Health and Care (Staffing) (Scotland) Act 2019: what it means for care homes

The Health and Care (Staffing) (Scotland) Act 2019 is the first UK law to set staffing duties for both health and care services. For care homes, its duties came into force on 1 April 2024, replacing the old staffing regulation. It doesn't set ratios. It asks you to decide what appropriate staffing is for the people you support, staff to it at all times, train people properly and be able to show your reasoning.

This guide is for care homes for adults and older people in Scotland, including care homes with nursing. The core duties apply to every registered care service, so care at home providers will find most of it relevant.

The duties at a glance

Section 9 puts an annual reporting duty on Scottish Ministers, not on providers.

Section 7: the duty to ensure appropriate staffing

Section 7(1) says any person who provides a care service must ensure that at all times suitably qualified and competent individuals are working in the service in such numbers as are appropriate for:

• the health, wellbeing and safety of people using the service;
• the provision of safe and high-quality care; and
• so far as it affects either of those, the wellbeing of staff.

Section 7(2) lists what you must have regard to when deciding the numbers: the nature of the service, its size, its aims and objectives, the number of people using it and their needs.

The statutory guidance (chapter 14) explains the wording:

• "At all times" has its everyday meaning. Changing needs during a day, week or year don't change the duty; you must show you've made every effort to adjust staffing.
• "Suitably qualified and competent" means you've considered each team member's level of practice, training, experience and professional registration (SSSC or NMC).
• "Safe" doesn't mean no risk. Positive risk-taking is part of good care, but people shouldn't face unnecessary risk because of staffing.
• Size and local context include things like the building's layout across several floors, or a small service that needs two staff on duty for safety or as a condition of registration even when one could manage the workload.

The guiding principles

Under section 3(1), you must have regard to the guiding principles in section 1 whenever you arrange staffing. The main purposes are to provide safe and high-quality services and the best care outcomes. In so far as consistent with that, staffing should be arranged while:

1. improving standards and outcomes for people using the service;
2. taking account of people's particular needs, abilities, characteristics and circumstances;
3. respecting their dignity and rights;
4. taking account of the views of staff and people using the service;
5. ensuring the wellbeing of staff;
6. being open with staff and people about decisions on staffing;
7. allocating staff efficiently and effectively;
8. promoting multi-disciplinary services as appropriate.

Section 8: training

You must make sure everyone working in the service gets appropriate training for the work they do and suitable assistance, including time off work, to obtain further qualifications appropriate to their work. "Working in the service" is wide: employees, agency and contract staff, apprentices and volunteers. Students on supernumerary placements aren't counted as staff.

In practice, section 8 sits alongside SSSC registration: support workers, practitioners, supervisors and managers often have qualification conditions to meet, and you need to support them to do it. See our SSSC registration guide and our training matrix template.

Staffing methods: not compulsory yet

Section 12 lets the Care Inspectorate develop staffing methods for care homes for adults, using tools that combine workload based on people's needs with professional judgement. Scottish Ministers can then require a method by regulations under section 82B of the 2010 Act.

As of October 2026, that hasn't happened. The statutory guidance says there is no requirement at present to use a specified staffing method. The Care Inspectorate's safe staffing programme offers a draft staffing method framework for adult care homes as a good practice document, through the Right Decisions app. Many homes use a dependency tool too; that's good practice, not law.

What records to keep

The Care Inspectorate's guidance on records (March 2025) says care homes should:

• keep individual records of at least four-weekly assessments of each person's physical, social, psychological and recreational needs and choices, and how they will be met;
• keep a record of the assessment that sets the minimum staffing levels and deployment of staff on each shift over a four-week period, showing how you meet sections 1, 3, 7 and 8, reviewed regularly and whenever something changes that affects staffing;
• make the overall staffing assessment available to visitors and everyone using the service;
• keep a record of all staff absences, with the arrangements made to keep care in line with people's personal plans.

The statutory guidance also suggests evidence such as rostering procedures that allow real-time allocation of staff to respond to risks, ways of gathering and acting on staff and resident feedback, assurance that mandatory training is up to date, and records of cancelled or postponed training.

Notify the Care Inspectorate of significant staff vacancies or absences that affect people's outcomes, and of significant changes in staffing whole time equivalents. See Care Inspectorate notifications.

How a rota shows appropriate staffing

Your staffing assessment sets the numbers and skill mix. The rota is where you prove you met them, shift by shift. A good rota:

• shows the minimum staff for each period from your assessment (days, twilights, nights), and the roles needed, such as a senior on every shift or a nurse on every nursing shift;
• makes gaps visible before the shift, not after;
• records what you did about a gap: agency, bank, a manager covering, or a decision to run short and why;
• avoids putting people on who aren't trained or registered for the role;
• is shared with staff, which supports the principle of being open about staffing decisions.

Our guides to care home rota software and nursing home staffing rotas cover building one.

How the Care Inspectorate checks it

Staffing sits under key question 3 of the quality framework, "How good is our staff team?", especially quality indicator 3.3: staffing arrangements are right and staff work well together. Inspectors will look at your assessment, your rotas against it, absence records and how you responded to shortfalls. The Care Inspectorate can also review how well the section 7 duty is working across the sector. See our Care Inspectorate inspection checklist.

How ShiftComplete helps

ShiftComplete doesn't implement the Act or a staffing method, and it doesn't calculate dependency: your staffing assessment decides the numbers. What it does is make the rota show whether you met them:

• Minimum staff and required roles per period (day, twilight, night), with each period shown as covered or short.
• Publishing with a gap asks you to confirm, so the decision is recorded.
• Warnings when you put someone on whose mandatory training has lapsed, from a training matrix with refresh periods you set.
• Open shifts posted to bank staff, holidays, and the published rota on every staff member's phone.

It costs £2.49 per active staff member per month, with no contract, and the first 60 days are free with no card needed.

See it set up for a Scottish care home on our care homes page, or for nursing on our nursing homes page.