Working in Care

Introduction

This article explores the base knowledge that is needed to work in a paid health and social care worker role.

We will look at your responsibilities, including the importance of honesty and transparency, reporting concerns, professional boundaries and working in partnership with others. We will also look at your practice, including the importance of working to standards and in line with your employer’s agreed ways of working.

Working in the care sector

From the moment that you begin working in the care sector, you have a professional responsibility to ensure that you provide high-quality care and support. This surpasses your responsibilities to your employer and will be embodied in your conduct, behaviour and attitudes, even outside of your working hours.

Code of conduct

It is essential that you familiarise yourself with the Code of Conduct for Healthcare Support Workers and Adult Social Care Workers in England. The Code sets out the minimum standards that you are expected to meet and can be used to provide guidance when you are faced with work-related dilemmas as well as identifying areas for professional development.

The seven core principles of the Code are reproduced below, however, it is important that you read the whole document so that you have a clear understanding of your responsibilities as a care worker.

As a Healthcare Support Worker or Adult Social Care Worker in England you must:

1. Be accountable by making sure you can answer for your actions or omissions.

2. Promote and uphold the privacy, dignity, rights, health and wellbeing of people who use health and care services and their carers at all times.

3. Work in collaboration with your colleagues to ensure the delivery of high quality, safe and compassionate healthcare, care and support.

4. Communicate in an open, and effective way to promote the health, safety and wellbeing of people who use health and care services and their carers.

5. Respect a person’s right to confidentiality.

6. Strive to improve the quality of healthcare, care and support through continuing professional
development.

7. Uphold and promote equality, diversity and inclusion.

Excerpt from https://skillsforhealth.org.uk/wp-content/uploads/2020/11/Code-of-Conduct-Healthcare-Support.pdf

Other standards

Other standards that you may use to measure the quality of your practice and identify areas for improvement are briefly covered below.

The Care Quality Commission’s Fundamental Standards

The Care Quality Commission (CQC) regulates health and social care providers in England and their thirteen fundamental standards are what everybody that receives these services can expect. These standards are:

  • Person-centred care
  • Dignity and respect
  • Consent
  • Safety
  • Safeguarding from abuse
  • Food and drink
  • Premises and equipment
  • Complaints
  • Good governance
  • Staffing
  • Fit and proper staff
  • Duty of candour
  • Display of ratings

The Six Cs

The six Cs were developed by the NHS Commissioning Board as part of their Compassion in Practice strategy to identify the values that are essential to compassionate care. Originally developed for the nursing profession to underpin culture and practice, they are now used by all organisations that provide care and support services. The six Cs are:

  • Care
  • Compassion
  • Competence
  • Communication
  • Courage
  • Commitment

The Care Certificate

The Care Certificate is a set of fifteen standards that were developed jointly by Health Education England, Skills for Care and Skills for Health to set out the minimum knowledge, skills and understanding that is necessary for workers that are new to the care sector. They were designed to be part of the induction process and to be completed around twelve weeks from the start of employment.

NMTS/NOS

National Minimum Training Standards (NMTS) define the minimum standards that all care workers should meet and National Occupational Standards (NOS) identify specific standards for particular roles.

The importance of honesty

When working in health and social care, honesty and transparency are of the utmost importance. Not only does it uphold your integrity with your co-workers, other professionals and the individuals that you provide care for, but it is also a legal requirement under your duty of candour.

Honesty is especially important when mistakes are made because it prevents or reduces any potential damage that may be caused as a result of the error as well as providing a learning opportunity so that measures can be put in place to prevent it from happening again.

If you make a mistake, you should report this to your manager as soon as possible so that they can provide guidance about what actions should be taken both in the short and long-term. If your mistake is detrimental to an individual that you support, you should explain to them what happened, apologise, and discuss how this may affect them and what you will do to reduce or eliminate the effects. Further information about your duty of candour can be found in the duty of care section.

Reporting concerns and whistleblowing

As well as reporting any errors that you make to your manager, you should also report any other concerns that you have relating to your workplace. This could include unsafe practices, suspicions of abuse or neglect or health and safety issues.

By doing this, you are promoting health, safety and wellbeing, fulfilling your duty of care and demonstrating your commitment to providing high-quality care and support.

It is also important that you ensure that your concerns are acted upon, especially if inaction will have a detrimental effect on yourself or others. If your initial report is not taken seriously or, for whatever reason, is ignored, you should escalate your concerns, with guidance from your organisation’s Whistleblowing Policy and Procedure.

Initially, this will usually mean escalating your concerns to senior management or the Registered Manager of your organisation. However, if you feel that your concerns are still not being dealt with in the proper manner, you may need to report your concerns to an external agency.

The agency that you should contact will be dependent on the nature of your concerns:

  • If your concerns relate to the health, safety and welfare of an individual or individuals that you support, you should contact CQC
  • If your concerns relate to the health, safety and welfare of staff or visitors, you should contact the Health and Safety Executive (HSE)
  • If you believe a crime has been committed, you should contact the Police

As long as you make a genuine report with the best intentions, the whistleblowing policy will ensure confidentiality and protect you from any repercussions. Organisations have whistleblowing policies and procedures in place so that employees can feel safe raising their concerns and so that any issues can be addressed promptly and efficiently.

If you are unsure about anything related to whistleblowing, you can get free, independent advice from:

  • Your trade union (if you are a member of one)
  • The Whistleblowing Helpline for NHS and Social Care on 08000 724725
  • The Public Concern at Work charity on 020 7404 6609.

Working and personal relationships

To provide safe, effective and high-quality care and support, it is important that you understand the difference between working relationships and personal relationships. It is important that you keep your working relationships strictly professional.

Working relationships

Working relationships are the professional relationships that you have with your colleagues, managers, other professionals, the individuals that you support and their families.

Working relationships are bound by working hours, workplace settings, agreed ways of working and professional standards and conduct. You will not be able to choose whom you have a working relationship with and there will be an unequal power balance between yourself and the individuals that you care for – for example, you will know more personal details about them than they do about you.

Personal relationships

Personal relationships are the informal relationships that you have with your family, friends and intimate partners. They can also extend to acquaintances, such as your neighbours or the parents of your children’s friends.

Unlike working relationships, you can choose with whom you have a personal relationship and can meet with them whenever and wherever you like. Personal relationships can be closer and more intimate and there will usually be an equal balance of power.

Working with your employer

As an employee, you have the responsibility to work in a way that is set out by your employer.

The aims, objectives and values of your employer

A good way to get a feel of what your employer expects from their employees is to take a look at their aims, objectives and values. These may be found on your employer’s website or other marketing materials, or you may be given a company handbook that provides this information during your induction. If you are unsure where to find this, ask your manager.

Your organisation’s aims are the overarching goals that they wish to achieve. These are often expressed in a Mission Statement and/or Company Vision. Objectives are goals or milestones that your organisation has set themselves to achieve their aims. Values are the ideals that they hold most dear and will be embedded in everything that they do. Examples of values include integrity, continuous learning and commitment to excellence.

By understanding the motivations of your organisation and the ideals that they strive for, you will have a better grasp of your workplace culture and how your employer expects you to work and behave.

Your duties and responsibilities

Your duties and responsibilities will be set out in your job description and contract of employment. It is important that you read these thoroughly so that you understand exactly what your role entails and what your employer expects from you.

Typical duties and responsibilities can include:

  • Assisting individuals with dressing
  • Providing person-centred care
  • Administering medication
  • Responding to complaints
  • Keeping accurate records

Working within the scope of your role

As well as understanding what you should do as part of your role, it is also important that you know the limits of your role and what you shouldn’t do.

Some tasks should only be performed by employees with specific training or experience. Examples could include administering medication, performing first aid or operating equipment. By carrying out tasks that you are not trained or qualified in, you could risk causing harm to yourself or others.

Although you should help your co-workers when you can, it is important to understand that if you are assisting with a task outside of your remit, it could leave your team lacking in another area. Employers will have planned and costed the various tasks that are performed by employees, so you should always seek permission from a manager before you work on something that is outside the scope of your job role.

Agreed ways of working

Agreed ways of working refer to the policies, procedures, protocols, plans, systems and practices that are used by your organisation.

You must work in line with your employer’s agreed ways of working to ensure that your work is safe, legal and adheres to best practices.

Unless you are part of a very small organisation (under 5 employees) your employer’s agreed ways of working will be documented and stored somewhere accessible. It is essential that you know how to access them so that you can read them and refer back to them if you are unsure of anything. If you do not know how to access your employer’s agreed ways of working, you should ask your manager as soon as you can.

Quality assurance processes

As part of your commitment to providing high quality care and support, you should contribute to quality assurance processes to promote positive experiences for the individuals you care for.

Quality assurance is a tool used for the continuous improvement of care services. It is a constant cycle that involves:

  1. Assessing care provision
  2. Identifying ways to improve
  3. Implementing solutions
  4. Monitoring the changes

Working closely with individuals on the front-line means that you will ideally placed to collaborate with them about their care provision. They may approach you to discuss aspects of their care provision that they are not happy with or would like changed. It is important for you to respect their views and work with them to find solutions as part of your commitment to person-centred care. After implementing changes, it is important that you review them at a later date to assess the impact that they have had and make further changes if required.

Your employment rights

As an employee, you also have certain legal rights.

Health, safety and wellbeing

Your employer must provide a safe working environment for their employees. Sometimes, it is not possible to eliminate all risk, however, employers must perform risk assessments to identify and reduce risk as much as is reasonably possible. Conversely, it is an employee’s responsibility to inform their employer if they have any concerns about workplace health and safety.

Holiday entitlement

Almost all employees are entitled to 5.6 weeks holiday each year, however, the specific rules about how much notice must be given and when holiday can be taken will be covered by an employees contract of employment.

National living wage

The National Living Wage is the minimum hourly rate that employees should be paid. This amount can vary depending on the age of the employee and whether they are an apprentice.

Working hours

The Working Time Directive limits an employee’s working hours to a maximum of 48 hours per week (usually averaged over a 17-week period). It is possible to voluntary opt-out of this, however, your employer cannot force or put pressure on you to do so.

Equality and discrimination

You have the right to be treated fairly by your employer and not be a victim of discrimination. This is legislated for in the Equality Act 2010.

Working with individuals that receive care

When you provide care and support services to individuals, you should do so in a way that is respectful, dignified and professional.

You should also ensure that individual’s rights are upheld and that they are free to make their own decisions about their care. They should be treated as an equal partner in their care planning and their unique views should be valued.

You have a duty of care to ensure that you look out for their best interests, however, you must also respect the choices that they make, even if you do not always agree with them. You should not let your own attitudes, beliefs or prejudice influence the choices of the individuals that you work with.

Partnership working

Partnership working is something that is essential to health and social care organisations to achieve the best outcomes for service users.

You will be part of a team and should maintain effective working relationships with your co-workers and managers. You may also be part of a wider team of other professionals from different agencies, such as advocates, social workers and nurses.

To work effectively with others, there are several attitudes and behaviours that you should exhibit. Of course, you should be professional at all times but you should also have strong communication skills. As well as being able to express your views succinctly, you should also take time to actively listen to others and value their input.

This does not mean that there will never be conflicts – indeed, conflict occurs even in the best relationships and some would argue that conflict is necessary for positive change. So it is important that you are able to resolve conflicts when they happen. This requires skills in negotiation and compromise. You should discuss and understand the reasons for the conflict and seek solutions that will work for all parties.

If you need support and advice about support and advice about partnership working and resolving conflicts, you may wish to speak with your manager. You may also obtain guidance from co-workers, your employer’s agreed ways of working, other professionals and other agencies and organisations.

CARE CERTIFICATE – STANDARD 1: UNDERSTAND YOUR ROLE

  • 1.1 Understand their own role
    • 1.1a Describe your main duties and responsibilities
    • 1.1b List the standards, codes of conduct and practices that relate to your role
    • 1.1c Demonstrate that you are working in accordance with the agreed ways of working with your employer
    • 1.1d Explain how your previous experiences, attitudes and beliefs may affect the way you work
  • 1.2 Work in ways that have been agreed by their employer
    • 1.2a Describe your employment rights and responsibilities
    • 1.2b List the aims, objectives and values of the service in which they work
    • 1.2c Explain why it is important to work in ways that are agreed with their employer
    • 1.2d Demonstrate how to access full and up-to-date details of agreed ways of working that are relevant to their role
    • 1.2e Explain how and when to escalate any concerns they might have (whistleblowing)
    • 1.2f Explain why it is important to be honest and identify where errors may have occurred and to tell the appropriate person
  • 1.3 Understand working relationships in health and social care
    • 1.3a Describe their responsibilities to the individuals they support
    • 1.3b Explain how a working relationship is different from a personal relationship
    • 1.3c Describe different working relationships in health and social care settings
  • 1.4 Work in partnership with others
    • 1.4a Explain why it is important to work in teams and in partnership with others
    • 1.4b Explain why it is important to work in partnership with key people, advocates and others who are significant to an individual
    • 1.4c Demonstrate behaviours, attitudes and ways of working that can help improve partnership working
    • 1.4d Demonstrate how and when to access support and advice about partnership working and resolving conflicts

LEVEL 2 DIPLOMA IN CARE – RESPONSIBILITIES OF A CARE WORKER

  • 1. Understand working relationships in care settings
    • 1.1 Explain how a working relationship is different from a personal relationship
    • 1.2 Describe different working relationships in care settings
  • 2. Be able to work in ways that are agreed with the employer
    • 2.1 Describe why it is important to adhere to the agreed scope of the job role
    • 2.2 Access full and up-to-date details of agreed ways of working
    • 2.3 Work in line with agreed ways of working
    • 2.4 Contribute to quality assurance processes to promote positive experiences for individuals receiving care
  • 3. Be able to work in partnership with others
    • 3.1 Explain why it is important to work in partnership with others
    • 3.2 Demonstrate ways of working that can help improve partnership working
    • 3.3 Identify skills and approaches needed for resolving conflicts
    • 3.4 Access support and advice about: partnership working, resolving conflicts

LEVEL 3 DIPLOMA IN ADULT CARE – RESPONSIBILITIES OF A CARE WORKER

  • 1. Understand working relationships in care settings
    • 1.1 Explain how a working relationship is different from a personal relationship
    • 1.2 Describe different working relationships in care settings
  • 2. Be able to work in ways that are agreed with the employer
    • 2.1 Describe why it is important to adhere to the agreed scope of the job role
    • 2.2 Access full and up-to-date details of agreed ways of working
    • 2.3 Work in line with agreed ways of working
    • 2.4 Contribute to quality assurance processes to promote positive experiences for individuals receiving care
  • 3. Be able to work in partnership with others
    • 3.1 Explain why it is important to work in partnership with others
    • 3.2 Demonstrate ways of working that can help improve partnership working
    • 3.3 Identify skills and approaches needed for resolving conflicts
    • 3.4 Access support and advice about: partnership working, resolving conflicts