In the Midst of Life

day’s training.’
    ‘What!’I gasped. ‘You can’t be serious!’
    ‘Yes, that was it, half a day. But remember, I had had experience in caring, and I had done some home visiting, too. If I hadn’t, I suppose they would have sent me for a whole day, perhaps even two.’
    So it
is
true.
    Induction consists of three parts, which can be completed in a morning:
    1. Fire drill, conducted by a fire officer
    2. Moving and handling
    3. Protection of vulnerable adults.
    ‘Moving and handling’ is instruction in how to use the winches, slings, pulleys etc., required for moving or lifting an immobile or helpless patient. Some of this equipment can be very complicated, and the company that makes these gadgets supplies a video instruction on the correct use. The purpose is to protect the employers and suppliers from claims of injury to nurses or care assistants from moving or handling patients incorrectly.
    ‘Protection of vulnerable adults’ is basically looking at different kinds of abuse, such as staff bullying or manipulating patients, or thieving. It is a video documentary, made by professional actors with advice and short, acted scenes of what can be done, and what one should not do. The purpose is to protect the employer from claims of malpractice. The video takes about forty-five minutes to run.
    National Vocational Qualifications (NVQs) have been available since the 1970s. They are based on national standards of practical competence in a wide range of occupations (over 1000) varying from bricklaying to hairdressing to catering.
    In 1988 the Healthcare Review Body (now the CQC) examined the position of carers, and, as a result, the NVQ training was started for prospective health care assistants. This is essentially a qualification in
practical
skills, and the training is on-the-job experience. There are three levels of achievement, trained, monitored and assessed by …
    Question(from ‘Everyman’):
… by whom?
    Answer (from my research):
It could be that the trust has a nurse-led training, followed by supervision of practice by a qualified assessor, and then both internal and external verification by an awarding body such as the City and Guilds.
    Q
: What is the training for care assistants in private hospitals or clinics or in nursing care homes?
    A:
This will depend on the organisation. In theory, a nurse on the staff should train and monitor care assistants. But, in practice, this is unreliable because some employers will take a carer after a day’s induction and there may be
no
nurse available to offer further training. There can be a wide difference between the training and supervision of care assistants in NHS hospitals and those employed privately.
    Q
: If the private establishment has no nurse to train potential carers, who does train them?
    A:
National Care Training Providers.
    Q
: And what training do they offer?
    A:
Telephone help throughout the day.
    Q:
So is it seriously proposed that basic nursing can be learned by telephone?
    A:
It is a telephone support line.
    Q
: Is this support line open at night?
    A:
No. Care assistants also have one-to-one contact with a specially trained NVQ Care Assessor.
    Q
: How often is one-to-one contact available?
    A:
By appointment, when it can be arranged.
    I have mentioned my two nieces who are HCAs. The younger one is on NVQ Level 3, and her elder sister is on Level 4. I asked the younger why she did not take the Level 4 qualification. She replied: ‘I don’t see the point. I wouldn’t earn any more.’
    ‘But it says here in the syllabus that you would.’
    ‘It may say that, but I wouldn’t get it.’
    ‘What do you earn now?’
    About £5.40 an hour. It might be
£$.70
– I’m not sure.’
    Hersister interrupted: ‘I was on £5 something an hour for years and years, even after I passed Levels 2, 3 and 4; it made no difference to the pay But now I get £8 something an hour because I have worked there for a long time. That makes a big difference.’
    My nieces both work in nursing care homes, one in Reading, the other in Plymouth. I asked them why they did the work for such a pitiful wage. They replied, almost in unison, one echoing or agreeing with the other:
    ‘Because I love it.’
    ‘It is deeply satisfying.’
    ‘I love knowing that I have made a difference to some old person’s life who might be lonely or unhappy.’
    ‘At the end of the day, or night as it might be, you feel you have done something worthwhile.’
    ‘It’s very