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. Mental Capacity Act 2005, c. 9. Available at: https://www.legislation.gov.uk/ukpga/2005/9/contents
3. Care Act 2014, c. 23. Available at: https://www.legislation.gov.uk/ukpga/2014/23/contents
4. Department of Health and Social Care (2022) NHS Continuing Healthcare Decision Support Tool.
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Abstract
This guide explains how NHS Continuing Healthcare operates where a person lives in a nursing home. It covers why nursing registration does not determine eligibility, the relationship with NHS-funded Nursing Care, what changes practically when funding is agreed, invoicing and contracts, the position of the home in the assessment, and what happens at review.
NHS Continuing Healthcare in a nursing home
Nursing homes are where most NHS Continuing Healthcare assessments happen, and where two opposite misunderstandings meet: that being in one qualifies you, and that being in a residential home rules you out. Neither is correct.
Registration describes the home, not the person
A nursing home is registered to provide nursing care, which describes what the provider can deliver. It says nothing about whether a particular resident has a primary health need. Many nursing home residents are not eligible, and eligibility rests on assessed needs analysed through the four key characteristics rather than on where the person lives.
The Funded Nursing Care relationship
Where a nursing home resident is not eligible for full NHS Continuing Healthcare, a flat rate NHS contribution towards registered nursing input may be paid directly to the home. The important sequence point is that anyone considered for Funded Nursing Care should have been assessed for full eligibility first. An award of the contribution does not settle the eligibility question.
What changes when funding is agreed
The Integrated Care Board becomes responsible for the full cost of the placement, including accommodation and living costs. The resident should stop paying, no top-up should be payable for the assessed placement, and any Funded Nursing Care contribution ceases because the whole cost is now met. The contract position also changes, since the Board becomes the commissioner.
Invoicing frequently continues
A recurring practical problem is the home continuing to invoice after funding has been agreed, simply because nobody told them. Ask the Board to confirm the funding position to the home directly and in writing, and ask about reimbursement of anything paid since the effective date. This is common and usually resolves quickly once raised.
The home's role in the assessment
Home records are the evidence base, and the registered manager or a senior nurse will usually contribute to the multidisciplinary assessment. Their contribution is most useful when it describes what the resident requires factually rather than expressing a view on eligibility, which is the Board's decision to make.
Where residents are commonly under-assessed
Nursing home residents are often stable precisely because the home manages them well, which is the well-managed need problem in its most concentrated form. Ask what the records show about the regime maintaining that stability, and ask specifically for night records, which are almost always held separately.
Key takeaway
Nursing registration describes the provider, not the resident. Funded Nursing Care should follow a full eligibility assessment rather than replace one. When funding is agreed, ensure the Board confirms it to the home in writing, and watch for well-managed need in a setting that manages needs well.
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Frequently asked questions
Does being in a nursing home mean we qualify?
No. Registration describes what the provider can deliver, not whether a resident has a primary health need. Many nursing home residents are not eligible, and eligibility rests on assessed needs.
Should CHC be assessed before Funded Nursing Care?
Yes. Anyone considered for the nursing contribution should have been assessed for full eligibility first, and an award of the contribution does not settle the eligibility question.
Do we stop paying if CHC is awarded?
Yes, for the assessed placement. The Board meets the full cost including accommodation, no top-up should be payable, and any Funded Nursing Care contribution ceases.
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.