Mental Health Care Homes
A mental health care home is a residential facility that provides 24-hour support for people living with conditions such as schizophrenia, bipolar disorder, personality disorders, and complex PTSD. It sits between a psychiatric hospital — which handles acute crises — and independent living, offering a stable, supported environment for longer-term recovery and daily life. If you or a relative were discharged from psychiatric hospital after being detained under the Mental Health Act, you may be entitled to free, unlimited aftercare under Section 117 — one of the most important and least-known rights in the care system.
Last updated: May 2026
This guide explains what mental health care homes are, who they're for, how to find a good one, how they're funded, and what rights apply.
Mental Health Care Home vs Psychiatric Hospital: What's the Difference?
People often confuse these two settings. They serve very different purposes.
A psychiatric hospital is an acute inpatient facility. It's where someone goes during a mental health crisis — when their condition has deteriorated sharply and they need intensive, clinical management, often under detention. Stays are typically measured in days or weeks. The focus is stabilisation: getting medication right, managing immediate risk, and preparing for discharge. It is not designed for long-term living.
A mental health care home is a community-based residential setting for people who need ongoing support but no longer need hospital-level care. Residents live there — sometimes for months, sometimes for years — in a smaller, more homelike environment. Staff provide 24-hour support with daily living, medication, and mental health management, but the focus is stability, recovery, and where possible, working towards greater independence.
The distinction matters because the pathway from hospital to care home is how most placements happen. Discharge planning — the process of deciding where someone goes after a hospital stay — is where Section 117 rights (see below) become critical.
Who Mental Health Care Homes Are For
Mental health residential care is not just for older people. Many residents are working age — in their thirties, forties, and fifties — with conditions that make independent living unsafe or unmanageable without significant support.
Conditions commonly supported in mental health care homes include:
Psychotic spectrum conditions
Schizophrenia and schizoaffective disorder are among the most common reasons for long-term residential placement. These conditions can significantly affect a person's ability to manage daily life, maintain relationships, and live safely without support.
Mood disorders
Bipolar disorder — particularly where episodes are severe, frequent, or involve psychosis — may require a residential setting where medication can be monitored and crises anticipated. Severe, treatment-resistant depression can also lead to residential placement.
Personality disorders
Emotionally Unstable Personality Disorder (EUPD, also known as Borderline Personality Disorder), and other complex personality disorders can involve significant risk and instability. Specialist residential care homes with staff trained in approaches such as Dialectical Behaviour Therapy (DBT) can provide a safer, more therapeutic environment than standard residential care.
Trauma-related conditions
Complex PTSD, OCD, and severe anxiety disorders sometimes require residential support, particularly where the level of distress is incompatible with independent living and community treatment has not been sufficient.
Comorbid conditions
Many residents have more than one diagnosis. Mental health conditions frequently co-occur with learning disabilities, acquired brain injury, autism, or — particularly in older residents — early-stage dementia. Finding a home with experience of the specific combination of conditions matters more than finding one that ticks a single diagnostic box.
Section 117 Aftercare: The Right Most Families Don't Know About
This is the most important section in this guide. If it applies to you or your relative, it could save tens of thousands of pounds.
What is Section 117 aftercare?
Section 117 of the Mental Health Act 1983 places a legal duty on the NHS and local authority to provide free aftercare to anyone who has been detained in psychiatric hospital under specific sections of the Act and then discharged.
It is not means-tested. Income, savings, and property are irrelevant. The aftercare is free for as long as it is needed.
Who qualifies?
Section 117 applies to people discharged from hospital after detention under:
- Section 3 (admission for treatment — the most common route)
- Section 37 (hospital order made by a court)
- Section 45A (hospital and limitation direction)
- Section 47 (transfer of sentenced prisoner)
- Section 48 (transfer of unsentenced prisoner)
It does not apply to voluntary admissions (informal patients) or people on community treatment orders who were never detained under one of the above sections.
If you are unsure whether detention was under a qualifying section, ask the hospital team or the person's care coordinator. It should be documented in their discharge paperwork.
What does it cover?
Section 117 aftercare covers all services necessary to meet a mental health need that arises from the condition that led to the detention. This can include:
- Residential care in a mental health care home
- Supported living arrangements
- Mental health treatment and therapy
- Medication costs
- Transport to appointments
- Day centre provision
- Support with daily living
The breadth of what qualifies is often wider than families or even professionals assume. If a service is needed to prevent deterioration or relapse — and that need arises from the mental health condition — it should be covered.
How long does it last?
Section 117 aftercare continues for as long as the person needs it. It ends only when both the NHS Integrated Care Board and the local authority jointly agree that aftercare is no longer required — usually because the person has recovered sufficiently to manage without it.
There is no time limit. It does not end after a fixed period. The person must be actively reassessed and both bodies must agree before it can be withdrawn.
What councils cannot do
Councils cannot charge for Section 117 aftercare. It has been unlawful to do so since a House of Lords ruling in 1999 (R v Manchester City Council ex parte Stennett). If a council attempts to charge, or includes Section 117 services in a standard financial assessment, this should be challenged immediately.
What to do if you think Section 117 applies
Raise it explicitly at the discharge planning meeting. Ask the hospital social worker or care coordinator to confirm in writing whether Section 117 applies and what services will be provided under it. If there is any dispute, contact the mental health charity Rethink Mental Illness (0808 801 0525) or a local advocacy service — they deal with Section 117 disputes regularly.
Finding a Mental Health Care Home
Mental health care homes are registered with the Care Quality Commission (CQC), which inspects them and publishes ratings. You can search the CQC directory at cqc.org.uk, filtering by service type and location.
When searching, be specific about what you need. “Mental health” covers a wide range of settings and specialisms. A home experienced in supporting someone with schizophrenia may not be equipped for someone with complex trauma or a personality disorder alongside a physical health condition.
Questions to ask when contacting homes:
- What mental health conditions do you specialise in?
- What training do staff have — and how is it kept up to date?
- Do you have experience with [specific condition or combination]?
- What is your staff-to-resident ratio during the day and at night?
- What is your staff turnover rate?
- How do you manage medication — who administers it and how is it monitored?
- What happens during a mental health crisis — what's your protocol?
- Are residents supported to maintain relationships with community mental health teams?
- What does a typical week look like for residents?
- What is your approach to supporting residents towards greater independence?
Size matters
Most mental health residential care homes are small — typically four to ten residents. This is intentional. Smaller settings are less institutionalised, staff can know residents individually, and the environment is closer to normal domestic life. Be cautious of very large facilities that may feel more institutional.
Read the CQC report carefully
For mental health homes specifically, pay close attention to the CQC's ratings on Safe (how is risk managed, are residents protected) and Caring (are staff respectful, do residents have a voice). The Well-led rating tells you about management culture, which in mental health settings has an outsized effect on the quality of day-to-day care.
Look for any enforcement actions or repeated concerns across inspections. A home that has had the same issues flagged multiple times without resolution is a warning sign.
What to Look For When You Visit
Unlike care homes for older people with dementia, many mental health care home residents have full capacity and an active say in where they live. If that's the case here, involve the person in the visit wherever possible.
What to observe:
- Do residents appear calm, occupied, and treated with dignity?
- Are staff interacting with residents as individuals — not just managing behaviour?
- Is there a genuine sense of community, or do residents seem isolated within the same building?
- Is there evidence of meaningful activity — not just a television in every room?
- Does the home feel like a home, rather than a ward?
Red flags:
- Staff who talk about residents in their presence as if they aren't there
- An atmosphere of tension or anxiety among residents
- Medication being administered without explanation or discussion
- Residents who seem heavily sedated or disengaged
- A manager who is defensive about the CQC report or vague about staffing levels
- No clear pathway or plan for residents working towards greater independence
Ask about restraint and restriction
Mental health care homes sometimes use restrictions — locked doors, limits on leaving unaccompanied — for residents whose conditions involve significant risk. These restrictions must be proportionate, regularly reviewed, and authorised under the Mental Capacity Act's Deprivation of Liberty Safeguards (DoLS) where the person lacks capacity to consent.
Ask the home directly: do any restrictions apply, what are they, how are they reviewed, and what is the process for challenging them? A good home will answer this clearly and confidently.
Costs and Funding
Mental health residential care typically costs between £1,298 and £1,535 per week for standard provision. Specialist homes — those with higher staffing ratios, specific therapeutic programmes, or expertise in complex presentations — will often be more expensive. Always ask for a full written breakdown of what is included in the fee and what is charged separately.
Section 117 Aftercare (Free)
If Section 117 applies, the placement is free. This covers the full cost of the care home, not just a contribution. See the section above for full details.
Council Funding
If Section 117 does not apply, the local authority may still fund some or all of the placement through the standard care funding route, subject to a needs assessment and financial assessment (means test).
The same capital thresholds apply as for any residential care:
- • Above £23,250 in assets — you self-fund
- • Between £14,250 and £23,250 — sliding scale contribution
- • Below £14,250 — council funds in full (minus income contribution)
A care needs assessment must be carried out first, establishing that residential care is the appropriate level of support.
NHS Continuing Healthcare
For people with very complex or high-intensity mental health needs, NHS Continuing Healthcare (CHC) may cover the full cost of care. As with physical health CHC, this requires a formal assessment and is difficult to obtain — but the amounts involved make it worth pursuing if the presentation is genuinely complex.
Self-Funding
If you are self-funding, the same practical steps apply as for any care home: claim Attendance Allowance if eligible (up to £114.60 per week, not means-tested), ask about NHS Funded Nursing Care if the home is registered as a nursing home, and consider a Deferred Payment Agreement if the family home is the main asset.
Rights, Choice, and Advocacy
Mental health care is an area where rights matter enormously — and where they are sometimes overlooked.
The right to choose
If the person has capacity to make decisions about their care, they have the right to be involved in choosing where they live. This includes the right to refuse a placement. A council or NHS body cannot place someone in a care home against their will if they have capacity to decide otherwise.
If the person lacks capacity, a best interests decision must be made — involving family, professionals, and ideally an Independent Mental Capacity Advocate (IMCA). This process must be documented and can be challenged.
Advocacy
Independent mental health advocates (IMHAs) are available to anyone subject to the Mental Health Act. They can help the person understand their rights, be heard in planning meetings, and challenge decisions they disagree with. Ask the hospital or community mental health team how to access an IMHA.
Useful organisations
- Rethink Mental Illness — rethink.org — advice, advocacy, and support on all aspects of mental health care including Section 117 disputes
- Mind — mind.org.uk — information and local services
- Age UK — ageuk.org.uk — for older adults with mental health needs
- Carers UK — carersuk.org — support for family members and carers
Could the NHS pay for your relative's care home fees?
NHS Continuing Healthcare is free care home funding — no means test, no savings limit. Many families don't know about it. The CHC Family Guide explains exactly how to claim it.
Find out in the CHC Family Guide — £57Have a question this guide didn't answer?
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Could the NHS pay for your relative's care home fees?
NHS Continuing Healthcare is free care home funding — no means test, no savings limit. Many families don't know about it. The CHC Family Guide explains exactly how to claim it.
Find out in the CHC Family Guide — £57