Every care option in Scotland, side by side
Families rarely start by asking for a care home. They start by asking what the choices are. This table sets out the full ladder of support, from a carer visiting the house to a nursing home with registered nurses on shift overnight, so you can see where a person sits today and where they may sit in a year.
| Option | Where the person lives | Who is on site | Best suited to |
|---|---|---|---|
| Home care (domiciliary care) | Their own home | Carers visiting at set times, nobody on site between visits | Someone safe on their own most of the day who needs help with washing, dressing, medication or meals |
| Sheltered housing | Own flat in a managed development | A warden or scheme manager, usually daytime only, plus an alarm pull cord | Someone independent who wants security, company and a smaller home, with no personal care included |
| Extra care or assisted living (very sheltered housing) | Own flat with a tenancy or ownership | Care staff on site, often 24 hours, care bought as separate hours | Someone who needs regular help but not constant supervision, and wants their own front door |
| Residential care home | Own room in a registered care home | Care staff on duty 24 hours, seniors on every shift | Someone who needs help through the day and night, meals, laundry and company |
| Nursing home | Own room in a home registered for nursing | Registered nurses on duty day and night, alongside care staff | Someone with clinical needs that legally require a registered nurse |
| Dementia care | Care home registered for dementia support | Higher staffing, dementia-trained team, designed environment | Someone living with dementia at any stage, particularly where distress or disorientation is part of the day |
| Respite and short stays | Care home, for a defined period | The same team as a permanent resident has | A carer needing a break, recovery after hospital, or a trial before deciding |
| Palliative and end-of-life care | Care home, hospice or own home | Care team working with GPs, district nurses and specialist palliative services | Someone in the last phase of life, where comfort and dignity come first |
These are not separate buildings in most cases. Many care homes, including most of ours, are registered for several of these at once, so needs can change without an address changing.
Assisted living vs a care home: the honest comparison
Assisted living, extra care housing and very sheltered housing all describe roughly the same thing in Scotland: a person has their own flat, holds a tenancy or owns it, and buys care hours on top. A care home is a single registered service where accommodation, meals and 24-hour care come together under one contract. The distinction sounds administrative and it is anything but, because it decides what happens on a bad night.
| Assisted living / extra care | Residential care home | |
|---|---|---|
| Legal basis | Tenancy or ownership, care bought separately | One contract covering accommodation and care |
| Care available | Booked hours, planned in advance | Care available at any moment, day or night |
| Overnight support | Usually an on-call responder, not personal care on demand | Staff awake and on duty overnight |
| Meals | Own cooking, sometimes an optional restaurant | All meals prepared and served, dietary needs catered for |
| Regulator | Housing regulation, with any care service registered separately | Registered and graded by the Care Inspectorate |
| Typical cost structure | Rent or mortgage, service charge, plus care hours | One weekly fee covering room, meals and care |
| Suits someone who | Manages most of the day alone and values a front door | Needs help unpredictably, or is no longer safe alone |
Assisted living works well until needs become unpredictable. The common pattern is a move to assisted living followed by a second move a year or two later, which is why it is worth being honest about the trajectory before deciding.
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 | Nursing care | |
|---|---|---|
| Staff on site | Care staff and senior carers, 24 hours | Registered nurses on shift day and night, plus care staff |
| Typical needs met | Washing, dressing, mobility, medication prompts, meals, continence support | Complex wounds, PEG feeding, catheters, unstable diabetes, oxygen, clinical observation |
| Funding contribution | Free Personal Care | Free Personal Care plus Free Nursing Care of £117.10 a week |
| Relative fee level | Lower weekly fee | Higher weekly fee, usually higher even after the nursing contribution |
| Assessment route | Council care needs assessment | Council assessment, normally with clinical input from the GP or community nurse |
Figures reviewed July 2026 and reviewed each Scottish financial year. Our costs guide works a full example through.
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, which is why the registration on the Care Inspectorate record matters more than the wording on a brochure.
Aged care, old people's home, assisted living: what the words mean here
Search results mix terms from several countries, which makes an already difficult decision harder. These are the phrases families type most often and what they translate to in Scotland.
| Term you may see | What it means in Scotland |
|---|---|
| Aged care | Australian term. Here it covers residential and nursing care homes for older people. |
| Assisted living facility | Largely a US term. The closest Scottish equivalent is extra care or very sheltered housing. |
| Old people's home or old folks home | Dated wording for a residential care home. |
| Rest home | Older wording for a residential care home, still used in some parts of the UK. |
| Long-term care | Ongoing care in a care home or at home, as opposed to a short stay. |
| Convalescent care | A short stay to recover strength after illness or surgery, often before going home. |
| Continuing healthcare or hospital-based complex care | NHS-funded care for very complex clinical needs, arranged and paid for by the health board. |
| Supported accommodation | Usually housing with support for adults with learning disabilities or mental health needs, not older people's care. |
If you are comparing a specific home, the Care Inspectorate register is the definitive record of what that service is registered to provide. Our guide to inspection grades explains how to read it.
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 knowledge hub covers the condition itself, and 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.