COMMUNITY STRATEGIES Mandy Adao s Cluster Carver Kingston Leicester

COMMUNITY STRATEGIES: Mandy Adao’s Cluster Carver, Kingston, Leicester, Middleboro and Paxton Comprehensive Program Review February 27, 2015 1

CLUSTER HIGHLIGHTS v Stephen Kelly received Star Award v Opening Leicester (9/5/14) v Leominster-Merriam opening in January 2015 v Increased Meaningful Day Participation Best Practice: v 100% of all residents are participating in Healthy Living 2

CHALLENGES v Being fully staffed in all programs v Finding Jobs for our individuals v Finding quality staff for the pay rate we offer 3

STAFFING Staff Turnover Rates Staff Retention Rates Staff Training Hours 4

STAFF RETENTION RATES Ø The current CS Cluster average is 75. 5% compared to the CSMA average of 70. 6% Ø Last CPR, Cluster average was 73. 2% compared to the CSMA average of 72. 4% Data obtained from HR Staff Retention & Turnover Report 5

STAFF TURNOVER RATES Ø The current CS Cluster average is 23. 9% compared to the CSMA average of 27. 5% Ø Last CPR, Cluster average was 28. 6% compared to the CSMA average of 26. 5% Data obtained from HR Staff Retention & Turnover Report 6

STAFF TRAINING HOURS July 2014 – December 2014 Ø Total of 581. 25 training hours were completed (This is a 34% decrease from last CPR) Ø Average of 15. 4 training hours per staff/over six months Last CPR: (November 2013 – April 2014) Ø Total of 891. 5 training hours were completed Ø Average of 27. 9 training hours per staff/over six months Data obtained from MMRs and HR Reports 7

CLIENT RELATED • Clinical Hours • Elopements • Medication • De-escalation and Restraints • Mainstream/Community Inclusion Activities 8

CLINICAL HOURS July 2014 – December 2014 Ø Ø A total of 154. 1 clinical hours (this is a 27% decrease from the previous CPR); the Cluster average = 1. 3 hours per client per month or 3. 9 per client/per quarter. Last CPR, a total of 213. 75 clinical hours; the Cluster average was 1. 9 hours per client per month. Data obtained from MMRs 9

CLIENT ELOPEMENTS November 2013 – April 2014 July 2014 – December 2014 Carver 0 0 Kingston 0 0 Leicester N/A 0 Middleboro 0 0 Paxton 0 0 Cluster - Totals 0 0 Data obtained from MMRs 10

MEDICATION INCIDENTS & OCCURRENCES July 2014 - December Ø A total of 6 medication incidents and 9 medication occurrences Ø This is 0. 10 medication incidents & occurrences per client per month Ø Last CPR, a total of 3 medication incidents and 0 medication occurrences Ø This is. 02 medication incidents & occurrences per client per month Data obtained from MMRs 11

DE-ESCALATIONS : RESTRAINTS November 2013 – April 2014 July 2014 – December 2014 De-escalations: restraints Ratios Carver 228: 3 76: 1 381: 4 95: 1 Kingston 213: 1 323: 0 0: 0 Leicester N/A Middleboro 213: 0 249: 0 Paxton 175: 5 15: 1 133: 8 17: 1 Cluster Totals 639: 9 71: 1 1, 086: 12 91: 1 Data obtained from MMRs 12

COMMUNITY INCLUSION Community Inclusion Participated In and Offered Per Client/ Month (July 2014 – December 2014) ØA total of 690 community inclusion activities participated in across the cluster by all clients over six months. (This is a 32% increase from last CPR) ØAverage of 5. 9 community inclusion activities participated in by client/per month or 34. 5 per client/six months (July 2014 – December 2014). The overall participation rate is 70% (C. I. offered = 984/C. I. participated in =690) Ø Last CPR, a total of 519 community inclusion activities participated in; an average of 4. 9 community inclusion activities participated in by client/month; The overall participation rate = 87% (C. I. offered = 591/C. I. participated in =519) Data obtained from MMRs 13

MAINSTREAM ACTIVITIES Mainstream Activities Participated In and Offered Per Client/ Month (July 2014 – December 2014) ØA total of 1, 766 mainstream activities participated in across the cluster by all clients over six months. (This is a 37% increase from previous CPR) ØAverage of 14. 4 mainstream activities participated in by client/month or 86. 4 per client over six months. (July 2014 – December 2014). This is a 20% increase from the previous CPR. The overall participation rate is 84% (mainstream offered = 2, 108/mainstream participated in =1, 766) ØLast CPR, a total of 1, 283 mainstream activities participated in; an average of 11. 9 mainstream activities participated in by client/month. The overall participation rate = 96%. (mainstream offered = 1, 331/mainstream participated in =1, 283) Data obtained from MMRs 14

QUALITY ASSURANCE Key MMR Results SQA Audit Results 15

KEY MMR RESULTS Employment/Education: (As of December 31, 2014) Ø 1 out of 23 in pre-vocational program; last CPR = 0 Ø 2 out of 23 (13%) clients competitively employed; last CPR = 1 out of 18 (6%)employed Ø 3 out of 23 (13%) clients are in school; last CPR, 2 out of 18 or (11%) = in school Ø 8 out of 23 (35%) clients are attending a sheltered workshop; last CPR, 11 out of 23 (48%) Ø 9 out of 28 (32%) clients are in day programs; last CPR, 4 out of 18 (22%) in day programs Other: Ø 100% of the clients chose to participate in the healthy living options within their program; last CPR = 100% Ø “ 1” contraband reported; last CPR = 0 contraband reported Staff Certifications: Ø 100% certified in PAC/CPI and First Aid/CPR: Ø 70. 4% of staff are MAP Certified; last CPR, (67% of staff were MAP certified) Ø Ø Current CPR: Carver 78%; Kingston = 83%; Leicester = 63%; Middleboro = 40% ; P axton = 88% Last CPR: Carver 73%; Kingston = 80%; Leicester = N/A; Middleboro = 57% ; P axton = 56% 16

RESULTS OF SQA MONITORING AUDITS July 2014 -December 2014 Positives • Average Scores – Confidential Files = 96. 14% – Financial Records = 98. 44% – Program Forms = 92. 2% • **Strengths of the Cluster – ISP Paperwork (Assessment and Provider Support Strategies) – Fire Drills – Required Training Sign-offs Areas In Need of Improvement – Walk-Throughs – Outdated Skills Plans and Required Signatures

CPR ACTION PLAN • ISSUE: Increase the number of clients employed • COMMENTS: Last CPR, of the 18 clients: 1 competitively employed; 0 in pre-vocational; 11 in sheltered workshops (12 out of 18 or 67%) 2 in school and 4 in day programs • IMPROVEMENTS MADE: Currently, of the 23 clients 2 competitively employed; 1 in pre-vocational; 8 in sheltered workshops (11 out of 23 or 48%) 3 in school and 9 in day programs • Work with Development Office (Paul Swindlehurst and Anna Poplasky) to write a story about the collaboration with Habitat for Humanity – Re-Store – Habitat for Humanity – CS working with Habitat - -clients are working at the store; and ‘bringing home scraps of wood to create shelves and other functional items to give back to Habitat. – Bill Coughlin to notified Paul and Anna about the need to document this story 18