What is the difference between a nursing home and a care home?

A residential care home offers a room, meals, company and help with everyday tasks: washing, dressing, getting to the toilet, and taking medication that is already prepared. Staff are trained in personal care, and many homes have a nurse or a link with a local surgery, but nobody on shift is a registered nurse whose job is nursing care itself.

A nursing home offers all of that, plus a registered nurse on duty at all times. It is registered with the Care Quality Commission to provide nursing care as well as accommodation, which under the regulated activities the CQC sets out means a service delivered, planned or supervised by a nurse, not just a carer. Many homes are dual registered, meaning they hold both registrations and can look after residents on either level, sometimes on the same corridor.

The how care homes work guide covers the wider process of moving into a care home, including what a typical day looks like and how a placement is arranged, and is worth reading alongside this page.

A registered nurse can manage a wound that needs regular dressing, look after a catheter or a feeding tube, set up and check a syringe driver for pain relief, and adjust care around a condition such as heart failure, kidney disease or advanced diabetes that needs watching day to day. They can also act immediately if something changes: calling the GP, arranging a hospital review, or starting emergency treatment, rather than waiting for someone else to notice and ring for help. Some nursing homes also run a unit for residents whose dementia has become complex alongside these medical needs, so the nursing and the dementia support happen in the same place.

None of this makes a residential care home a lesser choice. Most people who move into care never need nursing input, and a good residential home does everything above the line in the comparison well. The question is simply whether your relative's needs, now or soon, cross into the tasks only a nurse can do.

If several of these are true, ask for a local authority care needs assessment; it is free, and it settles the level of care your relative needs rather than leaving the family to guess. If the health needs are the main reason for the move, ask separately for an NHS Continuing Healthcare checklist; it can mean the NHS pays the whole cost of a nursing place rather than your relative paying towards it.

Where a nursing home fee is not fully covered, the same rules apply as for residential care: the council means-tests savings and income against the £23,250 upper capital limit in England, and anyone above it is expected to pay in full until their savings fall. How local authority funding works sets out the assessment and the limits in full.

The Care Quality Commission's service search lists every registered care home and nursing home in England with its current rating: Outstanding, Good, Requires improvement or Inadequate. It costs nothing to check before you visit.

Live-in care, where a self-employed carer moves into a spare room and is there through the day and night, covers everything a residential care home does: washing, dressing, meals, medication prompts, company and continuity with a face your relative knows. How live-in care works explains what a typical arrangement looks like, and because visits and travel are not part of the cost, it is often cheaper than a care home for one person.

What it cannot do is replace a nursing home for tasks that need a registered nurse, such as managing a wound or a catheter, in the same way a carer in a care home cannot. A district nurse can visit someone at home for those tasks, and some families combine a live-in carer with visiting nurses, but that only works while the nursing input needed is occasional rather than constant. Where nursing needs are frequent and unpredictable, a nursing home's round-the-clock staff usually serves the person better than piecing support together at home. Live-in care against a nursing home sets the two out side by side.

If the house itself is part of the problem, rather than the level of care, community retirement living and granny annexes are two ways to stay independent with support close by, without either a care home or the full commitment of live-in care. And for needs beyond what a nursing home is set up for, such as ventilator support or complex tube feeding at home, complex care covers what a specially trained carer or nursing team can provide.

PrimeCarers is an introductory service. It does not provide or manage care itself, and self-employed carers found through the site can support with personal care and company, but not with nursing tasks that legally require a registered nurse.

1. 1

   Ask for a care needs assessment

   Free

   Contact adult social care at the council, or ask a GP, hospital discharge team or district nurse to refer your relative. It settles what level of care is needed rather than leaving the family to guess between a care home and a nursing home.
2. 2

   Ask about NHS Continuing Healthcare if health needs are the main reason

   Free

   Request the checklist by name from anyone involved in your relative's care. If it passes, a fuller assessment follows, and it can mean the NHS pays the whole cost of a nursing place.
3. 3

   Check ratings before you visit

   Free

   Look up any home you are considering on the CQC website and read its most recent inspection report, not just its overall rating.
4. 4

   If staying at home might still work, look at live-in care

   This week

   Search live-in carers near your relative's postcode. It costs nothing to look, and talking to a carer can help you judge whether staying at home is realistic before committing to a move.