Intro to DCS Training

The proper training of Direct Care Staff is the single best investment that any facility can make.  The Direct Care Staff is vital to both the facility and the clients alike and the performance of the staff will make or break any survey.  Well trained staff give you piece of mind when you are not personally in the facility.  You will know that the clients are not just well cared for and safe but that active treatment actually occurs sometimes when there is no one watching.  Also well-trained staff will teach the new staff what to do. 

The following is a general guideline for the training of Direct Care Staff (DCS).

Prior to Working in a facility all employees must first complete the following:
Application
Check all references (even if in an unrelated field.)
Fingerprints are taken with life scan
Physical exam and either a negative TB test or an X ray.
CPR card (If they don’t have it yet, the Administrator will need to be sure that another staff on duty each day a current CPR card until the new employee can get theirs)

Formal DCS training starts as soon as the new employee firsts walks in the door to work.  Employees are given at least 8 hours orientation before working with any resident alone.  Orientation includes: Viewing the Department of Justice Abuse reporting video and completing the post test. Each facility has a slightly different Orientation program.

Example:
All new staff shall be provided with thirty two (32) hours of orientation by the QMRP or assigned staff person these hours shall be completed and be documented.

(1) Prior to providing direct client care and during the first eight (8) hours of employment each direct-care staff member shall be provided with the following Overview:
  • Training Area: Overview
  • Topic: Tour of Facility
  • Topic: Description of Clients
  • Topic: Role of Direct Care Staff/Job Description
  • Topic: Basic Client Care - Lifting and Positioning
  • Topic: Basic Client Care - Feeding
  • Topic: Basic Client Care - Toileting
  • Topic: Basic Client Care - Bathing and Dressing
  • Topic: Basic Client Care - Client Equipment
  • Topic: Identifying Client Rights, Denial of Rights, Client Abuse
  • Topic: Abuse Reporting
  • Topic: Emergency Procedures - Illness and Accidents
  • Topic: Emergency Procedures - Fire and Disaster
  • Topic: Emergency Procedures - Managing Seizures
  • Topic: Emergency Procedures - Incident Reports
  • Topic: Staff/Family Communications
  • Topic: Facility Manuals
(2) There After, Staff Will Receive 25 Hours Of Additional Training To Be Completed In The First 3 Months Of Employment.
  • Training Area: Programming
  • Topic: Understanding Developmental Disabilities
  • Topic: Purpose of Programming ISP Objectives Active Treatment
  • Topic: Interdisciplinary Team
  • Topic: Training Techniques
  • Topic: Self Help Skills Training
  • Topic: Special Needs of the Developmentally Disabled; PT, OT, Speech,
  • Topic: Understanding Regulations Training Area: Personnel Policies
  • Topic: Organizational Structure
  • Topic: Hours and Time Reporting, Employee Conduct and Dress
  • Topic: Disciplinary Actions Topic: Employee Safety Training Area: Nursing Care
  • Topic: Nursing Care Plan Topic: Observing Physical Changes
  • Topic: Skin Care Topic: Taking Vital Signs
  • Topic: Isolation and Infection Control Training Area: Dietary/ Food Services Topic: Reading the Menus and Recipes
  • Topic: Preparing Meals Topic: Using Equipment Topic: Serving, Portion Control and Family Style Dining
  • Topic: Diet Orders and Menu Substitutions
  • Topic: Food Storage Topic: Kitchen Cleaning and Dishwashing Training Area: Housekeeping and Laundry
  • Topic: Cleaning Procedures
  • Topic: Laundry Procedures Topic: Infection Control

After initial training the facility needs to provide 3 hours of monthly in-service trainings (36 hours per year). Mandatory in-service topics include:

  1. Program techniques
  2. Developing program objectives
  3. Evaluation and assessment techniques
  4. Client documentation
  5. Development need of residents
  6. Sensory deprivation
  7. Relationship and communication skills
  8. Psychosocial aspects of developmental disabilities
  9. Confidentiality
  10. Signs and symptoms of illness
  11. Skin care
  12. Basic nursing and health related skills
  13. Bowel and bladder training
  14. Oral hygiene
  15. Nutrition
  16. Behavior management
  17. Emergency intervention procedures for behavior control
  18. Infection control
  19. Fire and accident prevention and safety
  20. Disaster preparedness
  21. Client's rights
  22. The role of the parent/guardian/conservator
  23. First Aid
  24. CPR
  25. Epilepsy
  26. Use of program reference materials
  27. Death and dying
  28. Sexual harassment
  29. Hazardous material

Additional in-services may include the following:

  • Active Treatment
  • Behavioral Issues
  • Client Abuse
  • Disabled Clients Rights
  • Confidentiality
  • Documentation
  • Family
  • Grieving
  • Grooming and Hygiene
  • Safety Awareness
  • Speech
  • Sensory Deprivation
  • Normalization
  • Observation and Intervention
  • Privacy
  • Program Materials
  • Staff/Client
  • Assessment Techniques
  • Prompting Techniques
  • Transfers
  • Trust Accounts
  • Feeding Techniques
  • Education the Community
  • Speech Language Impairments
  • Choices
  • Direct Supervision
  • Menu Portion Control
  • Client Progress Documentation
  • Objectives
  • Family Style meals
  • Sex
In-services can be customized to fit the needs of your facility or situation. Topics like new residents and their needs, Changes of condition, new medical procedures should be added. However, these trainings should not be to the exclusion of mandatory topics. Also general staff meetings addressing personnel issues (like who needs an annual physical or renew CPR) and housekeeping issues (like who will do what) do not really fit the scope of in-service training.