Quality Assurance

RCRC purchases many services and supports for consumers. Working with our providers, we continually strive to increase the level of excellence of these services and supports so that they best enhance the lives of the individuals we serve. This is Quality Assurance. We are guided in this effort by the Lanternman legislation, Title 17, and Redwood Coast Regional Center's own Vision Statement:

RCRC Vision :

".....We envision a system of services that is determined by the individuals served. We envision a process that is complementary to the individual's own life, and which does not intrude upon the person's chosen lifestyle. We envision people residing in the living arrangement of their choice. We recognize that life is made meaningful by loving, being loved, and having friends and relationships. We acknowledge that life is enhanced by contribution, responsibility and the opportunity to learn new ideas and to engage in new experiences, including educational opportunities, social interactions and work activities. We envision a system of services and supports which acknowledges the person's age, lifestyle preferences and culture, and which is fluid and ever changing.

We envision all people being empowered to communicate with their own minds and hearts to determine their supports and services.

We also subscribe to a vision which represents the highest commitment to excellence. We envision a commitment to honesty, compassion, trustworthiness, flexibility, responsiveness, accountability, accessibility, creativity and a passion for community service......"

What is Quality Assurance?

Quality Assurance is a dynamic process by which the regional center, service providers, consumers, families and interested people all participate together in an effort to continually strive to improve the level of excellence of a specific service or support. Quality Assurance also involves recognizing providers for the excellence they are offering, and encouraging further improvement through provision of technical assistance.

The Community Service Department is responsible for writing and monitoring the agency's Quality Assurance Plan, however the entire regional center is involved in implementing the QA Plan, with a significant role on the part of the Consumer Services Department.

Title 17 currently requires a formal Quality Assurance process for regional centers in only in Residential Services, although it does mandate quarterly assessments for consumer progress in Supported Living and Day Services. Title 17 also sets up a separate Life Quality Assessment process through Area Boards. In addition, there are general efforts by the Community Service Department in addressing service quality done through a variety of means, including orientation for new providers, technical assistance efforts when issues arise for a particular vendor or consumer, training programs offered for providers, and similar efforts.

However, when there are questions about a service, a QA team can be assembled, and a review conducted, with written report on findings disseminated. DDS has also made available to each regional center a large supply of the booklet "Looking at Service Quality - Provider's Handbook," which is designed to be used by service providers for self-assessment. "The handbook is built on individual life quality outcomes which were developed with assistance from people with developmental disabilities, family members, regional center staff, service providers, advocates, professionals and community members. The individual life quality outcomes represent things that people have identified as being important in their everyday lives and to their overall quality of life - choice, relationships, lifestyle, health & well-being, rights, satisfaction." (DDS handbook). This booklet is routinely passed out to residential providers as part of orientation, and annually with the facility liaison QA. It is also distributed to other service providers on an as-needed basis.

What is Involved in a QA review?

All formal Quality Assurance efforts involve a variety of regional center departments and include four major approaches:

  • a paperwork review of service design, written training programs, record keeping, reports on consumer progress, and so forth.
  • observation of the service/support - what is happening? Does it reflect the service design and training protocols? Are consumer services consistent with consumer plans? Are consumer choices and rights respected?
  • interviews with staff to find out about their knowledge and interest in the people they serve, their knowledge of pertinent laws, their training, etc.
  • interviews with consumers and/or families-significant others. Are consumers satisfied with the service? Are they able to make choices, have their rights respected, enjoy relationships, have health and well-being? Are they satisfied with their lifestyle?

All efforts at Quality Assurance look at the strength of the support service offered, as well as assessing for areas where changes need to be made. Each Quality Assurance report includes a plan of action - who needs to do what, by when, in order to improve consumer quality of life. This is followed by a review to see that the necessary changes happened and were effective. Because Quality Assurance is a dynamic process, services and supports must continually be assessed and re-assessed.

Residential QA

Community Care Licensed Homes:

The Community Service Department and the Consumer Service Department work hand in glove on Quality Assurance in residential care. The Community Service Department takes the lead on writing RCRC's QA Plan, which is submitted to the Department of Developmental Services. This plan addresses quarterly visits by service coordinators to evaluate individual consumer progress, the facility liaison annual QA report looking at the whole facility, and the full QA review that must occur at least once every three years for each facility (starting in 7/98). In addition, each facility must receive at least two unannounced facility visits a year (although these can be part of a quarterly visit or annual facility liaison visit.) All but the full QA review are initiated by the Consumer Services Department.

The Community Service Department is responsible for leading the full Quality Assurance Review that must occur at least once every three years for each Community Care Licensed Facility. Staff from other departments of the regional center participate as part of the QA team. In the future, RCRC may start a training program to involve consumers, families, vendors or community members as part of the QA team.

{click here to see RCRC's Quality Assurance review tool}

Health Licensed Homes:

The regional center does not have the same responsibility for Quality Assurance review in these homes, except for the quarterly visits by service coordinators to evaluate individual consumer progress. In addition, the service coordinator and the Client's Rights Advocate (and others as appropriate) participate in quarterly meetings to address behavior intervention plans. The Community Services Department is available to participate in the exit interviews with Health Licensing and to support the facilities with technical assistance.. Annually, DDS is to coordinate a meeting with health licensed facilities, regional centers, Health Licensing, and other interested people to discuss key issues, in each regional center's area.

Supported Living QA

Title 17 originally required a full QA review yearly for Supported Living Agencies, however it is no longer required. The required mandate is only that each consumer in supported living receive quarterly visits from the service coordinator to evaluate the quality of the service. The Community Service Department also conducts Quality Assurance evaluations in collaboration with selected suppfeels very strongly that evaluations of the quality of the Supported Living Agency are also required. Once enough staff are hired and trained, Community Services Department will again take the lead of full QA reviews of Supported Living Agencies.

Life Quality Assessments

The Lanternman legislation mandates that Area Boards conduct Life Quality Assessments (4596.5) with those consumers living in residential facilities, supported living arrangements, or independent living arrangements no less than once every three years. These assessments are to use the "Looking at Life Quality Handbook" developed by DDS. Lanternman mandates that "prior to conducting the Life QA, the area board shall meet with the regional center to coordinate the exchange of appropriate information necessary to conduct the assessment and ensure timely follow-up to identified problems.... Following each Life QA, the area board is to develop a report of its findings and share that with the regional center." (Lanternman)

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