Choosing a nursing home for someone at the end of life means finding a place that can manage symptoms and nursing needs, that treats the person and the family with kindness, and that can be arranged fast. The regulator’s report tells you about safety and leadership; a visit and a few direct questions tell you about the rest. Funding often falls to the NHS under the fast-track continuing healthcare pathway, which means the decision can be about the right home rather than the affordable one.
This is a hard decision to make under pressure. Age UK (0800 678 1602) and the Marie Curie support line (0800 090 2309) will talk it through with you for free.
Key facts
| Question | Answer |
|---|---|
| Nursing or residential | Nursing home, for round-the-clock registered nurses, unless the person’s needs are simple |
| First check | The regulator’s rating and latest report (CQC in England, Care Inspectorate in Scotland, CIW in Wales, RQIA in Northern Ireland) |
| Key questions | End of life experience, anticipatory medicines and syringe pumps, GP and palliative care links, visiting, what happens after death |
| Funding | Fast-track NHS continuing healthcare pays everything if eligible; otherwise means-tested |
| Speed | Days, with an urgent assessment and a free bed |
Nursing home or residential care home?
A nursing home (in England, a care home with nursing) has registered nurses on duty 24 hours a day. They can give injections, manage a syringe pump, handle pressure care and catheters, and respond to a change in the night without waiting for a district nurse. For someone in the last weeks of life this matters.
A residential care home provides personal care from care workers, with the district nurses visiting for anything clinical. Many residential homes care well for people at the end of life, especially residents who have lived there for years and whose needs are mainly for comfort and company, but they depend on the responsiveness of the local district nursing service.
If the person already lives in a residential home and is settled, moving them is often worse than staying with extra support. If they are coming from hospital or from home with complex needs, a nursing home is usually the right choice. Endoflifecare.uk lists 4,707 nursing homes across the UK.
Start with the regulator’s report
Every care home in the UK is registered and inspected: by the Care Quality Commission (CQC) in England, the Care Inspectorate in Scotland, Care Inspectorate Wales, and the Regulation and Quality Improvement Authority (RQIA) in Northern Ireland. Listings on this site show the registration and rating where there is one. Of the 5,440 services listed, 4,438 are CQC-registered and, of those with a current rating, 197 are rated Outstanding, 2,251 Good, 400 Requires Improvement and 9 Inadequate (checked October 2026).
Read the latest report, not just the rating. Look for:
- The date. A rating from four years ago says less than one from last year.
- The “Safe” and “Well-led” sections (CQC), or the care and support and leadership grades (Care Inspectorate).
- What inspectors said about end of life care, medicines management and staffing at night.
- Whether earlier concerns were fixed.
Our guide to regulator ratings explains each system and why Wales has no overall rating.
A home rated Requires Improvement is not automatically a bad choice, and an Outstanding rating does not guarantee a good death. Use the report to decide what to ask about.
Questions to ask the home
About end of life care
- How many residents did you care for at the end of life in the past year?
- Have staff had end of life training (for example, through the local hospice or the Gold Standards Framework)?
- Do you keep anticipatory (“just in case”) medicines and manage syringe pumps on site?
- Which GP practice covers the home, and how often do they visit? Does the hospice or palliative care team support you?
- What happens if a resident deteriorates at 2am? Who decides whether to call an ambulance?
- Do you record residents’ wishes, including ReSPECT or DNACPR forms, and follow them?
About daily life
- Can family visit at any time, including overnight? Can a relative stay in the room?
- Can the person have their own things, their own routine, their own food preferences?
- Can they have a single room with an en-suite?
- Is there somewhere quiet for family to sit, and somewhere for children?
- How do you support residents’ faith or beliefs?
About staffing
- How many nurses and care workers are on at night, and for how many residents?
- How long have the manager and senior nurses been here? High turnover is a warning sign.
- Do you use agency staff at night?
After a death
- What happens in the hours after a death? Can family stay with the person?
- Do you support the family afterwards?
- What is the notice period for fees after death? (Most homes charge a few days to two weeks; longer is unreasonable.)
What to look for on a visit
Go, even if only for twenty minutes, even in a hurry. Notice:
- Whether staff know residents by name and speak to them, not about them.
- Whether call bells ring for long.
- Smell, cleanliness, warmth, light.
- Whether residents who cannot move are positioned comfortably and have a drink within reach.
- Whether the manager answers your questions directly or deflects.
- How the home feels at a mealtime or in the evening, if you can time it.
Ask to see the room the person would have, not a show room.
Funding and fees
If the person is nearing the end of life, ask the district nurse, hospital or GP to complete the fast-track NHS continuing healthcare tool before anything else. If eligible, the NHS pays the home directly and in full, and no means test applies. Most people in the last weeks of life with nursing needs qualify. If CHC is refused or not yet decided, the council means-tests the person’s savings and, in some cases, their home, and the NHS pays £267.68 a week in England towards nursing costs. Our guide to who pays for end of life care sets out the 2026/27 thresholds for all four nations, the twelve-week property disregard and deferred payments.
Get the fee in writing, broken down to show any NHS-funded nursing care deduction, what is included (continence products, GP visits, hairdressing, activities), and the notice period after death. Age UK puts the UK average nursing home fee at about £1,450 a week; homes that specialise in end of life care may charge more.
How quickly can it happen?
Days. Hospitals discharge to nursing homes every day and homes are used to urgent admissions. The steps:
- Fast-track CHC tool completed by a doctor or nurse (48 hours to a decision).
- Shortlist homes with a free bed; the hospital discharge team, the council’s brokerage team or the palliative care nurse can tell you which have vacancies.
- Visit, or send a relative.
- The home assesses the person (usually a nurse visits the hospital or home) and confirms they can meet the needs.
- Transfer, with the GP registration, medicines and care plan handed over.
If the person is very close to death, a move can do more harm than good; the palliative care team will say so if they think that.
Help that is free
- Age UK: 0800 678 1602, for choosing and paying for care homes.
- Marie Curie support line: 0800 090 2309.
- Beacon: 0345 548 0300, free advice on NHS continuing healthcare.
- Hospice UK: for hospice alternatives.
- The council’s adult social care team, for brokerage and urgent assessments.
Finding a nursing home
Endoflifecare.uk lists 4,707 nursing homes across 917 UK towns and cities, with the regulator’s registration and rating where one exists, services offered, and fees where the home publishes them (checked October 2026). Listings link to the regulator’s latest report. Use it to shortlist, then phone and visit.
Sources
- Care Quality Commission: Find a care home and What to expect from a care home
- Care Inspectorate (Scotland): Find a care service
- Care Inspectorate Wales: Find a care service
- RQIA (Northern Ireland): Find a service
- NHS: NHS continuing healthcare
- Age UK: Choosing a care home and Paying for a care home
- Gold Standards Framework: Care homes programme