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Are you up to standard? If Not, Why Not?

With the recent announcement of changes ahead for the accreditation reviews and audits system, it will place pressure on a care home to always be ready for that unannounced visit from the regulator. This factor can no longer be held in the hands of the management and leaders of the home, but more transferred down line to having focused and competent staff.

The role of the PCA/AIN is becoming more diverse as the changing care environments move into the new generation and regulators begin to scrutinise certain services. Working on the floor with the care workers gives a sense of poor competency towards the national standards within the act, when you see that much care being done can be done better, but alas the care workers have not been trained in competencies that meet the expectations of the role and issues such as accreditation are not truly valued and more seen as a barrier.

Many aged care PCA/AIN are still not competent in undertaking basic care skills such as base line observation and yet are asked to report on changes in a resident’s condition. Many carers do not understand the balance between legal and ethical consideration with documentation and accountability. The usual teaching is to have the PC/AIN report to the RN on shift if they believe that something is not “right” with the resident. This in itself creates the paradigm of an overload of information on many RNs about a resident and not enough data on from individuals in order to make a clinical judgement or validate the action of improvement.

The PCA/AIN today should have a solid fundamental understanding of healthy body systems and the impact of ageing on an individual. Basic care means basic understanding is needed in order to make an observation about a client’s general condition. The Care worker is in contact with the resident much more than an RN, and is the first point of contact for the resident and/or loved ones. As a standard competency a PCA/AIN should be confident to take a blood pressure, a pulse and respiration, and a blood sugar level, observe and correctly document the findings and identify the boundary for health and well-being for a person they care for. The carer should also be congruent with the care plans and interventions placed in the care models of the individual client. The functions of the gastro intestinal tract in regard to incontinence should be understood when assisting with bowel and bladder management, and in particular the type of incontinence they are dealing with in each client they care for and the recording of that information for audit.

Understanding the basics of skin care and the anatomy of the skin in an elderly person is essential for care workers who deal with chronic infections and ulceration on a daily basis, and documenting and reporting changes to the RN when necessary. Having an understanding of the role and function of the largest organ in the body is important and maintains a holistic focus when daily bathing occurs and alignment to the standards of accreditation in standard 2 will guide and validate care outcomes.

The training of such skills today can be undertaken in a contemporary flexible delivery system that should include targeted online learning for basic fundamental, competency and regulatory learning and face to face facilitation in direct care. FCS has a unique and engaging e-learning portal that allows the care staff to enhance their skills in this area of competency and many more. The courses are also good for the RNs to complete as then they too will know the level of education in the staff for effective delegation and performance management. Keeping staff up to date and regulating their interaction with learning is part of the continuous improvement and point 3 in every set of standards.

We have seen many changes in care standards over the last 5 years and there are many more to come as the ageing population grows larger and the regulators come under more pressure for compliance to the standards from the public. With an even more complex need in our elderly than ever before, the confidence in the care team will come from their confidence in their care skills and standards to accreditation, and who knows, with a desperate need for more nurses, we may encourage more junior carers to take up further education once they know their basics are at an expert level and they could hunger for higher Education. When you go to work this month ask yourself some questions.

‘Are my staff confident in their care understanding of accreditation standards?’

‘Are my staff confident in their care skills?’

‘Am I confident in their care skills?’

‘Are they well trained in personal care and documentation?’, and

‘If not, why not?’


Paulatim…….Dr Drew

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