The PSTN Switch-Off in Care Homes: Telecare, Nurse Call and Resident Lines

Quick answer

Care settings have more safety-critical kit on phone lines than almost any other kind of premises - telecare and nurse call, warden call, monitored fire and intruder alarms, lift emergency lines, door entry, and residents' own lines. All of it is affected by the switch-off on 31 January 2027. The single most important point: do not plug analogue telecare equipment into a digital line and assume it works. Industry guidance has been consistent that analogue telecare over IP can fail, sometimes silently, and the correct route is digital telecare equipment specified by your telecare supplier. Start with a written device register, then work through it with each equipment supplier.

I want to be clear about our lane here. We handle lines, connectivity and phone systems. We do not specify telecare or nurse call equipment, and nobody selling you phone lines should be telling you what your telecare should be. What we can usefully do is set out the whole picture so nothing gets missed, and be honest about which conversations belong with which supplier - because in care settings the cost of something being missed is not a lost sale. If you need the lines, broadband and phone system side handled around your equipment suppliers' schedules, get a no-obligation quote.

Why care settings are the hardest case

Most businesses have one or two things on the switch-off list. A care home has most of them at once, in a building occupied by people who depend on them, with a regulator interested in how you manage risk. The difficulty is not that any single item is unusually hard - it is the density and the fact that several suppliers all need access to the same building in a coordinated order.

There is also a knowledge problem. Telecare, nurse call and warden call systems are often decades old, installed by companies that may no longer exist, extended piecemeal over the years, and documented in a folder nobody has opened since the last inspection. Working out what you actually have is a real task, and it is the task everything else depends on.

The device register: what to look for

Build this as a spreadsheet with a column for which supplier owns it and a column for who confirmed it. If a row cannot be confirmed by someone who has physically looked, mark it unknown rather than assuming. In care settings especially, ceasing an unidentified line is not a risk worth taking.

Telecare: the one you must not improvise

This deserves its own section because it is where the real danger sits.

Traditional telecare - a pendant or pull cord connected to a dispersed alarm unit in the room, which dials a monitoring centre when triggered - was designed around the analogue network. It relies on the line's behaviour and timing, and on the fact that copper carried its own power from the exchange.

When those units are connected through a digital line or an analogue adapter, they sometimes work, sometimes work intermittently, and sometimes fail in ways that are not visible from the building. Industry bodies working on the digital telecare transition have been consistent about this for years, and the guidance has not softened: analogue telecare should be replaced with digital equipment, not adapted onto a digital line and hoped for. The failure mode that matters is the silent one - a unit that appears fine, and a call for help that never arrives.

There is a second, specific reason not to improvise. Because telecare users are among the most vulnerable people affected by the switch-off, the industry gave particular commitments about how they are migrated, including not migrating known telecare users without confirmation that their equipment will work. Those safeguards only function if your telecare users and devices are identified and registered with the relevant providers. An unregistered telecare line looks like an ordinary phone line to everyone except you.

Practically:

1. Identify every telecare device and every user relying on one. In writing.
2. Tell your telecare supplier and your line provider that these are telecare lines.
3. Ask your telecare supplier for the digital replacement specification and a commissioning date.
4. Do not accept an adapter as a solution, and be sceptical of anyone who offers one.
5. Test end to end after the change - trigger a device and confirm the monitoring centre received it and knows which room it came from.

Step five is the one people skip. A digital telecare rollout that has not been tested from pendant to monitoring centre, per device, is not finished.

Nurse call and warden call

These vary enormously. Some are entirely internal and wired, and the switch-off does not touch them. Others dial out to an on-call service, link buildings across a site over lines, or include a telecare element for residents in supported living. Some have a line purely for remote engineer access, which is not safety-critical but does mean every future change becomes a site visit if you lose it.

Because the variation is so wide, this is a direct question for whoever maintains the system: does any part of this rely on a phone line, and if so, what is the replacement? Get the answer in writing, and get it early - these are specialist installers with limited capacity.

Residents' own phone lines

Worth planning deliberately rather than letting it happen. Residents with their own lines in their rooms are, in effect, individual customers of the switch-off, and some will be exactly the vulnerable customers the industry safeguards are designed for.

Options usually come down to the home providing extensions from its own system, individual digital lines, or residents moving to mobiles - and the right answer depends on the home and the resident. Two things to get right regardless: communicate the change well in advance, in a form residents and families can absorb, and remember that a resident's phone may be their main contact with family, so a gap is a welfare issue rather than an inconvenience. Also check whether any resident's line is doubling as a telecare path, which happens more often than you would expect.

Resilience: the part that is different in a care setting

Everywhere else, "the phones might be down in a power cut" is an inconvenience with a workaround - staff use mobiles. In a care home the people who most need to call for help are the least able to switch to an alternative, and the equipment they depend on is fixed in place.

So resilience is not an optional extra here:

• Battery backup on routers, network switches and any equipment carrying safety-critical signalling, sized for a realistic outage rather than five minutes.
• A mobile fallback path for alarm and telecare signalling, so a broadband fault does not silence everything at once.
• A written plan for what staff do if connectivity fails - who checks on whom, and how.
• Testing, on a schedule, with the results recorded.

Our guide to landline resilience and failover covers the general approach, and SoGEA vs FTTP covers the connection underneath it. In a care setting I would treat 4G or 5G failover as standard rather than a nice-to-have, given how much now depends on one connection.

Who does what

The coordination row is the important one. Every supplier above will do their part competently, and none of them owns the whole picture. Somebody in the home has to hold the register and the running order, and it needs to be someone with the authority to say "not yet" when a line is due to be ceased.

Records and assurance

Keep a simple file containing, for each device: what it was, what replaced it, who did it, the date, written confirmation that it was commissioned and tested, and the result of the end-to-end test. Update your business continuity plan and your risk register to reflect that safety-critical signalling now depends on connectivity and power.

This is not bureaucracy for its own sake. If you are ever asked how you managed this transition - by an inspector, an insurer, or a family - a dated file answers the question in a way that recollection does not.

What to do this month

1. Build the device register. Walk the building. Include residents' rooms.
2. Phone four suppliers this week: telecare, nurse call, alarm, lift. Ask each what relies on a line and what the replacement is.
3. Flag telecare lines to your line provider so the safeguards apply.
4. Check what connectivity is available and specify resilience properly.
5. Get every date in one plan, with the line ceases last.
6. Communicate with residents and families before anything changes.

Our switch-off deadline guide sets out the general lead times, and for a site with this many suppliers, assume the longest one governs.

The bottom line

A care setting is the hardest version of this migration, not because any single item is difficult but because there are so many of them, they are safety-related, and several suppliers need to work in a coordinated order in one building. Two things matter more than everything else: never improvise analogue telecare onto a digital line, and hold the device register yourself rather than assuming a supplier has the whole picture.

We can take the lines, connectivity and resilience off your list and work to your equipment suppliers' dates, including making sure nothing is ceased until it has been proven: get a no-obligation quote or call 0333 006 9399.

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