Observations
Based upon an interview with employee #3 on July 11, 2008, and a review of nine client records on July 10 & 11, 2008, seven client records were reviewed for verification that work done by clients at the project was an integral part of their treatment. The facility failed to document in three of seven comprehensive treatment plans how work at the project is related to client treatment.
Client records #2 & 4 did not identify work done by the clients as work therapy in the comprehensive treatment plan.
Client record #1 included work therapy in the treatment plan; however, it was not defined as to how the work being done by the client served as an integral part of his/her therapy.
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Plan of Correction
Clinical Director met in a group supervision session on 7/15/2008 to address the importance of the implementation of "work therapy" on treatment plans. The clinical director retrained the staff in the appropriate completion of treatment plans, specifically in relation to work as treatment goals. The clinical director will review this monthly with each counselor during their supervision session. The process will be documented on the comprehensive treatment plan for each individual client. The documentation on the comprehensive treatment plan will indicate the therapeutic relationship between living a sober lifestyle and one's work ethic. This documentation will also include any "special needs" of the client in regard to work performance, client's work history, or disability. Daily details, community service, and special projects can all be utilized in the treatment planning and treatment plan update phases of treatment. The Clinical Director will include this training on the monthly supervision form he completes with each clinician. Clinical Director will monitor compliance on a monthly basis when he completes chart audits.
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