Richmond Society for Community Living

2005

Outcome Management Report
Contents

Executive Summary                                                                                3

Introduction                                                                                          7

Method                                                                                                7

Parameters and Omissions                                                                       9

Demographics Summary                                                                          9

Richmond Society for Community Living Programs:

Infant Development Program                                                                   11

                   Program Overview

                        Demographics

                        Outcomes Data Results

                        Analysis

                        Recommendations

Supported Child Development                                                          14

            Program Overview

            Demographics

            Outcomes Data Results

            Analysis

            Recommendations

Preschool/Daycare                                                                        19

                        Program Overview

                        Demographics

                        Outcomes Data Results

                        Analysis

                        Recommendations

Day Programs                                                                             22

                        Program Overview

                        Demographics

                        Outcomes Data Results

                        Analysis

                        Recommendations

Residential                                                                                   28

                        Program Overview

                        Demographics

                        Outcomes Data Results

                        Analysis

                        Recommendations

Respite                                                                                                33

Program Overview

                        Demographics

                        Outcomes Data Results

                        Analysis

                        Recommendations

Family Resource Coordinator                                                           37

External Stakeholders                                                                    39

Appendix

                Index of Graphs and Charts

Survey Cards

City of Richmond Hot Facts

Executive Summary

Each year, RSCL tracks the results of our programs and services. We call this Outcomes Management. We use this information to improve our services. This is a summary of our latest Outcomes Report. It shows positive results and high satisfaction with our programs. We also see a few areas that we want to work on.

For this report, we gathered information in seven different programs:

• Infant Development Program for families with babies and toddlers

• Supported Child Development for families with children and youth using child care

• Preschool & Daycare for children who are 3 to 5 years old

• Day Programs for adults, children and young adults with extra support needs

• Residential Services for adults with developmental disabilities

• Respite for adults with developmental disabilities and children with special needs

• Family Resource Coordinator for all families with a family member with a developmental disability

For each of these program areas, we set goals and collected information about:

• Effectiveness – how well things work compared to the results we expect

• Efficiency – how well we make use of the resources we have

• Accessibility – how easy it is for people to get the services they need

• Satisfaction – what people using our programs think about the program and RSCL

We also asked our external stakeholders how satisfied they were with RSCL services. Stakeholders are people and agencies we work with – including Community Living BC and the professionals and organizations that make referrals to our services.

We gathered information by sending out surveys, interviewing some people and reviewing files. The surveys were translated into three languages - English, Punjabi and Chinese. We interviewed some self-advocates and families, and all families receiving respite.  In spite of our efforts to gather input, we only had a response rate of 31%.

Here are the highlights of our results for 2005:

Infant Development Program (IDP)

Our IDP consultants supported between 215 and 232 families at any given time in 2005, although the program receives funding to support 125 families at a time. There were slightly more boys than girls in families with a wide range of ethnic backgrounds, including Caucasian, Chinese, South Asian, First Nations and Filipino.

In spite of the high number of families served, all the results for the program were achieved and some exceeded our expectations. The families who returned the satisfaction survey said they were satisfied or very satisfied and their child had made progress in their growth and development.

Supported Child Development

Supported Child Development Consultants worked with 133 children and youth in 2005. The children were about 30% girls and 70% boys. About one-third were from Caucasian families, and about two-thirds from other ethnic backgrounds including Asian, Chinese and Punjabi.

Supported Child Development is a new program for RSCL. Of the 24 families who responded, 88% indicated that they were satisfied or very satisfied with the service. The childcare providers who responded also indicated that they were satisfied with the support received from the program, to a moderate, great or very great extent. 88% said that their knowledge and skills in supporting children with special needs had increased because of their involvement with the program.

The program is going to work on improving the time between referral and the first meeting with a consultant, and increasing the number of children who are actively involved in a childcare program.

Preschool & Daycare

Treehouse is an integrated childcare centre for children age 3-5 years old. Of the 56 children who attended in 2005, seven children had special needs. 93% of Treehouse families who responded said they were satisfied with their childcare.

The families of children who need with extra support to attend Treehouse said their children had opportunities for growing and developing. In 2005, the daycare and preschool were full almost all of the time (97-98%), which is higher than last year.

Day Programs

Youth Connections, Avenues, Community Options, 2^nd Avenue and Transitions are the RSCL Day Programs. In total, there were 93 participants in 2005. Some day programs are open after school and when schools are closed and some are open Monday to Friday during the day.

We reviewed the files of the day program participants and we are pleased to report that over 93% of goals identified in the participants’ plans were worked on.

Satisfaction with our Day Programs is high, with 89% of participants interviewed and 94% of the families or caregivers who responded indicating that they were satisfied or very satisfied. We asked about honouring choices of the individuals in our day programs. This is an area we want to focus on this year.

Residential Services

RSCL supports 32 people, 12 men and 20 women, in a variety of living arrangements. 100% of the individuals and families who responded said they were satisfied or very satisfied.

Fewer staff left our residential services this year. We are very happy about this as it means that individuals get to know and count on the staff being there for them.

We wanted to know how well we are responding to people’s changing needs due to aging, health conditions etc. All the families who responded told us they felt we were responding to the changing needs of their family members. For example, we built a raised garden, added an extra railing on the stairs and added protective window screens. We are working on getting an accessible van, a bathtub lift and a ramp outside.

Respite

Respite caregivers give families of children and adults with disabilities a break by providing support in their homes and in the community; 16 adults and 48 children/youth received respite in 2005. The Respite Program interviewed families by phone this year to try to increase the number of families included in our survey. 80% of the families who responded to our survey said they were satisfied.

Some families feel concerned about whether they are getting enough respite. 66% of families felt their respite needs were met. It is important that families get respite when they need it. We keep track of the time it takes to match each family with a caregiver. Last year, on average it took 43 days.

Family Resource Coordinator

The Family Resource Coordinator helps families find the information they need and provides support to access other community supports for themselves or their family member. All the families who answered the survey said they were satisfied with the support they received. In 2005, our Coordinator sent out 600 ‘Family News’ newsletters and 124 people came to family-focused workshops or meetings.

External Stakeholders

We used a telephone survey to try to reach more stakeholders in 2005. We reached 14 people, including CLBC staff and referral sources. They were all satisfied with the respect for the rights and safety of people served by RSCL. Over 90% were also satisfied with advocacy provided. Several issues were raised, including a lack of respite caregivers, and inconsistencies in the way we accept referrals, do intake and report to CLBC.

At RSCL, we are very proud of our accomplishments this past year, and we believe we are making a positive difference in the lives of many people in the Richmond community. Based on the results of the 2005 Outcomes Report, we are working on the following improvements this year:

1. Increase Consultant hours and streamline the intake process in Supported Child Development.

2. Make changes to how we gather outcome information for Supported Child Development, including how we survey childcare providers, finding better ways to get input from families and, keeping track of how many families each consultant works with.

3. Set up a system at Treehouse to alert families if they need to speak to a staff person at pick-up time.

4. Expand the Day Program options, including the HandyCrew Cooperative and new volunteer opportunities.

5. Explore why some Day Program participants are feeling that their choices are not being honoured or they are not accessing community enough.

6. Get a wheelchair ramp and wheelchair accessible van for the 2^nd Avenue group home.

7. Explore ways to recruit respite caregivers quickly, and to improve the survey response rate for the Respite program.

8. Review the intake process with CLBC to make sure it is consistent and understandable.

9. Make sure critical incidents are reported within 48 hours.

10. Review how long it takes to respond to telephone enquiries from external stakeholders and set an appropriate standard.

We will report on how we have done with these planned improvements in the next Outcomes Report.

Introduction

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 third Outcome Management Report in a series of annual Outcome Management Reports.

This Outcome Management Report addresses seven program areas: Residential Services, Day Programs (including after-school care), Respite, Infant Development Program, Preschool/Daycare (3-5 years) and Family Resource Coordination, Supported child Development.  Each program area has identified measures for effectiveness, efficiency, accessibility and satisfaction.  In addition, an eighth 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      Compliance Report

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

Ø      Risk Management Report

Ø      Accessibility Plan

Ø      Technology Plan

Ø      Strategic Plan

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 who were involved in the life of a child, youth or adult with a developmental disability who was receiving service from the Society.  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 professionals and organizations that interface with RSCL programs and staff on a regular basis.

The Richmond Society for Community Living sent out a total of 517 surveys - 158 completed surveys were returned (response rate of 31%).  This return rate was lower than last year’s response.  Although RSCL mailed 106 additional surveys this year, the total number of returned surveys increased by only 13.  Last year the percentage of return was 38% (2004) compared to a 43% (2003) return rate for 2003.  In an attempt to increase the response rate of families receiving respite service, families from this program were interviewed instead of surveyed.   Of the 64 families receiving service, 10 families were interviewed.

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.

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.

Graph 2

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.

Also, in an attempt to increase the response rate for certain areas, this year we decided to interview families receiving Respite services as well as all external stakeholders.  Although a valiant effort was made to contact people (three telephone calls per respondent), this strategy did not produce a significant improvement in the response rates for these programs.

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 and, therefore can be used to inform the Society of practices that successfully respond to the needs of the people we support and highlight areas that require some improvement.

Demographic Summary

The City of Richmond’s present estimated population is 182,424 (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 ethnic (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.

Each year RSCL’s Accessibility Plan has addressed the need to reach out to the different ethnic groups in our community.  The agency has translated brochures and other orientation materials into Chinese and Punjabi.  In the fall of 2004 RSCL contracted an individual from the Chinese community to conduct focus groups and interviews with people from the Chinese community.  The purpose of these interviews and focus groups was to introduce RSCL services and solicit input on how the agency could facilitate better access to our services.  The feedback and suggestions gathered during these sessions has help to inform our 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.      

 Infant Development Program

Program Overview

Infant Development (ages birth to three years)

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.

Demographics

As of December 2005 the Infant Development Program was supporting 215 families.  The program is contracted for 125 families.  In April 2005 the program served a total of 232 families.

Chart 1 

Outcomes Data Results

Total surveys sent out: 176   Surveys returned:  55, response rate: 31%

Chart 2

Analysis

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 (25%) or very satisfied (75%) with the service.

Graph 3

IDP Program Satisfaction

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

“I enjoyed IDP!  It was great insight and info into my children's development!  Excellent program!  Thank you.”

“Each visit I learn new tips and techniques.”

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, 94% indicated that they either agreed (32%) or strongly agreed (62%) 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, 100% agreed (40%) or strongly agreed (60%) 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, 98% agreed (29%) or strongly agreed (69%) 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.

Graph 6

Offered Resources

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 (MCFD).  The results indicate that the program far exceeds the expectations of the contract with MCFD.  For most of the reporting year the contract required (and provided funds consistent with this requirement) the program to serve 100 families. In April 2005, the contract was increased in order to serve an additional 25 families. Although the contract increase enabled the Society to respond to a greater number of families, it did not allow the Society to meet the provincial practice guidelines regarding Consultant/family ratio (25 families per/fulltime Consultant). For example, although the service contract with the Society was increased in order to serve 125 families, during the month of April 2005 the program was serving 232 families. However, in spite of the funding challenges and relatively high Consultant/family ratio, it appears that the IDP program continues to be very effective. Given the high level of satisfaction reported by consumers, it does not appear that the high Consultant/family ratio has negatively impacted the quality of the program. 

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, 98% indicated that they had received service in the language of choice.  The 2% represents one individual whose comment was:  “I would have preferred Spanish but everything was worked out very well in English.”   Currently the IDP staff team is able to provide service in the following languages:

·  English                 ·  Cantonese            ·  Mandarin

·  Punjabi                ·  German

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