2023 Edition

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 programs provide temporary relief to caregivers with responsibility for the care and supervision of adults or children who: have physical, emotional, developmental, cognitive, behavioral, or mental health disabilities; are at risk of abuse or neglect; or are in foster care.

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 (RC), homemaker and personal care aid services (HCS), medical or social day programs (AD), adult foster care (AFC), group living (GLS) and residential respite services (RC).

 

 

Note:When an agency is completing the Family Foster Care and Kinship Care Services Standards (FKC) their respite program is covered under FKC 22: Respite Care unless they provide respite services for children and families outside of the family foster care/kinship care program. In this instance, the organization will also need to complete RC to capture all aspects of assessment, service planning, and coordination for these families.

 

Note:Please see 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.

2023 Edition

Respite Care (RC) 1: Person-Centered Logic Model

The organization implements a program logic model that describes how resources and program activities will support the achievement of positive outcomes.

Note: Please see the Logic Model Template for additional guidance on this standard.  

1
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.

Logic models have been implemented for all programs and the organization has identified at least two outcomes for all its programs.
2
Practices are basically sound but there is room for improvement, as noted in the ratings for the Practice Standards; e.g.,  
  • Procedures need strengthening; or
  • With few exceptions, procedures are understood by staff and are being used; or
  • Logic models need improvement or clarification; or
  • Logic models are still under development for some of its programs, but are completed for all high-risk programs such as protective services, foster care, residential treatment, etc.; or
  • At least one client outcome has been identified for all of its programs; or
  • All but a few staff have been trained on use of therapeutic interventions and training is scheduled for the rest; or
  • With few exceptions the policy on prohibited interventions is understood by staff, or the written policy needs minor clarification.
3
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
  • Logic models need significant improvement; or
  • Logic models are still under development for a majority of programs; or
  • A logic model has not been developed for one or more high-risk programs; or
  • Outcomes have not been identified for one or more programs; or
  • Several staff have not been trained on the use of therapeutic interventions; or
  • There are gaps in monitoring of therapeutic interventions, as required; or
  • There is no process for identifying risks associated with use of therapeutic interventions; or
  • Policy on prohibited interventions does not include at least one of the required elements.
4
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.,
  • Logic models have not been developed or implemented; or
  • Outcomes have not been identified for any programs; or
  • There is no written policy or procedures for the use of therapeutic interventions; or 
  • Procedures are clearly inadequate or not being used; or
  • Documentation on therapeutic interventions is routinely incomplete and/or missing; or
  • There is evidence that clients have been harmed by inappropriate or unmonitored use of therapeutic interventions.
Self-Study Evidence On-Site Evidence On-Site Activities
  • See program description completed during intake
  • Program logic model that includes a list of client outcomes being measured
  • Policy for prohibited interventions
No On-Site Evidence
  • Interviews may include:
    1. Program director
    2. Relevant personnel
 

RC 1.01

A program logic model, or equivalent framework, identifies:
  1. needs the program will address;
  2. available human, financial, organizational, and community resources (i.e. inputs);
  3. program activities intended to bring about desired results;
  4. program outputs (i.e. the size and scope of services delivered); 
  5. desired outcomes (i.e. the changes you expect to see in service recipients); and
  6. expected long-term impact on the organization, community, and/or system.

Examples: Please see the W.K. Kellogg Foundation Logic Model Development Guide and COA’s PQI Tool Kit for more information on developing and using program logic models.

Examples: Information that may be used to inform the development of the program model includes, but is not limited to: 
  1. needs assessments and periodic reassessments; 
  2. risks assessments conducted for specific interventions; 
  3. program and client outcomes data; and 
  4. the best available evidence of service effectiveness.
 

RC 1.02

The logic model identifies client outcomes in at least two of the following areas:
  1. change in clinical status;
  2. change in functional status;
  3. health, welfare, and safety;
  4. permanency of life situation; 
  5. quality of life; 
  6. achievement of individual service goals; and 
  7. 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 PQI 5.02 for more information on disaggregating data to track and monitor identified outcomes. 

 
Fundamental Practice

RC 1.03

Organization policy prohibits:
  1. corporal punishment;
  2. the use of aversive stimuli;
  3. interventions that involve withholding nutrition or hydration, or that inflict physical or psychological pain;
  4. the use of demeaning, shaming or degrading language or activities;
  5. unnecessarily punitive restrictions including cancellation of visits as a disciplinary action;
  6. forced physical exercise to eliminate behaviors;
  7. punitive work assignments;
  8. punishment by peers; and
  9. group punishment or discipline for individual behavior.
2023 Edition

Respite Care (RC) 2: Personnel

Respite care providers have the competency and support needed to provide temporary care services and meet the needs of individuals and families.
Interpretation: Competency can be demonstrated through education, training, or experience. Support can be provided through supervision or other learning activities to improve understanding or skill development in specific areas.

1
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.
2
Practices are basically sound but there is room for improvement, as noted in the ratings for the Practice Standards; e.g.,  
  • With some exceptions, staff (direct service providers, supervisors, and program managers) possess the required qualifications, including education, experience, training, skills, temperament, etc., but the integrity of the service is not compromised; or
  • Supervisors provide additional support and oversight, as needed, to the few staff without the listed qualifications; or 
  • Most staff who do not meet educational requirements are seeking to obtain them; or 
  • With few exceptions, staff have received required training, including applicable specialized training; or
  • Training curricula are not fully developed or lack depth; or
  • Training documentation is consistently maintained and kept up-to-date with some exceptions; or
  • A substantial number of supervisors meet the requirements of the standard, and the organization provides training and/or consultation to improve competencies when needed; or
  • With few exceptions, caseload sizes are consistently maintained as required by the standards or as required by internal policy when caseload has not been set by a standard; or
  • Workloads are such that staff can effectively accomplish their assigned tasks and provide quality services and are adjusted as necessary; or
  • Specialized services are obtained as required by the standards.
3
Practice requires significant improvement, as noted in the ratings for the Practice Standards.  Service quality or program functioning may be compromised; e.g.,
  • A significant number of staff (direct service providers, supervisors, and program managers) do not possess the required qualifications, including education, experience, training, skills, temperament, etc.; and as a result, the integrity of the service may be compromised; or
  • Job descriptions typically do not reflect the requirements of the standards, and/or hiring practices do not document efforts to hire staff with required qualifications when vacancies occur; or 
  • Supervisors do not typically provide additional support and oversight to staff without the listed qualifications; or
  • A significant number of staff have not received required training, including applicable specialized training; or
  • Training documentation is poorly maintained; or
  • A significant number of supervisors do not meet the requirements of the standard, and the organization makes little effort to provide training and/or consultation to improve competencies; or
  • There are numerous instances where caseload sizes exceed the standards' requirements or the requirements of internal policy when a caseload size is not set by the standard; or
  • Workloads are excessive, and the integrity of the service may be compromised; or 
  • Specialized staff are typically not retained as required and/or many do not possess the required qualifications; or
  • Specialized services are infrequently obtained as required by the standards.
4
Implementation of the standard is minimal or there is no evidence of implementation at all, as noted in the ratings for the Practice Standards.
Self-Study Evidence On-Site Evidence On-Site Activities
  • List of program personnel that includes:
    • Title
    • Name
    • Employee, volunteer, or independent contractor
    • Degree or other qualifications
    • Time in current position
  • See organizational chart submitted during application
  • Table of contents of training curricula
  • Procedures or other documentation relevant to continuity of care and case assignment
  • Procedures for health evaluations
  • Documentation tracking staff completion of required trainings and/or competencies
  • Sample job descriptions from across relevant job categories
  • Training curricula
  • Caseload size requirements set by policy, regulation, or contract, when applicable
  • Documentation of current caseload size per worker
  • Interviews may include:
    1. Program director
    2. Relevant personnel
  • Review personnel files
 

RC 2.01

Respite care providers are trained or demonstrate competency on the following, as appropriate to the services provided:
  1. assessing the need for additional services;
  2. identification of changes in functioning;
  3. identification of medical needs or problems;
  4. use of adaptive equipment, such as braces and wheelchairs;
  5. providing personal care, including lifting techniques; and
  6. determining if a crisis situation is imminent and intervene using appropriate resources.
 

RC 2.02

Supervisors are qualified by:
  1. an advanced degree in social work or a comparable human service field with one year of relevant experience; or
  2. a bachelor's degree in social work or a comparable human service field with two years of relevant experience.
 

RC 2.03

The organization minimizes the number of workers assigned to the client over the course of their contact with the organization by:
  1. assigning a worker at intake or early in the contact; and
  2. avoiding the arbitrary or indiscriminate reassignment of direct service personnel.
 
Fundamental Practice

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.

 
Fundamental Practice

RC 2.05

Personnel and respite care providers that provide personal care or basic health services receive a health evaluation prior to providing care to determine their ability to perform the essential functions of the job, with or without reasonable accommodation.
Interpretation: While a physical examination is preferred, personnel should receive a general health screening performed by a qualified medical practitioner, provided that the screening addresses communicable diseases.
NA The program is not designed to serve individuals with personal care or health services needs.
 

RC 2.06

Respite care providers sign a statement agreeing to refrain from the use of corporal punishment and degrading treatment, and receive training and support to promote positive behavior and implement appropriate discipline techniques.
 
Fundamental Practice

RC 2.07

Respite care providers are screened and approved prior to having contact with families to ensure they are able to provide the type of care needed, and screenings include:
  1. a criminal record and abuse registry check for all adults living in the provider’s home; and
  2. relevant caregiving experience.
Related Standards:
Interpretation: When a finding of child or adult abuse, neglect, or exploitation is indicated, guidelines should be used to determine the appropriateness of provider responsibilities.

Interpretation: Element (a) is only applicable if respite care is delivered in the provider's home.
 

RC 2.08

Employee workloads support the achievement of client outcomes and are regularly reviewed.

Examples: Examples of factors that may be considered when determining employee workloads include, but are not limited to:
  1. the qualifications, competencies, and experience of the worker, including the level of supervision needed;
  2. the work and time required to accomplish assigned tasks and job responsibilities; and
  3. service volume, accounting for assessed level of needs of persons served.
2023 Edition

Respite Care (RC) 3: Access to Services

Respite care is available to meet the needs of caregivers.

1
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.
2
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
  • For the most part, established timeframes are met; or
  • Proper documentation is 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.
3
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
  • Timeframes are often missed; or
  • Several client records are missing important information; or
  • Client participation is inconsistent. 
4
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.,
  • 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
No Self-Study Evidence
  • Outreach strategies and informational materials
  • Community resource and referral list
  • Interviews may include:
    1. Program director
    2. Relevant personnel
 

RC 3.01

Respite care providers assess the need for respite care in the community and collaborate with other organizations to promote available, affordable respite care.
 

RC 3.02

Outreach strategies connect caregivers with respite care before they become overwhelmed with care-giving responsibilities.
2023 Edition

Respite Care (RC) 4: Intake and Assessment

The organization’s intake and assessment practices ensure that persons served receive prompt and responsive access to appropriate services.

1
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.
2
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.
3
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. 
4
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
  • Screening and intake procedures
  • Assessment procedures
  • Copy of assessment tool(s)
No On-Site Evidence
  • Interviews may include:
    1. Program director
    2. Relevant personnel
    3. Persons served
  • Review case records
 

RC 4.01

Caregivers and providers are screened and informed about:
  1. how the caregiver’s request and the dependent person’s needs match the organization's services; and
  2. what services will be available and when.
NA Another organization is responsible for screening, as defined in a contract.
 
Fundamental Practice

RC 4.02

Prompt, responsive intake practices:
  1. ensure that applicants are treated equitably;
  2. address any concerns about using respite care;
  3. gather information necessary to identify critical service needs and/or determine when a more intensive service is necessary;
  4. give priority to individuals with urgent needs and emergency situations;
  5. support the timely initiation of services; and
  6. provide placement on a waiting list or referral to appropriate resources when individuals cannot be served or cannot be served promptly.
Interpretation: When a crisis respite program is at full capacity and cannot provide services to a family, the organization should assist the family in developing a plan to provide safe care for the child or adult and refer the family to another appropriate emergency service provider.
NA The organization accepts all clients.
 

RC 4.03

Persons served participate in an individualized, culturally, and linguistically responsive assessment that is:
  1. completed within established timeframes; 
  2. updated as needed based on the needs of persons served; and
  3. 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.

2023 Edition

Respite Care (RC) 5: Service Planning and Monitoring

Each caregiver participates in the development and ongoing review of a service plan that is the basis for delivery of appropriate services and support.

1
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.
2
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
  • For the most part, established timeframes are met; or
  • Proper documentation is the norm and any issues with individual staff members are being addressed through performance evaluations and training; or
  • In a few instances, client or staff signatures are missing and/or not dated; or
  • With few exceptions, staff work with persons served, when appropriate, to help them receive needed support, access services, mediate barriers, etc.; or
  • Active client participation occurs to a considerable extent.
3
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
  • Timeframes are often missed; or
  • In several instances, client or staff signatures are missing and/or not dated; or
  • Quarterly reviews are not being done consistently; or
  • Level of care for some clients is clearly inappropriate; or
  • Service planning is often done without full client participation; or
  • Appropriate family involvement is not documented; or  
  • Documentation is routinely incomplete and/or missing; or
  • Individual staff members work with persons served, when appropriate, to help them receive needed support, access services, mediate barriers, etc., but this is the exception.
4
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.,
  • 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
  • Service planning and monitoring procedures
No On-Site Evidence
  • Interviews may include:
    1. Program director
    2. Relevant personnel
    3. Persons served
  • Review case records
 

RC 5.01

An assessment-based service plan is developed in a timely manner with the full participation of persons served, and their family when appropriate, and includes:
  1. agreed upon goals, desired outcomes, and timeframes for achieving them;
  2. services and supports to be provided, and by whom; 
  3. possibilities for maintaining and strengthening family relationships and other informal social networks; 
  4. procedures for expedited service planning when crisis or urgent need is identified; 
  5. guidelines for requesting additional planned or emergency respite care;
  6. fees and payment arrangements, when applicable; and
  7. the individual’s signature.
 

RC 5.02

The organization works in active partnership with persons served to:
  1. assume a service coordination role, as appropriate, when the need has been identified and no other organization has assumed that responsibility;
  2. ensure that they receive appropriate advocacy support;
  3. assist with access to the full array of services to which they are eligible; and
  4. mediate barriers to services within the service delivery system, including transportation or fees.

Example: Examples of services referenced in (b) and (c) may include, but are not limited to:
  1. support groups and counseling services;
  2. health, mental health, and substance use services;
  3. domestic violence services;
  4. shelter and housing services;
  5. social, recreational, and day programs; and
  6. mentor services.
 

RC 5.03

The worker and a supervisor, or a clinical, service, or peer team, review the case to assess:
  1. service plan implementation;
  2. progress toward achieving goals and desired outcomes; and
  3. the continuing appropriateness of the agreed upon goals.
Interpretation: Experienced workers may conduct reviews of their own cases. In such cases, the worker's supervisor reviews a sample of the worker's evaluations as per the requirements of the standard.
 

RC 5.04

The worker and individual, and his or her family when appropriate:
  1. review progress toward achievement of agreed upon service goals; and 
  2. sign revisions to service goals and plans.
2023 Edition

Respite Care (RC) 6: Care and Supervision

Care recipients receive individualized care and supervision that promote their safety and well-being.

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VIEW THE STANDARDS

1
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.
2
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
  • For the most part, established timeframes are met; or
  • Proper documentation is 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.
3
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
  • Timeframes are often missed; or
  • Several client records are missing important information; or
  • Client participation is inconsistent. 
4
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.,
  • 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
  • Procedures for matching care recipients with respite care providers
  • Health and safety procedures
  • Client/staff ratio
  • Most recent safety/risk data, if available
  • Monthly client/staff ratios and coverage schedules for the previous six months, as applicable
  • Interviews may include:
    1. Program director
    2. Relevant personnel
    3. Persons served
  • Review case records
  • Review coverage schedules at each unit or group
 
Fundamental Practice

RC 6.01

Families are matched with respite care providers that can meet their needs or receive information to enable them to select a suitable respite provider.
Interpretation: Care recipients that require therapeutic or medical treatment should be matched with a provider that has appropriate skills and qualifications.
 
Fundamental Practice

RC 6.02

Respite care providers:

  1. are familiar with the care recipient’s daily routine, preferred foods and activities, and needed therapeutic or medical care; 
  2. respect the culture, race, ethnicity, language, religion, gender identity, and sexual orientation of the care recipient; and
  3. offer activities with content appropriate to the interests, age, development, physical abilities, interpersonal characteristics, and special needs of the care recipient.
Interpretation: When the care recipient is involved in regular therapeutic, educational, or employment activities, the respite provider should work with caregivers to plan for continued participation.
 
Fundamental Practice

RC 6.03

Crisis respite care provides needed developmentally and age appropriate interventions to help the care recipient cope with trauma or stress associated with the crisis.
NA The organization does not provide crisis respite care.
 
Fundamental Practice

RC 6.04

The program provides close supervision of care recipients to ensure safety and service quality, and provider-care recipient ratios do not exceed:
  1. one to four when children are under school age;
  2. one to eight during waking hours; and
  3. one to twelve during sleeping hours.
Interpretation: Ratios should be adjusted to meet the special needs of individuals that require therapeutic or medical care, or close monitoring, and include all other children or adults being cared for in the home or facility. Ratios should demonstrate capacity for safe evacuation of care recipients in case of an emergency.
 
Fundamental Practice

RC 6.05

When care recipients experience accidents, health problems, or changes in appearance or behavior, information is promptly recorded and reported to caregivers and administration, and follow-up occurs, as needed.
 
Fundamental Practice

RC 6.06

Respite care providers return care recipients only to the caregiver, or another person approved by the caregiver.
 
Fundamental Practice

RC 6.07

Procedures indicate how to respond by using appropriate organizational or community resources when a caregiver poses a safety risk or an individual requires protection.

Examples: Situations can include for example when individuals are intoxicated by drugs or alcohol, mentally or physically unstable, or who present a safety concern.
2023 Edition

Respite Care (RC) 7: Service Environment

Respite care is provided in an environment that ensures the individual’s health and safety.

Note: Please see the Facility Observation Checklist for additional guidance on this standard.

1
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.
2
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
  • For the most part, established timeframes are met; or
  • Proper documentation is 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.
3
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
  • Timeframes are often missed; or
  • Several client records are missing important information; or
  • Client participation is inconsistent. 
4
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.,
  • 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
  • Procedures for reviewing and approving respite homes
  • Procedures regarding care recipients' rights to make telephone calls
  • Documentation of licensing/approval
  • Sample of safety plans, if applicable
  • Interviews may include:
    1. Program director
    2. Relevant personnel
    3. Respite providers
    4. Care recipients
  • Review case records
  • Observe facility
 

RC 7.01

The family receives respite care in a location appropriate to their needs and preferences.

Examples: Respite care can be provided in the family’s home, the provider’s home, the community, or a facility.
 
Fundamental Practice

RC 7.02

Prior to use, all facilities and provider homes are licensed or approved as required by law or regulation, and regularly inspected to evaluate:
  1. fire, health, and safety hazards;
  2. cleanliness;
  3. adequacy and appropriateness of space and furnishings; and
  4. the safety and appropriateness of toys, materials, or equipment.
 

RC 7.03

When overnight care is provided, accommodations include:
  1. sleeping arrangements appropriate to the number, age, special needs, and gender of the individuals in the home or facility;
  2. adequately and attractively furnished rooms with a separate bed for each resident, including a clean, comfortable, covered mattress, pillow, sufficient linens, and blankets; 
  3. 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; 
  4. a non-stacking crib for each infant and toddler that is 24 months or younger that meets safety guidelines, as applicable; and
  5. a safe place, such as a locker, to keep personal belongings and valuables.
NA The organization does not provide overnight respite care.

Examples: The Consumer Product Safety Commission (CPSC) provides standards to ensure safety for full-size and non-full size cribs. The American Academy of Pediatrics recommends that cribs are used by children under 90 centimeters (35 inches) tall.
 

RC 7.04

When respite care is provided in a facility, space and amenities are adequate for the scope of the service provided, and include:
  1. indoor and outdoor recreation areas;
  2. dining, bathing, toileting, and personal hygiene facilities;
  3. private areas for meetings with individuals and caregivers;
  4. space for resting; and
  5. rooms for providing on-site services, when available.
NA The organization does not provide respite care in a facility.
 
Fundamental Practice

RC 7.05

When respite care is provided in the caregiver’s home, the provider is familiar with the safety plan for the home.
Interpretation: The provider should be familiar with the location of first aid, medical, emergency, and other supplies needed to provide care, and the ways to safely evacuate the individual receiving care.
NA The organization does not provide respite care in the caregiver’s home.
 

RC 7.06

Care recipients can have private telephone conversations and any restrictions are:
  1. requested by the caregiver;
  2. approved in advance by the program director or an appropriate designee; and
  3. documented in the case record.
NA The organization only provides care for infants and young children.
 

RC 7.07

Care recipients receiving overnight respite care have sufficient uninterrupted sleep and, when practical, follow their usual and familiar routines for bedtime, bathing, and meals.
NA The organization does not provide overnight respite care.
2023 Edition

Respite Care (RC) 8: Short Term Residential Respite and Crisis Nursery Services

Facilities and services are designed to meet the needs of care recipients that require a short term stay in a residential respite or crisis nursery program.
NA The organization does not provide residential respite or crisis nursery services.

Note: Please see the Facility Observation Checklist for additional guidance on this standard.

1
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.
2
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
  • For the most part, established timeframes are met; or
  • Proper documentation is 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.
3
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
  • Timeframes are often missed; or
  • Several client records are missing important information; or
  • Client participation is inconsistent. 
4
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.,
  • 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
  • Rules and behavioral expectations
  • Schedule of social and recreational activities
  • Interviews may include:
    1. Program director
    2. Relevant personnel
    3. Care recipients
  • Review case records
  • Observe facility
 

RC 8.01

Program personnel provide care recipients with predictability and structure by establishing daily routines and rules developed with care recipients and their caregivers.
 

RC 8.02

Care recipients are offered an organized daily program of age and developmentally appropriate social, recreational, educational, and therapeutic activities.
Interpretation: The organization and the caregiver should plan for continuation of educational services for children and youth, and the organization should coordinate educational services with relevant school districts.
 

RC 8.03

Facilities include:
  1. sufficient supplies and equipment to meet the needs of care recipients;
  2. space and equipment for housekeeping, laundry, maintenance, and storage;
  3. rooms for providing on-site services, as applicable;
  4. at least one room suitably furnished for the use of on-duty personnel and space for administrative support functions; and
  5. private sleeping accommodations for personnel who sleep at the facility, if applicable.
 

RC 8.04

The facility accommodates informal gatherings of care recipients, including places to gather in inclement weather.
2023 Edition

Respite Care (RC) 9: Case Closing

The organization works with care givers and family members, when appropriate, to plan for case closing and, when possible, to develop aftercare plans.

1
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.
2
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
  • Proper documentation is the norm and any issues with individual staff members are being addressed through performance evaluations and training; or
  • In a few instances, the organization terminated services inappropriately; or  
  • Active client participation occurs to a considerable extent; or
  • A formal case closing evaluation is not consistently provided to the public authority per the requirements of the standard.
3
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
  • Services are frequently terminated inappropriately; or  
  • Aftercare planning is not initiated early enough to ensure orderly transitions; or
  • A formal case closing summary and assessment is seldom provided to the public authority per the requirements of the standard; or  
  • Several client records are missing important information; or
  • Client participation is inconsistent. 
4
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.,
  • 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
  • Case closing procedures
No On-Site Evidence
  • Interviews may include:
    1. Program director
    2. Relevant personnel
    3. Caregivers
  • Review case records
 

RC 9.01

Planning for case closing:
  1. is a clearly defined process that includes assignment of staff responsibility;
  2. begins at intake; and
  3. involves the worker, the caregiver, and others, as appropriate to the needs and wishes of the caregiver.
 

RC 9.02

Upon case closing, the organization notifies any collaborating service providers, as appropriate.
 

RC 9.03

If an individual has to leave the program unexpectedly, the organization makes every effort to identify other service options and link the person with appropriate services.
Interpretation: The organization must determine on a case-by-case basis its responsibility to continue providing services to caregivers whose third-party benefits have ended and who are in critical situations.
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