Your Questions Answered

General

1. What is Safety-Care?

Safety-Care is a competency-based crisis prevention training program for professional staff who work with individuals who have the potential for dangerous behavior. It was developed and is provided by QBS LLC.

2. How is Safety-Care different from similar courses?

There are a number of ways that Safety-Care differs from other behavioral safety or “crisis management” courses. These include:

• Safety-Care procedures are based on procedures drawn from research on Applied Behavior Analysis (ABA). It is entirely based upon a positive reinforcement paradigm—in every technique. However, the curriculum is designed to be taught by and for staff who may or may not have prior training or experience with ABA procedures and concepts.
• We teach important concepts of behavior support directly within the course, including reinforcement, functional assessment, and differential reinforcement.
• Safety-Care is designed to be effective both with individuals who have the communication skills to engage in complex verbal interactions and with those who do not.
• De-escalation procedures are based not on a vague “processing” approach but on identification, prompting, and reinforcement of specific alternative behaviors. This procedure is easier for staff to learn and less likely to reinforce crisis behaviors.
• Physical procedures are designed to be both effective and gentle. Each procedure avoids any stress/hyperextension of joints, pain, or skin damage.
• Safety-Care is focused on practical methods for preventing, minimizing, and managing behavioral crises. Lectures are designed to support the acquisition, practice, and demonstration of competency with a series of specific functional skills.
• Safety-Care is taught using behavioral instruction methods such as errorless learning, task analysis, and role-playing to ensure competency on each critical skill.

Curriculum

3. What’s in the Safety-Care core curriculum?

The Safety-Care core curriculum is presented in a least to most restrictive format designed to provide staff with skills for prevention, minimization, and management of dangerous or challenging behaviors. Each chapter provides practical, functional skills for use in just about any educational, human services, or medical setting.

4. What physical procedures are included in the Safety-Care curriculum?

Safety-Care provides physical prevention, safety, and management procedures that are designed to be simple and safe. The physical prevention and safety skills include safe approach and contact strategies, physical redirection procedures, basic physical safety skills for safely avoiding contact, and releases from a variety of grabs (wrist grabs, clothing grabs, chokes, hair pulls, and bites).

Physical management (restraint) procedures are designed to be infrequent, safe, and practical. They include a 1-person and 2-person standing hold (including management options if the individual drops to the floor), two 2-person transports, and a chair hold.

Additional physical safety and physical management techniques (including procedures for management in vehicles, floor holds, and other specialized interventions) can be added to the course via optional Safety-Care modules.

5. Can Safety-Care be customized to meet our specific training needs?

Yes. You can select which parts of the curriculum to train staff in (within certain limits). Also, there are additional modules that can be added to the Safety-Care core curriculum to make it specifically suited to the needs of your staff and the individuals they serve.

Populations and Settings

6. What settings is Safety-Care designed for?

Safety-Care is appropriate for use in residential programs, schools, hospitals, day programs, group homes, foster care, clinics, mental health centers, rehabilitation programs, and other support settings where there is the potential for dangerous behavior.

7. What populations is Safety-Care designed for?

• Ages: Safety-Care has been designed to be safe and effective for a wide range of ages, including children, adolescents, and adults. There are some special sections that are taught for staff who will be working with smaller children.
• Cognitive and communication ability: Safety-Care is designed to be effective when working with individuals across the full spectrum of cognitive, language, and neurological abilities and disabilities. It provides interventions appropriate both for individuals who are highly verbal and able to engage in complex rational decision making and those who have significant challenges in domains such as communication, executive functioning, and social interaction.
• Challenging behaviors: Physical aggression, Self-injury, Verbal aggression, Uncooperativeness, Hyperactivity, Suicidality, Elopement, Tantrums, Sexual aggression, Intimidation, Use of weapons, Bullying, Property destruction, Fighting, and more.

• Treatment modality: Safety-Care is complementary to a wide range of treatment modalities and specialties. These include applied behavior analysis, positive behavior supports, cognitive-behavior therapy, social work, psychiatric rehabilitation, special education, medical model, person-centered planning, trauma-informed care, strength-based treatment, and others.

8. What settings is Safety-Care not designed for?

Safety-Care is not designed for law enforcement or adult correctional settings. (It is appropriate for any staff, including Security, in a healthcare, education, forensic, or human services setting.).

Training Details

9. How long is the training?

The core Safety-Care course is two days in length (12–16 hours of training time, depending on the size of the class and experience of the trainers). Trainer training in the core curriculum is three days. Additional modules require more time. An abbreviated version of the course may be shorter.

10. Can staff in our organization be trained as trainers?

Yes. There is a trainer training version of the course that includes the full curriculum, plus extensive material on instruction methods, practice in training, and additional written testing to ensure competency.

11. How many staff can be trained at a time?

Because of the intensive, competency-based nature of the course, no more than 10 staff may be taught by a single trainer per class. Two trainers can train up to 20 trainees. No larger class sizes are recommended.

12. Who can certified trainers train?

A certified Safety-Care trainer can train staff who work for his or her organization. Trainers may not train others (staff who work for other organizations, family members of persons served, independent consultants, etc.) without prior written approval from QBS. If you have any questions about who may or may not be trained, please contact us.

An optional specialized module, Safety Care for Families, is available for certified trainers to provide crisis prevention training directly to families and others who provide support in home or home-like settings.

13. Do certified staff receive documentation?

Trainees receive a training manual and QBS provides an electronic certificate for each person who passes the course (Safety-Care Specialists). Certified trainers also receive a certificate and access to electronic copies of training documents.

14. Are we required to buy instructional materials for in-house training?

The Trainer course includes a copy of the Trainer’s Manual and electronic copies of all necessary documents. Trainers may make as many copies of training docu-ments (including the Trainee Manual) as needed for training. There is a modest fee for replacement of a Trainer manual.

15. Is there a fee for certification?

Yes. When training is provided by trainers who work directly for your organization, there is a small administrative fee to cover certification of trainees. That fee applies to each initial training and annual recertification.

16. How often is recertification required, and how long does it take?

Certification lasts for one year for both Trainer and Specialist levels of certification Specialist recertification of the core curriculum takes half the time of an initial class (usually about one day). Trainer recertification is one day class. If recertifying during an initial trainer training it is a two day class. If a trainer or specialist is certified in additional modules, those also require annual recertification.

17. Why is recertification required annually?

Safety-Care provides training in a wide range of skills that are critically important for safe, supportive, and humane interactions with individuals who may exhibit behav-ior that is dangerous to self or others. Staff who don’t remember what to do or use skills incorrectly can put themselves, other staff, and the individuals they support at serious risk. While some Safety-Care procedures may be used frequently, no one uses all of the Safety-Care skills often enough to maintain competence indefinitely. For these reasons, we require an annual retraining and competency check to make sure that both trainers and specialists maintain their skills so they can be used cor-rectly when needed.

18. What are the physical requirements to participate in the course?

Anyone can participate in the non-physical portion of the course. To complete all of the physical skills, the requirements are:

• Normal degree of flexibility, can bend at the waist at 45 degrees and twist to either side
• Ability to stand, walk, run, and shuffle (including shuffling backwards) for at least several minutes.
• Ability to transition from standing to kneeling and return to standing without needing assistance or support.
• Can grasp firmly and raise hands above the head.
• Learn and correctly demonstrate multi-step physical procedures.

These requirements should be reviewed and discussed with anyone who will be expected to complete the full Trainer or Specialist courses. It is possible to be certified in the overall course while having restrictions on specific physical procedures that a trainee was not able to safely demonstrate. A Specialist with a restriction is not trained or certified to use that procedure, while a Trainer with a restriction is also not able to teach that procedure.

19. How should we select staff to become Safety-Care trainers?

If your staff will be trained as Safety-Care Trainers, we recommend that you putcareful thought into deciding who will participate. Optimal participants in the Trainerclass are:

• Experienced and respected staff.
• Enthusiastic about becoming a Trainer.
• Comfortable presenting to an audience
• Capable of learning and demonstrating moderately strenuous physicalprocedures.
• Able to commit to the time requirement of training and staff support.
• Fluent speakers and readers of English, as well as any language they might beteaching in.

Other

20. Are there research stidied that support Safety-Care?

Yes. There is no behavioral safety course that has a stronger base of researchevidence than Safety-Care. The procedures used are based on a large number ofscientific studies in the field of Applied Behavior Analysis published in peer-reviewedjournals indicating the effectiveness of the selected procedures for treating problematic and dangerous behavior. A bibliography is included in the trainer manual.

With respect to research specifically about Safety-Care, a pediatric hospital published a study of their restraint reduction program and found that, following implementation of Safety-Care, there were clear reductions in injuries, use of restraint,and worker’s compensation costs.

Reference:

Paccione-Dyszelwski, Margaret R., et al. (2012). A Crisis Management Quality Improvement Initiative in a Children’s Psychiatric Hospital: Design, Implementation, and Outcome. Journal of Psychiatric Practice, 18, 304–311.

21. What support will my organization receive from QBS after Safety-Care training?

QBS is committed to supporting the appropriate and effective use of the Safety-Care curriculum. After a training, QBS provides free chat, phone, and email support to Safety-Care users. QBS also periodically sends email bulletins to Trainers, hosts video Q&A sessions, and posts videos with information for Safety-Care users.

22. Will QBS provide legal or regulatory support if needed?

Yes. Upon reasonable request, QBS will testify on behalf of a client in legal or regulatory proceedings in which the client becomes involved, provided 1) such testimony shall be limited to a general description of Safety-Care, Safety-Care training methods, Safety-Care compliance standards, and other general characteristics of Safety-Care and its content; 2) QBS is provided sufficient notice to be available; 3) the client will pay consulting fees consistent with the then-applicable QBS daily consulting rate for each day (or any part thereof) of in-person testimony and reasonable out-of-pocket expenses incurred in connection with such testimony, including the cost of travel. QBS, however, will not provide testimony on behalf of a client if QBS is also a party to the same legal or regulatory proceeding or its activities are, independently, the subject of the same legal or regulatory proceeding.

23. How can I find out more?

Thanks for your interest in Safety-Care. Here are some ways to get more information:

• Point your web browser to: www.QBS.com.
• Call QBS toll free at (855) 727-6246 (855-QBS-MAIN).
• Send an email to: info@QBS.com.
• Send a postal mail inquiry to QBS, 49 Plain St., Suite 200, North Attleboro, MA 02760.

We’d love to hear from you and would be happy to answer any additional questions.