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Residential and nursing homes

A residential care home provides accommodation, meals and personal care for older people, people with disabilities, or people who are unable to manage at home, for whatever reason.

The level of care varies from home to home, but the Government defines it as the kind of care you would receive from a competent and caring relative. This includes: help with eating, washing, bathing, dressing and toilet needs; and caring for you if you become ill. However, residential care does not include nursing care.

The decision to recommend a residential or nursing home will only be made after a full assessment. If nursing home care is recommended, then the local health authority also has to agree to this. You can also consider homes in other local authority areas if your needs will be better met there.

When choosing a home, it is important to make sure that you choose one that will be right for you both now and in the future. You can get advice and information to help you make this important decision from:

  • your social worker or care manager
  • a district nurse
  • a health visitor
  • your family doctor

All residential homes, whether council-run or private, are regularly inspected by the Care Quality Commission.

Finding a home

If you are financially independent, you may obviously approach any of the homes within the private and voluntary sector directly, and make your own arrangements.

However, if you need help in finding the right home, or need financial assistance, then your local Social Services department will offer an assessment of your needs and help in planning your care. If you require financial assistance, you should not enter into any agreement with a home until you have ascertained what financial help is available.

Whoever is paying for your residential care, it is best to make a visit to several homes before making a final choice. Wherever possible the person who will be living in the home should be involved at every stage of the selection process.

When you are considering a home, it may be helpful if you look at some of the points:

  • Are the physical conditions suitable, eg is there a lift, handrails, ramps for wheelchairs, bathing aids, locks on doors?
  • Does the home provide a clear statement of the facilities available and the financial terms?
  • Are the residents able to use their own furniture and make their bedroom individual to them?
  • Are the shared areas homely, clean and sweet smelling?
  • Is the quality, quantity, and variety of food satisfactory?
  • Do staffing arrangements appear to be satisfactory and do staff treat residents with dignity, respect and friendliness?
  • Are there any activities arranged and what encouragement is given to residents to help them pursue their own interests?
  • Are there any limitations on visiting?
  • Are the arrangements for health care suitable?  
  • Would there be a trial period?

Inspection reports

Every residential care home is regulated by the Care Quality Commission (CQC). The CQC published reports about care homes. These reports are public and individual homes have copies of their reports, which they should show you if you ask. If there is a problem about seeing a report at the home then you can also read them online at the CQC website, or by prior arrangement you could see them at Borough Hall or at the CQC.

Principles of residential care and good practice

In order to help you make your decision about whether the care offered is likely to meet your needs, you may also want to consider the following issues.


Residents should be able to maintain their rights as a citizen including the freedom of personal religious or political expression. The Home Manager should support this view and must ensure that any restriction of a persons rights (for theirs or others protection) should only happen after full consultation with everyone involved, unless it is an emergency. Any such restrictions must be explained to the person concerned, recorded and regularly reviewed.


Residents should be helped to think and act independently. The Homes Manager must ensure that each resident's situation is carefully monitored to ensure a reasonable balance is achieved between independence and risk taking.


Being able to exercise choice is very important to all our well being and care staff should actively encourage residents to make informed choices wherever possible. They should establish the residents wishes regarding the care they wish to receive in the home. Residents should also be able to have to access to external advice, representation and where necessary advocacy.


Treating a person with dignity involves recognising their value as an individual and acknowledging their uniqueness. It means treating each person with respect. Care staff should treat all residents with respect and dignity.


Residents should be encouraged to use their skills, pursue their interests and maintain and make new relationships, which may include sexual relationships and/or marriage. A good home will build on residents' strengths, such as experience and knowledge, whilst meeting the needs which the resident themselves cannot meet because of their own physical or mental condition.


Residents have the right, if they wish, to be alone, undisturbed and free from intrusion. However there are situations where it would not appear to be in the interests of the resident to remain isolated in their own room. In these circumstances advice should be offered in consultation with relatives and all the appropriate professionals.

Resolving problems

Any difficulties, which arise in a home, should be referred to the person in charge at the time of the incident. If possible, problems should be resolved by that person or by the owner or manager. If you are still not satisfied with the outcome then please report the facts to:

Care Quality Commission

Tel: 03000 616161

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