Training to Care

Stephanie Rose examines the gap between what is taught and what is understood.


Health professionals are again in the news. Nurses are under scrutiny – some leaving college yet being unable, or unwilling to handle basic care tasks on the ward. Health care assistants who have had little or no training are being employed by health trusts and care homes. Even the humble ‘home carer’ is being questioned in relation to lack of qualifications and training. So what is going wrong?

Historically, excellence in the workplace did not require a high level of performance in the classroom. Carers, whether nurses or less qualified staff, started their ‘apprenticeships’ on the job. Caring was considered less of a profession, and more of a vocation; not something taught, but something felt and then assimilated. The supporting skills to perform well were handed down – accompanying sister on the ward round, having to take initiative, being watched, advised and constructively criticised. It’s the same for care in the home. The very best carers are those who were born to care, and who subsequently have been managed to effect the high standards of technical care required by example, repetition, observation, supervision and feedback.

Bucking the questioned methods (and apparently being in the vanguard of the new recommendations), here at Stephanie’s Bespoke Care Service we work towards excellence through the old tried-and-tested methods of meticulous ‘supervision and feedback’. The first questions we ask in recruiting prospective carers are not in relation to qualifications, or indeed even experience, but focus on the willingness to strive through on the job training, and continuation training throughout a career. Without the natural inclination to provide the very best bed-side care, the technical carer is of little use within the home. We then look to the technical aspects of caring:

“Cheap care is poor care, and poor care ends up as more expensive care. If you invest properly in your workforce, you will find you get more efficient and effective care with less complications”, says Dr Peter Carter of the Royal College of Nursing.  Nutrition, hygiene, aseptic technique, lifting and mobilising clients, are the bed-rock of skills required in the home, and they are best learned by careful on-the-spot example, training, re-training, and checking.

Perhaps the matrons of old were not so far from the mark, when it came to standards of performance. Coupled with sensitive management, this may be the hallmark for the future?

Thanks to Dr Helen Allen and Pam Smith 
Centre for Research in Nursing and Midwifery Education, University of Surrey

and Dr Peter Carter, the Royal College of Nursing's chief executive