2.5 Describe how to identify the numbers and patterns of staffing required to provide an outcomes-based, person-centred service

This guide will help you answer 2.5 Describe how to identify the numbers and patterns of staffing required to provide an outcomes-based, person-centred service.

Providing effective adult care means putting people at the heart of everything. Outcomes-based, person-centred care focuses on what matters most to each person, helping them reach their own goals. Choosing the right number and mix of staff is key to making this happen. This involves assessing people’s needs, matching staff strengths, and thinking ahead.

Outcomes-Based and Person-Centred Services

Outcomes-based care measures success by looking at how well individual outcomes are achieved for each person, not just by completing tasks.

Person-centred care means treating people as individuals, respecting their choices, and involving them in decisions.

When planning staffing, start by knowing what outcomes matter to each person being supported. For example, one person might want to keep independent with washing and dressing. Another might aim to take part in community activities.

Staffing planning must be flexible enough to meet these varied outcomes across different people.

Analysing Care and Support Needs

A clear starting point is detailed assessment of each person’s needs, preferences and risks. This helps work out:

• What outcomes they value most.
• Which support methods work best.
• Times of day when support is needed.

Use assessment tools and care plans. Review them with the person, their family, and professionals. Keep information up to date, as needs can change.

Patterns in assessed needs highlight when and how staff are required.

Calculating Staffing Numbers

Staffing numbers, often called “establishment levels” or “staffing ratios”, mean the amount of workers available at any one time.

To calculate the right numbers:

• Review the amount and type of support each person needs.
• Calculate the total staff hours needed for all people using the service.
• Factor in staff skills required (such as medication administration, moving and handling, or specialist communication).
• Consider staff breaks, supervision, and training time.

Create a staff rota that reflects these totals.

Using Dependency Tools

Dependency tools help measure the level of support each person needs. Tools used might include:

• Dependency Assessment Scales: Rate people from low to high need, depending on help with mobility, behaviour, cognitive skills, and medical needs.
• Time Allocation Tools: Estimate the amount of time staff spend supporting with each task.

For example, if a person’s needs change from mild to high dependency, you may need to increase their support hours and change the staff rota.

Skill Mix and Qualification Levels

Numbers are not the only focus. Staff must have the right mix of qualifications, experience, and qualities.

Think about:

• Registered managers or nurses, for clinical tasks and service oversight.
• Senior support workers for shift supervision.
• Direct care staff for daily support and relationship building.
• Specialists, such as physiotherapists or mental health workers, where needed.

Check all staff have mandatory training (e.g., safeguarding, infection control, moving and handling).

A broad skill mix helps meet varied outcomes, maintain safety, and support development.

Considering Individual Outcomes in Staffing Patterns

Staffing patterns refer to the timing and spread of staff coverage. Outcomes-based care often calls for more flexible, personalised rotas.

For example:

• If a person wants to go swimming every Wednesday afternoon, staff must be available then.
• If night-time support is needed (e.g. for trips to the toilet or help with anxiety), plan staff for those hours.
• Some people might only need morning support, while others need support at meal times or evenings.

Link staffing patterns directly to the times and types of support the care plan identifies.

Taking Account of Organisational Factors

Legal requirements and best practice guidance set minimum expectations for staffing. Care Quality Commission (CQC) regulations demand “suitable numbers of qualified, competent, skilled and experienced staff”.

Staffing must meet health and safety laws and employer duties.

Budgets and funding may affect staff numbers, but never at the expense of safe or person-centred care.

The building or environment may shape staff needs – for example, a large setting with long corridors requires more staff for observation and quick response.

Assessing Risks Related to Staffing

Shortages or poor skill mix can increase risk to people using the service. Risks may include:

• Poor outcomes, such as missed support with meals, appointments or medication.
• People left unsupported in times of distress or loneliness.
• Staff fatigue, accidents, and high sickness levels.

Always base staffing on the highest (not lowest) needs identified.

Using Rotas and Rostering Systems

A rota or roster organises shifts, start and end times, and who works where. Use software tools or a paper system, planning:

• Shift overlaps for safer handovers
• Staggered start and finish times to cover key periods
• Fair shifts to prevent burnout

Involve staff in rota planning. Ask about their availability and preferences. This can improve morale and reduce unplanned absence.

Responding to Changing Needs

People’s support needs can change fast. Build flexibility into staff planning. For example:

• Use bank or agency staff for absence cover or when people need extra support.
• Plan for seasonal pressures, such as winter illnesses.
• Create on-call systems for emergencies.
• Set regular reviews of staffing levels and skill mix.

Quick adjustments protect outcomes and safety.

Specialist and Community-Based Services

Some settings need specialist staff at set times, for activities like:

• End of life care
• Support for sensory impairments
• Complex mental health or learning disability support

Staff may work across locations, such as in outreach or day services.

Base staff deployment on who is present, where, and their specific needs.

Recording, Reviewing and Auditing Staffing

Good record-keeping proves that you have safe staffing in place.

Keep up-to-date records of:

• Assessments of individual needs and staffing levels
• Staff rota and shift logs
• Training records and professional registrations (if needed)

Audit staffing regularly. Look for patterns in incidents, complaints, or missed outcomes. Adjust staffing as needed.

Involving People Who Use Services

Ask people and their families if staff numbers and patterns meet their needs and preferences.

Collect feedback during reviews and encourage open communication.

Observe for signs that staffing is not enough, such as increased falls, delays in receiving help, or staff stress.

Use this feedback to improve staffing decisions.

Recruitment, Retention and Contingency Planning

Having enough staff means keeping your recruitment and retention strong. Plan:

• Recruitment drives to fill gaps
• Supportive supervision and training to help staff stay
• Agency or bank staff lists for emergencies
• Succession planning for key roles

Keep an eye on absence, turnover, and workplace morale.

Balancing Outcomes and Resources

Managers often work with limited budgets. Still, focus must always be on meeting people’s needs safely, with respect and kindness.

Be clear with funders and commissioners about what is needed to achieve outcomes.

Document how staffing impacts both people’s lives and staff wellbeing.

If unsafe, raise concerns using formal procedures. Do not accept unsafe staffing.

Supporting Staff Wellbeing

Staff working in supportive and safe teams provide better care.

• Give breaks and quiet spaces for rest.
• Hold regular team meetings and supervision.
• Offer support for stress and mental wellbeing.
• Prevent excessive overtime.

Leaders model positive values and notice when staff need extra help.

Legal and Regulatory Guidance

Stay up to date with:

• CQC guidance on safe staffing.
• Skills for Care resources.
• Sector-specific frameworks for qualifications and training.

Staffing decisions must comply with the Health and Social Care Act 2008 (Regulated Activities) Regulations.

Reviewing Staffing Effectiveness

Review the impact of staffing on outcomes using:

• People’s own feedback and personal progress
• Incident and accident reports
• Staff feedback and sickness records
• Audits by internal or external bodies

Make ongoing improvements, rather than sticking to fixed patterns.

Continuous Person-Centred Improvement

Treat staffing as a live process, not a one-off exercise. As new people arrive, needs change, or resources shift, return to your assessments and planning.

Practice reflective leadership:

• Celebrate when good outcomes are achieved.
• Learn openly when there are challenges.
• Share success and lessons with the whole team.

Final Thoughts

Getting staffing right is not just about filling shifts. It is about understanding each person, building a flexible and skilled team, and being ready to adjust as things change. Every decision about staffing must link directly to the outcomes and lives of the people you support.

If you make sure staff patterns and numbers reflect real, up-to-date needs, person-centred, outcomes-focused care is much more likely to happen.

Person-centred staffing is the foundation of high-quality adult care, supporting dignity, choice, independence, and safety every day.