Palliative and end of life care in care homes

Many care homes can provide palliative and end of life care so a resident can stay among familiar people and surroundings. NICE says people approaching the end of life should be able to reach a healthcare professional 24 hours a day, 7 days a week, plus an out-of-hours advice line and pharmacy. Ask any home exactly how it arranges this.

At a glance

• The NHS says some care homes can provide end of life care, with trained staff available day and night.
• NICE says advance care planning should be offered, and each person’s plan should be available where they live.
• In the last days of life, NICE expects an individualised care plan, monitoring at least every 24 hours and early prescribing of symptom-control medicines.
• The NHS fast track route can fund care in a care home without a full continuing healthcare assessment. The NHS should usually commission it within 48 hours.
• Check what the contract says about fees after a death.

What does palliative care mean in a care home?

Palliative care aims to relieve symptoms and support the person and their family when an illness cannot be cured. End of life care covers the final phase and the last days. The two overlap, and many residents receive palliative care for months or years before the end. Our guides on palliative vs end of life care and the stages of palliative care explain the difference.

The NHS says people nearing the end of life may be offered care at home, in a care home, in hospital or in a hospice, and that a palliative care team should try to organise care according to the person’s wishes. For many residents, staying in the care home they know is the preferred option.

Can every care home provide it?

Not every home is equally equipped. A care home with nursing has registered nurses on duty. A residential home without nursing relies on community nurses and the GP for clinical tasks. Either type can provide excellent end of life care if staff are trained and the clinical team is responsive, and the choice depends on the resident’s needs. See residential or nursing home.

Specialist palliative care teams or hospice services may advise care home teams. Ask a home which teams it works with, how quickly the GP responds and who is in charge at night.

What does good end of life care look like?

Two NICE guidelines set out what services should do. The table summarises the main points.

This is the standard to expect, not a guarantee that every home or local service meets it. Ask how the home turns each point into practice.

How do I plan ahead with a care home?

Good care starts with conversations before a crisis. Talk to your relative, where they are able, about where they want to be cared for, whether they want to go to hospital, and who should be told. Where they cannot take part, someone with a health and welfare lasting power of attorney may be able to decide. Read our guides to DNACPR and advance decisions and lasting power of attorney for health and welfare.

Ask the home to record the person’s wishes in the care plan and share them with the GP, the ambulance service if used, and the out-of-hours service. See what is a care plan in a care home.

Who pays for end of life care in a care home?

The usual funding rules apply, with some extra routes. In a nursing home, NHS-funded nursing care is paid at £267.68 a week at the standard rate from 1 April 2026. If the person has a primary health need, NHS continuing healthcare pays the whole cost: try our continuing healthcare checker.

For someone with a rapidly deteriorating condition that may be entering a terminal phase, the national framework provides a Fast Track Pathway Tool. A clinician completes it, and it replaces the Checklist and Decision Support Tool. It can be used in any setting, including for people already in a care home who wish to stay there. The framework says strict time limits based on expected length of life should not be imposed, and that an integrated care board must accept and immediately action a properly completed tool, usually commissioning the care package within 48 hours. See fast track CHC and NHS-funded nursing care.

Council-funded and self-funded residents continue as before, and Scotland, Wales and Northern Ireland have their own rules. A good place to start is what happens when money runs out in a care home.

What should I ask when choosing a home?

• Has the home cared for people at the end of life, and which clinical teams support it?
• Who is on duty at night, and can they get a nurse or doctor quickly?
• Does the home hold anticipatory medicines for residents when prescribed, and who can give them?
• How does it record and update advance care plans, and who sees them?
• Can family stay overnight, and how does the home support spiritual, religious and cultural needs?
• How does the home support other residents and staff after a death?

For the wider checks, use questions to ask when visiting a care home and read care home visiting rights.

What happens after a death?

Our guide what happens when someone dies in a care home explains each step, and funeral costs and the Funeral Expenses Payment covers help with costs.

Check the contract for how long fees continue. The Competition and Markets Authority found in 2017 that some homes charged fees for an extended period after a resident’s death and said it would act on unfair charges. See unpaid care home fees after death. Support for you is covered in bereavement support for carers.

Frequently asked questions

Can someone die in a care home instead of hospital?

Yes. The NHS says end of life care can be provided in a care home, where trained staff are available day and night. A resident’s wishes, the home’s capability and clinical support all matter, so plan ahead and record preferences.

Does a care home need a nurse to provide end of life care?

Not always. Homes without nursing can work with district nurses, GPs and palliative care teams. Residents who need frequent clinical care may need a nursing home or extra nursing input.

What is the fast track pathway for NHS funding?

It is a quicker route to NHS continuing healthcare for people with a rapidly deteriorating condition who may be entering a terminal phase. A clinician completes a tool instead of the usual checklist. The NHS usually commissions the care within 48 hours.

Can family stay with the resident at the end?

Many homes allow it, but policies differ. Ask in advance about overnight stays, meals and facilities, and have the arrangement written into the care plan so staff know what to expect.

Will fees stop when the resident dies?

Not necessarily. Check the contract. The CMA found in 2017 that some homes charged for extended periods after a death. Ask how many days, if any, are charged and get it in writing before signing.

Where to get help next

Speak to the GP or community nurse about palliative care support, and use Find care to shortlist homes. See end of life care at home if staying at home is possible, and signs of end of life if you are unsure how far things have progressed.

Sources

• NICE: Care of dying adults in the last days of life (NG31)
• NICE: End of life care for adults, service delivery (NG142)
• NHS: Where you can have end of life care
• GOV.UK: National framework for NHS continuing healthcare and NHS-funded nursing care
• CMA: Care homes market study, summary of final report

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.