	Residential Treatment Services

Introduction

Administration and Management

Service Delivery Administration Standards

Service Standards

PA-RTX 16: Care and Supervision

The agency provides 24-hour-a-day supportive care and supervision tailored to each resident’s developmental stage and clinical needs and guards against less than therapeutic group dynamics and unanticipated, possibly untoward individual effects of congregate living.

PA-RTX 16.01

Each resident’s basic daily living requirements are met, including necessary nutrition, clothing, and allowances.

PA-RTX 16.02

Adults that provide direct care and supervision offer residents:

a positive adult example;
nurturance, structure, support, respect, and active involvement;
consistent limit-setting;
guided practice to learn effective communication, positive social interaction, and problem solving skills; and
education and skills training specific to risk-taking behaviors, including practice with decision making and anger management.

Research Note: A report based on survey studies and review of the extant literature suggests common characteristics related to staffing in a culture where running away is less and more a problem. Concerns associated with high rates of children going missing include a lack of clear leadership, low staff morale, and a sense of inability to serve, protect and control children. Positive features associated with lower rates included clarity about leadership and how the home should operate, a high level of staff support and morale, agreement on a consistent approach, and involvement of youth in setting acceptable boundaries and patterns of behavior.

PA-RTX 16.03

Adults that provide direct care and supervision communicate, and implement, policies that promote security on-site including the prohibition of weapons and gang activity.

PA-RTX 16.04

Resident care and supervision is provided for according to the following criteria:

one on-duty adult providing supervision for every five residents when they are awake;
one awake on-duty adult providing supervision for each group or unit of eight sleeping children;
one awake on-duty adult providing supervision for each group or unit of ten sleeping adult residents with development disabilities or serious and persistent mental illness;
the availability of additional employees for emergencies or to meet the special needs of residents at busy or more stressful periods;
rotating after-hours and holiday coverage to provide supervision and support in crisis situations; and
availability of same gender and cross gender supervision when indicated by individual treatment needs.

Interpretation: Care ratios may exceed the standard if the group is transitional or stable and long-term. Agencies serving adults in residential substance abuse treatment must also meet state licensing requirements for care ratios. Electronic supervision is not an acceptable alternative to supervision by personnel.

PA-RTX 16.05

Direct care personnel workloads do not exceed 12 cases, and assignments are made, reviewed regularly, and adjusted based on:

case complexity and residents’ special circumstances;
age, gender, and population characteristics including ethnic and cultural considerations;
the qualifications, competencies, and experience of personnel, and level of supervision needed;
work and time required to accomplish assigned tasks and job responsibilities; and
case status and progress toward achievement of desired outcomes.

Interpretation: Direct care personnel are the residential treatment center's milieu counselors and/or child, youth, adult care workers.

QUICK JUMP TO


	PURPOSE: Residential Treatment Services are delivered according to an articulated philosophy that ties individual needs to specific interventions and education, and to achievement of stated goals, such as gains in measurable skills, increased productivity and pro-social behavior, improved functioning, and a stable living arrangement in the community.

RELATED FILES


	SERVICE One or more organization-operated programs or activities that have a common general objective and deploy the organization's material and human resources in a planned and systematic manner. An organization that publicly promotes or identifies itself in writing as offering a service, is licensed to deliver a service, assigns personnel and/or space to a service, or allocates financial resources to a service is considered to offer that service.


	COMMUNITY A specific group of people living in the same locality and who may share a common culture, values, and norms. Communities can also be defined by race, religion, ethnicity, age, occupation, political status, tribal affiliation, interest in particular problems or outcomes, or other common bonds. The term "community" encompasses worksites, schools, tribes, residential neighborhoods, business districts, recreational areas, and health and human service sites.


	SUPERVISION Assumption of responsibility for directly overseeing and evaluating the work or work products of personnel within an organization. Also includes inspecting the act or process of accomplishing a function or activity.


	CLINICAL The study, assessment, and diagnosis of the client situation followed by direct treatment to help the client achieve prescribed goals.


	CULTURE The customs, habits, values, skills, technology, beliefs, and religious, social, and political behaviors of a group of people in a specific period of time.


	LEADERSHIP A nonprofit organization's leadership consists of its governing body, chief executive officer, and may also include its senior management. In a public agency the term refers to the agency head and administration team. The term "leadership" is not generally applied to for-profit organizations. With respect to COA standards, in for-profit organizations the term leadership applies to the owner and board of directors if one exists.


	PERSONNEL The body of employees and/or volunteers that carries out the organization's tasks under the organization's administration and/or supervision. This definition does not include foster parents who are specifically referenced in relevant standards


	WORKLOAD The amount of work assigned to or expected from a person within a specified period of time. See also CASELOAD.


	CASE A general term used to designate clients (including individuals, families, and groups) served by an organization for purposes of monitoring the provision of services. A foster care case is generally based on the placement of an individual child, although casework for the child may include services to the child's family. A child protective services case is based on an entire family household if a family assessment model is used; otherwise a case is defined as a child.