Residential Care Homes in Wales
What residential care includes, typical costs, and how to find a residential home near you.
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Residential vs Nursing Homes in Wales
Choosing between a residential care home and a nursing home can be confusing. This guide explains the key differences, who each type of care is designed for, how nursing care differs from residential support, and the factors to consider before making a decision.
Every person's care needs are different
This guide provides general information to help families understand different types of care in Wales. Individual care decisions should always be based on professional assessment and personal circumstances.
At a glance
- Residential care focuses on personal care and daily support.
- Nursing homes provide personal care plus 24-hour registered nursing care.
- Some people move from residential care to nursing care as their needs change.
- The right choice depends on individual care needs rather than age alone.
- Professional assessments can help determine the most appropriate setting.
What is a residential care home?
A residential care home offers accommodation, meals and personal care in a homely, supportive setting. It is designed for people who can no longer manage safely at home but who do not need continuous care from a registered nurse.
Day-to-day support typically includes:
- Help with washing, dressing and personal hygiene
- Cooked meals and snacks tailored to dietary needs
- Prompting or administering routine medication
- Support with mobility, transfers and use of aids
- A programme of social activities, hobbies and outings
- Housekeeping, laundry and general daily living support
Residential homes work closely with GPs, district nurses and other community healthcare services, but they do not normally provide continuous nursing care by registered nurses on site.
What is a nursing home?
A nursing home provides all the personal care and daily support of a residential home, with the addition of registered nurses on duty 24 hours a day. It is intended for people whose care needs include ongoing clinical or medical support that cannot easily be met at home or in a residential setting.
Nursing care may include:
- Registered nurses available on site around the clock
- Care for complex or long-term medical conditions
- Regular clinical monitoring and reviews
- Full medication management, including complex regimes
- Wound care, pressure care and continence support
- End-of-life nursing care where appropriate
Nursing homes still support daily living and social wellbeing in the same way as residential homes. The main difference is the level of clinical care available on site.
Residential vs nursing care at a glance
The table below summarises the main differences between residential and nursing care in Wales. Every home is different, so treat this as a general comparison rather than a definitive description of any individual provider.
| Feature | Residential care home | Nursing home |
|---|---|---|
| Staff on site | Trained care workers and senior carers around the clock. | Trained care workers plus registered nurses on duty 24 hours a day. |
| Medical and clinical care | Support with day-to-day health tasks; GPs and district nurses visit as needed. | Ongoing clinical care delivered on site by registered nurses. |
| Personal care | Help with washing, dressing, toileting and continence support. | The same personal care as residential, alongside nursing support. |
| Medication | Prompting and administering routine medication under clear procedures. | Full medication management, including complex regimes and injections where required. |
| Typical residents | People who need help with daily living but not continuous nursing care. | People with ongoing clinical needs that require registered nursing support. |
| Suitability | Frailty, mild to moderate dementia, reduced mobility, social isolation. | Complex health conditions, advanced neurological illness, significant nursing needs. |
| Daily living assistance | Meals, laundry, housekeeping and support with routines. | The same daily living assistance provided in residential care. |
| Activities and social life | Structured activity programmes, outings and social events. | Activities are offered and adapted to individual health and mobility. |
| End-of-life care | May be supported with input from community nursing and palliative care teams. | Nursing staff can provide end-of-life nursing care on site. |
| Mobility support | Support with walking, transfers and use of mobility aids. | Support for more complex mobility needs, including hoisting and specialist equipment. |
Who might benefit from residential care?
Residential care can suit people who are managing less well at home but whose main support needs are around daily living rather than clinical care. Common circumstances include:
- Increasing frailty that makes living alone unsafe
- Loneliness or social isolation affecting wellbeing
- Difficulty managing meals, housework or personal care
- Mild to moderate dementia that is well supported by trained care staff
- Family carers finding it hard to provide the level of support needed
- Recovery and rehabilitation after illness where nursing care is not required
Not every situation above will lead to a residential care placement, and no single condition automatically requires it. A care and support needs assessment can help explore all available options.
Who might benefit from nursing care?
Nursing care is generally appropriate where a person has ongoing clinical needs that require regular input from registered nurses. Examples include:
- Complex or unstable health conditions
- Advanced neurological conditions such as Parkinson's disease or motor neurone disease
- Frequent nursing interventions, for example wound care or catheter management
- Serious mobility issues requiring hoisting or specialist equipment
- Complex medication regimes, including injections
- Palliative and end-of-life care needs that require on-site nursing
These are illustrative examples. Decisions about nursing care should always be based on professional assessment rather than a single symptom or diagnosis.
Can someone move from residential to nursing care?
Yes. Care needs often change over time, and some residents who start in a residential home later require nursing care. Planning ahead can make future transitions easier and less stressful.
- Ask each home whether they offer both residential and nursing care on the same site
- Find out how the home reviews and adjusts care plans as needs change
- Check whether a move within the home is possible if nursing needs develop
- If a future move to a different home is likely, ask how that would be supported
Our Choosing a Care Home in Wales guide has more detailed questions to ask when comparing homes.
Who decides which type of care is right?
The decision is rarely made by one person alone. It usually involves a combination of:
- The person receiving care, wherever possible, with their views at the centre
- Family members and any nominated advocate
- GPs, community nurses and other healthcare professionals who know the person
- Local authority social workers through a care and support needs assessment
- NHS professionals where nursing or continuing healthcare needs are being considered
A local authority assessment is a helpful starting point even for self-funders, because it provides an independent view of the level and type of support required.
How do costs compare?
As a general rule, nursing home fees are higher than residential care because they include care from registered nurses on site around the clock. Actual weekly fees vary considerably depending on the home, the location, the room type and the individual care needs involved.
Rather than publishing figures that quickly go out of date, we recommend asking each home directly for a written breakdown of fees and what they include. For a fuller explanation of how care in Wales is paid for, see:
- Paying for Care Homes in Wales — how funding, means testing and property rules work
- Care Home Costs — what affects fees and what to check when comparing homes
- NHS Continuing Healthcare — an introduction to fully NHS-funded packages of care
Questions to ask when comparing homes
Use these questions to explore whether a home can meet current and future needs:
- Do you provide residential care, nursing care, or both?
- Are registered nurses always available on site, day and night?
- How would you support a resident whose needs increase over time?
- Can specialist dementia care be provided within the home?
- How are medical emergencies handled, and how quickly can a nurse or GP be involved?
- Can additional one-to-one support be arranged if needed?
- How often are care plans reviewed, and how are families involved?
- How do you work with local NHS teams and community nursing services?
Common misconceptions
Myth: Residential homes are only for older people.
Adults of any age may need residential care, for example following long-term illness or serious injury. Registration and specialism vary between homes.
Myth: Everyone with dementia needs nursing care.
Many people living with dementia are well supported in residential homes, including specialist dementia units. Nursing care is only needed where clinical needs also require it.
Myth: Nursing homes are the same as hospitals.
Nursing homes provide long-term care in a homely setting, focused on quality of life. Hospitals treat short-term illness or injury and are not designed for long-term living.
Myth: Residential care provides no medical support.
Residential homes support daily health-related needs and work closely with GPs, district nurses and other services, even though they do not employ nurses on site around the clock.
Myth: Moving to a care home means losing independence.
Good care homes actively support choice, routine and independence — from what time to get up to how each day is spent.
Frequently asked questions
- What is the main difference between a residential home and a nursing home?
- A residential care home provides personal care and daily support such as help with washing, dressing, meals and medication. A nursing home offers all of that plus 24-hour care from registered nurses for people with ongoing clinical or medical needs.
- Which is more expensive, residential or nursing care?
- Nursing home fees are usually higher than residential care because they include care from registered nurses. Actual costs vary between homes, locations and individual care needs. For general information on fees see our Care Home Costs and Paying for Care Homes in Wales guides.
- Can someone move from residential care to nursing care later?
- Yes. Needs can change over time and some residents later require nursing care. Some homes offer both types of care on the same site, which can make transitions easier. Others may support a planned move to a different home.
- Does dementia always require nursing care?
- No. Many people living with dementia are well supported in residential care homes, including homes with specialist dementia units. Nursing care is only needed where dementia is accompanied by significant clinical or nursing needs. Professional assessment can help identify the right setting.
- Can couples with different care needs stay together?
- Some homes offer shared or adjoining rooms for couples, including where one partner has residential needs and the other requires nursing support. Availability is limited, so raise this early when enquiring.
- Who decides whether someone needs residential or nursing care?
- The decision usually involves the person themselves wherever possible, their family, healthcare professionals and a local authority care and support needs assessment. Where nursing needs are identified, an NHS assessment may also be involved.
- Do residential homes provide any medical support?
- Residential homes support daily health-related tasks such as prompting or administering medication and liaising with GPs, district nurses and other healthcare professionals. They do not usually employ registered nurses on site around the clock.
- Are nursing homes the same as hospitals?
- No. Nursing homes provide long-term care in a homely setting with nursing support, whereas hospitals treat short-term illness or injury. Nursing homes focus on quality of life, dignity and ongoing care, not acute medical treatment.
- Can I get help paying for nursing care?
- You may be eligible for local authority funding after a means test, and the NHS may contribute towards the nursing element of your care. In some cases NHS Continuing Healthcare may cover the full cost. Our Paying for Care Homes in Wales guide explains this in more detail.
- How do I know which type of home is right?
- Start with a care and support needs assessment from your local authority. They will look at daily living, health and social needs, and recommend the most appropriate type of care. Visiting a mix of residential and nursing homes can also help you understand what each type feels like day to day.
Find residential and nursing care homes across Wales
Browse care homes across every local authority in Wales, then contact homes directly to discuss the type of care they provide.
Recommended reading
Nursing Homes in Wales
Nursing care explained — 24-hour clinical support, costs, and choosing a nursing home.
Read guideDementia Care Homes in Wales
Specialist dementia care, what to look for in a memory-care home, and support for families.
Read guideChoosing a Care Home in Wales
A step-by-step guide to shortlisting, visiting and choosing the right care home for a loved one.
Read guideHow to Choose a Care Home
Practical advice on what to look for when comparing care homes, from staffing to inspection reports.
Read guideCare Home Visit Checklist
The questions to ask and things to look for when you visit a care home in person.
Read guide