This online toolkit has been developed to assist those responsible for delivering the Care Certificate to new employees as part of their induction, and for upskilling current employees. It has been created for a wide range of health and care staff, from small independent care homes to large organisations with experienced learning and development teams. It will enable you to feel confident about what the Care Certificate was designed to do, and will help you to decide the best ways to implement it within your organisation. You will find help with:
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You will find top tips linked to practice, quotes from practitioners and links to resources to help you get started. You will also find guidance and examples of good practice based on the Care Certificate programme designed and run by St Christopher’s Hospice. St Christopher’s were involved in the original pilots and were the first organisation to have their programme certificated by an Awarding Organisation.
In 2013 I was privileged to be involved with work completed by Camilla Cavendish, commissioned after the Francis report, in which she reviewed the roles of health and social care staff across the country. This work exposed the huge disparity in the experience and preparation of care staff as they provided care to people, often at a very vulnerable time of their lives.
Cavendish recommended that there should be agreed standards to set care staff on the road to a career in care. These standards needed to be based on fundamental care provided in health and social care settings. There was a requirement to provide not only the theory associated with this care but to ensure that these workers were assessed in practice to ensure that they had the skills and knowledge before they delivered care. This became the template for the development of the Care Certificate.
During 2014 I was asked to lead a small group of talented health and social care experts in developing the Care Certificate. This group included representatives from Skills for Health and Skills for Care and utilised the skills and knowledge of a far larger network, focusing on existing good practice. The final product is a testament to the work completed by these people, providing standards designed to be used by both health and social care organisations as part of the induction of their staff.
The development of the Care Certificate provides an opportunity to clarify the importance of effective induction and preparation of health and social care support staff. This toolkit, developed with support from St Christopher’s Hospice, sets out simple steps to ensure that this preparation is completed rigorously for the benefit of the learner and those that will receive care in the future.
Kay Fawcett OBE
Following the Francis Inquiry (2013), Camilla Cavendish was commissioned by the Secretary of State to complete an independent review into healthcare assistants and support workers in the NHS and social care settings. The Cavendish Review (2013), found failings in the preparation of new health or social care support workers for their roles and in their ongoing training and development. The review recommended the introduction of nationally recognised induction training for all care workers to ensure they provide compassionate and high-quality care.
Health Education England (HEE, 2014) describe the main purpose of the Care Certificate as follows:
“The Care Certificate is the start of the career journey for these staff groups [Healthcare Support Worker (HCSW) or Adult Social Care Worker (ASCW)] and is only one element of the training and education that will make them ready to practice within their specific workplace … The Care Certificate is a key component of the overall induction which an employer must provide, legally and in order to meet the essential standards set out by the Care Quality Commission (CQC).”
The Care Certificate Framework (Assessor), Health Education England, Skills for Care and Skills for Health (2014).
There are fifteen standards within the Care Certificate that all care workers must meet, as follows:
Each standard within the Care Certificate contains assessment criteria that specify the knowledge, understanding and skills needed by employees. Some assessment criteria are about knowledge whilst others are performance-based and can only be assessed in the workplace. The following extract from Standard 7: Privacy and Dignity illustrates the difference between knowledge-based and performance based criteria:
7.1 Understand the principles that underpin privacy and dignity in care
Learners will: 7.1a Describe what is meant by privacy and dignity
Assessment: The assessment can be undertaken on a 1:1 with the HCSW/ ASCW or as group work. Evidence to meet these criteria can be provided through:
7.2 Maintain the privacy and dignity of the individual(s) in your care
Learners will: 7.2a Demonstrate that their actions maintain the privacy of the individual. This could include:
Assessment:
As the employer, it is your responsibility to ensure that employees meet the standards and that you have evidence to prove this. The standards within the Care Certificate provide a framework for enabling you to structure a comprehensive induction and for providing the training to ensure the standards are met.
Q: Who is responsible for the Care Certificate?
A: The employer.
Q: Is the Care Certificate a qualification?
A: No. It contains standards of knowledge and performance that need to be covered during individual’s induction. The induction is the employer’s responsibility.
Q: is the Care Certificate mandatory?
A: No, but the employer’s induction is, and it is expected that the induction will cover contents of the Care Certificate.
Q: So we don’t have to offer the Certificate then?
A: The Certificate itself is a kite-mark of a robust programme of teaching, learning and assessment. The learning embodied within the standards of the Care Certificate is what you need to provide at induction. Whether or not you choose to award the Care Certificate is up to you, but when the CQC inspect you, they will be looking for evidence that you have delivered the learning and confirmation that all staff have met the standards.
Q: What do employers have to do?
A: You should provide a formal induction where you teach the knowledge required by the new member of staff and provide them with structured experience in the workplace to enable them to meet the standards within the Care Certificate. This is so that they can deliver the basic standards of care required by their role, and you can provide evidence of their competence for inspection purposes.
Q: What happens if employees don’t meet the standards in the Care Certificate?
A: Staff should not work unsupervised until they meet the relevant standards. It is possible for employees to be signed off against individual standards and to work unsupervised in the relevant area, but this approach is not recommended as the standards are best used as a reliable indicator of competence when taken together. The employer is responsible for ensuring the competence of staff and will have to decide if meeting the standards forms part of their probationary requirements (if these are part of the contract of employment).
Q: We already run an induction programme for new staff. What else do we need to include?
A: The Care Certificate standards complement but do not replace any induction you may carry out that is specific to your organisation and workplace.
Q: What about healthcare apprentices?
A: It is the employer’s and the training provider’s responsibility to ensure that the apprentice is ready for end-point assessment. This means ensuring that all gateway requirements have been met, including the standards within the Care Certificate. Towards the end of the apprenticeship, employers and providers will ‘sign-off’ the apprentice as ready for the end-point assessment – this sign-off is the ‘gateway’. Signing-off an apprentice indicates that the employer and provider believe their knowledge, skills and behaviours are the levels required to attain an apprenticeship. For example, the Apprenticeship Assessment Organisation (AAO) may ask for a declaration that the standards have been met before the apprentice can undertake the end-point assessment. Please note: Not all health sector related apprentices have to meet the standards within the Care Certificate, for example, healthcare science apprenticeships has no such requirement.
For more information on apprenticeship standards, visit the Healthcare Apprenticeships Standards Online website.
All new employees should undergo training linked to the Care Certificate within the first twelve weeks of taking up their posts. They don’t have to complete the Care Certificate within this time, but they must receive training and support to meet the standards it contains.
“Smaller organisations don’t need to work alone. Look at what’s available in the local community where there may be opportunities to create partnerships and work with organisations similar to yours. Check if there is an NSA Health Excellence Centre in your area and contact them for helpful advice” – Christina Pond, Skills for Health
“If you are wondering how you can incorporate the Care Certificate within your organisation, don’t feel isolated. We networked with other organisations and shared any problems.” - Charlie Bobin, NHS Blood & Transplant
“You need to allocate responsibility for the Care Certificate to a named individual and make it their responsibility to ensure relevant steps are undertaken and processes adhered to. “– Brian Burke, Sheffield Teaching Hospital NHS Foundation Trust
The Care Certificate is aimed at employees who are new to Healthcare Support Work or Adult Social Care Work. Other roles where the Care Certificate may apply include Health Care Assistants, Assistant Practitioners, Care Support Workers and those giving support to clinical roles within the NHS that involve direct contact with patients. Care Support Workers include:
Other social care roles where all or part of the standards for the Care Certificate may apply include:
The Care Certificate is aimed at new staff, but also offers opportunities for existing staff to refresh or improve their knowledge and skills. Use the standards and assessment criteria as a tool for assessing training needs.
Your organisation may have particular needs that the Care Certificate will not cover in enough detail, which means your staff may need further training. In this case, you will need to fit the Care Certificate around any existing induction you may carry out and/or provide additional training as necessary.
“You need to check whether or not you already carry out the training that underpins the Care Certificate. Do this by identifying what you do and map it against the Care Certificate standards. Then you’re in a position to fill in the gaps “– Brian Burke, Sheffield Teaching Hospital NHS Foundation Trust
You will find the following checklist useful to help you decide whether or not you want all staff to undertake the Care Certificate. If you answer no to one or more questions, this could be an indication that all staff would benefit from its introduction.
Care Certificate standards self-assessment tool: information for employers and staff – Guidance on how to self-assess against the standards in the Care Certificate.
The Care Certificate Mapping – The Skills for Health Guide to mapping The Care Certificate to other standards and training.
You need a structured programme of teaching, learning and assessment to enable your learners to meet the standards within the Care Certificate. A useful starting point is to make links between the knowledge elements (theory) and skills within the standards to the practical work tasks that the learner carries out so that they can practice what they are learning and apply it to their day-to-day work.
St Christopher’s Hospice deliver the Care Certificate in-house. This illustration shows their delivery and assessment model.
You can plan to deliver the knowledge requirements for the Care Certificate using one or more of the methods below:
Here are some methods you could use to ensure learners gain the skills and behaviours they need to meet the standards within the Care Certificate:
The standards within the Care Certificate are broken down into fifteen, individual areas that contain both knowledge and performance criteria – things learners must know and be able to do. In contrast, the day-to-day tasks carried out by carers at work normally cover several standards.
For example, carers communicate with patients (standard 6) whilst providing food and nutrition (standard 8). At the same time, they apply policies and procedures as they work (standards 3 and 4) and complete records (standard 14).
Grouping tasks together in this way is known as a ‘holistic approach’ to teaching, training and assessment. The benefits of adopting a holistic approach are that the learner can relate their learning directly to the tasks they carry out at work and they are more likely to remain motivated when learning.
The team at St Christopher’s adopted a holistic approach to delivery and assessment at the planning stage using the following steps:
Notice how topics do not follow the standards in order. Topics may also cover several assessment criteria from several standards at once.
You can see an example of holistic assessment on pages 18 – 21.
“Remember - the Care Certificate requires real work and practice: learners need practical experience which cannot be taught in a classroom” – Candace Miller, Skills for Health
“We’ve adapted our Care Certificate training to the learner’s work because we felt it vital that the training is relatable and transferable to their job role” – Christine Pearcy, Basildon & Thurrock University Hospitals NHS Foundation Trust
You will also need to take the following points into consideration when planning your delivery of the Care Certificate:
1. Re-visiting your recruitment processes
The standards within the Care Certificate require basic levels of literacy and numeracy to be met, so you may consider introducing diagnostic testing for potential employees to gauge how much support they will need.
2. Recognising prior learning
If you have a potential employee who already possesses a relevant qualification or who has achieved one or more relevant units as part of another qualification, or who has experience within the sector, then they may already possess the knowledge and skills to meet the standards within the Care Certificate. If you have a learner who claims they already have relevant knowledge or experience and can prove it to you, for example, by you observing them in action, then you might decide they do not need to undertake the Care Certificate.
This process is known as Recognition of Prior Learning (RPL) and it allows you to take account of existing learning, experience and/or achievements that the person brings with them. Whether you decide they need to meet the requirements of the Care Certificate or not, It’s important to look for evidence of their knowledge and performance as you will need to provide this to the CQC for inspection purposes. Remember too, you need to take account of anything potential employees bring with them at the recruitment and initial assessment stages, before their induction period.
3. Deciding which parts of the Care Certificate you can deliver in-house and any you want to outsource.
Delivering in-house means allocating experienced staff to supervise, train and assess to the standards. This will involve:
Outsourcing means paying individuals or organisations with appropriate expertise to supply resources and/or services, for example:
Staff training such as assessor or trainer training.
When learners have acquired the necessary knowledge and skills, and are putting these into practice within their jobs, the next step is to assess their performance against the standards in the Care Certificate.
The standards within the Care Certificate combine:
This means that learners need to be assessed on how they combine their knowledge, skills and behaviours within the Care Certificate standards whilst working with patients and clients. In the same way as delivering teaching and learning, this means adopting a holistic approach to assessment, grouping standards together according to the work task carried out by the learner and the assessment methods used by the assessor.
How and when you assess the learners’ skills depends on whether or not they are performing to the standards on a regular basis and are ready to be assessed. Here are the main methods the assessor should use:
Here are some of the methods you can use to assess learners’ knowledge:
The methods you choose depend on your circumstances. For example, you can ask learners to use workbooks with support from trainers or colleagues whilst they learn, then assess their written work against the standards when they have finished. Alternatively, you might choose to buy an e-learning package linked to the Care Certificate and use learners’ online work as evidence of their knowledge. Either way, the assessor would normally question the learner and discuss with them to check their understanding.
The following example from St Christopher’s shows how the standards can be linked when assessing, followed by an assessor observation. Here are some points to note when reading the observation:
Standards that link – Observing an episode of patient care
The carer must be able to demonstrate:
Learners must take responsibility for providing evidence of their knowledge. You can ask learners to be responsible for recording their own progress towards achieving the Care Certificate, however, you will need to support them throughout their learning process by meeting with them regularly and reviewing their progress so that they are confident when it comes to being assessed.
It is important to ensure all assessors of the Care Certificate reach their assessment decisions consistently to ensure fairness and to maintain the standards within the Care Certificate. This process is known as standardisation of assessment and it means having processes and procedures in place to enable assessors to reach their decisions in the same way, using similar procedures and accepting similar standards of evidence of performance from those they are assessing.
The person responsible for the quality of assessment is known as the internal quality assurer or internal verifier and is someone with experience of vocational assessment. They are responsible for observing assessors in action and holding regular standardisation meetings.
There are benefits to linking standardisation of assessment to overall quality improvement because assessors are well placed to gauge how well learners are performing within their jobs. For example, they will pick up on any poor practice during observations if learners are not meeting the standards. Equally, they will see the benefits of any training you might buy-in or deliver when they assess learners’ performance in the workplace.
Here are some of the areas the internal quality assurer is responsible for, the reasons why they take responsibility, and what they do in practice:
1. Consider holding standardisation meetings with other organisations offering the Care Certificate and using these as a way of improving the quality of assessment overall.
2. If you decide to outsource standardisation of assessment of The Care Certificate, you will need to know the outcomes of the standardisation process as these may have wider implications for other parts of the programme. For example, if learners fail to meet the standards it may be that they lack the necessary knowledge or skills, which will have implications for any teaching and learning you carry out.
‘It is important to remember the reasons why the Care Certificate was first introduced. If you have inadequate assessment and standardisation, you will allow learners with inadequate skills in caring for individuals to achieve the standards.’ - Janine Wilson, Skills for Health
Read, H (2012), The best quality assurer’s guide, Bideford, Devon, UK.
Here are some of the areas where in-house staff with responsibility for supporting learners may need training:
You need competent assessors within your organisation or access to someone who can perform the role for you. The assessor can be anybody who is ‘occupationally competent’. This means they need to be able to perform the tasks competently themselves and possess the necessary knowledge and understanding of the standard they are assessing learners against.
If your proposed assessor has not assessed the Care Certificate before or lacks confidence in reaching robust assessment decisions, then you may wish to consider further training. Those assessing the Care Certificate are not required to hold an assessor qualification, but there is an expectation that they will have undertaken some preparation to assist them with the process of assessment. The Care Certificate guidance for assessors says:
“There is no requirement for assessors of the Care Certificate to hold any assessor qualification; the employer must be confident that the person with this responsibility is competent to assess. We would suggest that where the assessor doesn’t hold a relevant qualification that they should be familiar with and work to the standard set out in the National Occupational Standard LSILADD09 ‘Assess learner achievement’.” The Care Certificate Framework: Assessor Document (page 3).
Recognised training ensures that consistent standards of assessment are applied across your organisation. Larger organisations often have more than one assessor for different standards, for example, a safeguarding specialist to assess the safeguarding standard, but don’t adopt a ‘one standard at a time’ approach to assessment overall or you will waste time and resources.
Here are some of the areas where assessors may need training and support:
for trainers to prepare and deliver any formal training and/or time for learners to attend
for assessors to assess learners against the standards and to give feedback on what they have achieved.
When final assessments have taken place, you will want to hold a final review session with the learner to confirm their achievements against the standards, review progress overall, and identify their further development needs and career aspirations. Once you are happy that the individual learner has demonstrated their knowledge and skills and has met all the Care Certificate standards, you can print off and sign their certificate. The certificate can be found here.
“Make sure you keep detailed records of the training and individual progress reviews you carry out with learners as these may be required at a later date as evidence of learning or for CQC inspections “- Janine Wilson, Skills for Health.
Certificate template – Word and PDF versions of the certificate with space for you to add your own logo.
Written by
David Evans and Hilary Read.
Grateful thanks go to the following people for their contributions to the toolkit:
The Skills Platform specialises in helping you to find Health and charity training, listing only accredited and quality providers for you to work with. You can find local and national providers offering anything from face to face training to eLearning and downloadable resources. https://www.skillsplatform.org/