GUIDE | ELDER CARE | GOV.UK SOURCE

Types of elder care in the UK

Elder care in the UK falls into four main categories. The right type depends on the level of need, the person's wishes, and what the local authority will fund after a needs assessment.

How to access elder care: the needs assessment

Anyone who may need care and support has the right to a needs assessment from their local council under the Care Act 2014. The assessment is free regardless of income or assets. The council sends a social worker or care assessor to evaluate what the person can and cannot do, and what outcomes they want to achieve.

If the assessment finds eligible needs under the Care Act 2014 eligibility criteria, the council must provide or arrange care. Eligible needs are those that arise from a physical or mental impairment or illness, where the person is unable to achieve two or more of ten specified outcomes (such as managing nutrition, maintaining personal hygiene, or engaging in social relationships), and where failure to do so has a significant impact on their wellbeing.

To request a needs assessment, contact the adult social care team at the person's local council. Assessments can be requested by the individual themselves, a family member or carer, or a health professional. The council must carry out the assessment within a reasonable timeframe -- if there is an urgent need, provision can be made immediately while the assessment is arranged.

Choosing a care home: what to look for

All care homes in England must be registered with and inspected by the Care Quality Commission (CQC). CQC rates homes across five domains -- Safe, Effective, Caring, Responsive and Well-led -- and assigns an overall rating of Outstanding, Good, Requires Improvement or Inadequate. The CQC rating is the most reliable independent assessment of a home's quality.

When visiting a care home, families should review the most recent CQC inspection report (available free on the CQC website), ask about staff-to-resident ratios, check whether the home is registered for the specific type of care needed (residential, nursing or dementia), and ask about the complaints process. Staffing consistency and the physical environment both feature prominently in what separates Outstanding from Good-rated homes.

Of 14,780 CQC-registered care homes in England, 82.7% are currently rated Good or Outstanding, according to analysis of the CQC Care Directory published June 2026. The Caring domain is the strongest -- 99.6% of homes are rated Good or Outstanding for Caring. Well-led is the most challenging domain, accounting for more Requires Improvement and Inadequate ratings than any other.

What does elder care cost?

Care home costs vary significantly by location, type of care and whether the home is state-funded or privately funded. Average fees across England in 2026 are approximately £42,000 a year for residential care and approximately £56,000 a year for nursing care. London and the South East are considerably more expensive than the national average.

Home care costs vary by provider and hours required. A typical package of two care visits a day, seven days a week, costs between £15,000 and £25,000 a year depending on location and provider. Live-in care, where a carer stays in the home full-time, typically costs £40,000 to £60,000 a year -- comparable to a care home but allowing the person to remain in their own home.

Funding depends on the means test. Those with capital assets below £23,250 may be eligible for council funding. Those above this threshold self-fund until their assets reduce to the lower threshold. Some people qualify for NHS Continuing Healthcare, which is entirely free. Read the full breakdown in the care funding UK guide.

Supporting a family member at home

Many families provide unpaid care before or alongside formal care arrangements. Unpaid carers providing substantial care have the right to a carer's assessment from the local council under the Care Act 2014, which can lead to support services, respite care or a direct payment to purchase support independently. Carer's Allowance (currently £81.90 a week in 2026/27) is payable to carers who spend at least 35 hours a week caring for someone who receives certain disability benefits.

Adaptations to the home -- grab rails, ramps, stair lifts, wet rooms -- can extend the period someone can live independently. Disabled Facilities Grants of up to £30,000 (£36,000 in Wales) are available from the local council for means-tested adaptations. Local occupational therapists can assess what adaptations are needed and support grant applications.

Frequently asked questions

What is a needs assessment and who carries it out?

A needs assessment is a free evaluation carried out by the adult social care team at the person's local council under the Care Act 2014. It looks at what the person can and cannot do, what outcomes matter to them, and whether their needs meet the eligibility threshold for council-funded care. Anyone can request one -- the individual, a family member or a health professional. The council must carry out the assessment regardless of the person's financial situation.

How long does it take to arrange a care home place?

Timescales vary. In an emergency -- for example, following a hospital admission -- a care home place can sometimes be arranged within days. For planned placements, the process of assessment, financial assessment, identifying a suitable home and completing paperwork typically takes two to six weeks. Some homes have waiting lists, particularly for Outstanding-rated homes in popular areas.

Can a person refuse to go into a care home?

Yes. An adult with mental capacity has the right to refuse any care, including a move to a care home, even if this means living with unmet needs or taking risks. The Mental Capacity Act 2005 protects this right. If there are concerns about capacity, a formal mental capacity assessment must be carried out before any decisions are made on the person's behalf. Decisions made on behalf of someone who lacks capacity must be in their best interests.

What is the difference between NHS Continuing Healthcare and local authority care?

NHS Continuing Healthcare (CHC) is a package of care funded entirely by the NHS for people whose primary need is a health need. It is not means-tested and is free regardless of assets. Local authority care is means-tested and subject to the capital thresholds. CHC eligibility is assessed using the NHS Decision Support Tool. People in care homes who qualify for CHC have all their care home fees paid by the NHS, including accommodation.