16th January 2015 Written by Skills for Health

Image: Carer and wheelchair user.With the much-anticipated Care Certificate due to commence roll out nationwide in April this year, the healthcare sector is keen to hear more about the progress of this ground-breaking initiative.   The background to the project is well-known – in the wake of the Francis Inquiry into the Mid-Staffordshire NHS Foundation Trust, Camilla Cavendish was appointed to undertake an independent review of healthcare assistants and support workers across health and social care.  Whilst recognising the value of these workers within the sectors, the review also found that the quality of training and support that they received in both health and social care varied greatly between organisations. Cavendish proposed that a ‘Certificate of Fundamental Care’, now known as the Care Certificate, be developed in order to deliver “common training standards across health and social care…written in language that is meaningful to patients and the public”.1

That was July 2013, and since then a partnership was formed led by Health Education England, working closely with Skills for Care and Skills for Health. The partnership’s remit has been to develop the standards and framework for the delivery of the Care Certificate, with guidance from the Department of Health and its Cavendish Governance Assurance Board. The outcome of this unique collaboration - the Care Certificate - looks set to be a first step in integrated health and social care education for these staff, with successful cross sector support and development at its heart.

Building on the Cavendish Review proposals

The Partnership was tasked with delivering a new certificate that would meet a number of different criteria set out in the Cavendish Review proposals, including that the initiative should be:

  • applicable across health and social care
  • portable across roles and transferable between employers

And should:

  • Build upon existing and tested Common Induction Standards (CIS) and National Minimum Training Standards (NMTS)
  • Work with, and as part of, existing qualifications
  • Equip  people with the skills and knowledge to be able to provide quality care and tests them to be  caring

The Care Certificate: the journey  

Part of the process of developing the Certificate has been to review existing standards and best practice across both the health and social care sectors to make sure that the very best of current guidance and practice is transferred over to the Care Certificate.  Following this, draft materials for the Care Certificate were developed and agreed in April last year and both formal and informal field testing took place since then until September 2014.

Field testing was an essential phase of the Care Certificate development, and the Partnership engaged with a wide range of employers and staff across health and social care in a number of ways. The formal pilot consisted of 29 organisations across health and social care, with a further 85 employers testing the Certificate involving over 1,000 support workers.  In addition, 80 organisations and individuals have responded directly to members of the working partnership, and Skills for Care received 155 responses to an online survey specific to the social care sector.  

The feedback given during this pilot phase and the comments submitted by employers was broadly positive and indicated that the draft proposals were appropriate in the terms of content and process. 

Care Certificate: Partnership key recommendations  

After a thorough analysis of the feedback, HEE, Skills for Care and Skills for Health made a number of recommendations which were agreed by the Department of Health Governance Assurance Board and publicly announced in December 2014.

The recommendations from the Partnership will help to shape the content, delivery and implementation of the Care Certificate when it is rolled out across England from March 2015 – from which point it will replace the Common Induction Standards and National Minimum Training Standards for all new starters in health or social care. 

A number of key recommendations from the Partnership have been accepted by the Governance Assurance Board and include:

  • The Care Certificate should be prioritised by employers for “new staff, new to care”.  
  • The Partnership has recommended that the suggested timeframe (12 weeks) for a full time employee to complete the Care Certificate remains as guidance for employers, but part-time support workers and those on low hours contracts may need longer to complete the process
  • That all employers will need to undertake assessment as prescribed in order for someone to be awarded the Care Certificate.  Detailed guidance on assessment will be available from January 2015.
  • Employers will be responsible for awarding the Care Certificate to individuals that have satisfactorily completed it. A nationally designed template for the Care Certificate will be made available
  • Quality assurance for the Care Certificate will be the responsibility of employers, and guidance will be produced on how employers can self-quality assure
  • A national workbook to accompany the Care Certificate will be developed and will be freely available to download and used or be used by employers as reference for developing their own materials

Care Certificate – the 15 Standards

The Care Certificate is based on 15 key standards which individuals will need to complete in order to be awarded:

  1. Understand Your Role
  2. Your personal development
  3. Duty of Care
  4. Equality and diversity
  5. Work in a person centred way
  6. Communication
  7. Privacy and dignity
  8. Fluids and nutrition
  9. Awareness of mental health, dementia and learning disability
  10. Safeguarding adults
  11. Safeguarding children
  12. Basic life support
  13. Health and safety
  14. Handling information
  15. Infection prevention and control

Portability and transferability 

Employees and employers will be reassured to that learn that the Care Certificate has been designed with transferability in mind. So, regardless of the setting in which care is delivered by support workers, the fundamental principles of the Care Certificate remain the same.  In other words, whether working in an acute hospital setting, a GP surgery or within domiciliary care, the Care Certificate provides employees with an essential understanding of the basic building blocks of care and the skills required to deliver this on the frontline. Once acquired, these “fundamentals of care” will be transferred by individuals between roles. 

The Care Certificate does not replace an employer’s induction process, but is a key component of the total induction process, which will naturally vary between organisations to reflect their individual visions, settings and language.

The role of the assessor and the assessment process

Many health and social care organisations will already have robust assessment processes in place to ensure employees are delivering the fundamentals of care to the best standards possible.  In this sense, the Care Certificate can be viewed as a way of standardising and formalising this process - and making it easier for all institutions and individuals to reach the high standards needed to ensure patient and service user safety and care.

The vast majority of supervisors  in both health and social care settings will be assessing the “fundamentals of care” in their staff on a regular basis and so the role of the manager as an assessor of the Care Certificate for new staff, new to care should be a natural progression from this.  The Partnership also envisages that many employers will utilise the standards set out by the new Certificate as a guide for all staff – to ensure that the current and future workforce as a whole is meeting the essential criteria to deliver frontline care. Whilst at the present time there is no requirement for existing staff to complete the Care Certificate it is likely that there will be staff who will be keen to do so and so employers can consider how best to retrospectively award it using review of each workers current experience and practice. 

So, how will assessment work?  The Partnership has set out that assessment must be within a care setting, in practice and with people who use services and patients.  Assessment will be completed face-to-face by an occupationally competent assessor.  Ultimately, the employer is responsible and accountable for assuring the quality of the delivery and assessment of the Care Certificate. Certification should be recorded by the employer and where possible, made accessible (for example, recorded on ESR – electronic staff records – in the NHS).

Certification: what does it mean for support workers?

The Care Certificate is a step to meeting the essential standards set out by the Care Quality Commission and there is an “expectation” that it is completed by all new starters in care and that this process is in place by the middle of 2015.

It is important to note that the Care Certificate should be seen as just the start of the journey for those applicable support workers entering the sector within Bands 1-4 – the knowledge and skills required to achieve the Care Certificate’s 15 standards cover the fundamentals of care. This is the first “stepping stone” from which support workers can enter a career pathway, taking advantage of opportunities such as apprenticeships and diplomas.

On completion of the Care Certificate, support workers will be awarded a Certificate.  The Care Certificate will be valid and have ongoing relevance throughout an individual’s personal career pathway.

Supporting the roll-out

The launch of a new initiative with such significance to the delivery of frontline care, spanning both the health and social care sector, naturally raises a number of questions for those tasked with its implementation.  The need for clarity in terms of delivery was an issue raised by a small number of organisations during the pilot testing and the Partnership has aimed to address this via the creation of a comprehensive series of support materials. These will include a national Workbook, and a range of guidance and supporting materials.   

The partner organisations will also be hosting a national event ‘The Learning Exchange’ where pilot sites will be sharing their experience of testing the Care Certificate with colleagues who have responsibility for learning and development. Furthermore, a series of regional events will take place from February to April 2015 for employer education and training leads to help prepare them for the delivery and implementation of the Care Certificate. These sessions will also give employers the opportunity to discuss their plans including delivery, assessment, learning materials etc.

Guidance, documentation and learning materials on the Care Certificate to support employers in preparing for the Care Certificate will be available to download free from the end of January 2015. Visit www.skillsforhealth.org.uk, www.skillsforcare.org.uk and www.hee.nhs.uk.  For updates on Twitter, follow or tweet #CareCert.

References:

  1. www.gov.uk/government/news

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