Using Agency, Bank and Temporary Staff Safely in Older People’s Services
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Agency, bank and temporary staff play a necessary role in many older people’s services, particularly during periods of recruitment pressure, sickness or seasonal demand. However, these staffing models also introduce elevated risks around continuity, communication, safeguarding and medication. Supporting ageing well requires that temporary staffing is tightly governed, not treated as a neutral substitute for permanent staff.
Two internal reference points that underpin safe temporary staffing are the Business Continuity — Mini Series and the Quality Assurance — Mini Series, both of which emphasise risk control and accountability.
Why agency use carries higher risk in older people’s services
Temporary staff are less likely to:
- Know people’s preferences, routines and communication needs.
- Recognise subtle changes in presentation or behaviour.
- Understand local escalation routes and safeguarding thresholds.
- Feel confident challenging unsafe practice.
Without clear systems, these gaps translate directly into falls, medication errors, missed deterioration and safeguarding incidents.
Commissioner expectation
Commissioner expectation: providers demonstrate that agency and temporary staffing is used safely, proportionately and as part of a wider workforce strategy—not as an unmanaged substitute for permanent staffing.
Regulator / Inspector expectation (CQC)
Regulator / Inspector expectation (CQC): staff, including temporary workers, are competent, supported and understand how to keep people safe. Inspectors will look for induction, oversight and clear accountability.
Setting clear rules for when agency staff are used
Effective services define:
- When agency use is permitted.
- Which roles can and cannot be covered.
- What induction and supervision is mandatory.
- Who authorises and reviews agency shifts.
This prevents ad hoc decisions made under pressure.
Operational example 1: Restricting agency use in high-risk roles
Context: A supported living service experienced repeated medication near-misses involving agency staff.
Support approach: The provider restricted agency use in medication administration roles unless competence evidence was provided.
Day-to-day delivery detail: Agency staff could support personal care and activities but not administer medication unless signed off locally.
How effectiveness/change is evidenced: Medication incident reports reduced and agency usage data showed clearer role boundaries.
Induction for agency staff must be focused and real
Agency induction should not mirror full permanent induction. It must focus on:
- Safeguarding and escalation.
- Medication boundaries.
- Recording expectations.
- Key risks for the people being supported.
Operational example 2: One-page risk briefings per shift
Context: Agency staff reported feeling unclear about risks during short placements.
Support approach: The service introduced one-page shift risk briefings.
Day-to-day delivery detail: Briefings highlighted falls risk, communication needs, behaviours of concern and escalation contacts.
How effectiveness/change is evidenced: Feedback from agency staff improved and incident reviews showed better early escalation.
Operational example 3: Monitoring agency reliance as a quality indicator
Context: A provider used agency staff extensively but did not analyse the impact.
Support approach: Agency usage became a standing governance metric.
Day-to-day delivery detail: Managers reviewed agency hours alongside incidents, complaints and continuity.
How effectiveness/change is evidenced: Trends informed recruitment priorities and reduced unsafe dependency.
Governance and assurance
Safe agency use requires:
- Clear policies and role restrictions.
- Induction records for temporary staff.
- Monitoring of agency-related incidents.
- Regular review of reliance and impact.
Why agency governance supports ageing well
When agency use is controlled and transparent, services protect continuity and safety even during pressure periods. This allows people to experience stable, respectful care while longer-term workforce solutions are developed.
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