Types of care explained
When someone close to you suddenly needs care, the words are unfamiliar and the decisions feel enormous. This is a plain-English guide to the main kinds of adult social care in England, who each is commonly used for, and — the two things that matter most — who decides what care is right, and who pays for it. It explains the choices; it does not make them for you.
The main kinds of care
Broadly, care is either brought to the person in their own home, or the person moves somewhere staff are on hand. Which fits depends on how much support someone needs, whether they need nursing, and what they want — and that is what the council’s needs assessment (below) is for.
Care at home
Also called home care or domiciliary care.
Carers visit the person in their own home to help with things like washing, dressing, medication, meals and getting around — from a single short visit a day to several longer visits.
Commonly used for: People who want to stay in their own home and need help with daily tasks rather than round-the-clock supervision.
A care home (residential)
Also called a residential home.
The person moves into a home where care staff are on site day and night, with meals, personal care and company. A residential home does not have nurses on site.
Commonly used for: People who can no longer manage safely at home, or who would be isolated living alone, but do not need day-to-day nursing.
A care home with nursing
Also called a nursing home.
A care home that also has registered nurses on site. It provides everything a residential home does, plus ongoing clinical care — for example wound care, managing complex medication, or care near the end of life.
Commonly used for: People with health conditions that need regular input from a qualified nurse, not just personal care.
Supported living
The person keeps their own tenancy or home and support workers come in to help them live as independently as possible. The housing and the support are usually separate arrangements.
Commonly used for: Younger adults, and people with a learning disability, autism or mental health needs, who want to live independently with the right support around them.
Not sure which fits? Use the care finder — tell it who the care is for and where, and it shows the local services registered for those needs, each with its CQC rating and the date it was published.
Who decides what care is right?
Not us, and not a website. If someone may need care, they (or you on their behalf) can ask their local council for a needs assessment — it is free, and it is the formal way the right level and type of care is worked out. You do not have to wait for it before looking at options.
- Ask your councilfor a needs assessment — search “[your council] adult social care assessment”, or start at GOV.UK: apply for a needs assessment.
- If it’s a hospital discharge, the ward’s discharge team arranges the assessment before the person leaves.
- Your GP can advise on health needs that feed into the decision.
Who pays for care?
This is where families are most often caught out. In brief, and as a signpost only — the exact rules are detailed and change, so check the official sources:
- Council-funded careis means-tested — the council looks at savings and income. Above a capital threshold, people usually pay for their own care (“self-funding”).
- NHS Continuing Healthcare (CHC) fully funds care for people whose needs are primarily health-related — it is not means-tested, and it is widely under-claimed. Eligibility varies a great deal by area.
- Check before you pay. The free, independent service Beacon advises on CHC; and MoneyHelper explains paying for care. Start with your council either way.
What the CQC ratings mean
CQC inspects and rates services as Outstanding, Good, Requires improvement or Inadequate, across five questions: is the service safe, effective, caring, responsive, and well-led? A rating is a snapshot from the last inspection — so we always show the date it was published, and flag when a rating is a few years old and a re-inspection could change it. Read every rating with its date, and read the full inspection report on cqc.org.uk for the detail behind it.
This guide is general information to help you navigate the choices, not advice about any individual’s care or a recommendation of any service. For a decision about what care a person needs, ask the council for a needs assessment. Find care near you →