Who works in a care home? Every role explained

A care home is staffed by a team led by a registered manager, with care workers providing most hands-on support. Depending on the home, the team may also include team leaders, registered nurses, an activity coordinator, cooks, housekeepers, maintenance staff and administrators, plus visiting professionals such as GPs and therapists. Nursing homes always have a qualified nurse on duty.

At a glance

• Every care home in England needs a registered manager approved by CQC to run the service day to day.
• Care workers deliver most personal care, and nursing homes add registered nurses.
• Activity coordinators, cooks, housekeepers and maintenance staff shape daily life even though they do not give personal care.
• Providers must employ enough suitably qualified, skilled and experienced staff to meet people’s needs at all times.
• New care workers without a regulated qualification are usually introduced to the job through the Care Certificate, which has 16 standards.

Which roles make up a care home team?

Job titles vary between providers. Some homes call team leaders senior carers, for example, so ask what a title means in practice.

Who is in charge?

The registered manager is in day-to-day charge and is the person CQC holds accountable alongside the provider. Read more in what a care home manager does. The provider, which may be a company, charity or council, also has legal duties, including making sure staff are fit and proper and properly trained.

Who gives the day-to-day care?

Care workers are the people residents see most. They help with washing, dressing, eating and drinking, moving around, appointments and social activities, and may help with medication. Our guide on what carers do in a care home covers their duties in detail.

Many homes also name a key worker for each resident. The Alzheimer’s Society suggests getting to know the manager and the person’s key worker, who will likely be your regular contact, and raising any concerns calmly at a quiet time with possible solutions in mind.

Some staff are trained to carry out delegated healthcare tasks such as catheter and stoma care, pressure area care or oxygen monitoring. These tasks must be taught, supervised and assessed by a registered healthcare professional, and the worker should not make clinical judgements beyond their role. In a nursing home, registered nurses lead on clinical care. Our guide to residential or nursing home explains when nursing is needed.

Who looks after daily life, food and the building?

Several roles do not involve personal care but matter a great deal to how a home feels. Cooks prepare meals to meet individual dietary, cultural and clinical needs. Housekeepers keep rooms and shared areas clean and look after laundry. Maintenance staff keep the building safe. An activity coordinator plans individual and group activities, which our guide on what an activity coordinator does explains.

How are staff trained and checked?

Providers must have effective recruitment procedures, including checks on employment history and good character, and must verify any professional registration. Staff need an induction, supervision and regular appraisal, and all staff must be trained to interact appropriately with people with a learning disability and autistic people at a level suited to their role.

The Care Certificate is an introductory set of 16 standards for people new to care. It covers topics such as duty of care, communication, privacy and dignity, fluids and nutrition, awareness of mental health and dementia, safeguarding, infection prevention and awareness of learning disability and autism. Care workers can progress to a Level 3 diploma in adult care, and managers study towards a Level 5 diploma.

In Scotland, social care workers in registered services are registered with the Scottish Social Services Council (SSSC) and must register within six months of starting. Wales and Northern Ireland have their own registration arrangements, so ask the home.

How many staff should there be?

There is no single legal ratio. Providers must deploy enough suitably qualified, competent, skilled and experienced staff to meet people’s needs at all times. CQC guidance expects a systematic way of deciding staffing numbers and skill mix, continuous review, and emergency procedures. Our guide to care home staffing levels shows what to ask, and the CQC inspection report guide shows where inspectors comment on staffing.

Frequently asked questions

Do all care home staff need qualifications?

Not all roles need formal qualifications on entry, but providers must make sure staff are competent, trained and supervised. Care workers are often introduced to the work through induction and the Care Certificate, with vocational qualifications following. Nurses must be registered with the Nursing and Midwifery Council.

Is there always a nurse in a care home?

No. A qualified nurse is always on duty in a nursing home, but a residential home provides personal care without a nurse on duty. Visiting district nurses and other community health professionals may support residents in residential homes.

Who is the best person to speak to about a concern?

Start with the senior member of staff on shift or the resident’s key worker, then escalate to the registered manager. If the concern is not resolved, use the home’s complaints procedure. See our guide to complaining about a care home.

Are care home staff background checked?

Providers must operate effective recruitment procedures including checks on employment history and good character before staff start, and check professional registration where it is required. Registered managers must also provide an enhanced DBS check to CQC.

Where to get help next

When you visit a home, ask who the manager, deputy and key worker are, and use the visiting questions. If you need to raise a problem, read how to complain about a care home. You can start a search with Find care.

Sources

• Skills for Care: Job roles in adult social care
• GOV.UK: Care workforce pathway for adult social care
• CQC: Regulation 18, Staffing
• CQC: Regulation 19, Fit and proper persons employed
• Skills for Health: The Care Certificate standards
• SSSC: Who should register and why?

Reviewed by The Care Panel team on 9 November 2026. This guide is general information about care in England, not legal, medical or financial advice. Rules and rates change; check with your council or an adviser before making decisions.