How to evaluate a group home question

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Here's another resource:

....Where the Heart Is - Choosing a Group Home

Written by: S. True, M.Ed

Moving up in the world, that's what it's all about. Choosing a

group-home can be a scary prospect to families and consumers alike.

Where to live, who to trust, getting the support needed to grow

towards independence, these are issues confronting parents and young

disabled adults everywhere.

I have been privileged to open and assist in the operation of

Intermediate Care Facilities, (ICF's), or group-homes in three

different states. Each organization was unique but provided some

common elements which are the core of the movement towards community

integration. From my personal experiences, I know that some are

better than others.

As a consultant, I now look back over twenty years of working

within the field of providing services for persons with a wide

variety of disabilities. I have met with parents, groups, and done

individual counseling, recommending everything from occupational

therapists to appropriate attire for the workplace. Perhaps, one of

the hardest choices that any individual or family must make is how to

pick a place to call home. Knowing what's available, what's close to

schools, work, stores, how to select an appropriate residential

setting can be very difficult for those not familiar with the

territory.

First, let me start out by saying that time invested before

the " big move " is the key to making the best possible choices. I

continue to encourage parents of young teens to be open to

considering what the future will bring for their sons and daughters.

I cannot stress enough how important it is to look into the future.

Questions such as, " What will happen to my child when I am too old

to care for them? What do we, (parents), do when they voice their

readiness to 'leave the nest'? " , call for consideration earlier

rather than later.

The first step is to research the possibilities. If you are

connected to a social service agency such as (State) Department of

Health and Human Services, ask what is available now. Parent support

groups and public school teachers and administrators can also be a

good source of information.

Most residential programs are required by law to have

associations with adult day activity centers, vocational training

settings, or job placement services. If this is not the case, (some

provide " day care " within the home), be wary. Regardless of

handicapping condition, integration into the community has a

significant impact on quality of life.

We, as a society, decided some thirty-odd years ago that

spending a life inside an institutional setting was a poor substitute

for the kind of life we enjoy outside such places. Today, a strong

movement across this nation is to move both the elderly and those

with disabilities who are currently living in nursing homes out and

into the community. Why? The experience of being placed together with

one hundred or so other persons, bedded, fed, " entertained " ,

and " occupied " , is just not the same as being home near friends and

family. Regardless of how badly an administrator want to create a

home-like environment, monetary constraints will only allow a few

people to be hired to care for the many. Even disregarding the horror

stories of the neglected and abused, close personal attention cannot

be provided if the staff is focused on getting folks dressed, fed,

give medication, and so forth. This is important to remember even

when considering a six-person group home!

So, here is my list of questions to ask and things to look for:

1) Do the staff seem focused on encouraging independence or are

they " care takers " ?

If you visit a home and the staff are doing everything for the

clients living there, you can bet very little will happen in the way

of personal growth. Choice-making is often a good indicator. Do the

residents get to choose the clothes they want to wear? What they will

be eating? What they will be doing during their leisure time? When

they will be going to bed at night?

Even for those who are unable to verbally express their wants

and desires, if there is not an individualized system, (i.e. allowing

clients to touch or point to preferred items, pictures or photos used

for choice-making, icons in communication books, electronic touch

talkers, etc.) that are actually being used, not only are choices not

being given but training in choice-making is not likely to be

occurring.

2) Do the administrators and staff seem familiar with the special

needs of their residents?

If a program does not include the availability of activities

and materials that are easily accessed by residents, if special

equipment is poorly maintained or non-existent, if you cannot easily

talk to support specialists such as physical and occupational

therapists, medical staff, speech clinicians, recreational

therapists, program and behavioral specialists, again, beware!

Sadly, I have seen and heard of situations where parents were

told by administrators that their home " specialists " would be in

after placement was made to evaluate and make recommendations. Then,

at the first Program Plan meeting, one month later, they are not

present and a recommendation has been made that " no services are

required at this time " !

Granted, in some homes this is not such a major issue. The

residents are active, healthy, and appear content within the setting.

But even if you understand that no services are likely to be

available in that setting, consider finding out who is contracted to

be the house physician, dentist, even barber or hair dresser. If you

can, talk to these people personally about your knowledge of any

special needs. This can go a long way in making you feel more secure

about general care being provided.

3) Is the overall appearance of the home neat and clean?

How does it look? Homey or austere, with bare walls, torn

bedspreads, and few personal items in bedrooms? How does it smell? Is

the kitchen area well kept?

The approach to providing comfort and care can easily be

assessed by how livable the home looks. Ask yourself, would you like

to live here? Attention to such details by staff is a good indicator

of how much personal regard they have for the people living there.

Also look at the overall condition of the home. Are there

screens off of windows, walls with holes, handles missing from

dressers or cabinets. This could indicate a lack of funds for repair

or a disregard of how the house is going to be kept up.

4) By what means and how often do the residents get to go out into

the community?

If transportation is unavailable or inadequate to allow for

routine outings, this would suggest that few, if any, are occurring.

If there are never enough staff to take residents into the community,

this too, can be a problem. Ask questions about daily involvement in

shopping trips, going out to restaurants, movie theaters, outside

clubs and organizations. If these are not on activity schedules, once

again, the reality is that they are probably not focused on this

important aspect of community involvement in this particular home.

5)What is the staff's attitude towards the people for whom they are

caring?

Although it seems obvious, it is a good idea to casually watch

how the staff are talking to the other residents in the home. Are

they using their proper names, pet names, demeaning tones? Do they

use " baby talk " to speak with adults? Do they keep directions simple

or do they chatter on about what is supposed to be happening? Do they

treat each client with respect or do they have their favorites and

ignore others? Are they ordering people around or are they asking

them to do things? Would you feel comfortable living here?

6) Active Treatment - Legal Obligations: What is it and will this be

happening?

To those on the " inside " of the system, Active Treatment is a

well known and understood term. Any home which is funded, all, or in

part, with Federal or State monies, must follow specific state and

federal laws now on the books. With these laws, group homes are

obligated to provide a service paid for by the taxpaying community.

This includes providing a safe and healthy environment, and providing

active treatment.

Active treatment simply put, is skill training. There should

only be a couple of hours per day where " nothing " is happening. This

down time should not all be happening at one period of the day, but

should be scattered breaks. This should also be the same on weekends!

For all practical purposes, there are new skills to be learned or old

skills to be practiced throughout the day. Daily Living skills such

as dressing, grooming, cooking, house keeping, and so on, social

skills, leisure and recreational skills, motor skills or

opportunities for exercise, communication skills, and community

access are all common goal areas.

When Treatment Plans or Program Plans are developed, what are

typical goals for other residents of the home? Is the talk between

staff and residents positive and learning-oriented? Are tasks being

learned broken down into steps? Are clients watching things happen

instead of actively helping in the daily routine? Very little

learning occurs without hands-on participation. If this is not

happening when you first visit the home, don't think you will be able

to change things after the move-in date! This program focus takes a

complete dedication from administrative staff to make it happen.

Often new or inexperienced staff won't see any reason for this

constant teaching, teaching, teaching. But unless this is ongoing,

the movement towards a greater level of involvement, toward more true

independence, is not happening.

This is just a brief overview of some of the critical things

that need to be examined when considering a place of residence. Other

considerations might be, in what kind of neighborhood is the home

located. How many staff are employed at the home. How many staff are

new? Do staff persons speak the same language? How long has the home

been operated? Are the owners/operators living in the same or a

nearby community?

Finally, form an alliance with the agency doing the referral

and placement. Work with them to give adequate time for arranging the

home tours and applying to the homes for placement. Remember, most

group homes have a waiting list. Sometimes actual placement can take

up to a year or more depending on availability and your preferences.