Read the home’s latest inspection report first. Then visit more than once, ask clear questions and check the contract and fees in writing before you sign. Ratings help, but they are only a starting point.
What should you check before you visit?
Start with the home’s latest inspection report. You can ask the home for it or find it on the Care Quality Commission (CQC) website. The CQC is the regulator for health and adult social care in England.
- Check the date on the report.
- Be careful with other people’s opinions. Care homes can change over time, so what others say may no longer be true.
- Decide what type of home you need. Nursing homes always have at least one qualified nurse on duty. Residential homes do not.
Rules can differ in Scotland, Wales and Northern Ireland.
What should you look for on the visit itself?
Notice how the home feels and how staff spend their time. You can visit more than once, so go back at a different time of day if you can.
- Do staff sit and chat with residents, or only do tasks?
- Are there social spaces with furniture arranged so small groups can sit together?
- Is there a wide range of activities, both in the home and outside it?
- Do residents seem calm and occupied?
- Do staff seem to have time, and do they speak kindly?
Trust your own impression. If something worries you, ask about it.
How do you read an inspection report?
Read the whole report, not just the headline rating. There are four possible CQC ratings. They may be shown at the home or found online.
Compare what the report says with what you see on your visits. If the two do not match, ask the manager about it.
What questions should you ask the manager and staff?
Ask about staff first, because they shape daily life in the home.
- Do staff and managers have enough time, skills and experience?
- What are the staffing ratios during the day, at night and at weekends?
- How many staff have left recently? High staff turnover can be a warning sign of low morale.
- Does the home ask residents for feedback, and how does it use it to improve care?
- Can the home still meet your relative’s needs if those needs increase?
A good answer is clear and specific, and the manager is happy to explain. A worrying answer is vague, avoids the question or makes you feel rushed. If you are unsure, ask for the answer in writing.
If the person has dementia
Add these checks to your visit and questions.
- Look for signs or pictures that show where things are, such as the toilet or dining room.
- Ask whether all staff are trained in caring for residents with dementia.
- Ask whether residents can choose their own daily routine, such as when they get up and go to bed.
- Look for a quiet place to sit away from noise. Take your relative with you if that is right for them, and see how they react.
What should you check in the contract and fees before signing?
Ask to see the home’s contract and terms and conditions in writing before your relative moves in. Take your time reading them.
- Ask how fees are structured, calculated and collected.
- Check that extras not covered by the basic fee are clearly identified and accounted for.
- Ask what the terms are for keeping the room if your relative goes into hospital.
- Check that the notice conditions for ending the contract are reasonable.
If family pay a top-up fee (extra money family pay on top of what the council pays) and later stop paying, the resident may have to move out. Be sure you can keep paying before you agree.
Ask someone independent to read the contract before you sign, such as a solicitor. Age UK runs a free advice line for families. You can find details on the Age UK care home guide. Our rights and benefits guide explains the means test and other help with costs.
Is a care home the right choice, or should you consider alternatives?
A care home is not the only option. Alternatives may be cheaper or help the person feel more independent.
Help at home, known as home care, is one alternative. You can read about how live-in care compares with a care home. Our free care cost calculator can help you estimate costs.
The first step towards council help is asking the local council’s social services for a needs assessment (a check of what care and support your relative needs). Do not sell the home or end a tenancy until the council has made its decision.
The NHS has more on care homes and your options.
What to do next
- Ask your local council’s social services for a needs assessment.
- Make a shortlist and read each home’s latest inspection report in full.
- Visit your top choices more than once, using the checks above.
- Ask for the contract and terms and conditions in writing, and have someone independent read them.
- Call the Age UK advice line if you want to talk your options through.