Author and Publication
Author: Ben Slater, Registered Social Worker, Founder and Managing Director of Nellie Supports
Reviewed by: Kerry Slater, Director of Operations
Last reviewed: 20 July 2026
Citation
1. Department of Health and Social Care (2022) National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care. Available at: https://www.gov.uk/government/publications/national-framework-for-nhs-continuing-healthcare-and-nhs-funded-nursing-care
2. Care Act 2014, c. 23. Available at: https://www.legislation.gov.uk/ukpga/2014/23/contents
3. The Care and Support (Charging and Assessment of Resources) Regulations 2014, SI 2014/2672.
4. Department of Health and Social Care. Care and support statutory guidance. Available at: https://www.gov.uk/government/publications/care-act-statutory-guidance
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Abstract
This guide compares NHS Continuing Healthcare provided in a person's own home with provision in a care home. It explains that setting does not affect eligibility, sets out what is funded in each, addresses the practical and safety considerations that influence where care is delivered, covers disputes about setting, and explains what happens when someone moves between the two.
CHC funding at home versus in a care home
Eligibility for NHS Continuing Healthcare does not depend on where someone lives, but what the funding covers differs considerably between a care home and a person's own home. Both points are frequently misunderstood, and in opposite directions.
Setting does not decide eligibility
The National Framework excludes setting as a factor in the eligibility decision. A person can be eligible living at home, in a care home, in supported living or elsewhere. Being told that funding is only available in a nursing home, or only at home, is not a correct statement of the test, and it is worth challenging where it appears in writing.
What is covered in a care home
The full cost of the placement, including accommodation, food and living costs alongside the personal and nursing care. This is the simplest arrangement financially, since nothing further is payable for the assessed placement and no top-up should arise for it.
What is covered at home
The assessed care package only. That can be substantial, including multiple daily visits, two carer calls, waking or sleeping nights, nursing input, equipment and specialist support. It does not include rent, mortgage, council tax, utilities or food, which remain the person's own responsibility because they are ordinary living costs rather than care costs.
How the Board decides where care is delivered
The Board must meet assessed needs and will consider how they can be met safely and sustainably. Relevant factors include the level and pattern of need, whether the home environment can support the care, equipment and access, the availability of a reliable package locally, and the person's own wishes. Cost can be a legitimate consideration but cannot be the only one.
Where disputes arise
The most common dispute is a family wanting care at home while the Board considers a care home more appropriate, or vice versa. These are disputes about how needs are met rather than about eligibility, and they follow a different route. It helps to keep the two separate, since conflating them tends to slow both down.
Moving between settings
Where a person moves from home to a care home or the reverse, the funded package changes even though eligibility does not. A review will usually follow the move. That review is a point of risk, because a person who has been stable under a good package can be recorded as having reduced needs, and the well-managed need principle applies just as strongly at review.
Practical considerations at home
Care at home can offer significant benefits but depends on a reliable local package, which is not always available, particularly for overnight or two carer support. Where the package cannot be sourced, the Board may propose a care home. Ask for that to be explained in writing, including what has been tried, rather than accepted as a general statement about local availability.
Key takeaway
Setting does not affect eligibility. A care home placement is funded in full including accommodation, while at home only the assessed care package is funded. Disputes about where care is delivered are separate from eligibility and should be run separately.
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Frequently asked questions
Can you get CHC while living at home?
Yes. Setting is excluded from the eligibility decision and packages at home can be substantial, including two carer calls and overnight support where assessed needs require it.
Does CHC pay my rent or mortgage?
No. At home the funding covers the assessed care package, not ordinary living costs. Rent, mortgage, council tax, utilities and food remain the person's own responsibility.
Can the Board insist on a care home?
It must meet assessed needs and will consider whether they can be met safely and sustainably at home. Cost may be a factor but cannot be the only one, and the reasoning should be provided in writing.
Related NHS Continuing Healthcare pages
These links take you to the most relevant Nellie Supports service page and to the supporting guides that explain the surrounding process.
Speak to an independent CHC specialist
Nellie Supports prepares independent needs evidence for NHS Continuing Healthcare assessments, reviews and appeals across England and Wales. Our reports are written by registered social workers on a permanent employed team, with internal peer review before release. Call 0333 987 5118 or send an enquiry and we will talk through where you are in the process.