Choosing a care home: what to look for

Ask for a needs assessment even if your relative will pay the fees in full. It costs nothing, the council must give you information and advice whether or not it will be paying, and the written assessment is useful later if their savings fall and the council takes over. Local authority funding explains how to ask. If the move is being planned from a hospital bed, hospital discharge explained covers how that process runs.

If your relative may need nursing at some stage, check now whether each home is registered to provide it. A residential home cannot bring a nurse in later, and a second move is hard on someone who has just settled. The difference between a nursing home and a care home sets out what each registration covers, and how care homes work covers the wider picture.

The four ratings are outstanding, good, requires improvement and inadequate, and CQC sets out what each rating means. Newer reports also carry a percentage score, so you can tell whether a home rated good sits near the top of that band or close to the edge of it. Homes must display their current rating at the home and on their website, so if you cannot see one, ask why.

The date matters as much as the word. A rating stays on a home’s page until the next assessment, and some have been there a long time: CQC is prioritising services rated more than six years ago, and services registered for over a year that have never been assessed. A good rating from six years ago describes a staff team and a manager who may both have changed. Find the date first, then read the ratings history to see which way the home has been moving.

If your relative has dementia, ask how the home supports people at their stage of it rather than whether it is a dementia home. Homes providing dementia care usually need more staff, which can be reflected in the fees, and not everyone living with dementia needs a specialist home. At what point should someone with dementia go into care? covers how that judgement is reached, and Age UK publishes a longer list of questions to ask a home.

Take somebody with you. Two people remember a visit differently, and the one who is not asking the questions has more attention for the room. If a brother or sister disagrees about the move, take them, so that you are both working from the same visit rather than a phone call. When siblings disagree about a parent’s care covers the rest of that conversation.

Turnover is high across the sector, so a home with some of it is normal rather than alarming. The national figures show where it sits worst. Skills for Care found turnover highest in establishments with lower CQC scores, better scores in care homes with more staff in post per bed, and better scores where the registered manager had more experience in the role.

So ask. How many care staff have left in the past year, and how many are on the rota tonight for this number of residents? How long has the registered manager been in post, and is the post filled now? A home between managers is not disqualified by it, but you want to know, because well-led is the key question that covers the manager and the provider’s oversight of its own home. Ask what share of shifts agency staff cover in a normal week as well: a home using the same agency workers repeatedly is different from one taking whoever is free.

Two rows are worth pressing on. The first is the top-up. Where the council arranges the placement it must show that at least one suitable home is available within the personal budget it has set, and the guidance says it should make sure there is more than one. A top-up can only be asked for where your family has chosen a home costing more than is necessary to meet the assessed needs. The home itself must not ask you for one directly: the arrangement is made with the council, in writing, and it has to say what happens if payments stop.

The second is nursing. If your relative needs care from a registered nurse, the NHS pays a weekly amount straight to the home, £267.68 at the standard rate or £368.24 at the higher rate from 1 April 2026, which are the national rates announced for 2026 to 2027. That is for the nursing part of their care, and the home has to explain how it has been reflected in the fee you are asked to pay. Ask for that in figures, in writing.

Then ask for the list of extras, and ask specifically about hairdressing, chiropody, newspapers, outings and transport to appointments. Some of what gets billed as an extra should be coming free from the NHS. How to privately fund care covers paying from savings or a property, NHS Continuing Healthcare covers the assessment that can make a placement free, and a care home week against a week of care at home sets the two costs against each other.

The government publishes a short guide to your consumer rights in a care home, and it is worth reading before you sign. Ask for the standard contract early, at the end of the first visit rather than on the day of the move. A home is expected to give you its terms before it offers a place, so that you can read them somewhere calmer. If you are asked to decide the same afternoon, that pressure is worth noticing. Read the fee-rise clause, the notice clause and the hospital clause, because those three change what a family pays over a year more than the headline weekly figure does. If a relative is asked to sign as guarantor, take advice first: that is a personal financial commitment rather than a formality.

1. 1

   Visit your two favourites again

   Before you choose

   Go at a different time of day from the first visit, ideally while a meal is being served. Take somebody with you, and write down what you saw the same evening.
2. 2

   Read the contract at home

   Before you commit

   Go through the fee, the extras, the notice, any deposit and the complaints procedure. Ask the home in writing about anything unclear, and keep the reply.
3. 3

   Ask about a trial period

   Before the move

   Some homes take someone on a trial basis, and a council arranging the placement may agree one. Hold off selling a house or ending a tenancy until the move is confirmed as permanent.
4. 4

   Hand over what only you know

   The first week

   Write down the routines, the food they will not eat, how they take their tablets, what a bad day looks like, and who to ring. The care plan is built from that.
5. 5

   Review after a month

   The first month

   Raise small things with the manager early rather than saving them up. If something is not resolved, the Local Government and Social Care Ombudsman looks at adult social care complaints, including privately funded ones.

Not every family that reaches this stage goes through with the move. If the visits leave you thinking that what your relative needs is help at the two hard ends of the day, or somebody in the house overnight, that is a reasonable conclusion to reach here. You can search for carers near you and compare their rates before you decide, and is live-in care cheaper than a care home? sets a carer in the house against the cost of a place.