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Key Components and Standards of the Care Certificate

The Care Quality Commission (CQC) is the independent regulatory body with authority and responsibility from the Department of Health and Social Care to regulate and inspect health and social care providers in the UK.

As part of their inspection process, the CQC expects health and social care providers to comply with the statutory requirements on staff training that are contained in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. More specifically, Regulation 18(2)(a) which says that:

“Persons employed by the service provider in the provision of a regulated activity must receive such appropriate support, training, professional development, supervision and appraisal as is necessary to enable them to carry out the duties they are employed to perform.”

The guidance for providers on how they can comply with Reg 18 states that: “Providers must ensure that they have an induction programme that prepares staff for their role. It is expected that providers that employ healthcare assistants and social care support workers should follow the Care Certificate standards to make sure new staff are supported, skilled and assessed as competent to carry out their roles.”

Also, Regulation 19(1)(b) says that:

“Persons employed for the purposes of carrying on a regulated activity must have the qualifications, competence, skills and experience which are necessary for the work to be performed by them.”

The guidance for providers as to how they can comply with Reg 19 states that: “It is expected that providers that employ healthcare assistants and social care support workers should follow the Care Certificate standards to assess their competence.”

The Care Certificate is intended to deliver standardised training on the fundamentals of care, which are the skills and knowledge needed to work in a quality caring way. The Care Certificate programme provides a solid foundation as part of a wider induction for new staff which covers the particular work environment, and the knowledge and skills specific to their role.

What is the Care Certificate?

In the wake of the Francis Inquiry into the Mid-Staffordshire Hospital in 2013, the government ordered a review, known as the Cavendish Review. The subsequent report from the results of the review identified that the training and development of healthcare assistants and adult social care workers was often not consistent or good enough. The Cavendish Review made suggestions on how to improve the quality of care provided by health and social care support workers and the development of the Care Certificate was one of the recommendations.

The Care Certificate was developed jointly by Skills for Health, Health Education England and Skills for Care. It was introduced in 2015 by the UK Department of Health and is based on 15 standards or competencies that care practitioners must adhere to:

care-staff-training-on-lifting-a-patient

Each one of these standards or competencies is broken down into learning outcomes and assessment criteria. Some of the assessment criteria only test knowledge, while others test knowledge and practical competence application in the workplace environment.

The Care Certificate has been designed to give everyone the confidence that health and care professionals have the same introductory skills, knowledge and behaviours necessary to provide compassionate, safe and high-quality care and support, emphasising the importance of empathy, communication, and understanding of the unique needs of each individual in their own particular workplace setting.

By establishing a common framework, the Care Certificate ensures consistency in the quality of care provided across various settings, including hospitals, care homes, domiciliary care and community settings.

The CQC have stated that using nationally recognised good practice, such as the Care Certificate, is a good way to help show that healthcare providers are delivering quality care and complying with their regulation assessment criteria.

Let’s look at some of the core criteria of the Care Certificate in more detail.

Person-Centred Care

Work in a person-centred way is Standard 5 of the Care Certificate, and learners must demonstrate knowledge and competency in the following learning criteria:

5.1 Understand person-centred values

5.2 Understand working in a person-centred way

5.3 Demonstrate awareness of the individual’s immediate environment and make changes to address factors that may be causing discomfort or distress

5.4 Make others aware of any actions they may be undertaking that are causing discomfort or distress to individuals

5.5 Support individuals to minimise pain or discomfort

5.6 Support the individual to maintain their identity and self-esteem

5.7 Support the individual using person-centred values

These are underpinned by a set of values in relation to what is important when caring and supporting individuals. These values are central to work in health and social care and are known as the 6 Cs:

  • Care – having someone’s best interests at heart and doing what you can to maintain or improve their wellbeing.
  • Compassion – being able to feel for someone, to understand them and their situation.
  • Competence – to understand what someone needs and have the knowledge and skills to provide it.
  • Communication – to listen carefully but also be able to speak and act in a way that the person can understand.
  • Courage – not to have fear to try out new things or to say if you are concerned about anything.
  • Commitment – dedication to providing care and support but also understanding the responsibility you have as a worker.

There is no single agreed definition of the concept of person-centred care; the term is used to refer to many different principles and activities that health and social care professionals utilise to work collaboratively with people who use their services. Working in a person-centred way means working in partnership with the individual person to plan for their care and support. The individual person is at the centre of the care planning process and is in control of all choices and decisions made about their life.

This way of working is at the core of the Care Certificate and believes that the individual person is best placed to decide what care and support they need and can plan for themselves. Each person is unique and has a unique set of preferences, tastes, beliefs, needs, wants and values that make them different and individual from everybody else.

When it comes to providing care and support, each individual person should be given information in a way that they can understand so they can be supported and empowered to make informed choices about the care and support they want rather than being provided with “one size fits all” care. Empowerment is an important aspect of person-centred care and means giving the individual people that you care for the confidence, voice and power to speak out on their own behalf, to be able to make their preferences known and to feel in control of their actions and choices thereby maintaining their independence.

In order to be able to provide care and support that respects the individual person’s wishes, needs and preferences, first it requires taking the time to find out about them. Talking with them in a safe, non-judgemental and compassionate place, the individual person can think about what is important to them, and/or reading any information available will give a deeper insight into their likes and dislikes, preferences, needs and values. This consultation will help the individual person make the best decisions for them, and the knowledge gained will help the care plan to be put together collaboratively.

Care plans are required documents that set out in detail the way daily care and support must be provided for an individual person. They are an important source of information as they are dynamic person-centred records that are constantly reviewed and updated in response to and with respect to any changing needs and preferences of the individual person. Care plan reviews are carried out with the individual person to look at what is working, what isn’t working and what might need to change.

Properly maintained care plans mean that all workers involved in the care of the individual person will always have up-to-date information about that person, enabling them to provide the best possible person-centred care. Providing person-centred care or support that is specific to the individual person’s needs, wishes, values and preferences will ensure that the individual person is always at the centre of their care.

Dignity and Respect

Privacy and Dignity is Standard 7 of the Care Certificate, and learners must demonstrate knowledge and competency in the following learning criteria:

  • 7.1 Understand the principles that underpin privacy and dignity in care
  • 7.2 Maintain the privacy and dignity of the individual(s) in their care
  • 7.3 Support an individual’s right to make choices
  • 7.4 Support individuals in making choices about their care
  • 7.5 Understand how to support active participation
  • 7.6 Support the individual in active participation in their own care

In the context of this unit of the Care Certificate, privacy is about giving someone space where and when they need it, and dignity is about focusing on the value of every individual, including:

  • Respecting their views, choices and decisions
  • Not making assumptions about how they want to be treated
  • Working with care and compassion
  • Communicating directly with the individual whenever possible

As far as is possible, it is important to get to know each individual person, finding out about their background and ideas, their wishes, likes and dislikes, enabling them to be as independent as possible whilst respecting their privacy and dignity. Working in this way reduces the risk of an individual person being treated in a way that is degrading or harmful, which is key to safeguarding their wellbeing. During this process, individuals may disclose very personal information, and it is important to build trust and confidence that any information shared such as, but not limited to, health conditions or personal history is kept confidential and only shared where appropriate, and with the permission of the individual person. Confidentiality is a very important right of individuals who receive care and support and information should always be shared on a need-to-know basis only.

Individuals should always feel safe and comfortable with the care that they are receiving; for example, each person has a different view of what they see as their personal space, so it is important to find out from them what is comfortable for them, and respecting that choice. Protecting an individual person’s privacy can involve treating them with general courtesies such as asking for permission before touching them in any way, knocking before entering a room, and protecting their dignity by ensuring they are shielded from view when dressing or washing.

Individuals should be fully involved in any decision that affects their care, including personal decisions such as what to eat, what to wear and what time to go to bed, and wider decisions about their care or support in order to be respected and to maintain their dignity. In order for an individual person to make an informed decision they need to be provided with as much information as possible and this information should be explained in a way that they are able to comprehend easily.

Communication Skills

Communication is Standard 6 of the Care Certificate, and learners must demonstrate knowledge and competency in the following learning criteria:

6.1 Understand the importance of effective communication at work

6.2 Understand how to meet the communication and language needs, wishes and preferences of individuals

6.3 Understand how to promote effective communication

6.4 Understand the principles and practices relating to confidentiality

6.5 Use appropriate verbal and non-verbal communication

6.6 Support the use of appropriate communication aids/technologies

In health and social care, workers need to build effective working relationships with a variety of people, and effective communication skills are crucial to achieving this. The clarity and accuracy of all communication is crucial for the safety and wellbeing of individuals. Some of this communication will be formal, some will be informal, and there will be a variety of communication methods used for each such as:

Care-assistant-chatting-with-senior-lady
  • Verbal communication – differences in how you speak, including the tone, pitch, speed and volume of your voice, could change how messages are taken in. Verbal communications should always be in a respectful way, and it helps to adjust speech and tone to suit the situation and individual(s). It is also helpful to avoid using jargon or abbreviations and complicated words and terminology to ensure that messages are clear and readily understood.
  • Body language – this is a type of non-verbal communication. There are many different aspects of body language, including gestures, facial expressions, eye contact, body positioning and body movements. Each of these will communicate information about an individual or a worker often without them realising it. Gestures such as hand or arm movements can emphasise what is being said or used as an alternative to speaking. Facial expressions support what is being said by showing reactions or feelings. They can give valuable clues that can be used to check out a person’s feelings. Maintaining good eye contact is an important way to show that you are engaged and listening. Also, posture, for example the way that we stand, sit or hold our arms when we are talking, will provide others with clues about our feelings, attitudes and emotions.
  • Written communication – this method is used to send messages, keep records, provide evidence, write reports etc. In the health and social care sector all written communication should be clear, concise, straightforward, honest, open, professional, respectful and accessible. The tone should communicate genuine understanding and respect and the listener or reader should feel empowered and informed. When writing about complex subjects, it is advisable to use words which are as simple and as accessible as possible, avoiding jargon, acronyms and unnecessary technical language.

It can be difficult to understand the needs of an individual or to provide them with adequate information if they are not verbal, or have impaired hearing or vision. It is a critical part of a carer’s role to find ways to overcome any barriers to effective communication. In these circumstances there may be the need to use other forms of communication for individuals with disabilities and/or special needs. These can include:

  • Sign language – this is a recognised key form of communication for health and social care professionals and service users. British Sign Language (BSL) is used by many hearing-impaired individuals in this country as their primary means of communication, with it being their first language. This can be difficult to understand for a hearing person. To overcome this, health and social care providers can (and should) partner with BSL interpreters or take courses to learn basic BSL signs.
  • Makaton – this is a form of language that uses a large collection of signs and symbols. It is often used with those who have learning and physical disabilities, or hearing impairment. Makaton is a communication tool strategically designed to improve spoken language development and is used by one million people in the UK. By seamlessly integrating signs and symbols, Makaton improves communication across various contexts, ensuring a personalised approach that caters to individual needs. Makaton can also be a useful tool to help effective communication with individuals for whom English is not their first language.
  • Braille – this is a code of raised dots that are read using touch. For people who are visually impaired or who are blind, the system supports reading and writing. Braille is only one of several ways in which people with sight loss access information. Communications can also be made available in large print, or audio format, and assistive technology such as a screen reader which converts text to speech can convert on-screen text to the spoken word.

It is crucially important to ask people if they have any information or communication needs, and to find out how to meet their needs and preferences. This information should be recorded and made accessible to others so that individuals receive information which they can access and understand, and receive communication support if they need it.

Handling Information, Privacy and Confidentiality

Handling Information is Standard 14 of the Care Certificate, and learners must demonstrate knowledge and competency in the following learning criteria:

14.1 Handle information

14.1a Describe the agreed ways of working and legislation regarding the recording, storing and sharing of information

14.1b Explain why it is important to have secure systems for recording, storing and sharing information

14.1c Demonstrate how to keep records that are up to date, complete, accurate and legible

14.1d Explain how, and to whom, to report if they become aware that agreed ways of working have not been followed

Privacy and confidentiality are very important rights of individuals who receive care and support. In the context of this unit, privacy and confidentiality refers to information shared, recorded and processed. The Data Protection Act 2018 and the UK General Data Protection Regulation 2020 (UK GDPR) regulate the use of this information (data) to balance the individual’s right to confidentiality and an organisation’s need to use it. There are six privacy principles contained within the UK GDPR:

  • Lawfulness, fairness and transparency.
  • Purpose limitations. Personal data can only be obtained for specified, explicit and legitimate purposes and can only be used for a specific purpose and no other, without further consent.
  • Data minimisation. No more than the minimum amount of data should be kept for specific processing.
  • Accuracy. Data must be accurate and where necessary kept up to date.
  • Storage limitations. Data no longer required should be removed.
  • Integrity and confidentiality. Data must be handled in a secure manner.

Health and social care providers will have policies and procedures in place detailing agreed ways of working to protect information. It is crucial that these are fully complied with in order to protect sensitive information and uphold individuals’ rights to privacy and confidentiality.

Accurate record-keeping is essential for individuals’ effective care, safety and wellbeing. For example, care plans are an essential key record about an individual’s needs and choices and include such information as an assessment of risks, and personal details including health data. They are an important tool in good communication between those who are involved in providing care and support, so it is imperative that the information that they contain is only accessible on a need-to-know basis, regularly and accurately updated, and that the care plans are stored in an appropriate secure environment. It is also important to note that they may become legal documents of evidence if, at any point, there is cause for concern or an enquiry.

Those receiving care need to be confident that their personal data is being managed appropriately, and health and social care workers have a duty to report unsafe or incompetent data protection practice to their management or their organisation’s regulatory body, for example the CQC.

Health or social care workers have a responsibility to safeguard an individual person’s personal information, and they should also treat any personal information about other workers that they may have access to in the same way. Breaching confidentiality, even inadvertently such as chatting openly about individuals’ personal information, leaving a record out of the filing system, sharing passwords or remaining logged into a computer when not present, may be a disciplinary offence, and in some cases may even be a criminal offence depending on what is shared.

Infection Prevention and Control

Infection Prevention and Control is Standard 15 of the Care Certificate, and learners must demonstrate knowledge and competency in the following learning criteria:

15.1 Prevent the spread of infection

15.1a Describe the main ways an infection can get into the body

15.1b Demonstrate effective hand hygiene

15.1c Explain how their own health or hygiene might pose a risk to the individuals they support or work with

15.1d List common types of personal protective clothing, equipment and procedures and how and when to use them

15.1e Explain the principles of safe handling of infected or soiled linen and clinical waste

Infectious diseases can spread from person to person, so following agreed ways of working that stop the spread of pathogens can help to prevent and control infection. Some of the main pathogenic organisms that can cause infectious diseases include, but are not limited to:

  • Bacteria – this can multiply quickly at body temperature and reach harmful levels very fast. Examples of harmful bacteria include Methicillin-resistant Staphylococcus aureus, commonly known as MRSA, and Clostridium difficile, commonly known as C.Diff. or C. Difficile.
  • Viruses – these can survive on surfaces and in food but can multiply only in living cells. It takes very few virus organisms to cause illness. They can be spread from person to person and from environment to food. Examples of viruses include Norovirus, also known as the winter vomiting disease, and influenza, the flu virus.
  • Fungi – these are organisms which live on hosts that can be alive or dead. Examples of fungal infections include athlete’s foot and ringworm.
  • Parasites – these live on or in another animal or a plant, known as the host. Scabies is caused by mites that burrow into the skin causing severe itching.
  • Protozoa – these are single-celled organisms that live in water and damp conditions. Malaria is an example of a disease caused by protozoa.

The steps taken to protect individuals and workers from infection are an important part of providing high-quality care and support. Standard precautions are the actions that should be taken in every situation to reduce the risk of infection. These include:

  • Good hand hygiene such as not touching areas that can be a source of pathogens more than needed, using foot operated bins rather than lifting bin lids with the hands, washing and/or sanitising regularly and using hand cream, good quality paper towels and soaps can help to protect the skin. Also, ensure all cuts are covered with waterproof dressings. Fingernails should be kept short. Rings, apart from plain wedding bands, wristwatches or bracelets should not be worn as they can make handwashing less effective. The World Health Organization (WHO) has identified five moments when health and social care workers should clean their hands. These moments are:
  • Before touching the individual that you are supporting.
  • Immediately before carrying out a clean procedure.
  • After exposure to body fluids and after removing gloves.
  • After touching the individual that you are supporting.
  • After touching the area or objects surrounding the individual you are supporting.
  • Safe disposal of waste. It is important to understand how different waste should be handled safely to protect yourself, your colleagues and the people that you provide support for. Health and social care providers should have a waste handling policy in place. This will detail how to deal with different types of waste. You must make sure that you understand and follow this policy at all times. Health and social care providers are also responsible for providing the correct equipment and materials for the disposal of sharps, such as needles and blades, to reduce the risk of injury. Waste containers should be handled carefully to avoid contamination and where appropriate PPE should be used to protect from contamination and infection.
  • Safe management of laundry. Bedding, towels and clothing, collectively known as linen, can become contaminated with harmful microorganisms and body fluids. Linen that is contaminated with body fluids must be washed separately from other items and should be moved to the washing area in sealed, colour-coded bags. Once linen has been decontaminated it must be stored separately from contaminated linen to prevent cross-contamination. Health and social care providers will have their own policies and ways of working which should be followed at all times.
  • Correct use of personal protective equipment (PPE); for example, clothes can become contaminated with harmful microorganisms. Disposable aprons and over-sleeves should be used when handling anything contaminated with body fluids to protect clothes from contamination. Other forms of PPE may include, gloves, face shields, masks etc. Health and social care providers must provide their employees with the equipment that they need to protect them from injury and, as far as possible, from the risk of infection while they are at work. This may include access to vaccinations offered as part of the prevention of infections spreading; examples might be the vaccination against influenza (flu) or Hepatitis. It is a worker’s personal responsibility to ensure that they keep vaccinations up to date as part of their duty to protect individuals by not spreading infection.
female-doctor-washing-hands

Safety and Risk Assessment

Health and Safety is Standard 15 of the Care Certificate, and learners must demonstrate knowledge and competency in the following learning criteria:

13.1 Understand their own responsibilities, and the responsibilities of others, relating to health and safety in the work setting

13.2 Understand Risk Assessment

13.3 Move and assist safely

13.4 Understand procedures for responding to accidents and sudden illness

13.5 Understand medication and healthcare tasks

13.6 Handle hazardous substances

13.7 Promote fire safety

13.8 Work securely

13.9 Manage stress

Health and social care providers will have a health and safety policy which sets out how they will protect everyone who is affected by their business, including employees, visitors, contractors and individuals who access services including services provided in the private homes of service users. Providers have many legal responsibilities to ensure the health, safety, welfare and/or wellbeing of all employees and others. Health or social care workers are responsible for taking reasonable care of themselves and others in the workplace.

There are a number of activities that health and social care workers must not carry out until they have received special training, as working in unsafe ways that have not been agreed with the care provider and without appropriate training can mean that the carer is putting themselves, the individuals that they support and others at risk of harm. This may include, but is not limited to, such areas as food preparation and serving, emergency procedures, lifting and manual handling and administering medications.

One of the key fundamentals to working safely is carrying out risk assessments. They are not only a legal requirement, but they also provide clear guidance and information on how to keep people safe and prevent danger, harm and accidents. A risk assessment is simply a careful examination of what could cause harm, that is, a hazard or a threat, to someone or something, and requires making a judgement on the risk severity, so that the care provider can weigh up whether they have taken enough precautions to either eliminate or mitigate the risk, or whether they should do more to prevent harm. A hazard or threat is anything that may cause harm. A risk is the chance, high, medium or low, that someone or something could be harmed by these and other hazards or threats, together with an indication of how serious the harm could be.

The risk assessment process, irrespective of the type of risk, involves a five-step process:

Step 1 – Identify the hazards or threats

Step 2 – Decide who or what might be harmed and how

Step 3 – Evaluate the risks and decide on precautions

Step 4 – Record the findings and implement them

Step 5 – Review the assessment and update if necessary

The most important part of hazard reporting is to act quickly and report it so that action can be taken to prevent an accident or harm.

care-giver-teaching-elderly-man-to-use-a-walker

Duty of Care

Duty of Care is Standard 3 of the Care Certificate, and learners must demonstrate knowledge and competency in the following learning criteria:

3.1 Understand how duty of care contributes to safe practice

3.2 Understand the support available for addressing dilemmas that may arise about duty of care

3.3 Deal with comments and complaints

3.4 Deal with incidents, errors and near misses

3.5 Deal with confrontation and difficult situations

Duty of care is a legal requirement and is part of the code of conduct for healthcare support workers and adult social care workers in England and will most likely also be in the job description. It is important to have the knowledge and skills to act on your duty of care in your role and that you do not work beyond it. Duty of care means promoting wellbeing and making sure that people are kept safe from harm, abuse and injury, with the interests and wishes of the individual at heart and that includes not only service users but also other workers, and other people in the premises.

Equality and Diversity

Equality and Diversity is Standard 4 of the Care Certificate, and learners must demonstrate knowledge and competency in the following learning criteria:

4.1 Understand the importance of equality and inclusion

4.2 Work in an inclusive way

4.3 Access information, advice and support about diversity, equality and inclusion

In order to work in ways that are inclusive, health and social care workers need to understand and value the things that make people different. The care and support provided must be specific to each individual person’s needs, wishes and preferences. It should be person-centred care which builds in the likes and dislikes, beliefs and personal history of an individual to meet their needs in the best way possible.

The Equality Act 2010 makes it against the law for people to be treated unfairly because of the things that make them different. The Act sets out how individuals should experience equality of opportunity and lists nine protected characteristics that help to safeguard them from discrimination. The Act also provides protection for individuals who experience discrimination by association with someone who has a protected characteristic. Promoting equality and respecting diversity help to ensure that people are valued and have the same access to all opportunities whatever their differences.

Health and social care workers can respect and promote equality, diversity and inclusion by providing person-centred care, treating the individuals that they support as unique rather than treating all individuals in the same way, by ensuring that they work in a non-judgemental way and by being confident to challenge or confront discriminatory practice if and when they see this in their workplace.

Final Thoughts

Although the Care Certificate standards are set out in separate units, these units all work together holistically in order to be able to demonstrate competence in the role. It is a framework for good practice, and sets out fundamental skills that care workers need to work competently in health and social care.

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About the author

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Liz Wright

Liz has worked with CPD Online College since August 2020, she manages content production, as well as planning and delegating tasks. Liz works closely with Freelance Writers - Voice Artists - Companies and individuals to create the most appropriate and relevant content as well as also using and managing SEO. Outside of work Liz loves art, painting and spending time with family and friends.



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