Orienting and training new staff members
One of the most important elements of running a successful assisted living facility is hiring, training, and retaining the right people to care for your residents. Yet, perhaps one of the most common deficiencies seen during the survey of an ALF is the failure to train (or keep record of training) employees along with properly documenting the paperwork required to be employed in the facility. Ironically, effectively training your staff is one of the most crucial aspects of how your facility will operate. To better understand the requirments for staff training and orientation in the state of Pennsylvania check out the following regulation provided by DHS:
- 2800.65. Staff orientation and direct care staff person training and orientation.
(a) Prior to or during the first work day, direct care staff persons and other staff persons including ancillary staff persons, substitute personnel and volunteers shall have an orientation in general fire safety and emergency preparedness that includes the following:
(1) Evacuation procedures.
(2) Staff duties and responsibilities during fire drills, as well as during emergency evacuation, transportation and at an emergency location, if applicable.
(3) The designated meeting place outside the building or within the firesafe area in the event of an actual fire.
(4) Smoking safety procedures, the residence’s smoking policy and location of smoking areas, if applicable.
(5) The location and use of fire extinguishers.
(6) Smoke detectors and fire alarms.
(7) Telephone use and notification of emergency services.
(b) Direct care staff persons shall complete an initial orientation approved by the Department before providing direct care to residents.
(c) Direct care staff persons shall be certified in first aid and CPR before providing direct care to residents.
(d) A sufficient number of direct care staff persons shall be certified in obstructed airway techniques to meet the staff to resident ratios under § 2800.63(a) (relating to first aid, CPR and obstructed airway training) before providing direct care to residents.
(e) Within 40 scheduled working hours, direct care staff persons, ancillary staff persons, substitute personnel and volunteers shall have an orientation training that includes the following:
(1) Resident rights.
(2) Emergency medical plan.
(3) Mandatory reporting of abuse and neglect under the Older Adult Protective Services Act (35 P. S. §§ 10225.101—10225.5102).
(4) Reporting of reportable incidents and conditions.
(5) Safe management techniques.
(6) Core competency training that includes the following:
(i) Person-centered care.
(ii) Communication, problem solving and relationship skills.
(iii) Nutritional support according to resident preference.
(f) Ancillary staff persons shall have a general orientation to their specific job functions as it relates to their position prior to working in that capacity.
(g) Direct care staff persons may not provide unsupervised assisted living services until completion of 18 hours of training in the following areas:
(1) Training that includes a demonstration of job duties, followed by supervised practice.
(2) Successful completion and passing the Department-approved direct care training course and passing of the competency test.
(3) Initial direct care staff person training to include the following:
(i) Safe management techniques.
(ii) Assisting with ADLs and IADLs.
(iii) Personal hygiene.
(iv) Care of residents with mental illness, neurological impairments, an intellectual disability and other mental disabilities.
(v) The normal aging-cognitive, psychological and functional abilities of individuals who are older.
(vi) Implementation of the initial assessment, annual assessment and support plan. (vii) Nutrition, food handling and sanitation.
(viii) Recreation, socialization, community resources, social services and activities in the community.
(x) Staff person supervision, if applicable.
(xi) Care and needs of residents with special emphasis on the residents being served in the residence.
(xii) Safety management and hazard prevention.
(xiii) Universal precautions.
(xiv) The requirements of this chapter.
(xv) The signs and symptoms of infections and infection control.
(xvi) Care for individuals with mobility needs, such as prevention of decubitus ulcers, incontinence, malnutrition and dehydration, if applicable to the residents served in the residence.
(xvii) Behavioral management techniques.
(xviii) Understanding of the resident’s assessment and how to implement the resident’s support plan.
(xix) Person-centered care and aging in place.
(h) Direct care staff persons shall have at least 16 hours of annual training relating to their job duties. The training required in § 2800.69 (relating to additional dementia-specific training) shall be in addition to the 16 hour annual training.
(i) Training topics for the annual training for direct care staff persons must include the following:
(1) Medication self-administration training.
(2) Instruction on meeting the needs of the residents as described in the assessment tool, medical evaluation and support plan.
(3) Care for residents with dementia, cognitive and neurological impairments.
(4) Infection control and general principles of cleanliness and hygiene and areas associated with immobility, such as prevention of decubitus ulcers, incontinence, malnutrition and dehydration.
(5) Assisted living service needs of the resident.
(6) Safe management techniques.
(7) Care for residents with mental illness or an intellectual disability, or both, if the population is served in the residence.
(j) Direct care staff persons, ancillary staff persons, substitute personnel and regularly scheduled volunteers shall be trained annually in the following areas:
(1) Fire safety completed by a fire safety expert or by a staff person trained by a fire safety expert. Videos prepared by a fire safety expert are acceptable for the training if accompanied by an onsite staff person trained by a fire safety expert.
(2) Emergency preparedness procedures and recognition and response to crises and emergency situations.
(3) Resident rights.
(4) The Older Adult Protective Services Act (35 P.S. §§ 10225.101— 10225.708).
(5) Falls and accident prevention.
(6) New population groups that are being served at the residence that were not previously served, if applicable.
(k) If a staff person has completed the required initial direct care staff person training within the past year as a direct care staff person at another residence, the requirement for initial direct care staff person training in this section does not apply if the staff person provides written verification of completion of the training.
(l) A record of training including the staff person trained, date, source, content, length of each course and copies of any certificates received, shall be kept.
- 2800.69. Additional dementia-specific training.
Administrative staff, direct care staff persons, ancillary staff persons, substitute personnel and volunteers shall receive at least 4 hours of dementia-specific training within 30 days of hire and at least 2 hours of dementia-specific training annually thereafter in addition to the training requirements of this chapter.
- (e) Within 40 scheduled working hours, direct care staff persons, ancillary staff persons, substitute personnel and volunteers shall have an orientation training that includes the following: 1-6
It is uber important to have the orientation process completed on the employees first day. I get it, you are short staffed and need the bodies on the floor. But chances are that you will not retain this employee and they will not be satisfied if you do not orient and train them properly. Plus, there is the pesky little agency known as DHS who will ensure you have completed the orientation process during the staff members first 40 working hours.
- (l) A record of training including the staff person trained, date, source, content, length of each course and copies of any certificates received, shall be kept.
So, you did a great job with orientation, everyone learned a lot and has hit the floor ready to serve your residents! Great job! But did you document the trainings? No? The it never happened in the eyes of the DHS. For each specific training you shall have a sign in sheet and a certificate of achievement to keep in each staff members personnel file. Surveyors typically pick through these files with a fine-tooth comb.