I worked as a band 2 HCA years ago when the pay was considerably more than minimum wage.
My role included:
Sole charge of upto 5 patients with MH issues for upto 12 hours overnight (supported by a nurse (band 5) I could call by phone who was on the other side of a locked door). In the day I would have a 2nd HCA.
Supporting patients with significant distress, hallucinations, and delusions.
Documenting presentation/ risk. Monitoring for any signs of changes to physical or mental health.
Taking patients on escorted community leave, including previously convicted murderers and sex offenders.
Responding to alarms and physically restraining patients. Including men significantly larger and stronger than me.
Responding to alarms where people had attempted suicide or were significantly self harming. Deescalating these situations. Sitting with and calming patients. Cleaning up blood / sharps after incidents.
Searching patients / rooms and belongings for dangerous objects / drugs.
I was injured and assaulted a number of times and verbally abused regularly.
There wasn't really a route for progression. We had a couple of people who had a band 3 role but they'd been there forever and unless they left there was no opportunity no matter how many courses you attended or skills you gained.
There is no way I would do that job for what band 2 is paid now.
Although, I'm not sure if the answer needs to be a combination of increased pay in general + some rebanding of roles to acknowledge the amount of work they actually do and the level of responsibility.