This FOI request is based on Commitment 7 of the Prime Minister’s Challenge on Dementia 2020 Implementation plan.
• Do all of your commissioned adult social care services contractually specify the minimum standards of training required for providers who care for people with dementia including residential, nursing and domiciliary care settings?
• If not, do any of your commissioned adult social care services currently contractually specify minimum standards of training required for providers who care for people with dementia including residential, nursing and domiciliary care settings? Please list them if so.
In response to both the above questions, we can confirm the following clauses are included in contracts with providers:
Staffing Requirements
The Provider must ensure that:
• All staff and workers are competent, skilled, qualified and have been appropriately vetted, including the undertaking of enhanced DBS (Disclosure Barring Service) checks as appropriate.
• All staff and workers are engaged in delivering any Package of Care and Support to Service Users must have a proficient written and spoken use of English Language. The Provider will make reasonable provision and adjustments for language systems that assist and enable greater understanding e.g. easy read documentation, BSL etc.
• They are following safe recruitment practices compliant with relevant national guidelines (i.e. Immigration, Asylum and Nationality Act 2006 and the Home Office Border and Immigration Agency Prevention of Illegal Working Guidance for Employers (Feb 2008)) and the requirements of the Rehabilitation of Offenders Act 1974 (Exemptions) (Amendment) order 1986.
• They are responsible for their own staff and worker recruitment, induction, training and supervision to ensure that all staff and workers are appropriately trained and supported to deliver the requirements of the specification. The Provider will monitor partners to ensure they also comply with this requirement.
• All its staff and workers have an awareness of (and work within) the care certificate standards and requirements of MCA (Mental Capacity Act 2005) DOLS (Deprivation of Liberty Safeguards) and have the appropriate skills, knowledge and access to qualifications necessary for their role and that partners also comply with this requirement.
• Its staff and worker training records must record the content of induction training and period it is delivered over and any subsequent training delivered and when delivered and that partners also comply with this requirement. This record must be available for inspection by the Commissioner on request.
• The appropriate conduct of its staff and workers. Any misconduct, dishonesty or behaviour, which is detrimental to the welfare or wellbeing of the Service User, will be thoroughly investigated, initially by the staff and worker’s employer. The Provider will ensure that any such matters are thoroughly investigated by itself or the staff and worker employer as appropriate. The Commissioner will be advised immediately, in writing, of any such investigation and its outcome. Full details of contact points will be made available to providers in the Provider Guidance.
• They will remove from any Service Users care arrangements any member of staff and worker who is deemed guilty of misconduct, dishonesty or negligence, is not medically fit to perform the work or does not treat the Service User, their Carer with due respect and courtesy.
• Staff and workers have good communication and listening skills and are sensitive and flexible when responding to issues relating to needs of Individuals and that they treat all people and Service Users with respect and dignity, irrespective of their race, disability age, gender, sexual orientation and religion.
Quality Requirements
The Provider must have policies in place which cover all aspects of the quality and delivery of the service, which are reviewed regularly (and any changes notified to staff and workers), and which are understood and applied by staff and workers in their delivery of the service.
The Provider will ensure:
• that its staff and workers recruitment process complies with relevant legislation and good practice guidance for services delivered to vulnerable people;
• that staff and workers at all levels (including volunteers) have received comprehensive induction and training which equips them with the knowledge and skills necessary for effective and safe delivery of the service including an understanding of how the organisation’s policies and procedures underpin day-to-day delivery of the service;
• that staff and workers are observed during the delivery of service in order to ensure that policies are being adhered to;
• that its staff and workers understand the principles of a person-centred service and are able to apply these principles in their day-to-day delivery of the service;
• that the findings of practice observation are discussed with staff and workers, and, where necessary, additional training and continuing professional development provided in order to ensure competence.
The Provider will ensure that Service Users are aware of any policies relevant to the service they receive, e.g. summarising these in a “welcome pack”, and to ensure that information is provided to Service Users in suitable formats regarding how to access relevant policies and procedures
The Provider must communicate effectively and appropriately to all Service Users the quality of service they can expect to receive, and to inform Service Users how to provide positive feedback or raise any concerns about the service through the procedure set out in section 9.1 below.
The Provider will have a robust quality assurance process in place which ensures that the following are regularly monitored and reviewed, with good practice being recognised and areas for improvement identified:
• Documentation about Service Users e.g. My Care and Support Plans; assessments; daily records; consent.
• How Packages of Care and Support is provided e.g. staff and worker practice, privacy, dignity, choice, daily life and activities, information supplied to the Service User, and strategies used and their successes.
• Medication management and administration (where applicable)
• General management of the service e.g. contingency plan; safeguarding and deprivation of liberty; quality assurance.
• Premises and equipment (where applicable) e.g. décor and condition; suitability; servicing and maintenance.
• Safe working practices e.g. health and safety; fire safety; water temperatures; legionella; environmental hazards; hygiene and infection control.
• Staffing e.g. staff and worker levels; induction; training needs; supervision and appraisal.
The Provider’s quality assurance process must include periodic gathering of feedback from Service Users and / or their Carers or advocates and from professionals such as community health and social care workers and GPs, through surveys, questionnaires, meetings or other appropriate methods.
Residential Care;
We do not have a direct clause we just request individual needs are met and require ;
The Service Provider shall make available to the Service Purchaser, on demand, a copy of the following policies, procedures or other documentation:
• Statement of purpose, business plan and latest copy of any relevant inspection reports;
• Accounts (audited where required by the Companies Act) and other relevant financial information (where this is reasonable);
• Evidence of adequate insurance cover (as set out in Condition B7);
• Health and safety, risk assessment, equal opportunities and quality standards policies;
• Policy and procedure for staff recruitment, induction, training and development;
• Complaint procedure, summary of complaints received and dealt with, and copies of records relating to complaints made in relation to the Service and the Service Provider’s response;
• Records of time worked by staff in the provision of the Service;
• Business Continuity Plan for minimising disruption to the Service due to emergencies or unforeseen circumstances;
• Any other documentation, relating to the delivery of the Service, as may reasonably be requested.
Living Well at Home – Personal care contract states;
Induction standards/care certificate and those yet to complete the NVQ/Diploma in Health and Social Care or equivalent vocational qualification. This analysis will inform and take account of the Skills For Care NMDS.
7.4.2. At the point of recruitment, not all Staff will have the necessary training or experience. The Provider shall not utilise a Care Worker in the delivery of Personal Care until they have successfully completed a programme of induction and training in line with the new care certificate. Staff will not be able to work unsupervised on an activity until they have been signed off as competent in that area of work. The Provider will ensure that Sub-Contractors also comply with this requirement.
7.4.3. The Provider will ensure that all its Staff have undertaken induction training and successfully met the common induction standards/care certificate within 12 weeks of employment. Whilst on an induction programme staff should be paid in line with the contract requirements.
7.4.4. The Provider shall ensure that all its Staff who have successfully completed common induction standards/care certificate have also received training, as a minimum requirement in:
• Safeguarding of Vulnerable Adults
• The requirements of Mental Capacity Act 2005
• The requirements of the Deprivation of Liberty Safeguards
• The administration of medications
• The safe Moving and Handling of vulnerable persons
7.4.5. The Provider should ensure that all its Staff who have passed induction should have the opportunity to undertake further qualifications such as the NVQ/Diploma in Health and Social Care or equivalent vocational qualification within 2 years of employment.
7.4.6. The Provider will agree with the Commissioners which occupational qualifications should be considered equivalent to the NVQ/Diploma in Health and Social Care.
7.4.7. The Provider shall ensure its Staff are trained and supported in all legal requirements, policy & practices relating to equality and diversity.
7.4.8. The Provider must be able to demonstrate that all Staff who prepare meals have received training in basic food hygiene.
7.5. Staff Standards and Conduct.
7.5.1. The Provider will ensure that all its Staff deliver care in line with the six fundamental values described in ‘Compassion in Practice NHS/DoH 2012’; Care, Compassion, Commitment, Courage, Competence and Communication. The Provider will encourage its partners and Sub-Contractors to do likewise.
7.5.2. The Provider (or Sub-Contractors) will ensure that Staff have good communication and listening skills and are sensitive and flexible when responding to issues relating to needs of Service Users, and that they treat all people with respect and dignity, irrespective of their race, disability, gender reassignment, sex, marriage and civil partnership, pregnancy and maternity, religion and belief, sexual orientation and age.
7.5.3. All Staff engaged in delivering care and support to people must have a proficient written and spoken use of English Language.
7.5.4. It is the responsibility of the Provider to ensure the good conduct of its Staff. Any misconduct, dishonesty or behaviour, which is detrimental to the welfare or wellbeing of the Service Users, will be thoroughly investigated, initially by the Care Worker’s employer. The Provider will ensure that any such matters are thoroughly investigated. The Commissioners will be advised immediately of any such investigation and its outcome.
• If you do specify minimum standards of training within contractual agreements with adult social care providers who care for people with dementia, do you monitor these training standards?
Monitoring of the training standards is carried out via Social Care National Minimum Data Set Return (NMDS-SC). We also monitor ad hoc via contract monitoring meetings and Quality and Improvement Team involvement with providers.
The Care Quality Commission also check staff training through inspection of providers through inspection and we meet with them bimonthly including discussion of any providers of concern.