Granite Bay Care – Newsletter

NEWSLETTER ARTICLES

Bridging the Gap
After Hours Monitoring
Exercise, Not Just for Heart
Introducing the CASAS
Good Food is...
Dementia and DD
Breathing Life into CDS

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A CARE-Giver's Newsletter

March 2011
Vol 1, Issue 2

"Bridging the Gap": A Management Training Program
It is common for an employee aspiring to a leadership position to be recognized at long last with a much anticipated promotion, only to find the mantle of responsibility offered without benefit of any formal management training. This can be especially true of professions beset with high employee turnover. In human services, a person can find themselves promoted up the job latter by virtue of tenacity, either by being next in line or just the last one standing, whichever occurs first. Often, this slight is a matter of happenstance and not the result of any grand corporate design to deprive this new manager of the tools needed to shoulder the demands of leadership. To counter this tendency, Granite Bay Care (CARE) has instituted a management in-service training program entitled “Bridging the Gap between Knowing and Doing”. As the cornerstone of the Agency’s continuous professional development program, “Bridging the Gap” is offered on a monthly basis and is required training for all members of the CARE management team. Launched on Wednesday January 26th, the initial presentation: “Developing Effective Teamwork through Role Clarity” provided a forum for defining the newly adopted House Manager (HM) role. Continued during a three-day session from Tuesday February 22nd to Thursday February 24th, “When the Job makes the Person and the Person makes the Job" was devised as an opportunity to review final job description drafts compiled from feedback derived from the previous training session (final job descriptions will be reviewed with all operations staff during the next few weeks and can be found on the Employment section of our web site. At the conclusion of this two part training, the next installment: “Planting the Seeds of DSP Achievement and Reaping the Bounty of Teamwork” was announced for March, from Tuesday the 22nd to Thursday the 23rd. As alluded to by the title, this training was specifically developed to introduce new managers to the range of available staff development resources. Through vignettes and role-plays, the training aims to instill a working knowledge of these various supervision tools. In addition to this upcoming training, some future training subjects and corresponding titles have been already scheduled: Reportable Events: “Using Crisis as an Opportunity for Positive Change”- April 19th to 21st Person-Centered Planning: “Working around Nightmares as We Reach for Dreams”- May 17th to 19th Cultural Competency: “Instilling Appreciation of Diversity in Life/Work-Place”- June 21st to 23rd Risk Appraisal: “Preparing for the Risks/Rights associated with Community Inclusion”- July 19th to 21st This is by no means an exhaustive list of training possibilities. Should you have a subject you believe could benefit the Management team, please submit your suggestion by clicking here.
~Gregory Robinson, Chief Operating Officer

	“After-Hours” Monitoring has Come A-Knocking
This past December (2010), Granite Bay Care (CARE) began a more formal initiative to provide “after-hours” monitoring of program homes across each of the three (3) supported regional catchment areas, North-to-South, from South Berwick to Hampden and East-to-West, Brunswick to Norway. While there were varied reasons for implementing the after-hours program, these ultimately boiled down to our recognition of the disparity of supports provided by administration to weekend direct support professional (DSP) staff teams. Just as CARE provides services beyond traditional, 9AM to 5PM, Monday through Friday, business hours, the administrative team needed to ensure those DSP working outside this narrow timeframe received ongoing supervision. Of course, acknowledging this need and resolving it would require more than lip service and good intentions. After much deliberation, CARE Program Managers (PM) and Area Directors (AD) developed an after-hours rotation thereby guaranteeing the quarterly coverage of all CARE programs by administrators. To ensure a consistent approach to these visits, CARE put together an outline comprised of the kind of competencies observed within those DSP interacting with administration during regular business hours, specifically: (a) professional presentation, (b) capacity of staff to explain efforts to promote active treatment, (c) ability of staff to explain team approved behavioral interventions to be used as necessary, (d) expressed understanding of current CARE policy/protocol concerns, (e) general observations about the look and feel of the home, and (f) any recommendations to the House Manager (HM) and PM overseeing the home. The Agency realizes how unlikely it is to expect a DSP team with only a superficial attachment to administration to report questions and concerns as these arise. If the current emergency “on-call” system is designed to report incidents and deviations from program norms, the Agency must build in opportunities to recognize those staff working off business hours for more than the sum of the negatives. Conducted randomly, unannounced after-hours visits are designed to “catch staff doing things right” and are intended to build confidence and competence within a DSP team relatively unaccustomed to scrutiny CARE. Because any change will undoubtedly feel strange at first, management will take care to approach the interview/inspection process as a means to validate rather than correct, to up-build rather than discipline, and to promote inter-connectedness and intra-Agency communication. We want both parties, on either side of the door, to experience the sound of a knock with positive anticipation and not apprehension. Beyond its stated quality assurance application, the Agency appreciates the potential after-hours monitoring presents as a means of promoting transparency and instilling confidence. Therefore, while the results of interviews/inspections will be reviewed with appropriate HM/PMs as a means of identifying targeted training needs, these may also be shared with guardians and Individual Support Coordinators (ISC). When the after-hours manager completes their review of the program and faxes this record to the State Director (SD), the SD can in turn forward this original (eFax) to the guardian and ISC for further review and comment. This feedback loop offers the opportunity for all involved, DSP, HM, PM, ISC, and Guardian, to work together as a more unified circle-of-support. With this ultimate goal in mind, the CARE management team hopes that this process will be helpful to all front line staff, weekday, weeknight, and weekend alike. During the past few weeks after its initial launch, Managers have found this process both helpful and rewarding. Because it is always a joy to be able to interact with individuals in our care and their staff team as they go about their day, Managers have found the opportunity to teach and encourage “in the moment”. Just as we identified areas requiring some improvement, we have also witnessed some excellent work diligently carried out by CARE employees. It is our hope, as the weeks and months progress, that this will be recognized as a richly rewarding experience for all involved, with the fruits of this labor more consistent realized for all to see.
~Elizabeth Sullivan, Area Director - Portland Office

Exercise, it’s not just for your heart!
Anyone who’s been to the doctor or seen the news recently has heard about the health benefits of exercise. But, did you know it’s also good for your brain? Exercise helps people improve their mood by releasing hormones in the brain. Regular exercise can help combat depression, anxiety, and stress related mental health problems. Many therapists won’t treat people who are depressed unless they are also exercising regularly. After twenty-five (25) minutes of vigorous exercise (the kind where you actually sweat) people’s moods improve. Exercise increases your body temperature which is very calming for many people. Surprisingly, exercise also increases your energy level because it delivers nutrients and oxygen to your muscles. When you have more energy, your desire to get off the sofa and do more fun things increases. This, in turn, can increase your ability and interest to be engaged in your community. People who are active and involved in their world are known to be more satisfied and happy. Lastly, exercise can also improve your sleep. With a good night’s sleep you can; improve your concentration, experience better moods, and increase your productivity. Though it’s best not to exercise right before bed, or you may find it difficult to fall asleep as your muscles also need time to relax. Getting a good night sleep is always important. When you don’t get a good night sleep you may find yourself more irritable and unable to focus very well, yet may not even realize it. Exercising thirty (30) minutes a day, three (3) to five (5) times a week can make a significant difference in improving your mood and coping with stress. But adding as little as ten (10) to fifteen (15) minutes can start you on the path to improved mental health. Exercising with a buddy also has several added bonuses. Your friend can motivate you when you don’t want to go. Additionally, the social connection and support helps reduce depression, anxiety, and can improve life satisfaction. So, get a friend, and go work out!
~Dr. Elise Magnuson, Clinical Psychologist and Clinical Director

Introducing the CASAS to the CARE Hire Process

Granite Bay Care (CARE) is committed to employing the most qualified job candidates and has a proven history of actively recruiting generational Mainers and resettled immigrants. This commitment to cultural and life diversity is not without its challenges. The recent changes in the training program from a classroom model based on the Direct Support Professional (DSP) curriculum to a hybrid model constructed around the College of Direct Support (CDS) online training program shifted the training emphasis from a whole language to largely visual learning approach. While arguably more consistent in application, the CDS model requires employees to meet higher reading comprehension standards.

To ensure CARE hires only those job candidates likely to meet the demands of the CDS training program, the Agency has implemented use of the Comprehensive Adult Student Assessment Systems (CASAS) as a pre-employment screening tool. An educational tool measuring a range of skills from beginning literacy to postsecondary education, the CASAS serves learners who function at or below a high school level. It includes a dynamic suite of assessment tools to better serve all learner levels. CASAS enables organizations like CARE to implement a standardized assessment system for collecting, processing, analyzing and reporting the data necessary to determine whether a prospective employee is likely to be a successful trainee. As the only adult assessment system of its kind approved and validated by the U.S Department of Education and the U.S Department of Labor for both native and non-native speakers of English, the CASAS is implemented in programs throughout the United States, in both public and private sectors. Developed to measure key competencies, the CASAS frames the testing environment within a “real world context”. Content standards provide options to measure priority skill areas in reading, math, listening, speaking, writing, critical thinking, and problem solving in life and workplace settings. The competencies identify more than 300 essential skills needed to be a successful member of the workforce. CASAS content standards provider clear benchmarks of what learners should know and be able to do. Documentation of goal achievement is intended to fulfill not just learner and employee requirements, but also federal, state, and local reporting obligations. As CARE implements the CASAS test/appraisal to his potential employees, the Agency will collect information on candidate ability to apply basic listening and reading skills in a functional context similar to the demands exerted by the CDS training program, and by extension, the rigors of providing and documenting Medicaid (MaineCare) reimbursable services in relatively autonomous settings. Often isolated from immediate supports, the DSP must necessarily become a resource to one’s self, learning to lean on an accurate understanding professional training to make sound decisions. To learn more about CASAS, go to www.casas.org
~E'nkul Kanakan, Continuous Quality Improvement Director

Good Food Is…

March is celebrated as National Nutrition Month. Because Granite Bay Care (CARE) is providing grocery shopping cards to either Hannaford or Shaw’s stores, we’d like to provide some timely shopping advice:

Ten (10) Grocery Shopping Tips designed to save time and money at the store:

Don’t shop when you are hungry. You are more likely to impulse shop and get less healthy items.
Make a shopping list and stick to it. Keep a running list and consider posting it on the fridge with a magnet and add to it during the week as necessary.
Organize your list. Get to know your grocery store’s layout and avoid areas with dietary traps (for example, the frozen ice cream area or the bakery area). If you are looking for healthy treats, know where the “skinny” Weight Watcher’s products are and only look there (as tough as it may be to exert self-control, TRY!).
Check for supermarket specials. If a grocery store has a flyer, use it to see what’s on sale and adjust your menu when possible. Also stock up on commonly used non-perishable items if they are on sale (for example, if hamburger is on sale, buy in bulk, separate it into smaller amounts, and freeze some for the following week).
Buy frozen fruits and vegetables. Take out what you need and keep the rest frozen.
Choose loose produce and examine it for freshness. Don’t purchase anything bruised and buy in small amounts, only what you know you will use over a few days (some things keep longer than others).
With respect to dairy products, check sell by/use by dates. Only purchase items cold to the touch. When selecting eggs, take care not to choose any that are cracked or broken.
For meat, poultry, and fish, also be sure to examine sell by dates and do not purchase cuts gray in appearance. If the packaging is broken, do not buy it. When checking out, have the person bagging the food items, pack meat, poultry, and fish separately from the other items.
When returning to the home, promptly unpack and refrigerate or freeze all fresh items as soon as possible. Do not leave items sitting out or in a vehicle.
Arrange food items in a logical fashion finding a place for everything and putting everything in its place. Keeping a well ordered kitchen/pantry/refrigerator will help you to identify low quantities of important food staples, such as bottled water.

Seven (7) Healthy Eating Tips designed to help mealtime be more satisfying:

Eat three (3) meals a day.
Do not skip breakfast.
Change from a larger plate to a smaller one to control portions.
At lunch or dinner, half the plate should be filled with vegetables, one quarter with lean meat, fish or poultry (protein) and the remaining quarter with grains.
Focus on the food. Slow down your eating and avoid eating in front of the TV.
Stop eating BEFORE you feel full. It takes approximately 20 minutes for your brain to get the message that your stomach has gotten fed.
Switch to low fat milk and whole grain products. Increasing your fiber intake with fruits, vegetables and beans will help you to feel full longer and also reduce your risk of developing diabetes and heart disease.

For more great information and a personalized eating plan, go to My Pyramid.

One (1) Healthy Recipe to get March started off right..

Beef & Bean Chile Verde - Recipe from © EatingWell.com

Chile Verde, usually a slow-cooked stew of pork, jalapeños and tomatillos, becomes an easy weeknight meal with quick-cooking ground beef and store-bought green salsa. Make it a Meal: Serve with fresh cilantro, red onion and Monterey Jack. Add your favorite hot sauce.

4 servings, about 1 1/2 cups each | Active Time: 20 minutes | Total Time: 30 minutes

Ingredients

One pound 93%-lean ground beef
One large red bell pepper, chopped
One large onion, chopped
Six cloves garlic, chopped
One tablespoon chili powder
Two teaspoons ground cumin
1/4 teaspoon cayenne pepper, or to taste
One 16-ounce jar green salsa, green enchilada sauce or taco sauce
1/4 cup water
One 15-ounce can pinto or kidney beans, rinsed

Preparation

Cook beef, bell pepper and onion in a large saucepan over medium heat, crumbling the meat with a wooden spoon, until the meat is browned, eight (8) to ten (10) minutes.
Add garlic, chili powder, cumin and cayenne; cook until fragrant, about fifteen (15) seconds.
Stir in salsa (or sauce) and water; bring to a simmer.
Reduce heat to medium-low, cover and cook, stirring occasionally, until the vegetables are tender, ten (10) to fifteen (15) minutes.
Stir in beans and cook until heated through, about one (1) minute.

Nutrition (per serving):

307 Calories
8 grams of Fat
3 grams of Saturated Fat
64 milligrams of Cholesterol
29 grams of Carbohydrates
27 grams of Protein
6 grams of Fiber
516 milligrams of Sodium
641 milligrams of Potassium

Tips & Notes

Make ahead, cover, and refrigerate for up to three (3) days, or freeze for up to 2 months.
Reheat just before serving.

~Claudia Stanley, Registered Nurse and Nursing Director

	When Dementia impacts Intellectual Disabilities- the “Nursing Aspect Group” Claudia Stanley, Granite Bay Care (CARE)’s Director of Nursing, has been invited to participate in a national task force group to develop best practice standards and tools for use with Intellectual and Developmental Disability populations confronting the challenge of Dementia.
This National Task Force “Nursing Aspect Group” is sponsored by the AADMD (American Academy of Developmental Medicine and Dentistry) which is a sister group of the national DDNA (Developmental Disabilities Nurses Association). Claudia, and the other nurses in the Nursing Aspect Group, will be advising and participating with the three other work groups that make up the task force, the Screening Group, the Health Care Group, and the Community Supports Group. The overall goal of the National Task Force is to review and update the technological and clinical practices used by agencies in delivering supports and services to adults with Intellectual Disabilities affected by dementia. The Task Group will use the existing AAIDD (American Association on Intellectual and Developmental Disabilities) practice guidelines on care management of dementia among people with intellectual disabilities (ID) to develop an update recommending: (1) a workable screening instrument to help distinguish dementia-related decline from changes attributable to benign aging, (2) a new set of practice guidelines for post-determination treatment, and (3) models of community-based support and long term palliative care of persons with ID affected by dementia. CARE is honored by Claudia’s presence on this tasks force. As a stalwart advocate for the health concerns of persons with ID, the Agency has long recognized the value of insights and ongoing contributions to improving the life conditions of those individuals receiving person-centered supports from CARE. As the life prospects for individuals with ID continues to grow, along with the lifespan of the general population, dementia, in all of its forms, presents unique and added complexities to persons already challenged by cognitive limitations. As an Agency, we consider it a privilege to support Claudia in this most important pursuit.
~Ken Olson, State Director

Breathing “Life” into the College of Direct Support
The Granite Bay Care (CARE) Training Department is excited to announce a new electronic registration procedure, making the entire process of signing up for training more efficient, allowing staff to be trained in a timelier manner. Special thanks are extended to CARE Management who provided assistance in getting this new initiative off the ground. For those not already acquainted with this change, please contact the training department for instructions how to access and complete this auto-fill registration form. Paper copies will also be made available through CARE Area Office Managers and at program locations. The CARE Training Department will continue to look for more ways to bring technology into training operations, and will be working hard to develop strategies to empower the employee with the objective to make training feel like a more like an opportunity for professional enrichment, and less like a burden. Working in close collaboration with the CARE IT department, future innovations will continue to put creative learning in the forefront as staff focus on their journey toward fulfilling Agency training obligations. This will include a two-day Direct Support Professional (DSP) annual re-certification program developed in conjunction with the Behavioral Health Sciences Institute . Of course, every journey begins with the first step. After countless hours of research and practical experience with the College of Direct Support curriculum, a “DSP/CDS Live” classroom counterpart to the online CDS coursework is under development. Intended to supplement the topics covered in the online format, “Live” sessions have been devised to bring the CDS to life. The Live training includes two additional modules, Documentation and Communication, not currently covered in the CDS online course, but considered mandatory subjects for review by the State. Ultimately, the goal is to roll out this Live training mid-March, as a two-day training session offered Monday/Tuesday on the second week of employment for new hires, or, for practical purposes, on an every other week basis. Staff would do well to remember the mandatory nature of the CARE training program, in compliance with DHHS and MAINE CARE regulations. Accordingly, both the Online and Live components of the DSP/CDS training program are required to maintain continued employment with CARE. For this reason, to avoid confusion arising from questions whether particular staff have satisfied all training requirements, all CDS certificates will be administered by the Training Department CARE appreciates the continued hard work and dedication by Agency employees as evidence of a commitment to training and ongoing professional development.
~David Kinsella, Training Director