EMPOWERING RUGBY CARE HOMES TO DELIVER INSULIN CARE SAFELY
23 September 2026
The situation
For people living with diabetes in care homes, receiving insulin at the right time is an important part of managing their condition safely and effectively.
In Rugby, the South Warwickshire University NHS Foundation Trust’s Rugby District Nursing Team identified an opportunity to support care home staff to provide insulin for residents with stable diabetes, while ensuring they had the right training, skills and ongoing NHS support.
The programme introduced the NHS England insulin delegation framework across care homes in Rugby. This enables appropriately trained care home staff to administer insulin to residents with stable diabetes, with specialist NHS teams providing training, competency assessments and ongoing clinical oversight.
The approach means residents can receive their insulin as part of their usual care within their care home, while district nursing teams can focus their time on patients with more complex clinical needs.
What we did
The Rugby District Nursing Team worked with care homes to introduce the insulin delegation programme safely and consistently.
Care homes were carefully selected, with senior staff who were already trained in medicines management receiving specialist education from the Diabetes Nurse Specialist Team.
Staff were trained and assessed to make sure they had the knowledge and skills needed to safely administer insulin. Once they demonstrated competency, insulin administration was delegated to the care home team.
District nurses continue to provide regular clinical oversight and support, helping care home staff manage residents’ diabetes safely and providing advice when needed.
The programme has now been introduced across eight care homes in Rugby, with more than 40 care home staff trained and assessed as competent to administer insulin.
The impact
The programme is helping people with diabetes receive more timely and consistent care in the place they call home.
17 residents are currently benefiting from the approach, while care home staff have developed greater knowledge and confidence in supporting residents with diabetes.
Improved monitoring and support have also contributed to better blood sugar control for residents. Four residents have achieved such improved diabetes control that they no longer require insulin treatment.
The programme is also making a difference to NHS services. By reducing the number of district nursing visits needed solely to administer insulin, the approach is saving 29 district nurse visits every day, equivalent to around 14.5 nursing hours each day, or more than 100 hours a week.
This additional capacity means district nurses can spend more time supporting people with complex clinical needs, while continuing to provide safe, high-quality care and support to residents living in care homes.
Next steps
The programme will continue to support participating care homes and their staff, with district nursing and specialist diabetes teams providing ongoing clinical oversight and support.
The experience in Rugby also demonstrates how NHS teams and care homes can work together to develop new ways of delivering care closer to home, while making the best use of NHS nursing resources.
By giving care home staff the skills and confidence to provide insulin safely, residents can receive consistent care in familiar surroundings, while NHS nurses have more time to support people who need their specialist care.