Moving into residential care

A residential care home is a shared home for a group of people. You usually have your own bedroom and bathroom. You may share living and dining rooms with other residents. 

It can be run by: 

• local council social services 
• a private company 
• a charity or voluntary organisation 

Staff are available for support 24 hours a day if you need them. They provide services like: 

• helping with personal care, like washing, dressing and going to the toilet 
• giving you your medication or reminding you to take it 
• cooking meals 
• doing laundry 

There are often activities you can join. Staff will usually try to support you with outside interests, such as going to classes or to a day centre. 

There can be different sizes and types of residential care homes. A few are for younger people.  

If you move into a residential care home, there is usually no limit on how long you can stay. But it may depend on funding.  

Who pays for residential care 

Some care homes might also have space for shorter placements. For example, if you need: 

• respite care 
• temporary housing during home adaptations  

Nursing homes 

Nursing homes are like residential care homes. But they also have 24-hour nursing care. Your council might decide that this meets your needs if: 

• you have been discharged from hospital or 
• you have a complex medical condition 

You may not have a choice about which type of care home your council say they will pay for.

Your local council’s social services look at your needs by carrying out a social care needs assessment. 

They will review any previous assessments you have had. 

Anyone can ask their local council for a social care needs assessment.  

Find your local council (GOV.UK) 

Part of the assessment will look at: 

• the cost of your existing care and  
• what other options will meet your needs  

You might need to complete a lot of paperwork. A social worker can help you with this. 

There are things you need to do if you move home. 

Moving house checklist (Which) 

Social services will look at how they can meet your care needs within their budget. Even if you plan to pay for residential care yourself, social services may still carry out a needs assessment.  

The person supporting you can also have a carer’s needs assessment.  

During a needs assessment, you can talk to your social worker about what is important to you in a care home. For example: 

• where it will be 
• what your room will be like 
• facilities 
• care and support 
• activities 
• if you can socialise with other residents 
• how easy it will be for people to visit you 

It can also help to think about: 

• what has changed and why your living situation no longer works 
• what type of accommodation can meet more of your needs 
• how your life will change if you move 

Social services will decide which care home or homes in your area meet your needs.

Once you have had a needs assessment, your local council will carry out a financial assessment. This is to work out if: 

• you need to pay towards the cost of your care and  
• if so, how much you must pay

Financial assessment for social care

The following can pay for residential care: 

• local council social services 
• NHS continuing healthcare (CHC) 
• you or a family member (called self-funding) or 
• a mix of these 

The council will write to you to tell you: 

• if you must make a contribution  
• how much the council can pay  

The cost of care homes depends on what your needs are and where you live. 

When the council might pay for your care (NHS) 

How are care homes paid for? (Which?) 

Your care will be paid for as long as the council assesses that you need it. 

If you are a homeowner

Shared care package  

A shared care package is when: 

• social services pay for some of your care because you have social care needs and 
• the NHS pays for some of your care because you also have a primary health need 

You have a primary health need if the main reason you have care is to: 

• support your health needs or  
• prevent them getting worse 

NHS continuing healthcare (CHC) is funding to pay for the medical care and support you need. 

With a shared care package, you do not pay for the primary health needs part of your care. 

Top-up funding  

You might decide you want to live in a residential care home that costs more than your council will pay. If you can afford to, you can pay the rest of the cost in ‘top-up funding’. If a friend or family member pays, it is ‘third party top-up'.

If you own your home, you may need to sell it to pay for residential care. 

There are exceptions. The people who live in your home may be able to stay there when you move into residential care. That is if they are: 

• your partner 
• a close relative over 60 
• a disabled relative 
• a child who depends on you for care, known as a dependent child 

You can sign a deferred payment agreement with your local council. This means that those people can carry on living in your home. But when they die or move home: 

• your house will be sold and  
• the council will receive the money they are owed 

What is a deferred payment agreement? (MoneyHelper) 

If you sell your home to pay for residential care but the money runs out, you should be able to stay in the care home. The council should review your needs every year. If they still feel the care home meets your needs, they will pay for your care.

You can search for a care home online by: 

• type of care home 
• name 
• location 

Find a care home in England (Care Quality Commission) 

Find a care home in Wales (Care Inspectorate Wales) 

Care home reports and reviews 

In England, the Care Quality Commission (CQC): 

• inspects residential care homes and  
• publishes reports on how well they are managed 

In Wales, it is the Care Inspectorate. 

It is a good idea to read the inspection reports of care homes on your list. You can: 

• read a summary of the report and 
• ask friends and family to help you research 

Care Quality Commission (CQC) inspection reports 

Care Inspectorate Wales inspection reports 

If the report mentions a high turnover of staff, this could mean that staff are unhappy there.  

If there are regular inspections, there could be problems at the care home. 

You can also search for reviews on social media and online forums. Reviews can be one person’s opinion and may not be based on facts.

Visit care homes before deciding. Take someone with you and use your visit to: 

• take a tour and get a first impression of the home, facilities and residents 
• check you can access any equipment you need 
• ask about any adaptations you need 
• find out about fees and any extra costs 
• see what activities are happening, and if they reflect what the home is advertising  

Ask about: 

• outings and transport: how can you access and pay for these? 
• mealtimes: can you have meals alone, at different times, with visiting friends, outside planned menus? 
• any personal wishes or hobbies that are important to you 

To get a feel for what the home is like, you can also arrange a second visit at a different time of day. You may also be able to arrange a trial stay before you commit to moving in.  

Choosing a care home (Carers Trust)

By law, your local council must give you information and advice on how to find residential care for you or someone you care for. Contact them to ask how to access their information service. 

Find your local council (GOV.UK)

Social services may encourage you to move to a particular care home. They may say that it:   

• meets your needs  
• is the only home in your area that has space for you and  
• is the most affordable option 

But if you do not feel the home can meet your needs, you can ask them to write to you saying why they recommend that care home. You can then give them evidence of why you feel the home is unsuitable. 

Getting an advocate to support you 

Social services might say you will have access to equipment or adaptations, so the care home meets your needs. 

You do not have to accept their offer of a place in that care home. But they could say they can no longer help if that care home meets your needs. 

Find out how to challenge or complain about a social care decision. 

You might prefer to live in a different care home, but they do not have a place for you. You can ask the care home to put you on the waiting list. Make sure that the council agrees to this.

There might be reasons that people around you feel a residential care home is best for you. For example: 

• your needs have changed after your condition has deteriorated or you have had an accident or 
• your family now find it hard to care for you 

Moving to a residential care home may be the only affordable option open to you. If you feel under pressure to move, you can get advice and support to talk through your options. 

Getting an advocate to support you 

Complaining about a residential care or nursing home

Mental capacity 

Having mental capacity means that you can make decisions for yourself. 

Some people do not have the mental capacity to decide where they should live. They may have a Deprivation of Liberty order. 

Deprivation of Liberty

If you feel under pressure to move, you can ask social services for an advocate or find someone yourself. Most advocacy services are free. 

An advocate is someone who knows what your rights are. Your advocate can help you to say the things you want to. You can take an advocate with you to social care assessments and appeals.  

A Care Act advocate from your local council

Complaining about a residential care or nursing home

You may not need the level of care that a residential care home gives. There are ways of living independently with extra support. For example:  

• supported living, also called sheltered housing, independent living or assisted living 
• Shared Lives