How to choose the best phone system for your care home

Care home phone problems tend to surface at the worst moments. A family member rings during handover and gets voicemail. A cordless handset loses signal at the far end of the building, halfway through a conversation with the GP practice. Then a letter arrives to say the analogue lines your building has always used will be switched off by January 2027.

A long feature list won’t tell you which phone system suits a care home. This guide explains what to look for, what to check before you sign anything, and the questions worth asking any supplier.

Updated 26 October 2026. Written by John McGilveray at Chrome Telecom. We’re a UK managed service provider working with care homes, GP practices and dental practices from Whiteley in Hampshire and from Leeds.

Three numbers frame the decision this year.

What does a care home need from its phone system?

Five things, in roughly this order.

1. Get each caller to the right person first time. Families, GPs, pharmacies, hospital discharge teams, new enquiries and job applicants all ring the same number. Each needs a different person.
2. Reach staff where they are. Care staff are in resident rooms, lounges, the dining room and the garden. Very few of them sit beside a phone.
3. Show what was missed. An unanswered call from a daughter, a district nurse or a family considering the home should be visible to someone. It needs a time and a number against it.
4. Keep a record when it matters. A complaint, a safeguarding review or a disputed instruction is easier to deal with when you can check what was said.
5. Keep working when something fails. Power cuts and internet faults happen. The phones are the one thing a home can’t be without for long.

If a system does those five things well, the rest of the feature list is a bonus. If it doesn’t, no amount of extra features will make up for it.

Cloud, on-premise or keep the landlines?

A cloud phone system carries calls over your internet connection. There’s no phone switch in a cupboard, and the handsets, cordless base stations and apps all connect to a service run elsewhere. Changes such as a new greeting or a different ring group are made through a web portal, often by your own staff. You may see it called hosted VoIP (voice over internet protocol), which means the same thing.

An on-premise system is a phone switch installed in the building. It still needs digital lines now that analogue and ISDN lines are being withdrawn, so it doesn’t avoid the switch-off. It can make sense where you already own a recent one, but for a new purchase most homes are better served by cloud.

Keeping the landlines is no longer an option beyond January 2027. Openreach stopped selling new analogue lines in September 2023. BT has set 31 January 2027 as the date by which its remaining customers must have moved to a digital service.

For a single home, cloud means fewer boxes to maintain and changes that don’t need an engineer. For a group, it means one system across every home, with shared queues, one directory and reports by location. Whichever route you take, the internet connection underneath matters as much as the system. A home with 40 handsets and staff on WiFi needs a business-grade connection. Ideally it has a second route for calls if the first one fails.

Which handsets work in a care home?

Reception and the manager’s office are the easy part. The harder question is how a carer on the first floor answers a call. Reception also needs a way to pass a GP through to the nurse on duty. The right mix depends on the building and on who handles which calls.

DECT is the option most care homes end up with for care staff. It doesn’t depend on the WiFi, and the handsets are built to be carried all shift. The catch is coverage. A base station that covers a modern open-plan lounge will struggle with a Victorian wing or a converted stable block. A supplier who quotes cordless coverage without walking the building is guessing.

Some nurse call systems can send alerts to the same cordless handsets staff use for calls. A carer then carries one device rather than two. Ask both suppliers whether yours can do this, and agree in writing who is responsible for making it work.

How should calls be routed when reception is busy?

Reception is rarely free when the phone rings. The person on the desk may be signing in a visitor, helping a resident or dealing with a delivery. Decide the rules before installation rather than accepting whatever the default is.

A short menu helps. “Press 1 for the care team, 2 for the manager, 3 for new enquiries” is about the limit. Older callers, and anyone ringing about a relative who is unwell, find long menus hard to follow. Some homes prefer every call to go to reception first. That’s fine as long as there’s a plan for when reception doesn’t pick up.

That plan is usually a ring group. After a set number of seconds, the call rings on a cordless handset carried by the senior on duty. It might go to the manager’s office or a sister home instead. Agree how long each stage rings and where the call ends up if nobody answers at all. A voicemail that’s checked twice a day is not a good ending for a call from a GP.

Outside office hours, a clear recorded message should say when the team is available and what to do in the meantime. If it includes instructions about urgent resident matters, someone should own that wording and review it regularly.

Check the settings each quarter. Staff change and opening hours change. A ring group pointing at a handset nobody carries any more is a common reason calls go unanswered.

Do care homes need call recording and call reporting?

Reporting, yes. Recording, usually, with some decisions made first.

Call reporting shows you which calls were missed, when, from which number, and how long callers waited. Without it, a manager only knows about a missed call when a relative complains. With it, someone can check the list each morning and ring back. The same report shows when calls peak, which helps you decide who carries a handset at the busiest times. The report doesn’t return the call on its own, so agree who checks it and how they record that the follow-up was done.

Call recording is useful when there’s a clear reason to listen again. A family says they were promised something. A district nurse disputes what was passed on. A member of staff took an abusive call and you want to understand what happened. In each case a recording settles it faster than memory. Recordings can also support staff training.

You don’t have to record every line. Ask whether recording can be limited to some extensions, such as reception and the enquiries number.

Before you switch it on, decide four things and write them down. Why calls are recorded. Who is allowed to listen. How long recordings are kept before they’re deleted. How callers are told, which is usually a short message before the call connects. Recordings contain personal and sometimes sensitive information. They fall under UK GDPR (the UK General Data Protection Regulation), so they need a lawful basis and secure storage.

Inspectors care about this too. CQC’s assessment framework in England asks how a home listens to people and acts on concerns, and how it is governed. A call log and, where appropriate, a recording, gives you evidence rather than recollection. The equivalent regulators in Wales and Scotland ask similar questions. Chrome can set up the technical side. Your organisation remains responsible for the policy, and it’s worth getting advice if you’re unsure.

Is your internet connection ready for phone calls?

With a cloud phone system, every call travels over your internet connection. Each call needs very little of it. Cisco puts a standard call at about 87 kilobits per second each way, less than a tenth of a megabit. Ten calls at once still need under 1 megabit each way. How many calls you can take at once then depends on the connection and how the system is set up, not on how many phone lines you rent.

Call quality problems more often come from a crowded connection or patchy WiFi than from the speed of the line. A large upload or a backup running during the day can make voices break up. So can residents and visitors streaming video, if their WiFi shares the same line.

A few settings make the difference:

• Give phone calls priority on your network, so other traffic waits instead of the call. Your phone supplier or IT provider sets this on the router.
• Keep resident and visitor WiFi on a separate network from the phones and office computers.
• If staff use WiFi handsets or the app on site, the WiFi needs to reach everywhere they take calls.
• Check there’s room on the line at the busiest times, such as handover, alongside everything else that uses it.

Before installation, ask the supplier to test the line at a busy time. Get anything that needs changing in writing.

What happens to the phones in a power cut or internet fault?

A cloud phone system needs mains power and a working internet connection. An analogue line carried its own power from the exchange. That’s why the old phone in the hall worked during a power cut. A digital phone won’t unless you’ve planned for it.

Ofcom expects providers to give customers a way of reaching the emergency services for at least one hour during a power cut. A battery back-up unit is the usual answer. That is a minimum aimed at households. A care home should plan for longer and for more than 999 calls.

In practice that means a UPS on the router, the network switch and the cordless base stations. A UPS is an uninterruptible power supply, a battery that takes over when the mains fails. It means a second internet route, usually a 4G or 5G connection that takes over when the main line drops. It means calls forwarding to nominated mobiles when the system can’t be reached. And it means a printed list of who to ring, kept somewhere that doesn’t need a password.

Ofcom’s one-hour rule is about calls to 999. Telecare alarms usually call a monitoring centre instead. A battery for the phones won’t necessarily keep them working. Telecare, nurse call, lift phones and fire alarm signalling each have their own rules on back-up power. Those come from the suppliers and standards for that equipment, not from the phone system supplier. Ask each of them.

Then test it. Once a year, at a quiet time, switch the mains off at the router and see what still works. It’s better to find the gap that way than during a real outage.

What else is plugged into your phone lines?

The analogue switch-off affects more than the phones. Care homes tend to have more devices on old lines than almost any other kind of building. Before choosing a system, walk the home and list every socket and what’s connected to it. The usual ones are:

• Nurse call systems with a dial-out to on-call staff or a monitoring centre
• Telecare and grouped alarm schemes
• Lift emergency phones
• Fire and intruder alarm signalling to a monitoring centre
• Door entry and gate intercoms
• Resident room phones
• Fax machines, if you still receive anything from pharmacies or hospitals that way
• Card payment terminals

The Government’s Telecare National Action Plan, published in February 2025, estimates that around 2 million people in the UK use telecare, some of them through grouped schemes in care homes and sheltered housing. An industry charter sits behind it. Under that charter, no telecare user should be moved to a digital line until someone has confirmed a compatible solution is in place. That someone can be the provider, the customer or the telecare company. That protects the migration step. It doesn’t replace the equipment, so you still need each supplier to confirm what theirs needs and to quote for it.

Don’t assume a device will carry on working because the line it uses still has a dial tone today. Some analogue devices work on a digital line adaptor for a while and then fail intermittently. The safe approach is a confirmed answer from the supplier of each device, in writing, before the line changes.

How much does a care home phone system cost?

Cloud phone systems are usually priced per user per month, with one-off costs for handsets, cordless base stations and installation. Care homes are a little different from offices because many handsets are shared between shifts. Count the handsets you need on the floor, not the number of staff.

What moves the price most:

• Number of cordless handsets and the base stations needed to cover the building
• Number of desk phones and headsets for reception and office staff
• Number of user licences, including any mobile apps
• Call bundle versus pay-as-you-go
• Call recording and how long recordings are stored
• Whether you’re connecting more than one home
• Installation, number porting and staff training

Ask for the monthly total and the one-off total as separate figures, and ask what isn’t included. Out-of-hours support, handset replacement and future changes to call routing are the usual gaps. Ask about the contract length and what happens at the end of it, in writing.

Questions to ask a phone system supplier

Any supplier can list features. These questions tell you whether they understand care homes.

1. Will you survey the building before quoting cordless coverage, and will the quote name the number of base stations?
2. What happens to a call when nobody at reception answers within 20 seconds? And after that?
3. Can calls pass between our homes, and can one home cover another’s reception at busy times?
4. How do we see missed calls, who gets that report and when?
5. Are calls encrypted between our phones and your system, and where are recordings stored?
6. Can recordings be deleted automatically when our retention period ends, and who at your company can listen to them?
7. What keeps working in a power cut, and for how long?
8. What happens to incoming calls if the internet connection fails?
9. Which of our existing devices use analogue lines, and who is responsible for each one?
10. Can our nurse call system send alerts to the same handsets, and what does it need to connect?
11. Who trains night staff and agency staff, and what do they get to keep?
12. Who do we ring at 3am, and how quickly do faults get looked at?

A supplier who answers these specifically, with examples from other homes, is worth shortlisting. One who answers with a feature list probably hasn’t done many care homes.

How do you get staff ready for the new phones?

Most of the people who answer a care home’s phones aren’t at a desk. Many work nights or weekends, and some come from an agency. Training has to reach all of them, not just whoever is on shift when the engineer visits.

• Run short sessions for each shift, including nights and weekends. Add the phones to the induction agency staff already get.
• Stick to what each role uses: answering, transferring a call, picking up a call ringing on another handset and checking voicemail.
• Name one person on each shift who knows the phones well and can help a colleague there and then.
• Leave a one-page guide by each desk phone and handset charger, with the main extension numbers on it.

Then check in a few weeks after go-live. Look at the missed-call report, ask staff what feels awkward and adjust the ring groups to match.

Running more than one home?

A care group shouldn’t have to manage each home’s phones separately. With one cloud system across the group, users, numbers and call routes sit in one place. Homes can transfer calls to each other, share responsibility for a busy queue and use one directory. Greetings and menus stay consistent, and managers can see reports by home.

The useful rule is to agree how calls are shared before setting anything up. A home that suddenly receives another home’s overflow calls without warning will not thank you.

How Chrome helps care homes

We start with the building. A site visit covers the layout, where staff work, which numbers you have, how calls are handled today and what’s connected to the existing lines. We’ll ask where calls are being missed and where cordless coverage is poor, because the people on shift already know.

You’ll then get a recommendation that explains why each handset, licence and setting has been suggested, with the costs set out clearly. Nobody is pushed towards equipment the team doesn’t need.

Installation is planned around the home’s day, not during handover or mealtimes. We show your team how to use the phones for their roles, including the people who work nights. We stay available afterwards for questions and changes.

A phone system depends on the technology around it. The same team can also look after the internet connection, care home WiFi, business mobiles, IT support and CCTV. That gives your organisation fewer suppliers to chase when responsibilities overlap. You can read more about how that works on our phone systems for care homes page.

Chrome Telecom is a UK managed service provider founded in Hampshire in 2014. We support care homes, GP practices, dental practices and other organisations across England, Wales and Scotland with business IT, cyber security and communications. The team is based in Whiteley, near Fareham, with a second office in Leeds.

A sensible place to start

Walk the building with a notepad. Write down where cordless calls drop, which calls get missed and what’s plugged into every phone socket. That list is worth more to a supplier than any brief, and it tells you quickly whether they’ve done this before.