10 Performance Reviews
Ensure Compliance and Reduce Risks
When reviewing DD and MI cases, staffing and facilities there are several key areas to assess that ensure the environment is safe, supportive, and conducive to well-being and effective care. Here are the most important:
1. Environment & Safety
Cleanliness and Hygiene
We inspect to ensure the facility is clean, free from hazards, and properly maintained. This includes sanitary conditions in living spaces, kitchens, bathrooms, and common spaces including those used by staff that are required to meet health and safety standards.
Safety Features
DD&M's checklist looks for appropriate safety measures, including secure doors, windows, handrails, non-slip flooring, accessible emergency exits, clearly marked evacuation routes and emergency procedures in place.
Accessibility
Our inspection ensures the facility is accessible for various physical disabilities. This includes inspection of wheelchair ramps, elevators, accessible bathrooms, and doorways required to meet ADA (Americans with Disabilities Act) standards.
Lighting and Ventilation
This inspection looks for proper lighting, especially in hallways, bathrooms, and stairways is critical for the safety of individuals with cognitive or sensory impairments. Good ventilation and air quality are also important, particularly for individuals who may have respiratory issues or sensory sensitivities.
2. Staffing and Training
Staff-to-Client Ratio
DD&M assess whether there are enough trained staff to meet the needs of individuals in the facility, because low staff-to-client ratio can compromise the quality of care and the ability to respond to crises.
Training and Qualifications
Our experienced team lead inspects whether staff members are appropriately trained in handling the unique needs of individuals with DD and/or MI. This includes training in behavior management, crisis intervention, medical needs, de-escalation techniques, acuity variance measurements, general care standards and verification that staff holds certifications, qualifications and milieu literacy relevant to their roles.
Background Checks
We will confirm all staff members have undergone thorough background checks, including criminal history and abuse clearances. This is done for the safety of residents.
3. Person-Centered Care
Respect for Individual Rights
DD&M inspects whether the facility respects and upholds the rights of individuals, including their rights to privacy, autonomy, and decision-making. This includes reviewing policies and practices related to informed consent, guardianship, and individual care plans.
Individualized Care Plans
Our program lead will ensure each client has a regularly reviewed and updated individualized care plan with a plan developed with input from the client (when possible), their family or guardian, and relevant Interdisciplinary professionals reflecting the clients personal preferences, goals, and needs.
Choice and Empowerment
We will verify clients have opportunities to make choices about their daily activities, routines, and care. This could include choices related to meals, activities, staff interaction, and schedules.
Confidentiality and Privacy
Check that the facility maintains confidentiality in accordance with laws such as HIPAA (Health Insurance Portability and Accountability Act). Individuals' personal and medical information should be protected.
4. Behavioral & Medical Health
Mental Health Services
Our extensive background in psychiatric treatment will ensure clients with mental illness receive appropriate psychiatric care, counseling, and therapy including medication management, psychiatric evaluations, and crisis intervention strategies.
Physical and Medical Health Services
DD&M team lead's 25 year licensed nursing background will verify clients receive regular medical check-ups and have access to necessary healthcare services including dental and vision care, physical therapy, and emergency medical support.
Medication Management
Our team member can provide oversight to verify medications are administered according to prescribed orders and that there are protocols for safely storing, tracking, and dispensing medications. This includes verifying that staff are trained in medication management.
Behavioral Health Interventions
We will inspect whether appropriate behavioral health programs are in place for managing challenging behaviors or mental health crises. This includes ensuring the use of evidence-based approaches like Applied Behavior Analysis (ABA) or cognitive-behavioral therapy (CBT), and not over-relying on restrictive interventions.
5. Social/Community Integration
Opportunities for Social Interaction
Ensure that individuals have access to opportunities for socialization and building relationships with peers. This might include group activities, community outings, and opportunities for recreation.
Community Involvement
Verify that the facility encourages and facilitates individuals' participation in the wider community, including work programs, educational opportunities, volunteering, and social events. This helps to promote independence, dignity, and inclusion.
Cultural Sensitivity
Ensure that the facility promotes an inclusive environment where individuals' cultural, religious, and personal beliefs are respected and incorporated into care planning and daily routines.
6. Behavioral & Crisis Management
Crisis Intervention Protocols
Inspect whether there are clear and well-communicated procedures for handling crises, such as behavioral outbursts, self-harm, or psychiatric emergencies. The facility should have trained staff ready to implement de-escalation techniques and, when necessary, more intensive interventions.
Use of Restraints and Seclusion
Check for policies around the use of physical restraints or seclusion. These should be used only in extreme situations and in accordance with regulations. The facility should have strict oversight to ensure that these measures are not overused or misused.
Behavioral Supports
Review the strategies and interventions being used to support individuals in managing challenging behaviors. These should be evidence-based and aligned with the individual’s care plan.
7. Quality of Life
Recreational and Leisure Activities
Ensure that individuals have access to a variety of recreational and leisure activities that align with their interests and preferences. These could include arts and crafts, exercise programs, group activities, and individual hobbies.
Living Environment
Inspect the quality of the living spaces—whether they are comfortable, personalized, and conducive to relaxation and well-being. This includes the condition of the rooms, furniture, and decor.
Nutrition and Meal Services
Review the quality of meals being provided. Ensure that the facility offers nutritious, balanced meals that accommodate individual dietary needs (e.g., allergies, preferences, religious considerations, and medical conditions).
8. Incident Reporting & Oversight
Incident Documentation
Check whether incidents such as injuries, accidents, or behavioral issues are properly documented and reviewed. There should be a system in place for reporting and investigating incidents to prevent recurrence.
Complaint and Grievance Mechanisms
Ensure that individuals and their families have clear and accessible ways to raise concerns or complaints. This process should be transparent, responsive, and lead to corrective action when necessary.
9. Regulatory Compliance/Accreditation
Licensing and Accreditation
Verify that the facility is licensed and accredited by relevant governing bodies, such as the state health department, Medicaid, or the Joint Commission. These agencies set standards that the facility must meet in order to operate legally and ethically.
Local and Federal Regulatory Compliance
Ensure that the facility complies with all relevant laws, including those related to medication administration, care standards, employment practices, and privacy.
10. Staff/Family Communication
Communication with Families
Check that the facility has clear and open communication channels with families and guardians. Regular updates on the individuals’ health, progress, and needs should be provided, and families should have a role in care planning.
Staff Communication and Teamwork
Inspect whether staff members communicate effectively with each other regarding the care needs of individuals. This includes checking for regular meetings, case discussions, and team collaboration.
Summary
DD&M site inspection services allow you to focus on your priority areas including safety, staffing, care quality, individual rights, behavioral support, and community integration. The goal is to ensure that the facility provides a secure, respectful, and supportive environment where clients thrive, receive appropriate care, and live fulfilling lives.