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Nurses and Babysitters
16 October 2017

A Personal Assistant’s role can change depending on who they are working with and the tasks they have been asked to do, however, PAs should also be aware of and adhere to the following principles:

Person-centred Support


The PA needs to listen to what the Client wants them to do and how they want it done. Their relationship should be primarily professional and the PA needs to:

- ensure that they do what is asked of them by their employer, providing that it is safe and legal to both parties

- not do what they think should be required by others

- not do what they, as a PA, think is best

This means the PA puts their employer at the centre of all decision-making.


What could I be called upon to do?

The employer may need PAs to provide a range of services to support them in:

- Personal Care

- Specialist Care

- Practical Care

- Social Care


The employer has a responsibility to their PA to ensure they have the skills and expertise required to do the tasks they are asking their PA to provide.

The PA has a responsibility to ensure that all legislation that applies to their activities is followed, whilst delivering services to employers, and to undertake to only deliver services that they are qualified, experienced and sufficiently competent to carry out.


When recruiting, the Employer should be clear what tasks will be part of the PAs role.

Here is an outline of some of the major tasks which an employer may need support with:



Tasks can include bathing and dressing, intimate care, hair, foot, nail care and maintaining hygiene. Personal Assistants should not carry out health care tasks (such as peg feeding) which are provided by the Primary Care Trust, or its successor organisation, unless they have had training first from a healthcare professional. These tasks should be discussed with a District Nurse.


In all aspects of Personal Care PAs should always consider:

- what the employer wants and likes

- whether it involves any equipment

- what sort of products the person likes and whether they need anything. specific, for example, to protect their skin


The PA should also remember that their employer:

- will have a way in which they want things to be done

- has a right to have their dignity maintained

- will always be the expert in their own care


The PA needs to:

- be sensitive to their employer’s needs

- listen carefully to them to ensure that they do what is asked; not what they as the PA think should be done


PAs should:

- always wash their hands thoroughly before and after each task if helping someone with intimate tasks

- ensure that they do not cross-infect, for example if they are helping dress a wound

- wear gloves when appropriate


Going to the Lavatory / Managing Incontinence

This is very intrusive support. Thought should be given as to what degree of support the employer needs and the most appropriate way to carry it out. If the employer has issues with continence they will need to explain what support they want and coach their PA in providing this. In some authorities, district nurses provide additional training if the employer feels it is needed.



Mobility awareness

A PA may work with an employer who has mobility issues and will need to listen to their employer’s exact needs.


Someone who has mobility issues may:

- use furniture to support them around their house

- have a walking frame or walking stick

- use a scooter


It is the PA’s job to work in a way that supports their employer best. It is important that the PA is guided by their employer about their mobility, not rushing them or choosing for them.


Sight and Hearing Awareness

People who are sight-impaired often have highly developed other senses. A PA needs to work with the person in a way which is empowering, being a guide to the person, not taking control. If the employer has an assistance dog to help them this may be all the support they need. The key to working with people with any impairment is to let them take the lead and to be there to ensure that there is support available if needed and to help them to stay safe.


If someone is hearing impaired, it would be useful for a PA to know or learn about different methods of communicating such as:

- a hearing aid or loop system

- lip reading and sign language

- adaptations such as flashing door bells, vibrating alarms and speaker/headphone systems for the television

- a text phone which may help to talk to people via the telephone system

- mobile phone texting

- the internet and email

- What they can do to make their communication clearly understood



If involved in helping with medication, a PA should normally do what their employer asks. However a PA does not have to do something illegal or agree with something harmful to their employer.

An example is contradicting the GP’s recommendation on the bottle or packet.


If concerned, the PA should:

- tell their employer that their health may be at risk by doing what they have requested

- say that either the employer or they, the PA, should seek further medical advice.





Cooking and preparing food can be an important part of a PAs job. This includes:

- Finding out if their employer wants to cook and what support they want.

- Asking the person what they like to eat and how they like their food prepared.

- Supporting their employer to do as much as they can for themselves.


Knowing how to cook may be an essential part of the PA role. If a PA does not know how to cook certain foods they can ask their Employer for help.


Food Hygiene

Hygiene is important when preparing food and a PA needs to use common sense and remember the skills learnt in their training.



A PA may be asked to assist their employer with shopping. This could involve:

- Physically helping someone to get to and around the shops.

- Facilitating ordering by supporting the person with on-line or telephone shopping.


The employer is the person who needs the shopping so the PA should always ensure the employer decides:

- where they go to shop

- when they shop

- what they buy



A PA may be asked to carry out housework, including:

- vacuuming

- dusting

- cleaning windows

- changing curtains

- laundry


It is important for the employer and PA to agree which tasks may be required regularly and which may need to be done in emergencies or infrequently.


An employer should never ask the PA to do something that could put them at risk, for example, a task which could put them in danger of a fall. If a PA feels worried about doing a certain task they should discuss the issue openly with the Employer so that a mutually satisfactory solution can

be found.


Child Care

In some situations a PA may be required to help their employer with childcare tasks.

This should be agreed before employment starts.

If you are asked to work with children, your employer needs to ensure that you have undertaken all appropriate training, including that of the Safeguarding Children (Generalist Course).

For further information about training, please contact SMBC Learning and Development Team.


Childcare tasks can include:

- escorting the child to and from school

- supporting the child with personal care tasks

- entertaining and taking out on trips

- baby sitting


If supporting a disabled child, there may be different skills needed for some tasks e.g. being able to work with children with specialist health, medical or communication needs. These should be made explicit by the employer and/or professionals before the PA starts work.


Pet Care

Some employers have pets that may require:

- Feeding

- Walking

- Being cared for.


It is best that when recruiting, an employer states that pet care will be part of the PAs role, as this allows the PA to:

- decide if they are comfortable working with an animal in the house

- choose whether they are happy to carry out this task, as not everyone likes caring for animals


Light Gardening

An employer may ask a PA to do gardening. The PA must feel comfortable doing this and be fit enough to undertake it, without causing problems. It is important for the employer to expect only light gardening. They may also need to teach the PA to do the gardening effectively.

An employer may find a PA who is excellent at many tasks but not at gardening. The alternative would be for the person to employ a gardener separately.



Social Contacts and Leisure

A PA may accompany their Employer to:

- meet family, friends and colleagues

- medical appointments

- shopping and leisure trips

- educational opportunities

- employment

- holidays

- any other activity or visit.


It is important that the employer and PA establish the role that the PA will play in these various situations, for example:

- How the employer will show if they want support and how much.

- Whether the PA should join in any of the activities or remain in the background.


In social situations a PA should:

- carry out tasks they are employed for

- observe confidentiality and never discuss their employer’s private business

- try not to “hover” over their employer or create tasks that are not needed but be ready to respond to requests

- have things to do if they are not needed.


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