Care Home vs Nursing Home
A care home provides personal care — help with washing, dressing, medication, and daily living — from trained carers. A nursing home does all of that but also has registered nurses on site 24 hours a day for people with complex medical needs. The difference matters because it affects the type of care someone gets, how much it costs, and who pays for it.
Last updated: March 2026
People use these terms interchangeably all the time, and honestly, even some professionals muddle them up. But there is a real difference, and it matters, because it affects the type of care someone gets, how much it costs, and who pays for it.
The Short Answer
Care Home (Residential)
Provides personal care: help with washing, dressing, eating, medication, and day-to-day living. Staff are trained carers.
Nursing Home
Everything a care home does, plus on-site nursing care from registered nurses, 24 hours a day. At least one qualified nurse always on duty.
That's the core difference. One has nurses, one doesn't.
What Personal Care Looks Like
In a residential care home, staff help with things like:
- Getting up in the morning and going to bed at night
- Bathing, showering, personal hygiene
- Getting dressed
- Eating and drinking (including help at mealtimes)
- Taking medication (given by trained carers, not nurses)
- Moving around the home safely
- Social activities, trips out, company
Residents in care homes are generally able to manage day-to-day life with support. They might be frail, have mobility issues, or have early-stage dementia, but they don't need ongoing medical treatment or clinical monitoring.
What Nursing Care Adds
A nursing home does all of the above, but also provides:
- Clinical care from registered nurses around the clock
- Management of complex medical conditions
- Wound care, catheter care, PEG feeding
- Administering injections and IV medications
- Post-operative recovery care
- Monitoring of conditions that could deteriorate quickly
- Palliative and end-of-life care
If someone has had a stroke, has advanced dementia with complex needs, has a condition like Parkinson's that needs close medical management, or is recovering from major surgery, a nursing home is usually the right setting.
Signs That Someone Needs Nursing Care
- ✓They need oxygen therapy or have a tracheostomy
- ✓They have pressure sores that need professional wound management
- ✓They need help with a stoma, catheter, or PEG feed
- ✓Their dementia is advanced with choking risk, frequent falls, or communication difficulties
- ✓They're receiving palliative care
The Cost Difference
Nursing homes cost more because you're paying for qualified nurses on site 24/7. As a rough guide:
Residential Care Home
£800–£1,000
per week on average
Nursing Home
£1,100–£1,400
per week on average
Who Pays For What
Self-funders (assets over £23,250)
Pay the full cost of whichever type of home they're in. However, if you're in a nursing home, you can claim NHS Funded Nursing Care (FNC), a flat rate payment of £219.71 per week that goes directly to the home. You get this regardless of your finances.
Council-funded residents
Have their care paid by the local authority after the means test. If the home costs more than the council rate, someone (usually family) pays a “top-up” fee.
NHS Continuing Healthcare (CHC)
If someone's primary need is health-related, the NHS pays for everything - the full cost of the nursing home, no means test, no contribution at all. Getting CHC funding is difficult, but it's always worth requesting an assessment if the person has significant, complex health needs.
What About Dementia?
This confuses a lot of people. Dementia care isn't automatically nursing care. Someone with mild to moderate dementia who needs support with daily living but is otherwise physically well can be perfectly suited to a residential care home - ideally one with a dedicated dementia unit.
Someone with advanced dementia who has complex physical health needs alongside cognitive decline, difficulty swallowing, frequent infections, or challenging behaviour that needs clinical management, is more likely to need a nursing home.
Making the Decision
Start with the needs assessment
Contact the local authority and ask for one. It's free and they're legally obliged to carry it out.
Talk to the GP
They know the person's medical history and can advise whether nursing care is likely to be necessary.
Visit both types of home
You'll get a feel for the difference quickly. Residential homes often feel more like a house.
Think about the future
If someone's condition is likely to progress, a nursing home or dual-registered home might avoid a disruptive move later.