Nursing home or residential care home in Romford: how to tell which one your parent needs

The difference in one sentence

A nursing home has a registered nurse on duty at all times; a residential care home has care staff but no nurse on site, and relies on district nurses and the GP visiting. Both provide a room, meals, help with washing and dressing, medication and company. Ashbrook is registered with the Care Quality Commission as a nursing home, so it can provide residential-level care as well as nursing care; a residential home can only provide the first.

Who needs nursing care

The decision is made by assessment, usually by a social worker from the London Borough of Havering or by a hospital team at Queen's, and it turns on whether the person's needs can be met safely without a nurse in the building. A nursing home is usually needed when the person has:

• Medication by injection, through a feeding tube, or needing clinical monitoring.
• A condition that can change quickly: unstable diabetes, heart failure, severe lung disease, epilepsy.
• Pressure sores, leg ulcers or wounds that need regular dressing.
• A catheter, a stoma or a PEG tube.
• Dementia at a stage where swallowing, mobility or behaviour needs clinical management.
• A recent stroke, fracture or major surgery with rehabilitation needs.
• A terminal illness, where comfort has to be managed without repeated hospital admissions.

Someone who needs help with washing, dressing, meals and medication reminders, but has no clinical needs, is usually assessed as needing residential care.

Why many families choose a nursing home anyway

Needs rarely stay at the residential level. A person who moves into a residential home at 84 with mild memory loss may need nursing care at 86 after a stroke or a fall, and a residential home cannot provide it, so they move again, often from a hospital bed, to a home nobody has had time to visit. Choosing a nursing home at the start means the person is cared for in the same room from residential-level needs through nursing care to the end of life. At Ashbrook that progression is normal: residents arrive needing little clinical care and stay as their needs change.

What it means for the fee

Nursing homes cost more per week than residential homes because of the nursing staff, but part of that is paid by the NHS. Anyone in a nursing home assessed as needing a registered nurse receives NHS-funded nursing care, £267.68 a week in 2026/27, paid directly to the home and deducted from the fee. It is not means-tested. A person in a residential home receives nothing from the NHS towards the fee. For the balance, Havering applies the same 2026/27 means test to both kinds of home, with capital limits of £23,250 and £14,250, a twelve-week disregard of the house and deferred payment agreements. Ask any home for the weekly fee in writing showing the NHS deduction.

What a nurse does on a shift at Ashbrook

The nurse in charge gives medication, including injections and controlled drugs; dresses wounds and checks pressure areas; manages catheters and feeding tubes; monitors residents with diabetes, heart failure or breathing problems; recognises when someone is becoming unwell and calls the GP or an ambulance; sets up and checks syringe drivers for people receiving end of life care; and supervises the care staff. The nurse also speaks to families, the GP, Queen's Hospital and Havering social workers, and keeps the records the CQC inspects. Our nurses are registered with the Nursing and Midwifery Council and work alongside care assistants, activity staff and the kitchen team.

What stays the same in both kinds of home

Personal care, meals, activities, laundry and the room. At Ashbrook every resident, whatever their level of need, has a single en-suite room, access to the bakery and bistro, the indoor garden room, the sensory room, the lounges and the garden, and the same activities programme. A resident needing residential-level care is not treated as a patient; the nursing is there when it is needed and in the background when it is not.

How to find out which your parent needs

1. Ask the London Borough of Havering for a needs assessment under the Care Act 2014. It is free and does not depend on whether the council will fund the care.
2. If the person is in Queen's Hospital, ask the ward team and the discharge team what level of care they are recommending and why.
3. Ask the GP whether any current needs require a nurse.
4. Ask Ashbrook for an assessment, which will show whether the person needs nursing care now.

Dementia and the two kinds of home

Dementia on its own does not settle the question. Someone in the early stages who is physically well can be cared for in residential dementia care; someone whose dementia is advanced, who needs hoisting, has swallowing problems or whose distress needs clinical review, needs nursing dementia care. Most people move from the first group to the second within a few years. Ashbrook is registered for both, so that progression happens in the same room, and the indoor garden room, the sensory room and the familiar routine stay constant while the care changes around the person.

Visiting Ashbrook

Ashbrook Nursing Home is at 217 to 219 Chase Cross Road, Collier Row, Romford RM5 3XS, two miles from Romford station on the Elizabeth line and close to the A12, A127 and M25 junction 28. Book a visit through the tour form or call 01708 736588, and ask to see a room, the bakery and bistro, and the garden room.