How to Choose a Phone System for Your Care Home

Choosing a phone system for a care home isn't the same as choosing one for a normal office. The phone is a lifeline — families call at all hours, GPs need to get through quickly, and every missed call could be an emergency or a lost enquiry. At the same time, the phone is one of the biggest sources of disruption for care staff.

Most care homes inherit whatever phone setup was in place when the building was last fitted out. It works, so nobody thinks about it. But as the demands on care homes change — more regulatory requirements, higher family expectations, tighter staffing — the way you manage calls starts to matter more.

One immediate factor for 2026: the UK's PSTN and ISDN telephone networks are being switched off in January 2027 — seven months from now. If your home still runs on a traditional landline or ISDN connection, this is a hard deadline, not a distant consideration. Full detail on what the PSTN switch-off means for care homes is in a separate guide; the key point is that the choice you make now needs to work on a digital (VoIP or cloud) foundation, not an analogue one.

The main options

Traditional landlines. Still common in care homes. Reliable and simple — but operating on borrowed time. BT and other providers are migrating all PSTN and ISDN lines to digital by January 2027. If you are on a traditional landline, you will need to move to VoIP or a cloud system before that date. The good news is that most VoIP systems are drop-in replacements for landlines, and call quality has improved significantly as fibre broadband has become the standard.

VoIP (Voice over Internet Protocol). Uses your internet connection instead of a phone line. Offers features like call forwarding, multiple extensions, voicemail transcription, and basic call routing. Requires stable broadband. Providers like 8x8, RingCentral, and BT Cloud Voice serve the UK market.

Cloud phone systems. A step up from basic VoIP. Includes features like auto-attendant menus, call queuing, call recording, and integration with other software. More suited to larger homes or groups managing multiple sites.

Mobile-first approaches. Some smaller homes rely on mobile phones, sometimes a dedicated care home mobile. Flexible but hard to manage — no shared number, no call logging, and no way to ensure calls are answered consistently.

What to consider for a care home

Reliability matters more than features. A phone system that goes down during a power cut or broadband outage is a serious problem in a care setting. If you move to VoIP, check whether your provider offers a failover to mobile or a backup line.

Call logging and records. CQC inspectors increasingly expect evidence of good communication management. A phone system that logs calls — who called, when, whether it was answered — gives you an evidence trail without extra admin work.

Out-of-hours handling. Families don't only call during office hours. If your phone system can't route or record out-of-hours calls, you're either missing them or expecting night staff to handle enquiries they're not set up for.

Nuisance call management. Care homes answer every call because any call could be important. Traditional phone systems have no way to distinguish a GP calling about a resident from a recruitment agency cold-calling. This is where the real time cost sits.

Cost. Landlines are cheap. VoIP systems typically cost £10–25 per user per month. Cloud systems with advanced features can be £25–50+. The total depends on how many extensions and features you need.

Where AI call management fits

AI call management isn't a phone system replacement — it sits on top of your existing setup. It monitors and analyses incoming calls, identifies nuisance callers, logs every call, and gives your manager a daily summary of everything that happened.

The AI phone tool market for care homes has grown considerably in 2026. You will find answering-focused tools (which handle calls on your behalf and take messages), monitoring-focused tools (which sit in the background, screen calls, and report), and hybrid services combining AI with human agents. Each approach has a different cost, a different risk profile, and a different fit depending on whether your biggest problem is nuisance calls, missed family enquiries, or lack of visibility. A care home AI phone buyer's guide covers the differences in detail.

CareTime's Silent Guard is a monitoring-first tool. It connects to your existing phone line, screens incoming calls, logs everything, and delivers a daily Morning Brief to your registered manager. No hardware changes, no new handsets, no retraining required. It works on a standard landline or VoIP line — and will continue to work after the January 2027 PSTN switch-off if you move to VoIP.

Making the decision

If your home still runs on a traditional PSTN landline, the January 2027 deadline makes VoIP migration a near-term priority, not a future consideration. Use the migration as an opportunity to review what features you need — call routing, call recording, out-of-hours handling — and choose a VoIP provider that supports them.

If your phone system works reliably and your main problems are nuisance calls, missed enquiries, and lack of visibility — start with AI call management. It is the fastest and cheapest way to solve those specific problems without touching your phone infrastructure.

If your phone system itself is the problem — poor reliability, no extensions, no voicemail — then a VoIP or cloud system upgrade is worth considering. Look for a provider who understands the care sector, offers reliable failover, and can integrate with call management tools.

Either way, the goal is the same: make sure every important call gets answered, every nuisance call gets filtered, and your manager can see what's happening without chasing staff for updates.