RESIDENTIAL QUALIFICATIONS?

Imagine that it’s the middle of the night and your partner develops a pain in their back and sides. Still in their 40s with no history of any health issues you both get up, painkillers seem to help, and you get them to a GP first thing in the morning to sort out whatever the problem is. 

Before even carrying out an examination the GP calls an ambulance. It is only then that you both realise that something could actually be seriously wrong – the ambulance arrives within minutes and your partner is taken to the local hospital. While the hospital does not employ a cardiologist, luckily for you, there happens to be one on duty from another hospital doing some extra shifts. Her very clear diagnosis is that your partner has had and is continuing to have, a heart attack.  

The standard treatment, administering clot busting medication, doesn’t work. Your partner needs to go to the capital’s much larger hospital. Road transfer is going to take too long and will be too risky. The Rescue Helicopter is called and with both a doctor and nurse onboard, your partner is transferred. That afternoon two consultant cardiologists perform a coronary angioplasty and successfully insert a stent. Your partner is then admitted to the cardiology ward where they get expert round-the-clock care from the specialist nursing staff and within a few days is discharged home.

Within the space of a few hours, you will have experienced primary, secondary and tertiary health care. The GP in primary care is well qualified but a generalist. The doctors and nurses in the small local hospital, secondary care, are also qualified but more specialist. And as for tertiary care, those involved in doing the coronary angioplasty and working in the cardiology ward, are the most qualified and specialised. In health care you’ll see a similar pattern pretty much anywhere in the world. 

So why in many jurisdictions are things so very different for young people with the most complex and challenging needs – those in need of residential care? And while the health analogy has some limits, beyond the rhetoric, why do countries, states, provinces and territories in reality take such different positions on this issue? 

There are examples across New Zealand, Australia, and Canada where training for residential staff has and is being taken seriously. However, here I want to look at the UK and in particular Scotland where back in the day I spent three years working in a fully qualified residential team, before moving into management. 

A joint document produced by the (renamed) Centre for Excellence for Children's Care and Protection (CELCIS) and the Scottish Social Services Council, articulates a vision that: all those working with children in residential care as practitioners, supervisors and managers should be: 

  • competent and confident; 

  • able to work in partnership with others to support and improve the wellbeing of children and young people; 

  • have the right knowledge, skills and values; 

  • respect and promote the rights of children and young people; 

  • be respected and recognised as champions for Scotland’s children and young people who are looked after; 

  • influence policy and practice at national and local levels; 

  • be recognised as an integral part of the wider children and young people’s workforce. 

Prior to that, as part of their statutory registration process (the pros and cons of registration maybe needs a separate blog post some time) there was already a requirement that all residential child care workers have, or be working towards, a recognised specialist qualification (with supervisors and designated managers needing to meet additional qualification requirements). More info at https://www.celcis.org/files/9714/3878/4778/Employees-without-qualificationsv1.pdf

However, to meet the vision outlined above, the Scottish government announced in 2015 plans for a degree-level residential child care qualification, and work on its development is underway (delayed in the light of action on the implementation of The Promise from the subsequent Scottish Independent Care Review). Initially this qualification would be for managers, supervisors and new entrants to the profession. Importantly it is proposed that the new degree will recognise and accredit prior learning (including existing qualifications) and also incorporate work-based learning. More information on the proposed qualification is available from CELCIS at: https://www.celcis.org/our-work/services/qualifications/

Importantly, a national, state, province or territory-wide residential child care qualification is not a panacea. And there is certainly a discussion to be had about whether a degree is the only or most appropriate qualification pathway. This is particularly the case for countries with indigenous populations where the challenges of ensuring a high number of Maori, Aboriginal and Torres Strait Islanders and First Nation staff are not to be underestimated. There are also likely to be other issues in relation to existing members of the workforce who are older.

However, if you had the opportunity to pick a hospital, would you really want your partner or close family member to go to one where your coronary angioplasty was carried out by someone who had no qualifications?

Or as Jim Anglin put it in 2015: Child and Youth Care is not rocket science: it's FAR more complex than that! (Professor Jim Anglin, University of Victoria School of Child and Youth Care, BC, Canada)

Residential CareIain Mathesonqualification, training, degree, child care, compentent