Care Home Pre-Admission Assessment: What to Expect

A care home pre-admission assessment is the provider’s own check, before a place is offered, of whether it can meet a person’s needs and preferences. It is separate from the council’s needs assessment and from the NHS continuing healthcare assessment. Care Quality Commission (CQC) rules require an assessment of needs and preferences carried out with the person, and CQC guidance says it should cover health, personal care, emotional, social, cultural, religious and spiritual needs.

At a glance

• Regulation 9 (person-centred care) requires an assessment of needs and preferences, carried out collaboratively with the person or their representative.
• It should cover health, personal care, emotional, social, cultural, religious and spiritual needs, and communication needs.
• It does not decide funding: the council needs assessment and NHS continuing healthcare assessment do different jobs.
• If a home cannot meet a preference, it must explain why and explore alternatives with the person.
• CQC guidance says assessments should be reviewed regularly, including when someone transfers between services or uses respite care.

What is a care home pre-admission assessment?

It is the process by which a care home finds out about a prospective resident, decides whether it can safely look after them, and starts to build a care plan. Homes may call it a pre-admission assessment, an initial assessment or a pre-placement assessment. The point is to match the person to the right home before they move, rather than discovering a mismatch afterwards.

The assessment is separate from the question of cost. Under the Competition and Markets Authority (CMA) guide for residents, a home should give clear information about fees, what is included, any trial period and the circumstances in which a resident could be asked to leave early on, so that it can be considered before you agree to a care needs assessment. Once the home has assessed needs and the person has chosen services, it must confirm the final weekly fee and allow enough time to consider the offer.

Is a pre-admission assessment a legal requirement?

For care homes registered with CQC in England, the legal basis is the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Regulation 9 says care and treatment must be appropriate, meet needs and reflect preferences, and lists carrying out an assessment of needs and preferences collaboratively with the person as something the provider must do. Regulation 12 requires risks to health and safety to be assessed, and CQC’s guidance says this applies when people are admitted or move between services.

CQC’s assessment framework also expects providers to assess and review health, care, wellbeing and communication needs with the person, using a range of assessment tools, and to keep assessments up to date. The regulations do not set a form or a deadline, so homes vary. See what is the CQC and CQC ratings explained for how this is inspected.

Who carries out the assessment, and does the person have to be there?

CQC guidance says needs and preferences should be assessed by people with the skills and knowledge for the task. It does not name a job title, so the assessor could be a manager, a senior member of staff or a nurse, depending on the home. Ask who will visit and what their role is.

The person must be involved as much or as little as they wish, with support to understand the choices. If someone lacks capacity for a decision, the home must follow the Mental Capacity Act 2005, which includes consulting family, carers or advocates where appropriate. Our guides to mental capacity assessment and lasting power of attorney explain who can speak for someone.

What information will the home ask for?

CQC says assessments should include all of a person’s needs, and should take account of issues common in particular groups, such as continence support needs and dementia in older people. In practice, expect questions on:

• health conditions, diagnoses, recent hospital stays and who is involved in care;
• medicines, including doses, timing and whether the person manages any themselves;
• personal care, such as washing, dressing, toileting and continence;
• mobility, falls and the equipment used;
• eating, drinking, swallowing and any dietary needs, as providers must have regard to nutritional and hydration needs;
• memory, mood, behaviour and sleep, and how best to support the person when distressed;
• sight, hearing and communication needs;
• emotional, social, cultural, religious and spiritual needs, routines and what matters to the person; and
• legal and funding details, such as attorneys, any advance decisions or DNACPR, and who will pay.

Our care needs checklist is a useful way to gather these details beforehand.

How is it different from the council and NHS assessments?

The home’s assessment does not replace the council or NHS processes, and it does not settle who pays. For the others, see preparing for a care needs assessment and the NHS continuing healthcare checker. Never sell a home or end a tenancy before the council has made its decision, as the NHS advises.

How can you prepare for the assessment?

• Gather the medication list, GP and hospital letters, discharge summary, and any existing care plan or assessment.
• Write down a typical day and a bad day, including nights, as nights are often where needs differ most.
• List what the person likes, dislikes and finds distressing, plus faith, food and language needs.
• Bring copies of power of attorney documents if they exist.
• Be candid. Under-describing needs can lead to a placement that cannot cope, and a later notice to leave.
• Ask for a copy of the assessment and the care plan, and for the review date. See what is a care plan.

What if the home says it cannot meet the person’s needs?

CQC guidance says that where a person’s needs or preferences cannot be met, the provider must explain the impact and explore alternatives so that the person can make informed decisions, and must fully explain why a preference cannot be met. Ask the home which needs concern it and what would be required, such as nursing registration, specialist dementia skills, extra staffing or equipment.

Take that seriously. The CMA guide lists a home no longer being able to meet someone’s needs, even after reasonable adjustments, as a valid reason to ask a resident to leave. A frank “no” at this stage is kinder than a move that fails. Options include a home with a different registration (see residential or nursing home), or EMI care homes for dementia needs. If the council is funding the place and a choice cannot be met, the Care Act statutory guidance says it must set out in writing why and offer suitable alternatives.

Some homes offer a trial period, and the CMA says they should tell you about it upfront. See care home trial periods for what to check. CQC guidance says assessments should be reviewed regularly and whenever needed, including when people transfer between services or use respite care, so the first assessment should be a starting point rather than a one-off.

Frequently asked questions

Do all care homes assess someone before admission?

Homes registered with CQC must base care on an assessment of needs and preferences done with the person. The regulations do not set a standard form or timescale, so what you experience varies from home to home.

Is the pre-admission assessment the same as a council needs assessment?

No. The home’s assessment checks whether it can meet needs. The council’s care needs assessment decides eligibility for council support, and a separate financial assessment looks at what the person pays.

Can a care home refuse someone after assessing them?

Yes, if it concludes it cannot meet their needs. CQC guidance says it should explain why and explore alternatives with the person and their family, rather than simply declining without explanation.

Does my relative need to be present?

They should be involved as much as they wish, with support. If they lack capacity for the decision, the home must follow the Mental Capacity Act 2005 and consult family, carers or advocates where appropriate.

Is an assessment needed for a respite stay?

Homes should still understand needs before a short stay. CQC guidance says assessments should be reviewed when people use respite care. See respite stays in care homes.

Where to get help next

Use find care to shortlist homes, check how to choose a care home and work out funding with the funding checker.

Sources

• Care Quality Commission: Regulation 9, Person-centred care
• Care Quality Commission: Regulation 12, Safe care and treatment
• Care Quality Commission: Assessing needs quality statement
• Competition and Markets Authority: Care homes, consumer rights for residents and their families
• NHS: NHS continuing healthcare
• NHS: Care homes, social care and support guide

See also: New care homes: how to find ones opening near you

Reviewed by The Care Panel team on 9 November 2026. This guide is general information about care in England, not legal, medical or financial advice. Rules and rates change; check with your council or an adviser before making decisions.