How to choose a care home: a checklist for your visit

Which nation does this checklist cover, and who regulates care homes?

This checklist is written for England. Care and support is a devolved matter, so the rules, regulators and funding systems differ across the UK.

• England: the Care Quality Commission (CQC) registers and inspects care homes and publishes reports and ratings.
• Scotland: the Care Inspectorate regulates care services.
• Wales: Care Inspectorate Wales (CIW) regulates and inspects care homes.
• Northern Ireland: the Regulation and Quality Improvement Authority (RQIA) is the regulator.

The questions in this article apply wherever you are, but check your own nation's regulator for its reports, and your local authority or health and social care trust for funding and assessment details.

What should you do before you visit a care home?

Preparation saves you from being swayed by a pleasant first impression. Before booking any visits:

• Be clear about the level of care needed. Residential homes provide accommodation and personal care. Nursing homes also have registered nurses on duty. Some homes specialise in dementia care. A needs assessment from your local authority, or a conversation with the person's GP or a social worker, can help you decide.
• Read the inspection report. In England, CQC reports rate services as Outstanding, Good, Requires improvement or Inadequate, and look at whether a service is safe, effective, caring, responsive and well led. Read the detail, not just the headline rating.
• Shortlist by location. A home close to family and friends makes frequent visits far more realistic, and regular visits matter enormously to residents.
• Write your list. Take this checklist, a notebook and, if possible, a second person. Two sets of eyes notice more.

What should you notice when you first walk in?

Your first ten minutes tell you a great deal. Use your senses and your instincts.

• Atmosphere: is it calm and welcoming, or hurried and tense? Does anyone greet you promptly and warmly?
• Smell: a well-run home should smell clean and fresh. Persistent unpleasant odours may suggest problems with continence care or cleaning.
• Interaction: do staff speak to residents with respect, using their names, getting down to eye level, and not talking over their heads?
• Residents' appearance: do people look clean, comfortable and dressed in their own clothes, in ways that reflect their personality?
• Call bells: if you hear one, how quickly is it answered?

What questions should you ask about staff and care?

Staff are the heart of any care home. Beautiful decor means little if the people providing care are overstretched or poorly supported. Ask the manager directly:

• How many care staff are on duty during the day, at night and at weekends, and how does the home decide staffing levels?
• How often are agency staff used, and do residents see familiar faces?
• What induction and ongoing training do staff receive, including dementia awareness and moving and handling?
• How long has the manager been in post, and how long have key staff stayed? High turnover can affect continuity of care.
• Will my relative have a named key worker, and how is a personal care plan written and reviewed? Who is involved?
• How does the home handle medication, GP visits, and access to dentists, opticians, chiropodists and therapists?
• How are dietary needs, religious practices, cultural preferences and communication needs met?

Also talk to care staff themselves when the manager is not hovering. Do they seem content, unrushed and proud of their work?

How do you judge the activities on offer?

Activities are one of the best windows into a home's culture. A good programme goes well beyond a television switched on in the lounge. Ask to see the current weekly timetable, and then check whether what is displayed matches what you observe.

Questions worth asking:

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• Who organises activities, and is it someone's dedicated role rather than an afterthought?
• Is there variety: music, gentle exercise, crafts, gardening, reminiscence, quizzes, outings and spiritual or cultural events?
• Are there options for people who stay in their rooms or have limited mobility, sight or hearing?
• How are residents' life stories, hobbies and past careers used to shape what is offered?
• Does the home offer cognitive stimulation, such as memory games, word and number activities or tablet-based brain games? Are these done with the resident, not just left running?
• Can relatives take part in events, and are there links with local schools, community groups or volunteers?

Look at the faces of residents during an activity. Engagement, laughter and conversation are good signs. Ask, too, whether residents choose what they join in, or are simply herded along.

Many homes now use digital tools to keep minds active. Our SCARLETT memory games for seniors are an example of the kind of approach worth asking about: short, enjoyable sessions that can be adapted to each person's abilities. If you work or volunteer in care, the course on cognitive stimulation for seniors offers practical ideas you can compare with what a home is doing.

How can you check hygiene, food and the environment?

Cleanliness and comfort affect health and dignity every day. Look closely, and do not be shy about asking to see more than the show room.

• Cleanliness: check communal areas, toilets, bathrooms and bedrooms. Are hand-washing facilities and hand gel available and used?
• Infection prevention: ask how the home manages outbreaks, visiting arrangements during illness, and how it keeps residents safe without isolating them.
• Bedrooms: can residents bring their own furniture, photographs and belongings? Is there a lockable space for valuables?
• Accessibility: look for clear signage, handrails, level access, good lighting and safe outdoor space. For people living with dementia, dementia-friendly design such as clear colour contrast can make a real difference.
• Food and drink: ask to see a menu, and ideally visit at a mealtime. Is the food appetising and presented well? Are choices offered, is help given to those who need it, and are drinks and snacks available between meals?
• Laundry: how are clothes labelled and returned, so they do not go missing?

What should you ask about safety and safeguarding?

Safety is about both the building and the culture. A safe home protects residents from harm while still respecting their independence and choices.

• How does the home prevent and respond to falls, and how does it manage risk without restricting freedom unnecessarily?
• What are the fire safety and emergency procedures, and when were they last tested?
• Who is the safeguarding lead, and how does the home report and handle concerns about abuse or neglect?
• How does it deal with complaints? Ask to see the complaints policy and how recent concerns were resolved.
• How are decisions made for residents who may lack capacity? Staff should understand the Mental Capacity Act 2005 and, where relevant, Deprivation of Liberty Safeguards.
• How are residents' money and personal property protected?
• What is the visiting policy, and can family visit flexibly?

If you ever have a concern about a care home, raise it first with the manager, then with the provider, your local authority and the regulator. In England, you can share your experience of a service directly with the CQC.

How do you assess social life and family involvement?

A comfortable bed and good meals are not enough. Loneliness is a real risk in later life, even in a busy building. Think about how your relative will build friendships and keep their own identity.

• Do residents chat to one another, or does everyone sit silently facing a screen?
• Are there quiet corners, a garden, a café area or lounges where small groups can meet?
• Can residents keep up their faith, hobbies, pets or favourite routines, such as an early-morning cup of tea or a daily walk?
• How does the home keep families informed and involved? Are there relatives' meetings, regular updates and a straightforward way to raise concerns?
• Are there residents of a similar age and interests? Ask whether your relative would find someone to talk to.

If dementia is part of the picture, our course on understanding Alzheimer's for families can help you know what good dementia care looks like and which questions to put to staff.

What about costs, contracts and funding?

Costs vary widely depending on region, level of care and the home itself, so we do not quote figures here. What matters is understanding exactly what you are paying for.

• Ask for a written breakdown of the fees and what is included, and what costs extra, such as hairdressing, outings or toiletries.
• Ask how and when fees can rise, and what notice is given.
• Check what happens if the person's needs change, or if they need to move to a different level of care.
• Read the contract carefully before signing, and consider asking an independent adviser or solicitor to look at it.

In England, your local authority can carry out a needs assessment and a financial assessment under the Care Act 2014 to see whether it can contribute to costs. NHS Continuing Healthcare may apply in some cases of significant health needs. Funding rules differ in Scotland, Wales and Northern Ireland, so check with the relevant local authority or health and social care trust.

How do you compare homes and make the final decision?

After several visits, details blur. Fill in a simple comparison straight after each one. A table like this helps you weigh what matters most.

Finally, ask whether a short trial stay is possible. It gives your relative a chance to see how they feel, and gives you confidence before a bigger commitment.

Frequently asked questions

How many care homes should we visit before choosing?

There is no fixed number, but visiting at least two or three lets you compare atmosphere, staff and routines properly. If you can, go back to your preferred home at a different time of day.

Is a good CQC rating enough to choose a home?

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No. A rating is a useful starting point, but inspections happen at a particular moment. Always combine the report with your own visit, conversations with staff and residents, and how well the home suits the person's needs and personality.

What is the difference between a residential home and a nursing home?

Both provide accommodation and personal care. A nursing home also has registered nurses on duty to provide nursing care, which is needed when someone has medical needs that require a nurse's skills.

Can we ask to see a home's most recent inspection report?

Yes. In England, reports are published by the Care Quality Commission, and homes should be open about their rating. Ask the manager how they have responded to any concerns raised.

What if my relative does not want to move into a care home?

Involve them as much as possible, and explore alternatives such as help at home or a trial stay. If they have capacity, the decision is theirs. If capacity is in doubt, the Mental Capacity Act 2005 sets out how decisions should be made in their best interests.

Which DYNSEO activities and games can support residents' memory and wellbeing?

Whether your relative is in a care home or at home, regular mental stimulation matters. DYNSEO designs resources for older people, families and care professionals. A few examples:

• Memory and brain games for seniors: SCARLETT offers short, adaptable games that can be enjoyed alone or together with a relative or carer.
• Training for care staff and families: the course on supporting seniors differently through play shows how to use games to stimulate and share moments with older people.
• Understanding dementia: the Alzheimer's course for families offers solutions for everyday life.

You can also explore our tools and our training courses to see what suits your situation.