Understanding Different Types of Care: Residential, Nursing, Dementia & Respite

Understanding the different types of care available is essential when choosing accommodation for your loved one. This guide explains residential care, nursing care, dementia care, and respite care in detail, helping families across Cheltenham, Gloucester, and the Cotswolds make the right choice.

Quick Reference Guide

Residential Care

Who it's for: Those needing help with daily living but not nursing care
Weekly cost: £900-£1,200
Key feature: Personal care and support

Nursing Care

Who it's for: Those with medical needs requiring registered nurses
Weekly cost: £1,200-£1,650
Key feature: 24-hour nursing care on-site

Dementia Care

Who it's for: Those with Alzheimer's or other dementias
Weekly cost: £1,100-£1,800
Key feature: Specialist dementia training and secure environment

Respite Care

Who it's for: Short-term stays for trial or carer breaks
Daily cost: £120-£180
Key feature: Flexible duration without long-term commitment

Residential Care Explained

What is Residential Care?

Residential care provides accommodation and personal care support for adults who can no longer live independently but don't require nursing care.

Also known as:
- Personal care homes
- Care homes (without nursing)
- Residential homes
- Sheltered accommodation (with care)

Who Needs Residential Care?

Suitable for those who:
- Need help with bathing, dressing, and personal hygiene
- Require assistance with meals and medication
- Can no longer manage housework and laundry
- Are unsteady or at risk of falls
- Feel lonely or isolated at home
- Don't require registered nursing care

Not suitable if:
- Complex medical needs requiring nurses
- Severe dementia requiring specialist secure unit
- Require end-of-life nursing care

What's Included in Residential Care?

Personal Care:
- Help with washing, bathing, and showering
- Assistance dressing and undressing
- Support with using the toilet
- Help with mobility around the home
- Medication reminders and administration

Daily Living Support:
- Three meals daily plus snacks
- Housekeeping and laundry service
- Activities and entertainment
- Social interaction and companionship

24-Hour Support:
- Care staff available day and night
- Call bell systems in rooms
- Help whenever needed
- Regular welfare checks

Residential Care Costs

Cotswolds Average: £1,050/week (£4,550/month)

- Cheltenham: £1,000-£1,300/week
- Gloucester: £900-£1,150/week
- Cirencester: £950-£1,250/week
- Stroud: £900-£1,200/week

Annual cost: £54,600

Nursing Care Explained

What is Nursing Care?

Nursing care provides everything residential care offers PLUS 24-hour access to registered nurses for those with more complex health needs.

Also known as:
- Nursing homes
- Care homes with nursing
- Registered nursing care

Who Needs Nursing Care?

Suitable for those with:
- Chronic medical conditions (diabetes, heart disease, COPD)
- Complex medication regimens
- Wounds requiring regular dressing
- Catheter or stoma care needs
- Post-hospital recovery needs
- Palliative care requirements
- Parkinson's disease or MS

The Nursing Care Test:
If your loved one needs a nurse to visit daily or multiple times weekly, nursing care is likely appropriate.

What's Included in Nursing Care?

Everything in residential care, PLUS:

Clinical Nursing Care:
- Registered nurses on duty 24/7
- Medication management and administration
- Wound care and dressing changes
- Catheter and stoma care
- Tube feeding support
- Oxygen therapy supervision
- Blood glucose monitoring
- Vital signs monitoring

Healthcare Coordination:
- GP liaison and visits
- Hospital appointment coordination
- Healthcare professional visits facilitated
- Medical records maintenance
- Care plan reviews with health teams

NHS-Funded Nursing Care:
Nursing homes automatically receive £219.52/week from NHS toward registered nurse costs. This reduces your personal cost.

Nursing Care Costs

Cotswolds Average: £1,425/week (£6,175/month)

- Cheltenham: £1,300-£1,700/week
- Gloucester: £1,200-£1,500/week
- Cirencester: £1,250-£1,650/week
- Stroud: £1,200-£1,600/week

Annual cost: £74,100

After NHS contribution: Reduces to approximately £1,205/week personal cost

Dementia Care Explained

What is Dementia Care?

Specialist care for those with Alzheimer's disease, vascular dementia, Lewy body dementia, or other forms of dementia. Can be residential or nursing level depending on physical health needs.

Also known as:
- Memory care
- Cognitive care
- Specialist dementia units
- EMI (Elderly Mentally Infirm) care

Who Needs Dementia Care?

Suitable for those with:
- Diagnosed dementia of any type
- Memory problems affecting daily life
- Confusion about time and place
- Wandering behavior
- Communication difficulties
- Changes in personality or behavior
- Need for secure environment
- Require dementia-specific approaches

Assessment determines:
- Early, middle, or advanced stage dementia
- Whether residential or nursing level needed
- Challenging behavior management needs
- Mobility and physical health status

What's Included in Dementia Care?

Specialist Environment:
- Secure buildings and gardens (can't wander out)
- Dementia-friendly design (clear signage, memory aids)
- Safe walking areas
- Reminiscence areas
- Sensory rooms

Trained Staff:
- Specialist dementia training (Level 3)
- Understanding of dementia behaviors
- Communication techniques
- Validation therapy approaches
- Gentle redirection skills

Personalized Activities:
- Memory boxes with personal items
- Reminiscence therapy
- Music therapy
- Sensory activities
- Life story work
- Familiar routines maintained

Family Support:
- Education about dementia progression
- Communication strategies
- Emotional support
- Regular updates on changes

Dementia Care Costs

Cotswolds Average: £1,450/week (£6,283/month)

- Cheltenham: £1,200-£1,800/week
- Gloucester: £1,100-£1,500/week
- Cirencester: £1,150-£1,700/week
- Stroud: £1,100-£1,550/week

Annual cost: £75,400

Note: Dementia nursing care costs more than dementia residential care.

Respite Care Explained

What is Respite Care?

Short-term stays in a care home, ranging from a few days to several weeks. Provides temporary care for your loved one while giving family carers a break.

Also known as:
- Short breaks
- Interim care
- Trial stays
- Emergency care

When to Use Respite Care

Common Reasons:

1. Carer Holiday/Break
- Family carers need rest
- Prevent carer burnout
- Maintain caring sustainability

2. Trial Before Permanent Move
- Test the care home
- See if your loved one settles
- Assess care quality firsthand
- Reduce anxiety about permanent move

3. Post-Hospital Recovery
- Bridge between hospital and home
- Additional support during recovery
- Assessment of longer-term needs

4. Emergency Coverage
- Carer illness or emergency
- Unexpected family crisis
- Short-notice accommodation needed

5. Regular Planned Breaks
- Weekly day care
- Fortnightly overnight stays
- Monthly week-long respite
- Gives structure and routine

What's Included in Respite Care?

Same Standards as Permanent Residents:
- Full personal care or nursing care
- All meals and activities
- Medication management
- Laundry service
- Same quality of care

Additional Benefits:
- No long-term commitment
- Flexible duration
- Try before you buy
- Builds familiarity if permanent move likely

Respite Care Costs

Daily Rate: £120-£180 (average £150)

Weekly equivalent: £1,050/week

Minimum stay: Usually 1 day (some homes require 2-3 days)
Maximum stay: Typically 6-8 weeks

Booking:
- Advance booking recommended (2-4 weeks notice)
- Emergency respite sometimes available
- May need to accept different room than if permanent

Choosing the Right Type of Care

Decision Framework

Start with these questions:

1. Does your loved one need a registered nurse?
- Yes → Nursing care
- No → Residential or dementia care

2. Do they have diagnosed dementia?
- Yes → Specialist dementia care (residential or nursing level)
- No → Standard residential or nursing care

3. Is this a trial or temporary need?
- Yes → Respite care first
- No → Permanent residential, nursing, or dementia care

Common Transitions

Typical Care Journey:

1. Start: Living independently
2. First step: Home care visits (2-4x daily)
3. Next: Residential care (personal care needs increase)
4. Then: Nursing care (medical needs develop) or Dementia care (cognitive decline)
5. Finally: End-of-life nursing care

Not Everyone Follows This Path:
Some move straight to nursing or dementia care depending on circumstances.

Mixed Needs

What if they need both nursing AND dementia care?
Look for homes offering "dementia nursing care" - specialist dementia units with registered nurses on staff.

What if needs might increase?
Choose a home offering multiple levels of care so they can transition within the same facility.

Funding Differences by Care Type

Council Funding Rates

Gloucestershire 2025 rates:
- Residential care: £725/week (maximum council pays)
- Nursing care: £875/week
- Dementia care: £825/week

Top-up fees likely needed as most homes charge more than council rates.

NHS Continuing Healthcare

More likely to be approved for:
- Nursing care (complex health needs)
- Dementia nursing care (complex + cognitive needs)

Less common for:
- Standard residential care (social care, not health need)

NHS-Funded Nursing Care

Automatic for nursing homes:
- £219.52/week paid by NHS
- Reduces your cost
- No means test required

Not available for:
- Residential care without nurses
- Dementia residential care without nurses

Questions to Ask Care Homes

About Care Type

1. "What level of care do you provide?"
- Residential only, nursing only, or both?
- Specialist dementia units?
- Can you accommodate increasing needs?

2. "Do you have registered nurses on staff?"
- How many nurses per shift?
- What are their qualifications?
- Available 24/7?

3. "What specialist training do staff have?"
- Dementia care training level?
- End-of-life care training?
- Specific condition training (Parkinson's, MS, etc.)?

4. "At what point would you no longer be able to care for our loved one?"
- When would they need to move?
- What triggers a level change?
- How much notice would we receive?

Regional Availability (Cotswolds)

Of our 24 featured care homes:

Residential Care: 14 homes
- Spread across all areas
- Most choice in Cheltenham and Cirencester

Nursing Care: 12 homes
- Good availability regionwide
- Cheltenham has most nursing homes

Dementia Care: 16 homes
- Majority offer some level of dementia care
- 6 homes have specialist secure units
- Cheltenham and Cirencester best supplied

Respite Care: 20 homes
- Most homes offer respite
- Subject to room availability
- Advance booking essential

Conclusion

Understanding the different types of care helps you choose the right home for your loved one's current and future needs.

Key Takeaways:

Residential Care (£900-£1,200/week):
- Personal care and daily living support
- No registered nurses
- For those without complex medical needs

Nursing Care (£1,200-£1,650/week):
- Everything residential offers PLUS 24/7 nurses
- For complex health conditions
- NHS contributes £219.52/week

Dementia Care (£1,100-£1,800/week):
- Specialist staff and secure environment
- Can be residential or nursing level
- For diagnosed dementia of any type

Respite Care (£120-£180/day):
- Short-term stays
- Trial periods
- Carer breaks
- No long-term commitment

Start Your Search:

Browse our directory of 24 CQC-registered care homes across the Cotswolds. Filter by care type, location, and CQC rating to find the right care for your loved one.

Understanding care types empowers you to ask the right questions and choose appropriately for your family's needs.