The care journey usually starts with a crisis or a gradual realisation — a parent is no longer safe at home, a hospital wants to discharge them, dementia is progressing, or the person caring for them can no longer continue.
At this stage most families feel overwhelmed and unsure what to do first. The most important thing to know is that you do not have to work it out alone — there are defined processes and legal rights that apply from this point forward.
Anyone who appears to need care has a legal right to a needs assessment from their local authority under the Care Act 2014. The assessment looks at what the person can and cannot do and what support they need. You cannot be turned away from an assessment on the grounds of finances or because the council thinks need is unlikely.
If your relative is in hospital, a separate hospital discharge assessment will also take place. These two processes can run in parallel and sometimes create confusion — understanding the difference matters.
Who pays for care is determined by a financial assessment. There are three possible outcomes. The NHS pays everything through NHS Continuing Healthcare if the person's needs are primarily health-related. The local authority contributes if the person has savings below £23,250 (2025/26 threshold). The person pays for themselves — known as self-funding — if savings are above that threshold.
This stage is where most families encounter problems. CHC is frequently refused on the first assessment even when a person qualifies. Financial assessments sometimes include assets that should be excluded. Both can be challenged.
Care does not always mean a care home. Depending on the level of need, options include home care visits, live-in care, sheltered housing, assisted living, residential care, or nursing care. The right option depends on the person's assessed needs, their wishes, and what is practically available locally.
Where a person wants to live and what they want from daily life should be central to this decision. A care plan should reflect their preferences, not just their clinical needs.
If a care home is the right option, the CQC inspection rating is the starting point — but it is not the whole picture. A Good-rated home visited in person can feel very different from what a report suggests. Ask about staffing levels, how they handle dementia, what a typical day looks like, and how they communicate with families.
You have the right to choose any home that meets your relative's needs, has a vacancy, and can be paid for. If the local authority is funding the placement, they must allow a reasonable choice.
Once a placement is agreed, a care home must carry out their own assessment and produce a care plan before or shortly after admission. The placement should be reviewed regularly — at least once in the first six weeks and annually after that.
If care is not being provided as agreed, or if you have concerns about quality or safety, you have the right to complain. Complaints go first to the home's registered manager, then to the Local Government and Social Care Ombudsman if unresolved, and to the CQC if there are safety concerns.