What's the difference between a care home and nursing home?

What is a care home?

A care home is a residential facility where older adults usually have their own room in a communal building, and can benefit from 24/7 support for basic care needs such as personal care (bathing, getting dressed, etc.), having meals and snacks provided, and receiving mobility support.

Care homes are designed for older people who need additional help, or who can no longer safely live alone in their own home, but do not require any serious medical care. The staff who work in care homes are trained caregivers with the relevant qualifications to look after older adults, and care homes are regulated by the Care Quality Commission. However, care home staff are not usually trained in medical fields like nursing, so they may not be able to provide care for people with more intensive health needs such as dementia or Parkinson’s disease. 

Alongside the basic needs they provide, care homes can:

• Offer a sense of safety for older people and their families, as they usually contain the equipment and infrastructure to help with mobility issues
• Make medication management easier
• Provide a sense of community to improve quality of life and avoid loneliness
• Offer opportunities for socialising with other residents
• Facilitate entertainment and group activities like crafting and games
• Make life easier for older people by managing all necessary administration (such as bills), organising meals, arranging any travel to healthcare appointments, and more

In a care home, everything is taken care of, so older residents can focus on enjoying their time free from the stress that comes with managing their own home. You can read more about the advantages and disadvantages of care homes in our guide to the benefits of home care vs a care home.

What are the key differences between a care home and nursing home?

Care homes and nursing homes offer similar care, but with a few key differences that mean one is likely to be more appropriate than the other depending on what your care needs and health needs are. The main differences are: 

The level of care provided

While the standard of care should be the same in both cases, nursing homes offer more medically-focused care than care homes do. Put simply, care homes focus on personal care and assistance with everyday tasks, while nursing homes provide clinical and medical services. This means that on top of the basic care provided by a care home, such as getting washed and dressed, cooking meals and moving around safely, trained medical staff are on hand to provide additional support with complex health conditions and things like:

• Stoma management
• Diabetes management 
• Wound care
• Post-operative support
• Ventilation 
• Feeding tube support
• And more 

Staff qualifications

The qualifications and training of staff members is one of the major things that sets care homes and nursing homes apart. Essentially, care home staff are usually care workers trained to help with the daily needs of an older person. For example, helping them to get washed and dressed, and to move around safely. Their qualifications might be NVQs or diplomas in Health and Social Care. 

On the other hand, nursing home staff are registered nurses trained in the same daily care needs, as well as a number of additional medical disciplines that give them the ability to administer certain medications, support more intense medical needs, monitor health conditions to support the person’s GP, and more. They are regulated by the Nursing and Midwifery Council (NMC) to ensure they provide the necessary care to residents in nursing homes. 

Resident demographics

Data from 2021 suggests similar numbers of care home residents and nursing home residents in the UK, with no large differences in the age range of residents; 49.4% of care home residents aged 65 and over were living in care homes with nursing, and 50.6% of the same age group were living in care homes without nursing. The male and female split of residents was also similar. 

Despite similar age demographics, care home and nursing home residents have different needs and health conditions. As above, care homes cater to those with daily care needs, but who generally are still healthy enough to enjoy their time socialising and taking part in activities. They might have mobility issues or mild cognitive impairment, but are otherwise capable of getting involved. 

Nursing home demographics usually include older adults with more serious health conditions who need regular health care, like those with advanced dementia or chronic illnesses that they cannot manage by themselves. Nursing home residents tend to be older, and may have an inability to socialise and take part in activities.

Facilities and services

As care homes are designed for older adults who can still get involved in their community, they usually aim to provide opportunities to socialise with fellow residents, enjoyable and stimulating activities, communal dining experiences, and a comfortable and friendly environment where everyone feels safe. 

Nursing homes may strive to achieve the same atmosphere, but their focus will usually be on providing the very best health care and avoiding emergencies. Their facilities may be designed for more frail residents, and there may be more medical tools, specialist hoists and other hospital-like equipment present. Socialising and activities may still exist in nursing homes, but as fewer residents will be healthy enough to take part in these, they may be less of a priority for staff.

What are the cost differences?

For many people, the cost of either a care home or nursing home could be a big part of the decision-making. In the case of both care homes and nursing homes, the exact cost will always depend on where you live in the country, how much care you require, the reputation and standard of the facility, the type of room you choose, and the facility’s offerings. In general, nursing homes tend to be more expensive than care homes due to several factors:

• Staff are typically on a higher salary for their additional training and qualifications
• More staff may be needed for overnight care to support critically ill patients 
• More specialist equipment may be needed in the facility to manage everyone’s needs

The cost of care homes and nursing homes differs; the NHS suggests a care home could cost an average of £600 a week, and a nursing home could cost an average of £800 a week. However, Age UK calculates this average cost as between £800 to £1,078 per week for a place in a care or nursing home, depending on where you are in the country. 

Carehome.co.uk also suggests slightly higher figures, with the average weekly cost of self-funded residential care in the UK estimated to be £1,266, and the average weekly cost of a self-funded place in a nursing home estimated to be £1,528. They also suggest the average difference in cost between a care home and a nursing home is around £180 per week. Care costs could increase across the board, with 2018 data from the National Audit Office suggesting the projected increase in people aged 65+ requiring care by 2038 is 57%.

For those who may be worried about costs, this can be funded using personal savings and property, NHS-funded nursing care, or by arranging a Care Needs Assessment with your local council to find out if you are eligible for funding. 

Another option is to receive the necessary care at home. The government actively aims to keep older people living at home for as long as possible, so there are often home care options available–even if nursing care is required–within the comfort of their own home. In the case of live-in care, a trained, professional carer (or two or three carers on rotation) will live in the home with an older person and provide all of the necessary care, or they might coordinate with other carers or medical professionals who can deliver this. 

Live-in care could be a more affordable option in some cases. Although this could cost roughly £1,350 to £2,000 per week in the UK, families only pay for the hours they themselves require, rather than moving into a 24/7 care facility and paying full-time rates for services they do not need. 

You can learn more in our guide on live-in care vs nursing and care homes.

How to choose the right option for your loved one

Deciding to move into a care home or nursing home is a big decision in itself, but finding the best one can be an even bigger challenge. Choosing the right care home or nursing home takes forward-thinking and research, so here are some of the steps you may find helpful:

• Start by speaking with your GP (or your loved one’s GP if they are considering this move)
• Arrange a Care Needs Assessment through your local council so they can determine what level of care you need, and let you know if you are entitled to have fees covered 
• Once you know the level of care needed, visit some potential facilities in convenient areas that would make visiting easier, and decide if you think they are suitable 
• It may help to make a list before you visit so you don’t forget any of the questions you want to ask, and things you want to see
• Don’t be afraid to ask questions of the staff, and ask to look around so you can see if this is a place you or your loved one would want to stay
• Pay attention to the cleanliness of the facility, the feeling of comfort, and the friendliness of staff with residents
• Ask what the arrangements are likely to be, i.e. which room is available, which staff members will be in charge of your care, what kind of meals are provided, and more
• If you are helping an older loved one decide on a facility, involve them in the decision-making process as much as possible to make sure their preferences are taken into account, and address any fears or concerns they have 

It can also help to create a checklist of priorities to help guide your choice. Here are a few that might help:

• Location
• Cost
• Availability of staff
• Specialist services available (such as dementia care)
• Atmosphere
• Activities provided for residents 
• Meal choices 
• Room allocation 
• Day trips and excursions 
• Safety precautions and security 
• Ratings (you can find care home ratings on the Care Quality Commission website)

We understand deciding on a facility for your loved one can feel like a big decision, so speak to professionals like your GP to put your mind at ease, do thorough research on the places you like the look of, and do several visits to determine if this could be the place for you.

Some of our other guides could help you to make a more informed decision: 

• The Benefits Of Home Care vs A Care Home
• Paying For Care: Who Pays What?
• Do I Need A Carer? How To Tell If You Or A Loved One Needs Support

Although no decision needs to be permanent, it is important to keep in mind that transferring between facilities can be stressful for your loved one, so avoid this as much as possible by selecting a facility that has more care available than your loved one might need. If you can, anticipate the progression of any health needs they may have, such as reduced mobility or increased pain, and try to choose a facility that offers flexible care, and can be adapted over time as needs change without the upheaval of having to move to another facility. 

For some, the best option could be home care as this is highly flexible and can be adapted as the person’s needs change over time. Home adaptations can also be made to make the environment safer and more comfortable for them. This option also enables older adults to stay in the home they know and love, in familiar surroundings, close to their loved ones. Ultimately, wherever someone feels safest will likely be the best option, so long as it meets their care and nursing care needs. 

Our experienced, supportive Care Professionals can provide the appropriate level of support at home, whether that means basic needs or more intensive medical care. You can reach out to your local Home Instead office to discuss your options.

We’re an award-winning home care provider and part of a worldwide organisation devoted to providing the highest-quality relationship-led care for older people in their own homes. Arranging care for yourself or your loved one shouldn’t be stressful, so whatever questions you would like answered, feel free to reach out to the Home Instead team to discuss your needs.