Implementing the Care Certificate: a developmental tool or a tick-box exercise?

Abstract

Introduction: The review into the role of healthcare support workers (HCSWs), carried out by Camilla Cavendish, resulted in the recommendation for standardised training for HCSWs ( Cavendish, 2013 ). Consequently, the ‘Care Certificate’ ( Health Education England (HEE), 2015 ) was introduced, with the aim of standardising initial training of HCSWs. However, no guidance on its implementation was provided nationally. Methodology: A ‘Day 2 Care Certificate Follow-up’ workshop was introduced by a team of clinical skills tutors in a London mental health trust, as a pilot study to evaluate the programme's effectiveness. Some 8 mandatory workshops were facilitated by tutors, 7 weeks after each group's induction. A total of 38 HCSWs and 32 clinical supervisors attended. Feedback on experiences was collated from a ‘Tabletop’ exercise, group discussions and course evaluation forms. Findings: Whereas the developmental value of completing the Care Certificate was acknowledged by attendees, there were overwhelming reports of inadequate support in clinical areas. Significant variations were identified for accessing protected time, team support and supervision. The findings suggest major systemic barriers impacting on HCSWs' achievement of the Care certificate. Discussion: Most competency-based training is supported by a framework that allows for protected time and pastoral support as part of the learning process. A good example is pre-registration courses for nurses. Student nurses are not expected to achieve their competency without adequate supernumerary time and support of their assessor (mentor). While not suggesting that HCSWs be made supernumerary throughout their ‘Care Certificate’ programme, clear guidance must be given nationally on implementation, outlining compulsory support systems to avoid the Care Certificate becoming another ‘tick-box’ exercise. Conclusion: While the Care Certificate has great potential for enhancing the educational development of HCSWs, the idea of national standardisation and a care passport is far from being a reality. Further consideration must be given to the impact of giving employers full control over implementation without clear guidance on method of delivery, quality assurance and a support framework.