Welcome to the second feature in the series, which talks about the the different options for care that are available. Hopefully, you will find it useful, but if you have any questions please get in touch through our website.


Since the mid-1980s, the range and choices of care which are available have changed beyond recognition. At that time, you had care at home, which was normally provided by your family, early forms of sheltered housing, residential care homes and nursing homes.

The homes were usually converted houses, with multi-bedded rooms, no en suites, possibly a chairlift for the stairs and very little in the way of activities. The care was much simpler, without the modern specialisations we see today, such as helping with people living with dementia, enabling people to maintain their independence, through home-care, extra and close care and delivering specialist residential and nursing care in purpose designed settings.

Most people have no real involvement with care until they are faced with an urgent need. So, to help in understanding the care that is available, we have provided a brief overview of the options below. If you would like to know more, or have any specific questions, we would be happy to help. Please request a call back here, or contact us on 0345 853 0300.

Companionship, or 24 hour live in care

One of the simplest types of care is to have a companion living with you in your own home, as a live-in carer. They can provide short term, or long-term home care, respite care, and care for dementia. They can be a friend and companion to the able bodied, or provide quality home care for those with more complex needs.

Some examples of the type of care that can be provided are:

Short term care for a few days or a few weeks, i.e. 24-hour live-in care for a loved one who needs more support, or cover where you have a business trip, or family holiday and require care cover while you are away.

Convalescent care is sometimes necessary following surgery, or for older adults with an illness that requires more time to recover before returning to independence.

Respite care is usually short term, and provides a much-needed break for many family carers.

Live-In care services can include:

  • Companionship and escorting to social activities/trips to friends
  • Help with, or preparation of meals
  • In home care and assistance with bathing and dressing etc.
  • Help with laundry, shopping and light housework
  • Helping with medication and appointments
  • Support with hobbies
  • Social care support and encouragement

Live-in care for elderly couples can help couples to stay together in the comfort of their own homes.

Live-in care for disabled adults enables them to focus on their abilities and on living a full and independent life.

24 Hour care can also include live in nursing care where this is appropriate.

Domiciliary Care

Domiciliary care is provided to people who still live in their own homes but who require additional support with household tasks, personal care or any other activity that allows them to maintain their independence and quality of life. Anyone at any stage of life could require domiciliary care including those with learning disabilities, mental health problems, sensory impairment or physical disabilities.

You, or your loved one, may be starting to find it difficult to complete different areas of your routine and want some support. Regular home visits, from 15 minutes through to several hours a day, can be arranged to help you with a wide range of everyday tasks, including:

  • Personal and continence care
  • Managing medication
  • Helping to mobilise in and around the home
  • Household tasks and meal preparation
  • Clinical care, including catheter and stoma management and PEG feeding
  • Like live-in care, domiciliary care offers a valuable source of companionship.
  • Seeing a familiar face every day, or a couple of times a week, brings comfort, a feeling of safety and friendship

Sheltered Housing

Sheltered housing is accommodation specifically designed for older people (or younger disabled people) to allow them to live independently. 

It usually consists of self-contained flats with communal facilities. In most cases, it’s available to people aged over 60, although some schemes may be open to those over 55 years old. When used exclusively for older people, it’s sometimes called ‘retirement housing’. 

Sheltered accommodation can be bought or rented, either by individuals or couples. Residents can pay for sheltered housing privately (out of their own funds) or, if they meet certain eligibility criteria they can apply to be allocated sheltered housing by their local council, or housing association. 

The main advantage of sheltered housing is that residents have help at hand if they need it. Most offer additional support in the form of:

  • A scheme manager (or warden) living on- or off-site, who gives advice to residents, ensures that communal areas are clean, and arranges maintenance and repairs.
  • A 24-hour emergency alarm system within each property, so that residents can call for help if they have a fall, for example.

The majority of sheltered housing schemes require residents to have a certain level of independence.
All sheltered housing schemes are different and will offer a range of services and facilities. Many schemes offer:

  • communal areas (such as gardens or a communal lounge) where residents can get together to socialise
  • social activities or entertainment, such as coffee mornings, crafts, bingo, bridge or quiz evenings
  • organised excursions to places of interest
  • guest rooms for family and friends so you can have visitors to stay over
  • communal laundry (washers and dryers).

Some larger sites may also offer restaurants, shops, hairdressers or even a gym. 
Domiciliary care can be arranged if required, but sheltered housing schemes don’t offer any medical or nursing care on site, so if you require specific medical care, you may find that a care home is a better option.

Close Care/Extra Care

New forms of sheltered housing and retirement housing have been pioneered in recent years, to cater for older people who are becoming more frail and less able to do everything for themselves.

Close Care schemes are a relatively new concept and consist of independent flats or bungalows built on the same site as a care home. Residents often have some services (such as cleaning) included in their service charge and other services can be purchased from the care home. Close care schemes can either be rented or purchased. Purchasers may receive a guarantee that the management will buy back the property if they enter the care home.

Extra Care Housing is housing designed with the needs of frailer older people in mind and with varying levels of care and support available on site. People who live in Extra Care Housing have their own self contained homes, their own front doors and a legal right to occupy the property. Extra Care Housing is also known as very sheltered housing, assisted living, or simply as ‘housing with care’.  It comes in many built forms, including blocks of flats, bungalow estates and retirement villages. It is a popular choice among older people because it can sometimes provide an alternative to a care home.

In addition to the communal facilities often found in sheltered housing (residents’ lounge, guest suite, laundry), Extra Care often includes a restaurant or dining room, health & fitness facilities, hobby rooms and even computer rooms. Domestic support and personal care are available, usually provided by on-site staff. Properties can be rented, owned or part owned/part rented. There is a limited (though increasing) amount of Extra Care Housing in most areas and most providers set eligibility criteria which prospective residents have to meet.

Residential Care and Nursing Homes

There are 2 main types of care home:

  • residential care homes – now called care homes
  • nursing homes – now called care homes with nursing

Some care homes offer both residential and nursing care places.

Care homes can be run by private companies, voluntary or charitable organisations, or sometimes by local councils.

Care homes are staffed 24 hours a day and a proportion of the staff will be qualified care assistants with NVQs (National Vocational Qualifications) at Level 2 or 3. Care home managers are required to have a Registered Manager’s Award or similar management qualification as well as experience in care, but do not need any nursing experience.

The kind of assistance with personal care that can be provided in all care homes includes help with washing, dressing, toileting and mobility.

Members of staff in care homes often also help residents with eating and drinking, communicating and joining in social activities. They have to keep records of the residents and devise and follow an individual care plan for each resident.

If nursing interventions such as the administration of medicines by injection or complex dressings are needed, the district nurses are usually called in to carry out these tasks.

A care home with nursing will provide all the day-to-day care that you would expect from any care home, but the care is supervised by registered nurses who are on duty all day and all night. People who have an illness or medical condition requiring frequent medical attention will be better off in a nursing home, where nursing care is available 24 hours a day and planned interventions can be carried out at convenient times.

Another benefit is that nursing staff are trained to recognise symptoms and changes in a person’s condition, so are better qualified to decide when to call a doctor or other health professional.

Nursing homes are often better equipped with specialist beds and a range of equipment for moving and handling people, and are usually the best choice for those who have severe mobility difficulties or who are unable to get out of bed.

Dementia Care

A person with dementia will need more care and support as their symptoms worsen over time. This may mean that a move into a care home can better meet their needs.

If you have been helping someone live independently with dementia, or are a carer, this can be a hard decision to make, but it’s important to remember that there can be many positive aspects to moving into a care home.

These include:

  • 24-hour support from care staff
  • knowing that the person with dementia is in a safe place
  • social activities with other residents
  • washing
  • dressing
  • taking medicines
  • going to the toilet

As you can see from this, the range of care options available is extensive, and the right choice of care support depends on the individual and their circumstances. It is important that you make the right choice at the outset, by talking to people with the expertise and experience to help you with making an informed decision.

If you would like to have a chat about the options which are available and which may be the most appropriate, request a call-back by clicking the link here, or call us on 0345 853 0300.