Fourteen out of Staffordshire's 21 council-run care homes will be closed, councillors have confirmed.
Rallies have been held against the original plans
The county council had initially looked at shutting all of the homes, but put forward the revised plans after consulting relatives.
The council has said more people should be cared for in their own homes or through the independent sector.
Residents and relatives staged protests over the original plans but failed in an attempt to secure a judicial review.
A meeting of the council's ruling cabinet confirmed the plans on Wednesday.
Council leaders have said it has a total of 310 residents in care homes.
It said 75 of those need nursing care, which local authorities are no longer allowed to provide.
In addition, another 110 will have the option to stay in their current county council care home.
HOMES WHICH WILL CLOSE
Billbrook House, Codsall
Greenwood House, Burntwood
Horace Pritchard House, Burton
Kniveden Hall, Leek
Lea House, Madeley
Nearfield House, Lichfield
The Homestead, Newcastle
The Laurels, Stafford
Thomas Hardy Court, Tamworth
Six of the homes that will be closed will be developed into specialist residential centres for people with dementia.
County council leader John Taylor said Staffordshire was just one of many authorities across the UK that was having to go through similar shake-ups.
He said: "We have always said that this was true consultation and today's decision proves that. We've not only consulted with those with the loudest voices, but with every service user and their families.
"It's also important to recognise this is not the end of residential care.
HOMES STAYING OPEN
Bracken House, Burntwood
Brighton House, Newcastle
Great Wyrley, South Staffs
Hillport House, Newcastle
"All over the country, councils are going through the same process that we at the county council are going through. The historic model of institutional care is simply not working any more and will deny service provision for so many people in the future."
He added that the changes were needed to help cope with the increasing ageing population. Rallies have been held in Stafford and Cannock against the original proposals to close all 21 care homes.