SAQA

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SOUTH AFRICAN QUALIFICATIONS AUTHORITY

REGISTERED QUALIFICATION:

Occupational Certificate: Home Based Personal Care Worker

SAQA QUAL ID	QUALIFICATION TITLE
104792	Occupational Certificate: Home Based Personal Care Worker
ORIGINATOR
Development Quality Partner - HPCA
PRIMARY OR DELEGATED QUALITY ASSURANCE FUNCTIONARY			NQF SUB-FRAMEWORK
-			OQSF - Occupational Qualifications Sub-framework
QUALIFICATION TYPE	FIELD		SUBFIELD
Occupational Certificate	Field 09 - Health Sciences and Social Services		Promotive Health and Developmental Services
ABET BAND	MINIMUM CREDITS	PRE-2009 NQF LEVEL	NQF LEVEL	QUAL CLASS
Undefined	135	Not Applicable	NQF Level 03	Regular-ELOAC
REGISTRATION STATUS		SAQA DECISION NUMBER	REGISTRATION START DATE	REGISTRATION END DATE
Reregistered		EXCO 0425/24	2018-10-25	2025-12-30
LAST DATE FOR ENROLMENT		LAST DATE FOR ACHIEVEMENT
2026-12-30		2029-12-30

In all of the tables in this document, both the pre-2009 NQF Level and the NQF Level is shown. In the text (purpose statements, qualification rules, etc), any references to NQF Levels are to the pre-2009 levels unless specifically stated otherwise.

This qualification replaces:

Qual ID	Qualification Title	Pre-2009 NQF Level	NQF Level	Min Credits	Replacement Status
64749	National Certificate: Community Health Work	Level 2	NQF Level 02	140	Complete
16691	Certificate: Home Health Care	Level 3	NQF Level 03	120	Complete

PURPOSE AND RATIONALE OF THE QUALIFICATION

Purpose:
The purpose of this qualification is to prepare a learner to operate as a Home-Based Carer.

Home Based Carers provide supervised care and support to patients and their immediate family's/household members in the home and appropriate community-based settings in order to promote, restore and maintain a person's maximum level of comfort, function and health including care towards a dignified death.

A qualified learner will be able to:

Assess, plan and provide holistic (physical, spiritual, emotional and social) care and support for patients and household members.

Capacitate patient and household/family members as participants in the patient care team.

Make appropriate referrals in order to facilitate a continuum of care.

Maintain records and reports regarding care and support provided.

Rationale:
This qualification will equip learners with the necessary skills and competence to operate as Home-Based Carers. The benefits of Home Based Care (HBC) to the patient, to the family, to the community and to the broader health care system are well documented. Evidence from many countries suggests that home and community-based health services are critical to good health outcomes (WHO 2007).

The World Health Organisation (WHO) defines HBC as the provisioning of health services by formal and informal care givers in the patient's home to promote, restore and maintain a person's maximum level of comfort, function and health, including care, towards a dignified death.

The national Department of Health Guidelines on Home-Based Care and Community-Based Carer suggests that HBC addresses several problems within the health care system including: shortage of hospital beds; inadequate number of medical, nursing and allied health professionals; lack of resources; overcrowded hospitals and overburdened staff which can result in an environment that is unsuitable for managing patients with terminal diseases and increase costs of institutional care.

The National Department of Health (NDoH) Strategic Plan for the Prevention and Control of Non-Communicable Diseases calls for patients with advanced progressive illness to receive care in appropriate settings, including HBC.

Research commissioned by the NDoH found that 628,000 admissions to public hospitals were for Immune Deficiency Syndrome (AIDS)-related illnesses. The cost of hospitalising Acquired Immune Deficiency Syndrome (AIDS) patients at public facilities was likely to be at least R3.6 billion, or 12.5% of the total public health budget.

Discharging patients into the care of an HBC programme allows for a shorter hospital stay, making more beds available for other patients and reducing costs. HBC provides the health care system with additional cost-effective beds, at home.

The NDoH Re-engineering of Primary Health Care (PHC) Strategy makes a distinction between the need for Community Health Workers (CHWs) and Home-Based Caregivers (HBCs). The strategy estimates that approximately 65,000 CHWs and 25,000 HBCs are required by the South African Primary Health Care (PHC) system.

The draft Municipal Ward Based Primary Health Care Outreach Team (WBPHCOT) National Policy Framework and Strategy calls for the deployment of HBCs alongside CHWs within the Ward Based Outreach Teams (WBOTs).

A NDoH Audit Report estimated that approximately 72 000 homes/community-based care givers were employed by Non-Governmental Organizations (NGOs) in South Africa at an estimated cost of R2.4 billion per annum.

This qualification is therefore essential in supporting the National strategies for providing quality and affordable health care to all the citizens of South Africa. The qualification is structured with one-part qualification specifically aimed at enabling the entry of community workers with limited or no prior formal education.

LEARNING ASSUMED TO BE IN PLACE AND RECOGNITION OF PRIOR LEARNING

Recognition of Prior Learning (RPL):
RPL for access to the external integrated summative assessment:
Accredited providers and approved workplaces must apply the internal assessment criteria specified in the related curriculum document to establish and confirm prior learning. Accredited providers and workplaces must confirm prior learning by issuing a statement of result or certifying a work experience record.

RPL for access to the qualification:
Accredited providers and approved workplaces may Recognise Prior Learning against the relevant access requirements.

Entry Requirements:
Level 1 with Mathematics.

RECOGNISE PREVIOUS LEARNING?

QUALIFICATION RULES

This qualification is made up of the following compulsory Knowledge, Practical Skills and Work Experience Modules:
Knowledge Modules:

532904-001-00-00-KM-01, Fundamentals of Home Based Care Level 2, 8 Credits.

532904-001-00-00-KM-02, Community Health Care and Social Support; Level 3, 14 Credits.

532904-001-00-00-KM-03, Rehabilitative Care within a home-based environment; Level 3, 7 Credits.

532904-001-00-00-KM-04, Therapeutic Care within the home-based environment; Level 3, 9 Credits.

532904-001-00-00-KM-05, Supportive and Palliative Care; Level 3, 7 Credits.
Total number of credits for Knowledge Modules: 45.

Practical Skill Modules:

532904-001-00-00-PM-01, Assess and identify the needs of patients and family/household members, and develop/update a standardised care plan in collaboration with a professional supervisor; Level 3, 5 Credits.

532904-001-00-00-PM-02, Identify and report on possible needs of patients and family/household members on an ongoing basis; Level 2, 5 Credits.

532904-001-00-00-PM-03, Implement delegated components of the care plan (Household and patient); Level 2, 20 Credits.

532904-001-00-00-PM-04, Educate patients and family/household members regarding the specific health/social conditions, implications and principles of care (to enable patients to make informed decisions); Level 3, 5 Credits.

532904-001-00-00-PM-05, Capacitate patients/family/household members in basic practical care skills; Level 2, 5 Credits.

532904-001-00-00-PM-06, Record and submit required information as per the schedule; Level 3 Credits.
Total number of credits for Practical Skill Modules: 45.

Work Experience Modules:

Work Experience, 532904-001-00-00-WM-01, Exposure to the processes of assessing, planning and providing holistic care in household and community settings; Level 3, 7 Credits.

Work Experience, 532904-001-00-00-WM-02, Exposure to the processes of monitoring the implementation of the home-based care plans; Level 2, 24 Credits.

Work Experience, 532904-001-00-00-WM-03, Exposure to the processes of ensuring the active participation of patients and households in the management of care at home; Level 3, 2 Credits.

Work Experience, 532904-001-00-00-WM-04, Exposure to the processes of capacitating patients/family/household members in basic practical care skills; Level 2, 2 Credits.

Work Experience, 532904-001-00-00-WM-05, Exposure to the referral processes; 3 Level, 2 Credits.

Work Experience, 532904-001-00-00-WM-06, Exposure to the processes of conducting follow up on referred patients at household; Level 2, 4 Credits.

Work Experience, 532904-001-00-00-WM-07, Exposure to the processes of reporting and maintaining records within the home-based care environment; Level 3, 3 Credits.

Work Experience, 532904-001-00-00-WM-08, Exposure to the processes of participating in care team activities; Level 2, 1 Credits.
Total number of credits for Work Experience Modules: 45.

EXIT LEVEL OUTCOMES

1. Provide holistic care and support to patients and household members.
2. Communicate effectively with patients and household members to provide care and support.
3. Operate effectively within a multi-disciplinary team context.
4. Recognise when to refer and who to refer to.
5. Complete a generic report guideline/template on patient care.

ASSOCIATED ASSESSMENT CRITERIA

Associated Assessment Criteria for Exit Level Outcome 1:

Assessment of the care and support needs of the patient, family and household members is comprehensive and the use of the appropriate assessment tools are accurate according to laid down procedures.

Identified needs are accurately translated into a patient care plan.

Explanations of the process of providing physical care (Palliative care, rehabilitation, therapeutic, care for older persons, care for children) is accurate and aligned with the World Health Organization (WHO) definitions and departmental guidelines.

Explanations of the processes of providing spiritual and cultural care and support is aligned with the constitutional requirements and appropriate to the given context.

Explanations of the processes for providing emotional and social care and support is appropriate to the given context and aligned to the departmental guidelines.

Explanations of the process of applying the universal precautions within health care is accurate according to the global guidelines and takes the need for water conservation into consideration.

Associated Assessment Criteria for Exit Level Outcome 2:

Explanations of the appropriate communication processes and behaviours required to deal with different home-based care situations is appropriate to the various contexts and reflects understanding of the fundamental principles of empathy and compassion within the home-based care environment.

Examples of how a home-based carer must apply empathetic listening when presented with a problem is relevant, feasible and appropriate to the patient and the context.

Descriptions of the barriers to effective communication is practical and examples of how to mitigate these barriers are appropriate and aligned with proven best practices.

Identification of what health information is required within different contexts is valid and descriptions of how this information will be provided to the patient and the family/household members are aligned to leading practices and departmental guidelines.

Associated Assessment Criteria for Exit Level Outcome 3:

Identification of the members of the primary health care and social support team is accurate and descriptions of the roles and responsibilities of each of the team members is aligned to the departmental guidelines and the WHO definitions.

Associated Assessment Criteria for Exit Level Outcome 4:

Identifications of situations for which patients require referral is accurate and descriptions to whom the referrals must be made is appropriate to the situation and relevant to the context.

Descriptions of the processes for referrals is accurately aligned to the primary health care guidelines.

Associated Assessment Criteria for Exit Level Outcome 5:

Home based care reports are accurate, neat, clear, complete, comprehensive, informative and give a full account of what happened.

Integrated Formative Assessment:
The skills development provider will use the curriculum to guide them on the stipulated internal assessment criteria and weighting. They will also apply the scope of practical skills and applied knowledge as stipulated by the internal assessment criteria. This Formative Assessment leads to entrance into the integrated external summative assessment.

Integrated Summative Assessment:
An external Integrated Summative Assessment, conducted through the relevant Quality Council for Trades and Occupations (QCTO) Assessment Quality Partner is required for the issuing of this qualification. The external Integrated Summative Assessment will focus on the Exit Level Outcomes and Associated Assessment Criteria.

INTERNATIONAL COMPARABILITY

The training of Home Based Carers varies in process and content relevant to the levels of development and the National Primary Health Care strategies of the various countries. Across the world, Home-Based Carers play a very important role in supporting the aims and objectives of the national health policies.

A comparative study was done to evaluate the extent to which the Occupational Certificate for Home Based carers aligns with international practice. Two countries were used for this purpose:

United Kingdom (UK):
In the UK the occupation is very well recognised. United Kingdom Homecare Association Ltd (UKHCA) is the professional association of home care providers from the independent, voluntary, not-for-profit and statutory sectors. UKHCA helps organisations that provide social care (also known as domiciliary care or homecare), which may include nursing services, to people in their own homes, promoting high standards of care and providing representation with national and regional policy-makers and regulators. The Association represents over two-thousand members across the United Kingdom, in England, Wales, Scotland and Northern Ireland.

A suite of Qualifications exists on the Scottish Qualification Framework from Level 2 to Level 7. These are mainly vocational training certificates and the assessments are done in the workplace. The qualifications are listed as Professional Development Awards: Enhanced Care Workers.

The Level two and three Awards: ''Enhanced Home Care Workers'' covers all the components that are covered in the South African Qualification. These qualifications allow for electives and therefore enable the learner to focus purely on the Home Based Physical care aspects, or the Emotional Care aspects or to move to the broader Health promotion issues.

The methodology, level of learning and duration is similar to the South African Qualification, but the South African Occupational Certificate is clearly linked to our unique situation as set out in the Primary Health Care re-engineering strategy.

Brazil:
The international example that is closest to the South African context is the model used in Brazil. Brazil has made rapid progress toward universal coverage of its population through its national health system, the Sistema �nico de Saúde (SUS). Since its emergence from dictatorship in 1985, Brazil which has the world's fifth-largest population and seventh-largest economy and has invested substantially in expanding access to health care for all citizens, a goal that is implicit in the Brazilian constitution and the principles guiding the national health system. The SUS comprises public and private health care institutions and providers, financed primarily through taxes with contributions from federal, state, and municipal budgets. Health care management is decentralized, and municipalities are responsible for most primary care services as well as some hospitals and other facilities. An important innovation in the system has been the development, adaptation, and rapid scaling up of a community-based approach to providing primary health care. After originating in the north-eastern state of Ceará in the 1990s as a maternal and child health program relying on community health agents (lay members of the community who are paid members of the health care team), the Family Health Program (now called the Family Health Strategy, or FHS) has evolved into a robust approach to providing primary care for defined populations by deploying interdisciplinary health care teams. The nucleus of each FHS team includes a physician, a nurse, a nurse assistant, and 4 to 6 full-time community health agents. Family health teams are organized geographically. The training of these Health agents covers both health promotion and the provisioning of physical care for specific patients. In Brazil the training is done on the job by the team leaders and then supported by a range of short courses covering the key skills needed to make the system work.

Conclusion:
The international examples evaluated indicate that the challenge for training Home Based Carers are similar everywhere. Learning is done on the job. In the more developed societies there is a surplus of qualified nursing staff that tend to take up this role as a career option. The learning that is provided is similar to what is covered in the South African Occupational Certificate. However, the South African Certificate is structured to meet our unique needs. There are two separate qualifications distinguishing between the Community Health Worker and the Home-Based Carer. Within the latter qualification we are also making provision for a cadre of workers who do not have high levels of literacy but who will perform excellently in providing the physical care required by a range of incapacitated patients within a home-based environment.

ARTICULATION OPTIONS

Horizontal Articulation:
This qualification articulates horizontally with the following qualification:

Occupational Certificate Health Promotions Officer (Community Health Worker), Level 3.

Vertical Articulation:
This qualification articulates vertically with the following qualifications:

Further Education and Training Certificate: Community Water, Health and Sanitation Facilitation, Level 4.

MODERATION OPTIONS

N/A

CRITERIA FOR THE REGISTRATION OF ASSESSORS

N/A

NOTES

Qualifying for External Assessment:
In order to qualify for an external assessment, learners must provide proof of completion of all required modules by means of statements of results and work experience records including the Foundational Learning Competence.

Additional Legal or Physical Entry Requirements:
None.

Criteria for the Accreditation of Providers:
Accreditation of providers will be done against the criteria as reflected in the relevant curriculum on the Quality Council for Trades and Occupations (QCTO) website.

The curriculum title and code are: Home Based Personal Carer: 532904-001-00-00.

Encompassed Trades:
This is not a trade qualification.

Assessment Quality Partner (AQP):
Health and Welfare Sector Education and Training Authority (HWSETA).

Part Qualifications:

532904-001-00#01, Home Based Personal Care Assistant, Level 2.

LEARNING PROGRAMMES RECORDED AGAINST THIS QUALIFICATION:

When qualifications are replaced, some (but not all) of their learning programmes are moved to the replacement qualifications. If a learning programme appears to be missing from here, please check the replaced qualification.

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PROVIDERS CURRENTLY ACCREDITED TO OFFER THIS QUALIFICATION:

This information shows the current accreditations (i.e. those not past their accreditation end dates), and is the most complete record available to SAQA as of today. Some Primary or Delegated Quality Assurance Functionaries have a lag in their recording systems for provider accreditation, in turn leading to a lag in notifying SAQA of all the providers that they have accredited to offer qualifications and unit standards, as well as any extensions to accreditation end dates. The relevant Primary or Delegated Quality Assurance Functionary should be notified if a record appears to be missing from here.

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