09/02/06 - Amendment to the interim guidance on qualifications for managers in care homes CSCI Press Release

We have amended this guidance to enable a fairer and more flexible approach to nursing qualifications for managers of care homes.

The guidance lists the various care qualifications that are accepted in meeting the standards.

Previously only "level 1" nursing qualifications were listed as acceptable.

The amendment means that other nursing qualifications are now acceptable provided that the manager is registered with the Nursing and Midwifery Council.

Our registration process, which checks a person is fit to manage a care home, will continue to look at managers' overall competence.

CSCI / SKILLS FOR CARE

Interim Policy and Guidance:

Qualifications for Managers in Care Homes for Older People and Adults (18 - 65), Domiciliary Care Agencies and Nurse Agencies

Outcome

1.1 The purpose of the qualifications targets within the national minimum standards is to drive improvement by promoting the development of a competent, qualified and skilled workforce which will better meet the needs of people who use services. This is an ongoing process in conjunction with a staff training and development programme to ensure that staff can fulfil the aims of the service and meet the changing needs of the people who use it.

1.2 This guidance is produced by CSCI and Skills for Care to assist inspectors and providers in judging whether the qualification standards for managers are met. It updates and replaces the National Care Standards Commission guidance issued on 22nd May 2003. It is interim guidance which focuses on the interpretation of the current national minimum standards pending the Department of Health review of the regulations and standards.

Main Points

2.1 Professional judgements about the fitness of the registered manager take into account national minimum standards covering the qualifications of managers. Qualifications are not looked at in isolation, however, as there are other factors which contribute to whether a home is well run. (See also paragraph 3.4)

2.2 The Care Homes Regulations 2001 make reference to the qualifications of the manager:

9.-(1) A person shall not manage a care home unless he is fit to do so.

2) A person is not fit to manage a care home unless-

(a) he is of integrity and good character;

(b) having regard to the size of the care home, the statement of purpose, and the number and needs of the service users -

(i) he has the qualifications, skills and experience necessary for managing the care home;

2.3 Standard 31 of the 'National Minimum Standards for Care Homes for Older People' states:

OUTCOME: Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully.

31.1 The registered manager is qualified, competent and experienced to run the home and meet its stated purpose, aims and objectives.

31.2 The registered manager: has at least 2 years' experience in a senior management capacity in the managing of a relevant care setting within the past five years; and [by 2005], has a qualification, at level 4 NVQ, in management and care or equivalent; orwhere nursing care is provided by the home (e.g. nursing home), is a first level registered nurse, and has a relevant management qualification [by 2005].

2.4 Standard 37 of the 'National Minimum Standards for Care Homes for Adults 18 to 65 years' states:

OUTCOME: Service users benefit from a well run home

37.1 The registered manager is qualified, competent and experienced to run the home and meet its stated purpose, aims and objectives. 37.2 The registered manager:

i. has at least two years significant management/supervisory experience in a relevant care setting within the past five years; and

ii. qualifications at level 4 NVQ in both management and care [by 2005]; or

iii. where nursing care is provided by the home, is a first level registered nurse and has a level 4 NVQ in management [by 2005].

2.5 The references to qualifications within the National Minimum Standards (NMS) for Care Homes providing Adult Placement have been excluded from this document as these standards will be superceded as adult placement schemes rather than individual carers gradually become registered.

2.6 The Domicilary Care Agencies Regulations 2002 make reference as follows to the qualifications of the manager:

9 (1) A person shall not manage an agency unless he is fit to do so.

(2) A person is not fit to manage an agency unless

(a) he is of integrity and good character;

(b) having regard to the size of the agency, the statement of purpose and the number and needs of the service users

(i) he has the qualifications, skills and experience necessary to manage the agency;

Standard 20 of the 'National Minimum Standards for Domiciliary Care Agencies' states:

OUTCOME: The personal care of service users is provided by qualified and competent staff, except for employment agencies solely introducing workers

20.5 Managers obtain a nationally recognised management qualification equivalent to NVQ level 4 in management within 5 years from the date of application of these standards, or following that period, within three years of employment.

2.7 The Nurses Agencies Regulations 2002 make reference as follows to the qualifications of the manager:

9.-(1) A person shall not manage an agency unless she is fit to do so.

(2) A person is not fit to manage an agency unless-

(a) she is of integrity and good character;

(b) having regard to the size of the agency, its statement of purpose and the number and needs of the service users-

(i) she has the qualifications, skills and experience necessary to manage the agency;

Standard 2 of the 'National Minimum Standards for Nurses Agencies' states:

OUTCOME: Service users are assured of the integrity of the agency and have confidence that it is run by a fit person or organisation

2.2 Owners and managers of the agency have a sufficient range of knowledge, experience and expertise between them for the effective and efficient running of the agency. The registered manager:

obtains a nationally recognised qualification, at level 4 NVQ or equivalent, in management within 5 years from the date of application of these standards or, following that period, within 2 years of employment; or



is a first level registered nurse and, within 5 years from the date of application of these standards or, following that period, within two years of employment, has a relevant management qualification.

2.8 CSCI fully supports the qualifications targets, within the national minimum standards as these assist with developing a competent qualified and skilled workforce which will better meet the needs of service users. CSCI expect providers to continue to progress towards these qualification targets in a timely manner.

Policy

3.1 What qualifications does a Registered Manager need?

a) For care homes, registered Managers are expected to have two qualifications by 2005. One of these has to be relevant to the care they are responsible for such as:

" The Diploma in Social Work (and its predecessors such as Certificate of Qualification in Social Work)

" Certificate of Social Services

" Nursing with live registration

" Diploma in Occupational Therapy

" Diploma in Physiotherapy; or

" National Vocational Qualification (NVQ) Care Level 4/NVQ 4 in Health and Social Care

All Registered Managers should hold one of these by 2005.

b) The second qualification should be in managing care services. There is a specific NVQ 4 for this purpose - Registered Managers (Adults) NVQ 4 or managers may hold the general management NVQ at level 4 (or 5) all of which are acceptable.

c) CSCI has agreed that the following management qualifications are acceptable in providing evidence of transferable knowledge and skills that a Registered Manager has been using in their current role:

" Certificate in Management Studies

" Diploma in Management Studies

" City and Guilds 325/3 - Advanced Management in Care

" Diploma in the Management of Care Services

" Masters in Business Administration

" Post Qualifying Award in Social Work

" Advanced Award in Social Work

d) These qualifications will be accepted as meeting the management component of the standard. Those managers with other management qualifications or certificates may be able to use work completed on these courses as part of their evidence of competence in undertaking the Registered Manager (Adults) NVQ 4. For care homes there is still the requirement that managers need to have a qualification relevant to the care provided in addition to the management qualification.

e) The lists of care qualifications and management qualifications within this guidance update those within the pre-existing National Care Standards Commission guidance. This is not an exhaustive list - it is recognised that managers may have other relevant professional qualifications that predate the introduction of the NVQ system and which they may wish to use as evidence of competence. The inspector will work with Skills for Care to identify the relevance of such qualifications to their management of the care service.

These lists of care and management qualifications which are deemed acceptable in relation to the standards seek to acknowledge the various different starting points for pre-existing registered managers and managers of pre-existing nursing homes when the standards were introduced. The NVQ4 Registered Managers Award is the preferred management qualification for new managers.

f) Whilst the standards are not explicit about a specific date in 2005 when the qualification target should be met, in order to achieve a common understanding the Commission has agreed that December 31st 2005 be the target date in relation to the qualification standards.

g) Where current registered managers will not have achieved this combination of qualifications by December 31st 2005 they should be registered and working towards these qualifications by September 30th 2005 unless there are particular individual circumstances that render this impracticable (see paragraph 3.3(c) for some examples). Registered managers should have completed their qualification by September 30th 2007 (subject to any changes to these targets which emerge from the Department of Health review of regulations and standards).

h) For new managers who do not possess the relevant qualifications this should be part of an individual personal development plan. They should be registered for the appropriate qualifications within three months and have completed their qualification within two years.

i) For managers of domiciliary care agencies the standards require a management qualification but not a care qualification.

j) For nursing agencies a non-first level nurse is not required to have a care qualification.



3. 2 "Equivalent" qualifications

a) There has been some confusion about what other qualifications are equivalent. There are no nationally recognised qualifications that provide evidence of work-based competence against the National Occupational Standards other than NVQs.

b) All care and management learning, certificates and qualifications have value however and will be set against the requirements within the NMS and for the good management of the service by the Inspector when assessing to what extent such learning/certificates and qualifications contribute to the overall fitness of the Registered Manager.

c) Where the manager has one of a number of certificates or qualifications which may be regarded as acceptable as providing evidence of transferable knowledge and skills it is suggested that they have as part of their continuing professional development a plan to achieve the Registered Managers Award (Adults NVQ 4) and/or NVQ Care level 4. Within the plan managers are encouraged to have achieved RM1 and RM2 units by December 2005 (this will be done using evidence from their previous learning and current work). Local colleges or other training and assessment organisations will be able to advise on this process.

3.3 Judgements about whether the standard is met

a) This element of the guidance focuses primarily on the standards for care homes, which have a 2005 target date rather than those for domiciliary care, and nurses' agencies, which have a longer timeframe for achieving the qualifications.

b) In conjunction with the introduction of new inspection report formats CSCI will report on its judgements about whether the outcomes contained within the national minimum standards are met. In scoring against the qualifications standards however it will be necessary to take into account the specific elements of the standard as quoted on page 2 of this guidance, as these would not be captured by focusing on the outcome statement alone.

c) Where the standard is not met, inspectors will take the following into account in deciding if the score is a 1 or a 2:

" Whether there is a plan being implemented, to ensure that the manager has the necessary competencies to meet the needs of the service users in their care, so that their service can achieve the objectives within the statement of purpose. The provider must demonstrate how they will meet the qualification targets and provide evidence that managers are working towards these qualifications.

" Whether the reasons for not meeting the standard are in the control of the provider and could have been addressed more effectively through better planning and investment in training. An example of one such element beyond the control of the provider might relate to the availability of trained assessors and verifiers. Information and assistance in relation to these matters is available from Skills for Care.

" Whether there is clear evidence that the home is not effectively and efficiently managed and the manager cannot provide evidence of a realistic improvement plan to respond to the deficit.

" Whether there is clear evidence that deficiencies in meeting the qualifications standards have resulted in a failure to deliver the quality of service as indicated within other regulations and standards and the statement of purpose.

" A score of 2 whilst accurate in terms of reporting on progress toward meeting the standards should not automatically lead to an inspection requirement. The score should be set against the evidence and judgement about the outcome as stated in the main body of the inspection report, any mitigating factors arising from consideration of the bullet points above and any special circumstances. An example of the latter might include an experienced and competent manager who is nearing retirement.

" In deciding upon an appropriate response where existing experienced managers have successfully undertaken the Registered Managers Award (Adults) NVQ 4 and updated themselves by means other than a care qualification recognized within the guidance, inspectors should consider this within the context of the home's performance across a range of standards that reflect the management of the home. Where the service is well managed and there are no concerns about the delivery of care any additional training or qualifications could be considered in terms of the longer term improvement of the service through its training and development programme.

3.4 Requirements for Fitness

a) As part of the process to register and inspect care services, CSCI has a responsibility to judge fitness of each Registered Manager.

b) Inspectors will take account of the relevant National Minimum Standards (NMS) when judging fitness but will not base their judgement about fitness on qualifications alone. A key factor will be the manager's competence to perform the role and the day-to-day operation of the home or agency by the manager.

The qualification targets are National Minimum Standards and should not be used as conditions of registration.

Further Information

4.1 NVQs positively encourage the recognition of competence gained and developed through experience.

4.2 The Level 4 NVQ Care, Health and Social Care NVQ 4 and the Registered Manager (Adults) NVQ 4 are gained by:

" Registering as a candidate through an approved NVQ assessment centre.

" Agreeing an evidence and assessment plan with an assessor appointed by the assessment centre.

" Undertaking learning in areas where they are not yet competent.

" Gathering evidence of their competence.

" Working with the assessor who will judge the evidence against the requirements of the NVQ.

4.3 Evidence of competence could come from a number of sources including:

" Previous work records or notes.

" Material from courses completed such as case studies or essays.

" New learning. " Current work including observed practice. 4.4 The Registered Manager (Adults) NVQ 4 focuses on the task of managing a care service and will be the correct choice for Managers who have no management qualification. The new qualification has some units taken from the Level 4 NVQ in Care, so people who need to achieve both a care and a management qualification can reduce the assessment burden and those with a Level 4 NVQ in Care or Health and Social Care NVQ 4 will have already achieved some units of the Registered Manager (Adults) NVQ 4. Details of the units that make up the qualification can be found on the Skills for Care website. 4.5 People who have nursing qualifications from overseas must be registered by the Nursing and Midwifery Council [NMC] in order to practise in the UK. The NMC website www.nmc-uk.org provides further details about requirements. CSCI and Skills for Care are unable to respond to queries about nursing qualifications obtained in other countries

Source : CSCI