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15 November 2021

Care homes and nursing homes explained: what’s the difference?

Care homes provide support for older people who can no longer look after themselves. Read about residential care homes and nursing homes, and the different services they provide.
W
Which?Editorial team

What is a care home?

Care homes provide safe and supportive accommodation for older people who are no longer able to live independently, with trained staff on duty day and night. 

There are two types of care home:

  • Residential care homes provide living accommodation, meals and help with personal care, such as washing, dressing and going to the toilet. They are also referred to as ‘care homes without nursing’. 
  • Nursing homes offer everything that’s available in a residential care home, plus access to 24-hour medical care from a qualified nurse. They are sometimes called ‘nursing care homes’.

A general term for care homes and nursing homes is ‘residential care’. 

Care homes are suitable for people who need long-term care and support, potentially for the rest of their lives. But some homes also provide support for people who require temporary care (after a fall or a stay in hospital, for example), respite care or day care.

Residential care homes vs nursing homes

In many ways, residential care homes and nursing homes provide a very similar service. Both provide living accommodation, meals, communal activities and 24-hour support. Residents usually have their own room with en suite facilities (although some homes still offer shared bedrooms), and meals are served in a communal dining area. Most homes also arrange social and leisure activities for residents. 

The key difference is that nursing homes employ registered nurses who can provide expert medical care 24 hours a day, seven days a week.

If you’re unsure which is the right residential care option for yourself or a loved one, here are some key factors to consider.

Medical needs

In residential care homes, carers will help residents to manage any medication they’re taking, as well as providing support for day-to-day living and personal care. But if a resident needs specialist medical attention – for a sudden illness or an accident, for example – then a district nurse or local GP will usually be called, or they might need to visit a hospital. 

Nursing homes, with their own registered nursing staff, are typically best suited to people with ongoing, complex health needs or severe physical disabilities.

Cost

A nursing home will usually cost considerably more than a residential care home – about 40% more, on average. See more information below about the average cost of residential care.

Activities

Life in a residential care home will usually be more active and varied than in a nursing home. A nursing home will inevitably have fewer active residents than a residential care home, but most nursing homes will still organise appropriate activities, such as small groups playing music or singing, storytellers, pet therapy or reminiscence activities.

Specialist care needs

Many care homes offer specialist support for people with health problems such as dementia, mental health conditions, visual impairment or physical disabilities. If you have needs of this kind, it doesn’t necessarily mean you need a nursing home. Many residential care homes are registered to provide specialist support for these types of conditions. 

When choosing a care home, check that it can provide for your individual care needs.

Get a needs assessment

The first step in arranging care for an older person is usually to get a free care needs assessment from your local authority. This will provide a professional assessment of your care needs and the types of support you would benefit from. It will tell you if a residential care home or a nursing home is the most appropriate choice for you.

More options to consider

Some care homes provide a mix of different care types. For example, there might be a set number of beds for residents requiring support with personal care, a certain number for those requiring nursing care, and further places for people with dementia.

If you currently need help with personal care, but have an illness or disability that might require regular nursing care in the near future, consider a care home that offers both types of care. In this way, your care plan can be ‘upgraded’ if your needs change, without having to move again.

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. This can be a good approach for couples where one partner might need residential care sooner. The other partner can continue to live independently, but in the same location.

Do you need a care home?

If you or someone you care for is finding it difficult to manage at home, don’t automatically assume that a care home is the only option. Solutions such as care at home or sheltered housing, for example, might be suitable options when someone needs extra support. For most people, moving into a care home is only considered when other options have been exhausted or are no longer suitable.

If you’re in any doubt, our article on when you should consider a care home will help to guide you. It also covers the alternative care options to consider.

How much does residential care cost?

According to research by LaingBuisson*, the average cost of residential care in the UK in the 2019-20 was:

  • £672 a week (£34,944 a year) for residential care homes
  • £937 a week (£48,724 a year) for nursing homes.

These prices are general averages for the UK as a whole. The actual fees charged by a care home 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 article on care home fees for more detailed information about costs.

What will life be like in a care home?

Care needs

In a residential care home, staff will attend to residents’ personal care and health, often with support from external professionals such as:

  • a local GP
  • district nurse
  • physiotherapist
  • chiropodist
  • holistic therapists
  • hairdresser
  • vicar, priest or other religious leaders.

In addition, nursing homes have their own registered nursing staff on duty at all times.

Social activities

As well as looking after day-to-day needs, many care homes have activity co-ordinators who arrange regular activities for residents. These might include arts and crafts, exercise, gardening, musical events or dancing, for example. 

If there’s a particular hobby or interest that’s important to you, check with the care home if these are supported before choosing the care home.

For more tips on how to make the most of life on a care home read our article on Moving into a care home.

Who runs care homes in the UK?

There are almost 10,500 registered care homes in the UK run by private companies or non-profit organisations, which provide about 435,000 places in total. There’s also a smaller number of homes run by local authorities and the NHS, which provide around 27,000 places for older people.

Care homes can be operated by the following organisations:

  • Private companies - Most care homes in the UK are owned by private businesses and are run on a commercial basis. These range from small family-run homes to large care groups that operate anywhere from 20 to 300 care homes. Some of the largest care home groups include Anchor Hanover, Barchester, Bupa, Care UK, Four Seasons Health Care and HC-One. 
  • Non-profit organisations - These include charities and housing associations, and account for less than 15% of care-home places in the UK.
  • Local authorities - The number of council-run care homes has decreased significantly in recent years. Most local authorities now rely on private companies or non-profit organisations to provide residential care services for their population.

Care home inspections

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.

Read more about how care homes are rated and inspected across the UK.