules” as “House Agreements”. When evolving from management developed house rules to “rules” developed by the residents themselves, the manager heard one resident say, “I agree” after a rule was suggested by a resident. She listened, and she agreed.

Who Benefits? All
How? Regarding the paychecks, the staff benefits from the reminder that although they are hired by the organization, they work for the people. The people receiving services benefit from the empowerment derived from the action. The organization as a whole benefits from an action that is symbolically very powerful, while not consuming any extra resources. Regarding the “House Agreements”, the resident benefited when his remark was heard and valued. All residents benefited by no longer being subjected to “rules” in their own home. They learned about compromise, consensus and self-governing. Other staff benefit from the realization that they too can seize upon opportunities to innovate and contribute

Practice
A provider developed creative strategies to teach money management skills on the basis that most often what individuals really want is to make their own purchases and control their own money although a support plan goal may read, “Learn money management skills” or “Learn to make change” or “Learn to count coins”… Instead, individuals obtain a pre-paid debit card. Then the training focus can be on safekeeping the card, learning their four-digit code, confidentiality, learning how to use different types of keypads, and retaining receipts. The provider developed a system to assist individuals in managing their accounts; two strips of colored paper that fit into slots in poster-board sandwiched together. At the beginning of the month, the slots are full signifying the days left in the month (red) and the money left in the card (green). As the individual uses the card, he saves receipts, and his coach adjusts the colored strips to give him a visual of how much money remains for the remainder of the month.

Another provider, unable to locate a user-friendly bank, identified with the individual her favorite stores and assisted her in purchasing refillable pre-paid gift cards at those stores.  As a result, the individual was able to make her purchases at her favorite store just like anyone else, which is all she really ever wanted.

Who Benefits? Individuals
How? Individuals achieve what is really most important to them. By getting to the bottom of what individuals really want, providers avoid years, sometimes decades, of ‘coin counting’ activities.

Practice
This provider involves the individuals in the development of their monthly summaries. At the end of each month, a staff member meets with the individual and asks a series of questions:
What is one new thing you learned this month?
What is one new thing you experienced this month?
What worked for you this month?
What did not work for you this month?
And, a fifth question about progress on their specific personal goals.
Then, the provider adds the summary of their data collection for the month.

Who Benefits? Individuals and the provider.
How? The individuals have a greater sense of partnership. They come to expect to be learning something new, to expect to have new experiences, and, that it matters if strategies are to their liking. They develop ownership of their goals, and their implementation plan, and their learning.

The provider benefits from the frequent feedback.