Outcomes management Report 2004

The Outcome Management System is designed to provide essential information to the Richmond Society for Community Living’s management and Board of Directors in order to monitor and make improvements to service delivery.

It is expected that the outcome results will assist the Richmond Society for Community Living to be more responsive to the needs of the children, youth and adults with a disability and their families who are served by the Society.

The Outcome Management System was developed using a self-assessment process which identified areas of strength, weakness, opportunities and possible threats to the services provided by the Society. This is the second Outcome Management Report in a series of annual Outcome Management Reports.

The Outcome Management System addresses six program areas: Residential Services, Day Programs (including after-school care), Respite, Infant Development Program, Preschool/Daycare (3-5 years) and Family Resource Coordination. Each program area has identified measures for effectiveness, efficiency, accessibility and satisfaction. In addition, this year a seventh area has been added that addresses and explores Stakeholder Satisfaction. Stakeholders are defined as the organizations and professionals that interface with RSCL programs and staff on a regular basis.

The Board of Directors will review the outcome results and approve the recommendations that arise from the analysis and results. The outcome results will also be reported in the Executive Director’s Annual Report to the membership and be included in the agency’s newsletter. Finally, the recommendations from the Outcome Management process will be included with the recommendations from the following reports to form the Business Improvement Plan for the year:

Ø Staff Reports - Human Resources, Complaints, Critical Incidents, Health & Safety

Method

Three different methods were employed to gather information regarding services provided by the Richmond Society for Community Living.

Survey

Surveys were developed to solicit the opinions and perspectives of parents, relatives and/or long-term caregivers that were involved in the life of a child, youth or adult with a developmental disability receiving service. In order to solicit the input from as many people as possible, all surveys were translated into three languages (English, Punjabi and Chinese). To review the surveys, please see the Appendix.

A separate survey was also developed to solicit specific input regarding Stakeholder Satisfaction from professional and organizations that interface with RSCL programs and staff on a regular basis.

The Richmond Society for Community Living sent out a total of 411 surveys - 155 competed surveys were returned (response rate of 38%). This return rate was lower than last year’s response. Although RSCL mailed 95 additional surveys this year, the total number of returned surveys increased by only 19. Last year the percentage of return was 43% compared to a 38% return rate for 2004.

As reported last year, although the return rate is lower than expected, this appears to be consistent with non-profit research.

Hagar (2002) suggests that researchers who study non-profit organizations draw on a wide range of empirical research methods, with the survey research method commonly employed. He further acknowledges that a substantial portion of mail survey recipients fail to respond to the invitation to participate and considerable debate continues to exist regarding what constitutes acceptable return rates.[1]

Therefore, given the return rate, the survey results must be viewed as possible trends, but not conclusive results.

The response rate for the overall agency and for each program is displayed below.

Respite: 28% returned

Residential: 46% returned

Day Program: 43% returned

Treehouse: 32% returned

IDP: 35% returned

FRC: 59% returned

External

Stakeholders: 44% returned

Interviews

Families/Caregivers that may have difficulty responding to a written survey were interviewed. Also, all self-advocates that were able to indicate their preference, verbally or by using any other communication system (e.g. pictorial symbols) were interviewed. The interviewer was not employed by the Society but was contracted by the agency to perform this specific task.

File Review

Existing documentation within the organization was used in some situations as the sole measure and in other cases as an additional measure in conjunction with a survey question.

Parameters and Omissions

Although the process was designed to solicit input from a broad range of people in order to capture the opinions of a representative group, it is important to mention that some people may not be well represented in the final report. Specifically, individuals who are not able to speak or communicate in ways that can be clearly understood by others, do not have a strong voice in the final report. In order to help mitigate this difficulty, the opinions of their families and caregivers have been solicited.

A second group of people that are not well represented in the final report are those individuals that do not have family involvement - especially if the individual is also unable to communicate in ways that can be clearly understood.

Lastly, although the process adopted methods and practices consistent with empirical research methods, the process and report do not conform to the stringent guidelines of empirical research practices. The final conclusions contained in the report are based largely on information and opinions gathered from the surveys, interviews and a review of specific documentation. That said, given that three stakeholder groups where consulted by way of survey or interview and three methods were used to obtain information, the writer is confident that the results and conclusions do represent many commonly held beliefs and opinions of self-advocates, families and other stakeholders regarding services provided by the Richmond Society for Community Living.

The City of Richmond’s present estimated population is 177,381 (this estimate is based on the number of dwelling units and is a measure used by the City in years when a census is not taken). Richmond has undergone enormous change over the last several decades, with significant growth in the early 1990's. Today, Richmond is a dynamic, multi-ethnic community. Much of the recent population growth has been made up of Asian immigrants. People of Chinese or South Asian ancestry now represent nearly sixty percent of Richmond residents (City of Richmond website).

According to the City of Richmond, the top three ethnic (single) origins in Richmond are Chinese, East Indian and Caucasian. In addition the City of Richmond “Hot Facts” on ethnicity indicate that in 2001 Chinese (59,920) and East Indian (9250) are the most frequently reported ethic (single) origins in Richmond. Although the Children’s Respite and Infant Development Program demographic information reflect a high ratio of Chinese and Indo-Canadian (East Indian) people served, other programs do not reflect the ethnic breakdown of the community. Although there may be many reasons for this, including immigration, age, etc., it does highlight the need for the organization to reach out to these ethnic communities.

Our current and last year’s Accessibility Plan has addressed the need to reach out to the different ethnic groups in our community. During the last year, the agency has translated our brochures and some of our orientation materials into Chinese and Punjabi. In the fall of 2004 we contracted with an individual from the Chinese community to conduct focus groups and interviews with people from the Chinese communities. The purpose of these interviews and focus groups was to introduce RSCL services and solicit input on how the agency can facilitate better access to our services in the future. The results of this work will be reflected in the Accessibility Plan for 2005 and 2006.

In addition to the large number of individuals reporting to be of East Indian and of Chinese ethnic origin, many people also report to be of Filipino origin. This is also reflected in languages spoken in the community. In Richmond, 44% of the residents indicated English as their mother tongue, 35% indicated Chinese, 3% indicated Punjabi and 3% indicated Tagalog. According to the City of Richmond “Hot Facts” on Languages, Tagalog (Philippines) is more often reported as a person’s mother tongue than Punjabi (India). This is an increase of 48.77% from the last census. This appears to be a trend that is worth watching in order to ensure RSCL is reaching out to all ethnic communities in Richmond.

Child development support for families with infants and toddlers who have extra support needs, a delay in their development, or who may be at risk of a delay.

As of December 2004 the Infant Development Program was supporting on 186 families. In September 2004 the program served a total of 207 families.

Gender

Ethnicity

Diagnosis

102 male

84 female

54 Caucasian

44 Chinese

25 South Asian

23 Bi-Racial

20 First Nations

9 Philipino

3 Arabic

5 Russian

2 Japanese

1 Spanish

78 Prematurity

25 Global Delay

19 NAS/FAS

7 Speech Delay

8 Motor Delay

10 At Risk

17 Autistic

1 Developmentally disabled

7 Down Syndrome

3 Cerebral palsy

12 Other

#	Outcome	Indicators	Target	Data Source	Results	Target Achieved
IDP1	Families will be satisfied with the service	IDP1a. percent of families that report satisfaction	80%	Survey	Satisfied: 15% Very Satisfied: 85%	Yes
IDP2	Families will have increased knowledge of how to support their child	IDP2a. percent of families who report increased knowledge of their child's disability	80%	Survey	Neutral: 4% Agree: 25% Strongly Agree: 71%	Yes
IDP3	Children will have opportunities for growth and development	IDP3a. percent of families who report their child has experienced growth and development	80%	Survey	Neutral: 2% Agree: 29% Strongly Agree: 69%	Yes
		IDP3b. percent of families who have been offered resources to foster child's growth and development (play group, lending library, resource materials, referral)	80%	Survey	Neutral: 5% Agree: 23% Strongly Agree: 72%	Yes
IDP4	Infant Development Program will achieve full capacity	IDP4a. Numbers served in the reporting period	Contract requirement	File review	100 contracted 207 families served	Yes
IDP5	Families will receive services in their language of choice	IDP5a. percent of families who report that they received services in their language of choice	80%	Survey	Yes: 100%	Yes

The Infant Development Program successfully achieved all of the targets originally set for the outcomes.

Satisfaction – The overall level of satisfaction with the Infant Development Program by consumers appears to be very good. This response is consistent with last year’s results. Of the 55 respondents to the survey, 100% indicated that they were satisfied (15%) or very satisfied (85%) with the service.

Effectiveness – Two outcomes were identified to address the effectiveness of the Infant Development Program. Firstly, families were asked if they believed that their knowledge of how to support their child had increased. Of the 55 respondents, 96% indicated that they either agreed (25%) or strongly agreed (71%) that their knowledge had increased. Secondly, two indicators were developed to measure whether families believed that their child had been provided with opportunities for growth and development. Of the 55 respondents, 98% agreed (29%) or strongly agreed (69%) that their child had experienced growth and development. Families were also asked if they were offered resources to foster growth and development. Of the 55 respondents, 95% agreed (23%) or strongly agreed (72%) that they had been offered resources. With respect to the outcomes utilized, it appears that IDP continues to be viewed by families as highly effective.

Efficiency – A file review was completed to determine if the Infant Development Program was serving the required number of families identified in the contract with the Ministry for Children and Family Development. The results indicate that the program far exceeds the expectations in the contract with MCFD. The current contract is for 100 families, however during the month of September 2004 the program was serving 207 families. Given the high level of satisfaction reported by consumers, it does not appear that this increased capacity has negatively impacted the quality of the program. That said, two sources of additional funding have helped to augment staff levels which has enabled the program to serve more families in need of this service in this reporting year. In 2004 the Regional Health Authority provided IDP with $15,000 and in early 2005 RSCL contributed an additional $15,000 of fund raised dollars to help bolster the staffing levels of this program. However, although these additional funds have no doubt enabled the program to serve more families, it appears that the IPD program continues to be very effective in balancing the increasing demand for the service with limited resources.

Accessibility - Given that Richmond is a multicultural community, it was determined that, if families were able to receive service in their first language, it would increase the accessibility and effectiveness of the program. Therefore, families were asked if they received service in the language of choice. Of the 55 respondents, 100% indicated that they had received service in the language of choice. Currently the IDP staff team is able to provide service in the following languages:

Preschool/Daycare

This is an integrated childcare centre that offers a diverse curriculum for children of varying abilities focusing on the whole child and learning through play.

Treehouse is licensed for 25 fulltime children. 49 children (13 children with special needs) were served at Treehouse during 2004. The total number children served accounts for those children in part and full time placements as well as placements that turned over during the year. The following chart outlines the demographics for the Treehouse program:

Gender

Ethnicity

Diagnosis

25 male

24 female

20 Caucasian

10 Chinese

1 Chinese/Caucasian

3 Indo Canadian

15 Other

1 Down Syndrome

1 Cerebral palsy

2 Global Delay

2 Premature

7 Other

#	Outcome	Indicators	Target	Data Source	Results	Target Achieved
TH1	Families will be satisfied with the service	TH1a. percent of families that report satisfaction	80%	Survey	Satisfied: 18% Very satisfied: 82%	Yes
TH2	Children will have opportunities for growth and development	TH2a. percent of families who report their child has experienced growth and development	80%	Survey	Moderate Extent: 9% Great Extent: 36% Very Great Extent: 55%	Yes
TH3	Treehouse will maintain full capacity	TH3a. percent of enrollment for the year (Jan - Dec)	95%	File review	77% preschool 94% daycare	No
TH4	Children (who require extra supports) will receive personalized supports as identified in their CFSP	TH4a. percent of goals identified in the CFSP have documented evidence that the goal was attempted	90%	File review	100%	Yes

The Preschool/Daycare Program successfully achieved three (3) of the four (4) targets originally set for the outcomes results.

Satisfaction – The overall level of satisfaction with the preschool/daycare program by consumers appears to be very good. Of the 11 respondents to the survey, 100% indicated that they were either satisfied (18%) or very satisfied (82%) with the service. This positive response is consistent with last year’s results.

Several families provided additional comments regarding their satisfaction with the program. The following is a small sample of these comments:

“Our child adores all the Treehouse staff and we really appreciate the loving environment he is in”

Contents

Introduction 3

Method 3

Parameters and Omissions 5

Richmond Society for Community Living Programs:

Infant Development Program 7

Preschool/Daycare 10

Day Programs 13

Residential 19

Respite 23

Appendix

Survey Cards

Introduction

Method

Survey

Interviews

File Review

Parameters and Omissions

Preschool/Daycare