Tuesday, February 21, 2017

Spot Check

On Friday, the State pulled files from one of the agencies that works with Lyn.  Our family's file was pulled for a spot check.  It has been pulled for inspection at least 5 times before.

These inspections involve representatives checking the files with the agency and seeing if everything is in order.  Has it been filed on time?  Are the monthly reports all there?  Are any necessary forms missing?  If there was an incident noted in the monthly report, is there a separate incident report?

They also visit the residence of the client.  They look to see if the client is living in a safe setting.  Does the client have a designated personal space for their belongings and their sleeping arrangements?  Does the client have the ability to go into another room for privacy?  This is not just about the physical space such as does she have her own room.  It is also about permission.  Does she have the right, the self-determination to decide to seek privacy and does the care giver respect that decision or are her rights as an individual limited by those around her?

The staff look for the notebook that is to be kept at the residence.  There are particular forms they look for there and they look to see if the daily activity log is up to date.  They will (and did) ask to see any dates which have not yet been submitted to the agency.  Mom was missing a printout of a single policy.

They also look for medical care resources.  What medications is the client on?  Are they up to date?  What allergies does the client have?  Does the care giver know and understand the risks of allergic reactions up to and including death?  Does the care giver know what to do if the client has a seizure or other medical emergency?  Does the care giver know how to administer or over see the taking of medication?  Does the residence have a first aid kit and is it properly filled?  Mom had a tube of expired neosporin in her first aid kit.  She indicated that she wasn't surprised it was expired because is it not a product they use.  That raised some eye brows.  Mom explained that she uses aloe instead and the response was not positive because aloe is not on the approved list of care options.

The State inspectors had questions for both Lyn and Mom.  Their questions were all answered in detail and at least one of the inspectors was surprised by some of the answers.  When they asked about "any noticed changes in the past year," Mom indicated that the Alzheimer's had progressed.  One of the two was familiar with Alzheimer's and the disease's progression.  When they asked if she lost weight, Lyn proudly exclaimed that she continues to loose weight.  One inspector was a little concerned about Mom doing something to Lyn to make her loose weight and Mom explained that it is a side effect of the Alzheimer's because the body is forgetting how to absorb nutrients.  Mom noted that the recent visit to the audiologist confirmed a 95% hearing loss in the left ear (Alzheimer's origin) and the physical revealed a near total loss in the ability to smell (also a result of Alzheimer's).

Overall, the inspection went well.  Lyn was cooperative.  Mom might be dinged on the two minor and easily corrected issues.

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