The government wants to improve services and supports for adults who have developmental disabilities and their families. It wants services and supports to:
To make these changes, the government passed the Services and Supports to Promote the Social Inclusion of Persons with Developmental Disabilities Act, 2008. The new legislation includes a regulation on Quality Assurance Measures – one of the new elements in Ontario’s Transformation of Developmental Services.
About the Regulation on Quality Assurance Measures
The new regulation is part of the Services and Supports to Promote the Social Inclusion of Persons with Developmental Disabilities Act, 2008. It talks about the rules that agencies and Developmental Services Ontario (called Application Entities in the Act) must follow. Quality assurance measures are rules that help agencies and Developmental Services Ontario provide high quality services and supports and meet set standards.
Service agencies and Developmental Services Ontario organizations are required to follow these rules. Individuals or families receiving direct funding do not have to follow these rules on quality assurance measures. The Ministry of Community and Social Services will have separate rules for direct funding. Direct funding is when money is paid directly to an adult with a developmental disability or to someone else for that individual. Giving money directly to people lets them manage their supports and make their own decisions.
Agencies and Developmental Services Ontario need policies and procedures about the quality of their services and supports. These are the rules they must follow. Policies and procedures are usually kept in a book in the agency’s office or at Developmental Services Ontario where everyone who works there can read them. They give staff and volunteers the information they need to do their jobs. The ministry will make sure the rules are followed.
When agencies give money to another organization or person to provide services and supports, they must make sure that the organization or person follows the same quality assurance rules that apply to agencies. These agencies must check to see that the other person or organization is following the rules.
Everyone in the agencies and Developmental Services Ontario must follow all policies and procedures. Each agency and Developmental Services Ontario will review its policies and procedures regularly, and update them as needed.
In some cases, the Ministry will give agencies and Developmental Services Ontario flexibility to create rules that best fit their services and supports. In other cases, the Ministry will tell agencies and Developmental Services Ontario what rules they must follow. The Ministry will check to make sure that agencies and Developmental Services Ontario are following these rules.
Each part of the Regulation on Quality Assurance Measures deals with different topics. Some parts apply to agencies, and others apply to Developmental Services Ontario. These are described below.
General Quality Assurance Measures for Service Agencies
Promoting social inclusion, individual choice, independence and rights
Promoting social inclusion means supporting people so that they can be a part of the community through activities such as volunteering, working, and participating in local sports teams. Agencies must provide support to make sure people with developmental disabilities can be a part of the community where they live.
Agencies must make sure that people have the supports they need to live on their own or with others, and help people make informed choices.
All agencies must have a mission statement, service principles and a statement of rights. These talk about the agency’s values and explain how it provides support. They should show how the agency will help people participate and be included in their communities.
Agencies must explain their mission statement and policies to everyone who uses their services and supports. Agencies must also hold meetings to discuss these policies and values with their staff, volunteers and board members.
Developing individual support plans
Agencies must have a support plan for every person who uses their services and supports. The plan must be made with the person who has a developmental disability or someone acting on their behalf. This plan must be checked and updated each year.
Individual support plans should include information on:
Sometimes a person with a developmental disability needs help to manage money. Agencies must have rules to explain how they can help a person to manage money, if the person needs or asks for help.
Agencies have to keep a separate record for each person who gets help. That record also has to be checked each year by a third party. A third party is someone other than the person at the agency who helps with finances.
Health promotion, medical services and medication
Agencies must have rules about providing public health information to the people they support. This can help people make informed choices about their health and can include information on:
Agencies need to have rules about monitoring the health concerns of people they support, when these concerns are included in their support plans. Agencies must keep records of medical services provided to the people they support. Agencies must also have rules about how they handle, store and use medication.
Staff and volunteers working directly with people who have a developmental disability must be trained on first aid and CPR. CPR is an emergency procedure that is performed when a person’s breathing or heartbeat stops.
Preventing and reporting abuse
Agencies need to have policies and procedures that keep everyone safe. These rules explain that no type of abuse or neglect is allowed. Types of abuse include:
1) Physical abuse, which may include:
2) Neglect, which may include:
3) Sexual abuse, which may include:
4) Emotional abuse, which may include:
5) Verbal abuse, which may include:
6) Financial abuse, which may include:
The rules must include information about what staff should do when:
In each of these cases, the agency must report the events to the police immediately. The agency cannot look into the situation before the police have completed their investigation. The rules must also outline how to deal with staff and volunteers involved in the abuse. Agencies must also check with the person who has been abused, to see if it is okay to tell family members or another person acting on that person’s behalf about the abuse.
Agencies must train their staff, volunteers and board members on these policies every year. Agencies also have to explain these policies to people receiving services and supports, and help them be aware about abuse and how to protect themselves.
Agencies must review their policies and procedures every year to see how effective they are and make the changes needed to stop abuse from taking place.
Confidentiality and privacy
Agencies must have rules about confidentiality and privacy. These are rules that protect the personal information of people they support. Agencies need to have rules about collecting, using, or sharing people’s personal information. The rules must follow Ontario’s privacy laws and any agreement the agency has with the government.
Agencies also have to train staff, volunteers and board members about these rules.
Safety in agency owned or operated places
There are a number of things that service agencies must do to make sure people are safe:
Agencies have to keep equipment in good working order. Examples of equipment may include:
Agencies must also have rules about the personal safety and security of the people who receive services and supports. Agencies need to have enough staff to ensure people’s safety and well-being.
Human resource practices
Agencies must complete reference checks and police record checks for all staff, board members, and volunteers. The checks must happen before those individuals can work directly with people receiving services and supports without being supervised.
All staff and volunteers must be trained on the agency’s policies and procedures about reference checks and police record checks.
Agencies must keep records on file for all people receiving services and supports for seven years after the person stops receiving services and supports from the agency. Agencies must also have rules about keeping and storing all records or files.
Quality Assurance Measures Related to Behaviour Intervention Strategies
This part of the regulation talks about behaviour intervention plans. These plans tell staff how they can help someone who behaves in a way that puts that person or others at risk of harm. This part of the regulation applies to service agencies when they are providing:
General behaviour intervention strategies
Some people who have a developmental disability may also behave in a way where they may hurt themselves, hurt other people or damage property. Agency staff need to know how to help a person who may harm themselves or others. This is called ’behaviour intervention’. This part of the regulation talks about the Ministry’s requirements about behaviour intervention methods and plans.
Agency staff may need to use different ways of helping people in different situations. For example, staff may use positive strategies such as helping individuals by talking to them to help them calm down, or to help solve their problems. Staff may use intrusive strategies only in situations where individuals are at a serious risk of injuring themselves or someone else.
The regulation states that all agencies must have rules about the use of behaviour intervention strategies for people who might hurt themselves or others or damage property.
Training in behaviour intervention strategies
Agencies have to train staff and volunteers on how to support these individuals and help them with their behaviour. Agencies must make sure that all staff learn how to help a person when that person’s behaviour is out of control and when that person cannot calm down.
Behaviour support plans
Every person who behaves in a way that may be harmful, needs to have a behaviour support plan. The plan lists how staff should support that person. It also lists the ways agency staff can help them, starting with positive methods and may also include more intrusive methods.
The plan is based on the person’s needs and well-being, and must be written by people who have skills in this area. The regulation tells agencies what professionals can write these plans. Agencies must review these plans at least twice a year. Staff and volunteers who work directly with a person who behaves in a way that may be harmful must be trained on how to use the person’s behaviour support plan.
Using intrusive behaviour intervention
Staff should use intrusive behaviour interventions only when a person might hurt themselves or someone else or damage property. Staff must use the least amount of force possible.
Quality Assurance Measures Related to Residential Services and Supports
Agencies that provide services and supports for intensive support residences (where one or two adults live with full-time support) and supported group living residences (where three or more adults live with support from an agency), have to meet some extra quality assurance standards.
Agencies must support the well-being of people who live in these residential settings. This includes things such as:
Agencies must also make sure that residences are safe, which includes:
Quality Assurance Measures for Developmental Services Ontario
The last part of the regulation talks about the rules that Developmental Services Ontario must follow. Many of them are similar to those for agencies. These are: