Care home workers poor English

Surely if you wish to work in the UK, it is down to you,not the employer, to make sure your English is acceptable. Taking classes , at your expense, or even online courses, is your responsibility. Then on interview the employer becomes responsible to ensure your English is good enough to ensure, above all, the safety of your clients,patients. Remember Daniel Obani.

Applicants for visas are supposed to pass a basic English test. Either the test is too basic, as the coroner suggested, or applicants are circumventing it - possibly those sponsored by care homes?

Staffing in care homes makes all the difference. When my Mum was in a lovely care home the staff were fantastic. Amongst the whole staff was just one non English person. She was Romanian and spoke excellent English. She also spoke slowly and carefully so the old folk understood.

3 years on and there have been major staff changes. Although Mum is no longer with us I often bump into former staff. They say several people have retired, some left after covid because they were exhausted and now the majority of staff are foreign agency workers and I hear the overall feeling is that, sadly it no longer has such a good reputation. 😢

Germanshepherdsmum

Applicants for visas are supposed to pass a basic English test. Either the test is too basic, as the coroner suggested, or applicants are circumventing it - possibly those sponsored by care homes?

Successful applicants for work visas are required to have English at CEFR Level B1 (higher for some jobs). B1 is approximately equivalent to a level a bit higher than an excellent GCSE pass. It's nowhere near fluency.

Somebody with Level B1 would be able to do straightforward transactions, such as shopping and following straightforward instructions (possibly with some repetition). It's doubtful that he/she would understand technical language, dialects or many idioms.

I don't personally know of any specialist courses for care workers and private agencies and homes don't have any incentive to run them, unless adequate English (ie above B1 with specialist input) is made a requirement for their licence.

If somebody is already at B1 level, the recommendation is for an additional 200 hours of study to reach the next level.

Even if care-workers' wages were to be increase significantly, it's not going to be a short-term fix. People with the right personal qualities need to be trained and be persuaded to leave other jobs. I do not believe that there are thousands of people just sitting around being economically inactive, waiting for the right moment for care-work to pay. The country is going to have some reliance on foreign care-workers, many of whom do have the right skills, apart from language. That means that the government (and it has to be the government because nobody else has an incentive to do it) has to have a long-term strategy, starting off with solid training for teachers of English as a foreign language and a curriculum for specific purposes. People will need to be given work visas, knowing that their responsibilities might need to be limited, if language could be a problem. It needs to a requirement for foreign care workers that they attend language classes for (probably) about a year.

Freya5

Surely if you wish to work in the UK, it is down to you,not the employer, to make sure your English is acceptable. Taking classes , at your expense, or even online courses, is your responsibility. Then on interview the employer becomes responsible to ensure your English is good enough to ensure, above all, the safety of your clients,patients. Remember Daniel Obani.

Other countries are running language for foreigners classes/courses for free.

I know because I taught German as a foreign language until last year and I was able to access loads of courses for free for my own students.

Germanshepherdsmum

Applicants for visas are supposed to pass a basic English test. Either the test is too basic, as the coroner suggested, or applicants are circumventing it - possibly those sponsored by care homes?

The coroner is correct. The level is too low for workers in specific roles. CEFR Level B1 is OK for general conversation, but not for technical language, especially if people don't always speak clearly and use standard vocabulary.

There are also care homes who circumvent requirements. As mentioned above, my sister worked as an NVQ assessor in care homes. She had had a long career as a nurse and NHS clinical manger, who took early retirement. She had a generous pension, but was still relatively young, so took the job as an assessor.

NVQ assessment is outsourced and care homes buy in packages. The care homes are under pressure to have a certain number of staff qualified, the training providers are under pressure to meet the targets for staff to pass the assessments and the individual assessors are under pressure to make sure that most of their students/mentees pass. That's a perfect environment for fiddling the figures to make sure that the vast majority of students pass. These days, a minimum level of English is required, even if caring skills are good (that goes for native English speakers as well).

My sister had spent her whole career in the NHS and had worked hard to pass all her exams and undergo demanding appraisals. She was shocked that the culture was so different and it seemed that every string was pulled to make sure students passed, even if they weren't up to it. Thank goodness I never worked for her because I think she was a stickler for protocols. My sister left after barely two years.

Why am I not surprised?

In case anybody thinks I'm just getting at foreign care-workers, I also remember a case in a local care home when my sister failed a number of English-speaking care-workers for NVQ Level 2 as a result of sloppy working practices.

It was a private home (part of a chain) set in beautiful surroundings and the building itself was impressive. However, it had a lot of time-serving staff, who were set in their ways and refused to change their working practices. Many of the patients had dementia, so it was always assumed they didn't know what they were talking about if they complained. I remember my sister telling me that at tea time, the tea was made in a large urn and sugar and milk was added to the tea before it was served. Patients weren't given the option of having unsweetened tea or without milk. Apparently, there was a selection of biscuits available, but they were dished out without giving people choice and the staff ate the nicest ones. There were also concerns about how patients were washed and prepared for bed. Most of the staff were native English speaking , but their standard of literacy was poor and it was found that records were inaccurate or incomplete.

As a result of failing the staff, my sister had to go to a meeting with her company's management and was asked to review her decisions because the care home threatened to stop paying the assessment company. My sister refused and gave in her notice shortly after that.

Well done your sister growstuff!
At the NHS care home where I volunteer there are very obviously staff who enjoy and are good at their jobs and those who are either just bank staff or are going through the motions. It's hard work providing nursing care to such a very debilitated group of patients. There are some non English speakers but I'd say the key thing is a lack of shared context. I can chat to patients about how their old neighbourhoods were, old workplaces, shops, entertainments etc. I'm familiar with local dialects and old words etc. The staff are all younger and sometimes just don't know what patients are talking about.
One tiny example - a lady had a very precious photo. She insisted it was on display. Staff assumed it was of her with a family member and would try to get her to say it was her son or nephew. She'd say in exasperation, 'Its Daniel. Me and Daniel.' They'd nod and go back to assuming it was a family member. Enter me. An older lady. I recognised him at once. It was Daniel O'Donnell of course. Meeting him was the high point of her life and she loved talking about it. It was so important to get but incomprehensible to staff.

So important to her!

Macaton

www.sense.org.uk/information-and-advice/communication/makaton/#what

This is very a flexible simple sign language that can be used simultaneously with spoken words. Even to learn 'cup of tea; or 'toilet' in makaton would enable any care worker to be better at their work.

So the ‘patient’ is also expected to learn it? Not very helpful for very elderly people or those with dementia I would imagine - and why should they have to adapt?

Caleo have you ever met or worked with someone with dementia? if you had you wouldn't have made the above suggestion.

But I am with GSM why on earth should those people in need of care, so already struggling physically, mentally, and often both, need to start learning any kind of language, however, flexible and simple, to communicate with people looking after them in their own community.

I agree with GSM and MOnica. It's not up to patients to learn sign language. However, it's pie in the sky to imagine that the 150,000+ care worker vacancies are going to be filled with native English speakers.

Care homes won't invest in communication skills, so the government has to step in, if it wants the elderly and vulnerable to have any quality of care.

Foreign care workers should, in theory, have basic conversational skills, but they need extra tuition in English for specific purposes. They also need training in communicating with (not necessarily via language) with patients with dementia and learning difficulties. Native speakers should have that training too. There should also be protocols in place for staff to ask for help if they haven't understood, especially when the subject is likely to have been something important.

None of it will come free or without skilled and trained trainers.

Caleo
What a ridiculous suggestion. My dear friends mother thinks that my friend is her mother and her husband ( the lady with dementia) thinks her hus band is her son.
Try explaining Makaton to this lovely gentle woman.

Caleo

Macaton

www.sense.org.uk/information-and-advice/communication/makaton/#what

This is very a flexible simple sign language that can be used simultaneously with spoken words. Even to learn 'cup of tea; or 'toilet' in makaton would enable any care worker to be better at their work.

There is quite a fast turnaround in care homes. By the time they have tried learning makaton they would have departed this earth.

I think the best which could probably be done is to teach patients to give a thumbs up for yes and a thumbs don for no and to make sure they are given choices, for example thumbs up for marmalade on toast/thumbs down for jam. There could be agreed signs for wanting to go to the toilet or feeling cold, which is what many parents do with their pre-verbal children.

That's a long way from having a conversation with a dementia patient. I suspect that staff new to care work possibly need some training in understanding how to communicate with them (and those with congenital learning difficulties). It really shouldn't be left to chance.

Makatron are developing a communication system to use with dementia sufferers.
Age UK is supportive.

I looked at 25 care homes after my mother's care home placement broke down and the hospital refused to send her back there. Some of the things I saw were quite shocking. I didn't just want a CQC "Good" rated home but an "Outstanding" one. There was one home within 50 miles of me with that criteria which was much too far away. Even those that had an overall "Good" would have a "Requires Improvement" in one or more of the domains of "Safe," "Caring," "Responsive," and "Well-led."
I was horrified. I expect anybody looking after my Mum to be Good in all those areas and I don't think that is unreasonable.

We eventually got put on a waiting list for a home which was good in every domain and luckily it came up with a space before the hospital started legal proceedings to evict Mum from her hospital bed. It is a couple of thousand pounds per week which we have to pay for. It is a lot of money and when the money runs out, the powers that be will move heaven and earth to get Mum moved to somewhere cheaper. However, the extra money goes on staffing and it is noticeable. Even so, there are obvious differences in the nationality of the staff and their understanding of my mother's needs but they are very kind and do their best.

It is only now my mother has got to the stage that she needs good care that I realise how appallingly we care for the elderly in this country. Whilst she was at home we had to fight for everything we needed in order to manage. Just what you need when you are up to your neck in faecal matter, violent episodes and somebody who is immobile.

If everybody learned Makaton from babyhood alongside spoken language, people with dementia would have a better chance of being able to communicate as it is usually short term memory that goes first. Babies would also be able to communicate their needs better before they could speak. It isn't something you could teach a person with dementia later in life but would be worthwhile promoting in early years.

I have worked for 12 years in care homes for the elderly. I have been at my present placement for just over five years.
I really do love my job and when I first started there five years ago, there were four Indians and all the rest were English, now there are four English and all the rest are Indians and I like the Indians,we have men and women and they are nice people they really are, but even if they have quite a good command of the English language, they are so heavily accented that it’s sometimes hard for me to understand never mind Our residents, most of whom are high dementia (a few have very good English and a few can barely understand what is being said to them)
Some people have mentioned CQC I can tell you that we have not had a CQC visit visit in four years.
I am 70 now so only work 18 hours a week in the care home, but I really do enjoy it. I’m staying with my daughter in St Albans at the moment and will be ready to go back to work on Tuesday. I miss the people I work with.(the residents) and I am looking forward to working Christmas Day because not many of our 39 residents will be going home with family because most of them like I said before have high dementia, but we try to make it as nice as possible all year round not just at Christmas
I work for minimum wage but money is not everything. I really enjoy the job I do and to be honest if they offered me £15 an hour to go and work with children I couldn’t do it and I know there are people who couldn’t do my job, so it is horses for courses and I will do it as long as I am able….
The Indians are contracted at my care home and have to stay there for a minimum of five years. Quite a few of them were nurses in India and also many of them worked in Dubai, but were not allowed to bring their family so they came to England
I have to tell you, I do not envy these people at all. In fact, I feel quite sorry for them especially now with what is being suggested now by this appalling government. Some of them have family over here already and we were hoping that would be okay but apparently they might not get their visas renewed I think it’s a terrible state of affairs.
Also, I was unaware until quite recently that it costs these people, thousands of pounds to even come to England. They have children settled in the schools here I just feel so very sorry for them being thousands of miles away from their families, quite a few have husbands and children still over in India and were hoping to bring them over and now that looks as though it might not happen. I can’t imagine how worried they must be.
I think the government are doing this because they know they haven’t got a hope in hell of stopping the small boats so they’re going to go for these people..

icanhandthemback

If everybody learned Makaton from babyhood alongside spoken language, people with dementia would have a better chance of being able to communicate as it is usually short term memory that goes first. Babies would also be able to communicate their needs better before they could speak. It isn't something you could teach a person with dementia later in life but would be worthwhile promoting in early years.

That really isn't realistic. You could put any number of topics on a wishlist.

Well said Shiname, apart from your last sentence. Ye.s the government is going for the families of care workers, but as a distraction from the people coming here on small boats. There are actually many more care workers and their families than there are asylum seekers on boats.

The government is just going for a headline figure to impress the voting public. The country does need to do something about asylum seekers (such as processing claims more efficiently) and weeding out those with almost no hope of a successful claim at a very early stage. It also needs to co-operate more with France and Belgium. Gunning for care workers' families won't help with the asylum issue or the shortage of care workers, especially those with good language skills.

We'll have to agree to disagree, Growstuff. I think it is entirely realistic for children to learn this in nursery school. It's one of the first things they recommend when ASD children are struggling with speech. Youngsters watch it on CBeebies already and it is becoming far more commonplace.

icanhandthemback

We'll have to agree to disagree, Growstuff. I think it is entirely realistic for children to learn this in nursery school. It's one of the first things they recommend when ASD children are struggling with speech. Youngsters watch it on CBeebies already and it is becoming far more commonplace.

The trouble is that if you were to read the list of things people think children should learn at school, it would never end.

Not only that, but learning isn't the same as teaching. It's possible to "teach" children loads of things, but whether they retain what they "learn" is another matter.

It's probably the subject for another thread, but I think training and career progression (with appropriate financial compensation) should be massively improved for care workers - maybe something like in-service nursery nurse/pre school training - so long as employers are prepared to pay for their upskilled workforces.

As an example, communication, including using simplified language, repetition, Makoton, sign language, etc etc could be a module in an NVQ qualification.