What Is a Secure Dementia Unit, and When Does Someone Need One? (2026)

In short: a "secure" dementia unit is a part of a care home where the doors are locked or need a code, so that residents who would be at risk going out on their own can't leave without support. It isn't an official type of care home, so ask each home exactly what it means. Any restrictions must be in the person's best interests, and the law has safeguards to make sure they are.

What "secure" usually means

There is no official definition, and homes use the word in different ways. A secure dementia unit is often a separate floor or wing of a care home, with doors that are locked or opened with a keypad code, and sometimes an enclosed garden. Inside the unit, residents can usually move around freely.

Homes may also call these units "dementia units", "memory care" or "EMI units". Our guide to EMI units and our guide to specialist dementia care homes explain those terms.

When might someone need one?

A secure unit is usually considered when someone with dementia would be at serious risk if they left the building on their own, for example because they no longer recognise danger from traffic or would not be able to find their way back. That is a decision about the individual, made with them and the people who know them, and based on an assessment of their needs.

Many people with dementia live well in care homes without locked units, so a diagnosis alone doesn't mean someone needs one. Needs also change over time, so the decision should be reviewed.

The law: best interests and least restriction

In England and Wales, the Mental Capacity Act sets out principles that apply when someone can't make a decision for themselves. Two matter most here:

• any decision made for someone who lacks capacity must be in their best interests;
• before deciding, people must consider whether there is a less restrictive way to achieve the same purpose.

The Act also says a person must be assumed to have capacity unless it is shown that they don't, and that making an unwise decision doesn't on its own mean someone lacks capacity.

Deprivation of Liberty Safeguards (DoLS)

If someone's care in a care home amounts to a deprivation of their liberty, the home must ask the council for authorisation under the Deprivation of Liberty Safeguards. These check that the arrangements are lawful and in the person's best interests, and the person has the right to challenge them in the Court of Protection.

DoLS still apply in care homes and hospitals for people aged 18 and over. Because the test has changed, councils and care homes are reviewing their cases. Ask the home whether the person has, or needs, a DoLS authorisation. Our guide to DoLS explains the process.

Questions to ask a care home

• What exactly is locked, and how do residents get outside or into the garden?
• How do you decide who lives in the unit, and how often is that reviewed?
• What do you do first when a resident is distressed or wants to leave?
• How do you keep residents active and involved, and how do they keep in touch with family?
• How do you handle DoLS applications, and will you keep us informed?
• Is the unit included in the home's latest inspection report?

Related guides

• Early-Onset Dementia Care: Options for People Under 65
• Dementia Respite Care: Giving Carers a Break
• Does the NHS Pay for Dementia Care? NHS Continuing Healthcare Explained
• How Much Does Dementia Care Cost in the UK? 2026 Fees by Region

Sources

• UK Supreme Court 2026 judgment on what constitutes a deprivation of liberty (GOV.UK)
• Mental Capacity Act 2005, section 1: the principles (legislation.gov.uk)