This article examines what it means for the support worker to be responsible for the care they deliver and to be accountable for their actions and omissions. Both terms will be defined and discussed, before moving on to identify the five different arenas that the support worker may find themselves accountable to. The support worker's role is ever-expanding, with fresh tasks and roles being undertaken that even only five years ago would have been the sole domain of other health and social care professionals. Assistant practitioners (APs) are now becoming firmly embedded within organisations. These new roles and jobs mean increased responsibility and ultimately increased issues of accountability for the support worker.