Types of care homes in the UK: how do you choose?

Reviewed by Helen Davies-Parsons

The decision to move an elderly parent or relative into residential care is a significant one that is both challenging and emotionally charged – particularly so since the pandemic cast a dark shadow over elderly care and the care home industry.

Stories about care home scandals, rising costs and continuing care staff shortages feature frequently in the news, so it’s natural to feel concerned and hesitant about elderly residential care. Not to mention the fact that care homes were COVID-19 hotspots during the pandemic, and people were prevented from visiting their elderly loved ones at this time.  

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Fortunately, reforms regarding care costs are underway and any concerns about restrictions on visiting elder loved ones need no longer worry us as new legislation is on the horizon, ensuring people in care homes and hospitals will be able to have visitors in all circumstances.

In addition, not all elder residential care is created equal. There are different standards and options available depending on where your parent or elder relative lives, how their care is being funded, and the level of care they require.

Read on to learn more about the types of care homes for older people in the UK, how they differ, and what other factors you need to consider before you start your search.

Types of care homes in the UK

The first thing to understand is that there are four main types of residential care options for older people in the UK. Each of these can be run or managed by private organisations, local councils, or charities, each with their own set of regulations. They can range from basic care facilities to luxury care homes that provide an exceptional standard of living for their residents.

The four main options are:

Assisted Living Facilities

Assisted living facilities provide a balance between independent living and residential care, offering support on hand as needed, such as help with bathing, transportation and housekeeping.  Services are either provided by in-house staff or through a partner domiciliary agency, depending on the type of facility.

Types of assisted living facilities include retirement villages, housing with care (previously known as sheltered housing) and close care housing.

Assisted living facilities allow older people to continue to live in a more private, homely environment and have more of their personal belongings around them, but with the reassurance of community and someone nearby to help if they need it.  While the assisted living accommodation may be smaller than their previous home, it allows an elderly person to maintain a higher level of independence and privacy than they would have in a care home.

It’s important to note, however, that buying or renting assisted living accommodation can be expensive and you need to take into account monthly service fees, which don’t include regular bills like water, electricity and council tax. Learn more about assisted living options and the pros and cons versus care homes.

  • Key features: Homely environment, allowing independence and more personal belongings.
  • Services: Help with personal care, daily activities, medication management, social events as requested.
  • Suitable for: Older people who are in relatively good health and value independence, but risk isolation and would like or benefit from support with healthy ageing (most assisted living facilities offer a wide range of activities to help residents stay physically active and socially connected).

Residential Care Homes

Residential care homes offer accommodation, meals, and assistance with daily activities. They are suitable for those who can no longer live independently, but do not require constant medical/nursing supervision. Residential care homes vary in size and style greatly. Some are converted from large family homes whilst the more modern ones are larger, purpose-built buildings.

Each resident has their own room, usually with an en-suite bathroom. Furnishings in residents’ rooms are typically minimal and often consist of a bed, a reclining chair, a TV, a wardrobe and a cupboard for storing personal belongings.

There will generally be common rooms on the premises that are used for mealtimes and socialising. Larger homes also often have onsite amenities such as hair salons and cafes.

  • Key features: Homely environment, communal living, personalised care plans.
  • Services: Assistance with daily activities, medication management, social activities, onsite amenities. Not all care homes offer the same services. It’s important to know exactly what services a care home provides for their residents and whether those services can be adapted if the needs of a resident changes in later life.
  • Suitable for: Older people who already need quite a bit of help with daily activities, meals, and personalised care and who prefer a more communal living environment, but do not have health conditions that require constant medical supervision.

Nursing Homes

Nursing homes are more specialised care homes for individuals who require round-the-clock nursing care from qualified nurses.  Most are equipped to handle complex health conditions – for example, if your parent requires artificial feeding through a tube or intravenous medication. That said, many will admit somebody with relatively low needs. This can be beneficial as it means the person can remain in the home and not be required to find an alternative as their needs increase.

  • Key features: Nursing homes provide a higher level of medical/nursing care than standard residential care homes.
  • Services: 24/7 nursing supervision, rehabilitation services, specialised medical care, entertainment and social activities.
  • Suitable for: Older people who have chronic, complex health conditions requiring round-the-clock medical supervision.

Dementia Specialist Care Homes

Dementia Specialist Care Homes are in many ways similar to residential and nursing care homes but cater specifically to individuals with dementia, offering a tailored environment and activities to meet their unique needs.

  • Key features: Specialised staff training, secure environments, dementia-friendly activities.
  • Services: Memory care programmes, sensory stimulation, cognitive therapies.
  • Suitable for: People with dementia who have reached the stage where they are struggling to live independently, or it is becoming too difficult for families to care for them safely at home.

Which type of residential care you decide to investigate further for your parent or relative will depend on their current and potential future health needs, and this is something you and they should discuss with their healthcare team.

But there are also a number of other surrounding factors that you and your parent or elder relative should carefully consider before you begin your search.

These include:

  • Location and Accessibility: Consider how close the assisted living facility or care home is to family and friends, local amenities (e.g., shops, cafes), and medical facilities. It’s not usually a good idea to look at care homes that are miles from family or friends who are going to visit, no matter how luxurious or less costly they may be.
  • Rating, Staff Qualifications and Reputation: The Care Quality Commission is the independent regulator that inspects and rates care homes. Their website is a good starting point for getting an idea of the standard of care at potential care or nursing homes, before deciding whether to add them to your shortlist.  Other good websites to check are carehome.co.uk and lottie.org, which are essentially like the Trip Advisor equivalents for care homes. You should also check Google reviews or Trustpilot, and ask your parent’s GP or health and social care team if they have any knowledge of the home’s reputation.
  • Facilities and Recreational Activities: What sort of person is your elder parent or relative, and what sort of facilities and recreational activities would they want or benefit from? Different care homes offer different options and sometimes these come at extra cost, so it’s a good idea to know what sort of recreation, facilities and entertainment your parent or relative cares about, what would make the biggest difference to their quality of life, and whether a potential home offers these.
  • Funding and Cost: Costs of assisted living and residential care vary considerably, depending on multiple factors including location, the ratio of care staff to residents, the level of personal and medical/nursing care someone requires and the activities and onsite facilities provided.  If your parent has complex health needs or limited funds to pay for care, government and NHS funding is available to support costs, but the process of determining their eligibility and accessing the funding can be confusing and complicated.

In summary

Proactive planning and informed decision-making are essential when it comes to choosing a care home for an elder loved one, which includes open communication with both your parent or elder relative and their GP or healthcare team.

Once you’ve understood what type of home your parent or elder relative needs, the next step is to research and make a list of potential homes to visit, considering all the other surrounding factors.  

Common questions

  • What is the difference between an assisted living facility and a care home?

Assisted living facilities provide a balance of independence and care for older people, where residents live independently in self-contained flats but round-the-clock support is on hand if required. Care homes offer more comprehensive care, where residents have a bedroom with an en-suite bathroom In care homes, all meals, housekeeping, laundry and maintenance is provided with care staff on hand to support care needs 24 hours per day.  Learn more

How do I know if a care home is good?

Research staff qualifications, read reviews, and visit the facility to get a firsthand impression of the people and environment. Before you visit the care home, make sure you know what to look for and what questions to ask.

  • How much does a care home cost?

Costs vary depending on a number of factors including where in the UK the home is located, the type of care your elder loved one requires, and any council or NHS funding they are entitled to. According to Age UK, it costs on average around £800 a week for a place in a standard residential care home and £1,078 a week for a place in a nursing home. However, these are UK average figures – costs in areas like London and the South East can be upwards of around £ £1250 per week.

  • What’s the best way to find a good care home?

Seek recommendations from healthcare professionals, friends, and family, and conduct thorough research online for homes in areas close to family and friends, checking CQC reports, ratings and online reviews – carehome.co.uk is a good site to check for reviews and personal experiences from the friends and families of residents.  Be sure to visit potential homes and ask the right questions to assess their suitability before making a decision.

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