Who Works in a Care Home? Roles and Responsibilities Explained

Topic cluster: Finding & Choosing a Care Home | Reading time: 6 min

Understanding who works in a care home — and what each role involves — helps you ask better questions during visits and know who to contact when something needs addressing. Care homes employ a wide range of staff, and each plays a different part in your parent's daily life and wellbeing.

The Care Team

Registered Manager

The registered manager is accountable for everything that happens in the care home. They are legally responsible for the quality of care, staff management, and regulatory compliance. Their name is registered with the CQC (in England) and they must meet strict qualification requirements.

A good registered manager sets the culture of the home. Ask how long they have been in post — stability in the manager role is strongly associated with consistently good care.

Senior Carers / Team Leaders

Senior carers lead shifts and support other care staff. They often have more experience and may hold additional qualifications. They are usually the first point of escalation for concerns during a day or night shift.

Care Assistants / Support Workers

Care assistants provide day-to-day personal care — helping with washing, dressing, eating, mobility, and using the toilet. They are the staff your parent will spend the most time with and will have the greatest impact on their daily experience.

Qualifications vary. Many hold a Care Certificate (a baseline qualification) and some have NVQ Level 2 or 3 in Health and Social Care. On-the-job training, supervision, and personal warmth matter as much as formal qualifications.

Registered Nurses (Nursing Homes Only)

In nursing homes, registered nurses (RNs) are on duty at all times. They carry out clinical procedures — administering medication, wound care, catheter management, monitoring health conditions — and make clinical decisions. They supervise care staff on clinical matters.

Health and Therapy Professionals

Most care homes work with external health professionals who visit regularly or can be called upon:

GP — usually visits the care home on a rota (some homes have a dedicated GP practice)
District nurses — provide nursing input to residential care homes where there are no on-site nurses
Physiotherapist — mobility assessment and rehabilitation exercises
Occupational therapist — equipment assessment and adaptations
Speech and language therapist (SALT) — swallowing assessment and communication support
Dentist, optician, audiologist — some homes arrange regular visits from community practitioners
Chiropodist / podiatrist — foot care, often visiting monthly

Ask the home how these services are accessed and how frequently visits happen.

Activities and Wellbeing

Activity Coordinator

Activities coordinators plan and deliver the social and recreational programme — from music sessions and art classes to reminiscence groups, games, outings, and gardening. In a good home, they also ensure activities are personalised to each resident's interests and abilities, not just group events on a rota.

Ask to meet the activities coordinator and look at the recent activities programme to get a sense of how varied and genuinely engaging it is.

Wellbeing or Lifestyle Lead

Some larger homes employ a wellbeing or lifestyle lead who focuses specifically on quality of life, social connections, and meaningful occupation for residents. This role reflects a person-centred approach to care.

Support and Administration Roles

Chef and Kitchen Team

Food quality has a significant impact on health and wellbeing. The kitchen team manages meals, dietary requirements, and texture-modified diets for residents with swallowing difficulties. Ask to see the menu and, ideally, visit at a mealtime.

Domestic and Laundry Staff

Responsible for maintaining cleanliness and hygiene throughout the home, and for managing residents' laundry. A clean, well-maintained home is a basic requirement.

Maintenance

Responsible for the fabric of the building — repairs, safety checks, equipment maintenance. Well-maintained equipment and a safe physical environment are part of the CQC's safety inspection.

Administration Team

Manages bookings, contracts, billing, and communications. Your first point of contact when joining the home and when queries arise about fees or paperwork.

What Good Staffing Looks Like

When you visit a care home, observe:

✅ Staff who know residents by name and show genuine warmth
✅ Staff who are unhurried — not rushing from task to task
✅ Low use of agency staff (high agency use suggests staffing difficulties)
✅ Staff who speak positively about their work and colleagues

Questions worth asking the manager:

What is your staff turnover rate in the past year?
How many agency shifts did you use last month?
What training do all staff receive, and how often?
Do you use a key worker model?

High turnover and heavy reliance on agency staff are among the strongest warning signs of a poorly managed home.

Ratios: How Many Staff Per Resident?

There are no mandated minimum ratios in England. A well-staffed residential care home typically operates at around 1 carer to 5–6 residents during the day, and 1 to 8–10 at night. Nursing homes may have similar care staff ratios but with registered nurses additional to these numbers.

Ask directly — any home that cannot give you a clear answer to this question should raise concern.

Find well-rated care homes with stable staff teams at homeformum.com