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If you've started searching for a suitable care home, you'll need to pick between a residential care home and a nursing home. Our guide can help you make an informed decision.
Residential care homes offer living accommodation, meals and help with personal care, such as dressing and going to the toilet. Meanwhile, nursing homes offer everything available in a residential care home, plus access to 24-hour medical care from a qualified nurse. You might also want to consider an alternative to a care home, such as sheltered housing.
Below, our experts explore when you should consider a care home, also sharing details on care home costs, contracts and inspections.
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If you’re unsure which is the right residential care option for you or a loved one, consider the following:
There are also settings where you can buy or lease a house or flat in the grounds of a care home. This is known as ‘close care’, and is often set up as sheltered housing or extra-care housing. It enables you to live independently, but with the option of moving into the main care home later on, if you need to.
Despite what other people might tell you, don’t assume that a care home is the only option when an older person needs extra care. Solutions such as home adaptations, care at home or sheltered housing can also help.
Many people only consider moving into a care home when other options have been exhausted or are no longer suitable. But if residential care provides greater benefits for the individual than any other available option, it’s often the right choice.
If one or more of these situations is a cause for concern, it might be time to consider residential care:
A care needs assessment can help you or a loved one get support for day-to-day activities. See our guide – care needs assessment: how to apply and prepare
Getting a dementia diagnosis doesn't automatically mean someone will need to move into a care home. With the right support and planning, they should be able to continue living at home for as long as possible. However, a care home might eventually be the best option, especially in the later stages of dementia.
If you’re thinking about a care home for someone with dementia, remember to:
We've rounded up the best devices to help people with dementia or memory loss stay safer. For more, consult our guide on choosing the best memory aids.
According to Carehome.co.uk, the average cost of residential care in the UK is:
These prices are general averages for the UK as a whole. The actual fees can vary greatly depending on where you live, the level of support you need and the standard of facilities provided by the home.
Read our guide to care home fees for detailed information about costs.
Before exploring local care homes, make sure that you (or the person you’re caring for) gets a free needs assessment from the local council’s adult social care department.
This is still worth doing even if you think you'll end up paying for your own care. It provides a professional assessment of the type of care and support that’s needed, which will help you to choose a suitable care home.
In the UK, there are four watchdogs responsible for inspecting and reporting on care providers. The reports are publicly available.
In England and Scotland, the care regulators also give care providers a quality rating. The regulators in Northern Ireland and Wales don’t rate the providers they inspect, but you can read the inspection reports.
Contact your shortlisted care homes and talk specifics. Speak with the care home’s manager about how the home can meet your needs, and ask them to be upfront about the fees as this will help you avoid wasted visits.
The home will want to know how you're paying for care: self-funding, local-authority funded or a mixture. You might not know yet, in which case you'll need to explain the situation.
Enquire about availability of places and ask the home to send you written details of costs, together with a brochure.
It’s important to visit all the homes on your shortlist to get as much information as possible. If you can, visit with a family member or friend. If you’re unable to see the care home in person, ask a representative from the home to come to you to assess your needs face to face.
When visiting a care home, you should also:
If your care is being paid for by the local authority and a care home suggests that a top-up fee could be paid (to cover the cost of the room, or for a room with a better view, for example), explain that you’ll talk to the local authority about this. Third-party top-up fees should always be a voluntary payment and the contract for this should be between the person paying the top-up and the local authority, not the care home.
NHS-funded Nursing Care (FNC) is another area that our research has shown is potentially being exploited by care homes. If an older person is eligible for a nursing care contribution, it’s paid directly to the care home by the NHS. So if you or the person you're caring for is going to be a self-funder, check with the care home that the fee it's quoting includes nursing costs. If FNC is then awarded, this amount should be deducted from the bill.
See our downloadable checklist of questions to ask a care home and start thinking about your priorities when choosing a home.
The contract will be between the care home provider and whoever is paying the care fees. There are three likely scenarios:
Regardless of who's paying, you have the same rights and protections under consumer law.
Care home providers are free to use whatever terms they consider reasonable, but the law stipulates that the terms mustn't be unfair.
A good care home contract should cover:
Before making a final decision about a care home, ask to see a copy of the contract. Competition and Markets Authority (CMA) guidance states that care homes must ensure self-funding residents have received a copy of their standard contract or terms and conditions, and have time to read and understand them, before they agree to move into the home.
Ask the care provider to explain any clauses you don’t understand. If you have power of attorney for a loved one, you might need to sign the contract on their behalf.
For more general information about your consumer rights and protections, see our advice: Consumer Rights Acts 2015.
Like all care providers in the UK, care homes have to be registered with the appropriate national regulator, for example the Care Quality Commission (CQC) in England and the Care Inspectorate in Scotland.
As a part of their registration, each care home has to say what types of care it specialises in, whether this is residential care, nursing care or other more specialist areas.
Make sure you research all the options before making a decision.
If you want to stay in your own home and maintain a degree of independence, home care services and other help at home could provide the assistance you need.
When staying at home is no longer viable, moving into sheltered housing might be more suitable. For those who need regular support with personal care, think about assisted living or extra-care housing schemes. These are purpose-built retirement communities that also provide access to care and support.
If a family member or friend is willing to provide support, another possible solution might be to share your home or move in with them.