Illustration: a personal support worker and a nurse look at a plan of care beside a smiling client, a red maple outside.

PSW scope of practice in Ontario: what you may do, and where the line sits

Insights · Clinical skills · October 9, 2026 · 6 min read

An Ontario PSW is an unregulated care provider, so no single law lists a PSW scope of practice. The limits come from the employer's job description and policies, the client's plan of care and Ontario law, and they change with the setting.

Status: A PSW in Ontario is an unregulated care provider who reports to a supervisor or registered staff
What sets the limits: The employer's job description and policies, the client's plan of care and applicable law
Controlled acts: Listed in section 27 of the Regulated Health Professions Act. A PSW does one only under delegation or the routine activities of living exception in section 29(1)(e)
Medication in long-term care: Only a physician, dentist, registered nurse or registered practical nurse administers drugs, except a topical that registered nursing staff permit a trained PSW to apply under supervision (O. Reg. 246/22, section 140)
Registration: Voluntary, with the Health and Supportive Care Providers Oversight Authority

What the scope of practice is for an Ontario PSW

A personal support worker in Ontario is an unregulated care provider. There is no regulatory college for PSWs and no single statute that lists what a PSW may do. In practice, the scope of a PSW is the space left by four things: the employer's job description, the employer's policies, the client's plan of care and applicable law.

Inside that space a PSW gives personal care and support, observes, reports and records. A PSW reports to a supervisor or to registered staff. A PSW does not diagnose, and does not adjust, start or stop a medication in any setting.

The four things that set your limits

The job description. It says what your employer has hired you to do. A task that is not in it is not yours, even if you have done it somewhere else.
Employer policy. Policies tell you how a task is done in this workplace, and who must be told. You are expected to find them and follow them.
The plan of care. It says what this client needs, and how. Ontario uses the term "plan of care", and it directs almost everything a PSW does with a client.
Applicable law. Some limits are written into Ontario law, and no employer or family member can waive them.

Your own competence is a fifth test. If you have not been trained in a task, you ask for guidance before you attempt it.

Controlled acts and delegation

Ontario's Regulated Health Professions Act lists controlled acts in section 27. These are procedures that only authorized people may perform. Administering a substance by injection or inhalation is one of them.

A PSW has no authority of their own to perform a controlled act. The law leaves two routes by which one can reach a PSW.

Delegation. A regulated health professional who is authorized to perform the act delegates it. The PSW then carries it out under that professional's direction, for that client.
The routine activities of living exception. Section 29(1)(e) of the Act allows such an act when it is done while assisting a person with their routine activities of living.

Neither route is a decision the PSW makes alone. The plan of care and the employer's policy must support the task. A client or family member asking you to do it is not delegation. If you are unsure whether a task is a controlled act, ask your supervisor or registered staff before you go further.

Medication: the rule depends on the setting

Medication is where the setting changes the answer most.

Long-term care homes

In a long-term care home, section 140 of Ontario Regulation 246/22 controls who gives drugs. Only a physician, a dentist, a registered nurse or a registered practical nurse administers them. There is one exception. Registered nursing staff may permit a trained staff member, such as a PSW, to apply a topical under their supervision.

So a PSW in long-term care never gives a resident an oral, injected or inhaled drug.

Retirement homes and the community

In a retirement home or a client's own home, a PSW assists with medication as the plan of care directs. The standard describes assistance with oral, rectal, ear, eye, nose, topical, inhalation and subcutaneous medication. That assistance follows the plan of care and applicable law. Any delegated act is done under a regulated health professional's direction.

Assisting is different from deciding. In every setting you observe how the client responds, then report and record it as instructed. You take any question about a medication to your supervisor or registered staff. You do not change a dose, skip one on your own judgment or give one early.

Observe, measure, report and record

A PSW takes and records pulse, blood pressure, respirations, oxygen saturation and temperature. A PSW measures height and weight as the plan of care directs. Each result is compared with the client's usual baseline and reported to the right person.

The limit is on what you do with the finding. You describe what you saw, heard and measured. You do not name the condition. "Mrs. Chen is short of breath and her lips look bluish" is a PSW's report. Deciding what is causing it belongs to regulated staff.

Scope is not only about tasks. Three legal duties also shape what a PSW does.

Reporting abuse. In long-term care, section 28 of the Fixing Long-Term Care Act, 2021 applies to anyone. A person with reasonable grounds to suspect abuse or neglect of a resident must report it immediately to the Director. In a retirement home the report goes to the Registrar under section 75 of the Retirement Homes Act, 2010.
Consent. When a client cannot decide for themselves, the Health Care Consent Act sets a ranked list of substitute decision-makers in section 20. A PSW does not choose which relative decides. The Public Guardian and Trustee decides if nobody on the list qualifies.
Privacy. The Personal Health Information Protection Act governs personal health information. A PSW employed by a health information custodian acts as its agent. You use a client's information only as needed for your duties.

How to tell a task is outside your role

Before you act on an unfamiliar request, run through a short check.

Is the task in my job description and allowed by employer policy?
Does this client's plan of care direct it?
Have I been trained to do it safely?
If it is a controlled act, has it been delegated to me for this client?

If any answer is no, you do not do the task. You explain kindly, you keep the client safe and comfortable, and you report to your supervisor or registered staff.

A worked example

Daniel is a PSW with a home care agency. He visits Mrs. Okafor each morning to help her wash and dress. Her plan of care says he reminds her to take the tablets from her dosette and records that she took them.

One morning her son is visiting. He asks Daniel to give his mother her insulin injection, because the visiting nurse is running late.

Daniel does not give the injection. Giving a substance by injection is a controlled act. It is not in Mrs. Okafor's plan of care, and no regulated health professional has delegated it to him.

Daniel explains this politely. He stays with Mrs. Okafor, notes how she looks and feels, and calls his supervisor at once to report the delay. He records what was asked, what he observed and whom he told.

How scope shows up in practice questions

Scope questions tend to follow one pattern. Somebody asks the PSW to do a little more than the plan of care allows. One option does the task to be helpful. One option refuses and walks away. The strongest option stays within the plan of care, keeps the client safe and reports to the supervisor or registered staff.

Check the setting before you answer. A medication question set in a long-term care home has a different right answer from the same question set in a client's home. You can practise the pattern with the free Ontario PSW practice questions. The duty to report is covered in more depth in the Residents' Bill of Rights for Ontario PSWs.

Common questions

Is a PSW regulated in Ontario?

An Ontario PSW is an unregulated care provider. Registration with the Health and Supportive Care Providers Oversight Authority is voluntary, and it is not a regulatory college.

Can a PSW give medication in an Ontario long-term care home?

An Ontario PSW in a long-term care home does not give oral, injected or inhaled drugs. Registered nursing staff may permit a trained PSW to apply a topical under their supervision, under section 140 of O. Reg. 246/22.

Can an Ontario PSW perform a controlled act?

An Ontario PSW may perform a controlled act only when a regulated health professional has delegated it, or under the routine activities of living exception in section 29(1)(e) of the Regulated Health Professions Act.

Can a PSW in Ontario take vital signs?

An Ontario PSW takes and records pulse, blood pressure, respirations, oxygen saturation and temperature, compares them with the client's baseline and reports them. A PSW does not diagnose.

What should an Ontario PSW do when asked to do a task outside the plan of care?

An Ontario PSW who is asked to do a task outside the plan of care does not do it, keeps the client safe and reports to the supervisor or registered staff.

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