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
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.
Key aspects of codes relevant to PCAs and AINs are
Proved health services in a safe and ethical manner
Ensure they do not put clients at risk, if diagnosed with an
infectious medical condition
Adopt standard precautions for infection control.
they must not practise:
Under the influence of alcohol or drugs
With certain physical or mental conditions
Improper personal or sexual relationships with clients
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.
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.'
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.
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).
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
1HCCC v Munivimi  NSW N&MT and
HCCC v Abad No2  NSW N&MT.
What happens if a patient, particularly a mental health patient,.
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