Group Living Services (CA-GLS) 4: Intake and Assessment
The organization’s intake and assessment practices ensure that residents receive prompt and responsive access to appropriate services and supports.
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VIEW THE STANDARDS
PurposeGroup Living Services allow individuals who need additional support to regain, maintain, and improve life skills and functioning in a safe, stable, community-based living arrangement.
All elements or requirements outlined in the standard are evident in practice, as indicated by full implementation of the practices outlined in the Practice Standards.
Practices are basically sound but there is room for improvement, as noted in the ratings for the Practice Standards; e.g.,
- Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality; or
- Procedures need strengthening; or
- With few exceptions, procedures are understood by staff and are being used; or
- In a few rare instances, urgent needs were not prioritized; or
- For the most part, established timeframes are met; or
- Culturally responsive assessments are the norm and any issues with individual staff members are being addressed through performance evaluations and training; or
- Active client participation occurs to a considerable extent.
Practice requires significant improvement, as noted in the ratings for the Practice Standards. Service quality or program functioning may be compromised; e.g.,
- Procedures and/or case record documentation need significant strengthening; or
- Procedures are not well-understood or used appropriately; or
- Urgent needs are often not prioritized; or
- Services are frequently not initiated in a timely manner; or
- Applicants are not receiving referrals, as appropriate; or
- Assessment and reassessment timeframes are often missed; or
- Assessments are sometimes not sufficiently individualized;
- Culturally responsive assessments are not the norm, and this is not being addressed in supervision or training; or
- Several client records are missing important information; or
- Client participation is inconsistent; or
- Intake or assessment is done by another organization or referral source and no documentation and/or summary of required information is present in case record.
Implementation of the standard is minimal or there is no evidence of implementation at all, as noted in the ratings for the Practice Standards; e.g.,
- There are no written procedures, or procedures are clearly inadequate or not being used; or
- Documentation is routinely incomplete and/or missing.
|Self-Study Evidence||On-Site Evidence||On-Site Activities|
Residents are screened to determine whether they meet the program’s eligibility criteria, and are informed about:
- how well their request matches the organization's services;
- what service options and levels of care will be available and when;
- the effectiveness of treatment, when available; and
- opportunities for active family participation and support, and involvement in community activities.
InterpretationScreenings will vary based on the program’s target population and services offered, and can include information to identify any of the following: trauma history, substance use conditions, mental illness, and/or individual’s risk of harm to self or others.
InterpretationWhen organizations provide services under contract with a “no reject” provision the interdisciplinary team should carefully review admission decisions to ensure the organization is prepared to address any special needs or services the resident may require.
InterpretationMatching individuals in recovery to a recovery house that will meet their needs is critical to ensuring resident safety. While this determination will sometimes be made by the referring provider, organizations should have procedures in place to ensure an appropriate match has been made prior to the individual moving in. Individual needs, preferences, and expectations should be considered when assessing the appropriateness of the living arrangement including, but not limited to:
- intensity of recovery supports needed or desired (e.g. availability of certified peer specialists, staff qualifications, etc.);
- any special needs (e.g. co-occurring mental health diagnoses, mothers with children, veterans, etc.);
- geographic preferences;
- transportation availability;
- chosen recovery pathway (e.g. medication assisted recovery, AA, etc.);
- level of medication assisted recovery support needed or desired (e.g. do others in medication assisted recovery live in the home); and
- time in recovery.
Generally, recovery housing should be low barrier, but when it is determined that the residence is not going to meet the support needs of the individual, linkages to a more appropriate provider should be offered.
NA Another organization is responsible for screening, as defined in a contract.
Prompt, responsive intake practices:
- gather information necessary to identify critical service needs and/or determine when a more intensive service is necessary;
- give priority to urgent needs and emergency situations;
- support timely initiation of services; and
- provide placement on a waiting list or linkages to appropriate resources when individuals cannot be served or cannot be served promptly.
Residents participate in a comprehensive, individualized, trauma-informed, strengths-based, culturally and linguistically responsive assessment that is:
- completed within established timeframes; and
- focused on information pertinent for meeting service requests and objectives.
InterpretationStandardized and evidence-based assessment tools should be used to support structured and consistent decision-making.
InterpretationIf the timelines are not specified by legislation, regulations, and/or contracts, assessments are to be completed no longer than 90 days after intake and updated minimally once a year.
The assessment is conducted by clinical personnel, including a licensed psychiatrist, psychologist, or other qualified mental health professional, as appropriate to the program model and population served, and addresses:
- behavioural and physical health;
- a trauma screen and, when appropriate, a trauma assessment;
- an evaluation of suicide risk, self-injury, neglect, exploitation, and violence towards others;
- family strengths, risks, and protective factors;
- community and social support, resources, and helping networks;
- environmental, religious or spiritual, and cultural factors;
- educational and vocational accomplishments;
- level of community engagement;
- social skills, recreational activities, hobbies, strengths and special interests;
- factors related to successful group living;
- additional tests and assessments needed; and
- a summary of symptoms and diagnoses.
InterpretationThe Assessment Matrix - Private, Public, Canadian, Network determines which level of assessment is required for COA’s Service Sections. The assessment elements of the Matrix can be tailored according to the needs of specific individuals or service design.
InterpretationVulnerable populations, such as people that are lesbian, gay, bisexual, transgender, and questioning (LGBTQ), are at high risk of violence and harassment while in residential care. The organization should consider these factors to ensure all people are safe and welcomed by staff and residents.
InterpretationPersonnel that conduct evaluations should be aware of the indicators of a potential trafficking victim, including, but not limited to:
- evidence of mental, physical, or sexual abuse;
- physical exhaustion;
- working long hours;
- living with employer or many people in confined area;
- unclear family relationships;
- heightened sense of fear or distrust of authority;
- presence of older significant other or pimp;
- loyalty or positive feelings towards an abuser;
- inability or fear of making eye contact;
- chronic running away or homelessness;
- possession of excess amounts of cash or hotel keys; and
- inability to provide a local address or information about parents.
InterpretationIn recovery housing, assessments should be driven by the resident and focused on their barriers to recovery, unmet service needs, strengths, and resources.
Examples: Organizations serving young children can tailor the assessment process to meet the age and developmental level of the service population. Assessments may include an evaluation of factors that impact the child’s social and emotional well-being (e.g., family characteristics), an observation of the child’s behaviour, and/or a thorough health and developmental history.
Examples: Factors that can impact group living success can include:
Examples: Factors that can impact group living success can include:
- possible reciprocal individual and group effects;
- the individual’s ability to adjust to a group;
- safety issues;
- previous placements; and
- trauma history.
When a resident’s assessment indicates a substance use condition, the organization records a thorough alcohol and drug use history, including an evaluation of the effects of alcohol and other drug use on the resident’s family, and:
- provides an appropriate level of service and detoxification, as necessary; or
- connects the resident and/or family members to appropriate services when the program does not serve individuals with substance use conditions.
Reassessments are conducted as needed, including at specific milestones in the treatment process including:
- after significant treatment progress;
- after a lack of significant treatment progress;
- after new symptoms are identified;
- when significant behavioural changes are observed;
- when there are changes to a family situation or parental status;
- when significant environmental changes occur; or
- when a resident returns following an episode of running away.