CQC compliance and the Care Certificate

What I would like to achieve with this session The Care Certificate – the context and its features What I would like to achieve with this session 1: An exchange of thoughts and ideas about how you might best use the Care Certificate to: a) Develop your organisational culture b) Promote good practice c) Promote CQC compliance (in the process) 2: I’d like it to be interactive So please …. don’t be shy

What I would like us to cover The Care Certificate – basic introduction – what it covers, how learners need to be assessed and who needs to do the assessing CQC – their take on the Care Certificate What inadequate and outstanding services ‘feel like’ from a CQC perspective How the Care Certificate and your induction process might be used to drive organisational culture and through this promote CQC compliance So where are people currently at with the Care Certificate?

The assessment of the Care Certificate Number of documents but two key ones The Care Certificate standards – a breakdown of the outcomes for each of the standards and what the learner must evidence The Care Certificate Framework – Assessors document = A breakdown of the outcomes for each standard and the way each of these needs to be assessed All relevant documents and frameworks can be found on Skills for Care’s Home page http://www.skillsforcare.org.uk/Home.aspx and typing Care Certificate materials into their search engine.

The Care Certificate – some changes / improvements There are 15 standards compared to the 8 in the Common Induction Standards – result is that each standard is more ‘bite sized’ and digestible 2. Your Personal Development 3. Duty of Care 1. Understand your role 5. Work in a Person Centred Way 4. Equality and Diversity

The Care Certificate – The 15 standards 8. Fluids and Nutrition 7. Privacy and Dignity 6. Communication 9. Awareness of Mental Health, Dementia and Learning Disability

The Care Certificate – The 15 standards 12. Basic Life Support 11. Safeguarding Children 10. Safeguarding Adults 14. Handling Information 13. Health and Safety 15. Infection Prevention and Control

The Care Certificate – some changes / improvements The flow between the Standards has been improved making it a better induction journey for new staff It is awarded by your organisation Good thing or bad thing? It is transferable between organisations Good thing or bad thing?

The Care Certificate – Other key features What needs to be assessed? Knowledge With the workbooks asking candidates to ‘describe,’ ‘explain,’ ‘define,’ ‘list,’ or ‘identify’ Knowledge can be assessed through Reflective account Group exercises One to one discussion Writing in a workbook

The Care Certificate – Other key features What needs to be assessed? Competence With the workbooks asking candidates to ‘demonstrate,’ ‘use’ or ‘show’ Competence can be assessed through Work placed observation Using real work activity unless simulation is expressly allowed (where it might not be possible to ‘demonstrate’)

The Care Certificate – Who needs to do the assessing? Assessment should be completed ‘face to face’ by an ‘operationally competent’ assessor Don’t need an assessor qualification but the employer must be confident that they are competent to assess the standards they are responsible for For almost all assessors this will be by virtue of holding a ‘qualification related to the role’ Considerations Are you going to make assessor responsibility a component of line management responsibility? If not, how are you going to ensure that assessors are available to observe workplace practice when required to assess competence? The same person may not be ‘operationally competent’ to assess every standard. e.g. it may be necessary to use a different assessor to assess Standard 12 – Basic Life Support to any of the other Standards

CQC’s perspective on the Care Certificate Welcome its development and focus on helping new entrants to the workforce to develop and demonstrate key skills, knowledge, values and behaviours Feel that : It is crucial that the essential role played by that Care and Support Workers should be recognised and that they should be appropriately valued, supported and trained Expect that : Providers induct, support and train their staff properly and that they are able to demonstrate that staff have, or are working towards, the skills set out in the Care Certificate Recognise that : it will take some time for Providers to map across to the Care Certificate but that they should operating fully by the autumn 

CQC’s perspective on the Care Certificate Will be using their new Key Lines of Enquiry framework (particularly ‘Is this service effective’) to explore a provider’s approach to staff induction, support and training In reality your organisation or service’s ability to deliver an induction that meets the Care Certificate’s requirements is likely to have implications for all of CQC’s Key Lines of Enquiry

CQC – gathering evidence They will gather evidence through a combination of: Observation: Watching and listening to how staff and service users interact and assessing how staff practice. Talking to staff: Asking about their experience of their induction, training and support. Testing their knowledge and understanding of different aspects of practice. Reviewing records: Review documentation within the service to assess whether different aspects are in place and whether it is consistent with information that has been provided.

CQC – what they want and don’t want to be seeing Inadequate Outstanding

Comments taken from CQC reports - ‘inadequate’ services There was a poor culture at the service. Leadership was weak and communication systems ineffective People we spoke with told us that leadership was poor. Day to day staff guidance and support was not evident Recruitment practices did not take the necessary steps to ensure that staff employed were suitable for their role or the responsibility it entailed The service was failing to induct and train their staff properly Not all staff had received training in topics that were relevant to the needs of people using the service Some staff’s training was out of date The person in charge was not able to tell us what training each member of staff had had

Comments taken from CQC reports - ‘inadequate’ services Staff were not adequately supervised and appraised. Some staff informed us they had not received any form of supervision for periods of over a year Staff did not understand their responsibilities in relation to a number of key areas including the Mental Capacity Act 2005, Safeguarding and Moving and Handling People’s needs were not always identified and dealt with promptly ... staff were not monitoring people’s needs effectively, particularly when these needs changed Where specialist advice had been received, it had not been acted upon … There was no evidence that best practice guidelines were being put into practise Where staff were receiving training and supervision, their competency and knowledge was not being assured through these processes

Comments taken from CQC reports - ‘outstanding’ services There was a clear set of values for the service and evidence that these were promoted to, understood by and implemented by staff. People were placed at the heart of the service. The ethos of the home was positive; there was an open and transparent culture There was evidence of a training programme for staff to meet both mandatory training requirements and the needs of individual service users There was evidence that staff had both received relevant training. All staff we spoke with could relay aspects of their learning from training they had received We observed that staff were highly skilled and experienced in delivering care and support in line with people’s needs Staff were motivated to provide a quality service through a support system that encouraged the development of their knowledge and skills There was evidence and confirmation that the service created positive changes in people’s lives. The service made the difference.

Comments taken from CQC reports - ‘outstanding’ services The service was person centred and inclusive and underpinned by a genuine desire to offer as high a quality service as possible. There was a tangible respect for people’s dignity, views, privacy and choices Staff were skilled and knowledgeable. They recognising when people felt unsafe and had the ability to act quickly and keep people safe Staff recognising signs of potential abuse and understood the reporting procedures to the local authority Staff showed an understanding of why and how they should assess people’s mental capacity and the processes for ensuring that people’s Best Interests were promoted

Comments taken from CQC reports - ‘outstanding’ services Staff indicated an awareness of how identified risks should be assessed and managed whilst balancing this with respect for people’s lifestyle choices and promoting their opportunities Staff were motivated to provide a quality service through a support system that encouraged the development of their knowledge and skills There was evidence and confirmation that the service created positive changes in people’s lives. The service could be seen to make a difference

OK … so what does this all mean for induction of staff? Promoting CQC compliance is not just about ‘are you doing the Care Certificate’ Its equally about ‘how are you using the Care Certificate’ to establish your organisational culture and ways of working Penny for your thoughts?

Challenges for providers when inducting staff As a manager or owner have you ever felt like this? or this or this and not … How are you going to ensure that staff behave and present themselves like this …

The Care Certificate - Things to think about For each of the standards - what do you want to say … How are you going to best get your message across to staff so that they understand? If you are assessing, how you are going to ensure that what you are assessing is sufficient to meet the standard in full? How are you going to ensure that the content of your Care Certificate based induction helps establish your organisational culture?

Personal / professional boundaries The Care Certificate - Things to think about Can you use illustration to better get your message across … Attitude Communication Respect Safeguarding Personal / professional boundaries Whistle blowing

The Care Certificate - Things to think about How are you going to ensure that your messages gets in and stay in? Good initial induction content and testing of staff knowledge around this This may not always be enough however Two good reasons why it is important that staff really need to ‘get it’ You want to be confident that staff really do understand what is required of them and practice as they should do 2. CQC inspectors will observe your staff’s practice and test their understanding as part of their inspection process Given the value of CQC’s rating to your business, how much do you want to leave to chance?

The Care Certificate - Things to think about How are you going to ensure that your messages gets in and stay in? Revisit topics as part of staff supervision Revisiting topics and promoting discussion and collective understanding at team meetings Random questioning of staff – either by the services’ management team or by a Quality Assurance Officer What techniques are people using to embed staff knowledge and how well are these working?

The Care Certificate - Things to think about How are you going to assess staff competency? Do you have formal mechanisms to assess staff’s workplace competency? Advantages Gives you an opportunity to really think through the competencies you are wishing to promote – it can help you establish your working culture Question: Should these just relate to the requirements of the Care Certificate or should they enable you to promote all key aspects of your organisational culture? Provides a clear framework to enable you to: a) Check staff’s working practice and to evidence that you have done this b) Revisit staff practice if it is seen to fall below the required standard

The Care Certificate - Things to think about How are you going to assure the quality of your Care Certificate ? The content of your Care Certificate As a minimum does it meet the requirements? Does it help establish your working culture? Timescales – are learners completing it within 12 weeks? How are you going to ensure and measure consistency of assessment between assessors? How are you going to assess whether staff have retained and are implementing their learning?

Thank you for listening Any further questions? Thoughts? Thank you for listening Mik Alban Phoenix Resolutions Mobile: 07788 498909 Email: mik.alban@careandsupportwest.co.uk