PROVIDER REPORT FOR	

	

	

	

	

	

	

	

	

	
	
P.R.I.D.E, INC
3 Maple Street
 Taunton, MA 02780    	

	

	

	

	

	

	

	

July 18, 2017	

	

	

	

	

	

	

	

	

Version	

	

	

	

	

	

	

	

	
Provider Web Report
July 5, 2017

	

	
Prepared by the Department of Developmental Services
OFFICE OF QUALITY ENHANCEMENT	

	

	

	

	

	

	

				
	SUMMARY OF OVERALL FINDINGS	

				

	

	

Provider	

	
P.R.I.D.E, INC	

	

	

	

	
Review Dates	

	
6/7/2017 - 6/12/2017	

	

	

	

	
Service Enhancement 
Meeting Date	

	
6/21/2017	

	

	

	

	

	

	
Survey Team	

	
Tina Napolitan	

Scott Nolan (TL)	

Laura O'Connor	

	

	

	

	

	

	
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	
1 location(s) 7 audit (s) 	
Full Review	
49 / 55 2 Year License 06/21/2017 -  06/21/2019	
	
31 / 41 Certified with Progress Report 06/21/2017 -  06/21/2019	

Community Based Day Services	
1 location(s) 3 audit (s) 	

Full Review	
11 / 14	

Employment Support Services	
0 location(s) 4 audit (s) 	

Full Review	
14 / 21	

Planning and Quality Management	

	
Full Review	
6 / 6	

	

	

			
EXECUTIVE SUMMARY :	

			
P.R.I.D.E., Inc. (Preparatory Rehabilitation for Individual Development and Employment, Inc.) is a non-profit organization established in 1969 providing residential, employment and social programs for people of all abilities in southeastern Massachusetts and Cape Cod.  Services to individuals with intellectual disabilities and acquired brain injury currently offered by the agency include Adult Foster Care (AFC), Day Habilitation, Personal Care Assistant Management Program (PCAM), Community Based Day Services, Job Placement and Supported Employment, and Transition to Work Program. The agency provides services to approximately 55 adults with intellectual disabilities receiving Community Based Day Services and 45 adults receiving Supported Employment.

This Licensure and Certification review by the Department of Developmental Services (DDS) survey team included a review of services provided to four individuals who received employment supports and three audits for individuals who received community based day supports. The current review included all licensing and certification indicators in the DDS survey tool, which as of August 2016 had been modified by the addition of new indicators and the strengthening of many of the existing ones. 

The agency has made significant organizational change since the last review; this included a transition from Center Based Employment which included sub-minimum wages to a work setting which provided prevailing wages for all agency contract work and hiring an integrated work force from the local community. In addition, the agency is more closely monitoring individual's health and promoting positive lifestyle choices within the agency.  Individuals were supported to understand the importance of nutritional food choices and daily exercise.  Implementation of positive behavioral supports which improved interactions on the work floor between peers was observed. The agency had built partnerships with local businesses as well as community organizations which provided individuals with more volunteer and employment options. For example, a recent partnership with Meals on Wheels created more opportunities for individuals to interact with members of the community while earning minimum wage. 

The agency demonstrated positive findings in several licensure areas.  Regarding the work site, in addition to being in good repair, the site was reviewed periodically with individuals to ensure that the space was designed and functioned optimally.  For example, the agency was in the process of renovating the space to accommodate additional rooms, one  will be a computer lab to support individuals in job training skills and the other will be for arts and cultural activities. These additions were in response to individuals' advocacy regarding more choices throughout the day and opportunities to learn new skills. The agency also ensured that staff were knowledgeable of individuals who required medical monitoring and provided assistance with medication administration. 
  
A continuing strength of the agency is the mutually respectful relationships individuals have with staff. Survey findings revealed that individuals were afforded opportunities to meet privately with staff regarding concerns. Three individuals who participated in the survey were actively involved in the Safety or Consumer Advisory Committees and worked in partnership with senior management to improve the agency's services. For example, committee recommendations such as hiring a cook to assist individuals to learn how to prepare healthy meals, and individuals actively engaged in the development of practices to ensure the safety of all individuals in the event of an emergency. 

Within the organizational areas, the agency strengthened the effectiveness of its Human Rights Committee to ensure it met membership requirements, held meetings regularly and addressed human rights issues which potentially impacted the rights of individuals. The agency also ensured that staff met all required trainings and were knowledgeable about incident and Disabled Persons Protection Commission (DPPC) reporting requirements. 

Although the agency had several positive findings, improvements were needed in the following areas pertaining to human rights.  While the staff had been trained in human rights and DPPC information was posted, there were some instances where individuals and guardians needed to be informed about how to report abuse, neglect or mistreatment to the DPPC.  The agency also needs to ensure the specific scope of information is provided when seeking informed consent for media use.

Within the certification areas, findings revealed that individuals were afforded opportunities to choose from a menu of activities that reflected their preferences and interests during the Community Based Day Support program.   Individuals attended parks, shopping malls and community events on a regular basis.  Volunteer opportunities allowed individuals greater access to participate in local non-profit organizations such as an art association, churches and local events such as Earth Day. During the course of the survey, individuals were given choices to go for a walk at a nearby park, attend a movie or volunteer at a local non-profit organization.  As part of CBDS, individuals were offered paid opportunities for seasonal work or off site employment.  However, effective methods to assess individual job interests such as current vocational assessments to identify career goals or a written plan on how to achieve work goals was not present for several individuals who expressed a desire to work in the community. 

While the Community Based Day Supports services was generally successful in the certification areas such as meaningful day activities and supporting individual choices, the employment services could benefit from further attention in some certification areas.  Within the agency's employment supports, additional focus should be directed to ensuring that individuals are provided  with paid jobs in the community that match their interests. Further emphasis on individualized career planning, beginning with a clearer understanding of a person's employment interests, followed by an assessment of their skills and training needs and culminating in the development and implementation of a plan for competitive employment should be strengthened. For example, the agency has made a concerted effort to establish sites for job training skills at local business; two of the individuals' in the survey attended these training sites to explore career options. The agency has a connection with various community businesses with both competitive job sites as well as training sites.  These unpaid work experiences were identified as volunteer or internships by the agency.  However, some of these jobs performed by individuals at these sites did not meet the standards required by the Department of Labor for volunteering, internships and/or unpaid work experiences. The agency needs to ensure that in locating community job sites, they distinguish between job training sites in which the agency needs to follow the criteria for volunteering, internships or unpaid work experiences as outlined in the Department of Labor (D.O.L) guidelines or employment sites in which individuals are fairly compensated for working.  

Based on the finding of this report, P.R.I.D.E will receive a Two-Year License for its Employment/Day services. Licensing indicators were 89% Met with follow-up conducted by the DDS Office of Quality Enhancement in 60 days.

The agency was Certified with a Progress Report with 76% of the certification indicators receiving a rating of Met.  The agency will have one year to address the certification findings and prepare its Progress Report on the certification indicators that were rated Not Met.	

	

LICENSURE FINDINGS	

	

	
Met / Rated	
Not Met / Rated	
% Met	

Organizational	
6/6	
0/6	

Employment and Day Supports	
43/49	
6/49	

    Employment Support Services
    Community Based Day Services

	

Critical Indicators	
8/8	
0/8	

Total	
49/55	
6/55	
89%	

2 Year License	

	

# indicators for 60 Day Follow-up	
	
6	

	

	

	

			

	

	
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.	
Four individuals were unable to express how to report alleged abuse/neglect; the agency did not provide written information and/or training to individuals and guardians pertaining to mandated reporting requirements. The agency needs to ensure that individuals and/or guardians are trained in how to report alleged abuse/neglect.	

 L15	
Hot water temperature tests between 110 and 130 degrees.	
The hot water temperature was tested within the employment and day supports programs.  Water temperatures exceeded allowable temperatures (over 120 degrees) in one section of the building.  The agency needs to ensure that water temperatures are maintained between 110 and 120 degrees. (Corrected)

	
 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.	
The agency Informed Consent Media Release lacked specificity to event, date and purpose for the use of an individual's picture for social media/publications. The agency needs to ensure that the media informed consent contains all the required components.  (Corrected)	

 L61	
Supports and health related protections are included in ISP assessments and the continued need is outlined.	
Supportive and health related protections were reviewed for one individual. The procedures for use and frequency of safety checks were not included.  The agency needs to ensure that all required components are included in supportive and health related protections. 	

 L86	
Required assessments concerning individual needs and abilities are completed in preparation for the ISP.	
The agency did not meet the DDS time-lines for four of the six individuals where assessments had been requested in a timely fashion.  The agency needs to ensure that assessments are submitted at least 15 days prior to the ISP.  	

 L87	
Support strategies necessary to assist an individual to meet their goals and objectives are completed and submitted as part of the ISP.	
The agency did not submit support strategies within 15 days prior to the ISP as required for four of the six individuals for whom this was reviewed. The agency needs to ensure that ISP timelines for the submission of support strategies are followed.	

		

		

	

	

CERTIFICATION FINDINGS	

	

	
Met / Rated	
Not Met / Rated	
% Met	

Certification - Planning and Quality Management	
6/6	
0/6	

Employment and Day Supports	
25/35	
10/35	

Community Based Day Services	
11/14	
3/14	

Employment Support Services	
14/21	
7/21	

TOTAL	
31/41	
10/41	
76%	

Certified with Progress Report	

	

	

	

	

	

	
Community Based Day Services Commendations on Standards Met:	

Indicator #	
Indicator	
Commendations	

 C13	
Staff (Home Providers) provide support for individuals to develop skills to enable them to maximize independence and participation in typical activities and routines. 	
Two Individuals were elected by their peers to serve on the Consumer Advisory Council. Individuals were afforded opportunities to participate in organizational activities that impacted all individuals such as hiring a professional cook to teach cooking classes. The agency is commended for supporting individuals to maximize their independence within the agency.	

 C45	
Individual's decisions of what to do during the day are revisited on a regular basis.	
The agency offered regular opportunities for individuals to make choices throughout the day while listening to their opinions for creating other options such as cooking or yoga classes. The agency is commended for supporting individuals to make meaningful choices on how to spend their day.	

	

	

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.	
Although efforts were made to include input from individuals in the hiring process, the agency had not yet to include input during the on-going evaluation of staff.  The agency needs to strengthen the processes through which individuals can provide feedback on their staff.	

 C44	
Staff have effective methods to assist individuals to explore their job interests if appropriate.	
The agency needs to ensure that it has effective methods of supporting individuals who are interested in working explore job interests customized to their learning style and needs and individuals employment interests are identified at least annually. Staff have regularly assessed the individual's job interests, and staff have explored with the individual those interests identified, and this is revisited at least annually.	

 C54	
Individuals have the assistive technology and/or modifications to maximize independence. 	
Three individuals had not been assessed to identify any assistive technology that they may have benefited from, or the need for modification of existing assistive devices to maximize their independence. The agency needs to ensure that all individuals are assessed to determine whether the individual would benefit from any assistive devices  or modifications to maximize independence in their work and community	

	

	
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.	
Although efforts were made to include input from individuals in the hiring process, the agency had not yet put forth efforts to include input during the on-going evaluation of staff.  The agency needs to strengthen the processes through which individuals can provide feedback on their staff.	

 C22	
Staff have effective methods to assist individuals to explore their job interests.	
For three of four people surveyed, the agency had not assessed the individuals' recent job interests.  The agency needs to ensure that individual's job interests are explored through assessments that enable them to identify their strengths and abilities to determine a job goal.	

 C23	
Staff utilize a variety of methods to assess an individual's skills, interests, career goals and training and support needs in employment.	
For three of four people surveyed, the agency had not assessed the employment related skills and training needs.  Assessments should address the individual's strengths and abilities, as well as settings that would further promote learning and skill development.  The agency needs to expand and refine the tools for assessing individual's employment related skills, interests and training needs relative to the individual's field of interest. 	

 C24	
There is a plan developed to identify job goals and support needs.	
Two of the people whose supports were reviewed expressed a desire to work competitively in other settings; however, there were no plans in place to identify competitive jobs which aligned with their career goals.  The agency needs to ensure that each individual is supported to establish a plan towards accomplishing their unique job goals, including a description of their support needs.	

 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.	
Two of three individuals for which this indicator was reviewed had not yet received an analysis of how future earnings could impact entitlements.  The agency needs to support each individual and their family/guardians to receive and understand this type of analysis.	

 C29	
Individuals are supported to obtain employment that matches their skills and interests.	
For two individuals, efforts to support them to obtain employment which matches their skills and interest was not present. The agency needs to ensure that individuals are supported to be competitively employed in areas that match their skills and interests.	

 C54	
Individuals have the assistive technology and/or modifications to maximize independence. 	
The agency needs to conduct assistive technology evaluations with each individual to determine which modifications or adaptive devices could help them to be as independent as possible at their jobs.	

	

	

		

					
	MASTER SCORE SHEET LICENSURE	

					
	Organizational: P.R.I.D.E, INC	

					
	
Indicator #	
Indicator	
Met/Rated	
Rating(Met,Not Met,NotRated)	

O	
 L2	
Abuse/neglect reporting	
1/1	
Met	

 L48	
HRC	
1/1	
Met	

 L74	
Screen employees	
1/1	
Met	

 L75	
Qualified staff	
1/1	
Met	

 L76	
Track trainings	
4/4	
Met	

 L83	
HR training	
4/4	
Met	

						
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	
2/4	
	
2/3	
4/7	
Not Met
(57.14 %)	

 L5	
Safety Plan	
L	

1/1	
1/1	
Met	

O	
 L6	
Evacuation	
L	

1/1	
1/1	
Met	

 L7	
Fire Drills	
L	

1/1	
1/1	
Met	

 L8	
Emergency Fact Sheets	
I	
4/4	
	
3/3	
7/7	
Met	

 L9	
Safe use of equipment	
L	

1/1	
1/1	
Met	

 L10	
Reduce risk interventions	
I	

3/3	
3/3	
Met	

O	
 L11	
Required inspections	
L	

1/1	
1/1	
Met	

O	
 L12	
Smoke detectors	
L	

1/1	
1/1	
Met	

O	
 L13	
Clean location	
L	

1/1	
1/1	
Met	

 L14	
Site in good repair	
L	

1/1	
1/1	
Met	

 L15	
Hot water	
L	

0/1	
0/1	
Not Met
(0 %)	

 L16	
Accessibility	
L	

1/1	
1/1	
Met	

 L17	
Egress at grade 	
L	

1/1	
1/1	
Met	

 L20	
Exit doors	
L	

1/1	
1/1	
Met	

 L21	
Safe electrical equipment	
L	

1/1	
1/1	
Met	

 L22	
Clean appliances	
L	

1/1	
1/1	
Met	

 L25	
Dangerous substances	
L	

1/1	
1/1	
Met	

 L26	
Walkway safety	
L	

1/1	
1/1	
Met	

 L28	
Flammables	
L	

1/1	
1/1	
Met	

 L29	
Rubbish/combustibles	
L	

1/1	
1/1	
Met	

 L30	
Protective railings	
L	

1/1	
1/1	
Met	

 L31	
Communication method	
I	
4/4	
	
3/3	
7/7	
Met	

 L32	
Verbal & written	
I	
4/4	
	
3/3	
7/7	
Met	

 L37	
Prompt treatment	
I	
3/3	
	
3/3	
6/6	
Met	

O	
 L38	
Physician's orders	
I	

3/3	
3/3	
Met	

 L39	
Dietary requirements	
I	

3/3	
3/3	
Met	

 L44	
MAP registration	
L	

1/1	
1/1	
Met	

 L45	
Medication storage	
L	

1/1	
1/1	
Met	

O	
 L46	
Med. Administration	
I	

2/2	
2/2	
Met	

 L49	
Informed of human rights	
I	
4/4	
	
3/3	
7/7	
Met	

 L50	
Respectful Comm.	
L	

1/1	
1/1	
Met	

 L51	
Possessions	
I	
4/4	
	
3/3	
7/7	
Met	

 L52	
Phone calls	
I	
4/4	
	
3/3	
7/7	
Met	

 L54	
Privacy	
L	

1/1	
1/1	
Met	

 L55	
Informed consent	
I	
0/2	
	
1/1	
1/3	
Not Met
(33.33 %)	

 L61	
Health protection in ISP	
I	

0/1	
0/1	
Not Met
(0 %)	

 L62	
Health protection review	
I	

1/1	
1/1	
Met	

 L77	
Unique needs training	
I	
4/4	
	
3/3	
7/7	
Met	

 L78	
Restrictive Int. Training	
L	

1/1	
1/1	
Met	

 L79	
Restraint training	
L	

1/1	
1/1	
Met	

 L80	
Symptoms of illness	
L	

1/1	
1/1	
Met	

 L81	
Medical emergency	
L	

1/1	
1/1	
Met	

O	
 L82	
Medication admin.	
L	

1/1	
1/1	
Met	

 L84	
Health protect. Training	
I	

1/1	
1/1	
Met	

 L85	
Supervision 	
L	

1/1	
1/1	
Met	

 L86	
Required assessments	
I	
1/4	
	
1/1	
2/5	
Not Met
(40.0 %)	

 L87	
Support strategies	
I	
1/4	
	
1/1	
2/5	
Not Met
(40.0 %)	

 L88	
Strategies implemented	
I	
3/4	
	
2/2	
5/6	
Met
(83.33 %)	

#Std. Met/# 49 Indicator	

	

43/49	

	
Total Score	

	

49/55	

	

	

	
89.09%	

		
						
	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	
0/3	
Not Met (0 %)	

 C8	
Family/guardian communication	
3/3	
Met	

 C13	
Skills to maximize independence 	
3/3	
Met	

 C37	
Interpersonal skills for work	
3/3	
Met	

 C40	
Community involvement interest	
3/3	
Met	

 C41	
Activities participation	
3/3	
Met	

 C42	
Connection to others	
3/3	
Met	

 C43	
Maintain & enhance relationship	
3/3	
Met	

 C44	
Job exploration	
0/3	
Not Met (0 %)	

 C45	
Revisit decisions	
3/3	
Met	

 C46	
Use of generic resources	
3/3	
Met	

 C47	
Transportation to/ from community	
3/3	
Met	

 C51	
Ongoing satisfaction with services/ supports	
3/3	
Met	

 C54	
Assistive technology	
0/3	
Not Met (0 %)	

Employment Support Services	

Indicator #	
Indicator	
Met/Rated	
Rating	

 C7	
Feedback on staff performance	
0/4	
Not Met (0 %)	

 C8	
Family/guardian communication	
4/4	
Met	

 C22	
Explore job interests	
1/4	
Not Met (25.00 %)	

 C23	
Assess skills & training needs	
2/4	
Not Met (50.0 %)	

 C24	
Job goals & support needs plan	
2/4	
Not Met (50.0 %)	

 C25	
Skill development	
4/4	
Met	

 C26	
Benefits analysis	
1/3	
Not Met (33.33 %)	

 C27	
Job benefit education	
4/4	
Met	

 C29	
Support to obtain employment	
2/4	
Not Met (50.0 %)	

 C30	
Work in integrated settings	
4/4	
Met	

 C31	
Job accommodations	
4/4	
Met	

 C32	
At least minimum wages earned	
3/4	
Met	

 C33	
Employee benefits explained	
4/4	
Met	

 C34	
Support to promote success	
3/4	
Met	

 C35	
Feedback on job performance	
4/4	
Met	

 C36	
Supports to enhance retention	
4/4	
Met	

 C37	
Interpersonal skills for work	
4/4	
Met	

 C47	
Transportation to/ from community	
4/4	
Met	

 C50	
Involvement/ part of the Workplace culture	
4/4	
Met	

 C51	
Ongoing satisfaction with services/ supports	
4/4	
Met	

 C54	
Assistive technology	
0/4	
Not Met (0 %)