Respite Care Definition
Purpose
Respite Care reduces caregiver stress, promotes the well-being and safety of care recipients, and contributes to stable families.Definition
Respite Care is provided in a supportive, enriching, and therapeutic environment, in the caregiver’s home, in the service provider’s home, in a program facility, or in the community. Services can be provided on a planned or as needed basis, including in response to a crisis. Families experiencing medical emergencies and stressful home situations, such as domestic violence or homelessness, may request crisis nursery respite care. Generally, care is provided for a few hours or days at a time. Crisis nursery and short-term residential respite services can extend to a few weeks or a month at a time. When services are provided in response to a crisis, the timeframes may be less predictable and dependent upon resolution of the crisis. Respite care providers can include employees, independent contractors, volunteers and foster parents.
Note:In the field of Adult Services, the term “respite services” often refers to an array of respite services that includes respite care in the person’s home or in a facility (PA-RC), in home care and support services (PA-HCS), medical or social day programs (PA-AD), adult foster care (PA-AFC), group living (PA-GLS) and residential respite services (PA-RC).
Note:When an organization is completing the Child and Family Services Standards (PA-CFS) their respite program is covered under PA-CFS 30: Respite Care for Children in Out-of-Home Care unless they provide respite services for children and families outside of family foster care or kinship care. In this instance, the organization will also need to complete PA-RC to capture all aspects of assessment, service planning, and coordination for these families.
Note:Please see CA-RC Reference List for the research that informed the development of these standards.
Note:For information about changes made in the 2020 Edition, please see the RC Crosswalk
Respite Care (PA-RC) 1: Person-Centered Logic Model
A rating of (1) indicates that the agency's practices fully meet the standard and reflect a high level of capacity.
- All elements or requirements outlined in the standard are evident in practice, with rare or no exceptions: exceptions do not impact service quality or agency performance.
A rating of (2) indicates that an agency's infrastructure and practices are basically sound but there is room for improvement.
- The majority of the standards requirements have been met and the basic framework required by the standard has been implemented.
- Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality or agency performance.
Partial Implementation, Concerning Performance
A rating of (3) indicates that the agency's observed infrastructure and/or practices require significant improvement.
- The agency has not implemented the basic framework of the standard but instead has in place only part of this framework.
- Omissions or exceptions to the practices outlined in the standard occur regularly, or practices are implemented in a cursory or haphazard manner.
- Service quality or agency functioning may be compromised.
- Capacity is at a basic level.
A rating of (4) indicates that implementation of the standard is minimal or there is no evidence of implementation at all.
- The agency’s observed service delivery infrastructure and practices are weak or non-existent; or show signs of neglect, stagnation, or deterioration.
Self-Study Evidence | On-Site Evidence | On-Site Activities |
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No On-Site Evidence
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PA-RC 1.01
- needs the program will address;
- available human, financial, agency, and community resources (i.e. inputs);
- program activities intended to bring about desired results;
- program outputs (i.e. the size and scope of services delivered);
- desired outcomes (i.e. the changes you expect to see in service recipients); and
- expected long-term impact on the agency, community, and/or system.
Examples: Information that may be used to inform the development of the program model includes, but is not limited to:
- needs assessments and periodic reassessments;
- risks assessments conducted for specific interventions;
- program and client outcomes data; and
- the best available evidence of service effectiveness.
PA-RC 1.02
- change in clinical status;
- change in functional status;
- health, welfare, and safety;
- permanency of life situation;
- quality of life;
- achievement of individual service goals; and
- other outcomes as appropriate to the program or service population.
Interpretation: Outcomes data should be disaggregated to identify patterns of disparity or inequity that can be masked by aggregate data reporting. See PA-PQI 5.02 for more information on disaggregating data to track and monitor identified outcomes.
PA-RC 1.03
- corporal punishment;
- the use of aversive stimuli;
- interventions that involve withholding nutrition or hydration, or that inflict physical or psychological pain;
- the use of demeaning, shaming or degrading language or activities;
- unnecessarily punitive restrictions including cancellation of visits as a disciplinary action;
- forced physical exercise to eliminate behaviors;
- punitive work assignments;
- punishment by peers; and
- group punishment or discipline for individual behavior.
Respite Care (PA-RC) 2: Personnel
A rating of (1) indicates that the agency's practices fully meet the standard and reflect a high level of capacity.
- All elements or requirements outlined in the standard are evident in practice, with rare or no exceptions: exceptions do not impact service quality or agency performance.
A rating of (2) indicates that an agency's infrastructure and practices are basically sound but there is room for improvement.
- The majority of the standards requirements have been met and the basic framework required by the standard has been implemented.
- Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality or agency performance.
Partial Implementation, Concerning Performance
A rating of (3) indicates that the agency's observed infrastructure and/or practices require significant improvement.
- The agency has not implemented the basic framework of the standard but instead has in place only part of this framework.
- Omissions or exceptions to the practices outlined in the standard occur regularly, or practices are implemented in a cursory or haphazard manner.
- Service quality or agency functioning may be compromised.
- Capacity is at a basic level.
A rating of (4) indicates that implementation of the standard is minimal or there is no evidence of implementation at all.
- The agency’s observed service delivery infrastructure and practices are weak or non-existent; or show signs of neglect, stagnation, or deterioration.
Self-Study Evidence | On-Site Evidence | On-Site Activities |
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PA-RC 2.01
- assessing the need for additional services;
- identification of changes in functioning;
- identification of medical needs or problems;
- use of adaptive equipment, such as braces and wheelchairs;
- providing personal care, including lifting techniques; and
- determining if a crisis situation is imminent and intervene using appropriate resources.
PA-RC 2.02
- an advanced degree in social work or a comparable human service field with one year of relevant experience; or
- a bachelor's degree in social work or a comparable human service field with two years of relevant experience.
PA-RC 2.03
- assigning a worker at intake or early in the contact; and
- avoiding the arbitrary or indiscriminate reassignment of direct service personnel.
PA-RC 2.04
There is at least one person on duty in each respite setting whenever care is being provided that has received first aid and age-appropriate CPR training in the previous two years that included an in-person, hands-on CPR skills assessment conducted by a certified CPR instructor.
PA-RC 2.05
PA-RC 2.06
PA-RC 2.07
- a criminal record and abuse registry check for all adults living in the provider’s home; and
- relevant caregiving experience.
Interpretation: Element (a) is only applicable if respite care is delivered in the provider's home.
PA-RC 2.08
- the qualifications, competencies, and experience of the worker, including the level of supervision needed;
- the work and time required to accomplish assigned tasks and job responsibilities; and
- service volume, accounting for assessed level of needs of persons served.
Respite Care (PA-RC) 3: Access to Services
A rating of (1) indicates that the agency's practices fully meet the standard and reflect a high level of capacity.
- All elements or requirements outlined in the standard are evident in practice, with rare or no exceptions: exceptions do not impact service quality or agency performance.
A rating of (2) indicates that an agency's infrastructure and practices are basically sound but there is room for improvement.
- The majority of the standards requirements have been met and the basic framework required by the standard has been implemented.
- Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality or agency performance.
Partial Implementation, Concerning Performance
A rating of (3) indicates that the agency's observed infrastructure and/or practices require significant improvement.
- The agency has not implemented the basic framework of the standard but instead has in place only part of this framework.
- Omissions or exceptions to the practices outlined in the standard occur regularly, or practices are implemented in a cursory or haphazard manner.
- Service quality or agency functioning may be compromised.
- Capacity is at a basic level.
A rating of (4) indicates that implementation of the standard is minimal or there is no evidence of implementation at all.
- The agency’s observed service delivery infrastructure and practices are weak or non-existent; or show signs of neglect, stagnation, or deterioration.
Self-Study Evidence | On-Site Evidence | On-Site Activities |
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No Self-Study Evidence
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PA-RC 3.01
PA-RC 3.02
Respite Care (PA-RC) 4: Intake and Assessment
Currently viewing: INTAKE AND ASSESSMENT
VIEW THE STANDARDS
A rating of (1) indicates that the agency's practices fully meet the standard and reflect a high level of capacity.
- All elements or requirements outlined in the standard are evident in practice, with rare or no exceptions: exceptions do not impact service quality or agency performance.
A rating of (2) indicates that an agency's infrastructure and practices are basically sound but there is room for improvement.
- The majority of the standards requirements have been met and the basic framework required by the standard has been implemented.
- Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality or agency performance.
Partial Implementation, Concerning Performance
A rating of (3) indicates that the agency's observed infrastructure and/or practices require significant improvement.
- The agency has not implemented the basic framework of the standard but instead has in place only part of this framework.
- Omissions or exceptions to the practices outlined in the standard occur regularly, or practices are implemented in a cursory or haphazard manner.
- Service quality or agency functioning may be compromised.
- Capacity is at a basic level.
A rating of (4) indicates that implementation of the standard is minimal or there is no evidence of implementation at all.
- The agency’s observed service delivery infrastructure and practices are weak or non-existent; or show signs of neglect, stagnation, or deterioration.
Self-Study Evidence | On-Site Evidence | On-Site Activities |
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No On-Site Evidence
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PA-RC 4.01
- how the caregiver’s request and the dependent person’s needs match the agency's services; and
- what services will be available and when.
PA-RC 4.02
- ensure that applicants are treated equitably;
- address any concerns about using respite care;
- gather information necessary to identify critical service needs and/or determine when a more intensive service is necessary;
- give priority to individuals with urgent needs and emergency situations;
- support the timely initiation of services; and
- provide placement on a waiting list or referral to appropriate resources when individuals cannot be served or cannot be served promptly.
PA-RC 4.03
- completed within established timeframes;
- updated as needed based on the needs of persons served; and
- focused on information pertinent for meeting service requests and objectives.
Interpretation: The 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.
Respite Care (PA-RC) 5: Service Planning and Monitoring
A rating of (1) indicates that the agency's practices fully meet the standard and reflect a high level of capacity.
- All elements or requirements outlined in the standard are evident in practice, with rare or no exceptions: exceptions do not impact service quality or agency performance.
A rating of (2) indicates that an agency's infrastructure and practices are basically sound but there is room for improvement.
- The majority of the standards requirements have been met and the basic framework required by the standard has been implemented.
- Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality or agency performance.
Partial Implementation, Concerning Performance
A rating of (3) indicates that the agency's observed infrastructure and/or practices require significant improvement.
- The agency has not implemented the basic framework of the standard but instead has in place only part of this framework.
- Omissions or exceptions to the practices outlined in the standard occur regularly, or practices are implemented in a cursory or haphazard manner.
- Service quality or agency functioning may be compromised.
- Capacity is at a basic level.
A rating of (4) indicates that implementation of the standard is minimal or there is no evidence of implementation at all.
- The agency’s observed service delivery infrastructure and practices are weak or non-existent; or show signs of neglect, stagnation, or deterioration.
Self-Study Evidence | On-Site Evidence | On-Site Activities |
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No On-Site Evidence
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PA-RC 5.01
- agreed upon goals, desired outcomes, and timeframes for achieving them;
- services and supports to be provided, and by whom;
- possibilities for maintaining and strengthening family relationships and other informal social networks;
- procedures for expedited service planning when crisis or urgent need is identified;
- guidelines for requesting additional planned or emergency respite care;
- fees and payment arrangements, when applicable; and
- the individual’s signature.
PA-RC 5.02
- assume a service coordination role, as appropriate, when the need has been identified and no other agency has assumed that responsibility;
- ensure that they receive appropriate advocacy support;
- assist with access to the full array of services to which they are eligible; and
- mediate barriers to services within the service delivery system, including transportation or fees.
- support groups and counseling services;
- health, mental health, and substance use services;
- domestic violence services;
- shelter and housing services;
- social, recreational, and day programs; and
- mentor services.
PA-RC 5.03
- service plan implementation;
- progress toward achieving goals and desired outcomes; and
- the continuing appropriateness of the agreed upon goals.
PA-RC 5.04
- review progress toward achievement of agreed upon service goals; and
- sign revisions to service goals and plans.
Respite Care (PA-RC) 6: Care and Supervision
A rating of (1) indicates that the agency's practices fully meet the standard and reflect a high level of capacity.
- All elements or requirements outlined in the standard are evident in practice, with rare or no exceptions: exceptions do not impact service quality or agency performance.
A rating of (2) indicates that an agency's infrastructure and practices are basically sound but there is room for improvement.
- The majority of the standards requirements have been met and the basic framework required by the standard has been implemented.
- Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality or agency performance.
Partial Implementation, Concerning Performance
A rating of (3) indicates that the agency's observed infrastructure and/or practices require significant improvement.
- The agency has not implemented the basic framework of the standard but instead has in place only part of this framework.
- Omissions or exceptions to the practices outlined in the standard occur regularly, or practices are implemented in a cursory or haphazard manner.
- Service quality or agency functioning may be compromised.
- Capacity is at a basic level.
A rating of (4) indicates that implementation of the standard is minimal or there is no evidence of implementation at all.
- The agency’s observed service delivery infrastructure and practices are weak or non-existent; or show signs of neglect, stagnation, or deterioration.
Self-Study Evidence | On-Site Evidence | On-Site Activities |
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PA-RC 6.01
PA-RC 6.02
Respite care providers:
- are familiar with the care recipient’s daily routine, preferred foods and activities, and needed therapeutic or medical care;
- respect the culture, race, ethnicity, language, religion, gender identity, and sexual orientation of the care recipient; and
- offer activities with content appropriate to the interests, age, development, physical abilities, interpersonal characteristics, and special needs of the care recipient.
PA-RC 6.03
PA-RC 6.04
- one to four when children are under school age;
- one to eight during waking hours; and
- one to twelve during sleeping hours.
PA-RC 6.05
PA-RC 6.06
PA-RC 6.07
Respite Care (PA-RC) 7: Service Environment
Note: Please see the Facility Observation Checklist for additional guidance on this standard.
A rating of (1) indicates that the agency's practices fully meet the standard and reflect a high level of capacity.
- All elements or requirements outlined in the standard are evident in practice, with rare or no exceptions: exceptions do not impact service quality or agency performance.
A rating of (2) indicates that an agency's infrastructure and practices are basically sound but there is room for improvement.
- The majority of the standards requirements have been met and the basic framework required by the standard has been implemented.
- Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality or agency performance.
Partial Implementation, Concerning Performance
A rating of (3) indicates that the agency's observed infrastructure and/or practices require significant improvement.
- The agency has not implemented the basic framework of the standard but instead has in place only part of this framework.
- Omissions or exceptions to the practices outlined in the standard occur regularly, or practices are implemented in a cursory or haphazard manner.
- Service quality or agency functioning may be compromised.
- Capacity is at a basic level.
A rating of (4) indicates that implementation of the standard is minimal or there is no evidence of implementation at all.
- The agency’s observed service delivery infrastructure and practices are weak or non-existent; or show signs of neglect, stagnation, or deterioration.
Self-Study Evidence | On-Site Evidence | On-Site Activities |
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PA-RC 7.01
PA-RC 7.02
- fire, health, and safety hazards;
- cleanliness;
- adequacy and appropriateness of space and furnishings; and
- the safety and appropriateness of toys, materials, or equipment.
PA-RC 7.03
- sleeping arrangements appropriate to the number, age, special needs, and gender of the individuals in the home or facility;
- adequately and attractively furnished rooms with a separate bed for each resident, including a clean, comfortable, covered mattress, pillow, sufficient linens, and blankets;
- rooms that are adequately and attractively furnished with a separate bed for each individual , including a clean, comfortable, covered mattress, pillow, sufficient linens, and blankets;
- a non-stacking crib for each infant and toddler that is 24 months or younger that meets safety guidelines, as applicable; and
- a safe place, such as a locker, to keep personal belongings and valuables.
Note: Please see the Facility Observation Checklist for additional guidance on this standard.
PA-RC 7.04
- indoor and outdoor recreation areas;
- dining, bathing, toileting, and personal hygiene facilities;
- private areas for meetings with individuals and caregivers;
- space for resting; and
- rooms for providing on-site services, when available.
Note: Please see the Facility Observation Checklist for additional guidance on this standard.
PA-RC 7.05
PA-RC 7.06
- requested by the caregiver;
- approved in advance by the program director or an appropriate designee; and
- documented in the case record.
Note: Please see the Facility Observation Checklist for additional guidance on this standard.
PA-RC 7.07
Respite Care (PA-RC) 8: Short Term Residential Respite and Crisis Nursery Services
Note: Please see the Facility Observation Checklist for additional guidance on this standard.
A rating of (1) indicates that the agency's practices fully meet the standard and reflect a high level of capacity.
- All elements or requirements outlined in the standard are evident in practice, with rare or no exceptions: exceptions do not impact service quality or agency performance.
A rating of (2) indicates that an agency's infrastructure and practices are basically sound but there is room for improvement.
- The majority of the standards requirements have been met and the basic framework required by the standard has been implemented.
- Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality or agency performance.
Partial Implementation, Concerning Performance
A rating of (3) indicates that the agency's observed infrastructure and/or practices require significant improvement.
- The agency has not implemented the basic framework of the standard but instead has in place only part of this framework.
- Omissions or exceptions to the practices outlined in the standard occur regularly, or practices are implemented in a cursory or haphazard manner.
- Service quality or agency functioning may be compromised.
- Capacity is at a basic level.
A rating of (4) indicates that implementation of the standard is minimal or there is no evidence of implementation at all.
- The agency’s observed service delivery infrastructure and practices are weak or non-existent; or show signs of neglect, stagnation, or deterioration.
Self-Study Evidence | On-Site Evidence | On-Site Activities |
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PA-RC 8.01
PA-RC 8.02
PA-RC 8.03
- sufficient supplies and equipment to meet the needs of care recipients;
- space and equipment for housekeeping, laundry, maintenance, and storage;
- rooms for providing on-site services, as applicable;
- at least one room suitably furnished for the use of on-duty personnel and space for administrative support functions; and
- private sleeping accommodations for personnel who sleep at the facility, if applicable.
Note: Please see the Facility Observation Checklist for additional guidance on this standard.
PA-RC 8.04
Note: Please see the Facility Observation Checklist for additional guidance on this standard.
Respite Care (PA-RC) 9: Case Closing
A rating of (1) indicates that the agency's practices fully meet the standard and reflect a high level of capacity.
- All elements or requirements outlined in the standard are evident in practice, with rare or no exceptions: exceptions do not impact service quality or agency performance.
A rating of (2) indicates that an agency's infrastructure and practices are basically sound but there is room for improvement.
- The majority of the standards requirements have been met and the basic framework required by the standard has been implemented.
- Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality or agency performance.
Partial Implementation, Concerning Performance
A rating of (3) indicates that the agency's observed infrastructure and/or practices require significant improvement.
- The agency has not implemented the basic framework of the standard but instead has in place only part of this framework.
- Omissions or exceptions to the practices outlined in the standard occur regularly, or practices are implemented in a cursory or haphazard manner.
- Service quality or agency functioning may be compromised.
- Capacity is at a basic level.
A rating of (4) indicates that implementation of the standard is minimal or there is no evidence of implementation at all.
- The agency’s observed service delivery infrastructure and practices are weak or non-existent; or show signs of neglect, stagnation, or deterioration.
Self-Study Evidence | On-Site Evidence | On-Site Activities |
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No On-Site Evidence
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PA-RC 9.01
- is a clearly defined process that includes assignment of staff responsibility;
- begins at intake; and
- involves the worker, the caregiver, and others, as appropriate to the needs and wishes of the caregiver.