When is it time for a care home? Usually when someone needs help around the clock that cannot be given safely or affordably at home, or when the family carer is at breaking point. It is rarely one event. More often it is a run of falls, nights without sleep and near-misses that build up until everyone can see the current arrangement is not working.
A care home is not the only answer to 24-hour needs. Live-in care, overnight care and extra care housing all fill parts of the gap. This guide sets out the signs, compares the options fairly, and explains costs and property rules in West Sussex so you can decide together.
In short: a care home tends to make sense when needs are constant, unpredictable or need nursing, when the home cannot be adapted, or when isolation is doing real harm. Live-in care can suit people who want to stay at home and have a spare room.
When is it time for a care home? Signs home care is no longer enough
Visiting care works well for set tasks at set times. It struggles when needs fall between visits. Watch for these patterns:
- Risk between visits: falls with long lies on the floor, leaving the house at night, leaving the cooker on, or forgetting to eat and drink despite prompts.
- Night-time needs most nights: repeated toileting, wandering or distress that no single overnight arrangement covers. See when overnight care is needed.
- Needs that call for two carers for most transfers, or care that needs a registered nurse several times a day.
- A carer who cannot go on: exhaustion, their own health failing, or a relationship turning into full-time nursing. Our guide to carer burnout in West Sussex covers the warning signs.
- Isolation: someone who is lonely and anxious alone, and who brightens in company.
- A home that cannot be adapted: stairs with no room for a stairlift or bedroom downstairs, or no bathroom that can be made safe.
One sign alone does not decide it. Several together, getting worse over weeks, usually mean it is time for a proper conversation, and for a fresh care needs assessment.
Care home or live-in care: a fair comparison
Both give round-the-clock support. They suit different people.
| Care home | Live-in care | Visiting care plus nights | |
|---|---|---|---|
| Indicative weekly cost | South East averages about £1,446 residential, £1,706 nursing (carehome.co.uk, September 2025) | £1,400 to £1,700+ | Varies widely; several visits a day plus nights can exceed a care home |
| Staffing | Shared staff, 24 hours, nurses on site in nursing homes | One main carer living in, with breaks covered | Carers at set times; sleeping or waking night carer |
| Home and routine | New setting, set routines | Stays at home with pets, garden, neighbours | Stays at home |
| Company | Other residents and activities | One-to-one company | Only during visits |
| Is the home counted in the means test? | Usually yes, after 12 weeks, unless a disregard applies | No | No |
| Needs | A spare bedroom is not needed | A spare bedroom for the carer | Space for night carer if sleeping in |
Live-in care often works well for couples, because one live-in arrangement can usually support both, for a higher fee than for one person, and they stay together. It works less well where two carers are needed at night, or where someone needs nursing input around the clock. Our detailed comparisons of live-in care vs a care home and home care vs a care home go through the trade-offs, and live-in care in West Sussex covers local costs.
Care home costs in West Sussex
Care home fees vary a lot by home, room and level of need. Two reference points help:
- Self-funder averages: carehome.co.uk data from September 2025 puts average self-funding fees in the South East at about £1,446 a week for residential care and £1,706 a week for nursing care.
- What the council pays: West Sussex County Council’s 2026/27 price guide sets rates of £900 to £1,035 a week for its higher-need residential bands, and £1,030 to £1,080 a week for nursing care, excluding NHS-funded nursing care. Self-funders are often quoted more than the council rate for the same room.
Treat these as indicative and always ask each home for its full fee in writing, including what is extra (hairdressing, chiropody, trips, toiletries). In a nursing home, the NHS pays a nursing contribution directly to the home, £267.68 a week from April 2026, for residents who need registered nursing care but are not eligible for NHS continuing healthcare. If needs are complex, ask for a continuing healthcare checklist before you commit, as CHC would cover the whole fee: see NHS continuing healthcare.
Is property counted for care homes?
Usually, yes. For care at home, the value of the person’s home is ignored. For a permanent care home place, the home normally counts as capital in the council’s financial assessment, unless it is still lived in by certain people. The key rules:
- Capital limits: with capital over £23,250 (including the home, if it counts), the person pays the full fee. Between £14,250 and £23,250, the council adds £1 a week of assumed income for every £250.
- 12-week property disregard: when someone first moves permanently into a care home, the value of their home is ignored for the first 12 weeks, giving time to decide what to do.
- When the home is ignored altogether: if it is still lived in by a spouse or partner, a relative aged 60 or over, a relative who is incapacitated, or a child under 18 who is the person’s dependant. The council can also use discretion in other cases.
- Deferred payment agreement: if the person’s other savings are below £23,250 and the home is counted, the council should offer a deferred payment agreement. Fees are secured against the home and repaid later, usually when it is sold. Interest and admin fees can be charged.
- Personal expenses allowance: anyone in a care home receiving council help keeps at least £31.80 a week for personal spending.
Giving away the house or savings to avoid fees can be treated as deliberate deprivation of assets, and the council can assess the person as if they still had it. Take independent advice from a solicitor or a specialist financial adviser before making any big decisions. Age UK’s factsheet on property and paying for residential care explains the rules in full, and our free funding checker gives a quick indication of what help might apply.
Extra care housing in West Sussex
Extra care housing sits between staying at home and a care home. Residents have their own self-contained flat with its own front door, usually one or two bedrooms, and care staff are on site. Many schemes have a restaurant, lounge and gardens, and a care team available day and night for emergencies as well as planned visits. Flats may be rented or bought on a leasehold basis.
West Sussex County Council’s extra care market position statement, last updated in 2024, lists 17 extra care schemes across the county, including three in Worthing, two in Arun and three in Horsham district. It recorded no schemes in Adur at that time. Access is through council adult social care, district and borough council housing teams, or directly from the housing provider. See the council’s housing options page for current details.
Extra care suits people who are lonely or anxious at home and need some care, but do not yet need 24-hour supervision. It is usually less suitable for advanced dementia with wandering, or for heavy nursing needs.
How to decide together
- Start with the person. Ask what matters most to them: staying near family, their garden, company, feeling safe. If they have capacity, the decision is theirs.
- Check capacity and paperwork. If they may lack capacity for this decision, a best-interests decision is needed, involving family and professionals. A lasting power of attorney for health and welfare makes this much easier.
- Get an up-to-date assessment from West Sussex County Council, and ask the GP whether nursing or continuing healthcare should be considered.
- Try before deciding. A short respite stay in a care home, or a trial fortnight of live-in care, tells you more than any brochure.
- Check quality. Read the latest CQC report for any home or agency you consider. Our guide to CQC ratings explains what to look for.
- Count the carer’s needs too. A decision that keeps someone at home by breaking their spouse is not a good decision.
Find care near you
Tell us your postcode and what you need help with. We pass your details to one vetted CQC-registered agency in your area — you are told who they are, and that they pay us a fee, before anything is sent.
Frequently asked questions
How do you know when it is time for a care home for someone with dementia?
Common turning points are needing supervision day and night, wandering or leaving the house unsafely, and care at home no longer keeping them safe or calm. Live-in care can delay a move for some people, so compare both before deciding.
Can the council force my parent into a care home?
No. If someone has capacity, they decide where they live. If they lack capacity for the decision, it must be made in their best interests, taking their wishes and feelings into account.
Will we have to sell mum’s house to pay for a care home?
Not necessarily straight away. The home is ignored for the first 12 weeks, and ignored altogether if certain relatives still live there. A deferred payment agreement can let fees be paid from the house after it is sold, often after death.
Is live-in care cheaper than a care home?
For one person it is often similar, at around £1,400 to £1,700 or more a week against South East care home averages of about £1,446 residential and £1,706 nursing. For a couple, live-in care is often cheaper than two care home places.
What is the difference between extra care housing and sheltered housing?
Sheltered housing usually offers a warden or alarm service but no on-site care team. Extra care housing has care staff on site, so residents can receive planned care and help in an emergency.
The Care Panel is an independent publication. We are not a care provider and are not regulated by the Care Quality Commission, because we do not deliver care. Always check a provider’s own CQC registration and inspection report before you commit.
Written and fact-checked by The Care Panel. Last updated September 2026. Sources: carehome.co.uk regional care home fees (September 2025); West Sussex County Council care home rates 2026/27 and extra care housing market position statement; Age UK Factsheet 38; NHS-funded nursing care rate 2026/27; GOV.UK. General information, not financial, legal or medical advice — figures are indicative and subject to change.