Care Certificate Standards Explained for Nursing Assistant Learners

Standard 1 covers your responsibilities in your specific role, how your role fits within your organisation, and the importance of working within the boundaries your employer sets. It includes understanding your employment rights, the aims and values of your service, and when and how to escalate concerns. This standard also covers your duty of candour, which is the responsibility to be open and honest with individuals and their families when something goes wrong, whether or not harm occurred.

Agreed ways of working is a key term here. It refers to your employer's policies, procedures, and expected practices, including those that are informal. You need to show you work in line with these, access them when needed, and know when to raise concerns through your organisation's procedures.

Nursing assistant example: Before performing a delegated clinical task, a nursing assistant checks their employer's agreed ways of working to confirm the task is within their role and that they have received the training required to carry it out safely.

Standard 2 focuses on your responsibility for your own learning and growth. It covers agreeing a personal development plan with your manager, identifying learning needs, reflecting on practice, and using feedback to improve. The 2025 update added digital skills explicitly alongside literacy, numeracy, and communication as functional areas you need to develop.

You need to demonstrate that you understand what continuing professional development (CPD) means and why it matters throughout your career, beyond induction.

Nursing assistant example: During a supervision session, a nursing assistant identifies that she is not confident using the ward's electronic patient record system. She and her supervisor agree a development plan to address this gap with targeted support.

Standard 3 covers two related but distinct duties. Your duty of care means you must aim to provide high-quality care to the best of your ability and tell someone if there are reasons you cannot do so. Your duty of candour means being open and honest when things go wrong.

This standard also covers handling complaints and comments correctly, recognising and reporting adverse events, incidents, errors, and near misses, and managing confrontation or difficult situations using communication to reduce risk.

Nursing assistant example: A nursing assistant notices she accidentally skipped a step in a pressure care routine. She reports this to her line manager as a near miss, documents it according to her organisation's incident reporting procedure, and participates in the learning review.

Standard 4 requires you to understand equality, including the nine protected characteristics under the Equality Act 2010, diversity, inclusion, and human rights. You need to recognise how discrimination happens, challenge it appropriately, and demonstrate culturally sensitive care in practice.

This standard expects you to identify the legislation and codes of practice relevant to your role and show that your interactions actively promote fair treatment for every individual you support.

Nursing assistant example: A nursing assistant works with a patient whose cultural background includes specific food preferences and religious practices. She checks the patient's care plan, communicates with the catering team, and adapts her approach to ensure the patient's cultural needs are met with respect.

Standard 5 covers putting the individual at the centre of everything you do. Person-centred values include individuality, independence, privacy, partnership, choice, dignity, respect, and rights. You need to understand how these apply in daily care and demonstrate them through your actions.

This standard also covers mental capacity. Under the Mental Capacity Act 2005, you must assume that a person has capacity to make decisions unless there is evidence they do not. You need to understand what capacity means, what consent requires, and what best interest decisions, advance statements, and advance decisions involve.

Nursing assistant example: A nursing assistant assists a patient who wants to wash independently despite mobility difficulties. Following the care plan and respecting the patient's preference for independence, she stays nearby to offer support if needed rather than taking over the task.

Standard 6 covers all forms of communication: verbal (tone, volume, clarity), non-verbal (body language, eye contact, positioning, touch), written, and digital. The 2025 update strengthened the focus on digital communication tools and assistive technologies, which now form an explicit part of this standard.

You need to show you adapt your communication style to meet the needs, wishes, and preferences of each individual, understand barriers to communication and how to reduce them, and maintain confidentiality in line with your organisation's policies.

Nursing assistant example: A nursing assistant works with a patient who has a speech impairment following a stroke. She uses a communication board provided by the speech and language therapy team, checks she has understood the patient correctly, and records the communication method used in the care plan.

Standard 7 covers maintaining the privacy and dignity of every person you care for. This includes practical actions such as knocking before entering a room, ensuring curtains and screens are in the correct position during personal care, using appropriate volume when discussing someone's care, and never disclosing information an individual would wish to keep private.

This standard also covers supporting individuals to make informed choices, understanding active participation, and ensuring your own personal views do not influence their decisions.

Nursing assistant example: A nursing assistant prepares to assist a patient with a bed bath on a four-bed ward. She draws the curtains fully, checks with the patient that she is ready to proceed, positions clothing appropriately throughout, and lowers her voice when asking about the patient's personal preferences.

Standard 8 covers supporting individuals to eat and drink safely in line with their care plan. You need to understand the importance of good nutrition and hydration, recognise signs of poor intake such as dark urine, confusion, dry mouth, weight loss, or fatigue, and know how to report concerns.

Food safety and hygiene form part of this standard, as does supporting individuals with restricted movement to access fluids and food as independently as possible.

Nursing assistant example: A nursing assistant notices that a patient on the ward has not finished their meals for two days and has reduced fluid intake. She records this accurately on the fluid balance chart and reports her concern to the nurse in charge at the end of her shift.

An important update first: as of March 2025, Standard 9 no longer covers learning disability. That content moved entirely to the new Standard 16. Any resource that still names this standard as covering learning disability is using the old framework.

Standard 9 now covers mental health conditions and dementia only. At minimum, you need to understand psychosis, depression, and anxiety as common mental health conditions, and understand what dementia means including its key types and causes. You need to recognise early signs of deterioration, understand why these conditions affect care needs differently, and know how to support individuals and families to access other services.

The standard also covers relevant legislation and policies and how they affect day-to-day care for people with mental health needs or dementia.

Nursing assistant example: A nursing assistant notices that a resident with dementia who is usually calm has become increasingly agitated and is not recognising familiar staff. She documents the change in behaviour, reports it to the registered nurse, and adjusts her communication approach, using slower speech, gentle eye contact, and familiar routines to reduce distress.

Standard 10 covers your responsibilities in protecting adults at risk from harm and abuse. Under the Care Act 2014, an adult at risk is a person aged 18 or over who has care and support needs and who is unable to protect themselves from abuse or neglect because of those needs.

Types of abuse covered include physical, domestic violence, sexual, psychological, financial, modern slavery, discriminatory, organisational, neglect, and self-neglect. This standard also covers restrictive practices, which are defined as interventions that restrict an individual's movement, liberty, or freedom to act independently. You need to understand your organisation's policies on restrictive practices and your role in implementing them safely.

Standard 10 also addresses risks associated with technology use and how to support individuals to stay safe online without being risk-averse.

Nursing assistant example: A nursing assistant notices unexplained bruising on a patient during personal care. She does not question the patient directly or discuss it with colleagues on the ward. She follows her organisation's safeguarding procedure, reports her observation to the nurse in charge, and documents it accurately.

Standard 11 addresses protecting children from abuse and neglect. This standard applies differently depending on whether you work in a health setting or a social care setting, and this distinction is not explained anywhere else online.

If you work in health

You must meet the most up-to-date national minimum training standards for safeguarding children at the level appropriate to your workplace, as set out in the intercollegiate guidance issued by the Royal College of Nursing. The level required depends on your role and the setting. A nursing assistant on a paediatric ward has a higher level of responsibility than one in an adult acute ward, but all health workers in CQC-regulated services have safeguarding children obligations.

If you work in social care

You must be able to explain what you must do if you suspect a child or young person you meet in any circumstances is being abused or neglected.

Nursing assistant example: A nursing assistant working in an NHS community setting attends training to confirm she meets the minimum intercollegiate safeguarding children standards appropriate to her role. She checks with her manager which level of training applies to her specific duties.

Standard 12 requires you to complete practical basic life support training that meets UK Resuscitation Council guidelines. Online learning alone does not satisfy this standard. The training must be practical and hands-on.

The type of BLS training depends on the patients you work with:

• Adult BLS applies to nursing assistants working with adults in health and social care settings.
• Paediatric BLS applies to those working with children in health settings.
• Newborn life support applies to those working with newborn patients in health settings.

You need to complete the correct training for your specific patient group and setting.

Nursing assistant example: A nursing assistant working on an adult medical ward completes annual adult BLS refresher training in the workplace with a trained facilitator. She practises correct compression depth and rate on a manikin and has her competence assessed and signed off by her assessor.

Standard 13 is one of the most comprehensive in the framework. It has nine distinct sub-outcomes, and infection control is not one of them. Infection control belongs in Standard 15. This is one of the most common errors in online content about the Care Certificate.

The nine areas Standard 13 covers are:

• Your health and safety responsibilities at work, your employer's responsibilities, and those of others in your setting
• Risk assessment, including why it matters and how and when to report risks you identify
• Moving and assisting safely, maintaining individual dignity. In health settings this is called moving and assisting. In social care it is called moving and positioning. The glossary distinguishes the two.
• Responding to accidents and sudden illness, including the types of accidents that occur and what you are and are not authorised to do in response
• Medication and healthcare tasks, including the agreed ways of working for medication, and which tasks you are not authorised to carry out until you are assessed as competent
• Hazardous substances, including how to identify them and demonstrate safe practices for storing, using, and disposing of them
• Fire safety, including preventing fires and what to do if a fire occurs
• Work security, including measures to protect your own security and the security of those you support
• Managing your mental health and personal wellbeing (sub-outcome 13.9, strengthened in the 2025 update), including recognising factors that affect your own wellbeing and knowing how to access support

Nursing assistant example: A nursing assistant identifies a spill of cleaning fluid in a patient's room. She puts up the hazard sign immediately, reports the spill to facilities following her organisation's agreed ways of working, and documents the incident on the reporting system.

Standard 14 covers how you access, record, store, and share information about individuals. You need to understand the legislation and agreed ways of working that govern information handling, including UK GDPR, and why secure systems matter.

The 2025 update added explicit guidance on data breach reporting. You need to know how and to whom to report if agreed ways of working or legislation have not been followed, or if there has been a data breach or risk to data security.

Keeping records that are up to date, complete, accurate, and legible is a core requirement of this standard.

Nursing assistant example: A nursing assistant finishes updating a patient's electronic care record. She saves the entry, logs out of the system, and does not leave the screen open. Later she realises a colleague accessed the record without authorisation. She reports this to her manager as a potential data security concern.

Standard 15 was significantly expanded in the March 2025 update. It now covers the full chain of infection across six links: the infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, and susceptible host. Understanding this chain helps you identify where to break transmission in your specific care setting.

The expanded standard now explicitly covers:

• Standard IPC precautions and your role in following them
• Effective hand hygiene, including demonstrating the correct technique using appropriate products
• How your own health, hygiene, and vaccination status affect infection risk
• Correct donning (putting on) and doffing (taking off) of PPE appropriate to the care activity
• Appropriate methods for cleaning and decontamination of the care environment and equipment
• Safe handling of blood and bodily fluid spills
• Safe handling and disposal of infected or soiled linen, equipment, and clinical waste

Nursing assistant example: A nursing assistant is about to provide personal care for a patient in a contact isolation room. She follows the correct PPE donning sequence: apron first, then mask if required, then gloves last. On leaving the room, she doffs in the correct order, disposing of each item safely before washing her hands.

Standard 16 is the new standard added in March 2025. It is not simply an awareness module. It carries a statutory training requirement for every nursing assistant working in a CQC-registered service.

Under Section 181 of the Health and Care Act 2022, all staff in CQC-registered services must receive training on how to interact appropriately with people with a learning disability and autistic people, at a level appropriate to their role. This applies to nursing assistants on general wards, in care homes, and in community settings. It is not limited to those working in specialist services.

The Oliver McGowan Code of Practice came into force on 6 September 2025. It sets the minimum standards for how this training must be delivered, including requirements for co-production and co-delivery with people with lived experience, and how training must be quality assured.

Standard 16 and the Oliver McGowan Mandatory Training are not the same thing:

• Standard 16 in the Care Certificate is the induction-level baseline. It confirms that a nursing assistant has foundational awareness of learning disability and autism as part of their overall induction.
• The Oliver McGowan Mandatory Training is a separate, more comprehensive programme with two tiers. It is the government's preferred route for providers to meet the legal requirement under the Health and Care Act 2022. Tier 1 is for all staff. Tier 2 is for those who provide direct care to people with a learning disability or autistic people.

Completing Standard 16 during induction is the starting point. Your employer then needs to ensure you complete the level of Oliver McGowan training appropriate to your role.

Nursing assistant example: A nursing assistant completes Standard 16 as part of her induction, building foundational awareness of how learning disability and autism affect communication and care needs. Her employer then enrols her in Oliver McGowan Tier 1 training to meet the organisation's statutory obligations under the Health and Care Act 2022.