Page Section: Centre Content Column
Disability service provider’s management of a relationship between a caregiver and client (11HDC01045)
Download Disability service provider’s management of a relationship between a caregiver and client (11HDC01045) (PDF 62Kb)
(11HDC01045, 26 June
Health care assistant ~ Caregiver ~ Hospital ~ Home care ~
Health and Disability Services Standard 8134:2008 ~ Professional
boundaries ~ Supervision and training ~ Rights 4(2), 4(4)
This case relates to the standard of disability services
provided to a 58-year-old man who had tetraplegia. In 2006, he was
admitted to a hospital providing residential care because he was
experiencing complications of his tetraplegia. The hospital is
operated by a trust (the Trust).
The following year the man moved back home, as his condition had
improved. A health care assistant from the hospital became the
man's caregiver in his home and moved into his house with her two
daughters. She remained employed by the Trust.
Until 2008, nurses visited the man once a week to care for a
wound (pressure sore). In addition, during 2007, another caregiver
from the hospital visited either monthly or fortnightly and,
following that caregiver's retirement in 2009, an enrolled nurse
visited the man occasionally.
Prior to March 2010 there was no care plan for the man nor did
the hospital have any policy about maintaining professional
boundaries. The caregiver took no leave, had no respite from
caring, and worked "24/7" constantly, even if she was sick.
Although payment for annual leave was added to her wages, no
arrangements were made to enable her to take leave.
The man and the caregiver developed personal feelings for one
another and commenced a relationship in 2009. By March 2010, staff
at the hospital knew about the relationship. In 2011, the man died.
After his death his sister complained about the care the caregiver
had provided and alleged that the man had been coerced and
It was held that there was no evidence that the caregiver failed
to provide adequate disability services to the man or that she
exploited or coerced him. While in many cases it would be ethically
inappropriate for such a relationship to exist between a consumer
and paid caregiver, in the circumstances of this case, it was found
that the caregiver did not breach the Code.
The Trust failed to supervise the caregiver adequately, failed
to provide her with sufficient orientation and training, and did
not discuss ethical issues and professional responsibilities with
her when it became aware of her relationship with the man. The
Trust took insufficient steps to minimise the risk of harm to the
man and, accordingly, breached Right 4(4).
The Health and Disability Services Standard 8134:2008 requires
that providers ensure that consumers are not at risk of abuse
and/or neglect. Services must have policies and procedures to
ensure that consumers are not subjected to exploitation, and
services must identify, document and communicate potential risks.
The Trust did not comply with those standards because it did not
have such policies and procedures, and it failed to identify and
document the potential risks to the man and communicate these to
him and the caregiver. The Trust failed to comply with professional
standards, and so breached Right 4(2) of the Code.