How to choose a care home: a step-by-step guide
Choosing a care home is one of the harder decisions a family makes, often under time pressure and stress. This guide breaks it into manageable steps — from working out what care is actually needed to the questions that reveal what a home is really like.
1. Start with a needs assessment
Before comparing homes, get a clear picture of the level of care needed. Anyone can ask their local council's adult social care team for a free care needs assessment — it's a legal right regardless of income or savings. It establishes whether the need is for residential care, nursing care, or specialist dementia support, which narrows your search considerably. See our guide to the types of care if you're unsure which applies.
2. Shortlist by location and rating
Being close to family matters more than people expect — regular visits are easier, and they're one of the best safeguards of good care. Start local, then filter by the home's latest Care Quality Commission (CQC) rating. CareMapped lists every home by town with its ratings on all five inspection areas, so you can browse homes in your area and rule out any rated Requires improvement or Inadequate before you spend time visiting.
3. Read the CQC report properly
The overall rating is only a headline. The CQC rates each home on five separate questions, and they don't always agree:
- Safe — are people protected from abuse and avoidable harm?
- Effective — does care achieve good outcomes?
- Caring — do staff treat people with compassion and dignity?
- Responsive — is care organised around the person's needs?
- Well-led — is the home well-managed and honest about problems?
A home rated Good overall but Requires improvement on Safe deserves a closer look at why. On each home's CareMapped page you can see all five ratings with their dates, then follow the link to read the full inspection report on the CQC website.
4. Visit — ideally more than once
Nothing replaces walking in. Visit at least twice, and try to include a mealtime and an unannounced visit. Trust your senses: does it smell clean, are residents dressed and engaged, do staff know people by name, is there a calm atmosphere or a rushed one?
5. The questions that actually reveal a home
- What is the staff-to-resident ratio, day and night? What's the staff turnover?
- Will my relative have a consistent, named key worker?
- How do you handle a resident whose needs increase — can they stay?
- What's the all-inclusive weekly fee, and what costs extra?
- When did fees last rise, and by how much?
- What happens if self-funded money runs out — do you keep residents on council rates?
- Can I see the most recent CQC report and your latest food hygiene rating?
The fees questions matter as much as the care ones — read our guide to paying for care before you commit to anything.
6. Take your time on the contract
Ask for the contract in advance and read the terms on notice periods, fee increases, deposits, and what happens if circumstances change. Never feel rushed into signing on a first visit, even when the situation feels urgent.