What is residential care?
- Personal care support: help with washing, dressing, meals, mobility, and daily living tasks.
- Staffed by care assistants (not nurses); supervised by a registered manager.
- Suitable for: stable health, no complex medical needs, can manage with GP/community nurse visits.
- Focus: maintaining independence, social activities, homely environment, dignity in daily life.
What is nursing care?
- All residential care support, plus 24-hour registered nurse supervision and medical care.
- On-site registered nurses; access to clinical equipment, medication management, wound care, and health monitoring.
- Suitable for: complex health conditions, regular medical interventions, unstable conditions requiring frequent assessment.
- Focus: clinical safety, health stability, coordination with GPs and specialists, managing deteriorating conditions.
Key differences
- Staffing: Residential = care assistants; Nursing = care assistants + registered nurses on-site 24/7.
- Medical support: Residential = GP/community nurse visits; Nursing = on-site clinical care and monitoring.
- Equipment: Residential = basic aids; Nursing = clinical equipment (hoists, pressure-relief systems, monitoring).
- Cost: Nursing care typically costs more due to registered nurse staffing and clinical infrastructure.
- Registration: CQC registers homes as "Residential" or "Nursing" (some offer both on separate floors/units).
When residential care may be sufficient
- Stable health conditions managed with GP/community nurse support.
- Mobility support needed but no complex medical interventions.
- Dementia care where behavioural support is the priority (not clinical nursing).
- Personal care and daily living support is the main need.
- Preference for a more homely, less clinical environment.
When nursing care is needed
- Complex medical conditions requiring regular monitoring or interventions.
- Wound care, catheter management, or other clinical procedures.
- Unstable conditions (e.g., frequent falls, medication changes, deteriorating health).
- Post-hospital discharge with ongoing clinical needs.
- End-of-life care requiring pain management and clinical support.
- Conditions where rapid clinical response is essential (e.g., stroke recovery, complex diabetes).
Assessment and decision-making
- NHS Continuing Healthcare (CHC) assessment may determine if nursing care is required.
- GP or community nurse assessment can advise on care level needed.
- Consider future needs: if health is likely to deteriorate, nursing care may prevent later moves.
- Some homes offer "dual registration" (residential + nursing on-site) allowing transitions without moving.
- Review care needs regularly: residential care residents may need to move to nursing care if needs increase.
Cost differences in Poole
- Residential care: typically lower weekly fees; varies by room type, location, and included services.
- Nursing care: higher fees due to registered nurse staffing; may include Funded Nursing Care (FNC) if eligible.
- FNC: NHS contribution toward nursing care costs (paid directly to the home); ask if this applies and how it affects fees.
- Local authority funding: both types can be funded, but nursing care rates are typically higher; check BCP Council's usual rates.
- Ask homes: what's included in each fee tier; how fees change if care needs increase from residential to nursing.
Dual-registered homes (residential + nursing)
- Some homes offer both residential and nursing care on separate floors or units.
- Benefit: residents can transition from residential to nursing without moving homes.
- Ask: how transitions are managed; whether fees change; how continuity of care is maintained.
- Check CQC registration: confirm which parts are registered for which care type.
Questions to ask homes
- What is your CQC registration: residential, nursing, or dual-registered?
- If residential: how do you coordinate with GPs and community nurses? What's the response time for health concerns?
- If nursing: what are the nurse-to-resident ratios? How do nurses and care assistants work together?
- If needs increase: can residents stay, or must they move? How is this transition managed?
- Fees: what's the difference between residential and nursing rates? Is FNC included or separate?
- Clinical equipment: what's available on-site? How is equipment maintained and updated?
Poole/BCP local considerations
- Transport: ensure family can visit easily (Parkstone: 7A/7B/7C/15/18 + rail; Hamworthy: 8/9/10 + rail; Broadstone: 3/4/18/32).
- GP access: check which homes have good links to local GP practices (Parkstone Health Centre, Broadstone Health Centre, Hamworthy Medical Centre).
- Hospital proximity: consider distance to Poole Hospital for emergency or specialist care.
- CQC reports: check whether homes are registered correctly and how they perform in "Safe" and "Effective" domains.
Making the decision
- Get a professional assessment: GP, community nurse, or social services can advise on care level needed.
- Consider current and future needs: if health is likely to deteriorate, nursing care may be more appropriate.
- Visit both types: see the difference in environment, staffing, and clinical support.
- Check CQC registration: ensure the home is registered for the care type you need.
- Discuss with family: consider preferences, visiting ease, and how care needs may change.
- Review funding: understand costs, FNC eligibility, and local authority rates for each type.
FAQ
- What is the difference between residential and nursing care? Residential care provides personal care support (washing, dressing, meals) with care assistants. Nursing care includes all residential care plus 24-hour registered nurse supervision and medical care.
- When is residential care sufficient? Residential care may be sufficient for stable health conditions managed with GP/community nurse support, mobility support without complex medical interventions, or dementia care where behavioural support is the priority.
- When is nursing care needed? Nursing care is needed for complex medical conditions requiring regular monitoring, wound care, catheter management, unstable conditions, post-hospital discharge with ongoing clinical needs, or end-of-life care requiring pain management.
- What is Funded Nursing Care (FNC)? FNC is an NHS contribution toward nursing care costs, paid directly to the home. Ask if this applies and how it affects fees.