Care Home Choosing Checklist

Choosing a care home is one of the biggest decisions a family makes, and it is almost always made under time pressure — often from a hospital bedside, with a discharge date looming. That combination produces rushed choices that are expensive and difficult to undo. Comparing homes against the same questions, visiting more than once and at different times of day, and reading the contract before signing all make a real difference. Use this checklist to compare systematically.

Sort the funding question before you fall in love with a home

Ask for a Care Act needs assessment and, where health needs are complex or unstable, an NHS Continuing Healthcare checklist before choosing anywhere. Continuing Healthcare is fully funded and not means-tested, and families who never ask for a checklist can spend years paying for care that should have been free. If the council will be funding the placement, find out what rate it pays for that type of care, because that determines what you can choose without a top-up.

  • Check the regulator: read the latest CQC inspection report in full, not just the overall rating, and look at how recent it is and whether any enforcement action has been taken.
  • Visit properly: go more than once, including unannounced and at mealtimes or in the evening. Watch how staff speak to residents when nobody is being shown around.
  • Read the contract: notice periods, fee increases, what happens if funding changes, and what is charged as an extra rather than included.

Do not commit from a hospital bed if you can avoid it. A short-term or interim placement keeps options open, and reablement may improve the picture enough to change the decision entirely.

Talk to residents and relatives if you can. They will tell you things no brochure or inspection report will.

Before visiting

0 of 6 complete

On the visit — physical environment

0 of 6 complete

Care quality

0 of 7 complete

Daily life

0 of 8 complete

Fees and contract

0 of 8 complete

Decision-making

0 of 6 complete

Helpful organisations

Age UK

Charity

The country's leading charity dedicated to helping everyone make the most of later life, providing advice, support, and companionship.

Visit website0800 678 1602

Citizens Advice

Charity

Provides free, confidential, and independent advice on a wide range of issues including benefits, housing, debt, and employment.

Visit website0800 144 8848

Frequently asked questions

What is a third-party top-up and when can we be asked to pay one?
Where the council funds a placement, it pays a set rate for that type of care. If you choose a home charging more, a relative may be asked to pay the difference as a third-party top-up. The resident cannot normally fund it from their own money. Before agreeing, be realistic about paying it for years, remember it rises with fee increases, and understand that if it fails the council must find a suitable alternative — which may mean a move.
How much notice do we have to give if we want to leave?
That is set by the contract, and notice periods of four weeks or more are common — including where the resident dies, which many families do not expect. Check what happens to fees during a hospital stay too, since homes often continue charging to hold the room. Read these clauses before signing rather than discovering them at a difficult moment, and ask for anything unclear to be explained in writing.
Can a care home ask someone to leave?
Yes, in defined circumstances set out in the contract, such as needs that exceed what the home is registered to provide, or non-payment of fees. There should be proper notice and involvement from the council or NHS commissioner where they fund the placement. If you believe a resident is being moved unfairly or without proper process, raise it with the home in writing, then with the council, the CQC and the Local Government and Social Care Ombudsman.
What should we do if the care is not good enough?
Raise it with the home first, in writing, using its complaints procedure — most concerns are resolved at that stage. If the response is inadequate, complain to the council where it arranged or funds the placement, and then to the Local Government and Social Care Ombudsman. Report safety and standards concerns to the CQC, which regulates providers. Where you suspect abuse or neglect, contact the council's adult safeguarding team immediately, and the police if there is an immediate risk.

Related guides

Care Home Fees Overview

Care home fees vary widely across England, typically ranging from £700 to over £2,000 per week depending on the type of care, location, and quality of the home. Understanding what the fees cover, how council-funded rates compare to self-funder rates, and what top-up fees are can help you make informed choices.

7 min

Paying for Social Care

Unlike the NHS, most social care in England is not free. Whether you receive care at home or in a care home, your local council will carry out a financial assessment to decide how much — if anything — you must pay towards the cost. Understanding the rules can help you plan and avoid unexpected charges.

8 min

Home Care vs Care Home: Which is Right for You?

Many people strongly prefer to remain in their own home as they get older or as their needs increase. Whether this is possible depends on the level and nature of your care needs, the safety of your home environment, and the support available to you. This guide helps you compare home care and residential care to make an informed decision.

7 min

NHS Continuing Healthcare

NHS Continuing Healthcare (CHC) is a package of ongoing care fully funded by the NHS for adults whose primary need for care arises from a health condition rather than social care needs. If you qualify, the NHS pays for all your care — including care home fees — with no means test. Eligibility is often misunderstood and many eligible people are never assessed. If the person you are asking about has a rapidly deteriorating condition that may be entering a terminal phase, the separate <a href="/care-later-life/chc-fast-track">CHC Fast Track pathway</a> bypasses this assessment and must be decided within 48 hours.

10 min

Care Home Closures, CQC Enforcement and Your Rights as a Resident

More than one in eight English care homes are rated 'requires improvement' or 'inadequate' by the Care Quality Commission, and dozens close every month — sometimes with only days of notice. This guide explains what CQC enforcement looks like in practice (special measures, conditions on registration, urgent suspension), what your rights are as a resident or relative when a home is failing or closing, who pays for an emergency move, and how to challenge a council's choice of replacement placement. It also covers what to do if neglect or abuse is happening now and you need to act before any inspection finds it.

12 min

Care Home Top-Up Fees

When a council-funded care home placement costs more than the council's standard rate, the difference is called a 'top-up' and is paid by a third party — usually a family member. Top-ups are a major source of dispute. The Care Act 2014 sets strict rules: they must be voluntary, properly documented, and not from the resident's own capital below the threshold. This guide explains the system.

9 min

Disclaimer

This information is for general guidance only and does not constitute legal, financial, or professional advice. Always check official sources and seek qualified help where needed.