How to Choose a Care Home

Before searching for specific care homes, establish the key requirements:

• Type of care needed — Residential care (personal care, no nursing) or nursing care (registered nurses on site). If the person has dementia, specific dementia-registered provision may be needed;
• Location — Proximity to family and existing community connections matters for the person's wellbeing. Being near family who can visit regularly is associated with better care outcomes;
• Funding situation — Is the placement council-funded, NHS-funded (CHC), or self-funded? This determines the available options and who is commissioning the placement;
• Specific needs — Particular medical conditions (Parkinson's, MS, acquired brain injury), cultural or religious needs, dietary requirements, language needs.

Use the CQC's care home search tool at cqc.org.uk to find registered homes in the required area and check their ratings. Focus initial research on homes rated Good or Outstanding. Read the full inspection report, not just the headline rating — it often contains important detail about specific strengths and weaknesses.

A visit is essential before making any decision. Prepare for the visit by:

• Preparing a list of questions (see the related guide on 20 questions to ask a care home);
• Visiting at a mealtime if possible — the quality and presentation of meals and the atmosphere at mealtimes is revealing;
• Asking to speak with current residents and their families without staff present if possible;
• Looking at communal areas, the garden (if any), and (if possible with consent) the rooms available;
• Observing how staff interact with residents — are they respectful, patient, and engaged?

Pay attention to smells, sounds, and atmosphere. A well-run home will smell clean, not of urine. Residents should appear engaged and cared-for, not left alone for long periods. Staff should know residents by name and greet you warmly. Trust your instincts alongside the objective checks.

Before committing to a placement, review the financial and contractual terms carefully:

• Full fee breakdown — What is included in the weekly fee and what is charged as an extra? Common extras include incontinence products, hairdressing, some activities, physiotherapy, and transport;
• Fee increase policy — How much notice is given of fee increases? How are increases calculated (e.g., linked to CPI, or at the home's discretion)? Is there a cap?
• Notice period — How much notice must you give to leave? Typically 28 days for the resident, but check what notice the home must give to ask you to leave;
• Bed-holding fees — What is charged if the resident is in hospital temporarily and the bed must be held?
• Third-party top-up arrangements — If council-funded, is a top-up required? Is it clearly set out in a written agreement?

Ask for the care home contract in advance to review. If any terms seem unusual or onerous, seek advice before signing. Age UK publishes guidance on care home contracts.

Choosing a care home is not simply a consumer decision — it is also the beginning of a legal relationship in which you (or the person entering care) have significant statutory rights. Knowing these rights from the outset helps ensure quality care and protects against poor practice.

The Right to a Written Contract

All care homes must provide a written contract before or at the time of admission. The contract must set out the fee, what is included, the notice period, and the arrangements for reviewing and increasing fees. If a care home attempts to admit a resident without a written contract, insist on one before signing anything. The Competition and Markets Authority (CMA) has published guidance making clear that unfair contract terms — such as excessive notice periods that apply only to residents (not to the home) or unrestricted fee increase clauses — may be unenforceable under consumer protection law.

CQC Registration and Fundamental Standards

Every care home in England must be registered with the Care Quality Commission (CQC) and comply with the CQC's Fundamental Standards of Care. These standards include:

• Person-centred care — Care must be tailored to the individual's needs, preferences, and choices;
• Dignity and respect — Staff must treat residents with dignity and respect their right to privacy and autonomy;
• Safety — The home must identify and manage risks to residents' safety, including falls, pressure injuries, and medication management;
• Safeguarding — The home must have robust safeguarding policies and staff must be trained to identify and respond to potential abuse.

If a care home fails to meet these standards, you can raise a concern with the CQC at cqc.org.uk/give-feedback-on-care. CQC can take enforcement action against care homes that persistently fail standards, up to and including cancellation of registration.

NHS Continuing Healthcare Assessment at Admission

If the person entering care has complex health needs, ask the hospital or council whether an NHS Continuing Healthcare (CHC) assessment has been carried out or should be arranged. If the person is eligible for CHC, the NHS — not the person or council — funds the full cost of care. People are sometimes admitted to care homes and begin self-funding before a CHC assessment is ever offered, when they might have been eligible for NHS funding from the outset. Raise this before or at the time of admission if health needs are significant. If CHC eligibility is established after admission, a retrospective claim for backdated funding is possible in some circumstances.

Discharge from Hospital to a Care Home

People are sometimes pressured into choosing a care home quickly as part of a hospital discharge. Under the Discharge to Assess (D2A) pathway, the NHS is expected to support short-term funded care to allow proper assessment to happen, rather than requiring a permanent decision to be made while the person is unwell or in crisis. If you or a family member is being pressured into a permanent care home placement before an adequate assessment, contact PALS (Patient Advice and Liaison Service) at the hospital and the council's adult social care team.