How to Choose a Care Home: A Step-by-Step Guide (2026)

Choosing a care home is rarely something you plan for months in advance. Often it follows a fall, a hospital discharge, or a slow realisation that things can't carry on as they are. Whatever brought you here, breaking the decision into clear steps makes it manageable — and helps you choose a home with confidence rather than under pressure.

What are the four steps to choosing a care home?

Most decisions follow the same pattern, whether you're planning ahead or acting quickly after a hospital stay.

1. Assess needs — work out what level of care is actually needed: residential, nursing, dementia care, or something else.
2. Shortlist — narrow down homes by location, care type, and CQC rating.
3. Visit — see homes in person, ideally more than once.
4. Decide — check the contract carefully, then commit.

Each step builds on the last. Skipping the needs assessment often leads to choosing the wrong type of home; skipping visits leads to surprises later. Take them in order where you can.

How do I work out what level of care is needed?

Before you look at any homes, get clear on what kind of support is required. This affects which homes are even suitable.

• Residential care — help with daily living (washing, dressing, meals, medication) but no ongoing nursing need.
• Nursing care — the above, plus care from a registered nurse for a health condition.
• Dementia care — specialist support, often in a setting designed to reduce confusion and risk.
• Respite care — short-term stays, often to give a family carer a break.

You can ask your council for a free care needs assessment — this is a legal right in England regardless of your finances. It gives you a professional view of the type and level of care needed, which then shapes your shortlist. See GOV.UK's guide to applying for a care needs assessment.

If the person may be eligible for fully funded care because of a serious health need, ask about an assessment for NHS Continuing Healthcare before assuming self-funding is the only route.

How do I shortlist care homes?

Once you know the type of care needed, narrow your list before you start visiting. Visiting every home in the area wastes time and energy you don't have to spare.

• Location — how far are you willing to travel, and how far can family and friends realistically visit?
• Care type — does the home offer the specific type of care needed (nursing, dementia, respite)?
• CQC rating — check every home's latest rating and read the full report, not just the headline score.
• Cost — get a guide price early. Ask what's included in the weekly fee and what counts as an extra.
• Availability — some homes have waiting lists; others have space now. Ask directly.

Aim for a shortlist of four to six homes. That's usually enough to compare properly without the process dragging on for weeks.

What should I look for on a care home visit?

A visit tells you things no brochure or website can. Trust what you see and feel on an ordinary day, not just what you're told.

Questions worth asking on every visit

• What's the staff-to-resident ratio during the day and overnight?
• How is medication managed, and who administers it?
• What happens if the person's needs increase — can they stay, or would they need to move?
• How are family and friends kept informed about changes in health or wellbeing?
• What activities happen day to day, not just on special occasions?
• How does the home handle a resident becoming unwell out of hours?

How do I check a care home's CQC rating?

Every care home in England is inspected and rated by the Care Quality Commission (CQC). Ratings run from Outstanding, Good, Requires improvement, to Inadequate. Look up the home's most recent report and check the date — a "Good" rating from four years ago is worth less than a recent one.

CQC inspectors score each home against five key questions:

• Safe — are people protected from abuse and avoidable harm?
• Effective — does care, treatment and support achieve good outcomes?
• Caring — are staff kind, respectful and dignified?
• Responsive — does the service meet people's individual needs?
• Well-led — is the leadership and management good enough to sustain high-quality care?

Read the full report, not just the overall rating. It often explains specific strengths and concerns — for example, staffing levels at the time of inspection, or how well the home manages medication — that matter more to your decision than the single headline word.

Scotland, Wales and Northern Ireland have their own regulators and rating systems — the Care Inspectorate, Care Inspectorate Wales (CIW), and RQIA respectively. If you're looking outside England, check ratings with the relevant regulator rather than the CQC.

What should I check in the contract before signing?

Once you've chosen a home, read the contract in full before committing. This is where problems later on are often prevented or created.

• What the weekly fee includes — meals, laundry, activities, toiletries. Ask what counts as an "extra" and how much those extras typically cost.
• Notice periods — how much notice is needed if the person wants to leave, and what notice the home can give if it can no longer meet their needs.
• How and when fees can change — most homes review fees annually, but check the process and how much notice you'll get.
• What happens during a hospital stay — some homes hold the room at full or reduced fee; others don't. Get this in writing.
• End-of-life terms — how the home handles fees and care in the final period, if relevant.

Ask for anything unclear to be confirmed in writing before you sign. A reputable home won't mind putting things in writing; reluctance to do so is itself a warning sign.

How does paying for care affect your choice?

Costs and funding shape which homes are realistically available, so it's worth understanding the basics before you visit.

• Local authority financial assessment (means test) — your council will assess income and savings to work out what you contribute, if you're seeking council-funded care.
• Self-funding — if your capital is above the upper threshold, you'll usually pay the full cost yourself. Check current thresholds, as these are reviewed and can change — see GOV.UK.
• Deferred payment agreements — let you delay paying care home fees, often secured against your home, if your money is tied up in property.
• Top-up fees — a third party (usually family) can top up council funding to afford a more expensive home, but this must be sustainable long-term.
• Attendance Allowance and Pension Credit — worth checking eligibility even if you're self-funding. See Attendance Allowance and Pension Credit on GOV.UK.

For a full breakdown of how the system works, MoneyHelper has independent guidance on paying for care, and the NHS social care and support guide covers assessments and funding routes in more detail.

Do you need power of attorney before choosing a home?

If the person moving into care can no longer manage their own finances or decisions, you'll need a registered lasting power of attorney (LPA) to act on their behalf — for signing the contract, managing fees, and dealing with the council or the home. Setting this up takes time, so start the process as early as possible if it isn't already in place. Without it, you may need to apply to the Court of Protection instead, which is slower and more costly.