Home › Guides › Nursing homes: what they cost and when you need one
A nursing home has a registered nurse on site around the clock. That single difference changes the price, the funding route and the questions worth asking.
A residential care home provides personal care: help with washing, dressing, eating, moving about, and someone there overnight. A nursing home does all of that and has a registered nurse on site around the clock. The Care Quality Commission registers the two service types separately, so a home either has nursing registration or it does not.
It matters because you cannot informally upgrade. If someone’s health needs cross into requiring a qualified nurse, a residential home cannot lawfully meet them, however much the staff want to. That is usually the moment a family discovers the difference exists.
The social care element. The council rate for nursing usually sits above the residential rate. Among councils that publish both for 2026/27:
| Council | Residential | Nursing, before NHS contribution |
|---|---|---|
| Hertfordshire | £768.02 | £880.86 |
| Norfolk | £867.49 | £877.02 |
| Sandwell | £775.11 | £775.11 |
| West Sussex | £900.00 | £1,030.00 |
| Nottinghamshire | £776–£868 | £869–£963 |
| Somerset | £834.00 | £862.00 |
Note Sandwell: identical. This is not a quirk. Oxfordshire has written to its providers explaining why its nursing rates are equal to or lower than residential once NHS-funded nursing care is removed, and Derbyshire has done the same. Several councils take the view that accommodation and personal care cost the same whether or not nursing is involved, and that the nursing element is the NHS’s to pay.
So “nursing homes cost more” is true of the final bill and often false of the council rate. Ask which figure you are being quoted.
NHS-funded nursing care. £267.68 a week from 1 April 2026, paid by the NHS directly to the home. It is not means-tested. It applies only in a home registered for nursing, and only after an assessment.
So a Hertfordshire nursing home actually receives £1,148.54 a week, not £880.86. Both figures are true, and councils publish whichever they prefer.
Is that figure before or after NHS-funded nursing care?
If the person quoting cannot answer, the number is not comparable to anything. A council quoting the inclusive figure looks 35% more generous than one quoting the exclusive figure, while paying exactly the same.
You receive this whether or not you are paying for your own care. Funded Nursing Care is not means-tested. Self-funders qualify on exactly the same basis as anyone else, and many never claim it — over a year it is worth £13,919. Ask the home to arrange an assessment. See NHS-funded care.
If needs are primarily health needs rather than social care needs, the NHS pays the entire bill — accommodation, meals, personal care, nursing — regardless of savings. That is NHS Continuing Healthcare, assessed by the NHS, not the council.
Funded Nursing Care of £267.68 is what applies when Continuing Healthcare has been considered and refused. The order matters. If nobody has mentioned it, ask for a Checklist assessment before agreeing to anything.
Who ends up paying — you, the council or the NHS — is set out in paying for a care home.
Nursing homes are inspected on the same five domains as residential homes and carry the same problem. Across England the middle care home was last judged more than four years ago, and 40% carry a rating over five years old — see our research.
For a nursing home the gap matters more, because nurse staffing and clinical governance degrade fastest when a home changes hands.
If the need is memory rather than nursing, the rate and the questions are different: dementia care homes. If staying at home is still on the table, compare it honestly against live-in care.
Question four separates homes. High agency use on nursing shifts is the most reliable early signal of a home under strain, and it appears in no rating.
Reviewed 11 August 2026. Figures are for 2026/27 unless stated. This is information, not financial or legal advice.
We publish prices and register data. We are not an advice service, and for the decisions that follow these are the sources worth your time — all free, none of them selling you anything.