Care Home vs Nursing Home

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.

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.

The Cost Difference

Nursing homes cost more because you're paying for qualified nurses on site 24/7. As a rough guide:

Who Pays For What

Self-funders (assets over £23,250)

If your assessable capital exceeds the limit, you usually fund your own social care. NHS funding follows separate needs assessments. In England, FNC pays a standard £267.68 weekly in 2026/27 for eligible registered nursing care when CHC does not apply. Check whether the quoted fee already excludes that payment.

Council-funded residents

May receive council support after needs and financial assessments, while still contributing from income or capital. The personal budget must cover suitable care meeting assessed needs. A top-up may apply if you choose a more expensive option when an appropriate placement is available within the budget.

NHS Continuing Healthcare (CHC)

CHC funds an agreed package of assessed health and social care needs for a person found to have a primary health need. This includes accommodation where the package is provided in a care home. It is not means-tested; eligibility depends on assessed needs, rather than a diagnosis alone.

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.