Providers may have concerns or complaints about the conduct of unregulated personal care assistants (PCA) or assistants in nursing (AIN). Traditionally, the only avenues available to providers have been disciplinary action and termination. However, there are limitations to such an approach they are usually site - specific and confidential proceedings which can lead to a PCA or AIN being employed at an alternative provider.
Concerns about unregulated health service providers/carers have sparked the emergence of codes of conduct to protect the community from persons that engage in harmful, exploitive conduct, or operate unethically.
These codes are significant in that they capture those who are not within the ambit of the Australian Health Practitioners' Regulation Agency (AHPRA) including health practitioners whose registration has been suspended or cancelled and who seek to practise in an area where they do seek to practice in an area where they do not need registration. These codes set out the minimum practice and ethical standards that unregulated health providers/carers are required to comply with.
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Key aspects of codes relevant to PCAs and AINs are that they must:
they must not practise:
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These codes inform consumers' expectations of practitioners and the mechanism by which they may complain about the conduct of, or services provided by, an unregulated PCA or AIN.
Codes also enable the relevant state complaints agency to issue prohibition orders where the agency believes the person poses an unacceptable risk to the health or safety of members of the public. An order may prohibit a person from providing health services for a specified period of time or permanently. It is an offence for a person to continue to provide a health service in breach of a prohibition order.
NSW
A Code of Conduct was introduced in August 2008 and has been applied to PCAs and AINs. The NSW Nursing and Midwifery Tribunal has held that 'whilst there is the position that there is currently no formal system of registration or enrolment [for PCAs or AINs], they certainly provide services within the nursing domain...and it is the view of the Tribunal that this includes the work performed by an AIN and even the work performed under job description such as personal carer.'
South Australia
Introduced a similar code of conduct on 12 March 2013. The Health and Community Services Complaints Act (2004) defines health service as including a service provided in association with the use of premises for the care, treatment or accommodation of persons who are aged, have a physical disability or mental dysfunction. The code extends to PCAs and AINs when they are providing care or treatment in residential care context.
Queensland
The Health Ombudsman Act 2013 commenced on 17 February enabling the Ombudsman to investigate compliants about unregualted health providers (including health services provided in a resisdential, community or home care setting).
Victoria
Whilst no code operations in Victoria presently, it is possible that the pending reviews of the Health Services Compliants scheme2 and the operations of AHPRA3, maybe influenced by the trend in other states of adopting codes to protect the community from unregistered health providers, including PCAs and AINs.
Regardless of the existence of codes it is imperative that providers carry out all the necessary pre-employment checks, address any concerns about a PCA or AIN;s conduct immediately, and comply with the mandatory reporting of abuse requirements under the Aged Care Act 1997. Complaining to a relevant complaints agency offers an additional avenue for providers to explore.
Footnotes
1HCCC v Munivimi [2008] NSW N&MT and HCCC v Abad No2 [2009] NSW N&MT.
2http://www.health.vic.gov.au/hscrareview/
3http://www.parliament.vic.gov.au/legal-and-social-issues-legislation-committee/inquiries/article/1959
