My Lords, in Committee noble Lords were rightly concerned about the way that healthcare assistants and social care support workers are trained and supported to carry out the crucial tasks assigned to them. Amendments were also tabled concerning the regulation of this group of workers. I sought then to reassure noble Lords that the Government were determined to ensure that this important part of the workforce received high-quality and consistent training to deliver the best standards of support and care to patients and service users. Having listened very carefully to the views expressed in Committee, I have reflected a great deal on this important issue and today I am able to go further than I was able to do on that occasion.
First, however, I shall provide a short recap. What we are now doing will mean building on what we have been putting in place since your Lordships’ House last discussed this issue during the passage of the Health and Social Care Act 2012. Common induction standards have been in place in social care since 2005, but the sector skills councils jointly published a code of conduct and national minimum training standards in March 2013. The standards place dignity and respect at the centre of the knowledge required to provide safe and effective care. The sector skills councils engaged comprehensively in the development of both the NMTS and the code of conduct across the health and social care sectors, including NHS and social care providers, the Health and Care Professions Council, the Royal College of Nursing, the Royal College of Midwives, the Nursing and Midwifery Council, and patient representative groups.
We know that we need to build on these standards. The department is investing £130 million in training and developing the social care workforce this year. Working through Skills for Care, the Department of Health provides funding of some £12 million each year to social care employers to train and develop their workforce. Health Education England is also investing £13 million in the training and development of healthcare assistants.
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Good employers understand that they need to ensure that their staff are properly trained. Compassion in Practice, launched in December 2012 by the Chief Nursing Officer for England and the Department of Health Director of Nursing, calls on NHS and social care providers to ensure that their staff are supported and trained to do their jobs effectively. The Social Care Commitment, launched in September 2013, is a public commitment by social care employers to improve the quality of care and support services that they provide through managing and developing their staff effectively.
The regulations covering CQC registration already place a legal obligation on employers in relation to the training of their staff. The regulations state that employers should ensure that their staff receive,
“appropriate training, professional development, supervision and appraisal”,
to enable them to carry out their responsibilities safely and to an appropriate standard. Where providers do not comply with registration requirements, the CQC has a range of enforcement powers that it can use, including prosecution. Statutory guidance on compliance with this registration requirement has also been published.
Employers across the health and care system are investing large amounts in training their staff, and the arrangements for induction, training and performance management of this workforce must take account of the type of care and support provided by various employers. Much of it is of a high standard, but it is fair to recognise that there are problems with the consistency and quality of training provided in some cases, and we know that we need to go further. For this reason, I am putting forward my amendment.
Amendment 153 will allow the Government to make regulations to specify who can set training standards for persons working in regulated activity, including healthcare assistants and social care support workers. Once the regulations come into force, the person or persons specified will provide a set of common training standards for healthcare assistants and social care support workers who provide regulated activities such as personal care. These standards can be used to evidence compliance with the CQC’s registration requirements, providing a consistency of approach in providing care that is dignified and respectful to patients and service users. The common training standards will also form the bedrock of what I am going to come to next.
In February, my right honourable friend the Secretary of State for Health commissioned Camilla Cavendish to review the training and support given to healthcare assistants and social care support workers. When we debated the issue in June, the review had not been published and could not be discussed in detail. Our plan is to respond formally to the Cavendish review at the same time as the Government respond to the Francis inquiry. However, recognising the strength of feeling on the issue, I pushed incredibly hard to be able to indicate our intentions today. In advance of that response, I can announce that the Government have asked Health Education England to lead work with skills councils, delivery partners, providers and other
stakeholders, such as the Nursing and Midwifery Council, to develop a certificate of fundamental care. We want to call this a “care certificate”.
Our goal in introducing the care certificate is to ensure that healthcare assistants and social care support workers receive high-quality induction in the fundamentals of caring. This should ensure that they understand the skills required and that they demonstrate the behaviours needed to deliver compassionate care. The care certificate, and any training that underpins it, will need to take full account of the standards set by the person appointed by the regulations to do so. This will be key to ensuring that those standards are applied consistently throughout the health and social care sectors.
Camilla Cavendish recommends that the certificate of fundamental care should build on the national minimum training standards, published by the sector skills councils in March of this year, which will also need to be aligned to any standards set in future. She also suggests that Health Education England should work with the Nursing and Midwifery Council on ensuring that practical elements of the nursing curriculum are incorporated into the certificate. We have asked Health Education England to ensure that the NMC and other stakeholders are fully involved in its work on the care certificate. Its work should also build on the best of training provision currently on offer across the health and care sectors.
The care certificate will provide clear evidence to employers, patients and service users that the person in front of them has been trained to a specific set of standards and has the skills, knowledge and behaviours to ensure that they provide compassionate and high-quality care and support.
We will work with the CQC to incorporate into its guidance the requirement for staff to hold a care certificate. In the same way as completion of the common induction standards is currently used as evidence of compliance with registration requirements for social care providers, so completion of the care certificate could, in future, be used as evidence of compliance with CQC registration requirements. The care certificate could be used as a set of standards not only in relation to CQC regulated activities but across all health and adult social care.
The Government recognise the concerns expressed on previous occasions in your Lordships’ House about the training of this critical part of the workforce. However, I hope that the House will recognise our commitment to bringing greater consistency and quality to the training provided to healthcare assistants and social care support workers, enabling them to place compassionate care at the heart of everything they do. I beg to move.