Health and Social Care is a highly complex business with lots of competing interests, the need to juggle many balls in the air at the same time. Ensuring that the staff you employ can cope within a stressful and relentless environment of caring for vulnerable residents can tax even the most compassionate and caring member of staff. Sickness leaves are amongst one of the highest in any sector of employment due to the pressures the job entails and the constant constraint on management to resource additional staff to ensure there is a viable amount of cover for each shift day and night. At a time when resources are stretched, training staff can get lost against other competing interests of simply managing shift cover, as yet another worker phones in sick. This ever-increasing cycle of backpedalling puts increasing strain on service delivery and resident care needs.
A case for training
In an article published in Community Care in partnership with UNISON, it analysed some 300 inspection reports published by the CQC from 1st October 2014 to 31st August 2015. Of the 250 homes told to improve 178 were identified as having gaps in training provision. Their findings were as follows:
- Training gaps were identified in 71% of care homes told to improve by the CQC
- Dementia care, safeguarding and the Mental Capacity Act were the topic areas that fared worst
- Almost half (49%) of the homes told to improve by the CQC were breaching regulations that require them to ensure a suitably trained and supported workforce.
Amongst the highest rated training gaps within homes were Fire Safety, Health and Safety, Food Safety, First Aid and Manual Handling.
Death of resident due to no systems of training and monitoring in place
An article in the HSE highlights a case in which lack of training was identified as a significant factor in the death of a 53-year-old man in an NHS trust hospital. In the HSE article it notes that, “The Court heard that the gentleman, who was a patient at the hospital, died on 10 April 2012 from internal injuries after falling onto an exposed metal post on the standing aid hoist that staff were using to support him.”
The NHS Hospital trust was ordered to pay £1 million in fines and £160,000 in costs.
What does the law require?
The key piece of legislation regarding an employer’s duty toward staff training is, The Health and Safety at Work Act 1974 section 2 (2) which states:
“Without prejudice to the generality of an employer’s duty under the preceding subsection, the matters to which that duty extends include in particular—
(c) the provision of such information, instruction, training and supervision as is necessary to ensure, so far as is reasonably practicable, the health and safety at work of his employees;
Clearly, the duty lies with the employer to ensure that workers employed are suitably trained for the tasks they are required to do.
In section 3 (3) this makes reference to self-employed and those not in the employer’s employment, where the employer has a duty to provide the person “not in the employer’s employment” “with information about such aspects of the way in which he conducts his undertaking as might affect their health or safety”.
How do I determine what training I need to provide?
There are some training courses which are mandatory in health and social care for all grades of staff such as:
- Health and safety awareness
- Fire safety awareness
- Manual handling
- Infection control etc
All staff who are non-regulated (i.e. doctors and nurses etc. are regulated) will be required to do the care certificate which covers a number of areas as follows:
- Understand your role
- Your personal development
- Duty of care
- Equality and diversity
- Work in a person-centred way
- Privacy and dignity
- Fluids and nutrition
- Awareness of mental health, dementia and learning disability
- Safeguarding adults
- Safeguarding Children
- Basic Life Support
- Health and Safety
- Handling information
- Infection prevention and control
Care home managers will be required to be registered with the CQC and need to have the Level 5 Diploma in Leadership for Health and Social Care. This qualification replaces the earlier Registered Manager Award and NVQ Level 4 in Leadership and Management for Care Services (both of which are still accepted as equivalent qualifications). There may be government funding available, see your QCS dashboard for more information.
Some courses will require refresher training to be undertaken periodically and regulated staff have to undertake revalidation every 3 years to remain in practice along with 450 practice hours.
What else is required?
Whilst training may be a mandatory requirement and tick some boxes for CQC inspectors it is important to note that training needs to be monitored in practice to ensure that it is effective. This means monitoring staff, asking questions and getting their feedback not just at the end of a training session when staff just tick the boxes so they can get home.
Supervision of staff is an opportunity to review the performance of staff, ensure that policies are embedded in practice and that staff understand what is required of them. It is also an opportunity to get their feedback about their role and review any potential training needs.
Training comes in a variety of formats from coaching, classroom, online training platforms however busy managers can easily lose track of staff training records.
Each member of staff should have their own personal development folder which should include any training completed both internally and externally.
To ensure that all staff receive training and refreshers it is highly recommended that a training matrix or a Learning Management System (LMS) is in place. This often uses a traffic light system i.e.
- RED – Courses which have expired or have not been completed,
- YELLOW – Courses which need attention within a month of expiry and
- GREEN – Courses which are up to date
Having a training matrix available for internal and external audits, CQC and local authority inspections greatly improves the chances of getting a high score rating provided training is up to date. Those with Outstanding are visited less often unless the home is reported. To get an Outstanding score you have to have your training up to date. Training is a key requirement of the CQC.
Managers need to be aware of the environment that staff operate in, what tasks they are required to do and then determine what appropriate courses of training are required for their staff to fulfil their role safely, professionally and to an industry high standard. Training is a legal requirement and is an area that care homes can find themselves rated as “need improvement” or “inadequate” and thus can affect your overall score. Remember if you have well-trained staff they are likely to work more safely, get less stressed, have less time off sick and help you reduce your agency bill. Training not only invests in your staff, it can help to keep them. I higher rating can also attract more funding to support your business and improve your brand awareness as a quality service provider.