Employer's Guide to Caregiver Hiring

Employers typically turn to caregiver certifications as a screening criterion when looking for a qualified live-in caregiver.

With so many different types of caregiver training and certification programmes out there, it can be overwhelming and confusing for you. In this article, we share with you the difference between a 'trained' caregiver and a 'certified' caregiver, the common types of caregiver qualifications and what you should look out for.

Trained or certified?

While the terms ‘trained’ and ‘certified’ is commonly used interchangeably, it is helpful to understand the distinction between the two:

What is caregiver training?

Training someone to become a caregiver typically includes the following essential topics:

• Assisting in personal hygiene, toileting, mobility, feeding
• Administering medications
• Monitoring vital signs
• Infection control
• Communicating with care recipients

The following is a list of essential topics covered under the ABCs of Caregiving Course. It is an approved course for the Caregivers Training Grant administered by the AIC. You can use it as a list of essential training topics when reviewing a caregiver's training background.

What are the common types of caregiver qualifications?

Generally, qualifications of a caregiver are obtained from 2 categories of training programmes:

Short courses in Singapore

A caregiver may have received training while working in Singapore on a foreign domestic worker work permit. There are 3 types of training common in Singapore:

1. Training on a caregiver’s rest days
2. Training by local training providers under schemes by the Agency for Integrated Care (AIC)
3. Training by a facility’s staff before a patient’s discharge

Training on a caregiver’s rest days

There are many short caregiver courses that a foreign domestic worker can choose to attend on her rest days.

Typically, these courses are held once every two weeks – e.g. 1st and 3rd Sunday of a month. Most of these courses can be completed in 5 – 12 sessions (3 to 6 months). The total number of training hours ranges from 20 hours to 72 hours. Each session can range from 2 – 6 hours long.

A certificate is typically issued at the end of the course. There may or may not be an assessment at the end of the course. Some training may also include an optional 1 or 2 sessions on-the-job training with a nursing home.

Training by local training providers under schemes by the AIC

There are two schemes under the AIC that are aimed at training caregivers – Caregivers Training Grant and Eldercarer Scheme. These trainings are usually arranged by employers to train their foreign domestic workers in caregiving for a loved one.

Caregivers Training Grant approved training courses

Employers can utilise the Caregivers Training Grant (CTG) to cover part of the caregiver training costs for their foreign domestic workers. These courses must be approved for the CTG-scheme. The trainers are licensed healthcare professionals in Singapore such as registered nurse or physiotherapist. Such courses are organised by private local training providers as well as local healthcare facilities.

Home-based CTG-approved courses are delivered a single session of tailored one-to-one training, ranging from 2 to 4 hours long. The care recipient typically participates in the training as demonstration and return demonstration may be carried out.

Class-based CTG approved courses are delivered in a classroom setting and the duration is about 7 hours.  

A certificate of participation is issued at the end of the course.

Eldercarer Foreign Domestic Worker (FDW) Scheme

The Eldercarer scheme provides a foreign domestic worker with 2 days of classroom caregiver training before joining an employer and a 3-hour on-the-job training after she has joined the employer. A certificate of attendance is issued upon completion of the whole training programme. The training is conducted by one of these organisations – Ang Mo Kio Thye Hua Kuan, Centre for Seniors and Peacehaven Nursing Home.  

Training by a facility’s staff before a patient’s discharge

Prior to a patient’s discharge, the facility, typically an acute care hospital or a community hospital, would usually provide some caregiver training to ensure that the patient’s caregiver has the required skills and knowledge to care for the patient at home. This is part of the procedure to hand over a patient’s care to the family.

It can range from a few days to a few weeks and, typically, depends on how fast a caregiver is able to demonstrate her ability to take over the patient’s caregiving. It is usually an informal 1-to-1 training given by a staff, like a nurse or physiotherapist. Due to the informal nature of such training, the caregiver may or may not receive a certificate of attendance at the end of training.

Short courses in the Philippines

There are 3 common types of short courses that you may see in potential caregivers applying from the Philippines:

1. Caregiving NC II
2. Health Care Services NC II
3. Caretaker course

Caregiving NC II (National Certificate)

This is a 6-month comprehensive, structured caregiver course typically comprised of 750 hours of learning coupled with 240 hours of on-the-job training in a hospital or health care institution. A caregiver attains the National Certificate, or ‘NC II’, issued by TESDA <link to below>, a government agency, through the accumulation of Certificates of Competency (COC) or demonstration of competence through project-type assessment for all required units of qualification. Caregivers who undergo this training programme and attained the NC II are competent to work in home environment as a caregiver of elderly or person with special needs.

Health Care Service NC II (National Certificate)

This is a comprehensive, structured course typically comprised of 996 hours of training with on-the-job attachments. Attainment of this National Certificate, or ‘NC II”, is done through the demonstration of competence through project-type assessment for all required units of qualification. Graduates of this course are competent to work in facility settings as a nursing attendant, nursing aide, hospital assistant or health aide.

Caretaker course

This is a short caregiver course that does not lead to the attainment of a National Certificate, unlike the two above courses. It is typically 100 – 150 hours and varies widely by the training provider as there is no standardised curriculum.

Short course in Indonesia - Caretaker Certificate

There is a formal certification scheme for ‘caretakers’ for workers who are looking to work in domestic settings as a caregiver. It is a competence-based training curriculum with over 20 units of caretaker competencies.

Participants typically have to attend approximately 400 hours of training which includes both theory and practical.

The caregiver is then required to undergo an assessment and certification by a licensed Professional Certification Institute before being allowed to work overseas.

Formal Nursing Programmes

These are formal professional programmes, namely diploma or degree, that would take between 2- 5 years to complete. There is usually an accompanying transcript which lists all the modules undertaken by a caregiver.

Diploma in Practical or Vocational Nursing

You may come across such qualifications in potential caregivers from the Philippines. It is typically a 2-year programme. A practical nurse is focused on assisting a patient in the activities of daily living, monitoring vital signs and reporting status of patients to a registered nurse. They have the opportunity to take the national licensure exam to become a licensed practical nurse in the Philippines.

Diploma or Bachelor of Science in Nursing

These are comprehensive nursing programmes typically between 3 – 5 years. Graduates have the option of taking the nurse licensure exam to become a registered nurse in their home countries.

In the context of Indonesia, you would look for D3 level (three-year post-high school diploma) or S1 level (three to five-year post-high school, university degree in nursing).

In the context of the Philippines, it is typically a Bachelor of Science in Nursing (BSN).

What should you look out for in a caregiver’s qualification?

Given that there are so many different types of caregiver training available, how then should you evaluate whether the training meets your requirements? Here are the 5 key areas that you should look at

1. Breadth of the training
2. Duration of the training
3. On-the-job training
4. Certificate of participation or competence
5. Assessment by an official certification body

Breadth of training

One of the first thing that you should look at is the curriculum of training. While you would expect formal nursing programmes to have rigorous curriculum that meet established standards, the same cannot be applied to short courses where a wide variation exists. Find out what topics are covered in the training that a caregiver has attended.

This information may be available on the certificate itself or sometimes a transcript may be available. If both are not available, then ask the caregiver directly if she can provide any documents or share with you what topics were covered. Minimally, her training should cover the essential topics that we have stated earlier.

Duration of training

Other than looking at the breadth of training which covers the ‘what’ she has been trained in, you should also look at depth of training which covers ‘how much’ she was trained in. Duration of training can provide us with some insight to how rigorous a training is. Given that there is a huge variation between the training hours, from a 20-hour training in Singapore to over 900 hours of training for Caregiving NC II under TESDA, this is an important factor for employers to look at and distinguish the amount of training a potential caregiver has received.

On-The-Job training (OJT)

Caregiving is a hands-on job which is why having real-world, practical experience is preferred. For example, transferring a real patient from a bed to wheelchair is different from doing it in a simulated environment. During a transfer, some patients may feel pain, some may have muscle stiffness due to their conditions which adds to the difficulty of transferring or some may refuse to cooperate.

For newly-trained caregivers, it is helpful for them to gain some practical hands-on experience through on-the-job (OJT) trainings. For Caregiving NC II, the caregivers typically undergo 240 hours of OJT. Some programmes in Singapore include a 4-hour OJT at a local nursing home. In the local setting, caregivers can also choose to volunteer in nursing homes on their rest days.

You may ask – how much OJT would be enough for a caregiver? A caregiver who has done substantial amount of OJT would have a better grasp of what caregiving is like compared to someone with 0 to a few hours of OJT. She would likely to have more realistic expectations of what caregiving entails and be better in adjusting to the actual caregiving work when she is hired.

Certificate of Participation or Certificate of Competence

At the end of training, caregivers would usually receive a certificate from the training provider. You should check if the certificate issued is for participation or for competence. A certificate of competence is given when a caregiver has undergone certain form of assessment and demonstrated competence in the area assessed. A certificate of participation is given upon completion of a training programme without any assessment done. Hence, certificate of participation does not provide employers with any indication on a caregiver’s competence.

As employers, you would prefer to hire a caregiver who has passed some form of competency assessment and demonstrated competence in caregiving over a caregiver who has been trained but yet to be evaluated. To put it simply, a certificate of competence is thus preferred over a certificate of participation.

Official certification bodies

If a competency assessment has been done, then you should also look at who the assessor was and what were the standards a caregiver was assessed against.

In the Philippines, the official certification body for Caregiving NC II and Health Care Service NC II is Technical Education and Skills Development Authority (TESDA), a government agency tasked with managing and supervising technical education and skills development in the Philippines. The Caregiving NC II and Health Care Service NC II are structured, modular programmes and requires demonstration of competency assessed by TESDA before a certification is issued.

In Indonesia, under the Caretaker Certification scheme, ‘Skema Sertifikasi’, the caregivers are required to take a competency test as specified in the Indonesian National Work Competency Standards, ‘Standar Kompetensi Kerja Nasional Indonesia (SKKNI)’. This test is conducted by an independent, licensed Professional Certification Institution, ‘Lembaga Sertifikasi Profesi (LSP)’, before a certificate is issued and allowed to work overseas. The LSP must have obtained license from the National Professional Certification Board, ‘Badan Nasional Sertifikasi Profesi (BNSP)’.    

In Singapore, if an assessment is performed at the end of a training, it is typically done by the training provider itself.

With a myriad of short courses that a caregiver can choose to take, as employers, you can always rely on looking at 5 key areas that we have shared earlier to evaluate a caregiver’s training qualifications. Other than looking at qualifications, you can also utilise interview to find out more on her knowledge and skills.

READ: 74 Interview Questions to Help You Hire the Right Caregiver

READ: How to Choose the Right Live-in Caregiver for Your Elderly Parent