What if I need more support that can’t be provided at home?
This page outlines the different types of care and housing options and how to access them through adult social care.
When might this apply?
You may need alternative care outside the home if:
- you need 24-hour care or supervision
- you have complex medical needs that require nursing support
- your home is no longer suitable and cannot be adapted in time
- you are waiting for assessments, equipment, or longer-term planning
- you need a period of recovery in a supported environment
Your hospital discharge team or Adult Social Care will support you to explore safe and appropriate alternatives.
Care and housing options
Sheltered housing
Who is it for?
- people who can live independently but would benefit from a safe environment with emergency support
- often suitable for older adults or people with mild disabilities
What’s included?
- your own self-contained flat or bungalow
- 24-hour emergency alarm service
- access to a scheme manager (at some sites)
- communal areas and optional social activities
Note: sheltered housing does not provide personal care, but home care can be arranged if needed.
More information
Extra care housing
Who is it for?
- people who need more support than sheltered housing but wish to remain independent
- suitable for those with moderate care needs
What’s included?
- self-contained flats with on-site carers available 24/7
- optional help with meals, cleaning, and personal care
- social and recreational opportunities in a supported environment
More information
Residential care homes
Who is it for?
- people who are no longer able to manage at home due to high care needs
- individuals needing support with daily living but not ongoing medical care
What’s included?
- full-time care and supervision
- support with personal care, medication, meals, and social interaction
- a safe and structured living environment
More information
Nursing homes
Who is it for?
- people with complex health conditions, severe disabilities, or who require regular nursing care
- suitable for people who need medical supervision and palliative or dementia support
What’s included?
- 24-hour on-site nursing staff
- ongoing medical and personal care
- access to specialist services for complex or end-of-life needs
More information
Applying for alternative care
To access these services:
- speak to the hospital discharge team or adult social care - they will assess your care needs
- undergo a financial assessment - to determine if you qualify for funding or will pay privately
- explore your options - you and your family can visit or learn about available placements
- transition to your new setting - support will be provided to ensure a smooth and safe move
Some placements may be temporary while you recover or await home adaptations. Others may be long-term or permanent, depending on your needs.
What about the costs?
- care home fees vary depending on the setting and level of support required
- you may be asked to contribute toward the cost, depending on your income and savings
Funding options include:
- Council-funded care following a financial assessment
- NHS funded nursing care (FNC) for eligible nursing home residents
- NHS continuing healthcare (CHC) for people with primarily health-based needs
What if I only need temporary support?
If you don’t need a permanent placement, you may be offered:
- rehabilitation or step-down care - a short-term stay to help you recover before returning home
- respite care - a temporary care home stay for rest and support
- intermediate care - therapy-led recovery support to improve independence
Ask the hospital team or Adult Social Care whether these temporary options are available for your situation.
Need more help?
Contact Lewisham Adult Social Care to discuss your needs, request a care assessment, or learn more about housing and care options.
Phone: 020 8314 7777 or email: gateway@lewisham.gov.uk.