Development of a Competence Profile and Performance Assessment for Care Assistants from a Labor Pool at a Nursing Home

This article presents the development of a competence-based professional profile and the subsequent performance assessment, which were built on behaviors that represent the competences in a sample of care assistants working in a nursing home. Nine employees who knew the tasks performed by care assistants were asked to select and rank the competences in order of significance, considering their importance for performing the job efficiently. Based on the weights obtained, the selected competences are transformed into behaviors and, finally, into a five-point Likert scale used to assess the sample of care assistants (a total de 16 employees) and classify them using overall and specific scores on each of the competences.


Introduction
Social sciences such as labor psychology and human resources have taken on greater importance in businesses in recent decades.The increase in the number of young people with a higher education (university degrees, master's degrees, doctorates, etc.), the mastery of languages and, in general, the highly qualified nature of the new generations of employees have made it necessary to create new systems of selection, evaluation and promotion for staff members, among others.These systems are intended to give the company the human capital that would enable it to reach the levels of efficacy and efficiency necessary in a labor market that is more competitive than ever and in a situation such as the present economic crisis (Fernández Millán & Fernández Navas, 2013).
With all of this in mind, this study is presented with the aim of showing current practices in the business sector in the area of competence profile development and performance assessment, specifically for care assistant positions in a nursing home.

Theoretical framework
As occurs with other terms in the social sciences, the concept of competence (professional or labor) has received numerous definitions, in particular, since McClelland (1973) expanded the focus based on competences, depending in part on the field in which it is used (Fernández-Salinero, 2006).Along these lines, Boyatzis (1982), based on the studies by Flanagan (1954), defined competences "as a set of observable behaviors that are causally related to the good or excellent performance in a specific job and a specific organization."Later, other authors have defined the term; one example of this is by Woodruffe (1993), who defines competences as "sets of behavioral patterns that the person must bring to a position in order to perform his or her tasks and functions efficiently." Moreover, performance has also been defined by different authors, starting with Murphy who defined it as "the set of behaviors that are relevant for the goals of the organization or organizational unit in which the person works" (Murphy, 1990, p. 162).Starting from this base, other authors created the foundation for the concept as "any cognitive, psychomotor, motor or interpersonal behavior under the individual's control that is scalable in terms of ability and relevant to the organizational goals" (Campbell, Gasser & Oswald, 1996;McCloy, Campbell & Cudeck, 1994).The concept of performance assessment is currently understood as the system through which the necessary information is obtained on how a worker behaves in a specific organization and position; its objective is to determine whether these behaviors are optimal.
The development of these terms and their applications in the labor field has led to management by competences gradually replacing other human resource models (Pereda, Berrocal & Sanz, 2003), and numerous applications created for the development of competence profiles, such as those by Bozu and Canto Herrera (2009) for university faculty and professional teaching competences, in which they attempted to determine which professional competences university instructors must have in order to meet the needs that the knowledge society demands of today's universities, and for performance assessment, where we can highlight the work by Díaz Cabrera, Hernández Fernaud, Isla Díaz, Delgado Rodríguez, Díaz Vilela and Rosales Sánchez (2014) on the development of mixed standard scales as a tool to measure employee performance or research to improve the accuracy and success of their application (López Martínez, Montaño Moreno & Ballester Brage, 2014).

The first nine competences explain a high percentage of performance (95.26%)
For some authors, such as Cubeiro and Fernández (1998), the use of competence development and management programs increases the results in some positions by between 30% and 72%.
The very people affected by the job position being studied are the ones who participate in the development of the professional profile, indicating on a previously provided competence questionnaire the competences that any person who holds the job position needs to have to perform his or her functions in an optimal manner.Only once the professional profile is obtained upon the analysis of the previously delivered questionnaires can the chosen performance assessment method be developed (mixed standard scales, Likert scales, etc.), since it is based on the competence profile that has been obtained.
However, not all the changes that occurred in personnel management were a product of the creation of new management systems.The variables that modify the creation of job positions, their number and the competences required for them are usually based on society's needs at a particular time.In the case of care assistants, the demographic changes arising over the last century have been what has determined their increasing demand.The population pyramid in Spain has evolved towards an inverted trend (Carabaña, 2003), which means that it has gone from being supported by a large number of young people (the product of high natality and mortality rates) to a large increase in the adult-elderly population (resulting from a reduction of both mortality and natality).
As a result of everything set out above, the present work describes the process followed to create the job competence profile and the subsequent assessment of the performance among the workers in the labor pool at a nursing home, as well as the results obtained.The intent is to offer a practical and objective tool for application in any area of human resource organization and management.The actions are also presented that have been taken to involve the interested parties, and to ensure impartial selection.In this case, the care assistants, who are the staff members whose function is to assist the nursing home users in the performance of daily activities that they cannot do for themselves and to perform those tasks aimed at the personal care of the able-bodied or assisted residents and their surroundings (personal hygiene of the user, cleaning and maintenance of the resident's room and utensils, making beds, picking up clothes and taking them to the laundry, collaboration in room maintenance, help feeding those users who cannot feed themselves, changes in posture, communicating incidents that occur in the health of users, cleaning and preparation of furniture, materials and first aid devices, and accompanying the user on outings, walks, errands, excursions, games and during their free time in general).

Participants
Participating in different ways and at different times during the process were the company director, the human resources manager, the trade union representatives (4), the company psychologist, the housekeeper (in charge of supervising the daily work of the assistants), the doctor, the registered nurses (2), the permanent care assistants (20), members of the personnel and hiring department (2) and the evaluated assistants (16).
To determine the score for each candidate on the behavior questionnaire, each was randomly assigned 3 evaluators

Procedure
The evaluation was carried out at the request of the organization's management and with the consent and collaboration of the human resources department.
The steps that were established by recommendation of the technician (psychologist) were the following: 1. Meeting with the trade union leaders and the company's human resources managers to explain the procedure, obtain their acceptance and involve all parties in the selection of the evaluators.2. Development of the professional profile based on competences and the respective behaviors that define them.3. Development of the evaluation questionnaire.4. Determining the extent to which each evaluee exhibits the defining competences (evaluation of the level of each competence presented by each assistant). 5. Informative session for the evaluated employees.

Meeting with trade union leaders and the company's human resources managers
The process began by calling a meeting with the trade union leaders and the company's human resources managers to explain the procedure to follow, obtain their acceptance and involve all parties in the selection of the evaluators.

Development of the professional profile based on competences and the respective behaviors that define them
Since there was no previous professional profile of the competences for the evaluated position, the first step was to develop said profile.To do this, it was agreed which professionals would choose the competences that would best describe the nursing assistant job position.The questionnaire on competences (list of competences with their definitions previously created ad hoc at the company for other occasions) was distributed among the evaluators (3 care assistants with a permanent contract, 2 registered nurses, the housekeeper and the doctor) and they were asked to choose 5 competences and rank them in order of importance (see Appendix 1).Following the method for selecting the competences according to relevance (percent of evaluators who choose the competence out of the total number of participating evaluators) and importance (sum of all the scores for each competence over the total of the evaluators) by Pereda, Berrocal and Sanz (2003), the weights and the order of each competence were obtained (see Table 1).The weight of each competence consists of calculating the product between the relevance and the importance of each competences and dividing it by the sum of these products for the set of all the competences as a whole (R × I) / Σ c 1-26 (R × I).
At this point, it is the job of the technician to decide the number of competences chosen to evaluate the employee.In terms of their cumulative weight, the competences must explain at least 90%, but for practical reasons, they must be as few as possible to prevent a large number of items (behaviors) from being required for evaluation.The first 9 competences explain a high percentage of performance (95.26%).In spite of being a large number of competences, the decision was made to include all 9, reducing the number of behaviors they reflected to 2 (which resulted in a total of 18 behaviors for the profile).

Development of the evaluation questionnaire
Once the competences were determined that make up the professional profile of the job position being studied, Human Resources (the psychologist) selected and adapted the behaviors that would reflect these competences (based on interviews with the registered nurses, whom we asked to describe behaviors that would depict the competences in their daily work) and would conform the items for the Likert scale that would be presented to evaluate the competences (see Appendix 2).As can be seen, the response scale used to evaluate each behavior consisted of 5 points, where "Never" was worth 0 and "Always" was equal to 4 (Never = 0; Sometimes = 1; Often = 2; Almost always = 3; Always = 4).
Although there are other systems to develop questionnaires that make them more accurate and credible, such as mixed standard scales (Díaz Cabrera et al., 2014), we opted for a more traditional Likert scale system, since it is simpler to respond to and requires less time.To determine the score for each candidate on the behavior questionnaire, each evaluee was randomly assigned 3 evaluators.The evaluators were selected at random from among the housekeeper, nurses (2), permanent care assistants (20) and the doctor.It is important to remember that the persons being evaluated are employees who are performing the work associated with the position at the time of evaluation and that all the potential evaluators have direct, ongoing contact with these employees and observe their performance on a daily basis.

Competences
The scores obtained were used to create a list with different statistical measures (total average score and the standard deviation for each candidate, overall mean and standard deviation, and statistics to determine Chebychev's rule) that were used as an evaluation criterion.
Once the scores were obtained that the evaluators (3 per evaluee) gave on the 18 items for each evaluee (in this case, 16 of them), the totals were calculated, along with the averages for each evaluee and the standard deviation (see

Table 2
Direct scores on the competences, mean and standard deviation of the evaluated care assistants The overall mean and total standard deviation were obtained from all the total scores (see Table 3).The first decisionmaking criterion that was adopted is intended to rule out candidates that have large differences in the evaluations In addition to the random assignment of evaluators, two other measures were agreed to ensure impartiality: the candidates never knew who was going to evaluate them and the statistical processing was done by students in the 3rd year of the Labor Relations and Human Resources degree program at the College of Social Sciences on the Melilla Campus (supervised by their professor), who did not know the name of the evaluee, which had been replaced by the label "Candidate No. …," with the correspondence of the identities remaining inside a sealed envelope.
Informative session for the evaluated employees Finally, once the decisions were made about the evaluated staff and made known to the trade union representatives, the evaluees were gathered and informed about the criteria (evaluated behaviors) used and the results.Besides sharing the results with those affected, this served to give the rest of the staff information about what competences were expected of them in order to effectively develop them.
Those candidates who earned the highest scores were also congratulated in writing.

Results
The scores on which the decision-making was based in this evaluation were the total mean score of each candidate (X i ) and his or her standard deviation (SD i ).The overall mean score was obtained from the total score of all three evaluators (the same method was used to obtain the standard deviations).The decision-making was based on the statistical criteria established by Chebychev's rules (see Table 4) and agreed on with management and the company's trade union representatives.

Scores-criteria obtained according to Chebychev's rules
The first decision-making criterion that was adopted is intended to rule out candidates who have large differences in the evaluations, indicating "disagreement" among the evaluators, since this would indicate that they did not minimally coincide about their performance.
Statistically speaking, there are procedures and formulas to determine the reliability or agreement among judges.Along these lines, the intraclass correlation coefficient (ICC), Pi or Kappa coefficient (for reliability) or the concordance correlation coefficient can be used to determine the equivalence of the values.
However, the processes are complex and, for the purpose of these studies, basing the agreement or homogeneity among the judges' responses on a cut-off point based on an index (the standard deviation) that is objective, but "agreed upon" in a subjective manner (two times the value of the SD), seemed more suitable when reaching agreements with the social forces in the business environment.
To do this, the cut-off point was set as those standard deviations (SD i ) that were above 2 times the total standard deviation (SD t ; standard deviation of all the total scores), since according to The second criterion is intended to indicate those candidates who, as indicated by their low scores, would not reach certain minimum levels in terms of their competences in order to perform efficient work Chebychev's rule, 75% of the data of any series have a value that is less than two times the standard deviation (SD t ) from the mean (X t ).In this case, the cut-off point was a SD i greater than 27.38, and no candidate presented a SD greater than this value; for this reason none was eliminated (see Table 4).
The second criterion is intended to indicate those candidates who, as indicated by their low scores, would not reach certain minimum levels in terms of their competences in order to perform efficient work.Chebychev's rule was used once again to obtain the cut-off point.In this case, it was established that those candidates who had obtained a score (X i ) of less than X t -2 SD t (= 34.48) met this criterion.Table 2 shows that candidate 8 had a X i (20.33) lower than the aforementioned cut-off point.
Finally, the third criterion seeks to establish the closest match between the competence profile and the position being evaluated.Consulting the means and the standard deviations obtained for each candidate, it is observed that none of them exceeds Chebychev's rule for this criterion (X > X t +2 SD t (89.23); therefore, we are limited to ranking the candidates according to their scores and selecting those with the best average.
With all the statistical data obtained, a normal curve is calculated on which the different candidates are "positioned" (see Table 5), which will be used as easy-to-understand teaching material for later explanations given to the social forces and company representatives, as well as the employees themselves.In addition to the performance evaluation and based on the data obtained in a general manner for each competence (mean of the scores in a range of 0 to 8, four maximum points per item), the level of acquisition of the different competences by the labor pool employees was studied.Table 6 shows an example of how the total scores were obtained to determine the level of acquisition of each competence in the group of evaluees, which will aid us in determining what training contents the company must focus on.The data obtained (see Table 7) show that "Communication" is one of the most commonly shared competences among the employees, which translates into a good exchange of information at shift change.Even so, it should be noted that over these months, the notes in the incident report book were sporadically reviewed and a style was observed that is not very specific, and in some cases that is rather offensive and exaggerated."Responsibility" is another competence that is fairly well developed among the assistants.
On the negative end (even through the means are not low) is the level attained in terms of "Energy" (the level and the intensity of work do not remain constant) and "Planning" (the work day is not structured).This latter deficit may be due to the management and organization of the work (its unpredictability and supervision can have an influence, making planning difficult).
Finally, the third criterion seeks to establish the closest match between the competence profile and the position being evaluated Between these two extremes (even though there is not a large difference between the means) are, in decreasing order of average scores, "Team work," implying that the candidate performs the assigned task within the work group; "Technical knowledge," which translates into knowing the risks and occupational hazard prevention measures that are appropriate for his or her job; "Empathy," which involves understanding and attending to the feelings of the elderly; "Collaboration," or providing information and assistance to one's colleagues; and "Resistance to stress," meaning that the candidate keeps calm and maintains a logical order in urgent or problematic situations.

Conclusions
The intent of the present study has been to offer the application of a human resource management tool based on the competence model.The application of the professional profiles and competence evaluations enables us to have greater objectivity and impartiality in personnel management, which favors the perception of fairness on the part of the company (Martínez-Tur, Moliner, Ramos, Luque & Gracia, 2014) by the employees, since they can see objective criteria on which decisions are based.
One obstacle that must be overcome before implementing this type of actions is the perception that exists even today regarding performance assessments, which are seen by employees and trade union representatives as something negative and harmful, jeopardizing the security of the job position.It is necessary to obtain the support of the staff within the company, since otherwise, even if the most efficient technique is applied, its effectiveness and feasibility will be limited (Farr & Jacobs, 2006;Keeping & Levy, 2000).Furthermore, the development of these techniques permits important positive repercussions in employee motivation, thanks to the feedback provided to them by performance evaluations.For all of these reasons, management by competences should be a tool implemented by the various organizations, due to all the positive effects that come from its application.Of course this also entails economic benefits that the organization obtains with its use, such as in the case of an The development of this professional profile and subsequent evaluation was the first system and criterion used for the company for personnel management based on competences.Until then, criteria such as seniority or training had been used to grant promotions.The proposed evaluation system (in which the employees' coworkers and supervisors participate, and which is based on observable behaviors) improves the attitude towards evaluation and decisionmaking, and as mentioned earlier, provides a perception of fairness in the workplace in terms of the process by using objective criteria.
With regard to the use of a statistical indicator (Chebychev's rule) as a criterion for decisionmaking in personnel management, on the one hand, it enables us to increase the objectivity of these decisions, and on the other hand, to vary the cut-off points (considering one or two standard deviations) in order to adapt it to our goals, as long as this is agreed upon with the company and the trade unions.
Even through the evaluation was conducted with the goal of selecting the care assistant from the labor pool with the best developed competences in order to sign a permanent contract with him or her (promotions policy and staff motivation), the appearance of an employee whose score fell below X t -2 SD t , i.e., in the 2.1% of the residual population with the lowest scores on the normal curve, prompted that this evaluation was also used as decision-making criterion not to rehire the employee in question.
At the end of the process, we considered that the relevance of the scores for the competences on the evaluation should reflect the weight they had in the profile, since each competence has a different level of importance in terms of effective job performance.Therefore, for example, the score on the "Team work" competence (with a weight of 26.74) for a subject who would have earned 16 points, after being weighted, would become 427.84(16 × 26.74), while this same score, after being weighted, would only represent 62.4 (16 × 3.90).Consequently, in subsequent evaluations conducted, the total score earned in each competence was weighted, multiplying it by the weight of that competence; this seems to be a wise approach and an improvement over the process described in this work.

Table 1 Competences organized in order of weight after the statistical processing of the questionnaires
Determining how closely each evaluee exhibits the defining competences (evaluation of the level of each competence presented by each assistant) Table 2).

Table 6 Example of the calculation of the level (over 8) of acquisition of the competences in the group of evaluees Scores obtained on the items and the sum of the scores in order to obtain the scores on the competences Mean of the competence scores
Item 13.When starting his or her shift, speaks with coworkers to receive information and instructions or consults the incident book and upon leaving his or her shift, waits for coworkers to give them information and instructions and records anything he or she deems important in the incident book.

Table 7 Mean score (over 8) for each competence, obtained from the mean of all the evaluees
who does not comply with the functions and demands of his or her job position, with the savings that this would bring about. employee