Director Rachel Gilbert explains Care UK’s successful nursing formula : Care Home Professional


Rachel Gilbert, Director of Care Quality and Governance, explains how Care UK excels in nursing care in an increasingly challenging marketplace.

Source: Director Rachel Gilbert explains Care UK’s successful nursing formula : Care Home Professional

Atos threatens to call police after claimant questions PIP assessor’s mental health training   | Govt Newspeak


Staff working for a discredited benefit assessments contractor threatened to call the police after a claimant asked about the mental health qualifications of the nurse who was assessing his eligibility for personal independence payment (PIP).

Atos has now launched an investigation into what happened at the assessment centre in Leeds, which saw the nurse abandon Kris Weston’s assessment after just a couple of minutes.

She did not realise that Weston, a composer and trained sound engineer, had been recording the assessment.

Weston began the assessment last month by telling the nurse that he had stayed up all night because of the extreme anxiety he experiences when he has to deal with institutions.

He had spent three days putting together a 10-page description of his complex mental health problems – and what he says is the “continual failure to even listen to his problems by multiple institutions” – in the hope that the assessor would help him secure the financial and health support he needed.

He explained that he had been unfairly described in the past as “violent” by the NHS after a telephone argument, although she told him that Atos had no record of this.

She appears to have wrongly blamed the decision to refuse him a home assessment on the Department for Work and Pensions (DWP), when such decisions are taken by the assessment companies, Atos and Capita.

 

Source: Atos threatens to call police after claimant questions PIP assessor’s mental health training   | Govt Newspeak

The social care recovery model


The Social care recovery model is simple to understand. It involves 9 domains that come together to create a cohesive system of care provision based upon skills development and recovery in an efficient and enabling environment.

The first 6 domains (the support domains) focus upon direct work with service users. They are developed through regular keyworking sessions and tools are provided to help service users and keyworkers to develop and plan for a range of situations as required.

Mind the care training

I’m a great believer in process. That doesn’t mean pigeon-holing the people we work with. It means having a process, a system that’s clear enough to keep us on track and flexible enough to allow truly collaborative and individualised working. That’s why I developed 2016-the-social-care-recovery-model-final. Designed around existing keyworking processes this model allows mental health care providers, housing association support workers and residential care workers to pinpoint exactly what their service-user needs and plan with them to meet their needs in a straightforward but effective way.

the-social-care-recovery-model-2016-mind-the-care-training
The Social care recovery model is simple to understand. It involves 9 domains that come together to create a cohesive system of care provision based upon skills development and recovery in an efficient and enabling environment.

The first 6 domains (the support domains) focus upon direct work with service users. They are developed through regular keyworking sessions and tools are provided to help…

View original post 264 more words

Hidden Disabilities | DisabledGo News and Blog


In certain industries such as the retail or catering industry, training is given to employees to help them to accommodate the needs of customers with disabilities better. Unfortunately, this has not yet become a widespread practice, meaning those living with a disability are often subject to discrimination – even if it was not intended. Even less in the way of training is given to employees about accommodating the needs of those living with hidden disabilities. Assumptions are often made about a person’s abilities based on their physical appearance. Many grievances are raised every year based on customers being told that their needs will not be accommodated as the facilities provided are for those with ‘actual’ disabilities. Typically, this is because, without training, many people simply do not understand that disabilities range further those which may require the use of a wheelchair, guide dog or, crutches. Another all-too-common grievance raised is the lack of facilities on offer or,

Source: Hidden Disabilities | DisabledGo News and Blog

Countdown to Rio: Rowlings ready to ‘smash it’ after years of ‘selfish’ preparation | DisabledGo News and Blog


When Ben Rowlings lines up on the start-line in Rio, he will know that he could not have done anything more to prepare himself for his bid to win a medal. The wheelchair racer, who is taking part in his first Paralympic Games at the age of 20 – only five years after being spotted at a British Athletics talent identification day – describes himself as stubborn, single-minded and “quite selfish”. “I think a lot of athletes have to be quite selfish, and just kind of look after themselves and make sure nothing impacts on their training or the bubble that they are in,” he says. “But I’m hard-working and I make sure that I put the hours in in training, and the results are showing on the track.” He has been doing “long, hard sessions” in the gym, two or three times a day, six days a week, and believes there are “very few” of his competitors who will have been able to match that. But he has also benefited from the peer support he has received as part of the training group set up by

Source: Countdown to Rio: Rowlings ready to ‘smash it’ after years of ‘selfish’ preparation | DisabledGo News and Blog

Parents who record child protection meetings: what do social workers need to know?


A group of lawyers has produced guidance after identifying a number of councils not fully understanding the law around recording child protection meetings

Source: Parents who record child protection meetings: what do social workers need to know?

New body for social workers to help improve standards announced by the government


Government also announces it will set up a new body to take responsibility for social work standards, training and regulation of the profession

Source: New body for social workers to help improve standards announced by the government

Poor training of care home staff leaving residents at risk, investigation finds


Original post from Community Care

‘……………by

Community Care research finds residential care staff are missing out on vital training in dementia care, safeguarding and the Mental Capacity Act

Credit: Image Broker/Rex Features
Credit: Image Broker/Rex Features

Published in partnership with UnisonUnison-logo-150x77

Staff working in residential and nursing homes are not being provided with the training they need to support adults with complex needs, research by Community Care has found.

Dementia care is particularly falling short, with even specialist dementia homes failing to provide training on the topic to their staff. Safeguarding, the Mental Capacity Act (MCA) and the Deprivation of Liberty Safeguards (Dols) were the other most common gaps.

We found examples of where the lack of training had resulted in safeguarding concerns not being reported, residents being unlawfully deprived of their liberty, and people with dementia being treated with no empathy or understanding of their care needs.

Unison said the findings highlighted the “shocking lack of investment” in the residential care system.

The Care Quality Commission’s chief inspector for social care said it was worrying that gaps existed in areas that are fundamental to the protection of vulnerable people’s rights.

About the research

Community Care wanted to understand the training gaps among residential care workers. We analysed 300 inspection reports published by the Care Quality Commission (CQC) between 1 October 2014 and 31 August 2015. We looked at where training had been identified as an issue by inspectors and where the gaps were in terms of topic area.

The analysis of 125 ‘inadequate’ services, 125 ‘requires improvement’ and 50 ‘good’, showed:

  • 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.

The 300 care homes we looked at were inspected under the CQC’s new approach, provided residential and/or nursing care and supported adults over the age of 65 years.

Of the 250 homes told to improve by the CQC, 178 had gaps in training provision.
Of the 250 homes told to improve by the CQC, 178 had gaps in training provision.

As would be expected, training issues were much rarer in homes rated ‘good’ by inspectors. Gaps were identified in only five of the 50 homes looked at, however, these gaps were also in the three topics specified above, suggesting a widespread issue with training in these areas.

Dementia care

Dementia care has been a government priority for the last five years. In March 2012, Prime Minister David Cameron set a ‘national challenge’ to drive major improvements in care, research and awareness by 2015. More recently, the challenge has been extended to 2020.

But our findings suggest this drive has yet to make an impact on some of the worst-performing care homes, with more than a quarter of those rated ‘inadequate’ or ‘requires improvement’ found to be lacking when it comes to providing training on the condition.

Excerpt from an inspection report of an 'inadequate' care home in Blackpool

This is particularly worrying given that estimates published by the Alzheimer’s Society show 80% of people living in care homes have either dementia or severe memory problems.

Even more concerning is that of these 69 homes, 66 listed dementia as one of their specialisms on the CQC website, or supported residents living with the condition. In the worst cases, ‘specialist dementia homes’ were operating without providing any dementia training to staff.

Excerpt from an inspection report of an 'inadequate' care home in Dorset

Andrea Sutcliffe, chief inspector for social care at the CQC, said the findings were worrying due to the impact poor practice can have on people living with dementia.

“We know if people who are living with dementia are not supported in the appropriate way it can cause them additional confusion and distress.

“It impacts on their wellbeing and it may impact on their behaviour, which actually makes the jobs of people working in the service even harder because they are potentially dealing with a manifestation of that distress and confusion,” she added.

George McNamara, head of policy at the Alzheimer’s Society, said there was a massive challenge ahead to ensure the health and social care workforces are equipped with the right skills to support people with dementia.

“Central government must provide adequate resources to local authorities to tackle the crisis in staffing levels in care homes and this must factor in time for dementia training to ensure a person-centred service is consistently provided,” he said.

Mandy’s story

Mandy*, a night worker, has worked at the same care home for the last ten years. The home supports older people, some of whom have dementia.

“I haven’t had dementia training for at least four or five years,” she told Community Care. “There are some staff who get to go on the training but the providers don’t send everybody.”

“It makes me feel frustrated because I liked to keep updated and extra training would help me to better support the people I’m caring for. I could find better solutions and understand more.”

Safeguarding

Our investigation also found gaps in safeguarding training, with a quarter of care homes told to improve by the CQC failing to provide adequate training in this area.

In some cases, care workers had not received any safeguarding training, despite being in post for more than 12 months. Other examples included staff not receiving regular refresher training, or not being able to demonstrate the learning from training in practice.

Of 23 members of care staff working at the home, 17 had not received training on the safeguarding of people. – an ‘inadequate’ care home in Hampshire

Safeguarding is a statutory responsibility for providers, but nearly a third (32%) of care homes rated ‘inadequate’ or ‘requires improvement’ were also found to be in breach of Regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) 2014. This regulation requires providers to ensure service users are protected from abuse and improper treatment.

These findings correspond with concerns raised in the CQC’s latest State of Care report, which found one in 10 adult social care services falling short on standards of safety. The report cited safety as the greatest concern in the sector and identified a lack of adequately-skilled staff as one of the key factors driving ‘inadequate’ ratings in this area.

Mental Capacity Act

Gaps in training on the Mental Capacity Act were also particularly prevalent. Our research found 42% of care homes told to improve by the CQC had MCA training gaps. A further 29% had not delivered training on the associated Deprivation of Liberty Safeguards.

Under the MCA, care providers should ensure decisions about a person’s care are made with their consent. Where a person is assessed as lacking capacity to make a decision, the provider must make a decision in the person’s best interests in line with the MCA code of practice.

The Dols should be applied where a person assessed as lacking capacity to consent to their care arrangements is likely to be deprived of their liberty. Where care home staff suspect care arrangements could constitute a deprivation of liberty, they must refer the case to their local authority to have it authorised.

An 'inadequate' care home on the Isle of Wight

Unsurprisingly, homes with an ‘inadequate’ rating were performing less well – more than a third had not provided adequate training in both the MCA and Dols. In the worst cases, staff spoken to by inspectors had ‘no understanding’ of how to ensure people’s rights and wishes are respected, and this had led to people being unlawfully deprived of their liberty.

One in 10 ‘inadequate’ homes were found to be depriving residents of their liberty unlawfully.

Andrea Sutcliffe said the findings supported those recorded by the Care Quality Commission in its annual Dols report – there isn’t a consistent understanding of the Act and the safeguards and that is “undoubtedly related” to the fact people are not getting appropriate training.

“It’s worrying that these are the places where we have the gaps because the MCA, Dols, and safeguarding are absolutely fundamental to people’s human rights being respected,” she said.

“What I’m bothered about is making sure people do something about it. Providers need to think about what they can do to address that deficit and how they can ensure the training they provide meets the needs of residents, is thorough and robust, and is not a one-off event.”

As would be expected, training issues were much rarer in homes rated ‘good’ by inspectors. Gaps were identified in only five of the 50 homes looked at, however, these gaps were also in the three topics specified above, suggesting a widespread issue with training in these areas.

Dementia care

Dementia care has been a government priority for the last five years. In March 2012, Prime Minister David Cameron set a ‘national challenge’ to drive major improvements in care, research and awareness by 2015. More recently, the challenge has been extended to 2020.

But our findings suggest this drive has yet to make an impact on some of the worst-performing care homes, with more than a quarter of those rated ‘inadequate’ or ‘requires improvement’ found to be lacking when it comes to providing training on the condition.

Excerpt from an inspection report of an 'inadequate' care home in Blackpool

This is particularly worrying given that estimates published by the Alzheimer’s Society show 80% of people living in care homes have either dementia or severe memory problems.

Even more concerning is that of these 69 homes, 66 listed dementia as one of their specialisms on the CQC website, or supported residents living with the condition. In the worst cases, ‘specialist dementia homes’ were operating without providing any dementia training to staff.

Excerpt from an inspection report of an 'inadequate' care home in Dorset

Andrea Sutcliffe, chief inspector for social care at the CQC, said the findings were worrying due to the impact poor practice can have on people living with dementia.

“We know if people who are living with dementia are not supported in the appropriate way it can cause them additional confusion and distress.

“It impacts on their wellbeing and it may impact on their behaviour, which actually makes the jobs of people working in the service even harder because they are potentially dealing with a manifestation of that distress and confusion,” she added.

George McNamara, head of policy at the Alzheimer’s Society, said there was a massive challenge ahead to ensure the health and social care workforces are equipped with the right skills to support people with dementia.

“Central government must provide adequate resources to local authorities to tackle the crisis in staffing levels in care homes and this must factor in time for dementia training to ensure a person-centred service is consistently provided,” he said.

Mandy’s story

Mandy*, a night worker, has worked at the same care home for the last ten years. The home supports older people, some of whom have dementia.

“I haven’t had dementia training for at least four or five years,” she told Community Care. “There are some staff who get to go on the training but the providers don’t send everybody.”

“It makes me feel frustrated because I liked to keep updated and extra training would help me to better support the people I’m caring for. I could find better solutions and understand more.”

Safeguarding

Our investigation also found gaps in safeguarding training, with a quarter of care homes told to improve by the CQC failing to provide adequate training in this area.

In some cases, care workers had not received any safeguarding training, despite being in post for more than 12 months. Other examples included staff not receiving regular refresher training, or not being able to demonstrate the learning from training in practice.

Of 23 members of care staff working at the home, 17 had not received training on the safeguarding of people. – an ‘inadequate’ care home in Hampshire

Safeguarding is a statutory responsibility for providers, but nearly a third (32%) of care homes rated ‘inadequate’ or ‘requires improvement’ were also found to be in breach of Regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) 2014. This regulation requires providers to ensure service users are protected from abuse and improper treatment.

These findings correspond with concerns raised in the CQC’s latest State of Care report, which found one in 10 adult social care services falling short on standards of safety. The report cited safety as the greatest concern in the sector and identified a lack of adequately-skilled staff as one of the key factors driving ‘inadequate’ ratings in this area.

Mental Capacity Act

Gaps in training on the Mental Capacity Act were also particularly prevalent. Our research found 42% of care homes told to improve by the CQC had MCA training gaps. A further 29% had not delivered training on the associated Deprivation of Liberty Safeguards.

Under the MCA, care providers should ensure decisions about a person’s care are made with their consent. Where a person is assessed as lacking capacity to make a decision, the provider must make a decision in the person’s best interests in line with the MCA code of practice.

The Dols should be applied where a person assessed as lacking capacity to consent to their care arrangements is likely to be deprived of their liberty. Where care home staff suspect care arrangements could constitute a deprivation of liberty, they must refer the case to their local authority to have it authorised.

An 'inadequate' care home on the Isle of Wight

Unsurprisingly, homes with an ‘inadequate’ rating were performing less well – more than a third had not provided adequate training in both the MCA and Dols. In the worst cases, staff spoken to by inspectors had ‘no understanding’ of how to ensure people’s rights and wishes are respected, and this had led to people being unlawfully deprived of their liberty.

One in 10 ‘inadequate’ homes were found to be depriving residents of their liberty unlawfully.

Andrea Sutcliffe said the findings supported those recorded by the Care Quality Commission in its annual Dols report – there isn’t a consistent understanding of the Act and the safeguards and that is “undoubtedly related” to the fact people are not getting appropriate training.

“It’s worrying that these are the places where we have the gaps because the MCA, Dols, and safeguarding are absolutely fundamental to people’s human rights being respected,” she said.

“What I’m bothered about is making sure people do something about it. Providers need to think about what they can do to address that deficit and how they can ensure the training they provide meets the needs of residents, is thorough and robust, and is not a one-off event.”

Other key findings

training-gaps-by-topic-area-1024x826

Our research also highlighted a need to better support care staff in managing the health needs of residents. Of the homes told to improve by the CQC, 15% had training gaps in health conditions such as diabetes and epilepsy. Providers were also failing to provide staff with training on pressure sores, catheter care and invasive procedures.

Sutcliffe said better integration between the NHS and care homes was key to ensuring care staff have the skills and confidence to manage complex health conditions. “We need to be absolutely clear that the NHS does not stop at the care home door,” she said.

Sector reaction

Des Kelly, chief executive of provider organisation, the National Care Forum, said: “While it is difficult to know if the sample is representative, 300 care homes is a large enough survey to be disturbed by the findings. It is the responsibility of providers to ensure that staff are appropriately trained and developed. I am alarmed that services described as ‘specialist’ fall short on such fundamental statutory responsibilities.”

Heather Wakefield, head of local government at Unison, added: “This research highlights the shocking lack of investment in our residential care system, leaving clients vulnerable to inadequate care as a result of insufficient funding to support required training, appropriate staffing levels and safeguarding mechanisms.

“UNISON members and other staff are being exposed to criticism as a consequence. The UK is one of the world’s richest countries and we can afford to treat our elderly citizens better than this. We can also afford to put money into staffing and proper training for the job. Unless the government shifts its priorities and recognises that care needs to be properly funded, our residential care system will be unable to cope.”

Why do training gaps exist?

The responsibility for ensuring staff are trained and supported rests primarily with care providers, but our findings suggest in many cases training is not being seen as a priority.

Sutcliffe said staffing issues and financial pressures were two factors driving the problem.

“If homes are operating at a level that means they cannot release people for training because there aren’t enough staff then that’s a problem,” she said.

“Providers also see training as the area where they can cut the corners [when in financial difficulty] but it is a false economy. If you don’t train people and give them the capability and the confidence, they won’t be able to cope with the job and will leave.”

The increasing financial pressures the sector is facing have made the headlines recently, with significant cuts to council budgets, the increasing complexity of people’s needs and high vacancy rates all playing a part in providers’ ability to deliver care.

As part of this research, we also asked local authorities to provide their annual training budgets for the financial years 2013-14 and 2014-15, for staff working in the residential care services they commission. Only 30 councils were able to provide this information following a Freedom of Information request.

Of these, 60% of the councils had cut their budgets in 2014-15. In 2013-14, councils were spending an average of £55,000 on training for residential care workers, this reduced to an average of £43,000 in 14-15.

Kelly added: “I do not believe that the erosion of monies for training from local authorities can be used as an excuse. However, it seems likely to have contributed to the worrying picture that emerges from this survey.”

Do you need to brush up on your knowledge of dementia but haven’t been given the opportunity?

Dementia-webinar_Ad-for-Inform_200x200Community Care’s free webinar will offer tools to help.

The webinar will provide an overview of the key practice elements – from recognising how the condition affects people to communicating with individuals more effectively.

Our expert panel of speakers from the Care Quality Commission, the Alzheimer’s Society and Unison will also share success stories from the frontline, examples of what good care looks like, and strategies for building more positive relationships with people living with dementia.

Register for this free webinar here.        …………..’

 

Why David Cameron’s immigration rules will worsen nurse shortages


Original post from The Guardian

‘……………By 

It takes time to train NHS nurses so in the meantime, trusts have to recruit from abroad

A scene from the opening ceremony of the 2012 London Olympic Games. There are thousands of vacant nursing posts. Photograph: KeystoneUSA-Zuma/Rex
A scene from the opening ceremony of the 2012 London Olympic Games. There are thousands of vacant nursing posts. Photograph: KeystoneUSA-Zuma/Rex

Recruiting skilled and motivated nurses is key to delivering good quality hospital services. So Newcastle upon Tyne hospital NHS foundation trust was delighted when it found its latest crop of new nursing staff, who, according to chief executive Sir Leonard Fenwick, were expected to become “part of the backbone” of its workforce. Trouble is those nurses are still sitting some 6,500 miles away in the Philippines after the trust’s applications to bring them into the country were rejected.

“It’s a frustration,” says Fenwick. “We have had a great success story with bringing in staff from the Philippines over the past decade. They have been fabulous – they have hit the ground running and they have become indispensable. This is about bringing to the UK calibre people who quickly become thoroughly engaged in our social fabric.”

The Newcastle trust’s problems – it has had three applications for a total of 85 certificates of sponsorship that non-EU staff need to enter the country refused between June and September – are just one example of an issue that NHS trusts say could put patient safety at risk. That’s why 10 hospital trusts, including Newcastle, last week signed up to a letter to the home secretary, Theresa May, calling for an easing of immigration rules. The NHS Employers organisation, which coordinated the letter, estimates that around 1,000 nurses from outside the EU have been rejected by the Home Office to date, with a further 1,000 applications expected over the next six months.

The Home Office disputes the figures and claims NHS trusts have been given more than 1,400 sponsorship certificates for nurses since April this year, but more than 600 of the places allocated to them in April and May this year had been returned unused.

In recent months, when places for Tier 2 visas for nursing and a number of other professions have been oversubscribed, priority has been given to shortage occupations.

“The independent Migration Advisory Committee, which took evidence from a number of NHS trusts and representative bodies from across the UK, recommended against adding nurses to the shortage occupation list earlier this year,” a Home Office spokesperson adds.

But NHS Employers’ chief executive, Danny Mortimer, says hospitals around the country are being affected and that until moves to train more nurses in the UK start to pay off, hospitals need to be able to recruit flexibly.

“There are two principal areas of concern, he says. “The first is if you can’t recruit permanent staff, whether from the UK, the EU or outside the EU, that drives demand for agency staff – and that comes at a premium.

“Then people are looking at their plans for winter and the need to expand capacity and thinking: ‘Gosh, how do we staff that?’ We are not given to the waving of shrouds but it does create a risk. We know the winter period is going to be pressured.”

As well as reconsidering the decision not to add nursing to the shortage occupation list, NHS Employers wants rules on the salary criteria for entry to be eased to reflect the fact that skilled health staff are not paid as much as, say, migrants offered jobs in financial services.

But the problem goes wider than nurses who are not able to enter the country to take up the jobs they are offered – it could also hit thousands already here. The Royal College of Nursing has warned that new rules requiring non-EU workers must be earning at least £35,000 before they are allowed to stay in the UK after six years could “cause chaos” in the NHS. According to RCN research, by 2020 some 6,620 nurses could be forced to leave, wasting almost £40m in recruitment costs.

Then there’s the impact of the tougher climate on care homes, which already find it more difficult than NHS trusts to recruit nurses. Analysis by consultancy Christie & Co suggests that adult social care has a 9% nurse vacancy rate, compared with 7% in the NHS.

“It takes time to train nurses so in the short term we have to get nurses who are already trained into the country,” says Michael Hodges, director of healthcare consultancy at Christie & Co. “Care homes really want to hire nurses from overseas, which in the past has been really successful. The tightening of the system and the fact that some could even be forced to return home doesn’t help matters at all.”

Dr Pete Calveley, chief executive of care home provider Barchester, says that with 15,000 nursing vacancies across the NHS and social care it’s a “nonsense” for nursing not to have official recognition as a shortage occupation. Despite the difficulties with securing their entry, Barchester has returned to trying to recruit nurses from outside the EU because of the shortage in the UK and the fact that EU nurses who join the care sector often move on quickly to the NHS.

“Last year we recruited 800 nurses but lost 1,000,” he says. “The cost of recruiting is absolutely huge. Yes, let’s train more nurses in the UK but let’s also recognise that nursing is hugely in demand and not make the search for them so inappropriately burdensome. Although there are thousands of vacant posts it’s not considered a shortage which seems bizarre.”

We’re running a themed week on nursing on the Healthcare Network. If you’ve got a standout experience you’d like to share about your nursing career, tell us about it here.

Join our network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views.  ……’

Councils failing to provide adequate support for personal assistants, investigation finds


Original post from Community Care

‘……………by

Personal assistants speak out about their isolation as Community Care finds postcode lottery of support and training opportunities

Photo: lassedesignen/fotolia
Photo: lassedesignen/fotolia

Published in partnership with Unison

Councils are offering inadequate support for personal assistants despite the critical role they have to play in delivering personalised Unison-logocare under the Care Act, according to research by Community Care.

Figures obtained from 117 of England’s 152 local authorities through a freedom of information request show councils are falling short of minimum standards of support published by sector leaders in 2013. Key concerns include:

  • Personal assistants and their employers face isolation as 86% of councils don’t facilitate support networks for personal assistants and 65% don’t offer this provision to employers.
  • Training is a ‘postcode lottery’ with some councils only offering access to e-learning or free safeguarding sessions. One in 10 councils offering training do not meet the cost.
  • Opportunities for career development are also limited, with 82% of councils not promoting apprenticeships to personal assistants.
  • Nearly two thirds of councils do not provide a register of accredited personal assistants that employers can access when looking to recruit. 

The 2013 guidance, which was developed by Skills for Care, Learn to Care and the Association of Directors of Adult Social Services (ADASS), includes nine minimum standards and states that, due to the growing number of people receiving personal budgets and direct payments, councils need to be offering support of the ‘highest possible standard’ to employers and their personal assistants.

But personal assistants like Heather, who supports an elderly lady with mental health needs, continue to feel isolated. “I don’t know of any local networks and I wouldn’t know where to look for email addresses I could use to make contact with people myself,” she told Community Care.

“I just feel like there is no support out there. Who do I let off steam to? If I witness abuse or neglect, who do I speak to? If you work for an agency you will always have your line manager, but when you are employed through direct payments you have no point of contact. I have no one to turn to.”

standard-7-edits

‘I’ve got no support, no manager, and no access to supervision’

Sean, a personal assistant to a young man with complex health needs, has struggled to access support ever since his client’s family switched from an agency to a personal health budget, which is jointly funded by the NHS and the local authority.

“I’ve got no support, no manager, and no access to supervision,” he said. “I can talk to the NHS trainer but although he can try and give advice, the only concerns he can really raise are those related to the health needs of my client.”

Sean is also unaware of any local support groups for personal assistants. “The only place I can think of would be the group I take my employer to and that’s not the best place to do it – everyone’s clients are there to enjoy themselves, not talk about the issues we have.”

‘Persistent challenge’

A survey undertaken by Skills for Care in 2014 also found peer support to be lacking, but said it was recognised by councils as a ‘desirable intervention’. This was, however, the third consecutive year in which peer support was identified as a gap by the organisation’s research.

Responding to Community Care’s findings, Georgia Turner, programme lead for employer engagement at Skills for Care, said: “That support isn’t more widely embedded is indicative of the challenges local authorities need to work to overcome in engaging a group who often don’t comply with our traditional idea of what a ‘workforce’ looks like.”

Matt Bowsher, joint chair of the Association of Directors of Adult Social Services’ personalisation network, added: “There is something very distinct about the personal assistant role itself and where there is a willingness on all parts to do so, there’s no reason why personal assistants could not be put in contact with one another and offer support.

“The technical means for people to communicate with each other have never been so great, so it’s about how those networks are built, informally as well as formally. Not all of this is about what councils do, it’s about how councils could act as a catalyst for how these networks could be made.”

‘Postcode lottery’

Our investigation also found a significant variation in the learning and development opportunities available to personal assistants (standard 5 of the advice note).

While 77% of councils provided access to in-house training, the quality ranged from e-learning modules or basic induction sessions to a willingness to provide ‘any relevant training’ to the personal assistant’s role. Other councils only offered free safeguarding training and one said it would open training up to personal assistants “only if there were spaces available”.

Funding was also an issue. Of the councils that made in-house training available to personal assistants, 1 in 10 did not meet the cost. Some councils said they costed monies for training into the service user’s personal budget allocation, but would not meet the associated costs such as shift cover for the personal assistant while they attended training (known as backfilling) – the individual employer would have to fund this. Others expected personal assistants to foot the bill.

Two councils said they considered it to be the responsibility of the individual employer and the personal assistant to source and fund learning and development opportunities.

Sean says the external training he has received since his client’s family switched to the personal health budget has not been as good as when he was employed by an agency.

“When I worked under the agency I had access to a five day training package every year but now I can’t remember the last time I had that. For manual handling we were given a one hour online course, before it would have been at least a day of face to face training.”

Career development

Skills for Care’s 2014 survey recommended that local authorities support individual employers to access the Workforce Development Fund, which is distributed by the organisation on behalf of the Department of Health. The fund can be used to access additional learning and development opportunities for individual employers and their personal assistants.

Our investigation found nearly half of councils do not support individual employers to access the funding. Of those that did, some only provided information via email, while others assisted individual employers to complete the full application process.

Personal assistants were also missing out on apprenticeship opportunities (standard 3), with 82% of councils not promoting them.

standard3edits-364x400‘My employer is not able to push these issues’

Heather is keen to pursue further learning and development opportunities on top of her existing NVQ level 2 in health and social care. Although she’s done the research, it’s now down to her employer to agree to her attending and to secure the funding, which is a lot to ask of someone who already has complex needs, she points out.

“I rely on my employer to push these issues but because of her needs she’s not able to that, so it means I just go to a lady four days a week and I’m not pursuing my career.”

ADASS’ Bowsher agrees training for personal assistants is challenging. “The very difficult balance that needs to be struck here is how you create the same opportunities for people where you don’t have the same economies of scale that some of the registered providers do – volumes of workforce, training budgets, ability to fund backfilling cover.

“Wherever possible, training and development needs to take place on the job and it’s very challenging to be able to take a large chunk of time where you as the individual employer can do without your personal assistant.”

He added: “We are going to have to very creative in the way that’s done, we don’t have an infinite sea of resources here that can be provided. And I don’t think anybody wants to be responsible for creating a two tier workforce. Both groups should be equally as attractive to a potential carer.”

Recruitment support

Our findings also show that nearly two thirds of councils do not keep a register of accredited personal assistants that employers can access when looking to recruit. Of the councils that did, some held an in-house register, while others commissioned an external organisation to manage it.

The 2014 Skills for Care survey reported a 15% increase in the number of councils providing a register (from 41% in 2012 to 56% in 2014), but said encouraging councils to use one still remained a persistent challenge. The figures obtained by Community Care suggest there has since been a reduction in the number of councils providing this service.

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Skills for Care’s Turner said: “We must remember that local authorities are working to ensure their actions keep employers and personal assistants safe, without removing the choice and control that is central to personalisation. Local authorities must focus their efforts on enabling informed decision making and effective risk management, rather than imposing arbitrary controls.”

When asked if personal assistant registers are a service councils would be likely to cut as a result of funding pressures, Skills for Care declined to comment further.

‘Incredibly reckless’

Matthew Egan, professional officer at Unison, said the findings were ‘especially worrying’ given the context of funding cuts that are likely to be exacerbated under the new government.

“If the personalisation agenda is being really pushed then it is incredibly reckless to do it unless you have the adequate levels of training, support and funding in place, which the findings show aren’t currently there. It’s not just bad for the worker, it’s bad for the individual employer – they are both being let down by the lack of support.

“It’s also a postcode lottery – you could be lucky enough to be in a local authority area where the council provides a good level of support and training but a lot of other people are in ones where they are just on their own.”

Government response

A spokesperson for the Department of Health said: “This data doesn’t show the whole picture – our survey of local authorities over the last three years show most do have support available to personal assistants and this situation is improving year on year.

“We know there is some variation across the country so in 2013 we published advice setting out minimum standards and we also want to make sure we facilitate the sharing of best practice in our work with partners and stakeholders.”

ADASS’ Bowsher added: “Clearly some time has passed since the Skills for Care and Department of Health guidance was published and we now have data that says very clearly that we need to look at this again and ask ourselves the question what can be done to support individual employers and what can be done to support personal assistants.

“We don’t want people feeling isolated like they don’t have any career development opportunities and there is no one to support them, whether they are an employer or a personal assistant.”

He added: “All of these comments are made in the context of significant and longstanding financial challenges, but I do think the cuts themselves should not be used as an excuse to stop us exploring every opportunity to encourage personal choice and control.”

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