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Practice standards set out requirements for specific aspects of LPN practice. They link with other BCCNM standards, policies and bylaws and all legislation relevant to LPN practice.

What is a health care assistant?

Health Care As​sistants (HCAs)1 are caregivers who provide personal care assistance and services in a variety of health care settings such as acute care, assisted living, residential care, and home and community care. In some practice settings, LPNs may be responsible for assessing clients and assigning client care, or parts of client care, to HCAs.

In British Columbia (BC), HCAs have no legally defined scope of practice and are not members of a regulated health profession. While some HCAs are registered with the BC Care Aide and ​Community Health Worker Registry and have a core compe​tency profile, all HCAs have a job description and are accountable to their employers for the satisfactory performance of assigned care. 

Employers provide the organizational supports and systems necessary for LPNs to meet BCCNM Standards of Practice.


  1. LPNs are responsible for assessing clients, making a nursing diagnosis, planning care and assigning care appropriately to HCAs.
  2. LPNs are responsible for knowing the HCA’s role description in their practice setting.
  3. LPNs only assign care to HCAs when the care is:


    within the LPN scope of practice,


    within the LPN’s individual competence,


    permitted within employer policy,


    within the HCA core competency profile,


    within the HCA’s role description and training, AND


    set out in a client’s care plan.

  4. Before assigning care to an HCA, the LPN assesses the client’s needs, makes a nursing diagnosis, determines the activity is within the HCA’s job description and identifies any potential risks.
  5. LPNs may provide training and ongoing support and guidance to HCAs if it is an employer expectation set out in the LPN’s job description.
  6. After an LPN assigns care to an HCA, the LPN continues to be responsible for assessing the outcomes of the care and for updating the overall plan of care.

Applying the principles to practice

When making a decision about assigning client care to an HCA, you:

  • Review employer processes for LPNs assigning care to HCAs
  • Evaluate the client’s health status and the client’s ability to direct his or her own care
  • Make a nursing diagnosis and develop the plan of care
  • Review the client’s plan of care and identify activities that could be assigned to the HCA
  • Consider both the intended and unintended outcomes associated with the care
  • Review the HCA’s role description
  • Clarify your responsibility and accountability as the LPN
  • Work with the HCA to clarify his or her level of responsibility and accountability
  • Evaluate client outcomes and revise the plan of care as needed
  • Provide ongoing support, guidance and feedback

If you are a manager or supervisor, your job description may also include the responsibility to teach HCAs and provide feedback on their performance.

For more information

Email BCCNM’s Regulatory Practice Consultant or call 604.742.6200 x8803 (Metro Vancouver) Toll-free 1.866.880.7101 x8803 (within Canada only).

BCCNM Bylaws

BCCNM Practice Standards

BCCNM Professional Standards

BCCNM Scope of Practice Standards

Other resources



HCAs may also be referred to as resident care aides, home support workers, community health workers or assisted living workers.

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​Toll-free 1.866.880.7101 (within Canada only) ​

We acknowledge the rights and title of the First Nations on whose collective unceded territories encompass the land base colonially known as British Columbia. We give specific thanks to the hən̓q̓əmin̓əm̓ speaking peoples the xʷməθkʷəy̓əm (Musqueam) and sel̓íl̓witulh (Tsleil-Waututh) Nations and the Sḵwx̱wú7mesh-ulh Sníchim speaking Peoples the Sḵwx̱wú7mesh Úxwumixw (Squamish Nation), on whose unceded territories BCCNM’s office is located. We also give thanks for the medicines of these territories and recognize that laws, governance, and health systems tied to these lands and waters have existed here for over 9000 years.

We also acknowledge the unique and distinct rights, including rights to health and wellness, of First Nations, Métis, and Inuit peoples from elsewhere in Canada who now live in British Columbia. As leaders in the settler health system, we acknowledge our responsibilities to these rights under international, national, and provincial law.​