The five types, at a glance
| Type of care | Who it suits | What is different about it |
|---|---|---|
| Residential care | Someone who needs help with daily living but not clinical nursing | Personal care, meals, laundry and company, with care staff on site around the clock |
| Nursing care | Someone with clinical needs that require a registered nurse | Registered nurses on shift day and night alongside the care team |
| Dementia care | Someone living with dementia at any stage | Higher staffing ratios, specialist training and an environment designed to reduce confusion and distress |
| Respite and short stays | Someone who needs care for a defined period, or a carer who needs a break | The same care, booked for days or weeks rather than permanently |
| Palliative and end-of-life care | Someone in the last phase of life | Symptom and comfort focus, family support, close work with GPs and specialist nurses |
These are not separate buildings in most cases. Many homes, including most of ours, are registered for several of these at once.
Care home or nursing home: the difference that matters
This is the question families ask most, and the answer is simpler than the language suggests. Both provide 24-hour care. The difference is whether registered nurses are employed on site.
- Residential care covers personal care: help with washing, dressing, medication, mobility, meals and the ordinary business of the day, delivered by trained care staff with senior staff on every shift.
- Nursing care adds registered nurses on duty around the clock, for needs such as complex wound care, PEG feeding, catheter management, unstable diabetes, oxygen therapy or conditions that need clinical observation and judgement.
- A residential home can still support someone with a health condition. What it cannot do is provide nursing interventions that legally require a registered nurse.
- Financially, nursing care attracts the Free Nursing Care contribution of £117.10 a week on top of Free Personal Care, but nursing fees are also higher, so the net cost is usually greater. Our costs guide works this through.
What dementia care registration really means
Almost every care home will tell you it supports people with dementia, and most genuinely do, because dementia is very common in later life. Specialist dementia care is a step beyond that, and it shows up in staffing, training and the building itself rather than in the brochure.
- Higher staff-to-resident ratios, particularly in the late afternoon and evening when distress is more common.
- Staff trained in recognised dementia approaches, with training refreshed rather than done once at induction.
- An environment designed to help: clear sightlines, contrasting colours on doors and handrails, good natural light, secure outdoor space, memory prompts and personalised bedroom doors.
- Small lounges and quiet spaces rather than one large room, so people can find the level of stimulation that suits them.
- Activity built around individual life histories rather than a single group programme.
- A settled staff team, because familiar faces are part of the care for someone who cannot rely on memory.
When you visit, ask how the home supports someone who becomes distressed in the evening, and ask what they do instead of medication. The answer tells you more than any inspection report about how the home really works. Our dementia care service page sets out our own approach.
Respite, short stays and trial stays
Respite care is the same care, for a defined period. Families use it for very different reasons, and all of them are legitimate.
- A family carer needs a holiday, an operation, or simply a rest before exhaustion becomes a crisis.
- Someone is recovering after a hospital stay and needs support and rehabilitation before going home.
- A family wants to try a home before committing to a permanent move, which is often the kindest way to make the decision.
- Winter care, where a person who manages at home in summer struggles with ice, isolation and darkness.
Palliative and end-of-life care
Palliative care is care focused on comfort, dignity and quality of life rather than cure. It is not only for the last few days. Someone with a progressive condition may receive palliative support for a long time alongside other treatment.
In a care home this means close work with GPs, district nurses and specialist palliative teams, careful attention to pain and symptom control, and equal attention to the things that are easy to overlook: familiar music, a favourite chair by the window, family able to visit at any hour, and staff who know the person well enough to notice a change before it is measurable.
It also means supporting the family. Ask any home you are considering how they involve families in end-of-life planning, whether relatives can stay overnight, and how they support residents and staff after a death. The way a home answers that question tells you a great deal about its culture.
How to work out the right level of care
- 01Request a local authority care needs assessment. It is free, you can ask for it yourself, and it is the formal answer to what level of care is needed.
- 02Talk to the GP and any community nurse involved. They will often see the clinical trajectory more clearly than the family can.
- 03Write down a real week: what help was needed, when, and what happened overnight. Patterns emerge quickly on paper.
- 04Ask any home you visit for a pre-admission assessment, and take seriously any home that says it cannot meet the needs. That honesty is a good sign, not a rejection.
- 05Check the home's Care Inspectorate registration covers the care that may be needed later, not only the care needed now.
Once you know the level of care, our guide to choosing a care home covers how to compare individual homes, and you can browse our homes by care type to see which of ours are registered for what.