CQL | The Council on Quality and Leadership

Never A Stranger at My Door

Posted 6/25/19 via Capstone
By Cathy Yadamec | CQL Director of Personal Outcome Measures®

Imagine coming home and when you walk in the door of your home a person greets you, helps you to put away your coat, makes you dinner, then helps you shower, change your clothes, and get ready for bed. Now imagine that you have never met this person before in your life. For some people in full life service, this is their reality on a regular basis. Involving people in the interviewing, training, and evaluation processes for organizational staff - at all levels - sends a strong message that the organization values the opinions of the people receiving services. It supports the person to take control of the important things in their lives - to lead self-directed lives. It increases the likelihood that there will never be a stranger at the person’s door to provide support.

People receiving services must be actively supported to be involved in hiring, training, and evaluating staff. In this Capstone article we highlight a few of those organizations and share data from approximately 1,500 Personal Outcome Measures® interviews. In those interviews we found that most organizations are not actively soliciting information about preferences for staff, providing people with options, or honoring their choices about direct support professionals (DSPs) or other staff. We hope that this Capstone gives you some ideas about what you can do to change your systems and practices around including people supported in hiring, training, and evaluating their staff.


What Data Tells Us About Staffing Decisions

By Carli Friedman | CQL Director of Research

According to approximately 1,500 Personal Outcome Measures® interviews conducted by Certified Interviewers in 2018, most organizations did not actively solicit people receiving services’ preferences, provide them options, or honor their choices regarding direct support professionals or other staff. The figure below details the percentage of organizations which solicited and honored people’s opinions regarding staff in the following categories: home; employment; health; case management; and, community. 


Organizations Actively Soliciting the Person’s Preferences,
Providing Options, and Honoring Choices About Staff

Percentage of Organization That Actively Solicit the Person’s Preferences, Provide Options to The Person, and Honor the Person’s Choices About Staff

Organizations most often solicited and honored people’s opinions about community staff (54.2%), and least often about employment staff (40.9%). However, the numbers were relatively low regardless of staff type. This is problematic not only because people are not being involved in decisions that directly affect them, but also because when they are included in decisions about staff, people have higher quality of life (see figure below). When organizations actively solicit the person's preferences, provide options to the person, and honor their choices for all five staff types, the person has more personal outcomes present (14.5 out of 21 outcomes present; 68.8%) – better quality of life – than when they do not do this (8.6 out of 21 outcomes present; 41.0%).


Relationship Between Involvement in Choices About Staff
and Total Personal Outcome Measures®

The Relationship Between Involvement in Choices About Staff and Total Personal Outcomes


Moreover, when organizations have a system that addresses the preferences and choices of people receiving services when hiring or identifying regularly assigned staff for them, organizations also score better on the Basic Assurances® (see figure below). Organizations that have a system that addresses people’s preferences and choices when hiring or identifying regularly-assigned staff scored higher on average overall on the Basic Assurances® – 81 out of 92 indicators present (88.1%) – than organizations that did not – 71 out of the 92 indicators present (77.5%).


Relationship Between Organizational Systems:
Involving People in Hiring and Total Basic Assurances®

Relationship Between Organizational Systems for Involving People in Hiring and Total Basic Assurances®


Expect the Best

By Leanne Mull | CQL Quality Enhancement Specialist

In my work at CQL, I specialize in providing CQL Training on the Personal Outcome Measures®, Rights, and Self-Advocacy. It’s my passion to include people with disabilities in my work. I especially enjoy co-teaching with self-advocates. My experience in supporting people with disabilities is that it is important to look at people’s strengths and individual life circumstances to guide their supports in everything they do but especially when people are hiring, training, and evaluating staff. 

Staff Hiring/Interviewing

Job interviewIn general, I see many promising systems and practices. Some organizations that provide employment, community inclusion, and other non-residential supports, have developed a pool of self-advocates to participate in interviews with applicants. In organizations that provide residential services, ideally, people who will be supported by the potential new hire should be included in the interview. Organizations should provide support so that people participating in interviewing applicants are prepared. Including people in interviews will result in some interesting questions that we may not think of. In talking to people who receive services about what questions they think are most important two popular questions were “What do you like to cook?” and “What do you like to do for fun?”

If having people receiving services participate actively in interviews is not something your organization is able to implement right away, start by having all applicants meet with the people they will be supporting. This is a great opportunity to gauge the comfort level and respect an applicant demonstrates.

Kim Harris with Developmental Services Center (DSC), serves as an advisor to the Advocates in Motion (AIM) self-advocacy group in Champaign, IL. The self-advocates told her “We feel that taking an active role in hiring and evaluating the staff we work with sends a strong message that they are first and foremost accountable to us, and that we expect the best from the staff that we work with.”

The interview process for DSC is:

  1. The program manager interviews the applicant
  2. The applicant visits the home and meets the people they might be supporting
  3. Self-advocates meet with the applicant and ask a series of questions
  4. The self-advocates who interviewed applicants meet with the program manager to talk about what they liked, and didn’t like about each person
  5. They decide together if the potential staff will be offered the position

The self-advocates developed their questions by thinking about people they have really enjoyed working with and what important qualities are needed to be successful. These are some of the questions they ask and why they ask them.


Ask: To Learn:
Why do you want to work here? What motivates the person
What are some of your hobbies or interests?  What can the person help us learn about; what interests and hobbies do we have in common
How do you handle differences of opinion?  Do they listen to people’s point of view and work to find solutions
Tell us about a time when you made a mistake and had to fix it.  Is the person able to admit mistakes and learn from them
What would you do if your supervisor told you to do something that you felt was wrong?  Is the person strong enough to take a stand for what’s right

Staff Training

Having people receiving services participate in on-boarding and orientation, along with staff training, can change the flavor of the relationship between the person supported and their staff. Examples of how to include people served in training include: having people describe their lives and what they want, talk about what program they work in, show people around, routines in the home, their self-advocacy group, and demonstrate communication devices or power chairs - the sky is the limit! If you are conducting transportation training, you can have a person talk about how it feels to ride on a wheelchair lift, and then have staff ride the wheelchair lift. If there are people who use Hoyer lifts, have the person receiving services talk about that and then have all new staff take a turn in the lift. 

Performance Evaluation FormStaff Evaluations

As staff, we work for the people who receive services from our organization. It is their funding that pays our salary, from the DSP to the Executive Director. Doesn’t it make sense then that the people we work for have a chance to evaluate us? Staff who work for organizations that have implemented this share that, at first, they were nervous about what people would say but now it is their favorite part of their annual review. When men from one group home were asked about staff, they declared that they really liked the man who worked in the morning because “He bakes muffins for breakfast!” You can bet that he continued baking muffins and was thrilled to hear how much that meant to the men with whom he worked.

Supporting people who receive services to participate in staff interviews, training, and evaluations is an excellent way to live out the concept of “person centered supports and services." There is a great resource for incorporating people receiving services into staff evaluations from the Self Advocacy Alliance.

The AIM self-advocacy group has also compiled a list of important criteria they use to evaluate staff:

  • Treats me with respect
  • Is trustworthy & responsible
  • Treats me like an adult
  • Communicates clearly
  • Listens to what I say
  • Is easy to find when I need help
  • Gives advice without telling me what to do
  • Offers choices and solutions when I’m having a hard time
  • Talks to me about my goals and dreams

“After seeing the positive results of advocacy and getting more involved, we developed a presentation called “Expect The Best: How to get the most out of your support staff”. In “Expect The Best,” we discuss hiring, training, evaluating, and solving conflict with support staff. We’ve enjoyed giving our presentation at conferences for self-advocates, as well as other professionals,” says Kim Harris. For more information, please contact Kim Harris at kharris@dsc-illinois.org.


Where the Rubber Meets The Road

By Cathy Yadamec | CQL Director of Personal Outcome Measures®

“Fundamentally as human beings we all want some of the same things. We want a place to belong, we want relationships, and we want to make a valuable contribution," says Deborah Conway, Executive Director of Cross Plains Community Partner. The organization provides employment services to people with intellectual and developmental disabilities in Dalton, Georgia, and successfully achieved CQL Person-Centered Excellence Accreditation.

Cross Plains Community Partner

She and others in the organization understand that including people being supported in hiring and training their staff is critical to the success of the person supported and the new employees. Adding people to the interview team was simple enough. The team included the supervisor, people supported, and someone in the same position as the person being hired. One of the responsibilities of the people supported and the person who had the same position, was to explain their expectations for the new employee. It's the way for each candidate to learn what the job really is about and to understand the mission and values of the organization.

Cross Plains Community Partner had to be creative and focused on developing resources for the interview so that everyone was prepared. Through the use of a one-page profile they had found successful for people they supported, they set about to design a system that identified the important characteristics and skills that the successful candidate should have. Using intentional conversations learned from years of partnering with CQL, they talked with organizational leaders that included people supported, staff in similar roles, and supervisors. While the one-page description included some skills, the focus was really on the traits people needed or wanted the successful candidate to have. While developing the one-page document, they didn’t utilize a specific format or even specific questions they would ask to develop the one-page description. Rather, they asked questions that would help them learn about what was important. For example, many people said they wanted someone just like “Elizabeth,” someone who had worked for Cross Plains Community Partner for eight years. They had to “peel back the onion” to find out what that means and learned that they wanted someone passionate about employment who really cares about getting a job the person liked. What they discovered was that people wanted the person to be “fun” because Elizabeth was very fun-loving in her approach and made people feel comfortable.Interview Questions Resource

They also designed an interview questions resource that would help the interview team evaluate whether the person might fit into the organization’s culture. Looking at the core values of choice, leadership, and employment, they developed questions like, “How does respect look?” and “Tell us about a time you took a leadership role?” Answers to these questions help the interview team evaluate if the candidate can put the organizational values “where the rubber meets the road."

Cross Plains Community Partner is committed to hiring the right person for the job. Here is an example of a one page description that the interview team used in their hiring process. Supervisors understand the importance of finding the person that meets their one-page description and would rather fill in themselves than hire someone who doesn’t match.

April DeLozier Job Coach and one of CP’s young leaders. Once there is a good match, the person supported and the employee’s mentor begin the training. Although there are people supported who participate in a traditional training presentation, the real training is the day-to-day experiences where people teach staff about what they actually need or what areas they would like to be supported. Training is ongoing and collaborative. New staff sit with people while they plan their schedule for the week. The goal is that the new staff see first-hand how people make choices about where they go and what they do. For example, Cross Plains Community Partner provides employment supports for Stacey at the Salvation Army. Stacey tells the new staff what supports he needs and when he needs them. He is also very good at providing feedback and telling people “to back off” if they are offering too much support. This puts the classroom training about rights and choices into action. New staff watch people make choices and exercise rights. Each person supported reviews their own one page descriptions with the new staff. This helps the new staff to learn what support the person wants and what is important to and for the person. It helps new staff to learn how to provide quality supports.

Cross Plains Community Partner embraces the value of leadership. At monthly leadership meetings, they invite people supported and staff to discuss what they are learning. Many people in the organization participate in leadership training and share their experiences with each other.

Over the years, the organization has learned many things about including people in hiring and training staff, something they refer to as the “overhauling” of their system and practices:

  • They estimate their retention rates to be at around 84%, which is higher than the national average. They find that people leave for “legitimate” reasons like they are moving out of the area.
  • Outcomes and supports for “People experience continuity and security” (CQL's Personal Outcome Measures®) have improved.
  • People supported are empowered. They are connected to the organization and feel free to initiate conversations with supervisors and others about their experiences of what’s working and what’s not working for them.
  • They rarely hire candidates solely based on years of experience supporting people with disabilities. Their focus is on finding the right candidate that meets everyone’s expectations as written in the one-page description.
  • There are many leaders in the organization who don’t all have titles. They are leaders where the rubber meets the road. Cross Plains Community Partner seeks to identify the leadership qualities of all people - Direct Support Professionals, people with disabilities, board members, and the leadership team. In this quest to discover everyone’s skills, the organization promotes leadership. Ms. Conway says their goal is to create an environment where everyone is a leader. She said that “first and foremost, this is about being in this all together.”

Involving people supported in hiring and training their staff improves quality of life and helps Cross Plains Community Partner to meet their goal of empowering people with disabilities to live their best and most fulfilling lives.


Print edition of Capstone e-Newsletter 

CQL is offering a version of Capstone e-Newsletter that can be downloaded, printed, and shared. The online edition still contains the most robust information with hyperlinked resources, but this PDF version provides another way for you to share best practices.

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