April 2015 will be a date that goes down in history as the start of a big year of positive change for health and social care. Next April will see the introduction of the Care Act and the biggest change to health and social care in England, Wales and Northern Ireland for 70 years – and it is already having an impact.
Since October 2014, managers across many settings have reported that the Care Quality Commission (CQC) inspections are more person-centred, with more time spent checking that staff are safe to practise, compared with those carried out by the former Commission for Social Care Inspection. In one care home I visited, the manager described the previous inspection regime as desk and paper based, in stark contrast to the new practice of questioning supported by observations. “How would you rate this change?” I asked her. “It’s a massive improvement,” she said.
The principle of wellbeing runs throughout the legislation and will link everything in health and social care. April 2015 will also see the introduction of the fundamental standards of safety and quality which will replace the current essential standards – those which providers are currently measured against. The fundamental standards are more explicit. For example, regulation five states that directors must be competent as well as “fit and proper persons”. Regulation 19 contains similar wording for staff and regulation 12, “safe care”, also states that staff must be competent.
To the casual observer, these changes might appear subtle, but they illuminate a seismic culture change that is also clear in the care certificate excerpt from the technical document page three, under the heading “assessment”: “Evidence of performance must be undertaken in the workplace, during the learner’s real work activity and be observed by the assessor”. It will no longer be acceptable to attend induction, complete the workbook and start working alone shortly thereafter. After April next year, your practice must be checked - and with the people you support.
Another example of this culture change is the Skills for Care recommendations for CQC providers guide released recently. The seven documents include “inducting care workers”. Page 16 of this document states: “The assessment of a care worker’s induction programme cannot be undertaken by an external learning provider, via e-learning or through simply reviewing a completed workbook”.
Page 16 continues: “The common induction standards should include a recorded assessment which identifies the areas of work that the worker is competent to undertake at that point in time. Most assessments should be within a care setting, in practice, with people who need care and support, and should be completed face-to-face.”
The care certificate is a fantastic opportunity to focus the minds of health and social care and shift the culture of “everyone must go on the training course” to a new more enlightened culture of ensuring that staff are safe to practise.
In the past, providers were predisposed to ensure everyone had attended the course, herding staff through the annual “sheep dip” training regime because that is what inspections measured. It is clear that this was not in the best interests of organisations, staff, and most importantly, the people you support.
Thankfully this is all about to change. The CQC has changed inspections for good, the regulations are changing. Induction has changed and we cannot afford to continue doing the things we have always done. After April 2015, measuring staff competence will no longer be about sheep dipping and training matrices but will instead be a genuine shift in focus towards providing evidence of safety to practise.
Since 2006, The Grey Matter Group, a company that improves lives through learning, has championed this way of working. We use online assessments to support providers to build robust evidence portfolios that enable them to demonstrate to the CQC and local authority contract, commissioning and quality monitoring teams that their staff are safe to practise, rather than simply “trained”.
More than 80,000 care workers have saved time and money for their organisations. Most importantly, this approach has been demonstrated in a growing library of case studies that evidencing safety to practise provides a positive impact on the beneficiaries of health and social care services – and these, ultimately, are the people we want to support.
The Grey Matter Group sponsors Skills for Care’s Accolades.
Content on this page is paid for and provided by Skills for Care, sponsor of the Guardian Social Care Network leadership, learning and development hub.
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This article was amended on 6 February. Due to an editing error, an earlier version referred to “former chartered scientist inspections”, this should instead be inspections carried out by the former Commission for Social Care Inspection. This has been corrected.
