Care workers need better training and regulation, independent review says Cavendish said: 'Many of us will rely on care assistants at some point in our lives, in particular in old age, and we need them to be as good as they can possibly be.' Photograph: Montgomery Martin/Alamy Healthcare assistants and care support workers - who wash, dress and feed the elderly and the infirm - will have to obtain a "certificate of fundamental care" to work in the health and social care system, an independent review recommends. The review, carried out in the wake of the Francis inquiry into the scandal at the Mid Staffordshire NHS foundation trust, recommends a new training regime for healthcare assistants, who work in hospitals, and social care support workers, who are employed in care homes and people's own homes. Camilla Cavendish, a former management consultant turned Sunday Times columnist, argues in the review that healthcare assistants and support workers are essentially an unregulated workforce numbering hundreds of thousands and need new training standards. This recommendation, first made by Robert Francis QC in his lengthy report into NHS regulation, is the first step towards regulating the sector. The report says the quality of training and support that care workers receive in the NHS and social care system varies between organisations. Cavendish also calls for staff who fall short of the required standards to be taken to task. There has been a spate of reports suggesting that patient neglect is more common than previously assumed. The report says that "legal processes for challenging poor performance should be reviewed so that employers can be more effective in identifying and removing any unsatisfactory staff." Cavendish said: "Many of us will rely on care assistants at some point in our lives, in particular in old age, and we need them to be as good as they can possibly be - especially as some support workers are carrying out procedures which used to be done by nurses, even doctors. I have seen many examples of excellent and skilled care, but I have been struck by how disconnected the systems are. The airline industry figured out 30 years ago that the most junior staff could be a critical link in the passenger safety chain. Patient safety in the NHS and social care depends on recognising the contribution of support workers, valuing and training them as part of a team. But the Royal College of Nursing said: "Without mandatory regulation ... there is a danger that those staff who are found to be unsuitable could move from one employer to another unchecked. The priority must now be to underpin the recommendations made by the review in the regulatory structure which governs care. Welcoming the review, the health secretary, Jeremy Hunt, said: "We are determined to build a compassionate health and social care system - one where people are always treated as individuals, with kindness and respect."