Audit of carer and workforce training in SCOTLAND

Final REPORT

David Clelland, Hannah Engleman and Lynne Macdougall

Training and Employment Research Unit (TERU)

October 2010

Professor Alan McGregor University of Glasgow

Email: Adam Smith Building

Tel: 0141 330 512840 Bute Gardens

Glasgow

G12 8RT

TABLE OF CONTENTS

1. Introduction

2. Overview Of The Respondents

2. Training Delivery

3. Training Development

4. Conclusions And Recommendations

Appendices: 1 List Of Respondents

Appendix 2: Geographical Location of Respondents

Appendix 3: Carer Training by Deliverer

Appendix 4: Workforce Training By Deliverer

1

1. introduction

Context for the Audit

It has long been recognised that access to quality training opportunities can greatly enhance the quality of life for both carers and the people they care for. This need for carer training has been highlighted in recent health and social care policy. Alongside this, there is recognition that the workforce who come into contact with carers require training to ensure they are more aware of carers’ needs. Policy around the development of training for carers and the workforce which works with carers set out in Care 21 The Future of Unpaid Care[1]has focused on the development of two types of training:

  • for carers, to help them develop their own caring skills, knowledge and expertise; and
  • for the workforce, to ensure they have a better understanding of the role and position of unpaid carers and can use this to improve their capacity to work with carers effectively and develop better partnership approaches with carers.

In this report the workforce we refer to are health, social care and voluntary sector staff providing a service to unpaid carers. The workforce refers to staff across all sectors both statutory and voluntary and at all levels. Training is essential to ensure that health and social care staff have:

  • a clear appreciation of the role of unpaid carers;
  • an appreciation of their personal needs and requirements; and
  • a commitment to engage with carers as equal and expert partners in the design and delivery of health and social care services now and in the future.

Since the launch of Care 21 there have been a number of significant developments in carer and workforce training such as Carer Information Strategy Funding and the National Carers’ Organisations training pilots. In tandem with these are initiatives at a local level drawing on a range of partners and funding sources. Accurate and up to date information is needed to enable a strategic view to be taken of carer and workforce training and to develop appropriate plans and funding requirements to address real needs and build on identified opportunities.

To help to develop training, the National Carers Organisations (NCO) has funding of £211,000 which aims to ensure carers increase their knowledge and confidence about caring and help the workforce recognise carers as key partners in care, more effectively identify young carers and support them more effectively.

This training development will build on significant work already carried out in Scotland. This includes the development of the carers’ and young carers strategy for Scotland [2] for 2010 to 2015, which makes specific reference to training for carers and the workforce, identifying that carers should have access to similar training opportunities as the paid workforce. The Government has also required NHS Boards to develop carer information strategies[3] which should include plans for training both frontline staff to identify and provide information to carers as well as directly to carers themselves. This should:

  • help carers become more positive about caring;
  • help them to feel more confident in the caring role;
  • have a positive impact on the carers’ health; and
  • increase health and social care workers’ appreciation of the role of carers.

This Audit has been produced as part of the above funding and seeks to evidence the kinds of training currently delivered in Scotland. There was a need to find out more about the pattern of training delivery for carers and the workforce, to improve knowledge and understanding of the nature and extent of the training available to provide a basis for future planning.

This report provides an overview of the results of the audit. It attempted to capture information:

  • at both national and local level;
  • which is accurate and up to date; and
  • which identifies both needs and opportunities.

A Snapshot of Training

The audit looked to collect general information about the kind of organisations which provide training and also some detailed information about their provision. It looked specifically at training delivered from June 2009 to June 2010. Although this inevitably provides only a ‘snapshot’ of training, it would have been too onerous for respondents to detail all of their training over a longer period than this and it would also have made sensible analysis difficult.

Methods: Survey of Organisations

The main method used to collect the information for the audit was an electronic survey of organisations which are stakeholders in training for carers and the workforce. The organisations were identified through:

  • discussion with the NCO steering group (who also provided contacts);
  • contacts provided through the Scottish Government;
  • internet searches of likely organisations, particularly in the voluntary and community sectors;
  • ‘snowball sampling’ through which additional contacts were identified by the survey respondents.

The organisations included the following categories of organisations:

  • Carers organisations, e.g. :

-Carers Scotland

-The Princess Royal Trust for Carers

-The Coalition of Carers in Scotland

-Crossroads Scotland

-Shared Care Scotland

-Scottish Young Carers Services Alliance

-Local carer organisations

  • Other charities/social economy and voluntary organisations which provide support for individuals and their carers but which are not specifically carer organisations
  • Workforce organisations, e.g.:

-Local authorities – social services

-NHS Boards

-Community care providers

-Training Organisations

-Colleges

An email inviting recipients to complete an online survey about the provision of training was sent to a total of 273 organisations. This included all of Scotland’s local authorities, health boards and further education colleges.

For public sector organisations a letter from the Scottish Government explaining more of the background of the research was attached as well. This initial email requested that somebody from the recipient's organisation complete the online survey, and gave them a deadline of two weeks. After this deadline had passed, a reminder email was sent out to all organisations which had not yet completed the survey. Finally, after around another two weeks all recipients who had not completed the survey were emailed one more time, letting them know that the survey was still available and asking them to complete it before the final deadline of 13th August.

One hundred and forty returns were suitable for analysis giving a response rate of 51%.

The full list of respondent organisations is given in Appendix 1.

Consultation

The survey was supplemented by a small number of one to one interviews with individuals experienced in the delivery of training to gain further insights into some of the issues around the development and delivery of training. Additionally, the NCO facilitated a conference which took place in Glasgow in July to consult with a range of organisations with and interest in carer and workforce training about what are some of the current issues in delivery of training. Feedback from these consultees is used throughout the report to add context to the survey findings.

The report is organised as follows.

  • Chapter 2 provides an overview of the characteristics of the respondents;
  • Chapter 3 reviews training for carers and the workforce based on the survey findings;
  • Chapter 4 reviews organisations’ plans for training in the short term;
  • Chapter 5 presents the conclusions and recommendations for the development of training in Scotland.

1

2. Overview of the Respondents

Introduction

This chapter provides an overview of the organisations which responded to the survey. This allows an assessment of the characteristics of organisations which provide training for carers and the workforce. The chapter also looks at some of the broad factors which might affect the nature and extent to which organisations provide training, such as funding and demand from carers or the workforce.

Type of Organisation

The returns can be divided into different categories of organisations:

  • 44 returns were from carer organisations;
  • 23 were from voluntary sector projects who have some input into carer training or who are condition specific organisations primarily;
  • 23 were from colleges or college representative bodies;
  • 20 were from care providers;
  • 15 returns were from local authorities – therefore just under half (47%) of Scotland’s local authorities responded;
  • 9 returns were from health boards representing 64% of Scotland’s health boards;
  • 4 returns were from Community Health Partnerships (CHPs) and one was from an NHS Mental Health Partnership; and
  • there was one return from a private sector training provider.

Thus a diverse range of organisations provide training for carers and the workforce in Scotland. These include organisations in the public, private and voluntary sectors:

  • the majority of returns (60%) were from the voluntary sector: this includes the carer organisations which are also in the voluntary sector;
  • 37% were from the public sector; and
  • 3% were from the private sector.

There was a relatively poor response from the health boards and the local authorities. This may reflect the timing of the survey which took place during the holiday period but may also be a reflection of the fact that despite the introduction of Carer Information Strategies, it is difficult to identify who is responsible for training within both local authorities and health boards. This may also be a reflection of the complexity of the landscape of provision. In some areas local authorities and health boards have a key role in provision, in others partner organisations, such as carers’ centres are the key providers with local authorities and health boards relying on these to provide training.

Geographical Spread

Responses were received from organisations based across Scotland. Some of these organisations work in specific local authority areas, but some work across larger geographical areas such as Ayrshire, Lothians, Forth Valley etc. Around a fifth of the organisations covered the whole of Scotland. The geographical location of the respondents is given in Appendix 2.

Trainers and Non Trainers

Not all of the respondents had provided training for carers and the workforce during June 2009 to June 2010:

  • 7 (5%) had never provided any training for the workforce or carers;
  • 10 (7%) had provided training at some point in the past, but not in the past 12 months;
  • 126 (88%) had provided training during the period identified for audit.

The responses from these ‘non training’ organisations are still useful as some of them had experience of training in the past. Their answers also provide some insight into the reasons why organisations do not provide training themselves. Reasons include:

  • using external training. In several of these cases training was provided by external carers’ organisations;
  • lack of uptake;
  • lack of access to funding;
  • difficulty finding appropriate training: one organisation could not find any provision for training in the evening for the young carers they work with.

General Issues Related to Training

There are a number of issues that might affect the nature and extent of training provision, including how need is identified, funding and the extent to which organisations can overcome barriers to training for trainees. In the following sections we provide a brief overview of the respondents’ views on these issues.

Identifying a Training Need

The respondents used a range of different methods to identify training needs including one to one interviews, group interviews, discussion and formal surveys. The kinds of approaches and methods used by the different types of organisations are discussed in more detail below.

Carers Organisations

Carer organisations have regular contact with carers for a range of reasons including undertaking carer assessments, meetings, drop ins. They often use these meetings to assess carers’ training needs rather than carrying out formal needs assessment exercises. However, needs assessment can also occur on a more formal basis, for example, as part of carer registration and assessment processes. This direct discussion with carers was the most common way of eliciting information about carers’ needs among carer organisations.

Six of the 44 carer organisations used carer assessments as an opportunity to find out about training needs. For example:

‘At the time of an assessment carers are asked what training needs they feel they need and then at events carers attend e.g. support groups, other training opportunities, complementary therapies or via our quarterly newsletter we ask carers to advise us of their training needs. I think carers sometimes need to know what is available to them so we will sometimes include in questionnaires or surveys a list of training opportunities’

‘When carers first register with us we talk to them about the benefits of training, in helping them with their caring role. We then complete a training form indicating which training they would be interested in. This information is collated on our data base’.

Some carer organisations also carried out surveys with carers. These can be on a regular basis, such as when newsletters are circulated, or after training events.

It also seems clear that carers organisations are continually 'scanning' the environment to pick up any trends or new developments which might be of interest to carers and the workforce as well as listening to direct feedback from carers.

Voluntary Organisations

In much the same way as the carer organisations, the other voluntary sector organisations use a mix of informal and formal feedback from service users to identify issues of concern as well as responding to changes in relation to the care of specific conditions or in policy or legislation.

Care Providers

Care providers tend to focus on training for the workforce. They have a range of courses available for staff that is relevant to the types of people they are caring for and the issues they are dealing with. Some of this is mandatory. None of the care providers had done any training needs analysis with the carers they work with.

Colleges

Colleges tend to be responsive to the market for training and will use contacts with employers and partner agencies in the voluntary and public sectors to identify demand for specific courses.

Local Authorities

Within local authorities, identifying the need for carer awareness training seems to be part of the staff appraisal and assessment processes used to develop workforce training in general. Staff may have individual training plans or needs may be discussed at support and supervision sessions; other methods of identifying needs may include staff surveys, assessment of organisational skill needs, direction from users of the services and families, legislative requirements, practice development requirements and some quality development tools or external audit e.g. Care Commission feedback. Some are increasingly trying to engage with services users and carers to elicit their views on service provision.

Some of the local authorities (and health organisations) were working in partnership with local carers organisations to identify needs. This could be related to the development of Carer Information Strategies. For example, in one area a carers planning group has been established. This group is responsible for consulting with carers and determining their training needs. The planning group is also responsible for commissioning training based on policy, strategic priorities and feedback from carers. The planning group also takes responsibility for evaluating the effectiveness of training programmes and implementing changes.

NHS

From the feedback from the NHS, it seemed that partnership working with local carer organisations was the key way that carers’ needs were identified, although some collected feedback directly from carers at carers’ events. For the workforce, the health organisations also have knowledge and skills frameworks which drives workforce training.

From the feedback from the organisations on training need analysis there is considerable effort to ensure that training is relevant to carers and workforce needs. This relies on forming good relationships:

  • With carers to assess their needs;
  • Across organisations to identify key training issues and needs. This often involves organisations that are close to carers as these have best knowledge of carers’ needs.

However, identification of need is just one factor determining the nature and extent of training provision. We look at other factors in the following sections.

Funding Training

Just under half (48%) of the organisations were able to supply information about the total cost of the training they had delivered between June 2009 and June 2010. In total the organisations spent just over £1.5m during this period. The public sector tends to spend more on training per organisation than the voluntary or private organisations. In several organisations spend is significant, with the mean spend across the organisations of around £24,000 per organisation.

It is possible to look at the costs of each training place provided by organisations using information about the cost of training and the types of courses delivered. However, only a small number of the respondents (35) supplied information about the total amount they had spent on training and the numbers of training places that they delivered, so this means any interpretation of the cost information needs to be done cautiously. It also needs to be borne in mind that there are many different factors that affect the costs of training, such as the type of course, its length, the content etc. However, from the cost information we were able to collect the average cost per place was approximately £57 across all types of training.

Main Funders of Training