Care homes

If you're looking for a residential care home, there's a huge variety of options. They include:

  • care homes for older people
  • care homes for younger adults with disabilities
  • care homes for children

Care homes may be privately owned or run by charities or councils. They vary in size.

Is a care home right for you?

Going into a care home is a major commitment – it involves changing where you live and potentially paying a lot of money for your ongoing accommodation and care needs.

Before you opt for a move to a care home, think about other less disruptive – and potentially less costly – options, including:

Consider whether you really need the amount of care on offer at a care home, and look at alternatives such as "extra care" housing schemes or warden-controlled sheltered accommodation. These offer independence with an increased level of care and support.

Read more about your housing options.

Personal care or nursing care?

One of the first things to consider when choosing a care home is whether you need it to provide nursing care, or just personal care.

A care home registered to provide personal care can help you with things like:

  • eating meals
  • washing
  • going to the toilet
  • taking your medicine

Find care homes without nursing.

If you need nursing care, a nursing home will be more suitable. For example, a nursing home might specialise in certain types of disability or health conditions such as dementia.

Find care homes with nursing.

Care homes for adults aged 18 to 65

There are also residential care homes that provide care and support for younger adults with complex needs, for example:

  • severe physical disabilities
  • learning disabilities
  • brain injury resulting from an accident
  • mental health problems

They can care for adults with more than one health problem and some have expertise in providing care for adults with alcohol or drug dependency. These care homes may offer permanent residence or provide care for a temporary period.

Residential care for children and adolescents

Some care homes specialise in residential care for children with physical disabilities, learning disabilities or emotional problems.

Residential special schools focus on education and provide teaching on-site.

In some cases, care homes for children offer "transition" support for young people until they reach their early 20s.

Your right to choose a care home

If your local council is funding accommodation, it must allow you to choose which care home you prefer, within reason.

The council must first agree the home is suitable for your needs and that it would not cost more than you would normally pay for a home that would meet those needs.

Paying for a care home

Local council help with the cost of residential care is means-tested. You can choose to make your own arrangements (self fund) if you can afford it. However, it's worth asking the local authority for a needs assessment, because it might pay some or all of your care costs.

In the financial assessment, the local council can only take into account your income and assets you own. It is not allowed to ask members of your family to pay for the basic cost of your care.

Read more about local council funding for care and funding your own care.

If you choose a care home that costs more than the local council usually expects to pay for a person with your needs, you may still be able to live in the care home if a relative or friend is willing and able to pay the difference between what the local council pays and the amount the care home charges – this is known as a "top-up" fee.

However, if their situation changes and they are no longer able to pay the top-up, the local council may have no obligation to continue to fund the more expensive care home place and you may have to move out.

Read more about topping up.

Do not cancel your tenancy or sell your home until the final decision has been made by the local council. The value of your home must not be included in the local authority's means-testing until 12 weeks after you've confirmed that the care home placement will be permanent.

Deferred payment schemes

If you are thinking about moving into a residential care home and are worried about meeting the costs, ask your council for information about a "deferred payment scheme". This is where you arrange with their local council to pay some of the care fees at a later date. It means you should not be forced to sell your home during your lifetime to pay for your care.

Choosing a care home if you're paying yourself

If you're funding your own care, you have a lot of options.

Do as much research as you can on which care home is best for you in terms of cost, location, services, and so on.

Search our directory of care homes with nursing

Search our directory of care homes without nursing

Choosing a care home paid for by the local authority

After a needs assessment from social services, you will be provided with a care plan, which should make clear whether you need residential care and what other options, if any, might be available and most appropriate.

Even if you're unlikely to be eligible for financial help with care home fees, it's still worth involving social services. The needs assessment, and information they provide, could be very helpful when making decisions about your care.

Tips on choosing a care home

  • Check the most recent inspection report to see how well the care home is doing and if there is anything of concern. You can get inspection reports by searching for the care home on the Care Quality Commission (CQC) or Ofsted for children's care homes.
  • Consider the location of a care home. Is the care home near family and friends? Are there shops, leisure or educational facilities in the area? Is the area noisy?
  • Is the care home focused on the residents' individual needs, or do they insist that residents adapt to their routine?
  • What arrangements are there for visitors? Can residents come and go as they please, as far as it is safe to do so? Are staff able to help residents to go out? Are outings arranged?
  • What involvement would you have in the care home? How would you communicate with staff? Are there any support groups or regular meetings?
  • If safety and security are issues, what arrangements or supervision can the care home provide?
  • Will the care home meet your specific religious, ethnic, cultural or social needs? Will the correct diet be provided? Will the right language be spoken? Will there be opportunities to participate in religious activities? Do they allow pets?
  • Check what people who have used the care home say about it from online feedback and review services.
  • Ask for a temporary stay in the care home before you decide.

A good care home will:

  • offer new residents and their families or carers a guide describing what they can expect while they're living there
  • have staff who have worked there for a long time, know the residents well, and are friendly, supportive and respectful
  • employ well-trained staff, particularly where specialist care such as dementia nursing is required
  • involve residents, carers and their families in decision-making
  • support residents in doing things for themselves and maximising their independence
  • offer a choice of tasty and nutritious food, and provide a variety of leisure and social activities
  • be a clean, bright and hygienic environment that's adapted appropriately for residents, with single bedrooms available
  • respect residents' privacy, modesty, dignity and choices
  • be accredited under the Gold Standards Framework for end of life care

An unsatisfactory care home might:

  • have a code of practice, but not adhere to it
  • fail to take into account residents' needs and wishes, with most decisions made by staff
  • let residents' care plans become out of date, or fail to reflect their needs
  • have staff who enter residents' rooms without knocking, and talk about residents within earshot of other people
  • deny residents their independence – for example, by not allowing someone to feed themselves because it "takes too long"
  • have staff who don't make an effort to interact with residents and leave them sitting in front of the TV all day
  • be in a poorly maintained building, with rooms that all look the same and have little choice in furnishings
  • need cleaning, with shared bathrooms that aren't cleaned regularly

Moving into a care home

Moving home can be unsettling at the best of times, so when you move into a care home, it's good to plan it in advance. Have family or friends around you when you move to make you feel more comfortable.

You should also:

  • contact the benefits office, if you have one (including disability benefits, as these can be affected by care home stays)
  • make sure other services at your previous address have been notified
  • let friends and family know your new contact details and when you might feel up to receiving visitors
  • let the care home know about any health problems or disabilities you have

Rights of care home residents

The Care Quality Commission (CQC) is the regulator of health and adult social care in England, whether it's provided by the NHS, local authorities, private companies or voluntary organisations.

Standards for care homes are outlined on the CQC website.

The CQC can enforce fines, public warnings, or even suspend or close a service if they believe people's basic rights or safety are at risk.

If your care home closes

Care homes sometimes close. This can be because the owner decides not to carry on (for instance, if they retire), or because the home has been sold or failed to meet legal standards.

Closing a care home can obviously cause great distress. If the care home is operated by the local authority, it has to follow a consultation process with residents and families.

It may be best to get specialist legal advice in this situation. You can find a solicitor through the Law Society.

Complaining about a care home

You have the right to make a complaint about any aspect of a care home. For example, you might want to complain about the quality of care provided or the fees charged. There are a number of ways you can make a complaint.

If the care is funded or arranged by the council, they are responsible for it, even if it is provided in an independent care home. Complain directly to the council.

If you're not satisfied with the response you get from the council, ask the Local Government Ombudsman to investigate.

If you are funding or arranging your own care, complain to the care home operator. The law says all care homes must have an appropriate complaints procedure. If you're worried about doing this, complain directly to the Care Quality Commission. The CQC monitors, inspects and regulates care homes to make sure they meet fundamental standards of quality and safety. You can report poor care to the CQC, anonymously if you wish. You can also tell them when you have received good care.

Read more about how to make a complaint about a care home.

If you are finding it difficult to make a complaint, find out how an advocate can help you.

Page last reviewed: 19/01/2018
Next review due: 19/01/2021