Care homes vs nursing homes – what’s the best option?

Written by Zenya Smith16/08/23


24-Hour Care At Home

When it comes to residential care – i.e care that’s delivered in a specialist facility, the terms nursing home and care home are sometimes used interchangeably. However, there are considerable differences between the two, and which one is right for you will depend on the type and level of care you need. in this article, we’ll look at what makes them different, the care each provides, and how you can identify which option is best for you or your loved one. 

The similarities between care and nursing homes

Care homes and nursing homes provide 24-hour care in a dedicated residential facility. This means those being cared for will need to move into accommodation on site, which will usually be an individual en-suite bedroom. Residents share communal facilities such as recreational rooms, gardens and dining halls. In both care homes and nursing homes staff are on hand round-the-clock to support and assist with personal hygiene, getting dressed, and daily meals which are prepared for them and often served in a dining room. Homes will often include a schedule of regular physical activities such as yoga and chair based exercises that residents can do, as well as recreational activities that encourage social interactions, such as arts and crafts, day trips, gardening, and guest talks or visits from therapy animals. 

Both care home staff and nursing home staff will usually be able to assist with medication management, such as prompting or reminding people to take their medicines, helping to remove it from packaging, and administering certain medications. However, this comes with special considerations. Those on medication that needs specialist training to administer, or which is considered a controlled drug may be better suited to a nursing home, which we’ll cover in more detail later on.  

The differences between care and nursing homes

Although it may seem as though the terms are interchangeable, there are some significant differences between care homes and nursing homes. While both types of home offer elderly care and supervision from staff, nursing homes also have full-time qualified nurses (also known as registered nurses, or RNs) on duty round-the-clock. This means that they are better able to care for residents with more complex needs, such as those requiring help to treat or manage diabetes, Parkinson’s disease and the after-effects of a stroke, as well as those requiring advanced dementia care.

Nurses are also qualified to administer drugs through injection and to apply complex wound dressings if needed. In care homes, district nurses are usually called out for such tasks and with multiple visits to make and multiple patients to see, their arrival time can be difficult to predict. This may disrupt other parts of the day such as meal times or social events.

Do care homes or nursing homes offer dementia care?

Some do and some don’t, so it’s important to ask any home you’re considering whether they have the means to support the different stages of dementia, and whether all staff are experienced in delivering specialist care to people with dementia.

There are also specialist types of care homes that are built specifically for dementia care. These facilities ensure the unique needs of people with dementia can be met and offer things like more accessible layouts, clear signage, and dementia-friendly furnishings. For example many use contrasting colours to help residents know where they are. Residents also usually have secure access to all areas of the building and gardens. There are sometimes sensory gardens that can benefit people with dementia by stimulating their sense of sight, smell and touch. 

Does my loved one need nursing care?

The capabilities and services of each care home can vary, and some care home facilities offer nursing care on the same site. These are called dual-registered care homes. The benefit of this type of home is that if your loved one’s living in a care home, but over time their needs resulting in them needing nursing care the home can update their care plan. This eliminates the upheaval of moving into a new home and disruption to their daily routine. 

To get clear on your loved one’s needs it’s widely recommended to request a care needs assessment from the local council. Assessors will look at day to day life, where support is needed and make recommendations as to the best type of care to meet these needs. They’ll also draw up a care plan for the home to follow. However, if you’d like to get an insight into what the outcome of the assessment may be it can help to think about whether your loved one is living with or requires any of the following, as this may indicate their best suited to a nursing care homes. 

  • PEG feeding 
  • Stoma care and management 
  • On-going wound Care
  • Ventilation, Oxygen Support, BiPAP or CPAP Support
  • Unstable Epilepsy
  • Controlled Drug Administration
  • Daily injections
  • Acute mental health conditions
  • Degenerative health conditions 
  • If they are bed-bound and require hoisting or regular moving to avoid pressure sores 
  • Regular speech therapy or support from physical therapists 

Paying for residential care homes

If your loved one needs residential care, it’s always advised to contact your local council’s social services department for a care needs assessment. As well as identifying the exact levels of care they need, it’s the first step in understanding if you’re eligible for any financial support towards care home fees. After the needs assessment they’ll carry out a financial assessment of their savings, income and assets. This’ll calculate whether the council will financially contribute to all or some of their care costs, or if your loved one has enough to pay for care themselves. Find out more here.

Paying for nursing care homes

If your loved one is in need of nursing care, they may be eligible for greater funding support. This is because they need more complex care, and funding is based on health and medical conditions and therefore comes from the NHS.

The nursing component of your care i.e support that focuses on medical care and treatment, rather than social care and daily living, may be covered by the NHS-Funded Nursing Care – meaning you’d only be covering the portion of costs for social care either by yourself, or through your local council if you’re found to need financial support.

If you’re loved one is living with a complex condition or the later stages of a progressive disease, they may qualify for NHS Continuing Healthcare Funding, or CHC, which will pay your nursing home fees in full. Find out more here.


How do I know which care option is right? 

Ultimately, this will depend on how much care your loved one needs. However, when reviewing your options it can also help to consider – 

  • Social aspects and hobbies. Do they offer a wide range of daily activities that align with your loved ones interests? Are they likely to take part in things or are they more introverted? Will the home benefit their quality of life? 
  • Independent living. Will they adapt to a more regimented routine, or will they want to live daily life their own way? Do homes in your area offer any flexibility in the daily routine, such as when meals are served, or when residents get up in the morning? If not, you may want to look into assisted living facilities, which offer a greater sense of independence, alongside 24/7 staff support. 
  • Mobility. Can care homes cater to people with physical disabilities or poor mobility? Is the building old with stairs or narrow hallways? Is there a stair lift of elevator they can use to access all the amenities and explore the home? 
  • Staying connected to the outside world. Will your loved one be able to leave the grounds of the home regularly if they wish too? 30% of residential homes stated it was unlikely that residents would be able to get outside the grounds for a walk. It’s also worth asking about visits – can they see family and friends at any time or are there set visiting hours?  
  • Food. Can the home provide an example menu, and do they offer healthy meals that meet a range of different tastes, cuisines, or dietary requirements? Can residents request or get snacks when they want, or have a say over what they’re served? 


Alternatives to care homes and nursing homes

Research has found that 97% of people said they don’t want to go into a care home when they’re older. 

Often residential care is the first option that comes to mind when thinking about later life care. However, many care needs can be met within a person’s own home. 

Home care gives your loved one the opportunity to remain in familiar surroundings while benefiting from the one-to-one assistance they may need to continue to live independently. You can choose between regular visits from a carer, or live-in care, where a carer moves into the home to provide support around the clock. Live-in care in particular is highly person-centred care, as older people don’t need to change their routine, leave their community, or get used to a changing rota of support staff. 

This approach is particularly beneficial for those in need of dementia care. Your loved one’s carer will assist in a range of daily tasks, including shopping and preparing nutritious meals, taking your loved one to and from various appointments and social events, and help with personal care tasks, such as bathing and going to the toilet.

For more able-bodied individuals, companion live-in care can help them get out and about and stay connected to the outside world. Many elderly people build up a deep bond of trust and friendship with their live-in carer and enjoy the mental stimulation of having someone nearby with whom to chat and share their hobbies and pastimes.


Read more later life articles 

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