PROVIDER REPORT FOR	

	

	

	

	

	

	

	

	

	
	
COOPERATIVE FOR HUMAN SERVICES
420 Bedford St, Ste. 100
 Lexington, MA 02420    	

	

	

	

	

	

	

	

	

	

	

	

	

	

	

	

	

Version	

	

	

	

	

	

	

	

	
Provider Web Report	

	

	

	

	

	

	

	
Prepared by the Department of Developmental Services
OFFICE OF QUALITY ENHANCEMENT	

	

	

	

	

	

	

				
	SUMMARY OF OVERALL FINDINGS	

				

	

	

Provider	

	
COOPERATIVE FOR HUMAN SERVICES	

	

	

	

	
Review Dates	

	
3/30/2016 - 4/5/2016	

	

	

	

	
Service Enhancement 
Meeting Date	

	
4/19/2016	

	

	

	

	

	

	
Survey Team	

	
John Downing	

Steve Goldberg	

John Hazelton (TL)	

Mark Boghoian	

	

	

	

	

	

	
Citizen Volunteers	

	

	

		

	

	
Survey scope and findings for Residential and Individual Home Supports	

Service Group Type	
Sample Size	
Licensure Scope	
Licensure Level	
Certification Scope	
Certification Level	

Residential and Individual Home Supports	
13 location(s) 13 audit (s) 	
Full Review	
84 / 85 2 Year License 04/19/2016 -  04/19/2018	
	
49 / 49 Certified 04/19/2016 -  04/19/2018	

Residential Services	
8 location(s) 8 audit (s) 	

Full Review	
14 / 14	

Placement Services	
1 location(s) 1 audit (s) 	

Full Review	
14 / 14	

Individual Home Supports	
4 location(s) 4 audit (s) 	

Full Review	
15 / 15	

Planning and Quality Management	

	
Full Review	
6 / 6	

	

	

			
EXECUTIVE SUMMARY :	

			
Incorporated in 1981, the Cooperative for Human Services, Inc. (CHS) is a not for profit organization providing residential support options to adults with developmentally disabilities.  Agency supports are primarily funded by the Massachusetts Department of Developmental Services (DDS) and are located in its Northeast region.  The range of residential options includes residences providing twenty-four hour support, individual home supports (IHS), and placement services; the agency is also currently developing a residence to support individuals with Acquired Brain Injuries.

As part of this survey, a full licensing and certification review of the agency's residential, placement and individual home support services was conducted.
 
Throughout the course of this survey it was observed that the agency excels in many areas of service delivery.  The agency has a robust and effective quality assurance system in place, and places an emphasis on maintaining systems focused on the analysis of internal data such as the review of incidents, restraints, medication occurrences, accidents, investigations, and hospitalizations.  This data, in addition to feedback received from families and guardians, and other stakeholders, has been utilized in developing both short term agency goals, as well as the agency's strategic plan.  The agency has embraced the use of technology in its quest to standardize systems, and increase the efficiency of most tasks; this has reportedly allowed managers and direct supporters to provide increased focus on tasks that directly benefit individuals served.  

At all sites surveyed, it was noted that the health care and support systems in place provided exceptional support to individuals to maintain optimal health.  For each individual surveyed, it was noted that a chronological list of medical events was in place, sometimes dating back more than 10 years.  All required medical appointments were made and kept, preventive screenings were reviewed with physicians, and events requiring emergency medical intervention were effectively managed.

The agency has placed an emphasis on implementing a positive behavioral approach for individuals requiring behavioral supports.  An expansive curriculum was developed by the agency, not only focusing on the implementation of traditional Positive Behavioral Supports (PBS) principles, but also on creating a culture within the agency that fosters a deep understanding among supporters of how these principles should be utilized in daily life.  Since the last survey, the agency has eliminated all level II behavior plans, and decreased the number of level I behavior plans.  The agency's success in creating a PBS oriented culture among supporters was evident, as all individuals surveyed were observed to be supported utilizing the tenets of Positive Behavioral Supports.  

Throughout the course of the survey, it was observed that managers and supporters were knowledgeable of individual's preferences, and actively assisting individuals to pursue areas of interest, hobbies, and personal relationships.  The agency also demonstrated a strong commitment to supporting social and interpersonal relationships among those served.  This was noted to be occurring on an agency wide level, as evidenced by the agency's creation and support of such entities as Tea Parties, Cookie Swaps, Sports Night, and the Giving Back Campaign.  All individuals surveyed were noted to be supported in areas relating to intimate relationships, while others received support and guidance around maintaining and navigating friendships and complex relationships with family members.  Individuals were found to be active, and have rich and expansive social lives and personal hobbies.  The agency excelled in its pursuit to support individuals in the development of non-paid relationships in natural settings, as well as its ability to strategically decrease and eliminate the level of staff support as relationships developedbetween individuals and their new-found friends.  

Among the licensing domains reviewed for residential services, the survey identified one area where the agency might productively focus its attention on improving supports and strengthening its methods of oversight to ensure consistent outcomes.  During the survey, it was identified that the agency needs to focus attention on ensuring the accurate tracking of individuals' personal funds.

As a result of this survey, the Cooperative for Human Services received a rating of met in 99% of licensing indicators, including all critical indicators and will receive a Two Year License for Residential/Individual Home Supports.  Since the licensing scores were over 90%, the agency will conduct its own follow-up on those licensure indicators that received a not met rating, and report the results to OQE within 60 days of the Service Enhancement Meeting.  The agency is certified with 49 out of 49 of certification indicators (100%) met in the combined areas of residential services, placement services, individual home supports, and planning and quality management.  The Cooperative for Human Services is congratulated for its continued success in providing high quality services to those whom it supports.	

	

LICENSURE FINDINGS	

	

	

	
Met / Rated	
Not Met / Rated	
% Met	

Organizational	
10/10	
0/10	

Residential and Individual Home Supports	
74/75	
1/75	

    Residential Services
    Placement Services
    Individual Home Supports

	

Critical Indicators	
8/8	
0/8	

Total	
84/85	
1/85	
99%	

2 Year License	

	

# indicators for 60 Day Follow-up	
	
1	

	

	

			

	

	
Residential Commendations on Standards Met:	

Indicator #	
Indicator	
Commendations	

 L77	
The agency assures that staff are familiar with and trained to support the unique needs of individuals.	
 The agency is commended for the methods in which it supports the unique needs of the individuals served. Staff fostered a strengths-based, supportive environment and displayed superior knowledge about individualized preferences and unique learning styles. It was observed throughout the survey that staff supported each individual to achieve his or her aspirations during the ISP planning policy and throughout the course of the year.  For example, "Preparing for My ISP" was a collaborative document included in each individual's record which described unique characteristics about the person, such as their communication style and suggestions for improvement of services. The agency utilized a comprehensive General ISP Assessment outlining the unique aspects of each person's life in several domains, including communication style, mobility needs, clinical supports, health and medical needs and community and home-based activities. The agency had also developed an innovative pictorial depiction of daily life entitled, "My Year!" which captured the essence of an individual's interests and unique experiences via monthly pictures of seasonal activities and interactions with family members and friends. These documents, coupled with the knowledge and longevity of staff, highlighted the agency's person-centered approach to the daily support of individuals, as well as their unique needs, challenges and strengths.	

	

	
Residential Areas Needing Improvement on Standards not met/Follow-up to occur:	

Indicator #	
Indicator	
Area Needing Improvement	

 L69	
Individual expenditures are documented and tracked.	
In three of the thirteen homes surveyed, there were issues with how the individuals' money was being tracked with receipts and/or cash in/out was not being recorded accurately. On a monthly basis, the agency transcribes the hand written financial tracking sheets completed by staff. The hand written financial tracking sheets are discarded once they have been transcribed. The transcribed FTRs document only the actual expenditure(s) and not the amount(s) disbursed for the transaction.  The agency needs to ensure cash in/out is documented and tracked at the time of the transaction(s) and documentation of and tracking needs to be kept in its original form.	

	

						

	

CERTIFICATION FINDINGS	

	

	

	
Met / Rated	
Not Met / Rated	
% Met	

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

Residential and Individual Home Supports	
43/43	
0/43	

Individual Home Supports	
15/15	
0/15	

Placement Services	
14/14	
0/14	

Residential Services	
14/14	
0/14	

TOTAL	
49/49	
0/49	
100%	

Certified	

	

	

	

	

					
						
	MASTER SCORE SHEET LICENSURE	

						
	Organizational: COOPERATIVE FOR HUMAN SERVICES	

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

O	
 L2	
Abuse/neglect reporting	
15/15	
Met	

 L3	
Immediate Action	
15/15	
Met	

 L4	
Action taken	
15/15	
Met	

 L48	
HRC	
1/1	
Met	

 L65	
Restraint report submit	
6/7	
Met(85.71 % )	

 L66	
HRC restraint review	
6/7	
Met(85.71 % )	

 L74	
Screen employees	
7/7	
Met	

 L75	
Qualified staff	
2/2	
Met	

 L76	
Track trainings	
20/20	
Met	

 L83	
HR training	
20/20	
Met	

						
	Residential and Individual Home Supports:	

						
	
Ind. #	
Ind.	
Loc. or Indiv.	
Res. Sup.	
Ind. Home Sup.	
Place.	
Resp.	
ABI-MFP Res. Sup.	
ABI-MFP Place.	
Total Met/Rated	
Rating	

 L1	
Abuse/neglect training	
I	
8/8	
4/4	
1/1	

	
13/13	
Met	

 L5	
Safety Plan	
L	
8/8	
4/4	
1/1	

	
13/13	
Met	

O	
 L6	
Evacuation	
L	
8/8	
3/3	
1/1	

	
12/12	
Met	

 L7	
Fire Drills	
L	
8/8	

	

8/8	
Met	

 L8	
Emergency Fact Sheets	
I	
7/8	
4/4	
1/1	

	
12/13	
Met
(92.31 %)	

 L9	
Safe use of equipment	
L	
8/8	
4/4	
1/1	

	
13/13	
Met	

 L10	
Reduce risk interventions	
I	
1/2	
1/1	
1/1	

	
3/4	
Met	

O	
 L11	
Required inspections	
L	
8/8	
	
1/1	

	
9/9	
Met	

O	
 L12	
Smoke detectors	
L	
7/8	
	
1/1	

	
8/9	
Met
(88.89 %)	

O	
 L13	
Clean location	
L	
8/8	
	
1/1	

	
9/9	
Met	

 L14	
Site in good repair	
L	
8/8	
	
1/1	

	
9/9	
Met	

 L15	
Hot water	
L	
8/8	
	
0/1	

	
8/9	
Met
(88.89 %)	

 L16	
Accessibility	
L	
8/8	
	
1/1	

	
9/9	
Met	

 L17	
Egress at grade 	
L	
8/8	
	
1/1	

	
9/9	
Met	

 L18	
Above grade egress	
L	
7/8	
	
1/1	

	
8/9	
Met
(88.89 %)	

 L19	
Bedroom location	
L	
5/5	

	

5/5	
Met	

 L20	
Exit doors	
L	
7/8	

	

7/8	
Met
(87.50 %)	

 L21	
Safe electrical equipment	
L	
8/8	
	
1/1	

	
9/9	
Met	

 L22	
Clean appliances	
L	
8/8	
	
1/1	

	
9/9	
Met	

 L23	
Egress door locks	
L	
6/6	

	

6/6	
Met	

 L24	
Locked door access	
L	
7/7	

	

7/7	
Met	

 L25	
Dangerous substances	
L	
8/8	
	
1/1	

	
9/9	
Met	

 L26	
Walkway safety	
L	
8/8	
	
1/1	

	
9/9	
Met	

 L28	
Flammables	
L	
8/8	
	
1/1	

	
9/9	
Met	

 L29	
Rubbish/combustibles	
L	
8/8	
	
1/1	

	
9/9	
Met	

 L30	
Protective railings	
L	
8/8	

	

8/8	
Met	

 L31	
Communication method	
I	
8/8	
4/4	
1/1	

	
13/13	
Met	

 L32	
Verbal & written	
I	
8/8	
4/4	
1/1	

	
13/13	
Met	

 L33	
Physical exam	
I	
8/8	
4/4	
1/1	

	
13/13	
Met	

 L34	
Dental exam	
I	
8/8	
4/4	
1/1	

	
13/13	
Met	

 L35	
Preventive screenings	
I	
8/8	
4/4	
1/1	

	
13/13	
Met	

 L36	
Recommended tests	
I	
8/8	
4/4	
1/1	

	
13/13	
Met	

 L37	
Prompt treatment	
I	
5/5	
4/4	

	
	
9/9	
Met	

O	
 L38	
Physician's orders	
I	
4/4	
1/1	

	
	
5/5	
Met	

 L39	
Dietary requirements	
I	
5/5	
1/1	
1/1	

	
7/7	
Met	

 L40	
Nutritional food	
L	
8/8	
	
1/1	

	
9/9	
Met	

 L41	
Healthy diet	
L	
8/8	
4/4	
1/1	

	
13/13	
Met	

 L42	
Physical activity	
L	
8/8	
4/4	
1/1	

	
13/13	
Met	

 L43	
Health Care Record	
I	
7/8	
4/4	
1/1	

	
12/13	
Met
(92.31 %)	

 L44	
MAP registration	
L	
8/8	

	

8/8	
Met	

 L45	
Medication storage	
L	
8/8	

	

8/8	
Met	

O	
 L46	
Med. Administration	
I	
8/8	

	

8/8	
Met	

 L47	
Self medication	
I	
8/8	
4/4	
1/1	

	
13/13	
Met	

 L49	
Informed of human rights	
I	
8/8	
4/4	
1/1	

	
13/13	
Met	

 L50	
Respectful Comm.	
L	
8/8	
4/4	
1/1	

	
13/13	
Met	

 L51	
Possessions	
I	
8/8	
4/4	
1/1	

	
13/13	
Met	

 L52	
Phone calls	
I	
8/8	
4/4	
1/1	

	
13/13	
Met	

 L53	
Visitation	
I	
8/8	
4/4	
1/1	

	
13/13	
Met	

 L54	
Privacy	
L	
8/8	
4/4	
1/1	

	
13/13	
Met	

 L55	
Informed consent	
I	
6/7	
4/4	
1/1	

	
11/12	
Met
(91.67 %)	

 L56	
Restrictive practices	
I	
1/1	

	

1/1	
Met	

 L57	
Written behavior plans	
I	
2/2	

	

2/2	
Met	

 L58	
Behavior plan component	
I	
2/2	

	

2/2	
Met	

 L59	
Behavior plan review	
I	
2/2	

	

2/2	
Met	

 L60	
Data maintenance	
I	
2/2	

	

2/2	
Met	

 L61	
Health protection in ISP	
I	
4/4	

	

4/4	
Met	

 L62	
Health protection review	
I	
4/4	

	

4/4	
Met	

 L63	
Med. treatment plan form	
I	
8/8	

	

8/8	
Met	

 L64	
Med. treatment plan rev.	
I	
8/8	

	

8/8	
Met	

 L67	
Money mgmt. plan	
I	
8/8	
3/3	
1/1	

	
12/12	
Met	

 L68	
Funds expenditure	
I	
8/8	
3/3	
1/1	

	
12/12	
Met	

 L69	
Expenditure tracking	
I	
5/8	
3/3	
1/1	

	
9/12	
Not Met
(75.00 %)	

 L70	
Charges for care calc.	
I	
8/8	
	
1/1	

	
9/9	
Met	

 L71	
Charges for care appeal	
I	
8/8	
	
1/1	

	
9/9	
Met	

 L77	
Unique needs training	
I	
8/8	
4/4	
1/1	

	
13/13	
Met	

 L78	
Restrictive Int. Training	
L	
2/2	

	

2/2	
Met	

 L79	
Restraint training	
L	
2/2	

	

2/2	
Met	

 L80	
Symptoms of illness	
L	
8/8	
4/4	
1/1	

	
13/13	
Met	

 L81	
Medical emergency	
L	
8/8	
4/4	
1/1	

	
13/13	
Met	

O	
 L82	
Medication admin.	
L	
8/8	
1/1	

	
	
9/9	
Met	

 L84	
Health protect. Training	
I	
4/4	

	

4/4	
Met	

 L85	
Supervision 	
L	
8/8	
4/4	
1/1	

	
13/13	
Met	

 L86	
Required assessments	
I	
8/8	
4/4	
1/1	

	
13/13	
Met	

 L87	
Support strategies	
I	
8/8	
4/4	
1/1	

	
13/13	
Met	

 L88	
Strategies implemented	
I	
6/8	
4/4	
1/1	

	
11/13	
Met
(84.62 %)	

#Std. Met/# 75 Indicator	

	

	

74/75	

	
Total Score	

	

	

84/85	

	

	

	

	
98.82%	

		
						
	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	

	

	

						
Individual Home Supports	

Indicator #	
Indicator	
Met/Rated	
Rating	

 C7	
Feedback on staff performance	
4/4	
Met	

 C8	
Family/guardian communication	
4/4	
Met	

 C9	
Personal relationships	
4/4	
Met	

 C10	
Social skill development	
4/4	
Met	

 C11	
Get together w/family & friends	
4/4	
Met	

 C12	
Intimacy	
4/4	
Met	

 C13	
Skills to maximize independence 	
3/3	
Met	

 C14	
Choices in routines & schedules	
4/4	
Met	

 C15	
Personalize living space	
1/1	
Met	

 C16	
Explore interests	
4/4	
Met	

 C17	
Community activities	
4/4	
Met	

 C18	
Purchase personal belongings	
3/3	
Met	

 C19	
Knowledgeable decisions	
4/4	
Met	

 C20	
Emergency back-up plans	
3/3	
Met	

 C21	
Coordinate outreach	
4/4	
Met	

Placement Services	

Indicator #	
Indicator	
Met/Rated	
Rating	

 C7	
Feedback on staff performance	
1/1	
Met	

 C8	
Family/guardian communication	
1/1	
Met	

 C9	
Personal relationships	
1/1	
Met	

 C10	
Social skill development	
1/1	
Met	

 C11	
Get together w/family & friends	
1/1	
Met	

 C12	
Intimacy	
1/1	
Met	

 C13	
Skills to maximize independence 	
1/1	
Met	

 C14	
Choices in routines & schedules	
1/1	
Met	

 C15	
Personalize living space	
1/1	
Met	

 C16	
Explore interests	
1/1	
Met	

 C17	
Community activities	
1/1	
Met	

 C18	
Purchase personal belongings	
1/1	
Met	

 C19	
Knowledgeable decisions	
1/1	
Met	

 C20	
Emergency back-up plans	
1/1	
Met	

Residential Services	

Indicator #	
Indicator	
Met/Rated	
Rating	

 C7	
Feedback on staff performance	
8/8	
Met	

 C8	
Family/guardian communication	
7/7	
Met	

 C9	
Personal relationships	
8/8	
Met	

 C10	
Social skill development	
8/8	
Met	

 C11	
Get together w/family & friends	
8/8	
Met	

 C12	
Intimacy	
8/8	
Met	

 C13	
Skills to maximize independence 	
8/8	
Met	

 C14	
Choices in routines & schedules	
8/8	
Met	

 C15	
Personalize living space	
8/8	
Met	

 C16	
Explore interests	
7/8	
Met (87.50 %)	

 C17	
Community activities	
7/8	
Met (87.50 %)	

 C18	
Purchase personal belongings	
8/8	
Met	

 C19	
Knowledgeable decisions	
8/8	
Met	

 C20	
Emergency back-up plans	
8/8	
Met