Accounts, tax, payroll and fee planning for residential and nursing homes, with each resident's funding and each home's occupancy in the monthly figures.
Residents in the same home are paid for by different bodies on different terms. These are the four routes in England on 2026/27 rates.
Capital below £23,250 in England. The council arranges the place and pays the rate it agrees with the home.
Capital above £23,250. The part of Care Act section 18 that would let a self-funder ask the council to arrange a care home place has not been brought into force.
The standard rate of NHS-funded nursing care from 1 April 2026, up from £254.06.
Arranged and funded solely by the NHS where the resident has a primary health need.
Regulation 13 of the Care Quality Commission (Registration) Regulations 2009 requires a provider to "take all reasonable steps" to run the regulated activity in a way that keeps it financially viable, so that it can meet its statement of purpose and the registration requirements. Directors also have to pass the fit and proper person test in regulation 5 of the 2014 Regulations.
The Insolvency Service recorded 144 insolvencies of residential care companies in England and Wales in the twelve months to September 2026, against 110 in the twelve months before. Monthly figures for each home show whether occupancy and fees still cover the staff bill while there is time to act.
Because care fees are exempt, VAT on a refurbishment or an extension is generally a cost to the home. The tax relief on the same spending comes through capital allowances:
Supplies of staff are generally standard-rated. VAT Notice 701/57 section 6.6 sets out a concession for a regulated nursing agency supplying registered nurses, or auxiliaries directly supervised by a qualified nurse, to a care home with nursing. Care assistants who only help residents wash and dress fall outside it, so the agency's invoice for them carries VAT the home cannot reclaim.
There is no business rates relief specific to care homes. Small business rate relief removes the bill on a rateable value of £12,000 or less and tapers to £15,000. A charity can get up to 80% mandatory relief, and property used wholly for welfare services for disabled people is exempt under the Local Government Finance Act 1988.
No. Care in a care home registered with CQC is exempt from VAT as a welfare service (VAT Act 1994 Schedule 9 Group 7; VAT Notice 701/2). The exemption also means the home generally cannot reclaim the VAT it pays on its own costs.
The NHS pays it directly to the care home. The standard rate is £267.68 a week from 1 April 2026, up from £254.06. It counts towards the nursing resident's fee.
Yes. The allowance is 3% a year of qualifying construction costs. Dwellings are excluded, but the Capital Allowances Act 2001 section 270CF and HMRC's manual at CA11520 treat a residential or nursing care home providing personal care as outside that exclusion.
Yes. Management accounts can be split by home, with occupancy, fee income by funding route and staff hours for each, and consolidated for the group.
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