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Accountability means being legally answerable for your work and conduct. It is fundamental to the protection of people in the care of healthcare assistants (HCAs).
HCAs must understand where and to whom they are accountable, and work competently and with integrity within the boundaries of the law.
Three legal areas - criminal, negligence and employment - are used to hold staff to account. If it is shown that an HCA's actions did not amount to proper care, this could lead to prosecution. A support worker was jailed recently for assault after he stood on a patient's foot and then tore her skin by holding her arm too tightly.
Failure to act with integrity can also result in prosecution. In one case, a community support worker was jailed after a jury decided that accepting gifts of money from a vulnerable patient amounted to theft.
HCAs are accountable to individual patients to whom they owe a duty of care or a legal obligation to avoid causing harm through carelessness. The law of negligence allows a patient to sue for compensation if they have been harmed by the acts or omissions of a HCA. A patient was awarded £30,000 in damages after HCAs failed to carry out the instructions of a tissue viability nurse and the patient developed a pressure ulcer on each hip.
Employers are also able to hold staff accountable through contract and employment law. They can take disciplinary action against staff who fail to follow reasonable instructions and the policies of their employer. In England, that includes meeting the Care Quality Commission's 16 essential standards for quality and safety.
Imposing accountability on HCAs is necessary to protect the public, discourage staff from misconduct or unlawful behaviour, and regulate their actions by making clear the expected standard of conduct and competence.
Richard Griffi th is lecturer in law at Swansea University