1. Dr Carolyn Downs Principle Investigator Lancaster University
Helpcare Project
Dr Carolyn Downs
Principle Investigator
Lancaster University

2. Project Team Lancaster University (UK)
Lancaster and Morecambe College (UK)
Commune di Ortona (Italy)
University of Lodz (Poland)
Znanie Organisation (Bulgaria)
South East Europe Research Centre (Greece)
Our project partners are a mix of organisations. Lancaster University are leading research into new Alzheimer's drug treatment as well as into social care. LMC run a wide range of health-related courses from level 1-4, and work closely with other FE colleges across the EU. SEERC are based in Thessaloniki, Greece and our team there include specialist psychologists in geriatric care as well as sociologists. Zanie Organisation are a leading 3rd sector organisation based in Sofia. They run the only training course for carers in Bulgaria and also the only day-care centre for the elderly in Bulgaria. The Commune di Ortona are the Italian equivalent of a borough council; we are working with the social services department. They have responsibility for overseeing adult social care and are developing a training remit. University of Lodz in Poland are a leading university with experts in management and commissioning of services working on the project.

3. Problem Identification
Funding
Increasing need for professional care of the elderly across the EU
Patchwork of qualifications with no unifying framework
Recruitment and retention problems in the care sector in the UK, France and Germany
Need to develop a care sector in many southern and eastern European countries
Demographics
Social Change
Global Shortage of Care workers (WHO)
Scandals
Hospitalisation
Demographic ageing is a significant social care issue for the future; within the EU the proportion of the population aged 65 or over is projected to increase from 17.4% in 2010 to 30.0 % in 2060.
In the UK alone it is predicted 800,000 will need care by 2017; by million in the UK over 65 will have no adult children to provide care (IPPR, 2014) and this pattern is common across the EU
The World Health Organization has noted global shortages in home / health care assistants. In the EU significant movement of healthcare assistants from low to middle or high income countries have been seen. In Italy the proportion of non-native care workers increased from 20% in 2001 to 81% by 2006 (Sprano, 2006) with 83% working in the informal economy (WHO 2008).
Although in-EU migration has eased some of the problems in receiving countries almost half UK employers surveyed found it difficult to recruit careworkers and the increasing number of very old people (over 85) will place additional demands on services over the next 20 years.
While there are qualifications available in many EU countries these are not mandatory and many healthcare workers are unqualified and working in the informal economy which leads to their work being poorly paid and unregulated. In some countries (Finland for example), care workers are highly qualified and well-paid, but in many countries care work is not seen as a professional career, and this puts young people off choosing care as a career.
These problems have a direct impact on the rate of inappropriate hospital admission for people aged over 75 with studies suggesting that up to 30% of stays in hospital by this age group are directly linked to a shortage of suitable home care

4. Overview of Project Aims
To develop and transfer innovative practices in education for the qualification and professionalization of health and social care workers that can be adapted and adopted across the EU28 to make better use of the existing workforce through training.
To develop clear career paths in care to encourage young people to view health and social care work as a career choice with recognised routes for progression.

5. Our Objectives
1. To develop a model based upon best practice for training and regulation standards for existing home / healthcare workers that can be adapted and adopted across the EU either nationally, regionally or locally dependent on setting
2. To work with those currently providing home /health and social care services VET/HE establishments and users and commissioners of homecare to develop a model of CPD to develop pathways to professionalization and provide new routes for progression from home /healthcare work into the wider range of health and social care.
3. To explore existing health and social care qualifications in partner countries and develop a new model of work-based/VET/HE-based learning outcomes for health and social care that will fit into the HELPCARE framework for professionalization.
4. Develop a transnational network and community of practice comprising service commissioners, policy makers and VET providers to disseminate best practice in health and social care workers education and progression through the EU.

6. Innovations and Sustainability
Working with lead adoptors such as Devon and Hertfordshire county councils, Commune di Ortona, The Work Foundation
Online learning environment accessible to care workers
Pathways to Progression in Social Care model for policy makers adopted by Skills for Care
Participatory action research (PAR) is an approach to research in communities - in this case the community of care workers - that emphasizes participation by the community in the research and action based upon the findings of the research, with the action to be taken developed collaboratively and following reflection.
Within a PAR process, "communities of inquiry and action are created and address questions and issues that are significant for those who participate as co-researchers". Within Helpcare our co-researchers are being recruited from amongst care workers. They will attend training workshops and receive guidance on how to research ethically and will then interview up to three care-users, enabling the concerns of users to inform our research processes. In addition, our co-researchers will come together as a community of inquiry to explore key issues set out in our objectives. In

7. Overview of Methods Quantitative – a survey of 500 care workers
Qualitative
100 semi-structured interviews with care workers
5 Community of Inquiry workshops with care workers (co-researchers)
48 unstructured interviews with care users conducted by our co-researchers
25 in-depth case studies based upon our work with carers
Desk-based research on best-practice in education and training of care workers across EU.

8. Key Findings
Care workers, especially those working full time suffer high levels of stress, often coupled with low self-esteem
Care workers often feel they have inadequate training for the demands of their role and identified numerous training needs that were currently unmet
A significant minority of care workers feel undervalued by wider society and sometimes by those they care for or their families
Care workers wanting to progress within care do not know how to acquire the skills or knowledge needed and cannot see a route through to a management role
Care workers feel their role is not recognised by the State and that the State does little to support their work
Care workers identified strong soft skills as critically important in fulfilling their role
Care commissioners identified lack of integration of health and social care as a significant barrier to progress
Care for vulnerable adults is not consistently regulated in the way that care for babies and young children is.

9. Interviews
Quote: “Care is undervalued by the general public and the local authorities” (Italy)
Quote: “When people ask me about my job I am ashamed to say I am a carer” (UK)
Most caregivers feel that their role is being valued by society, though a quarter feel their role is not appreciated.
Some caregivers mentioned that they  are treated as second-class workers.

10. Training needs There is a need for specialization
The participants reported 498 different Training Needs!
Nursing and Medical skills reported 491 times
nursing certain conditions (91)
manual handling (70)
first aid (69),
general nursing skills (51)
safe dispensing of medication (36)
Soft skills reported 185 times
Emotion Regulation (37)
Communication Skills (41)

11. Working with Trainers
Lancaster and Morecambe College and Zanie Organisation led this aspect of the work.
In the UK a new national basic training scheme is not working well.
In Bulgaria a comprehensive training programme in care is not being adopted
A number of employers have set up in-house training in response to recent scandals.
Helpcare training resources show the types of materials that can be developed and deployed. They are available via our Moodle pages from our website.
Care Certificate
Launched April 2015
Beginning of a process
Patchy training standards
Not externally validated.
Many workers unable to access further CPPD
In the UK the Care Certificate was launched in April This provides a core training for workers in the formal care sector, although it does not address the needs of informal carers (Helpcare also proposes to make training available for informal carers).
The Care Certificate is an identified set of standards that health and social care workers adhere to in their daily working life. Designed with the non-regulated workforce in mind, the Care Certificate has been implemented to help ensure that workers have the same introductory skills, knowledge and behaviours to provide compassionate, safe and high quality care and support. In this innovation the UK is making a considerable commitment to the aim of building a more professional care service that can set an example of good practice for countries moving towards more professional care. However, the care certificate is only the beginning of this process, and currently Continuous Professional Development for care workers is piecemeal and patchy and very much depends on individual employers ability to organise and fund CPD
The Care Certificate will provide the basis for building a model of care training between level 1-5 (level 2 being GCSE level, level 4 = 1st year undergrad level) that can be developed across the EU.

12. Developing our Training Framework
Research based
The results of our survey and interviews informed the development of outputs
Input from our advisory panel assisted in developing resources
A pilot of resources took place amongst our project supporters such as Blackpool Carers, Comune di Ortona and many other sites

13. Career Pathways
Previous research by the World Health Organisation and the EU suggest that one of the reasons for recruitment problems in the care sector is perceived lack of career development.
We worked with careers experts to develop career mapping tools to help promote care work as a career. These are available via our website and can be viewed at our stand

14. At least triennial registration of all care workers initiated by Government Conditions of registration to include basic (entry level ) training and enhanced police checks
Within 12 months of entry onto register care workers should achieve level 1 qualification to remain on register. Regular CPD should be a requirement of at least triennial re-registration
All care work qualifications to be externally validated and with uniform curriculum (national or EU wide)
Governments should legislate that care organisations and establishments employing more than 4 staff must be led by an advanced care practitioner
Governments should value the important role of informal carers and provide training opportunities for this group alongside support via the tax system to recognise their contribution
Proposed new structure for Professionalisation of care work:
Entry Level Registered Carer
Level 1 Registered Carer
Level 2 Registered Carer
Level 2 Care Specialist
Level 3 Care Specialist
Level 4 Care specialist practitioner and care team leader status
Level 5 Care specialist practitioner and care team leader status
Level 6 Advanced care practitioner, care manager
A new suite of qualifications for care specialists covering level 2 and level 3 should be launched (stroke, dementia, stoma, diabetes, pressure sores, nutrition etc)
Level 4 and Level 5 qualifications should include care leadership. This type of qualification should be available via work-based learning.
Degrees in care work should be widely available, and should be a pre-requisite for a new role, Advanced Care Practitioner, allowing care specialists to progress beyond level 3 either directly to degree level study, or via work based learning at levels 4 and 5 to a top-up degree for level 6
Governments to establish legally-binding care standards that should be applied by all registered carers
With the support of the Erasmus Plus Programme of the European Union. This project has been funded with support from the European Commission. This publication [communication] reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information contained therein.

15. HELPCARE ASSISTANCE POINT ORTONA

16. A new initiative including the seven towns of Ortona, Arielli, Crecchio, Giuliano Teatino, Poggiofiorito, Tollo, Canosa Sannita.

17. These towns are part of the consortium for the management of the Area Plan of social services in the province of Chieti in the Abruzzo region of Italy.

18. AIM:
Improving the health and wellbeing of those receiving care through offering training and development to care workers.
The initiative will see recommendations of the Helpcare project implemented.

19. Free services and support to:
care workers;
individuals who are interested to work as carers or simply want to know more about it;
families who need domestic care for elderly relatives no longer able to manage without support.

20. MAIN SERVICES
Information, personal advice and tutoring;
Matching supply to demand (for care work);
Supporting carers in using the Helpcare self-assessment tool to evaluate their own training needs;

21. MAIN SERVICES
Organising training courses for care workers in cooperation with the local Health Units with specific language modules for migrant care workers;
Creating a local register for care workers;
Cultural mediation to help and facilitate the communication between families and migrant care workers.

22. Our team service coordinator Psychologist social assistant
cultural mediators.

23. Elderly Care Associations
Our network
Municipality
Region
Local Health Unit
Elderly Care Associations

24. Helpcare Assistance Point
LOCATION
Helpcare Assistance Point
Intercultural Research Center
of Ortona Municipality
Piazza Donatori del Sangue
66026 Ortona (CH)
Italy
Tel (0)
Fax 0039 (0)

25. Please feel free to contact the team at any time.
Any questions?
Please feel free to contact the team at any time.

26. This project has been funded with support from the European Commission.
This publication [communication] reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information contained therein.