Hospital discharge to a care home: what happens next

By · Published 2026-09-20 · Last reviewed 2026-09-20

A long, bright hospital corridor with a handrail and people walking in the distance.
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Hospital discharge to a care home usually starts with a short, temporary stay rather than a permanent move. Once doctors say your relative no longer needs a hospital bed, the discharge team arranges a place, often funded for a few weeks, where they can recover. Long-term needs, the choice of a permanent home and who pays are assessed afterwards, with the family involved throughout.

When someone is well enough to leave hospital but not well enough to go straight home, the usual next step across the UK is a short, temporary stay in a care home or community bed, not an immediate permanent move. Decisions about long-term care, and about who pays for it, are meant to come afterwards, once your relative has had time to recover. Families should be involved from the start, and nobody who can make their own decisions can be placed in a care home against their will.

This is general information. The rules differ between England, Scotland, Wales and Northern Ireland, and money decisions in particular deserve personal advice before anything is signed.

What does "ready for discharge" actually mean?

Hospitals talk about a person being "medically fit", "medically optimised" or having "no criteria to reside". All mean that the treatment that needs an acute hospital bed has finished. It does not mean your relative is back to normal or can manage alone.

Government guidance for England says people should have as much choice and control as possible from the suitable options available, but also that nobody has a legal right to stay in a hospital bed once they no longer need hospital care. Scottish guidance is blunter still: a patient or their representative cannot ask to wait in hospital until their preferred care home has a vacancy.

Why is the first move usually temporary?

In England the approach is called "discharge to assess" and "home first". Wales uses a very similar model called "Discharge to Recover then Assess". The idea is that a ward is the wrong place to judge what someone will need long term, because people often improve once they leave it.

The hospital discharge and community support guidance for England sorts discharges into four pathways:

The same guidance says that, other than in exceptional circumstances, no one should be discharged straight into a permanent care home place for the first time without first having the chance to recover in a temporary placement. It also says people should not have to make decisions about long-term care while they are in crisis or in an acute hospital bed.

If a ward says your relative must choose a permanent care home this week, ask which pathway they are on and whether a period of recovery has been considered first.

Who arranges the care home place?

Ward staff work with a discharge team. In England this is often a "care transfer hub" of NHS staff, council social workers and others. In Scotland it is the hospital and the local health and social care partnership, in Wales the health board and council, and in Northern Ireland the Health and Social Care Trust.

In England, NHS trusts have a legal duty to involve patients, and unpaid carers where appropriate, in discharge planning as soon as it is feasible when the person is likely to need care afterwards. Age UK's page on leaving hospital explains that nobody should be discharged until staff have assessed their immediate needs.

In practice, this is what tends to happen:

  1. Ward staff refer your relative to the discharge team, who talk to them and to the family about what they can manage and what they want.
  2. For a temporary recovery stay, the team usually finds a bed from those the NHS or council has arranged locally, so choice is often limited.
  3. The care home normally carries out its own assessment, in person or from the hospital's paperwork, to be sure it can meet your relative's needs before it accepts them.
  4. A date is agreed. The NHS says the care home should be told the date and time of discharge and be given a copy of the care plan.
  5. The hospital arranges transport if it is needed, medication to take away, and a discharge letter for the GP.

Ask for a named discharge coordinator and their direct number.

Who pays for the care home after discharge?

It depends on what kind of stay it is. Always ask the discharge team to confirm, ideally in writing, who is funding the placement, for how long, and what happens when that funding ends.

The temporary recovery stay

If your relative is offered intermediate care or reablement, which can be given in a care home, it is free. The NHS page on intermediate care says it usually lasts for a maximum of six weeks, depending on needs and progress. In England the free period of up to six weeks is set in the Care Act regulations. Scotland, Wales and Northern Ireland have their own free short-term support after a hospital stay, so ask the discharge team what applies locally.

Any further free period depends on local arrangements. Before the funded period ends, the council or Trust should carry out a care needs assessment and then a financial assessment, so that nobody is left without support or surprised by a bill.

A permanent place

Once a long-term care home place is agreed, the normal funding rules for that nation apply:

If your relative owns their home, do not sell it or sign a contract with a care home in a hurry. In England, the value of the home is normally ignored for the first 12 weeks of a permanent council-arranged stay, and a deferred payment agreement may be possible after that. Get advice from Age UK, Citizens Advice or a regulated adviser who specialises in care fees.

Can we choose the care home?

For a short recovery stay, usually only from what is available. For a permanent home, yes, within rules that vary by nation.

England. If the council is arranging and funding the place, your relative has a right to choose a particular home as long as it is suitable for their assessed needs, has a place, and will accept the council's terms. The council must offer at least one suitable home within the personal budget it has set. If the chosen home costs more, someone else, usually a relative, can pay a third-party top-up. Age UK says you should not be asked for a top-up if your relative is in a more expensive home because of need and not preference, or because nothing was available at the budget amount.

Scotland. The Scottish Government's guidance on choosing a care home on discharge from hospital says people may name up to three homes, one of which should have a suitable vacancy available within a reasonable period. If none of the preferred homes has a place by the discharge date, the person is expected to move to an interim home and wait there.

Wales. The Welsh Government's hospital discharge guidance has its own process for choosing a care home after a hospital stay.

Northern Ireland. The official nidirect guidance says that on leaving hospital you have the right to choose the residential or nursing home that best meets your needs, and that you cannot be moved directly into a home against your will.

In every nation, accepting an interim home does not mean giving up on the home you want. Ask to stay on its waiting list and how you will be told when a place comes up.

What if your relative cannot decide, or does not want to go?

A person who has the mental capacity to make the decision cannot be made to move into a care home. They are entitled to make a choice that others think is unwise.

If there is doubt about capacity, staff must assess it for this specific decision. In England and Wales, under the Mental Capacity Act 2005:

Scotland has its own law, the Adults with Incapacity (Scotland) Act 2000, under which a welfare attorney or guardian may be needed. Northern Ireland has separate legislation too. Note that a power of attorney covering only property and finances does not give authority over where someone lives.

What if you disagree with the discharge plan?

Say so, clearly and early, to the ward manager or the named discharge coordinator. If that does not resolve it:

Frequently asked questions

How long can someone stay in a care home after leaving hospital?

A recovery stay lasts as long as the person is benefiting from it. Free intermediate care usually runs for up to six weeks. Before it ends, the council or Trust should assess longer-term needs and finances, and explain the options, which may include going home with support.

Can a hospital discharge someone to a care home without telling the family?

In England, NHS trusts have a duty to involve the patient, and carers where appropriate, in discharge planning as soon as it is feasible. Your relative's consent is needed to share their medical details. If they lack capacity, staff should consult family before making a best interests decision.

Do we have to pay a top-up for the temporary care home?

Intermediate care and reablement are free, so you should not be charged for that care. For a permanent council-funded place in England, a top-up applies only when a more expensive home is chosen by preference. Ask for any request for payment to be set out in writing.

Will Attendance Allowance stop?

Attendance Allowance is suspended after 28 days in hospital, and Age UK notes that a free short-term stay in a care home after discharge counts towards that limit. It should restart when the person goes home.

Key takeaways