Make changes to your conditions of registration

Care homes for older people

We are aware that some care providers are experiencing significant challenges in recruiting and retaining nurses within the care sector. A number of providers have approached us to discuss reconfiguring their staffing models, including developing the role of senior care workers. Their aim is to use nursing staff more effectively and, in some cases, reduce reliance on agency nurses to support more stable and consistent staff teams.

We recognise and strongly support the vital contribution nurses make in many care homes, particularly in providing clinical leadership and planning high‑quality care for residents. At the same time, we are committed to supporting innovation that responds to changing needs and demands, where this leads to improved outcomes for people using services.

Where a care home for older people proposes to change its skills mix and this requires an amendment to its staffing schedule, we will consider the proposal through our registration variation process. We expect any such proposal to demonstrate clear benefits for the quality of care provided to residents. Care homes will be asked to supply specific information to support their request.

If a variation is approved, we may apply time‑limited conditions to the service’s registration. We will expect the provider to evaluate the impact of the new arrangements before any decision is made about making them permanent. Where a variation is granted, the next inspection is likely to cover all quality themes, even if the service has maintained high performance over time.

Before submitting a variation request, providers should contact the registration team for guidance on the actions required to support their application. This should include engagement with local commissioners, residents, and relatives, as well as the development of a plan to evaluate the effectiveness and impact of the proposed changes. Please note that cost savings alone will not be considered a valid reason for applying.