Shelter Care, Inc.

Risk Prevention and Management Report

01/01/17– 3/31/17

During the first quarter 2017, Shelter Care, Inc. conducted the following Risk Prevention and Management activities and action steps:

  1. Compliance with all federal, state and local laws through reviews by:
  1. Shelter Care, Inc. submitted an application to the Ohio Department of Job and Family Services to amend the current certificate. An on-site inspection was held on February 6 on the Antoinette respite home to increase the capacity of the home.
  2. The Shelter Care, Inc. Board of Directors conducted meetings in Januaryand March, 2017.

B.Annual reviews at the time of renewal of liability, property, vehicle and health insurance.

1.All insurances remained intact.

C. Annual fire inspections, bimonthly fire and safety drills; annual well water inspections; annual CPR training:

  1. American Red Cross First Aid and CPR trainings were held inFebruary2017;
  2. Two fire drills are conducted monthly at all residential facilities.
  3. Well water inspections were conducted in January 2017for the Highspire, Antoinette, Nokomis, and Caston Road houses.
  1. In 2017Shelter Care, Inc. maintained the following contractual agreements:
  2. Summit County Children Services Board through the continued contract;
  3. Summit County Juvenile Court for services provided at Safe Landing Youth Shelter;
  4. Stark County Department of Job and Family Services for residential services at Shelter Care, Inc.;
  5. Child Guidance & Family Solutions for the respite care program;
  6. Medina County Job and Family Services for residential services at Shelter Care, Inc.
  7. Geauga County Job and Family Services for residential services at Shelter Care, Inc.
  8. Shelter Care, Inc. began a new contract with Mahoning County Children Services for youths placed at The Highlands and at Safe Landing Youth Shelter.
  9. Shelter Care, Inc. continued a contract with Cuyahoga County Family Services.
  10. Staff training sessions were held for areas of risk including:
  11. Psychotropic Medication with Beth Kinney-Murphy was held on February 10, 2017;
  12. Universal precautions with Dr. Erme was held on February 24, 2017;
  13. Listening for Goodness Sake with John Ward was held on March 10, 2017.
  14. Hiring practices that include background checks, pre-employmentphysicals; three references; training that includes 52 hours of training the first year and 24 hours of ongoing training thereafter; and annual evaluations;
  15. All background checks, pre-employment physicals, and reference checks are completed prior to hire;
  16. Orientation training is completed prior to staff being left alone with youth;
  17. All staff received 24 hours of ongoing training annually.
  18. Research Protections policy involving a resident in any publicity activity;
  19. Shelter Care, Inc. has not conducted any research or publicity involving youth, parents, or legal guardians the first quarter of 2017.
  20. Review of the internet service provider’s capabilities and risk of breach of security to ensureconfidentiality; the security of all storage areas and file systems were inspected in first quarter of 2017. Shelter Care is now in the process of migrating to a cloud based system. The goal of the migration would be to deliver 35 users into Exchange Online & Skype for Business Online through Office 365. A SharePoint Online Intranet would be deployed to increase employee awareness and productivity. These services will be provided through the Microsoft charity program.
  21. Any fundraising outside the funds raised through the grant writing process;
  22. In 2017 funds were raised through the grant writing process and requests to foundations;
  23. During the first quarter of 2017, Shelter Care, Inc. submitted continuation grants on behalf of The Highlands Teen Pregnancy Shelter, Safe Landing Youth Shelter and the Street Outreach Program to the United States Department of Health and Human Services, Administration for Children and Families.
  24. A grant was submitted to The GAR Foundation for operating expenses for girls’ Safe Landing. A tour was provided for foundation staff.
  25. Four additional grants were submitted in the first quarter.
  26. The Open House at boys Safe Landing was postponed until all renovations are completed.

J.Any risk involved with any conflict of interest within the agency;

1.In the first quarter of 2017 there were no conflicts of interest within the agency.

K.The following staffing concerns and issues were discussed during the Senior Management Team meetings2017:

  1. Three retirements coming up this year: Ms. Ashworth, Mrs. Bartoletta, and Mrs. Hartney.
  2. Mrs. Lund’s job title has changed to controller after a recommendation from a board member.
  3. There are three openings for houseparents in April, May and June. Girls are moving to the Third Street house in April as the Bollingers transition out. The Daughertys are retiring again. The Wilsons are leaving the end of May; Casey and Caroline Adams have been hired to replace them.

L.The Executive Director and Clinical Director report to the Senior Management Team on a monthly basis regarding the ongoing communication between Shelter Care, Inc. and its referring agencies and any risk in these relationships.

1.Shelter Care, Inc. maintained the contract with Summit County Juvenile Court to provide services for youth through the Juvenile Detention Alternatives Initiative through 2017.

2. ADM Board has funds to assist with the placement of youth from opioid addicted parents. Possible placements by SCCS to Safe Landing.

  1. Dr. Fair and Dr. Rizzo met with the new Executive Director of CGFS. She mentioned they are very pleased with the Respite Program and Safe Landing.

M. There were no grievances during the first quarter of 2017.

Incident Reviews

  1. The senior management team, which includes the Executive Director, the Clinical Director, the Program Directors and the Licensing Coordinator, met January 26 and March 21, 2017to review:
  1. Critical Incidents Reports where a person was determined to be a danger to self or others, serious injuries or death;
  2. The first quarter 2017 at Safe Landing Youth Shelters clinical staffings, 22 CIRs were reviewed that included: AWOL’s; victim of alleged abuse and/or neglect; delinquent activity; SCCS referral for abuse/neglect, suicide ideation, and sexual abuse. In the Shelter Home Program there were 18 CIR’s.
  3. Medication Error and Omission forms, Medication Logs and procedures:

There were twostaff medication errors throughout the agency in the first quarter of 2017.

  1. Service modalities or other organizational practices that involve risk or limit the youth’s freedom of choice;

a.There were no incidents where a service modality or organizational practice involved risk or limited the youth’s freedom of choice during the first quarter of 2017.

  1. Any use of restrictive behavior management interventions, including de-escalation and restraints;

a.There were no incidents involving restraints by any staff members.

5.Any incident involving staff misconduct or staffing issues:

1.There wereno incidents of staff misconduct.

6. Facility safety issues, maintenance or repair issues.

  1. In the first quarter of 2017the following issues were discussed:
  2. Steps at the Drop In Center are deteriorating. Who is responsible?
  3. The kitchen backsplash will be replaced in order to insulate the kitchen wall.
  4. Mr. Radebaugh is taking over the majority of repairs while Mr. Pickens is working on the computer system.

PQI Data 2017

Shelter Home Program

4 case files were reviewed.

  • The admission documentation was complete for 100 percent of the files reviewed.
  • 100 percent of case files included current photos.
  • 100 percent of placement physicals were completed for new admissions.
  • One ISP and one assessment were completed; two ISP’s and assessments were within the timeframe.
  • Two discharge summaries were completed.
  • There werenostaff medication errors.
  • The length of stay ranged from 18 days to 2 years with the average being 8 months.

Safe Landing Youth Shelter for Boys

13 case files were reviewed.

  • The admission documentation was complete for 84 percent of the files reviewed.
  • 100 percent of files had photos.
  • 92percent of case files included medical screenings that were completed in a timely manner or the youth had left the shelter within the timeframe.
  • There were no staff medication errors.
  • The average length of stay was 10 days. The range was a few hours to 68 days.

Safe Landing Youth Shelter for Girls

14 case files were reviewed.

  • The admission documentation was complete for 78 percent of the files reviewed.
  • 100 percent of files had photos.
  • There was one staff medication error.
  • 92 percent of case files included medical screenings that were completed in a timely manner or the youth left the shelter within the time frame.
  • The average length of stay was 8 days and ranged from 2 days to 17 days.

Respite Care Program

17 case files were reviewed.

  • The admission documentation was complete for 100 percent of files reviewed.
  • 100 percent of files contained current photos.
  • 96 percent of Admission Intake and Permission to Dispense forms were complete and accurate.
  • 100 percent of Discharge Summaries were completed.
  • There wasone staff medication error.

The Highlands Teen Pregnancy Shelter

8 teen mother and 2 infant case files were reviewed.

  • The admission documentation was complete for 100 percent of files reviewed.
  • 100 percent of files contained current photos.
  • 100 percent of medical screenings were completed within the timeframe.
  • One ISP and one assessments was completed within the timeframe.
  • The average length of stay was four months. The range was 7 days to9 months.
  • There were two staff medication errors.

There were five staff medication errors the first three months of 2016; there were four staff errors in the first quarter of 2017.