Social Care or Health Care? What is the difference?

Hi all,

Been caring for a friend for many years, but I’m currently locked in a battle with the LA over them continuing to fund direct payments for care for a family member. They are arguing that their needs fall under health care, not social care. The NHS and the CHC checklist don’t add up to providing funding for care, so we’re in a rock and a hard place.

My question to you all is this - does anyone know what activities/needs are actually classified as “social care”?

Where do they draw the line between saying this is an “essential daily activity” and “you only need to do that because you’re ill”. Is there some kind of list that shows what activities/needs/tasks LA’s will accept under the direct payments umbrella, because from what I’m seeing now it seems kind of vague and arbitrary at best.

If anyone could share their experience or understanding of what social care includes, or where the line is drawn it would be a huge help in getting my family member the care they need.

Thanks all.

Hi Jenne … welcome to an extremely quiet forum as I type.

Health v. social care ?

No better place to start the deerstalking … a Canadian site … which gives the best explanation :

The UK health care system – Evidence Network

Compass Continuing Healthcare … a commercial site but with a good explanation :
What Is The Difference Between Healthcare And Social Care? • Continuing Healthcare

I would recommend reading through those links before returning to us with numerous questions / observations ?

Social care ?

Wikipedia a good a place to start :

Social care in England - Wikipedia

The real joker in the pack … numerous links available for a " Definition " as to the exact nature of this beast.

NONE do so in the way we know social care to be on this forum !

Trouble is … as funded differently to health care under the NHS , it depends on who gets to define it !

A LA ? … A care home proprietor ? … CHC assessors ? … Or , very rarely , the person seeking " Social care ? "

Gets even more confusing when anyone spends time in a hospital.

ALL care is free … no bill for any " Social care " on the way out !

Feel free to expand on any of the above … it’s probably the greyist of all grey areas ???

( Direct payments … NOT used to fund family members I hope ? )

( CHC / NHS Continuing Healthcare ? Main thread :
plenty on there for you to explore … and colour coded ! )

Green Paper thread … and my constant example of a cancer patient with dementia … ).

You could always ask Adass, details below if they hold any guidelines for this.

General Enquiries:
Association of Directors of Adult Social Services
18 Smith Square
Tel: 0207 072 7433

Contact your own Head of Social services too, and ask for a copy of their policies regarding what services provided for. This will assist you especially if the old post code lottery comes in to play.


CHC is supposed to be available for anyone who needs care above the level that the LA can lawfully provide.
Have a look at the CHC Framework.
My “rough guide” :-
“Social Care” homes don’t have to have a qualified nurse on duty at all times. They expect residents to be able to move independently, wash and dress themselves.
“Nursing” homes do have to have a qualified nurse on duty at all times

So the dividing line SHOULD be very clear.
If someone can’t get out of bed, get themselves to the toilet, wash themselves, then they need more care than a Social Services home can provide.

The reality is very different.
You would expect Social Services to keep telling the NHS "this patient needs too much care for a social care home, but they don’t! Especially if they know the patient owns a house!


The reality is very different. >

Health / social care ?

Therein lies the reality … not to be found in any textbook !

WHO gets to define which is which ???

That chalk line between the two … who gets to draw It ???
( Green paper thread again … recombining the two ugly twin sisters … our cancer patient with dementia … ??? )

And please … no " What about the Care Act , 2014 ? " … as if regular readers needed reminding ?

I contacted the Care Quality Commission for reasons needn’t go into now. I asked them to explain the difference between a care home and nursing home. They replied within 10 days or less and defined the difference very well. Maybe try them for yourself. It may help. Enabled me to continue with my concern.

Care home v. Nursing home ?

( CHC / NHS Continuing Healthcare = Nursing home . )

Brief explanation :

Explaining the difference between a care home and a nursing home
Many people do not realise the differences between care homes and care homes with nursing, as nursing homes are now called.

Both types of home provide accommodation, supervision from staff 24 hours a day, meals and help with personal care needs, but nursing homes also have registered nurses on duty at all times.

This means that they can provide care for people with more complex needs and those who need regular nursing interventions.
Care Homes

Care homes are staffed 24 hours a day and a proportion of the staff will be qualified care assistants with NVQs (National Vocational Qualifications) at Level 2 or 3.

Care home managers are required to have a Registered Manager’s Award or similar management qualification as well as experience in care, but do not need any nursing experience.

The kind of assistance with personal care that can be provided in all care homes includes help with washing, dressing, toileting and mobility.

Members of staff in care homes often also help residents with eating and drinking, communicating and joining in social activities. They have to keep records of the residents and devise and follow an individual care plan for each resident.

If nursing interventions such as the administration of medicines by injection or complex dressings are needed, the district nurses are usually called in to carry out these tasks.

This can be somewhat disruptive, as the district nurses have lots of visits to carry out and are unable to specify what time they are likely to arrive.

If their visit coincides with a mealtime, it may not be convenient for them to wait until the resident has finished eating.

Nursing Homes

A nursing home will provide all the day-to-day care that you would expect from any care home, but the care is supervised by registered nurses who are on duty all day and all night.

People who have an illness or medical condition requiring frequent medical attention will be better off in a nursing home, where nursing care is available 24 hours a day and planned interventions can be carried out at convenient times.

Another benefit is that nursing staff are trained to recognise symptoms and changes in a person’s condition, so are better qualified to decide when to call a doctor or other health professional.

Nursing homes are often better equipped with specialist beds and a range of equipment for moving and handling people, and are usually the best choice for those who have severe mobility difficulties or who are unable to get out of bed.

Some nursing homes provide specialist care and support for people who have been diagnosed with dementia and whose needs cannot be met in a simple care home. These homes may have specially trained care staff as well as RMNs on duty.

The physical surroundings are also very important for people with dementia, and include things such as signs to help them to find their way around and a calming decor to help them to settle more easily.

All care homes have to specify exactly what level of care they can provide and demonstrate how they can meet each resident’s needs. When choosing a home, it is important to consider not only current care needs, but also how much help is likely to be needed in the future.

Thank you all for your responses.

@Pet66 Do you still have that information, and if so, could you share it with me please? It would be a huge help for the battle we’re about to enter into.

I contacted the CQC today myself to ask them for some information, but unfortunately they weren’t able to provide anything and redirected me to the local authority. I’m dubious of asking them for this for a number of reasons, as I would not be surprised if they edited things according to individual cases to cover their backsides. It would be nice to have guidelines or a definition from somewhere more impartial that lose looking to protect budgets. Thanks :slight_smile:

I’m dubious of asking them for this for a number of reasons, as I would not be surprised if they edited things according to individual cases to cover their backsides.

The post code lottery at it’s finest ?

Social care … depends on who gets to define it … as previously posted … no law case sets out a clear precedent.

Even then , odds on ALL out there working to the same definition … as per the Care Act , 2014 ?

Hi Jenne
If you are happy to private message me your email address I will be happy to forward the email that was sent to me.

Thanks for sharing.

This is an old thread, therefore I am locking it.

Melly1 Moderator