Industry sector:

Care home: Services and quality standards


Decide at an early stage in your planning what types of service you will offer. The first stage is to decide whether your care home will offer:

  • just residential care
  • residential care with nursing

You could also consider offering sheltered housing or assisted living.

Your choice will affect the level of fees that you charge, the amount and type of equipment and staff that you will need and also your start up and operating costs.

There are other areas that you might consider besides caring for the elderly. Specialist care sectors include people with learning difficulties, people with a severe physical disability and sufferers of a particular condition or illness (for example dementia).

Domiciliary care (looking after people in their own homes) is an area of the care sector that is currently receiving a lot of attention. Some care home businesses - particularly the larger providers - have already diversified into this market.

Think about the range of services that will be available to residents in your care home. Some of these may earn extra fees for your business. You might, for example, install facilities for:

  • private medical treatment
  • intensive nursing care
  • physiotherapy

Decide what level of quality and service your residents will receive as standard. Things to consider include:

  • bedroom sizes, and the level and standard of furnishings and equipment (for example a microwave oven, refrigerator, telephone, broadband internet or WiFi and so on)
  • the provision of essential services, for example hairdressing and chiropody
  • the number and nature of communal rooms - these might, for example, include a bar, separate television lounge, library and so on
  • recreation and entertainment; this might include regular outings and on-site events
  • other facilities that you will offer; for example, will residents have easy access to specially designed areas of the garden?

Bear in mind that in some regions of the UK certain minimum accommodation standards, for example regarding minimum bedroom size, are required by law under the statutory minimum care standards. (Other minimum standards apply to all care homes throughout the UK.) These are monitored and enforced by the Care Quality Commission (CQC) in England, the Regulation and Quality Improvement Authority (RQIA) in Northern Ireland, the Care Inspectorate in Scotland, and the Care and Social Services Inspectorate Wales (CSSIW).

You should take into account both the level of care and the standard of facilities that you offer when you set your fee level.

While many care homes offer high quality care, a few well publicised examples of neglect and even abuse tarnish the image of the industry, which regularly faces criticism over quality standards. Make sure that all your staff understand the importance of maintaining a happy, caring atmosphere in the home and that they have received appropriate training. Remember that even small things can make a difference to residents - for example, mealtimes will be the highlight of the day for many.

Rating schemes

The CQC uses a colour/symbol-based rating scheme for the services it inspects, with four rating levels ranging from 'outstanding' (green star) down to 'inadequate' (red dot). A fifth symbol - a grey dot - indicates 'no rating', 'rating under appeal' or 'rating suspended'. Inspected providers' ratings are available to view on the CQC website.

As a food business you may receive a rating under the Food Hygiene Rating Scheme in which many local authorities participate. Rated businesses receive a rating of zero to five (where five is 'very good') which they can display at their premises.

Food businesses in Wales and Northern Ireland are required by law to display their rating in a prominent location at their premises.

The last few years have seen the hospitality rating website TripAdvisor become hugely popular, and there has been much talk by the government of supporting similar ratings websites for care homes. Several such websites now exist, including carehomeadvisor.com, but there isn't yet a major 'go-to' ratings website comparable to TripAdvisor.