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PROVIDER REPORT FOR
CLASSOne Parker Street Lawrence, MA 01843
August 28, 2017
Version
Provider Web Report
Prepared by the Department of Developmental ServicesOFFICE OF QUALITY ENHANCEMENT
SUMMARY OF OVERALL FINDINGS
Provider
CLASS
Review Dates
6/26/2017 - 6/29/2017
Service Enhancement Meeting Date
7/14/2017
Survey Team
John Downing (TL)
Steve Goldberg
Citizen Volunteers
Survey scope and findings for Employment and Day Supports
Service Group Type
Sample Size
Licensure Scope
Licensure Level
Certification Scope
Certification Level
Employment and Day Supports
2 location(s) 8 audit (s)
Full Review
57 / 62 2 Year License 07/14/2017 - 07/14/2019
22 / 41 Certified with Progress Report 07/14/2017 - 07/14/2019
Community Based Day Services
1 location(s) 4 audit (s)
Full Review
7 / 13
Employment Support Services
1 location(s) 4 audit (s)
Full Review
9 / 22
Planning and Quality Management
Full Review
6 / 6
EXECUTIVE SUMMARY :
CLASS, Inc. is a non-profit organization providing Community Based Day Services (CBDS) and Employment Supports to adults with intellectual disabilities residing throughout the five geographical areas that comprise the Northeast Region. The agency, which began providing services in 1976, currently has two program centers which are located in Lawrence and Wilmington, MA. The agency provides services to over 400 individuals within Day Habilitation, Community Based Day Services, Competitive Employment, Group Supported Employment, Specialized Employment Services, and Adult Foster Care programs.The scope of this survey conducted by the Office of Quality Enhancement (OQE) was a full review of all licensing and certification indicators within the agency's Community Based Day and Employment Supports programs, including indicators which were new or revised in August 2016. Since the last survey, CLASS has made gains in terms of addressing a number of environmental issues. For example, the propane- fueled fork-lift truck had been replaced by a battery- operated fork-lift. Flammable materials were appropriately stored in identifiable fire rated cabinets. The agency has also developed and recently begun implementation of two innovative certificate training programs to further create skills training and paid employment opportunities for individuals. The first is a rudimentary carpentry training program taught by a licensed carpenter. Individuals currently participating in this program were also involved in a paid renovation project within the warehouse section of the Lawrence program site. Individuals were excited by their newly attained skills and particularly proud of their finished product. The second certificate program is teaching the sewing trade. A combination of skills training by a seamster and the agency's investment in machinery is preparing individuals for jobs in this industry. The initial products currently being manufactured are handbags made from colorful textile products including recycled videotape. A notable practice used by CLASS is known as the President's Club. The President's Club is comprised of seven Human Rights Presidents from the agency's two facilities. These individuals were elected by their peers to represent them at bimonthly meetings with the President of CLASS, Inc. to discuss a wide range of issues pertaining to services, facilities, events, and staffing. The elected Presidents attend the various advocacy groups within CLASS, Inc. to gather input and information from their peers to present to the President of CLASS, Inc. The Presidents Club periodically invites agency directors or other staff to attend their meetings depending on the agenda items for discussion. Individuals become part of the decision making process and effect positive changes for themselves and their peers.The agency supports a number of individuals with complex and unique behavioral and forensic needs. CLASS relies on its health care resources (OT, PT, and Nursing) to train staff and ensure the individuals' needs, whether long or short term, are met. Staff had been trained and demonstrated competency when discussing individuals' unique needs and protocols. The high level of attention, caring and respectfulness by staff towards the individuals was witnessed by surveyors during personal interactions and during documentation review. Since the previous licensing survey, the agency has experienced a significant change in and restructuring of its administrative staff. As a result, several of its goals and objectives with respect to enhancing the supports currently provided across all models have not had the benefit of time to become fully implemented, and were considered to be works in progress. For example, the agency was in the process of conducting an AFLS (Assessment of Functional Living Skills) for each individual supported as a means to better identify baseline strengths and needs. CLASS is encouraged to continue its efforts towards reaching its goals and objectives specific to these areas. The agency needs to focus attention and improve its current system(s) for tracking data/documentation to ensure compliance with several of the licensing indicators that were reviewed. Specifically, there were instances where the annual Human Rights and Reporting of Abuse and Mistreatment Trainings for individuals had lapsed. Another example included instances where Objectives and Support Strategies were not submitted within the required ISP timelines. Restraint reporting for the initial report and restraint manager review was also not completed within regulatory timelines. There were several areas identified through the certification indicators that require the focused attention of the agency. The agency needs to improve upon its ability to obtain information from the individuals it supports on a number of levels and variety of ways. Individuals did not have opportunities to provide feedback at the time of hire and on an ongoing basis on the performance of staff that support them. While staff is familiar with the individuals and their support needs, further assessment and exploration of each individual's skills as well as their personal, social and vocational interests should be collected and utilized to the benefit of each person and groups of people with similar interests. Within the employment model, the agency needs to develop a comprehensive Career Plan that includes assessments of interests and skills, goals and objectives, as well as supports needed to ensure integration, independence, retention, and satisfaction. As a result of this licensing and certification review of the agency's CBDS and Employment Supports model, CLASS, Inc. met 92% of the licensing indicators reviewed, with all critical indicators rated as met. Due to this positive outcome, the agency will receive a Two-Year license for its CBDS and Employment Services, and also be responsible to complete its own follow-up on the licensing indicators rated not met, within 60 days of the Service Enhancement Meeting (SEM). The agency met 54 % of the certification indicators reviewed, and is certified with a progress report. The agency is required to complete and submit the progress report on all certification indicators rated not met, within one year of the SEM.
LICENSURE FINDINGS
Met / Rated
Not Met / Rated
% Met
Organizational
9/10
1/10
Employment and Day Supports
48/52
4/52
Community Based Day Services Employment Support Services
Critical Indicators
8/8
0/8
Total
57/62
5/62
92%
2 Year License
# indicators for 60 Day Follow-up
5
Organizational Areas Needing Improvement on Standards not met/Follow-up to occur:
Indicator #
Indicator
Area Needing Improvement
L65
Restraint reports are submitted within required timelines.
25% of the restraint reports reviewed did not meet required timelines in regards to submission and review. The agency needs to ensure that all restraints reports are filed within three days of the applied restraint, reviewed by the restraint manager within five days of the applied restraint, and reviewed by the agency's Human Rights Committee within 120 days of the applied restraint.
Employment/Day Areas Needing Improvement on Standards not met/Follow-up to occur:
Indicator #
Indicator
Area Needing Improvement
L1
Individuals and guardians are trained in how to report alleged abuse/ neglect.
For three of the eight individuals, information regarding how to report abuse and/or neglect had not been provided as required. For two individuals in CBDS there was no evidence that their guardians had received the required information. There was no evidence of required training for one individual in employment supports. The requirement is annually for individuals and guardians.
L49
Individuals and guardians have been informed of their human rights and know how to file a grievance or to whom they should talk if they have a concern.
For three of the eight individuals, information regarding human rights and grievance procedures had not been provided as required. For two individuals in CBDS there was no evidence that their guardians had received the required information. There was no evidence of required training for one individual in employment supports. The requirement is annually for individuals and guardians.
L55
Informed consent is obtained from individuals or their guardians when required; Individuals or their guardians know that they have the right to withdraw consent.
One individual had an informed consent form obtained for photograph(s) of which the specific use and audience was not identified. The agency should refrain from obtaining a blanket informed consent form for the purpose of taking photographs of an individual. Informed consent should only be obtained when the agency intends to use or release the photograph for social or media purposes.
L87
Support strategies necessary to assist an individual to meet their goals and objectives are completed and submitted as part of the ISP.
For three of the eight individuals, support strategies had not been submitted within the required time-line. Strategies must be submitted to the service coordinator 15 days prior to the ISP meeting.
CERTIFICATION FINDINGS
Met / Rated
Not Met / Rated
% Met
Certification - Planning and Quality Management
6/6
0/6
Employment and Day Supports
16/35
19/35
Community Based Day Services
7/13
6/13
Employment Support Services
9/22
13/22
TOTAL
22/41
19/41
54%
Certified with Progress Report
Community Based Day Services- Areas Needing Improvement on Standards not met:
Indicator #
Indicator
Area Needing Improvement
C7
Individuals have opportunities to provide feedback at the time of hire and on an ongoing basis on the performance of staff that support them.
None of the four individuals surveyed had the opportunity to provide feedback at the time of hire and on an ongoing basis on the performance of staff that support them. The agency needs to develop a system to ensure that individuals in CBDS have the opportunity to be involved in the hiring and ongoing performance evaluation of their supporters.
C40
Individuals are supported to explore, discover and connect with their personal interest and options for community involvement, personal interest and hobbies.
For three out of four individuals, there was insufficient evidence to indicate that the process of exploration, discovery and connection of personal interests and options for community involvement occurred on a consistent and sustained basis. The agency needs to develop and utilize a variety of means to expose individuals to new options for community involvement for the purpose of broadening their interests.
C41
Individuals participate in activities, including those in the community, that reflect their interests and preferences.
For four individuals, there was insufficient evidence to indicate that activities were based on their specific interests and preferences. Staff need to take an active role in supporting people to more fully explore their interests, and assist them to realize their preferences and interests on an individualized basis as much as possible.
C42
Individuals are involved in activities that connect them to other people in the community.
For four individuals, there was insufficient evidence to suggest that the community activities provided served in a purposeful way to connect them to others in the community. The agency needs to ensure that community activities offered allow for frequent contact with the community at large.
C43
Staff act as bridge builders to support individuals to develop, sustain, and enhance relationships with others.
For four individuals, there was no evidence of staff acting as bridge builders so that individuals could develop personal relationships with people other than paid staff. The agency needs to ensure that opportunities for social contact are consistently provided so that staff can support individuals in having a more rich connection with other people who share their interests.
C45
Individual's decisions of what to do during the day are revisited on a regular basis.
For three out of four individuals, there was no evidence that individuals' decisions of what to do during the day are revisited on a regular basis (at least quarterly). The agency needs to ensure that individual interests, including an interest in employment, are revisited on a regular basis.
Employment Support Services- Areas Needing Improvement on Standards not met:
Indicator #
Indicator
Area Needing Improvement
C7
Individuals have opportunities to provide feedback at the time of hire and on an ongoing basis on the performance of staff that support them.
None of the four individuals surveyed had the opportunity to provide feedback at the time of hire and on an ongoing basis on the performance of staff that support them. The agency needs to develop a system that provides individuals the opportunity to provide feedback on the hiring and performance of staff.
C22
Staff have effective methods to assist individuals to explore their job interests.
None of the three individuals surveyed completed an interest survey to identify their current job interests. There was no other documentation to support staff have effective methods to assist with the exploration of job interests. The agency needs to ensure staff have and utilize effective means to explore job interest on an individualized basis.
C23
Staff utilize a variety of methods to assess an individual's skills, interests, career goals and training and support needs in employment.
None of the three individuals surveyed had their skills assessed, interests obtained, a career goal or identified training and support needs documented. The agency needs to ensure staff utilize a variety of methods to assess each person's skills, interests, goals and support needs.
C24
There is a plan developed to identify job goals and support needs.
None of the three individuals surveyed had a plan developed to identify their job goals and the support needed to attain their goal. The agency needs to ensure there is a comprehensive Career Plan in place that addresses job goals and support needs.
C25
Staff assist individuals to work on skill development for job attainment and success.
None of the three individuals surveyed were working on specific skill development for job attainment or future success. The agency needs to ensure that once the career goal and required skills are identified that there is a plan for skill development in order to obtain employment and success.
C26
Career planning includes an analysis of how an individual's entitlements can be managed in a way that allows them to work successfully in the community.
For two of the three individuals, there was no analysis of how their entitlements can be managed that allows them to work successfully in the community.
C29
Individuals are supported to obtain employment that matches their skills and interests.
None of the three individuals had a skills or interest assessment completed in order to be able to make a match based on skill and interest. The agency needs to ensure individuals are supported to obtain meaningful employment that matches their skill level and interests.
C30
Individuals are supported to work in integrated job settings.
Two of the three persons were not afforded the opportunity to work in integrated settings. The agency needs to ensure all individuals are supported to work in an integrated job settings.
C31
Accommodations and adjustments are made to enable an individual to perform his/her job functions.
For two of the individuals, there was no assessment or documentation with respect to any accommodations or adjustments to enable the individual to perform his/her job. The agency needs to ensure accommodations and adjustments that enable an individual to perform his/her job functions are assessed and documented.
C34
The agency provides the optimal level of support to promote success with a specific plan for minimizing supports.
For two of the three individuals, the agency was not providing optimal level of supports to promote success with a specific plan for minimizing supports. The agency needs to ensure there is a specific plan in place to promote success and minimizing supports.
C35
Individuals are given feedback on job performance by their employer.
For two of three individuals, there was no evidence they received feedback from their employer. The agency needs to ensure individuals are given feedback on job performance by their employer or the process by which feedback will be given to the individual.
C36
Ongoing supports are provided to enhance job retention and advancement.
For two of the three individuals, there was no retention plan or ongoing supports to enhance job retention and advancement. The agency needs to ensure there are ongoing supports provided to every individual to ensure job retention and advancement.
C54
Individuals have the assistive technology and/or modifications to maximize independence.
For two of the three individuals, there was no evidence of an assessment or utilization of assistive technology to maximize their independence. The agency needs to ensure individuals are assessed and have access to assistive technology to maximize their independence.
MASTER SCORE SHEET LICENSURE
Organizational: CLASS
Indicator #
Indicator
Met/Rated
Rating(Met,Not Met,NotRated)
O
L2
Abuse/neglect reporting
2/2
Met
L3
Immediate Action
15/15
Met
L4
Action taken
11/11
Met
L48
HRC
1/1
Met
L65
Restraint report submit
43/57
Not Met(75.44 % )
L66
HRC restraint review
56/57
Met(98.25 % )
L74
Screen employees
3/3
Met
L75
Qualified staff
4/4
Met
L76
Track trainings
16/16
Met
L83
HR training
14/16
Met(87.50 % )
Employment and Day Supports:
Ind. #
Ind.
Loc. or Indiv.
Emp. Sup.
Cent. Based Work
Com. Based Day
Total Met / Rated
Rating
L1
Abuse/neglect training
I
3/4
2/4
5/8
Not Met(62.50 %)
L5
Safety Plan
L
1/1
1/1
2/2
Met
O
L6
Evacuation
L
1/1
1/1
2/2
Met
L7
Fire Drills
L
1/1
1/1
2/2
Met
L8
Emergency Fact Sheets
I
4/4
4/4
8/8
Met
L9
Safe use of equipment
L
1/1
1/1
2/2
Met
L10
Reduce risk interventions
I
1/1
1/1
Met
O
L11
Required inspections
L
1/1
1/1
2/2
Met
O
L12
Smoke detectors
L
1/1
1/1
2/2
Met
O
L13
Clean location
L
1/1
1/1
2/2
Met
L14
Site in good repair
L
1/1
1/1
2/2
Met
L15
Hot water
L
1/1
1/1
2/2
Met
L16
Accessibility
L
1/1
1/1
2/2
Met
L17
Egress at grade
L
1/1
1/1
2/2
Met
L18
Above grade egress
L
1/1
1/1
2/2
Met
L20
Exit doors
L
1/1
1/1
2/2
Met
L21
Safe electrical equipment
L
1/1
1/1
2/2
Met
L22
Clean appliances
L
1/1
1/1
2/2
Met
L25
Dangerous substances
L
1/1
1/1
2/2
Met
L26
Walkway safety
L
1/1
1/1
2/2
Met
L28
Flammables
L
1/1
1/1
2/2
Met
L29
Rubbish/combustibles
L
1/1
1/1
2/2
Met
L30
Protective railings
L
1/1
1/1
2/2
Met
L31
Communication method
I
3/3
4/4
7/7
Met
L32
Verbal & written
I
4/4
4/4
8/8
Met
L37
Prompt treatment
I
2/2
4/4
6/6
Met
O
L38
Physician's orders
I
3/3
3/3
Met
L39
Dietary requirements
I
2/2
2/2
4/4
Met
L44
MAP registration
L
1/1
1/1
2/2
Met
L45
Medication storage
L
1/1
1/1
2/2
Met
O
L46
Med. Administration
I
1/1
2/2
3/3
Met
L49
Informed of human rights
I
3/4
2/4
5/8
Not Met(62.50 %)
L50
Respectful Comm.
L
1/1
1/1
2/2
Met
L51
Possessions
I
4/4
4/4
8/8
Met
L52
Phone calls
I
4/4
4/4
8/8
Met
L54
Privacy
L
1/1
1/1
2/2
Met
L55
Informed consent
I
1/1
0/1
1/2
Not Met(50.0 %)
L61
Health protection in ISP
I
3/3
3/3
Met
L62
Health protection review
I
3/3
3/3
Met
L63
Med. treatment plan form
I
1/1
1/1
Met
L64
Med. treatment plan rev.
I
1/1
1/1
Met
L73
DOL certificate
L
1/1
1/1
2/2
Met
L77
Unique needs training
I
4/4
4/4
8/8
Met
L79
Restraint training
L
1/1
1/1
Met
L80
Symptoms of illness
L
1/1
1/1
2/2
Met
L81
Medical emergency
L
1/1
1/1
2/2
Met
O
L82
Medication admin.
L
1/1
1/1
2/2
Met
L84
Health protect. Training
I
3/3
3/3
Met
L85
Supervision
L
1/1
1/1
2/2
Met
L86
Required assessments
I
4/4
4/4
8/8
Met
L87
Support strategies
I
3/4
2/4
5/8
Not Met(62.50 %)
L88
Strategies implemented
I
4/4
4/4
8/8
Met
#Std. Met/# 52 Indicator
48/52
Total Score
57/62
91.94%
MASTER SCORE SHEET CERTIFICATION
Certification - Planning and Quality Management
Indicator #
Indicator
Met/Rated
Rating
C1
Provider data collection
1/1
Met
C2
Data analysis
1/1
Met
C3
Service satisfaction
1/1
Met
C4
Utilizes input from stakeholders
1/1
Met
C5
Measure progress
1/1
Met
C6
Future directions planning
1/1
Met
Community Based Day Services
Indicator #
Indicator
Met/Rated
Rating
C7
Feedback on staff performance
0/4
Not Met (0 %)
C8
Family/guardian communication
4/4
Met
C13
Skills to maximize independence
4/4
Met
C37
Interpersonal skills for work
4/4
Met
C40
Community involvement interest
1/4
Not Met (25.00 %)
C41
Activities participation
0/4
Not Met (0 %)
C42
Connection to others
0/4
Not Met (0 %)
C43
Maintain & enhance relationship
0/4
Not Met (0 %)
C45
Revisit decisions
1/4
Not Met (25.00 %)
C46
Use of generic resources
4/4
Met
C47
Transportation to/ from community
4/4
Met
C51
Ongoing satisfaction with services/ supports
4/4
Met
C54
Assistive technology
4/4
Met
Employment Support Services
Indicator #
Indicator
Met/Rated
Rating
C7
Feedback on staff performance
0/4
Not Met (0 %)
C8
Family/guardian communication
3/3
Met
C22
Explore job interests
0/3
Not Met (0 %)
C23
Assess skills & training needs
0/3
Not Met (0 %)
C24
Job goals & support needs plan
0/3
Not Met (0 %)
C25
Skill development
0/3
Not Met (0 %)
C26
Benefits analysis
1/3
Not Met (33.33 %)
C27
Job benefit education
3/3
Met
C28
Relationships w/businesses
1/1
Met
C29
Support to obtain employment
0/3
Not Met (0 %)
C30
Work in integrated settings
1/3
Not Met (33.33 %)
C31
Job accommodations
0/2
Not Met (0 %)
C32
At least minimum wages earned
1/1
Met
C33
Employee benefits explained
1/1
Met
C34
Support to promote success
1/3
Not Met (33.33 %)
C35
Feedback on job performance
1/3
Not Met (33.33 %)
C36
Supports to enhance retention
1/3
Not Met (33.33 %)
C37
Interpersonal skills for work
4/4
Met
C47
Transportation to/ from community
2/2
Met
C50
Involvement/ part of the Workplace culture
1/1
Met
C51
Ongoing satisfaction with services/ supports
3/4
Met
C54
Assistive technology
1/4
Not Met (25.00 %)
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