Ask Sheila - Archive England

Sheila Scott OBE has now retired and therefore is no longer available to answer your social care questions. However, you might still find the answer you’ve been searching for down below.

28th November 2018

What are the key differences between a care home and a supported / assisted living house?

Dear Sheila, what are the key differences between a care home and a supported / assisted living house?


Dear R,


Thank you for your question.


I want to refer you to the Care Quality Commission (CQC) website which has a useful document entitled The Scope of Registration.


This document describes a care home as follows:


"The regulated activity consists of providing residential accommodation together with personal care (for example, a care home) or nursing care (for example, a care home with nursing). It is important to consider the relationship between the accommodation provider and the care provider – whether personal care or nursing care is provided 'together with' the accommodation or whether they are provided separately – so that we can be clear about where the boundaries of responsibility lie".


This activity is explicitly exempt from the provision of accommodation together with personal or nursing care to an individual by a Shared Lives scheme under the terms of a carer agreement.


Shared Lives schemes should register only for the regulated activity 'personal care' if personal care is being provided and not the regulated activity of 'accommodation for persons who require nursing or personal care'.


You do not have to additionally register for the activities of personal care or nursing care if you provide 'Accommodation for persons who require nursing or personal care'.


There is another very useful document on the CQC website entitled 'Housing with care - Guidance on regulated activities for providers of supported living and  extra care housing'.


The introduction to this document says: "This supplementary guidance clarifies the main differences between the regulated activities ‘Accommodation for persons who require nursing or personal care’ and ‘Personal care’ and how they apply to ‘supported living’ and ‘extra care housing’ (referred to jointly as ‘housing with care’ in this guidance)."


On page 3, point 5 the guidance says this:


Supported living providers that do not provide the regulated activity ‘Personal care’ do not have to be registered with CQC.


I think I would advise you to read both of these documents to understand the finer details of these two services.


With best wishes.




*All information is correct at the time of publishing.

About Sheila

Sheila Scott OBE has now retired and over the years , prior to her retirement she has answered thousands of your social questions. You can still access the many questions below.

For Sheila Scott OBE as the former CEO of National Care Association (NCA), care is Sheila's life. She possesses a strong command of the issues facing the care sector informed by her long career as a nursing professional, the owner and manager of a care business, and as a leader in the care sector.

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