Camilla Cavendish’s review into the learning and development of the unregistered health and social care workforce found multiple inconsistencies in the application of training standards for frontline staff. Some employers were sending workers home with a video to watch at the end of their first shift, while others were providing no training at all.
The overall picture was some unscrupulous employers were just not understanding the importance of this sort of thing, the Sunday Times journalist told Community Care ahead of the launch of the Care Certificate, one of the key recommendations from her review.
The certificate, which comes into force on 1 April, sets out 15 national standards that all new workers joining the health and care sectors will be expected to meet.
The Care Certificate standards have been developed by Skills for Care, Skills for Health and NHS Health Education England and will be rolled out from 1 April 2015.
1. Understand Your Role
2. Your Personal Development
3. Duty of Care
4. Equality and Diversity
5. Work in a Person-Centred Way
7. Privacy and Dignity
8. Fluids and Nutrition
9. Dementia and Cognitive Issues
10. Safeguarding Adults
11. Safeguarding Children
12. Basic Life Support
13. Health and Safety
14. Handling Information
15. Infection Prevention and Control
“One of the good things about the certificate is it’s not just about functions,” said Cavendish, who was asked to undertake the review in the wake of the Francis Inquiry on the Mid-Staffordshire hospital scandal.
“It’s about working in a person-centred way, it’s about dignity, and it’s about how you respond to people – the best kind of social care.”
But while Cavendish is hopeful the standards will create a more valued workforce, she admits she did not find “the perfect answer” to ensuring employers, who are responsible for quality assuring teaching and assessment of the certificate, actually enforce it.
“A number of people had discussions about if it would be possible to create a central body to assess quality but I’m very aware I didn’t solve that problem either,” she said.
“The potential danger is that people may not take it sufficiently seriously…I think we will have to look at it in a year’s time and see how it’s working.”
The Care Quality Commission (CQC) will have a critical role to play in the meantime, she added, as the regulator has “ended up being the enforcer on this one”.
The CQC has published guidance for providers on how to meet its new standards and have stated that employers of health and social care workers should be able to demonstrate that staff have, or are working towards, the skills set out in the Care Certificate.
“The CQC’s role will be very important in terms of ensuring this is front of mind when inspectors go in and that they are observing practice,” said Cavendish. “It is absolutely critical that we have these standards and that they are observed on the frontline.”
The Care Certificate will replace the existing Common Induction Standards and National Minimum Training Standards for healthcare assistants and social care workers, and was piloted with 29 employers in 2014, including 16 from the adult social care sector.
It was agreed that the initially proposed 15 standards would remain, subject to some amendments, and individuals would be expected to complete all of them before being awarded the certificate.
“It was very important to me that we piloted the certificate and that we took note of what employers thought of the standards,” said Cavendish. “We wanted them to be relevant and not to be overly burdensome – from what I understand employers are happy with them.”
Cavendish added that most of the amendments were “fairly uncontroversial” but she was surprised by the response to standard 12, which requires workers to complete basic life support training that meets guidelines published by the UK Resuscitation Council.
“I know there has been some push back from the social care sector on this,” she said. “I was a bit disappointed by that to be honest because it’s not acceptable to expect a domiciliary care worker to just call 999 when there’s a problem.”
Similar to the Common Induction Standards, health and care workers will be expected to complete the Care Certificate within 12 weeks of starting employment. This includes training, education and assessment, which will differ depending on each element of the qualification.
“We wanted to make sure this wasn’t just a tick box exercise, it has to be about observed practice,” said Cavendish. “The timeframe for completion shows this is something serious – if you expected people to do it in a week then it wouldn’t be taken seriously.
The certificate will however not receive any formal accreditation – something sector professionals have been calling for – but Cavendish believes it can work without it.
“I absolutely envisaged this would be a basic qualification but under discussion now is a higher certificate and I think we are going to see a new kind of career structure developing out of this,” she said. “But it is has been very important to do this carefully and not rush it.”
Once completed, the certificate is portable and the aim is that it will allow healthcare assistants and social care workers to move more freely between the sectors.
“I hope this will be the foundation towards getting one workforce with increasingly overlapping skills, which is useful across the sectors and will breakdown the silos between them,” said Cavendish.
“At the end of the day, this is about valuing these staff and explaining to people that what we call basic care is not basic, it is actually really skilled.”