Finding a Residential Provider that is Right for You
The information provided below is intended to be used as a guide for people seeking a residential provider. When searching for a provider it is recommended that you gather information through a variety of ways. Look at licensure reports, conduct personal visits, observe staff and obtain feedback from people who use the service. This information will give you the most complete picture of the agency and help determine if the provider is right for you or your loved one.
Please note: The finished size of this booklet is 8 1/2 x 5 1/2 inches and was prepared in booklet format. To print, please copy double-sided in the page order provided (including the blank page) and fold accordingly. All of the information in the booklet is provided below.
Prior to Your Visit
Prior to visiting any provider agency you should consider the following:
- Keeping a binder and record information as it is gathered.
- Is there a complete plan that contains the following:
- The types of supports needed, including supports for health concerns, behavioral supports, communication etc.
- Things that are “non- negotiable” or that the individual must have to assure health, safety and a good quality of life.
- Activities that the individual currently participates in and that need to continue (e.g. church, work). Ask the provider how they will ensure this continues.
- Has the agency asked individuals living in the facility or home if you may visit? Remember you would not want someone to visit your home uninvited.
- You should be sensitive to the privacy of individuals receiving services when asking questions about services, where they live etc.
Prior to your visit review the following:
- The mission and vision statement of the provider. Do they match with your own ideas and preferences?
- The agency website. Explore it to gain information and insight.
- The last several certification/licensure reports. Were there serious deficiencies? Providers are required to make this information available, or you may request the information by writing the Missouri Department of Mental Health, Certification and Licensing, 1706 E. Elm St., Jefferson City, MO 65101
- Agency abuse/neglect findings.
- If there has been a Division of Mental Retardation and Developmental Disabilities - Self Advocates and Families for Excellence (SAFE) survey, review the results.
- The most recent fire inspection.
During Your Visit
Observe the Physical Environment
Outside
- Does the home blend in with others in the neighborhood, or does it have a different appearance then neighboring homes?
- Is it located in an area that you would want to live? (low crime, close to community events, shopping etc.)
- Is the yard neat and the grass trimmed?
- Is there lawn furniture that is in good repair that can be used in nice weather?
- Are there typical outdoor accessories and things to enjoy? i.e. a bbq grill, flowers, a place for a garden?
- Are the paint, windows, steps and walk ways in good repair?
- Are all areas of the yard accessible?
- Is the home near a busy road, fire station or train tracks?
Inside
- Does the level of neatness in the home match your preferences?
- Is the house clean and odor free: does it smell like a home rather than antiseptic?
- Is there a homelike atmosphere or does it feel like an institution?
- Do people have enough space to engage in a variety of activities?
- Do people have privacy?
- Are personal mementos of individuals living there displayed throughout the home or do common living areas only display items belonging to staff?
- Does the furniture match and is it in good repair?
- Is the home well lighted?
- Is the temperature even throughout the home? Warm enough? Cool enough?
- Is the home accessible for someone with mobility or visual challenges?
- Do bedrooms look the same or do they reflect individual preferences and tastes?
- Are staff/individuals allowed to smoke? If so are there designated smoking areas? Are these areas kept clean?
- Is the noise level in the home comfortable?
- Do there appear to be fire hazards? Are there smoke detectors and fire extinguishers and carbon monoxide detectors?
- Does office space intrude on the living area of the home?
- Is there acknowledgment of different cultures of the people living there?
- Are there pets and if so, how are they cared for?
- Is the home comfortable for people with sensory issues?
- Are the facility’s disaster plans in place?
Observe Staff
- Who answers the door in the home?
- Who answers the phone? Is the phone answered using the company name or in a way typical for private homes?
- Listen carefully to the language used by staff. Language often conveys true attitudes staff has about their jobs, persons supported and the community.
- Do staff “take care” of people or do they provide support to people according to their individual needs and preferences?
- Do they knock prior to entering an individual’s personal space (bedroom/bathroom)?
- Are staff able to use alternative forms of communication such as sign language when needed?
- Do staff ask questions about your or your loved one’s preferences, likes, dislikes, needs etc?
- Preparing meals: is there enough food? Does it look appetizing?
- Is staff respectful? Do they talk to people and not about them?
- Are staff respectful of issues around gender, sexuality, intimacy?
- Are staff engaged with individuals being supported?
- Are staff trained to work with people who have sensory issues?
Observe People Who live in the home
- Are their support needs compatible with your loved ones?
- Are individuals using adaptive equipment like communication devices and wheelchairs? Are they in good repair?
- Are individuals engaged in a variety of activities?
- Do individual’s dress and hairstyles reflect personal tastes?
- Are individuals supported in participating in the running of the home as they are able: keeping it clean, meal preparation, laundry, yard work?
Questions to Ask During Your Visit
Ask Direct Support Staff
TIPS:
|
- How long have you worked with people with disabilities and for the agency?
- Why do you choose to work here?
- What is the best thing about working here?
- What is the biggest challenge?
- How do you support the housemates/roommates to make group decisions?
- Who makes the house rules?
- What happens if there is a complaint or problem? How is it handled?
- Are you involved in individualized planning meetings?
- Do you know what plan outcomes/goals people are working on?
- How do you support people in achieving their outcomes?
- What would you do if someone did not seem to be progressing on his or her plan outcomes?
- How do you ensure people receive ongoing medical and dental care?
- What happens if someone is too ill to participate in typical daily activities (work, day programming)?
- Do you eat the same meals as those prepared for individuals you support?
- What is your emergency on-call procedure?
- Can he or she stay with us at our home whenever he or she wants?
Ask Staff and Individuals Supported About Choice
| TIP: Recognize that sometimes people have different perceptions about “how much choice” people have. For example, staff may state that people have a choice because individuals may shower between 6 – 8 PM. Individuals who wish to shower in the mornings may not see this as a “choice” at all. |
- Can people choose when to shower or bathe?
- Can people choose when to have friends over?
- Can people choose when to use the phone?
- Do people choose their own house or roommates?
- Are people supported in choosing the menus and shopping for groceries? How?
- Can people eat meals at times or places other than the scheduled times/places?
- Are people supported in handling their personal money? (Do people have their own checking accounts, etc.?)
- Do people choose their own doctors and dentists? How many different ones are used?
- Do people attend the church of their choice? How many different churches are attended?
- What rules do people need to follow and who developed them?
Ask Staff and Individuals Supported About Community/Family Involvement
| TIP: Asking a variety of people the same question will give you a clearer understanding of whether the supports are truly meeting the needs of individuals supported. |
- Are there “visiting hours” or do people come and go in a way that is consistent in typical homes?
- Do individuals have privacy when having visitors?
- How does the agency support the individual in taking part in current recreational interests?
- Do individuals ever go on vacation? Who decides where to go? How is it funded?
- Are recreational activities planned for the group or individually? Who plans them?
- What are some of the recreational activities that individuals do on their own or with the support of a staff person? How often?
- To what types of community organizations do individuals currently belong?
- What community resources are available to individuals in the immediate neighborhood?
- What community resources do individuals regularly use (where do people bank, get a haircut etc.)?
- What types of transportation is available to individuals?
- Are their limits to how far or how often staff will transport individuals?
- Does staff use their own vehicles or are there agency vans available?
- What types of public transportation is available? Are individuals supported in using public transportation?
- How are individuals supported in keeping in touch with friends and family?
- How often do you communicate with families? Are there weekly, monthly or “as needed” phone calls? Can the resident visit with family at the family’s request?
Ask Individuals
- How do you decide who attends your planning meeting and when/where it is held?
- Who decides what goes in your plan?
- What do you like about most living here?
- What do you like least about living here?
- What types of events have you participated in with your neighbors?
- What types of activities do you do outside the home? Who do you do them with? How often? Who decides what you are going to do?
- Are snacks of your choice available when you want them?
- If there is something planned for a meal that you do not like can you ask for something else?
Ask Administration
Agency Information
- How many years have you been in business?
- What specific supports/services does your agency provide?
- Does your agency specialize in providing services to persons with specific support needs?
- What is your agency’s philosophy about how to support people with challenging behaviors?What process would someone follow if they wanted to change their specific support needs or move to a different home?
- Does your agency have a board of directors? Do family members and individuals with disabilities sit on the board?
- How are families and individuals involved in evaluating the quality of services and supports provided?
- How does the agency, maintain and make repairs to it property(s)?
- What procedures do you follow to make sure personal monies are accounted for on a regular basis?
- What is your agency’s grievance procedures for individuals and families?
- Is the facility staffed 24 hours a day?
Self Determination
- Do you have a consumer run advisory board? How often do they meet?
- Can you give an example of a concern raised by the advisory council and how it was addressed?
- How are people informed / trained on their rights and grievance procedures?
Training
- What types of mandatory training do staff receive? How do you ensure that staff is able to implement what has been learned?
- What other types of training are offered? How often?
- Do staff receive training specific to the needs of people they support or only those required like medication administration, first aid and CPR?
- Can you describe trainings that have been offered through partnerships with other agencies/organizations?
- Are people you support involved in training staff?
Staff
- What characteristics do you look for when hiring new staff?
- What is your turnover rate among supervisory staff and direct care staff?
- How do you handle staff not reporting to work as scheduled?
- To what extent do you use temporary staffing agencies?
- How many hours a week does a typical staff member work? How often are people asked to work overtime?
- How are disagreements between direct support staff and individuals resolved?
- How many of the direct support staff have been with your agency for over one year?
- What types of “specialized “staff (e.g. nurses, recreation etc.) is available? How often do they provide support?
- Do individuals supported or families participate in hiring and evaluating staff? How?
- Does your agency use volunteers? In what way?
After the Visit
- Call the families of other residents and ask about their experiences.
- Visit the home several times at different hours of the day and evening to observe different staff, shift change, activities etc.
- Write down any agreements or promises made with support providers.
This document was produced under grant CFDA 93.779 from the US Department of Health and Senior Services, Centers for Medicare and Medicaid Services. However, the contents do not necessarily represent the policy of the U.S. Department of Health and Senior Services, and you should not assume endorsement by the Federal Government.
Published by the Missouri Department of Mental Health’s Division of Mental Retardation and Developmental Disabilities.
The Department of Mental Health does not deny employment of services because of race, sex, creed, religion, marital status, national origin, disability, or age of applicants or employees.
Missouri Department of Mental Health
Division of Mental Retardation
and Developmental Disabilities
1706 E. Elm St.
P.O. Box 687
Jefferson City, MO 65102
800-364-9687 • 573-751-4122
www.dmh.mo.gov
