Last reviewed 10 November 2014
The piloting of the Care Certificate, which has been developed from the recommendations of the Cavendish Review, has now been completed. There should follow a short period of revision of its structure and contents before it is rolled out from March 2015 onwards but this seems quite a short timeframe in which to iron out inevitable glitches for what is a major innovation in training, writes Chris Payne.
“The start of a career journey”
The Care Certificate is the first practical attempt to apply a common framework of occupational standards and competences across the entire field of health and social care. It is described as the start of a career journey for anyone taking up a caring role in any health or social care occupation.
Attainment of the new Care Certificate will be obligatory for all new healthcare assistants and social care workers if they are to be allowed to carry out their work unsupervised. Care service providers and managers will be asking: What do we have to do differently to put our new staff through the Care Certificate? Will it take up more time and will it cost more?
The Care Certificate will replace the Common Induction Standards, which are by now firmly established, and the National Minimum Training Standards, which, as they were only launched in March 2013, have not really taken root.
It consists of 15 occupational standards, some of which are similar to the Common Induction Standards, and some new topics that reflect the much broader scope of the certificate target group; standard “basic life support” being an obvious example here. The Care Certificate does not replace the requirement to provide all new workers with an induction programme for the particular work setting, though there are plenty of crossover points, eg in terms of learning about health and safety, which is a certificate standard requirement.
The 15 Care Certificate standards
Understand your role
Your personal development
Duty of care
Equality and diversity
Work in a person-centred way
Privacy and dignity
Fluids and nutrition
Dementia and cognitive issues
Basic life support
Health and safety
Infection prevention and control
As with the Common Induction Standards, the Care Certificate is expected to be completed within 12 weeks of the person starting his or her employment. This timescale will probably need to be reviewed as it seems too tight and might not be practical in many situations without compromising the quality of the learning and assessment.
Only health and care workers who are new to the work will be required to achieve the Care Certificate, although there would seem to be nothing in principle to prevent existing staff from achieving it too, by showing that they have met all the standards.
Non-care staff might also achieve part of the Care Certificate by meeting specific standards, where relevant. For example, everyone working in services for people with dementia and involved in some way with their care and support could be expected to achieve Standard 9: Dementia and cognitive issues. However, the certificate guidance makes it clear that, to be awarded the certificate, “the person must meet all of the outcomes and assessment requirements”.
Given that not all of the required standards are applicable to every health and social care setting and corresponding roles, this requirement could prove problematic to the attainment of the Care Certificate in some cases.
For example, care home and care at home providers will need to pay particular attention to Standard 12: Basic life support, which requires them to provide training to all new staff (and, by implication, existing staff) in basic life support at level 2 as specified by the UK Resuscitation Council. Although the need for a person to be resuscitated might occur at any time and in any place, to make this a mandatory requirement for every new care worker in every setting might be stretching the matter too far.
Not an accredited qualification
It is surprising to find that, as with the Common Induction Standards, the Care Certificate will not be accredited by a recognised awarding body, but will be awarded by the staff member’s employer following assessment by a “professionally approved assessor”. As with the Common Induction Standards, certificate holders can then use their achievement as contributory evidence for further qualification (eg Diploma in Health and Care) purposes.
The Cavendish Review made some trenchant criticisms about the lack of consistency in the application of the Common Induction Standards as a result of assessments being the responsibility of individual employers. It recommended the Care Certificate as a means of assuring that all healthcare and social care workers would be able to attain comparable levels of competent and kind care wherever they were employed.
Without the Care Certificate being formally accredited, which would show achievement of a common national standard, it is difficult to see how the recommended consistency will be realised. This is a fundamental weakness as it calls into question whether the changes required to implement the Care Certificate are worthwhile.
As with the Common Induction Standards, it will be left to the Care Quality Commission (CQC) to make sure that new staff are being trained to certificate standards and meeting its requirements. Given that the CQC is embarking on its new inspection ratings-based approach at the same time that the Care Certificate is being rolled out, it is difficult to see how it will find the time and space to assess the standards with sufficient rigour.
Also, inspectors are not appointed for their training expertise, so in no way can they take the place of a proper accreditation system. One can only assume that the complexity and costs of providing an accredited certificate have overruled all other considerations.
Achieving the Care Certificate
New staff will achieve their Care Certificate through a combination of training, supervision and assessments of their learning and competence.
It is recognised that the assessment will “differ dependent upon the component part of the Care Certificate”. As with the Common Induction Standards, candidates will be able to meet the knowledge requirements through formal and informal training, e-learning and other accepted forms of learning. They will have their learning assessed following the templates included in documents provided for assessors.
For example, to show their “understanding of the importance of equality and inclusion” (Standard 4.1), they must explain to their assessor (verbally or in writing) what is meant by diversity, equality, inclusion and discrimination. Verbal evidence can be provided from a one-on-one discussion or as a group exercise. The written evidence will feature in a workbook or portfolio.
Assessors should accept evidence from simulations and role-plays only where it is impossible to observe the candidate directly for those elements that require assessment by observation. It is not permissible to make assessments via Skype or from videos, presumably because of difficulties of verifying the evidence. (This would be less problematic in the use of Skype, one would have thought, for assessing some knowledge elements, where candidates have to “describe”, “list” or “explain”.)
As is conventional with all vocational qualifications, certificate candidates must have their practice observed to meet some of the criteria. For example, the assessor will have to decide from observation if the candidate is showing respect for people’s “beliefs, culture, values and preferences” in his or her work with them (Standard 4.2b). The assessment will be recorded in the candidate’s workbook/portfolio.
This example shows how the assessment methods have been refined compared with the Common Induction Standards, which had no required observational component in the equivalent standard. On the whole, the assessment requirements are clear for each standard and elements.
What is less clear is who should be doing the assessment. The documentation states that assessment should be carried out by an assessor who is “occupationally competent”. It does not specify whether occupational competence means that the assessor must or should have a recognised qualification to carry out the role, and who might be external to the individual’s supervisory or line management relationships.
The Assessor Document implies that the assessment is best done by a single assessor, with whom the candidate will have a formal working agreement on what will be assessed and when. It does accept, however, that it will not always be practical for one assessor to assess everything.
Where more than one assessor is required, there would always be a lead assessor to check and pull together with the candidate the agreed assessment plan. Assessment is expected to be carried out with the same rigour as for an accredited qualification. The assessor will notify the registered manager or responsible individual that the candidate has successfully completed the assessment. The manager or responsible individual will then sign off the candidate and award the Care Certificate. The employing organisation therefore will be responsible for the quality of the certification process.
Supervision and assessment
There is a crucial distinction to be made in the certification process between supervision and assessment.
A key principle of the Care Certificate in line with the Cavendish Review is that new and inexperienced staff should not be allowed to work unsupervised until they have shown that they are competent to do so. Once they have obtained the Care Certificate they will be considered sufficiently competent to carry out the work without being under direct supervision.
The assessment framework does allow for phased assessment, so that if a candidate successfully completes one standard or elements he or she could be allowed to carry out the work associated with that standard unsupervised.
The Technical Document includes this statement: “A care worker who has not yet successfully completed any standard of the certificate must be supervised directly for this standard and always be in the line of sight of the individual providing supervision. Indirect/ remote supervision of the HCSW/ASCW will still be required following award of the certificate.”
From a study of the standards, the idea of flexible supervision relative to standard achievements does not seem very realistic, in general. One standard that might be assessed early through observation, with competence in it assumed thereafter and therefore not requiring further direct supervision, is Standard 15.2b: Infection control — “demonstrate effective hand hygiene”, ie “make sure you wash your hands”.
Not all of the standards require supervised practice and those that do (mainly relating to Standard 5: Work in a person-centred way) will need to be assessed as a whole rather than in terms of their individual elements.
There are several elements requiring observed assessment that it is acknowledged might not present opportunities for assessment during the 12-week period. Assessments can then be made using simulation or role-play. If it is likely that a new care worker will not be experiencing these situations in this period, one wonders why they are included in the assessment framework as this will lead to unnecessary complications in the certification process.
One implication of the certification process is that, in some services, new workers could be seen as supernumerary for up to 12 weeks, with the costs of this having to be taken into account. This is in addition to the costs of the Care Certificate itself.
Employers will be expected to keep records of certification and presumably should be prepared to verify the certification of employees who are leaving to take up similar jobs elsewhere. Certificate holders will, of course, carry their certificates with them from one job to another so that they do not have to start their training afresh every time.
The principle is, in line with The Cavendish Review, that by achieving the certificate they will have the right caring attitudes and be deemed competent in the fundamentals of care to take up any related role, eg as healthcare assistant, or care home or domiciliary care worker.
Any changes to the certificate framework following the pilots are awaited with interest. There is no doubt that a common framework of occupational standards for healthcare assistants and social care workers is a step in the right direction, not least because of the increasing interchangeability of these respective roles.
The Care Certificate is arguably more of an innovation for healthcare assistants and the healthcare services than it is for social care, which at least has an established structure of training and qualifications. For social care, the Care Certificate does not appear to be the most helpful of developments, adding little or no educational value to the current Common Induction Standards, but at the same time requiring significant organisational change and costs.
It is difficult to say at this stage, but one suspects that certificate programmes will increase care providers’ training costs, particularly where they have to buy in external training and assessment. Meanwhile, sources of funding remain unknown.
Whether the lack of accreditation will erode the value of the new Care Certificate remains to be seen. One fears that it will.
Background information can be found on the Skills for Care website.
There are three supporting documents:
Healthcare Support Worker and Adult Social Care Worker document (learner document).
Care providers and managers are advised to study these. This documentation is currently in draft form and should be updated in the near future.