Our Performance

THE CHILDREN’S HOME OF CROMWELL ANNUAL PERFORMANCE IMPROVEMENT REPORT
JULY 2009 – JUNE 2010

The report that follows summarizes the improvements that were accomplished within The Children’s Home programs and services during the past year.
Each program and support service department identifies the areas they want to see improved, collects data monthly, reviews the data and uses it to discuss ways to make their program/department more effective in serving youth and their families.

RESIDENTIAL TREATMENT PROGRAM

ACCOMPLISHMENTS

• This year we formed our Positive Behavioral Support Integration Team (Residential program and the Learning Center) to improve integration and standardization of response using a PBS reference.  We developed a consistent point sheet and rewards system. The PBS Integration Team focused on maintaining Youth at school and introduction of rooms where Youth on safety status may continue to attend school
• We also developed Focus Groups of Direct Care Staff and our Youth Advisory Board to provide recommendations for reduction of Restraint, AWOL, Police.
• We also implemented a review of all Critical Incidents documenting Restraint, Seclusion, AWOL, or Police Involvement by House Supervisors for fidelity to our Therapeutic Crisis Intervention and Risking Connection training, and our Residential Procedures.  The review is individualized and involves the Clinician, the Youth, and the Staff involved in the incident.  Results/recommendations are reported in monthly Performance Improvement Meetings and follow up on recommendations is assigned. 
• The program implemented Ansell Casey Life Skills Assessments which resulted in summaries and individual reports for each youth in our Residential and the School and utilized these reports to improve interventions to build skills and improve feelings management by Youth.  Implementation of ACLS Groups on all Houses with focus on skill development as identified by Youth and House Assessments.  Goals and Objectives tied to each Youth's Master Treatment Plan were revised to include the information we learned from the surveys.
• We initiated bi-monthly Multi-Family Therapy Group and monthly Family Activities to increase involvement of families, improve their understanding of their child and improve parenting skills, and to enhance supports for youth.
• We opened Comfort Rooms for the Girls Houses, Boys Houses, Jordan House and in the Learning Center, including training of staff, development of sensory plans for each youth, and enhancement of each youths Individualized Crisis Management Plan to address sensory approaches to feelings management
• Working in partnership with the Department of Children and Families we implemented the Focal/Strategic Plan. This plan includes; Implementation of Agency Wide Weekly Leadership Meeting including Director Treatment Services, Residential Coordinator, Clinicians, House Supervisors, Director Medical Services, Teachers, and all available line staff for review of Youth status', to review and brainstorm planning for Youth who are struggling, and to review program changes or staff training needs secondary to review of Critical Incidents for Restraint, Seclusion, AWOL, and Police Intervention.
• We also development a Training for Youth and Staff regarding Sun Protection.  This was completed in April 2010 in preparation for Summer Programming.

 Results:

• Police calls reduced by 44%
• AWOLS reduced by 21%
• Incidents of physical aggression reduced by 19%
• Restraints reduced by 56% during the second half of the year
• Total reports reduced by 19%

RECOMMENDATIONS FOR THE COMING YEAR

Increase programming for youth and young adults with developmental disabilities

THE LEARNING CENTER

ACCOMPLISHMENTS
The focus during the 2009-2010 school year was to reduce negative behavior of students attending the Learning Center through the implementation of Positive Behavior Support (PBS).  The reduction of restraints, seclusions and police involvement were also tracked and were greatly reduced.

The goal was to reduce the number of behavioral incidents.  Data was collected through the SWIS reports, Critical Incident Reports, and Daily Rounds.

Several strategies were employed to improve behaviors.  At the start of last year, students who were displaying unacceptable behavior were selected for discussion at the meetings held every two weeks.  If the student was a residential student, his/her clinician and residential staff were invited to participate with school staff to develop specific plans to address this behavior.  The plans were monitored and adjusted as needed.  If the problems continued a PPT would be called to discuss the need for additional resources such as a one-to-one.

Prior to the start of the new school year, all staff was trained in the new procedures for reporting restraints and seclusions.  They were also informed of the agency’s focus to continue to reduce the number of restraints and seclusions.  Staff meetings will address these issues of the frequency begins to increase.

 During the 2009-2010 school year, we experienced a 60% reduction in the number of restraints and a decrease in the number of students requiring seclusion by 65%.  We will continue to work on reducing these numbers.

HUMAN RESOURCES / PASTORAL MINISTRIES

1.  Overall, staff turnover rates stayed below the targeted 20% level.  In CHOC, there was one exception in the 2nd quarter when the Maintenance Department exceeded 20%. 

2.  Progress was made toward the goal of hiring culturally competent employees whose ethnic backgrounds reflect the ethnic backgrounds of youth in care. At the end of the 2nd quarter, data showed that the number of Black/African American males and females and the number of Latino/Hispanic females on staff increased. Black employees are 33%  of the total staff, up from 28% the prior year, while Black residents are 26%  of the population, down from 32% the previous year. Hispanic employees are 5% of our total employee population, up from 3% the prior year, while Hispanic residents are 22% of the population, down from 36% the prior year.  The closer alignment of ethnic backgrounds of staff to residents is due in part to a concerted effort to make the percentage of Blacks and Hispanics in the employee population more aligned with the percentage of Blacks and Hispanics in the resident population.

4.  The Chaplain works 12 hours per week on a contractual basis. He continues to provide chapel services throughout the calendar year on Fridays and Bible study during the academic year on Wednesdays. Much of his ministry is provided through music, as he actively engages youth in recording CDs, both music and poetry. During Camp CHOC, he taught our residents about the fundamentals of and various categories, types and styles of music.

VOLUNTEER SERVICES

ACCOMPLISHMENTS

1. In my review of the data for the total fiscal year, I note that The Children's Home had an average of 67.5 Volunteers working in various capacities each month.  This does not include Volunteers that worked as part of Mission Groups or Volunteers that served as part of a corporate, civic, or religious group to plan activities or special events for the residents.  On June 15th, 2010 the Independent Sector Website released their most recent figure for the value of the Volunteer Hour on both the national and state levels.  The value of a Volunteer hour nationally is $20.85 and for the state of Connecticut a Volunteer hour is valued at $27.27.  Volunteers have worked 4770 hours and 43 minutes in service to The Home over the past fiscal year.  This is equal to $99,468.94 nationally or $130,097.44 in Connecticut.  Both of these figures represent a significant savings to the agency and in most cases represents programming that would not exist were it not for the contribution and dedication of Volunteers. 

2. During the last quarter of this fiscal year, I also focused on expanding the Pet Assisted Therapy Program in collaboration with the Clinical Department.  PAT Teams are now working with young people individually at The Home and, even in it's beginning stages, this is starting to have positive results.  PAT is becoming a new tool at The Home for young people who have had limited success with other interventions.
3. The Annual Volunteer Appreciation event was held Wednesday April21st, 2010.  This serves to recognize the efforts of Volunteers at the agency. We truly appreciate the time and dedication of our volunteers.
4. The Procedure for Becoming a Volunteer at The Home has recently been revised to reflect changes to the screening of Volunteers for activities with the young people. 

 MEDICAL SERVICES

ACCOMPLISHMENTS

• We are happy to report that throughout the past year, medication errors were few and far between.
• Over the past year the medical department has made great progress towards reducing the amount of medication refusals that had once been a fair number.
•  All staff in the medical department has completed 100% of the professional development trainings assigned to their job descriptions.
• Current employees who hold certifications to administer medications have completed their requirements to remain certified.

NURSING  SERVICES

1. Several of the nurses have successfully undergone the TCI course.
2. We have 100% compliance with state statutes surrounding the nursing staffs maintaining their appropriate licenses. Copies are kept in the Human Resource office.
3. Supervision is received by the Director of Medical Services. This is ongoing and is done both overall to all staff in the medical department as well as on an individual basis.
4. CPR certification was maintained as current by 100% of the staff working in the medical office.
5. Informational updates in the form of in services were not offered by the Pharmacy this past year.

MAINTENANCE SERVICES

ACCOMPLISHMENTS
Through our continued partnership with the Cromwell Fire and Police Departments, we focused our efforts this past year on reducing the number of false alarms caused by our youth. Through a combination of many actions (i.e. having the Fire Chief meet with our youth to talk about community safety, working with the Cromwell Fire Department and the state fire Marshall to implement a new Fire Watch procedure, involving the Police Department and our Youth Advisory Board in strategies to reduce false alarms, etc.) we have experienced a reduction of false alarms of over 90%.

FOOD SERVICES

ACCOMPLISHMENTS

1. The Food Services Department received ratings of above 98% on all Health Department inspections during the past year.
2. At the request of the youth Advisory Board the snack program was reviewed and revised during the year. We have piloted for the past three months a change from group snacks to individual snacks, with each youth choosing their snacks from a menu of snack items.