Purpose
Respite Care reduces caregiver stress, promotes the well-being and safety of care recipients, and contributes to stable families.
INTRODUCTION
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 (PA-RC), in-home care and support services (PA-HCS), medical or social day programs (PA-AD), foster care (PA-GLS), and residential respite services (PA-RC).
Note: Please see PA-RC Reference List for a list of resources that informed the development of these standards.
Note: When an organization is completing the Family Foster Care and Kinship Care Services Standards (FKC) their respite program is covered under FKC 18: 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.
Table of Evidence
Self-Study Evidence
- Provide an overview of the different programs being accredited under this section. The overview should describe: a. the program's service philosophy and approach to delivering
services;
Respite Care
Purpose
Respite Care reduces caregiver stress, promotes the well-being and safety of care recipients, and contributes to stable families.
b. eligibility criteria; c. any unique or special services provided to specific populations;
and d. major funding streams.
- If elements of the service (e.g., assessments) are provided by contract with outside programs or through participation in a formal, coordinated service delivery system, provide a list that identifies the providers and the service components for which they are responsible. Do not include services provided by referral.
- Provide any other information you would like the peer review team to know about these programs.
- A demographic profile of persons and families served by the programs being reviewed under this service section with percentages representing the following: a. racial and ethnic characteristics; b. gender/gender identity; c. age; d. major religious groups; and e. major language groups
- As applicable, a list of groups or classes including, for each group or class: a. the type of activity/group; b. whether the activity/group is short-term or ongoing; c. how often the activity/group is offered; d. the average number of participants per session of the
activity/group, in the last month; and e. the total number of participants in the activity/group, in the last
month - A list of any programs that were opened, merged with other
programs or services, or closed - A list or description of program outcomes and outputs being
measured
Respite Care
Purpose
Respite Care reduces caregiver stress, promotes the well-being and safety of care recipients, and contributes to stable families.
PA-RC 1: Access to Services
Respite care is available to meet the needs of caregivers.
Rating Indicators
1) Full Implementation, Outstanding Performance
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. 
2) Substantial Implementation, Good 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.  
3) 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.
4) Unsatisfactory Implementation or Performance
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.  Please see Rating Guidance for additional rating examples. 
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Respite Care
Purpose
Respite Care reduces caregiver stress, promotes the well-being and safety of care recipients, and contributes to stable families.
Table of Evidence
On-Site Activities
PA-RC 1.01
Respite providers assess the need for respite care in the community and collaborate with other agencies to promote available, affordable respite care.
Research Note: Research on respite care for children shows that most families access respite care through referral from a social service or medical provider.
PA-RC 1.02
Outreach strategies connect caregivers with respite care before they become overwhelmed with care-giving responsibilities.
Research Note:Studies on respite care for adults repeatedly show that respite care is underutilized. One study found that 5% of caregivers surveyed used respite care. Another study found that caregivers of adults often wait until caregiving becomes overwhelming before accessing services, and researchers caution that this may limit the ability to keep the adult in the home.
Research Note: Literature suggests that a lack of trust in the agency or the provider and limitations on the location of respite care can be barriers for some families.
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Respite Care
Purpose
Respite Care reduces caregiver stress, promotes the well-being and safety of care recipients, and contributes to stable families.
PA-RC 2: Screening and Intake
The agency's screening and intake practices ensure that individuals receive prompt and responsive access to appropriate services.
Rating Indicators
1) Full Implementation, Outstanding Performance
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. 
2) Substantial Implementation, Good 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.  
3) 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.
4) Unsatisfactory Implementation or Performance
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.  Please see Rating Guidance for additional rating examples. 
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Respite Care
Purpose
Respite Care reduces caregiver stress, promotes the well-being and safety of care recipients, and contributes to stable families.
Table of Evidence
On-Site Activities
- Interview: a. Program director b. Relevant personnel c. Respite providers d. Caregivers
- Review case records
(FP) PA-RC 2.01
Caregivers and providers discuss:
a. how the caregiver's request and the dependent person's needs match the agency's services;
b. what services will be available and when; and c. concerns about using respite care.
NA Another agency is responsible for screening, as defined in a contract.
(FP) PA-RC 2.02
Prompt, responsive intake practices:
a. ensure that applicants are treated equitably; b. give priority to individuals with urgent needs and emergency situations; c. support the timely initiation of services; and d. provide for initial screening or placement on a waiting list, if applicable.
Interpretation: Crisis respite programs have protocols in place for prioritizing referrals.
PA-RC 2.03
Caregivers who cannot be served, or cannot be served promptly, are
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Respite Care
Purpose
Respite Care reduces caregiver stress, promotes the well-being and safety of care recipients, and contributes to stable families.
referred or connected to appropriate resources.
Interpretation: When a crisis respite program is at full capacity and cannot provide services to a family, the agency assists the family in developing a plan to provide safe care for the child or adult and refers the family to another appropriate emergency service provider.
NA The agency accepts all clients.
PA-RC 2.04
During intake, the agency gathers information to identify critical service needs and/or determine when a more intensive service is necessary, including:
a. personal and identifying information; b. emergency health needs; and c. safety concerns, including imminent danger or risk of future harm.
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Respite Care
Purpose
Respite Care reduces caregiver stress, promotes the well-being and safety of care recipients, and contributes to stable families.
PA-RC 3: Assessment
Caregivers participate in an individualized, strengths-based, culturally responsive assessment.
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.
Rating Indicators
1) Full Implementation, Outstanding Performance
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. 
2) Substantial Implementation, Good 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.  
3) 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.
4) Unsatisfactory Implementation or Performance
A rating of (4) indicates that implementation of the standard is minimal or there is no evidence of implementation at all.  
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Respite Care
Purpose
Respite Care reduces caregiver stress, promotes the well-being and safety of care recipients, and contributes to stable families.
- The agency’s observed service delivery infrastructure and practices are weak or non-existent; or show signs of neglect, stagnation, or deterioration.  Please see Rating Guidance for additional rating examples. 
Table of Evidence
On-Site Evidence
- Review case records
PA-RC 3.01
The information gathered for assessments is directed at concerns identified in initial screenings and limited to material pertinent for meeting service requests and objectives.
PA-RC 3.02
Assessments are conducted in a culturally responsive manner to identify resources that can increase service participation and support the achievement of agreed upon goals.
Interpretation: Culturally responsive assessments can include attention to geographic location, language of choice, and the person's religious, racial, ethnic, and cultural background. Other important factors that contribute to a responsive assessment include attention to age, sexual orientation, and developmental level.
PA-RC 3.03
Respite Care
Purpose
Respite Care reduces caregiver stress, promotes the well-being and safety of care recipients, and contributes to stable families.
Each caregiver participates in the development and ongoing review of a service plan that is the basis for delivery of appropriate services and support.
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Respite Care
Purpose
Respite Care reduces caregiver stress, promotes the well-being and safety of care recipients, and contributes to stable families.
PA-RC 4: 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.
Rating Indicators
1) Full Implementation, Outstanding Performance
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. 
2) Substantial Implementation, Good 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.  
3) 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.
4) Unsatisfactory Implementation or Performance
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.  Please see Rating Guidance for additional rating examples. 
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Respite Care
Purpose
Respite Care reduces caregiver stress, promotes the well-being and safety of care recipients, and contributes to stable families.
Table of Evidence
On-Site Evidence
- Review case records
Caregivers are engaged in a strengths-based planning process for identifying needed services and desired results.
PA-RC 4.02
During service planning the agency explains:
a. available options; b. the benefits and alternatives of planned services; and c. how the agency can support the achievement of desired outcomes.
PA-RC 4.03
An expedited service-planning process is available when crisis or urgent need has been identified, and service plans are completed within time frames established by the agency.
PA-RC 4.04
The service plan is developed with the caregiver prior to the provision of care, and includes:
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Respite Care
Purpose
Respite Care reduces caregiver stress, promotes the well-being and safety of care recipients, and contributes to stable families.
a. a description of services to be provided; b. service goals, desired outcomes, and timeframes for achieving them; c. guidelines for requesting additional planned or emergency respite care; d. fees and payment arrangements, when applicable; and e. the caregiver's signature on the initial plan and significant revisions to
the plan.
Research Note: Research suggests that respite care for caregivers of adults is more effective when used regularly and frequently.
PA-RC 4.05
The service plan addresses, as appropriate:
a. the family's unmet service and support needs; b. possibilities for maintaining and strengthening family relationships; and c. the need for support of the individual's informal social network.
PA-RC 4.06
The worker and a supervisor, or a clinical, service, or peer team, review the case to assess:
a. service plan implementation; b. progress toward achieving goals and desired outcomes; and c. 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. Timeframes for the review should be adjusted depending upon issues and needs of persons receiving services, and the frequency and intensity of services provided. Planned respite care should be reviewed at least quarterly, and crisis respite care should be reviewed in a timeframe consistent with the length and frequency of service.
PA-RC 4.07
The worker and caregiver regularly review progress toward achievement of agreed upon service goals.
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Respite Care
Purpose
Respite Care reduces caregiver stress, promotes the well-being and safety of care recipients, and contributes to stable families.
PA-RC 5: Service Philosophy
The program is guided by a service philosophy that:
a. provides a basis for how the program will meet the needs of service recipients; and
b. guides the development and implementation of program activities and services based on the best available evidence of service effectiveness.
Interpretation: A program model or logic model can be a useful tool to help staff think systematically about how the program can make a measureable difference by drawing a clear connection between the service population's needs, available resources, program activities and interventions, program outputs, and desired outcomes.
Rating Indicators
1) Full Implementation, Outstanding Performance
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. 
2) Substantial Implementation, Good 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.  
3) 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.   
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Respite Care
Purpose
Respite Care reduces caregiver stress, promotes the well-being and safety of care recipients, and contributes to stable families.
- Capacity is at a basic level.
4) Unsatisfactory Implementation or Performance
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.  Please see Rating Guidance for additional rating examples. 
Table of Evidence
On-Site Evidence
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Respite Care
Purpose
Respite Care reduces caregiver stress, promotes the well-being and safety of care recipients, and contributes to stable families.
PA-RC 6: Support Services for Caregivers
Caregivers receive coordinated services and support to help resolve issues related to caretaking.
Rating Indicators
1) Full Implementation, Outstanding Performance
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. 
2) Substantial Implementation, Good 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.  
3) 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.
4) Unsatisfactory Implementation or Performance
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.  Please see Rating Guidance for additional rating examples. 
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Respite Care
Purpose
Respite Care reduces caregiver stress, promotes the well-being and safety of care recipients, and contributes to stable families.
Table of Evidence
- Interview: a. Program director b. Relevant personnel c. Persons served
- Review case records
Providers work with service recipients and their caregivers to:
a. coordinate services; and b. resolve obstacles to accessing or receiving services, including
transportation or fees.
PA-RC 6.02
Caregivers receive support to address issues related to caretaking and caregiver stress and are provided with referrals for needed services including:
a. support groups and counseling services; b. health, mental health, and substance use services; c. domestic violence services; d. shelter and housing services; e. social, recreational and day programs; and f. mentor services.
PA-RC 6.03
The agency maintains a comprehensive, up-to-date list of community resources.
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Respite Care
Purpose
Respite Care reduces caregiver stress, promotes the well-being and safety of care recipients, and contributes to stable families.
PA-RC 7: Care and Supervision
Care recipients receive individualized care and supervision that promote their safety and well-being.
Rating Indicators
1) Full Implementation, Outstanding Performance
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. 
2) Substantial Implementation, Good 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.  
3) 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.
4) Unsatisfactory Implementation or Performance
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.  Please see Rating Guidance for additional rating examples. 
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Respite Care
Purpose
Respite Care reduces caregiver stress, promotes the well-being and safety of care recipients, and contributes to stable families.
Table of Evidence
- A description of services - Procedures and criteria for matching service recipients with providers - Health and safety procedures and protocols - Client/staff ratios
On-Site Evidence
as applicable
On-Site Activities
- Interview: a. Program director b. Relevant personnel c. Respite providers d. Caregivers e. Care recipients
- Review case records - Review coverage schedules at each unit or group
(FP) PA-RC 7.01
Families are matched with 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.
(FP) PA-RC 7.02
Respite providers:
a. are familiar with the care recipient's daily routine, preferred foods and activities, and needed therapeutic or medical care; and
b. respect the culture, race, ethnicity, language, religion, and sexual orientation of the care recipient.
Interpretation:When the care recipient is involved in regular therapeutic,
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Respite Care
Purpose
Respite Care reduces caregiver stress, promotes the well-being and safety of care recipients, and contributes to stable families.
educational, or employment activities, the respite provider works with caregivers to plan for continued participation.
PA-RC 7.03
(FP) PA-RC 7.04
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 agency does not provide crisis respite care.
(FP) PA-RC 7.05
Close supervision of care recipients ensures their safety and improves service quality, and provider-care recipient ratios do not exceed:
a. one to four when children are under school age; b. one to eight during waking hours; and c. one to twelve during sleeping hours.
Interpretation: Ratios must be adjusted to meet the special needs of individuals that require therapeutic or medical care, or close monitoring. Ratios include all other children or adults being cared for in the home or facility. Ratios demonstrate capacity for safe evacuation of care recipients in case of an emergency.
(FP) PA-RC 7.06
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.
(FP) PA-RC 7.07
Respite Care
Purpose
Respite Care reduces caregiver stress, promotes the well-being and safety of care recipients, and contributes to stable families.
The respite provider returns care recipients only to the caregiver, or another person approved by the caregiver, and follows guidelines for situations when a caregiver poses a safety risk or an individual requires protection.
Interpretation: Protocols should provide direction on how to use appropriate agency or community resources to respond to individuals who are intoxicated by drugs or alcohol, mentally or physically unstable, or who present a safety concern.
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Respite Care
Purpose
Respite Care reduces caregiver stress, promotes the well-being and safety of care recipients, and contributes to stable families.
PA-RC 8: Service Environment
Respite care is provided in an environment that ensures the individual's health and safety.
Note: Please see Facility Observation Checklist - Private, Public, Canadian  for additional assistance with this standard.
Rating Indicators
1) Full Implementation, Outstanding Performance
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. 
2) Substantial Implementation, Good 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.  
3) 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.
4) Unsatisfactory Implementation or Performance
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
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Respite Care
Purpose
Respite Care reduces caregiver stress, promotes the well-being and safety of care recipients, and contributes to stable families.
deterioration.  Please see Rating Guidance for additional rating examples. 
Table of Evidence
On-Site Evidence
On-Site Activities
- Interview: a. Program director b. Relevant personnel c. Respite providers d. Caregivers e. Care recipients
- Review case records - Observe facility
PA-RC 8.01
The family receives respite care in a location appropriate to their needs and preferences.
Interpretation: Respite care can be provided in the family's home, the provider's home, the community, or a facility. When the agency does not offer the type of respite care needed or preferred by the family, a referral is made to another provider.
(FP) PA-RC 8.02
Prior to use, all facilities and provider homes are licensed or approved as required by law or regulation, and regularly inspected to evaluate:
a. fire, health, and safety hazards; b. cleanliness;
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Respite Care
Purpose
Respite Care reduces caregiver stress, promotes the well-being and safety of care recipients, and contributes to stable families.
c. adequacy and appropriateness of space and furnishings; and d. the safety and appropriateness of toys, materials, or equipment.
PA-RC 8.03
When overnight care is provided, accommodations include:
a. sleeping arrangements appropriate to the number, age, special needs, and gender of the individuals in the home or facility;
b. rooms that are adequately and attractively furnished including a separate bed or crib for each individual with clean linens; and
c. a safe, lockable place that locks to store personal belongings.
NA The agency does not provide overnight respite care.
PA-RC 8.04
When respite care is provided in a facility, space and amenities are adequate for the scope of the service provided, and include:
a. indoor and outdoor recreation areas; b. dining, bathing, toileting, and personal hygiene facilities; c. private areas for meetings with individuals and caregivers; d. space for resting; and e. rooms for providing on-site services, when available.
NA The agency does not provide respite care in a facility.
(FP) PA-RC 8.05
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 agency does not provide respite care in the caregiver's home.
PA-RC 8.06
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Respite Care
Purpose
Respite Care reduces caregiver stress, promotes the well-being and safety of care recipients, and contributes to stable families.
restrictions are:
a. requested by the caregiver; b. approved in advance by the program director or an appropriate
designee; and c. documented in the case record.
NA The agency only provides care for infants and young children.
PA-RC 8.07
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 agency does not provide overnight respite care.
(FP) PA-RC 8.08
Agency policy prohibits:
a. corporal punishment; b. the use of aversive stimuli; c. interventions that involve withholding nutrition or hydration, or that inflict
physical or psychological pain; d. the use of demeaning, shaming or degrading language or activities; e. unnecessarily punitive restrictions including cancellation of visits as
disciplinary action; f. forced physical exercise to eliminate behaviors; g. punitive work assignments; h. punishment by peers; and i. group punishment or discipline for individual behavior.
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Respite Care
Purpose
Respite Care reduces caregiver stress, promotes the well-being and safety of care recipients, and contributes to stable families.
PA-RC 9: 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 agency does not provide residential respite or crisis nursery services.
Note: Please see Facility Observation Checklist - Private, Public, Canadian  for additional assistance with this standard.
Rating Indicators
1) Full Implementation, Outstanding Performance
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. 
2) Substantial Implementation, Good 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.  
3) 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.
4) Unsatisfactory Implementation or Performance
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Respite Care
Purpose
Respite Care reduces caregiver stress, promotes the well-being and safety of care recipients, and contributes to stable families.
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.  Please see Rating Guidance for additional rating examples. 
Table of Evidence
On-Site Activities
- Review case records - Observe facility
PA-RC 9.01
Program personnel provide care recipients with predictability and structure by establishing daily routines and rules developed with care recipients and their caregivers.
PA-RC 9.02
Care recipients are offered an organized daily program of age and developmentally appropriate social, recreational, educational, and therapeutic activities.
Interpretation:The agency and the caregiver plan for continuation of educational services for children and youth, and the agency coordinates educational services with relevant school districts.
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Respite Care
Purpose
Respite Care reduces caregiver stress, promotes the well-being and safety of care recipients, and contributes to stable families.
PA-RC 9.03
Facilities include:
a. sufficient supplies and equipment to meet the needs of care recipients; b. space and equipment for housekeeping, laundry, maintenance, and
storage; c. rooms for providing on-site services, as applicable; d. at least one room suitably furnished for the use of on-duty personnel and
space for administrative support functions; and e. private sleeping accommodations for personnel who sleep at the facility,
if applicable.
PA-RC 9.04
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Respite Care
Purpose
Respite Care reduces caregiver stress, promotes the well-being and safety of care recipients, and contributes to stable families.
PA-RC 10: Case Closing
Rating Indicators
1) Full Implementation, Outstanding Performance
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. 
2) Substantial Implementation, Good 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.  
3) 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.
4) Unsatisfactory Implementation or Performance
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.  Please see Rating Guidance for additional rating examples. 
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Respite Care
Purpose
Respite Care reduces caregiver stress, promotes the well-being and safety of care recipients, and contributes to stable families.
Table of Evidence
On-Site Evidence
- Procedures that address continuation of services for persons whose third party benefits have ended
On-Site Activities
- Interview: a. Program director b. Relevant personnel c. Caregivers d. Care recipients
- Review case records
The case closing process:
a. is clearly defined and includes assignment of staff responsibility; and b. involves the worker, the caregiver, and others, as appropriate.
PA-RC 10.02
Upon case closing, the agency notifies any collaborating service providers, as appropriate.
PA-RC 10.03
When third-party benefits or payments end or termination of services is probable due to non-payment, the agency works with the caregiver to identify service options, and determines its responsibility to provide services until appropriate arrangements are made.
Interpretation:The agency 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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Respite Care
Purpose
Respite Care reduces caregiver stress, promotes the well-being and safety of care recipients, and contributes to stable families.
NA The agency does not receive third-party benefits or payments for service.
PA-RC 10.04
When the agency decides to discontinue services against the caregiver's wishes the agency makes every effort to link the person to appropriate services.
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Respite Care
Purpose
Respite Care reduces caregiver stress, promotes the well-being and safety of care recipients, and contributes to stable families.
PA-RC 11: Personnel
Respite care providers are qualified for, and receive support in, providing temporary care to improve individual and family well-being, reduce caregiver stress, and promote family stability.
Rating Indicators
1) Full Implementation, Outstanding Performance
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. 
2) Substantial Implementation, Good 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.  
3) 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.
4) Unsatisfactory Implementation or Performance
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.  Please see Rating Guidance for additional rating examples. 
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Respite Care
Purpose
Respite Care reduces caregiver stress, promotes the well-being and safety of care recipients, and contributes to stable families.
Table of Evidence
Self-Study Evidence
- Program staffing chart that includes lines of supervision - List of program personnel that includes:
a. name; b. title; c. degree held and/or other credentials; d. FTE or volunteer; e. length of service at the agency; f. time in current position
- Table of contents of training curricula - Procedures for screening respite providers - Procedures and criteria used for assigning and evaluating workloads
On-Site Evidence
On-Site Activities
- Review personnel and respite provider files
PA-RC 11.01
Respite care providers have the personal characteristics necessary to provide flexible, affectionate care.
PA-RC 11.02
Respite care providers are competent to:
a. assess the need for additional services; b. respect and appreciate the cultural background, heritage, and identity of
persons receiving services; c. communicate effectively; d. identify changes in functioning; and
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Respite Care
Purpose
Respite Care reduces caregiver stress, promotes the well-being and safety of care recipients, and contributes to stable families.
e. determine if a crisis situation is imminent and intervene using appropriate resources.
Interpretation: Competency can be demonstrated through education, training, or experience.
PA-RC 11.03
Respite care providers are skilled in the following areas, as appropriate to the services provided:
a. methods of engagement; b. helping individuals cope with trauma; c. identification of medical needs or problems; d. the agency's plans for handling emergencies; e. case advocacy; f. use of adaptive equipment, such as braces and wheelchairs; g. providing personal care, including lifting techniques; and h. other areas necessary to serve the target population.
Interpretation:Skills can be acquired or improved through education, training, or supervision.
(FP) PA-RC 11.04
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:
a. a criminal record and abuse registry check for all adults living in the provider's home; and
b. relevant caregiving experience.
Related: PA-HR 3.05
Interpretation: Record checks are conducted in compliance with applicable law. When a finding of child or adult abuse, neglect, or exploitation is indicated, guidelines are used to determine the appropriateness of provider responsibilities.
Note: Element (a) is only applicable if respite care is delivered in the provider's home. 
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Respite Care
Purpose
Respite Care reduces caregiver stress, promotes the well-being and safety of care recipients, and contributes to stable families.
(FP) PA-RC 11.05
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 may 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 service needs. 
PA-RC 11.06
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.
Note: Agencies that permit restrictive behavior management techniques must implement relevant Behavior Support and Management (BSM) standards.
PA-RC 11.07
Personnel who conduct assessments are qualified by training, skill, and experience, and have the ability to recognize individuals and families with special needs.
PA-RC 11.08
Supervisors have:
a. an advanced degree in social work or a comparable human service field with one year of relevant experience, or
b. a bachelor's degree in social work or a comparable human service field with two years of relevant experience.
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Respite Care
Purpose
Respite Care reduces caregiver stress, promotes the well-being and safety of care recipients, and contributes to stable families.
PA-RC 11.09
Employee workloads are regularly reviewed and are based on an assessment of the following:
a. the qualifications, competencies, and experience of the worker, including the level of supervision needed;
b. the work and time required to accomplish assigned tasks and job responsibilities; and
c. service volume, accounting for assessed level of needs of new and current clients and referrals.
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Introduction
PA-RC 1.01
PA-RC 1.02
PA-RC 2.01
PA-RC 2.02
PA-RC 2.03
PA-RC 2.04
PA-RC 4.01
PA-RC 4.02
PA-RC 4.03
PA-RC 4.04
PA-RC 4.05
PA-RC 4.06
PA-RC 4.07
PA-RC 6.01
PA-RC 6.02
PA-RC 6.03
PA-RC 7.01
PA-RC 7.02
PA-RC 7.03
PA-RC 7.04
PA-RC 7.05
PA-RC 7.06
PA-RC 7.07
PA-RC 9: Short Term Residential Respite and Crisis Nursery Services
PA-RC 9.01
PA-RC 9.02
PA-RC 9.03
PA-RC 9.04