Skill for Care
Noted
Skills for Care recommends that every frontline care worker within a CQC regulated service should receive First Aid training, including basic life support as part of their initial induction to the sector, and ensure these skills are regularly refreshed. They highlight existing guidance and initiatives, but note that they cannot mandate training. (AI summary)
View full response
Dear Mr Horstead, Thank you very much for sharing a copy of your report with Skills for Care and giving us the opportunity to respond. Firstly, we would like to express our deepest sympathies to the family, friends and carers of Mr Waite for their loss at what will continue to be a difficult time. Skills for Care is the strategic workforce development and planning body for adult social care in England. Whilst we have no regulatory remit, we strive to support the adult social care sector to consider good and best practice approaches to enable it to always deliver quality care. Our guidance and advice is informed by consultation with employers and includes recommendations related to workforce development. This advice spans the initial induction training for new care workers, through to the refreshing of knowledge and skills of experienced workers, as well as their longer-term development. Our advice includes encouraging adult social care providers to arrange training and assessment related to First Aid, including Basic Life Support for frontline carers from the moment they join the sector to the end of their careers. Our guidance and advice include: Core and Mandatory training This guidance is currently being updated in line with the Care Quality Commission’s new Single Assessment Framework and is due for republication in spring 2024. Pertinent to this request, our current guidance states that all care workers should ‘Understand and know how to follow procedures for responding to accidents and sudden illness’ and ‘Be able to provide basic life support’. In line with HSE guidance, it further states that ‘Establishments must provide adequate personnel to respond if someone is taken ill or injured at work. It’s the employer’s responsibility to determine how many people need training and to what level.’ We note that this HSE guidance applies to First Aid and First Aid at Work, not specifically to Basic Life Support.
The adult social care sector’s statutory training requirements for the non-regulated workforce are drawn from general employer requirements, e.g. in relation health and safety, or from CQC regulations. CQC recommendations We note that the Coroner is requesting information directly from the CQC. Skills for Care draw on CQC recommendations and guidance when developing our products and services, and signpost stakeholders across the sector to CQC documentation. Pertinent to this request, Skills for Care notes CQC’s recommendations relating to Regulation 18: Staffing, which include (but are not limited to): ‘Providers must ensure that they have an induction programme that prepares staff for their role’ and ‘Where appropriate, staff must be supervised until they can demonstrate required/acceptable levels of competence to carry out their role unsupervised’. We also note CQC recommends that ‘Staff should be supported to make sure they can participate in: [....], Other learning and development opportunities required to enable them to fulfil their role. This includes first aid training for people working in the adult social care sector’. Care Certificate The Care Certificate is an agreed set of 15 standards that define the knowledge, skills and behaviours expected of specific job roles in the health and social care sectors.
It was introduced in 2015 and was jointly developed by Skills for Care, Health Education England and Skills for Health under a grant commission from the Department of Health and Social Care. Skills for Care host a wide range of Care Certificate resources on our website.
The 15 standards are:
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 disabilities
10. Safeguarding adults
11. Safeguarding children
12. Basic life support
13. Health and safety
14. Handling information
15. Infection prevention and control
Standard 12: Basic life support states: The learner must be able to carry out basic life support. This BSL training must meet the UK Resuscitation Council Guidelines.
The Care Certificate is not a mandatory programme for care providers. Instead, it is considered to be the minimum training, supervision and assessment that staff ‘new to care’ (health and adult social care) should receive as part of a robust induction and before they start to deliver care out of the line of sight of more experienced workers.
In practice, it is employers who determine the point at which a worker can work out of the line of sight of more experienced workers based on their assessments of their workers’ competence and the skills required in particular situations.
Level 2 Adult Social Care Certificate Qualification Earlier this year Skills for Care was commissioned by the Department of Health and Social Care (DHSC) to develop a specification for the development of a new Care Certificate qualification based on the existing Care Certificate standards. Awarding organisations are currently developing the qualification in preparation for a June 2024 launch. The qualification will not be mandatory. And it will not replace an employer’s responsibility to provide appropriate support, training, professional development, supervision and appraisal as necessary to enable the worker to carry out the duties they are employed to perform. Employers are expected to provide a robust induction as part of this process. It's the employer’s responsibility to ensure staff undergo any mandatory training as part of an induction, and relevant mandatory training cycles. As with the current version of the Care Certificate, those undertaking the qualification will need to understand procedures for responding to accidents, sudden illness and providing basic life support. Learning from Events Skills for Care’s digital module, Learning from Events, may be of interest to the Coroner. It is available at no cost to the sector and is based on the PAcE model (People, Activity and Environment). The module aims to support leaders and managers carry out learning reviews to holistically explore adverse events and create actions plans to avoid repeat incidents. Learning from Deaths Review Programme (LeDer): We acknowledge that due to the circumstances of Mr Waite’s death, a LeDer review would be completed and that recommendations from this may also be considered if directed to Skills for Care or it leads to sector-wide mandated training or regulatory changes. If this was to happen, Skills for Care would align our guidance and advice to reflect updated messaging from CQC and HSE etc. Coroner’s Concerns To reiterate, Skills for Care recommends that every frontline care worker within a CQC regulated services should be supported to receive First Aid training, including
basic life support as part of their initial induction to the sector, and ensure these skills and competences are regularly refreshed beyond that. We recognise the importance that First Aid training, including Basic Life Support, and encourage providers to adhere to the CQC’s Regulation 18: Staffing recommendation: ‘Where appropriate, staff must be supervised until they can demonstrate required/acceptable levels of competence to carry out their role unsupervised’. In this context, we believe that this would mean that staff scheduled to work alone, out of sight of more experienced colleagues must receive the training before being left unsupervised, rather than before they start working in a care environment. Whilst Skills for Care is committed to influencing improvements in the standards and the quality of personalised care across the adult social care sector, as an independent charitable body, we are not able to mandate or enforce what training is undertaken. We hope this information and advice is useful to any further actions. Skills for Care would be happy to engage further on this matter with your office, the CQC and the provider should you deem that helpful. Our deepest sympathies again to the friends, family and carers of Mr Waite.
The adult social care sector’s statutory training requirements for the non-regulated workforce are drawn from general employer requirements, e.g. in relation health and safety, or from CQC regulations. CQC recommendations We note that the Coroner is requesting information directly from the CQC. Skills for Care draw on CQC recommendations and guidance when developing our products and services, and signpost stakeholders across the sector to CQC documentation. Pertinent to this request, Skills for Care notes CQC’s recommendations relating to Regulation 18: Staffing, which include (but are not limited to): ‘Providers must ensure that they have an induction programme that prepares staff for their role’ and ‘Where appropriate, staff must be supervised until they can demonstrate required/acceptable levels of competence to carry out their role unsupervised’. We also note CQC recommends that ‘Staff should be supported to make sure they can participate in: [....], Other learning and development opportunities required to enable them to fulfil their role. This includes first aid training for people working in the adult social care sector’. Care Certificate The Care Certificate is an agreed set of 15 standards that define the knowledge, skills and behaviours expected of specific job roles in the health and social care sectors.
It was introduced in 2015 and was jointly developed by Skills for Care, Health Education England and Skills for Health under a grant commission from the Department of Health and Social Care. Skills for Care host a wide range of Care Certificate resources on our website.
The 15 standards are:
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 disabilities
10. Safeguarding adults
11. Safeguarding children
12. Basic life support
13. Health and safety
14. Handling information
15. Infection prevention and control
Standard 12: Basic life support states: The learner must be able to carry out basic life support. This BSL training must meet the UK Resuscitation Council Guidelines.
The Care Certificate is not a mandatory programme for care providers. Instead, it is considered to be the minimum training, supervision and assessment that staff ‘new to care’ (health and adult social care) should receive as part of a robust induction and before they start to deliver care out of the line of sight of more experienced workers.
In practice, it is employers who determine the point at which a worker can work out of the line of sight of more experienced workers based on their assessments of their workers’ competence and the skills required in particular situations.
Level 2 Adult Social Care Certificate Qualification Earlier this year Skills for Care was commissioned by the Department of Health and Social Care (DHSC) to develop a specification for the development of a new Care Certificate qualification based on the existing Care Certificate standards. Awarding organisations are currently developing the qualification in preparation for a June 2024 launch. The qualification will not be mandatory. And it will not replace an employer’s responsibility to provide appropriate support, training, professional development, supervision and appraisal as necessary to enable the worker to carry out the duties they are employed to perform. Employers are expected to provide a robust induction as part of this process. It's the employer’s responsibility to ensure staff undergo any mandatory training as part of an induction, and relevant mandatory training cycles. As with the current version of the Care Certificate, those undertaking the qualification will need to understand procedures for responding to accidents, sudden illness and providing basic life support. Learning from Events Skills for Care’s digital module, Learning from Events, may be of interest to the Coroner. It is available at no cost to the sector and is based on the PAcE model (People, Activity and Environment). The module aims to support leaders and managers carry out learning reviews to holistically explore adverse events and create actions plans to avoid repeat incidents. Learning from Deaths Review Programme (LeDer): We acknowledge that due to the circumstances of Mr Waite’s death, a LeDer review would be completed and that recommendations from this may also be considered if directed to Skills for Care or it leads to sector-wide mandated training or regulatory changes. If this was to happen, Skills for Care would align our guidance and advice to reflect updated messaging from CQC and HSE etc. Coroner’s Concerns To reiterate, Skills for Care recommends that every frontline care worker within a CQC regulated services should be supported to receive First Aid training, including
basic life support as part of their initial induction to the sector, and ensure these skills and competences are regularly refreshed beyond that. We recognise the importance that First Aid training, including Basic Life Support, and encourage providers to adhere to the CQC’s Regulation 18: Staffing recommendation: ‘Where appropriate, staff must be supervised until they can demonstrate required/acceptable levels of competence to carry out their role unsupervised’. In this context, we believe that this would mean that staff scheduled to work alone, out of sight of more experienced colleagues must receive the training before being left unsupervised, rather than before they start working in a care environment. Whilst Skills for Care is committed to influencing improvements in the standards and the quality of personalised care across the adult social care sector, as an independent charitable body, we are not able to mandate or enforce what training is undertaken. We hope this information and advice is useful to any further actions. Skills for Care would be happy to engage further on this matter with your office, the CQC and the provider should you deem that helpful. Our deepest sympathies again to the friends, family and carers of Mr Waite.