Types of Care Homes
Understanding the differences between residential, nursing, and specialist care — so you can find the right fit.
Why the type of care home matters
Not all care homes offer the same level of support. The type of home you need depends on the person's care requirements — whether that is help with everyday tasks, round-the-clock nursing, or specialist support for a condition like dementia. Choosing the right type is the first decision to make, even before comparing individual homes.
Residential care homes
Residential care homes provide personal care — support with washing, dressing, eating, taking medication, and moving around. Staff are trained carers, but there are no qualified nurses on site permanently. A GP will visit regularly, and the home will call for medical help when needed.
Residential care is suitable for people who can no longer manage safely at home but do not have complex medical needs. Many residents have some level of frailty, mobility difficulties, or early-stage cognitive decline.
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Nursing care homes
Nursing homes (also called "care homes with nursing") have at least one registered nurse on duty 24 hours a day. This makes them suitable for people with complex, ongoing medical needs — for example, advanced dementia with challenging behaviours, stroke recovery, catheter care, PEG feeding, or end-of-life care.
The presence of a nurse does not mean the home feels clinical. Good nursing homes balance medical expertise with warmth and homeliness. The NHS contributes a Funded Nursing Care payment (currently £219.71/week) to cover the nursing element for anyone in a nursing home.
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Dual-registered homes
Some homes are registered to provide both residential and nursing care. These "dual-registered" homes can be particularly valuable because a resident can move from residential to nursing-level care without leaving the building — staying in familiar surroundings with the same staff and routines. If you anticipate that needs may increase over time, a dual-registered home offers continuity and peace of mind.
Specialist care
Many care homes are registered to provide specialist support for specific conditions. The CQC records which specialisms each home offers:
Dementia care
Dementia care homes have staff trained in supporting people with Alzheimer's disease and other forms of dementia. They often feature secure outdoor spaces, memory-friendly design (clear signage, contrasting colours, familiar objects), structured routines, and activities designed to stimulate memory and reduce anxiety. The best dementia homes focus on the person, not the condition — maintaining identity, dignity, and joy.
Learning disability care
Homes specialising in learning disabilities support people with conditions such as Down's syndrome, autism spectrum conditions, and other developmental disabilities. The focus is on maximising independence, social participation, and quality of life. Many of these homes are smaller and more community-based, offering a domestic rather than institutional environment.
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Mental health care
Mental health care homes support people with conditions such as schizophrenia, bipolar disorder, severe depression, or personality disorders. Staff are trained in therapeutic approaches and de-escalation. These homes often work closely with community mental health teams and may offer structured day programmes alongside residential care.
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Physical disability care
Homes registered for physical disability care are designed and equipped for people with mobility impairments, neurological conditions (such as multiple sclerosis or motor neurone disease), or acquired brain injuries. They typically feature fully accessible environments, hoisting equipment, physiotherapy support, and occupational therapy input.
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Sensory impairment care
These homes specialise in supporting people with significant visual or hearing impairments. Adaptations may include tactile signage, hearing loops, high-contrast decor, specialist communication training for staff, and assistive technology. They ensure that sensory loss does not lead to isolation.
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How to decide which type you need
The best starting point is a needs assessment from your local council. This is free, and the council has a legal duty to carry one out for anyone who appears to need care. The assessment will identify:
- Whether the person needs residential or nursing-level care
- Any specialist needs (dementia, physical disability, etc.)
- Whether care at home might still be an option
If the assessment recommends a care home, the council will specify the type and level of care required. This does not dictate which home you choose — only the category of care that is needed.
One last thought
The right type of care home provides a foundation, but it is the people inside who make it a home. Once you know the type of care required, visit several homes, meet the staff, and — most importantly — bring your loved one along whenever possible. The warmth of the welcome matters more than the category on the registration.
Frequently Asked Questions
What is the difference between a residential home and a nursing home?
A residential care home provides personal care — help with washing, dressing, eating, and medication — but does not have qualified nurses on site. A nursing home has at least one registered nurse available 24 hours a day, making it suitable for people with complex medical needs such as wound care, catheter management, or conditions requiring regular clinical monitoring.
Can someone move from a residential home to a nursing home?
Yes, and this is quite common. As care needs increase — for example, after a stroke or as dementia progresses — a person may need to transfer from residential to nursing care. The care home, GP, and local authority will usually be involved in planning the move.
What is a dual-registered care home?
A dual-registered home provides both residential and nursing care under one roof. This means a resident can receive nursing care if their needs change without having to move to a different home. Dual-registered homes can be especially reassuring for families.
How do I know which type of care home is right?
Start with a needs assessment from your local council — this is free and will identify the level of care required. If the person needs clinical or medical care (not just personal care), a nursing home is likely needed. For specialist needs like dementia or learning disabilities, look for homes with specific CQC-registered specialisms.
Are specialist care homes more expensive?
Generally, yes. Specialist care requires additional staff training, adapted environments, and sometimes higher staffing ratios. Dementia and nursing care tend to be the most expensive. However, if a need is identified through assessment, the local authority or NHS may contribute to costs.