The HCA in aged residential care has a role of huge complexity. Working with a heavy and large client load, they assume the role of the RN far too often and are expected to assist other staff, as well as families. The clients commonly have multiple health issues, requiring not only a wide range of skills but also knowledge to support these skills. The HCA’s are no longer the person who feeds, baths and walks with an older person. They are the person providing intricate and complex cares to very vulnerable people. The HCA is also vulnerable, responding to employer demand and expectations (sometimes exploitation and abuse), being guided by a job description (if they have one), by purpose statements of qualifications and more importantly by their own values and conscience. They have no regulatory governance, no protection, no defined role and we are continuing to allow this. The Healthcare Assistant can only gain protection from regulation. Regulation is not likely to happen as long as they have the title of assistant as this means they have supervision from a person such as a Registered Nurse and yet we are all aware that this is not always the case. Regulation will also not happen unless a professional body such as Nursing Council assumes the role and functions of a regulatory body for this sector of our healthcare workers. Regulation will not happen whilst some employers continue to advocate against protection of this workforce. Regulation is the only true form of protection however until this happens I strongly suggest that we ensure that all healthcare assistants sign up to a Code of Rights, understand this Code and have a body to go to if it is violated.
Dr C Clark
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