QUALITY OUTCOMES REPORT – Living Situation
Keystone Institute India
October 2024
Keystone Institute India is pleased to provide a summary report of our efforts over the past year to both quantify and qualify our work towards our two major objectives in India.
1. Provide the foundational understanding and subsequent implementation tools to forward the movement to a more inclusive society in India.
2. Communities become more inclusive of people with disabilities through developed infrastructure, learning opportunities, and partnerships led by KII.
Although our scope is broad and covers many areas, we will limit this report to the areas of direct relevance to Quality Initiatives and quality thrusts of Keystone Human Services. We operate under a robust Monitoring, Evaluation and Learning Plan with our primary funder, the Rural India Supporting Trust, which sets specific targets and activities to be met and completed.
Evaluations of Services
With a dual aim to a) assist existing allied programs across India to improve services b) develop evaluation skills among All-India SRV Leadership Alliance members, our current 5-year grant involved conducting 5 multi-day onsite, intensive evaluations since 2020. Of these evaluations, three included services with a residential focus as follows. The table indicates how many recommendations were made, how many were directly relevant to residential services, and how many of those recommendations were followed up with programmatic changes.
We are also very pleased to note that two individuals identified as job seekers have obtained full-time, fitting work. Four other people have obtained internships which may lead to work.
Community Lives: We continue to promote and work towards inclusive employment within the Community Lives program, serving 8 women previously institutionalized. There is no new data to add since May of 2024, the women continue to earn at about the same averages over the past month.
Jhalak, our annual magazine highlighting the ideas of inclusive practice at work in the lives of people and organizations across India continues to be circulating widely online and in print. The three Supported Employment Hubs, located in Kolkata, Bengaluru, Delhi, and previously reported on continue as before, with no new data to report, but showing great promise. These hubs have resulted in high quality job profiling for 9 people, and fulltime work for one person along with several internships for others.
II. Living Situation/Goal Attainment
We continue to work towards the reunification of institutionalized persons with their families in the Himalayan state of Uttarakhand. As reported in June of 2023, we successfully reunified 16 persons from two institutions. As of one year later, 27 people have been reunified, as the following chart indicates:
Year Number of Reunifications
2022 7
2023 15
2024 Jan - June 5
The government is pleased with our work, and as a result we have mapped the additional 4 government institutions for women with disabilities in Uttarakhand. A comprehensive mapping report can be viewed here, showing the immense amount of information gathered about institutionalized
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women who may be able to be reunified. It should be noted that two of the reunified persons have left their homes and are living elsewhere. We know that this is inevitable in reunifying families which have significant stressors, even with good planning and support. However, we continue to reach out to family and local authorities to help the families locate both of the persons.
III. Satisfaction and Other Quality of Life Measurements
In 2023, we provided data on Perceived Quality of Life for eight of the women we have supported to leave the Nari Niketan government institution in Dehradun, demonstrating consistent improvement before and after, and also over time. This measurement is important because it informs us if the women believe they are “better off” than they were at the institution and continued use tracks this perception over time. However, we wish to close this annual look-back with the additional data that was collected, reminding us that living in the community appears to be, across time and across cultures, better for people in every way we can measure. Only in collecting and showing the longitudinal data can we see a proxy for the immense benefits of community living. The full report can be viewed HERE, and shows immense improvements over time in the areas of autonomy and control, integrative activities, elements of person-centered planning, adaptive skills, and challenging behavior, as well as the already reported ‘perceived quality of life’.
IV . Health and Well-Being
‘Direct Support Practitioner’ is not a role that has been well -defined in India, and we recognize that the formation of a valued and dignified profession matters as we move towards a more inclusive society. In March of 2024, we reported on the Foundations of Direct Support Training Modules as our effort to create a national curriculum for the formation of Direct Support Practitioners. Of the numerous modules, this includes 5 specific module sections addressing areas of health and well-being. As noted, the modules cover the following areas:
1) Assessing Healthcare Needs
(2) Assisting with Activities of Daily Living
(3) Common Health Problems
(4) Interventions and Various Aspects of Safety.
(5) Wellness including both Physical and Mental Health Wellness
46 Master Trainers from across the country (16 states) have been certified by completing a rigorous course and are also actively training the modules. As last report, in March, we noted that 1345 persons have received the DSP Phase 1 training, and this has now increased to 1402. As a testimony to
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the quality of this effort, Ms. Vinakshi Singh, both a Master Trainer for the course and a fully mentored protégé of KII, received the ANCOR International DSP of the Year award in April of 2024.
Lastly, it should be kept in mind that that national training institute offers a great deal of high-quality training and development across the country, impacting thousands of people with disabilities and their families. A significant amount of information is collected on the scope of these events, the impact, and the satisfaction of those who engage with us.
Respectfully Submitted,
Elizabeth Neuville Executive Director, KII