Choosing an In-Home Care Provider
There are many factors which need to be considered when one makes the important decision about an in-home care provider. We believe that the more carefully families look at these factors, the better the decision they will make.
Our goal, with every client, is to be the highest quality, most trusted in-home care (private duty) agency. If your evaluation of agencies enables you to identify a short list of the best in-home care providers, we know we will be on the list. Whether that results in a family choosing Support For Home is honestly less important to us than that a very high quality agency is selected.
So, what are some of the questions you should ask? With the exception of the first question, below, there is no priority order implied in the list below. They are all important.
Why should I hire an agency, instead of an individual?
The answer to that question is another question -- "What happens if something goes wrong?" This is really important. In hiring individual caregivers, there is not much recourse if she or he does not show up or gets sick or does something they should not do. You can fire them, but then you are starting over, and, if they damaged property or, even worse, stole from you, you are on your own. With an agency as the actual employer of your Home Care Aide, it is their responsibility to "make things right." If your regular Home Care Aide is ill, the agency should provide backup coverage. Liability insurance, dishonesty bonds, Workers Comp insurance, background checks, payroll taxes, etc. -- these are all things you should expect from an agency, not items you should have to worry about.
Is the agency CAHSAH Certified?
CAHSAH is the California Association for Health Services at Home, the standards-setting body for in-home care in California. The certification program focuses on six specific standards for Home Care Aide organizations, including:
· The agency must have adequate general and professional liability insurance
· Workers' Compensation Insurance must be provided for all Caregivers / Home Care Aides
· Pre-employment background checks are required for each Home Care Aide
· All employees must be covered by a Dishonesty Bond
· Pre-employment Tuberculosis screening is required for each Home Care Aide
· Client Service Agreements must specify fees that will be charged
Support For Home is CAHSAH Certified, as you can see at the bottom of the page. Many of the questions below elaborate on these requirements, as Support For Home believes agencies must exceed the minimum standards.
Are caregivers employees of the agency?
Frankly, if the answer is “no,” look elsewhere. If a private duty (non-medical in-home care) agency does not take the responsibility of hiring caregivers, but tries to send “independent contractors,” there are several problems you need to worry about.
The first is that the company is trying to back away from taking responsibility, legally and ethically, from the caregivers it sends. Secondly, there is the question of who is paying workers’ compensation, unemployment insurance and other personnel expenses. The chances are that you may end up, as the client, being responsible for more than you think. An agency that looks like it is cheaper, in terms of rates it quotes, may result in much higher real costs to you, as a result.
Support For Home’s caregivers are employees and part of our extended family.
For a very good analysis of the issues with referral agencies and registries, please take a look at an article on Consumer and Worker Risks published by the National Private Duty Association.
Is the company (plus its caregivers) adequately insured and bonded?
If the company cannot show you a certificate of insurance, including professional liability and workers’ compensation, again, look elsewhere. You need to be protected against claims, and the company needs to be able to meet any financial obligations that may occur through its actions.
Support For Home provides a certificate of insurance to all prospective clients. Our Dishonesty Bond is at $50,000, five times what most agencies provide.
Does the agency provide a free, no-obligation assessment?
If the company charges for an in-home assessment (or makes it free only if you sign up with them), look elsewhere. There is no justification for such a charge. At Support For Home, assessments are free, with no obligation on your part. Some agencies will charge you an "Administrative Fee" if you sign up for them. We know of one franchise that actually charges $75 for you to sign up do business with them! We don't think that makes any sense.
Are caregivers experienced, skilled and certified?
Some agencies require no experience for their caregivers. Others feel that serving as a family caregiver substitutes for professional experience and training. Support For Home only hires experienced professionals, for all levels of care, including Homemaker Care and Companion Care. For Personal Care, assisting with the most intimate activities of daily living (ADLs), Support For Home requires state certification (Certified Nurse Assistant, Home Health Aide). More than 70% of Support For Home caregivers are California state certified CNAs and HHAs.
Support For Home proudly participates in Leading Home Care's Caregiver Quality Assurance Program 
Are caregivers subject to thorough background checks?
Some private duty agencies point with pride to their use of governmental background checks, which, in reality can be quite limited in scope. At Support For Home, we include a nationwide felony/misdemeanor check, a Federal crimes check, DMV records in the state of California, and Sex Offender Registration verification. The nationwide check includes running the social security number through a national database to retrieve address history. A check is then run wherever additional residences are found.
Reference checks should be part of all background checks. They are at Support For Home. Additionally, Support For Home ensures there is a negative TB test within the last year.
Do you get to choose the caregiver?
This one may be a little counter-intuitive. If (as we discussed above), the caregiver is the employee of the agency, the company must protect against all forms of discrimination (age, sex, race, etc.). So, a good agency will work extremely hard to match a caregiver to a client in terms of skills and personality, but the agency is responsible for the employee’s assignment.
If the caregiver does not work out, will the agency make a change?
This is the other side of the coin we just examined. Continuity is a good thing. If a caregiver and a client are well matched, the agency should not be changing on you. However, if there are problems, the agency should move quickly to resolve them, including changing a caregiver, where appropriate.
Is there a minimum number of hours of care?
This is not as straight-forward as it appears. Caregivers work for a living, and it is much more difficult to schedule a 2-hour shift than a 4-hour shift. This is especially true with excellent caregivers, who are in demand. It is also easy to under-estimate the services, and therefore the time needed (we’ll talk about that next). At the same time, if the agency is unable to meet your real need (financially as well as in terms of services) they will tell you, not make false promises. A good agency will work with you, being as flexible as possible, but will be honest about what can be accomplished.
How is a plan of care determined?
A plan of care should comprehend all of the services that you and your family need. To achieve that, the in-home care agency needs two capabilities. One is a thorough needs assessment tool, covering both the client and family and the client’s residence (from the standpoint of safety). The other is a network of plan of care partners who provide complementary services to non-medical, in-home care. Those partners may include private fiduciaries, social workers, home health (medical) providers and others. A private duty (in-home care) agency provides only a slice or two of the plan of care pie. At the same time, that agency should be charging for only its own services, not have a financial stake in others.
Do caregivers receive continuing education and training?
In addition to the skills, experience and certification requirements at the time a caregiver joins Support For Home, we provide in-service training during the employee’s tenure with us. We use experts in a variety of areas, as well as the best available material from the leading training provider in the field of in-home care. Support For Home certified caregivers are expected to maintain their certification through continuing education.
Is there on-going quality control?
Do the owners/managers of the company perform close supervision of caregivers? At Support For Home, we visit the new client and caregiver on days one and two of new client care assignments, and perform regular supervisory visits thereafter. Is client feedback actively sought and responded to quickly? If the agency is Support For Home, the answer is yes.
The ultimate screening for caregivers
For Support For Home, the ultimate question we ask before hiring a caregiver is whether we would have this person take care of our own parents or other family members. This is a true "gut check" in our decision making. If the answer is no, we simply will not send that person to take care of your family. Our clients become part of our extended family.
Are the owners of the agency "hands on" and available?
Providing in-home care is a 24x7 effort -- not just by caregivers, but by the owners. At Support For Home, we are available any time our clients or caregivers need us.
If you have any other questions about how to make the right choice, give us a call, at 916 482-8484 or 530 792-8484. Email us at: info@supportforhome.com Good luck. Bert and Siew Pheng
|
 |
| Support For Home is certified by CAHSAH (California Association for Health Services At Home) |
|
|
|