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SOUTH AFRICAN QUALIFICATIONS AUTHORITY 
REGISTERED QUALIFICATION THAT HAS PASSED THE END DATE: 

Further Education and Training Certificate: Institutionally-based Care 
SAQA QUAL ID QUALIFICATION TITLE
80447  Further Education and Training Certificate: Institutionally-based Care 
ORIGINATOR
Task Team - Private Hospitals 
PRIMARY OR DELEGATED QUALITY ASSURANCE FUNCTIONARY NQF SUB-FRAMEWORK
HW SETA - Health and Welfare Sector Education and Training Authority  OQSF - Occupational Qualifications Sub-framework 
QUALIFICATION TYPE FIELD SUBFIELD
Further Ed and Training Cert  Field 09 - Health Sciences and Social Services  Curative Health 
ABET BAND MINIMUM CREDITS PRE-2009 NQF LEVEL NQF LEVEL QUAL CLASS
Undefined  120  Level 4  NQF Level 04  Regular-ELOAC 
REGISTRATION STATUS SAQA DECISION NUMBER REGISTRATION START DATE REGISTRATION END DATE
Passed the End Date -
Status was "Reregistered" 		 SAQA 06120/18  2018-07-01  2023-06-30 
LAST DATE FOR ENROLMENT LAST DATE FOR ACHIEVEMENT
2024-06-30   2027-06-30  

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 does not replace any other qualification and is not replaced by any other qualification. 

PURPOSE AND RATIONALE OF THE QUALIFICATION 
Purpose:

The primary purpose of this qualification is to provide the learner with the necessary knowledge and skills required to function as a careworker in an institutional setting in both private and public health care environments. The careworker works under supervision of the practice nurse or a qualified regulated professional to undertake activities of daily living (ADL) duties that are delegated to them. They will work collaboratively with the general practice team to meet the needs of clients, following policy, protocols and procedures as stipulated within the care setting. The learner will be competent to deliver a service in accordance with the current, relevant legislation, ethics and codes of practice.

Learners completing this qualification will be able to:
  • Maintain a safe environment for the client.
  • Communicate effectively with both client and members of the multi-disciplinary healthcare team.
  • Assist the client in maintaining the optimal level of functioning in activities of daily living.
  • Provide support to members of the multi-disciplinary healthcare team and/or unit organisation in the care of the client.
  • Respond to medical emergencies.
  • Perform all the supportive care within the selected area of specialisation.

    Rationale:

    South Africa has growing health needs which are in both chronic and acute settings. Whereas community healthcare workers are able to perform promotive and preventive tasks in the community, there are large populations of South Africans who need acute or chronic institutional care such as geriatric, paediatric and palliative care facilities. The critical shortages of professional healthcare staff has led to a need to support healthcare services with the use of an ancillary worker who can perform supportive tasks that are delegated to them, thus allowing for increased quality of care and a multi-skilled complementary care strategy. Environments where the careworker can be of optimal value include:
  • Old Age Homes.
  • Acute Hospitals.
  • Frail Care Centres.
  • Palliative Care Facilities.
  • Sub-acute Facilities.
  • Chronic Mental Health Facilities.
  • Rehabilitation Facilities.
  • Baby and Childcare Facilities. 
    		•

    LEARNING ASSUMED TO BE IN PLACE AND RECOGNITION OF PRIOR LEARNING 
    Learners who are admitted to this qualification must be competent in:
  • Mathematical Literacy at NQF Level 3.
  • Communication at NQF Level 3.

    Competence in end-user computing is strongly recommended.

    Recognition of Prior Learning:

    This qualification can be achieved wholly, or in part, through recognition of prior learning. Evidence may be presented in a variety of forms, including previous international or local qualifications, reports, testimonials, portfolios, work records and performance appraisals.

    Recognition will be granted in accordance with the specific institutional requirements, in agreement with the relevant ETQA.

    Access to the Qualification:

    Access is open, conditional to the learning assumed to be in place and learner access to a facility that will enable clinical practice to take place. 
    		•

    RECOGNISE PREVIOUS LEARNING? 
    Y 

    QUALIFICATION RULES 
    The Qualification consists of a Fundamental, a Core and an Elective Component.

    To be awarded the Qualification, learners are required to obtain a minimum of 120 Credits as detailed below:

    The Fundamental Component consists of:
  • Mathematical Literacy at NQF Level 4 to the value of 16 Credits.
  • Communication at NQF Level 4 in a First South African Language to the value of 20 Credits.
  • Communication in a Second South African Language at NQF Level 3 to the value of 20 Credits.

    It is compulsory therefore for learners to do Communication in two different South African languages, one at NQF Level 4 and the other at NQF Level 3.

    All learning areas in the Fundamental Component are compulsory.

    The Core Component consists of learning areas to the value of 50 Credits, all of which are compulsory.

    Elective Component:
  • A minimum of 14 Credits must be obtained in the Elective Component for the learner to be awarded the Qualification.
  • Learners may choose from six Elective options.
  • Each Elective is an area of specialisation and carries a minimum of 14 Credits.
  • Learners must complete all the competencies for the chosen Elective to be awarded the qualification.
  • Elective 1: Care of the Elderly.
  • Elective 2: Care of those in Mental Health facilities.
  • Elective 3: Care of those in Physical Rehabilitative facilities.
  • Elective 4: Care of those in Infant and Child care facilities.
  • Elective 5: Care of those in Palliative care facilities.
  • Elective 6: Care of those in Acute Care facilities.

    Note: During the course of this qualification, the learner must be enabled to become competent in First Aid at NQF Level 3. 
    		•

    EXIT LEVEL OUTCOMES 
    1. Maintain a safe environment for the client.

    2. Communicate effectively with both client and the members of the multi-disciplinary healthcare team.

    3. Assist the client in promoting the optimal functioning of activities of daily living.
  • Outcome Range: ADL include but are not limited to: Eating, drinking, washing, dressing, breathing, elimination, mobilisation, pressure care, sleeping, comfort, death and dying.

    4. Provide support to the multi-disciplinary team and /or the unit organisation in the care of the client.

    5. Respond to medical emergencies.

    6. Perform the required supportive care within the selected area of specialisation.

    Critical cross-field outcomes:
  • Identifying and solving problems within the acute and chronic care setting in order to provide optimal care to clients.
  • Working effectively with others as a member of a team, group and organisation to generate awareness and knowledge of health care issues, treatments and options within an institution.
  • Organising and managing oneself and one's activities responsibly to ensure own well being and productivity in order to effectively administer and assist in the implementation of tasks within own work context.
  • Collecting, organising and critically evaluating information relating to the health care industry, legislation, structures and processes that affect health care in order to ensure that effective assistance is provided.
  • Communicating effectively using visual, mathematics and language skills in the modes of oral and/or written persuasion to interact with clients, colleagues, supervisors and any other stakeholders that affect the implementation of health care within the institution.
  • Using science and technology effectively and critically showing responsibility towards the environment and the health of others in order to effectively administer, record and report data relating to own contributions and functions within the institution.
  • Demonstrating an understanding of the world as a set of related systems by recognising that problem-solving contexts relating to health care do not exist in isolation and that a variety of external factors, including political, socio-economic, capacity, resources, budgets and clients needs are recognised as influencing day-to-day activities. 
    		•

    ASSOCIATED ASSESSMENT CRITERIA 
    Associated Assessment Criteria for Exit Level Outcome 1:

    1.1 Cross infection is prevented through application of infection control methods such as disposal of medical waste in keeping with standard precautions.
    1.2 Handling of bodily fluids is carried out in a safe and responsible manner according to protocols and/or standard operating procedures.
    1.3 Medico-legal hazards are averted through the continuous application of the safety, health and environmental quality (SHEQ) requirements and safe client care practices SHEQ requirements include but are not limited to: Infection prevention, medico-legal risks' control and prevention, medical waste safe disposal.

    Associated Assessment Criteria for Exit Level Outcome 2:

    2.1 All people within the work environment are consistently addressed in a courteous and professional manner.
    2.2 Ethical principles and patient confidentiality are applied at all times and communications reflect effective telephone etiquette.
    2.3 Clients care is optimised by acknowledging diversity and applying cultural sensitivity.
    2.4 Clients and their significant others are consistently handled in compliance with the Bill of Rights and the Patient Charter.

    Associated Assessment Criteria for Exit Level Outcome 3:

    3.1 Any abnormalities identified during any of the ADL are reported immediately to prevent further deterioration and/or complications.
    3.2 Knowledge and skills related to feeding methods, use of feeding devices, positioning for and provision of any required therapeutic diets are applied in assisting the client with nutritional activities.
    3.3 The client is assisted with personal hygiene care in the areas washing, hair and nail grooming, personal aids such as dentures, mouth cleaning and skin care.
    3.4 The safety of the client is maintained during personal hygiene routines through strict adherence to safety precautions.
    3.5 Privacy is maintained and dignity of the client is upheld during personal hygiene routines.
    3.6 The client with breathing difficulties is assisted in by applying knowledge of optimal positioning and identifying and reporting abnormalities in breathing.
    3.7 The use of equipment and gases to aid breathing is demonstrated through principles of application, care and appropriate storage thereof.
    3.8 The privacy and dignity of the client is maintained when assisting with elimination needs.
    3.9 Care, use and storage of elimination aids are carried out in accordance with the required health and safety practices.
    3.10 Elimination waste is disposed of according to the required protocols and/or standard operating procedures.
    3.11 The mobilisation of the client is demonstrated through the application of the safe techniques and methods as suggested by the therapeutic practitioner.
    3.12 Knowledge and skill in pressure care and prevention is demonstrated in the promotion of the care of the client's skin.
    3.13 The transfer and lifting of the client reflects correct techniques of own back protection.
    3.14 The client is positioned for rest and/or sleep in a safe and optimal posture in a therapeutic environment.
    3.15 Pain management principles for the suffering client are applied in accordance with the relevant medical prescriptions.
    3.16 A deceased client is cared for in a dignified manner and all legal requirements are carried out with due deference to the known personal wishes of the late client and significant others.
    3.17 Support and comfort for the significant others is provided a professional and caring manner.

    Associated Assessment Criteria for Exit Level Outcome 4:

    4.1 Accurate records are maintained through documentation and administrative procedures for all interactions and care interventions.
    4.2 Equipment is prepared as requested used equipment is cleaned and stored according to manufacturer's specifications and/or standing operating procedures.
    4.3 A therapeutic environment is prepared and maintained to promote rest and healing for the patient and comfortable working conditions for the care team personnel.

    Associated Assessment Criteria for Exit Level Outcome 5:

    5.1 In case of medical emergency the alarm is given and professional assistance is called for.
    5.2 First Aid measures are applied in response to the type of medical emergency and are maintained until professional help arrives.
    5.3 Assistance is given to the professionals as requested.
    5.4 A full report is submitted once the emergency has passed.

    Associated Assessment Criteria for Exit Level Outcome 6:
  • Range of Specialisation Care Areas: The Elderly, those with Mental Health problems, those with Physical Rehabilitative needs, Infants and Children, Care of those in Palliative care facilities, those in Acute Care facilities.

    6.1: The Elderly
  • Common degenerative conditions and/or disease and trauma processes that effect on the body system in old age are identified.
    > Range of common diseases or conditions includes but is not limited to: Common degenerative diseases or illnesses such as arthritis or osteoporosis, cataract and impaired eye sight; impaired hearing; Alzheimer's Disease; Parkinson's Disease; Senile Dementia; chronic constipation; urinary tract infections; cerebral vascular disorders including stroke, dehydration; congestive cardiac failure.
  • The changes in functioning of body systems in old age are described and reasons for the changes are given.
  • The relevant current legislation pertaining to the rights and care of the elderly is identified and explained.
    > Range of legislation includes but is not limited to that pertaining to: Older persons, domestic violence, promotion of equity and prevention of unfair discrimination, social service grants.
  • Supportive aids and equipment for the frail/elderly client are identified and the use of each type is explained and demonstrated.
    > Range of aids includes but is not limited to those used for supporting: eating, walking, mobility, elimination, sleeping, hearing, seeing and breathing.
  • The risks associated with each type of aid are described and the prevention and/or control of each potential risk is explained.

    6.2: Care in Mental Health
  • The role of the careworker in a mental health facility is described in terms of maintaining a therapeutic environment.
  • The effects of mental illness on clients are described with regard to the activities of daily living
  • Care interventions aimed at promoting the optimal use of the physical and cognitive skills of the client are described.
    > Range of care includes but is not limited to: Coping with behavioural problems of the disabled patient, memory problems, emotion and mood swings, aggressive behaviour, inappropriate sexual behaviour, sexuality of the disabled child/adult, attention deficit - hyperactivity disorder, the child with learning disabilities, depression, speech defects, principles of group work, purpose of therapeutic programmes, health promotion.
  • Clients to are assisted to access services in accordance with their health related human rights.
    > Range of services includes but is not limited to: disability pensions, old age pensions, compensation for occupational diseases and injury, road accident fund.

    6.3: Physical Rehabilitation
  • Independence in activities of daily living is encouraged in clients within a physical rehabilitation setting.
  • The effective positioning and seating of clients to ensure applicable full functioning for activities of daily living is described.
    > Range for full functioning includes, but is not limited to: positioning for feeding, maintaining airway, avoiding hypotension, pressure relief.
  • Mobilization and transfers of clients are managed to ensure safe ambulation, safe transfer to different surfaces and successful negotiation of obstacles.
  • The limitations caused by sensorimotor deficits are described in terms of activities of daily living.
    > Range of areas affected includes but is not limited to: balance, tone, sensation, muscle strength.
  • The usage of assistive devices and splints is described and their care is demonstrated.

    6.4: Infants and children
  • The types and common causes of illnesses and conditions that lead to impairment and disability in babies and children are described.
    > Range of illnesses includes but is not limited to: Measles, mumps, rubella, pneumonia, whooping cough, diphtheria, meningitis, chickenpox, tuberculosis.
    > Range of conditions includes but is not limited to: Spina biffida, cerebral palsy, intellectual disabilities, sensory deficits such as blindness, deafness, AIDS-related illnesses, attention deficit and learning disability, autism, conditions related to nutritional dysfunction.
  • The normal developmental milestones of infants and children from birth to three years are described.
  • Babies and children are assisted to participate in the activities of daily living according to individual developmental level.
    > Range of activities of daily living include, but is not limited to: feeding, bathing, playing, mobility, positioning, rest and sleep.
  • The ethical and legal issues related to children and childcare are described.
    > Range includes but is not limited to: Rights of children, childcare and childcare grants, sources of referral for various conditions/illnesses, legislation referring to children.
  • The precautions to be taken in the care of infants and children to prevent the occurrence of medico-legal incidents are described and demonstrated where applicable.

    6.5 Palliative Care
  • The concept of life-threatening diseases including HIV and AIDS is described.
  • Palliative care principles are applied when assisting and supporting the client and significant others to manage a life threatening disease.
    > Range of issues to be addressed includes but is not limited to: common symptoms experienced by dying patients, diversity, cultural sensitivity related to death and dying, activities of daily living for the dying patient.
  • Support and care are provided to the client and significant others at the scene of death.
    > Range of issues to be addressed includes but is not limited to; Psychological responses of both the dying patient and significant others such as anger, guilt, denial, acceptance, transference, collusion, conspiracy of silence, response to loss, hope, care of the deceased, legislative requirements.
  • Ethical principles and current relevant legislation are applied at all times when dealing with dying patients an their significant others.

    6.6: Acute Care
  • The most common signs and symptoms for common acute conditions/illnesses usually encountered in acute care hospitals are described.
    > Range of conditions/illnesses includes but is not limited to: Cardiac, respiratory, endocrine, renal, neurological, gastro-intestinal, reproductive, sensory, muscular-skeletal and immune diseases.
  • Equipment required in the acute care facility is demonstrated and the need for usage is explained.
  • Equipment used in the acute care facility is checked, cleaned and stored according to manufacturer specifications and/or standard operating procedures.
  • The members of the multi-disciplinary care team are assisted as required according to own scope of practice within the unit organisation.
    > Range of unit functions includes, but is not limited to: welcoming patients and significant others, orientation of patients and significant others to ward layout and use of bell call and functioning of bed, generating a therapeutic environment, admission and discharge processes and daily ward routine.

    Integrated Assessment:

    Assessment and evaluation during the programme takes place through a process of continuous evaluation, based on a comprehensive and integrated approach. The criteria for assessing learners are based on the required learning outcomes and the strategies used to ensure that all the outcomes are achieved.

    Formative assessment may be given by means of:
  • Case presentations.
  • Clinical simulations.
  • Peri-operative care plans.
  • Workbooks.
  • Tests.
  • Oral presentations by individuals and project teams.
  • Clinical evaluations.

    Summative assessment may be made by means of:
  • Written and oral examinations.
  • Clinical examination. 
    		•

    INTERNATIONAL COMPARABILITY 
    In countries where the training of the required numbers professional healthcare personnel has not kept pace with the growing need for staffing the various types of health care facilities, the more basic tasks and procedures have devolved to sub-professional workers. This has led to the need for the development of recognised courses and qualifications to enable these semi-professionals to provide the best possible support that they can. This qualification is one such product.

    New Zealand has a Certificate in Health care Assistance: This qualification has been a response to the growing healthcare industry and the worldwide scarce skills. The Healthcare Assistant works in a clinical setting and is able to provide professional and effective support in specific controlled clinical environments under the supervision of a registered nurse.

    Areas of practice include:
  • Caregiver (rest home or community based).
  • Home Support worker in the community.
  • Teacher Aide (special physical needs).
  • Community Worker.
  • Childcare Assistant.
  • Physiotherapy Assistant.

    Canada has a Certificate in Healthcare Assistance in which candidates are trained to provide daily personal care for elderly clients with chronic health problems. Many Health Care Assistants find employment in residential care facilities. Others find employment in home support, providing care in the individual's house rather than in an institutional setting. A small number of Health Care Assistants are employed in acute care areas in hospitals.

    The United Kingdom has clinical support workers (sometimes known as healthcare assistants) who provide vital assistance to healthcare professionals in diagnosing, treating and caring for patients. They are involved in looking after the general well-being and comfort of patients. Clinical support staff work in a variety of settings, depending upon their role, including working in:
  • A specific hospital department (e.g. therapy, cardiac or radiotherapy department).
  • A community clinic or health centre.
  • Patients' homes.
  • Care homes.
  • A hospital labour or maternity ward.
  • A community delivery suite.
  • A laboratory.
  • A hospital neonatal or postnatal unit or clinic.
  • A GP clinic.

    Clinical support workers (sometimes known as healthcare assistants) provide vital assistance to healthcare professionals in diagnosing, treating and caring for patients. In some cases, they are involved in looking after the general well-being and comfort of patients. These are all responsible and rewarding roles with a direct impact on patients' lives. They also offer an ideal entry route to many National Health Service careers for people with commitment and enthusiasm rather than academic qualifications.

    Compulsory regulation through registration is required. Clinical support staff work in a variety of settings, depending upon their role, including working in:
  • A specific hospital department (e.g. therapy, cardiac or radiotherapy department).
  • A community clinic or health centre.
  • Patients' homes.
  • Care homes.
  • A hospital labour or maternity ward.
  • A community delivery suite.
  • A laboratory.
  • A hospital neonatal or postnatal unit or clinic.
  • A GP clinic.

    The United States of America has a Certificate for a Nursing Assistant. The Nursing Assistant is an important member of the health care team who often holds a high level of experience and ability, but without qualification is unable to perform some tasks due to issues of liability and legality. Attempts to regulate, control and verify education have been made in some places, and the result is the North American Certified Nursing Assistant (CNA), a credential gained by registering completion of the statuary level of workplace experience and academic achievement with a central body. This central certification allows an employer to verify experience and knowledge as well as to assist in preventing individuals who have been "struck off" (had registration/certification invalidated) from continuing to work in healthcare roles.

    Conclusion:

    This qualification compares well with the qualifications discussed above and should prove to be of great benefit to both private and public hospitals in South Africa as well as in most of the other sub-Saharan countries. 
    		•

    ARTICULATION OPTIONS 
    This qualification provides horizontal articulation to NQF level 4 qualifications in related health and development fields, such as:
  • ID 64697: Further Educational and Training Certificate: Community Health Work, NQF Level 4.
  • ID 50019: Further Educational and Training Certificate: Auxiliary Nursing, NQF Level 4.

    This qualification provides vertical articulation to:
  • ID 59236: National Diploma in Nursing, NQF Level 6. 
    		•

    MODERATION OPTIONS 
  • Anyone assessing a learner or moderating the assessment of a learner against this qualification must be registered as an assessor with a relevant Education, Training, and Quality Assurance (ETQA) Body or with an ETQA that has a Memorandum of Understanding with the relevant ETQA and be in possession of a relevant qualification at least at NQF Level 8. Current registration with the relevant statutory health council is also required.
  • Any institution offering learning that will enable the achievement of this Qualification must be accredited as a provider with the relevant ETQA.
  • Moderation of assessment will be overseen by the relevant ETQA or by an ETQA that has a Memorandum of Understanding with the relevant ETQA, according to the ETQA's policies and guidelines for assessment and moderation.

    Note: During the course of study for this qualification, the learner is must be enabled to become competent in First Aid up to NQF Level 3. 
    		•

    REREGISTRATION HISTORY 
    As per the SAQA Board decision/s at that time, this qualification was Reregistered in 2012; 2015. 

    NOTES 
    N/A 

    LEARNING PROGRAMMES RECORDED AGAINST THIS QUALIFICATION: 
     
    NONE 


    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.
     
    NONE 


    All qualifications and part qualifications registered on the National Qualifications Framework are public property. Thus the only payment that can be made for them is for service and reproduction. It is illegal to sell this material for profit. If the material is reproduced or quoted, the South African Qualifications Authority (SAQA) should be acknowledged as the source.