Professor Martin Green OBE, Chief Executive, Care England
The health and social care systems spend enormous amounts of money on training and development, yet we are still in a situation where things sometimes go wrong. When this is serious enough to need an independent Inquiry, one of the first recommendations is the need for training. Sadly, what is not often done, is inquire into why the training people have already had has failed us. I think we need a new approach to training, which is far from less formulaic and more about developing people’s capacity to deliver rather than routinely teaching them to perform tasks.
It is my view that we have got ourselves into a very restrictive approach to training and we tend to focus on the minutia of delivering every element of the service, rather than focusing on the outcome and how people experience care. Social care services are about people and we should never try to distil our relationship with the people we support into a series of tasks. Rather, we should focus on relationship-based care, which is about giving people a life rather than a service.
Of course, in advocating this new approach, I am not saying we should not train people to do some of the required tasks because this has a part to play. I would not, for example, want to fly on an aeroplane where the pilot has been beautifully trained in customer service but never been told how to land safely. Similarly, in social care we have a range of things which we need to know how to do, but these are underpinning skills, they should not be the only focus of social care.
Training people to understand how to enable outcomes is very important, particularly when we are training and developing the managers in social care. There is a need for managers who can understand how to deploy resources efficiently, but who also understand the primary role of their services is to give the people who use them a good life and the staff who deliver them a supportive environment.
The way in which the current system works is not very conducive to flexibility or outcome-based measures. For example, the Regulator will ask for evidence that people have received training in health and safety, lifting and handling, food preparation and a range of other processes, what they are not good at doing is asking whether or not people have been trained in how to communicate, to have good interpersonal skills and know how to respond to the needs of the people who use services. In my more positive moments, I think this may be because these areas are seen as a given and they are the things that every regulator and every service user expect to have, though sadly, many do not receive.
As we look towards a new era of health and social care, where there will be increasing use of technology and an emphasis on measuring outcomes and the experience of service users, I hope we will use this is as our opportunity to revolutionise and overhaul the training and development of social care staff. I want to see ongoing training, which blends the needs of the service user and the skills of the member of staff, to provide bespoke training packages which will enable people to facilitate outcomes rather than just deliver care.
The transition from where we are to where we need to be is going to be significant, it will require everyone in the system from providers, educational institutions, regulators and commissioners to think differently about what training staff need to do a good job. It will also require service users and the general public to be less focused on process and more on outcomes and experience. There is a massive task ahead of us, but I do believe there is a window of opportunity and I hope that new approaches to the funding and development of health and social care will also be mirrored by changes to training and development packages, which will enable people to deliver good outcomes for their service users.