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. Â
- All elements or requirements outlined in the standard are evident
in practice, with rare or no exceptions;Â exceptions do not
impact service quality or agency performance.Â
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.Â
- The majority of the standards requirements have been met and the
basic framework required by the standard has been
implemented. Â
- Minor inconsistencies and not yet fully developed practices are
noted; however, these do not significantly impact service quality
or agency performance. Â
3) Partial Implementation, Concerning Performance
A rating of (3) indicates that the agency's observed infrastructure
and/or practices require significant
improvement. Â
- The agency has not implemented the basic framework of the
standard but instead has in place only part of this
framework.  Â
- Omissions or exceptions to the practices outlined in the standard
occur regularly, or practices are implemented in a cursory or
haphazard manner.Â
- 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. Â
- 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.Â
Council on Accreditation - Copyright 2019 Page 3
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.
Council on Accreditation - Copyright 2019 Page 4
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. Â
- All elements or requirements outlined in the standard are evident
in practice, with rare or no exceptions;Â exceptions do not
impact service quality or agency performance.Â
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.Â
- The majority of the standards requirements have been met and the
basic framework required by the standard has been
implemented. Â
- Minor inconsistencies and not yet fully developed practices are
noted; however, these do not significantly impact service quality
or agency performance. Â
3) Partial Implementation, Concerning Performance
A rating of (3) indicates that the agency's observed infrastructure
and/or practices require significant
improvement. Â
- The agency has not implemented the basic framework of the
standard but instead has in place only part of this
framework.  Â
- Omissions or exceptions to the practices outlined in the standard
occur regularly, or practices are implemented in a cursory or
haphazard manner.Â
- 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. Â
- 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.Â
Council on Accreditation - Copyright 2019 Page 5
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
Council on Accreditation - Copyright 2019 Page 6
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.
Council on Accreditation - Copyright 2019 Page 7
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. Â
- All elements or requirements outlined in the standard are evident
in practice, with rare or no exceptions;Â exceptions do not
impact service quality or agency performance.Â
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.Â
- The majority of the standards requirements have been met and the
basic framework required by the standard has been
implemented. Â
- Minor inconsistencies and not yet fully developed practices are
noted; however, these do not significantly impact service quality
or agency performance. Â
3) Partial Implementation, Concerning Performance
A rating of (3) indicates that the agency's observed infrastructure
and/or practices require significant
improvement. Â
- The agency has not implemented the basic framework of the
standard but instead has in place only part of this
framework.  Â
- Omissions or exceptions to the practices outlined in the standard
occur regularly, or practices are implemented in a cursory or
haphazard manner.Â
- 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. Â
Council on Accreditation - Copyright 2019 Page 8
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.Â
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.
Council on Accreditation - Copyright 2019 Page 10
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. Â
- All elements or requirements outlined in the standard are evident
in practice, with rare or no exceptions;Â exceptions do not
impact service quality or agency performance.Â
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.Â
- The majority of the standards requirements have been met and the
basic framework required by the standard has been
implemented. Â
- Minor inconsistencies and not yet fully developed practices are
noted; however, these do not significantly impact service quality
or agency performance. Â
3) Partial Implementation, Concerning Performance
A rating of (3) indicates that the agency's observed infrastructure
and/or practices require significant
improvement. Â
- The agency has not implemented the basic framework of the
standard but instead has in place only part of this
framework.  Â
- Omissions or exceptions to the practices outlined in the standard
occur regularly, or practices are implemented in a cursory or
haphazard manner.Â
- 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. Â
- 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.Â
Council on Accreditation - Copyright 2019 Page 11
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:
Council on Accreditation - Copyright 2019 Page 12
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.
Council on Accreditation - Copyright 2019 Page 13
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. Â
- All elements or requirements outlined in the standard are evident
in practice, with rare or no exceptions;Â exceptions do not
impact service quality or agency performance.Â
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.Â
- The majority of the standards requirements have been met and the
basic framework required by the standard has been
implemented. Â
- Minor inconsistencies and not yet fully developed practices are
noted; however, these do not significantly impact service quality
or agency performance. Â
3) Partial Implementation, Concerning Performance
A rating of (3) indicates that the agency's observed infrastructure
and/or practices require significant
improvement. Â
- The agency has not implemented the basic framework of the
standard but instead has in place only part of this
framework.  Â
- Omissions or exceptions to the practices outlined in the standard
occur regularly, or practices are implemented in a cursory or
haphazard manner.Â
- Service quality or agency functioning may be
compromised.  Â
Council on Accreditation - Copyright 2019 Page 14
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. Â
- 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.Â
Table of Evidence
On-Site Evidence
Council on Accreditation - Copyright 2019 Page 15
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. Â
- All elements or requirements outlined in the standard are evident
in practice, with rare or no exceptions;Â exceptions do not
impact service quality or agency performance.Â
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.Â
- The majority of the standards requirements have been met and the
basic framework required by the standard has been
implemented. Â
- Minor inconsistencies and not yet fully developed practices are
noted; however, these do not significantly impact service quality
or agency performance. Â
3) Partial Implementation, Concerning Performance
A rating of (3) indicates that the agency's observed infrastructure
and/or practices require significant
improvement. Â
- The agency has not implemented the basic framework of the
standard but instead has in place only part of this
framework.  Â
- Omissions or exceptions to the practices outlined in the standard
occur regularly, or practices are implemented in a cursory or
haphazard manner.Â
- 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. Â
- 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.Â
Council on Accreditation - Copyright 2019 Page 16
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.
Council on Accreditation - Copyright 2019 Page 17
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. Â
- All elements or requirements outlined in the standard are evident
in practice, with rare or no exceptions;Â exceptions do not
impact service quality or agency performance.Â
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.Â
- The majority of the standards requirements have been met and the
basic framework required by the standard has been
implemented. Â
- Minor inconsistencies and not yet fully developed practices are
noted; however, these do not significantly impact service quality
or agency performance. Â
3) Partial Implementation, Concerning Performance
A rating of (3) indicates that the agency's observed infrastructure
and/or practices require significant
improvement. Â
- The agency has not implemented the basic framework of the
standard but instead has in place only part of this
framework.  Â
- Omissions or exceptions to the practices outlined in the standard
occur regularly, or practices are implemented in a cursory or
haphazard manner.Â
- 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. Â
- 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.Â
Council on Accreditation - Copyright 2019 Page 18
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,
Council on Accreditation - Copyright 2019 Page 19
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.
Council on Accreditation - Copyright 2019 Page 21
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. Â
- All elements or requirements outlined in the standard are evident
in practice, with rare or no exceptions;Â exceptions do not
impact service quality or agency performance.Â
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.Â
- The majority of the standards requirements have been met and the
basic framework required by the standard has been
implemented. Â
- Minor inconsistencies and not yet fully developed practices are
noted; however, these do not significantly impact service quality
or agency performance. Â
3) Partial Implementation, Concerning Performance
A rating of (3) indicates that the agency's observed infrastructure
and/or practices require significant
improvement. Â
- The agency has not implemented the basic framework of the
standard but instead has in place only part of this
framework.  Â
- Omissions or exceptions to the practices outlined in the standard
occur regularly, or practices are implemented in a cursory or
haphazard manner.Â
- 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. Â
- The agency’s observed service delivery infrastructure and
practices are weak or non-existent; or show signs of neglect,
stagnation, or
Council on Accreditation - Copyright 2019 Page 22
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.Â
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. Â
- All elements or requirements outlined in the standard are evident
in practice, with rare or no exceptions;Â exceptions do not
impact service quality or agency performance.Â
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.Â
- The majority of the standards requirements have been met and the
basic framework required by the standard has been
implemented. Â
- Minor inconsistencies and not yet fully developed practices are
noted; however, these do not significantly impact service quality
or agency performance. Â
3) Partial Implementation, Concerning Performance
A rating of (3) indicates that the agency's observed infrastructure
and/or practices require significant
improvement. Â
- The agency has not implemented the basic framework of the
standard but instead has in place only part of this
framework.  Â
- Omissions or exceptions to the practices outlined in the standard
occur regularly, or practices are implemented in a cursory or
haphazard manner.Â
- 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. Â
- 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.Â
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. Â
- All elements or requirements outlined in the standard are evident
in practice, with rare or no exceptions;Â exceptions do not
impact service quality or agency performance.Â
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.Â
- The majority of the standards requirements have been met and the
basic framework required by the standard has been
implemented. Â
- Minor inconsistencies and not yet fully developed practices are
noted; however, these do not significantly impact service quality
or agency performance. Â
3) Partial Implementation, Concerning Performance
A rating of (3) indicates that the agency's observed infrastructure
and/or practices require significant
improvement. Â
- The agency has not implemented the basic framework of the
standard but instead has in place only part of this
framework.  Â
- Omissions or exceptions to the practices outlined in the standard
occur regularly, or practices are implemented in a cursory or
haphazard manner.Â
- 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. Â
- 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.Â
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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. Â
- All elements or requirements outlined in the standard are evident
in practice, with rare or no exceptions;Â exceptions do not
impact service quality or agency performance.Â
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.Â
- The majority of the standards requirements have been met and the
basic framework required by the standard has been
implemented. Â
- Minor inconsistencies and not yet fully developed practices are
noted; however, these do not significantly impact service quality
or agency performance. Â
3) Partial Implementation, Concerning Performance
A rating of (3) indicates that the agency's observed infrastructure
and/or practices require significant
improvement. Â
- The agency has not implemented the basic framework of the
standard but instead has in place only part of this
framework.  Â
- Omissions or exceptions to the practices outlined in the standard
occur regularly, or practices are implemented in a cursory or
haphazard manner.Â
- 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. Â
- 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.Â
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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