Client safety: Adult day services
Staffing shortages are affecting nearly every corner of human services, and adult day services centers are feeling the strain. These programs serve some of the most vulnerable individuals in our communities, often those with complex medical, cognitive, or behavioral needs. When staffing is stretched thin, the risks to client safety, regulatory compliance, and overall program quality rise sharply.
Why staffing matters
Adult day centers are built on trust, care, and vigilance. Adequate staffing is not just a best practice, it’s a safety requirement. Understaffing can lead to serious consequences: lapses in supervision, delayed medication administration, and increased incidents such as wandering, falls, or behavioral escalations. These are not just operational issues, they are potential liabilities.Managing risk in real time
Even during staffing shortages, there are proactive steps organizations can take to protect clients and maintain service quality. Key strategies include:
- Enforcing sign-in/sign-out procedures and ensuring staff have access to each client’s authorized pickup list.
- Maintaining up-to-date client files, including medical records, care plans, and medication logs.
- Training all staff and volunteers on abuse prevention, emergency response, and client interaction protocols.
- Monitoring staff-client interactions, both on-site and during off-site activities, with a written crisis plan in place.
- Establish a Fleet Safety Program: Create a safety program for all employee and volunteer drivers who transport clients, including screening through background checks and MVRs, and providing safety training, with specialized instruction for those operating 15-passenger vans.
Strengthening oversight and resilience
To go further, organizations should consider additional risk management practices that build resilience and reduce exposure:
- Cross-train staff to cover multiple roles. This ensures continuity of care and supervision when absences occur.
- Define volunteer boundaries clearly. Volunteers should never perform clinical tasks or supervise high-risk clients without proper training and oversight.
- Hold daily safety huddles to review staffing levels, client needs, and any emerging risks.
- Track incidents and analyze trends to identify areas needing additional training or staffing adjustments.
- Develop emergency staffing protocols, including on-call staff and pre-approved volunteers, with clear activation criteria.
- Stratify client risk levels to allocate staff more effectively and ensure high-risk clients receive appropriate supervision.
Turn awareness into action
When staffing is tight, it can be tempting to cut corners, but doing so can expose your organization to serious liability. Instead, lean on structured policies, cross-functional training, and proactive risk management. These strategies protect both clients and staff while reinforcing your commitment to safe, compassionate care, even in the most challenging circumstances
Resources
- Support this conversation: Adult day services centers checklist
- More on this topic: Volunteer management: Strategies for success
- Human services resources: Risk management for human services organizations