Nursing home rota: how to make sure there's a nurse on every shift

The nursing home rota has one rule that matters more than any other: a registered nurse on every shift, with the skills and registration to cover the nursing needs of everyone in the building. Miss it on a Saturday night and you're relying on a phone call to an agency at 7pm and hoping.

Nurses are also the hardest staff to replace at short notice, the most likely to be sponsored workers on visas with their own rules, and the only staff with a professional registration that can lapse. So the nursing home rota carries more risk than a residential one, and needs more checks.

What the rules say

There is no fixed nurse-to-resident ratio in England. Regulation 18 of the 2014 Regulations requires "sufficient numbers of suitably qualified, competent, skilled and experienced persons", and CQC's guidance says providers should have a systematic approach to deciding staff numbers and the range of skills needed, including the registered professionals and support workers, adapted as people's needs change.

For a home registered to provide nursing care, nursing needs don't stop at night, so in practice the systematic approach means at least one registered nurse on every shift, day and night, with more on days or on units with higher dependency. Write that into your staffing policy alongside your dependency tool, so you can show the rota matches it.

Three other things sit behind the rota:

• NMC registration. Nurses renew their registration every three years through revalidation, with an annual fee in between. Check the NMC register by PIN before a nurse starts and keep the result, and track revalidation dates.
• Fit and proper checks. Regulation 19 requires Schedule 3 information, including an enhanced DBS check with barred list information where applicable, before anyone starts, agency and bank staff included.
• Night work. Nurses on regular nights are night workers: they shouldn't work more than an average of 8 hours in 24, and can't opt out of that limit, though GOV.UK lists exceptions for jobs that need round-the-clock staffing.

In Wales, Scotland and Northern Ireland

NMC registration and revalidation are the same across the UK. The care regulator and the staffing law change:

• Wales goes further than England in writing. Regulation 34(2) of the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017 says that where anyone in a care home has been assessed as needing 24-hour nursing care, the provider must ensure a sufficient number of suitably qualified registered nurses are deployed at all times. The Welsh Government's statutory guidance adds that they must be responsible, accessible and present for meeting nursing needs at all times, and that you show how you decided the number. Care Inspectorate Wales regulates. See our care home rota guide for Wales.
• Scotland: care homes with nursing are regulated by the Care Inspectorate, and since 1 April 2024 section 7 of the Health and Care (Staffing) (Scotland) Act 2019 has required appropriate numbers of suitably qualified and competent staff at all times. See our guide to the Staffing (Scotland) Act.
• Northern Ireland: nursing homes are regulated by RQIA under the Nursing Homes Regulations (Northern Ireland) 2005 and the Department of Health's care standards for nursing homes. See our RQIA inspection checklist.

Care assistants and senior carers working alongside your nurses must be registered with Social Care Wales, the SSSC or NISCC in those nations; England has no equivalent register.

Building the rota: nurse first, then skill mix

1. Nurses on every period first. Days, twilight if you use one, nights. Name the nurse in charge for each.
2. Senior carers next. One per unit or floor, so the nurse isn't the only person leading.
3. Care assistants to your dependency numbers. Use the latest dependency scores, not last month's.
4. Specialist skills. Who is trained in the hoist, PEG feeds, catheter care, end-of-life care? Spread them across shifts.
5. Check for lapses. Anyone with expired mandatory training, an NMC revalidation due, a DBS renewal or a visa expiry coming up.
6. Fill gaps from bank before agency. Your own bank nurses know the residents.

Our care staff rota template has a printable layout with a nurse-in-charge row for each period.

How ShiftComplete handles nursing home rotas

ShiftComplete for care runs in the browser on any phone, tablet or computer.

• "Nurse on every shift" as a rule. For a nursing home, set required roles per period, for example "Nights: 1 nurse, 1 senior carer, 3 staff minimum". Every period on the rota shows as covered or short, and publishing with a gap asks you to confirm.
• NMC, DBS, right to work and visa dates in one file. The staff compliance file holds each nurse's NMC PIN and revalidation date, DBS certificate number, issue date and Update Service status, right to work and visa or sponsorship dates, visible only to managers with permission.
• Warnings at the point of rota'ing. Put a nurse on whose revalidation date has passed, or whose mandatory training has expired, and the rota warns you before you publish.
• Open shifts for bank nurses. Post a gap to your bank nurses' phones. The first to accept gets it, or you approve. You see who was offered it and when.
• Training matrix. Mandatory and nursing-specific training on one grid, green, amber and red, with certificate photos. See our training matrix template.
• Availability, holidays and patterns. Staff mark availability on their phones; long days and nights, up to four time blocks per person per day, units as areas and day notes.

Sponsored nurses

Many nursing homes employ nurses on Skilled Worker or Health and Care visas. The sponsor has its own reporting duties, including reporting certain changes such as long unauthorised absences or a cut in salary within 10 working days. ShiftComplete stores visa and sponsorship dates and warns before they lapse. Our guide to sponsor licence duties for care providers covers the rules.

When you can't cover a shift

Have an escalation plan written down: bank list, agency, on-call manager, and what the nurse in charge does if a colleague doesn't arrive. If you can't staff the home safely, check whether it needs a CQC notification: Regulation 18 of the 2009 Registration Regulations includes events that stop or may stop the service running safely, and lists insufficient numbers of suitable staff as one. Our guide to CQC statutory notifications explains what to send and when. In Wales, any event that prevents or could prevent safe provision is notified to CIW under Schedule 3 of the 2017 Regulations; in Scotland and Northern Ireland, see our guides to Care Inspectorate notifications and the RQIA inspection checklist.

The rest of the home's evidence

The same app runs your premises checks (fire alarm tests, emergency lighting, water temperatures, hoist and sling checks, bed rails, kitchen fridges), certificate due dates for gas, EICR, PAT and LOLER, care audits with action lists, incidents with a CQC notification prompt, complaints, supervisions and appraisals, and a one-click inspection pack grouped under CQC's five key questions. See our CQC inspection checklist for what to have ready.

What it doesn't do

ShiftComplete works alongside your clinical and care-records systems. It does not do care plans, eMAR, daily care notes, wound records or clinical scores. Residents are recorded by initials or room number only. Data is hosted in the UK (London).

What it costs

£2.49 per active staff member per month, no minimum and no contract. A 70-staff nursing home pays £174.30 a month, with every care feature included. The first 60 days are free with no card needed, and a free 15-minute set-up call can get your cover rules set up.

See how it works for nursing homes on our nursing homes page.