The purpose of NORTH COAST SUPPORTABILITY, LLC is to increase the availability of opportunities for people with disabilities to live good lives in a place of their choice, to enjoy a lifestyle that is self-directed, to the greatest extent possible, and to interact with their community in ways that enhance and strengthen both.
All curriculum components are consistent with the Principle of Normalization, which states that all services should be provided in a manner that strengthens and supports the appearance, reputation, behavior, and status of those we serve. We provide services such as training and supports in “real” environments and do not utilize artificial training settings or readiness model strategies.
Curriculum is flexible to allow for provision of whatever training, support and assistance is required to help the consumer maintain the living arrangement and lifestyle of their choice. Curriculum and scheduling choices should also be based upon what is fun and meaningful to the consumer. All curriculum and scheduling choices are determined by the consumer, whether through specific (verbal or written) direction, or through facilitation and discovery with those who do not communicate in traditional ways.
Curriculum will focus on a number of areas, designed to make community integration more meaningful and effective while successfully addressing the consumers IPP objectives. These curriculum areas are intended as a general guide. Specific objectives and plans are developed with the consumer and their supporters. The major areas of focus are:
Preference and Interest Exploration
- Identification of Preferences – regarding personal interactions, physical supports (when applicable) and other physical needs.
- Cataloging and Documentation of Preferences and Interests – regarding activities and community goals.
- Facilitation and Exploration in community setting.
Preference and Interest Exploration has deliberately been chosen as the first area of Curriculum because of its importance in guiding the direction of service delivery. We are serving adults that have significant histories and experience in some unique environments. Some of the consumers we serve have lived in the institution where they had little or no experience with expressing preferences or exploring what their interests might be. Nevertheless, they have through their life experience developed a sense of comfort and familiarity in a variety of settings and situations. SUPPORTABILITY will identify and document preferences of each consumer beginning with the initial assessment period through direct contact with the consumer and those that care for and assist them. This process of identification and documentation will lead to the identification of activities that can be used during the course of time together. Creating schedules and designing activities based on preferences and interests of the consumer should also have other positive benefits. People actively engaged in the activities that they enjoy, tend to be more satisfied. This process also ensures that services are self-directed in nature.
Preferences are a product of a process in which choices are being offered, considered and made. It would be a mistake to limit our understanding of preferences to simple choices such as which shirt will I wear today. In assessing preferences, it is important to keep the whole person in mind. This means that all choices will be affected by factors such as how the person feels physically, what their personal history or experience might be or how they trust those around them. Thus, assessments of preferences will also include information such as how does the person communicate choices, how does the person indicate yes or no, how does the person let others know if something is frightening or painful? Does the consumer have preferences about how their personal care is provided? Are there preferences related to time frames or the order in which tasks occur? Assessments of this kind of information must be part of an on-going process of service delivery. They must be assessed and re-assessed continually, to ensure effectiveness and satisfaction.
Identification and documentation of preferences provides clues to what interests the consumer may already have and new ones that might be pursued. When new events, activities and environments are encountered, they will be documented in the consumer diary. As part of this exploration process, new activities, events and environments will be considered and pursued, based upon other known interests of preferences of the person.
As part of an on-going process, consumers will receive facilitation from service staff in planning and participating in a schedule of activities and events that is driven by preferences, interest and choices of the individual consumer.
Self-Reliance and Activities of Daily Living
- Training and Support for all aspects of Daily Living skills related to maintaining
presence in the community
This area of Curriculum is an essential component to a service that strives to serve the consumer in a person-centered way. This part of our services is designed to provide supports that maximize the consumers’ ability to care for themselves in a variety of self-care and domestic skills. When consumers are unable to care for themselves, care should be provided in a respectful way that preserves the dignity of the person served.
Specific information regarding the skills and abilities of individual consumers will be gathered as part of assessment data. Preferences regarding care and assistance will be documented and made part of service plans. Information regarding changes in these areas will be documented and utilized to keep support plans current and meaningful.
Services in this area are provided in a support-driven model. We attempt to view the whole person and what works for them. Decisions regarding what specific areas are addressed as training versus support are individual and related to experience with the consumer and their performance. We view the entire task and provide this variety of supports (training and assistance) as needed to complete the task. ADLs that are consistent with the consumer’s goal of community presence may be provided. These service needs are identified in consumers IPP and are individually identified and delivered.
Community Integration
- Training and Supports which lead to a presence in the community.
- Looking at the comfort of the person served in a variety of settings.
- Cataloging of activities, events and environments explored and considered
SUPPORTABILITY is designed to help those in our community who have historically or experientially had a difficult time maintaining a presence in the community. There may be, as there often is, a variety of reasons for this challenge. We attempt to focus on what makes the consumer unique and what abilities they have that we can support as a beginning or continuation of their community presence.
Through our assessment process we develop an understanding of the consumer through interaction in environments, through activities, with people and events. This information is used to develop community-based objectives and schedules. This assessment includes current Community presence and participation, Individual Community goals and barriers to achievement.
Schedules of activities include a balance of environments that allow the consumer to feel comfortable and yet allow opportunities for growth (comfort in new of different settings) in an expanding community. For example, some consumers may benefit from the ability to be comfortable in a doctor’s office or other public place.
The meaningful inclusion and comfort of the person being served should be the primary driver of the service. These allow the opportunity for the development of relationships which may lead to improved trust and learning.
Positive Behavior Support
- Focus on Supporting Abilities!
- Emphasis and Focus on Behaviors as Communication
- Collaboration with other Service Providers
- Use of Positive Support Strategies
We feel that the first and foremost task we have in relation to our consumers is to identify and support their individual abilities. (Unfortunately for many of our consumer, their reputations are based upon all of those things they have ever done wrong or are unable to do.) The sooner we are able to identify and connect with our consumer’s abilities, the sooner they are likely to relate to and work with us.
Indeed, our experience tells us that much of what is described as “problem” behaviors is actually the person’s attempt to communicate some form of difficulty. Perhaps the issue is one of empowerment, preference or even healthcare needs that are unmet. We approach issues of “behavior’ in a whole-person manner aimed at clarity of understanding before “program development.
We operate collaboratively with families, Residential and other supporters to provide consistent and reliable supports. Communication with others is an integral part of good service delivery.
We do not believe in punishment or other forms of negative feedback to consumers. We only subscribe to activities and techniques that promote the dignity and respect of the person served. Any behavior that constitutes a threat to others will be responded to in as safe manner as possible. The service reserves the right to discontinue service to individuals who have demonstrated behavior that is harmful to others.
All Supervisors are certified by The Institute for Applied Behavior Analysis in Behavior Assessment, Positive Behavior Support Emergency Management and Assuring Staff Consistency. Regular training of staff occurs in all the above areas. North Coast Supportability Staff have a certified In-Service Instructor and Staff are trained in Pro-Act principles with regular reviews.
Effective Communication Training
- Assessment and evaluation of current Communication Skills, Techniques, and Messages.
- Documentation of Communication Skills
- Targeting of Use and Outcomes
- Use of Augmented Systems
In an attempt to make our services as self-directed as possible, it is necessary to have as a good communication as possible between the consumer and those around them. For those consumers with good verbal or traditional communications, this is a somewhat straightforward process of conversational interaction. However, for many consumers who do not have or use traditional communications (verbal, sign language, written word, etc.) this is an on-going process of discovery. We begin this process during our initial assessment and continue throughout the service deliver relationship.
We document communications including messages, forms (signs, gestures, etc.), styles and targets. The emphasis for communications is on the consumer’s ability to make their wants and needs known to others in effective ways. This ranges from simple concepts such as “stop”, “go”, “yes”, “no” to conversation and assertive communications.
We utilize a variety of augmented systems including pictures and objects to assist communication efforts.
We develop “Behavior Dictionaries” for each consumer that describes individual behaviors and what the behaviors communicate. These are based upon our experience with the individual consumer and are dynamic in nature.