Nursing Home Property: Finding and Assessing Suitable UK Care Property

A practical guide for care operators, investors, landlords and developers looking for nursing home property across London and the UK

Nursing home property is a specialist area of the UK healthcare real estate market, covering buildings designed, adapted or capable of being used to provide residential accommodation alongside nursing care.

For care operators, finding the right property can determine how effectively a service can operate. For investors and developers, the opportunity involves assessing not only the building but also its planning position, regulatory requirements, condition, layout and potential future use.

The Care Quality Commission describes care home services with nursing as accommodation and personal care provided together, with qualified nursing care available to meet the needs of people using the service. Nursing homes fall within this category.

What is nursing home property?

Nursing home property refers to buildings used or intended for residential nursing care.

This can include:

• Purpose-built nursing homes

• Former care homes

• Converted residential properties

• Former healthcare buildings

• Specialist nursing facilities

• Nursing homes for older people

• Dementia nursing facilities

• Complex care properties

• Respite care facilities with nursing

• Rehabilitation properties with nursing provision

The building requirements can vary significantly depending on the residents the service is designed to support.

A nursing home for older people with general nursing needs may have different requirements from a facility specialising in dementia, physical disabilities or complex healthcare needs.

What makes a suitable nursing home property?

The physical building needs to support both accommodation and care delivery.

Important features can include:

• Suitable bedrooms

• En-suite bathrooms

• Accessible communal areas

• Treatment or clinical spaces

• Staff offices

• Medication storage

• Dining facilities

• Kitchen facilities

• Laundry areas

• Storage

• Accessible entrances

• Lifts

• Fire safety systems

• Suitable outdoor areas

• Staff facilities

• Adequate circulation space

The suitability of individual features depends on the proposed service and resident population.

CQC expects care environments and equipment to be safe, properly maintained and suitable for their intended purpose.

Nursing home property and planning

Planning due diligence should be carried out before acquiring or adapting a nursing home property.

The buyer should establish:

• Existing lawful use

• Previous use

• Planning permissions

• Planning conditions

• Whether extensions have been approved

• Whether proposed alterations require permission

• Whether a change of use is required

• Whether the property has an appropriate use class

• Whether local planning restrictions could affect the proposed operation

CQC's current guidance for care homes states that planning permission should confirm that premises are legally authorised for use as a care home and may show a use class such as C2 for residential care. Where planning documents are unavailable, confirmation from the local authority may be required.

Planning and building regulations should therefore be assessed before committing to a property.

Building regulations and nursing home conversion

A conventional residential building may look suitable for conversion into a nursing home but still require extensive work.

CQC guidance notes that building regulations approval is required when changing the use of property for business or institutional purposes, including a nursing home or home for elderly people.

Potential works can include:

• Creating accessible bedrooms

• Installing accessible bathrooms

• Improving fire safety

• Upgrading electrical systems

• Altering internal layouts

• Improving ventilation

• Installing or upgrading lifts

• Improving emergency lighting

• Upgrading heating systems

• Creating staff areas

• Improving kitchen facilities

A full survey and professional assessment should be completed before calculating the likely conversion cost.

Bedrooms and resident accommodation

Bedrooms are one of the most important components of nursing home property.

Operators and investors should examine:

• Number of bedrooms

• Room sizes

• Single or shared accommodation

• En-suite provision

• Accessible rooms

• Natural lighting

• Ventilation

• Privacy

• Corridor access

• Distance to communal facilities

• Potential for future reconfiguration

The number of rooms should not be considered on its own. A building with fewer bedrooms but an efficient layout and appropriate facilities may have a different operating model from a larger property with significant circulation or refurbishment requirements.

Bathrooms and accessibility

Nursing home residents may have significantly different mobility and care requirements from occupants of conventional residential property.

The property should therefore be assessed for:

• Accessible bathrooms

• Level access

• Appropriate door widths

• Handrails

• Hoist compatibility where required

• Accessible showers

• Lift access

• Suitable corridors

• Wheelchair circulation

• Emergency evacuation arrangements

The exact specification should be based on the needs of the intended residents and the proposed care model.

Communal areas in nursing home property

Communal areas are important because residents may spend significant periods outside their bedrooms.

Potential spaces include:

• Lounges

• Dining rooms

• Activity rooms

• Quiet rooms

• Therapy areas

• Visitors' areas

• Reception spaces

• Gardens

• Outdoor seating areas

A well-planned layout can help staff manage the service while providing residents with appropriate areas for socialising, activities and visitors.

CQC's person-centred care requirements emphasise that care should be personalised around the needs and preferences of the people using the service.

Nursing facilities and staff areas

A nursing home property needs to support the staff delivering care as well as the residents receiving it.

Depending on the service, the property may require:

• Nurses' stations

• Staff offices

• Meeting rooms

• Medication storage

• Clinical storage

• Staff changing facilities

• Staff toilets

• Secure records storage

• Equipment storage

• Laundry facilities

The location and size of these areas can influence how efficiently staff move around the building.

Consider the surrounding location

The property's location can affect both operations and long-term investment considerations.

Useful factors to assess include:

• Access to healthcare services

• Public transport

• Staff accessibility

• Local amenities

• Parking

• Ambulance access where relevant

• Residential surroundings

• Noise levels

• Outdoor space

• Local planning policies

• Availability of suitable properties nearby

London nursing home property can present different challenges from properties in regional towns and cities. Land values, building types, planning considerations and acquisition costs can vary substantially between locations.

Buying nursing home property as an investment

Investors may approach nursing home property in several ways.

For example, an investor may:

• Purchase an operating nursing home

• Acquire a vacant care property

• Buy a property and lease it to an operator

• Refurbish an existing nursing home

• Convert another building into a nursing facility

• Expand an existing care property

• Acquire a specialist healthcare asset as part of a wider portfolio

The investment appraisal should include more than the purchase price.

Potential costs include:

• Stamp Duty Land Tax

• Professional fees

• Surveys

• Planning costs

• Refurbishment

• Building regulations

• Fire safety upgrades

• Financing

• Insurance

• Maintenance

• Property management

• Void periods

• Specialist equipment

The strength and experience of the intended operator should also be considered where the property is being acquired as an income-producing healthcare asset.

Buying an existing nursing home

An existing nursing home can offer a different proposition from a vacant building.

The buyer may acquire:

• The property

• Existing resident accommodation

• Existing facilities

• An operating business

• Existing staff arrangements

• Existing supplier relationships

• Established local demand

• An existing regulatory history

However, the buyer should carry out detailed operational due diligence.

This can include reviewing:

• Occupancy

• Fee levels

• Revenue

• Staffing costs

• Agency usage

• Maintenance expenditure

• Utilities

• Insurance

• Financial accounts

• CQC history

• Outstanding compliance matters

• Planned capital expenditure

A property with an established operation should therefore be assessed as both a real estate asset and, where applicable, an operating business.

CQC requirements for nursing home property

Buying the property does not by itself mean the new operator is authorised to provide regulated care from it.

CQC identifies care homes as locations where people live and receive care or treatment, and providers must identify the relevant locations in their registration arrangements.

For new care-home applications, CQC currently requires additional supporting documentation, including items such as a business continuity plan, business plan and forecast, environmental risk assessment, evidence of legal occupancy, fire risk assessment, floor plan and gas and electrical safety certificates.

This makes regulatory planning an important part of acquiring or developing nursing home property.

Assess the property's fire safety

Fire safety should be examined carefully before acquiring a nursing home.

Potential considerations include:

• Fire alarm systems

• Emergency lighting

• Fire doors

• Escape routes

• Compartmentation

• Emergency evacuation arrangements

• Fire risk assessment

• Sprinkler systems where appropriate

• Staff procedures

• Accessibility during evacuation

The appropriate requirements will depend on the building and proposed use.

CQC's safe-care requirements also require providers to ensure premises and equipment used in care are safe for their intended purpose.

Refurbishing nursing home property

Older nursing home properties may require refurbishment to remain competitive and operationally suitable.

Potential improvements can include:

• Bedroom modernisation

• Bathroom upgrades

• Kitchen refurbishment

• New flooring

• Heating improvements

• Electrical upgrades

• Fire safety works

• Lift upgrades

• Accessibility improvements

• Communal-area refurbishment

• Garden improvements

• Energy-efficiency works

Investors should obtain detailed refurbishment estimates before completing an acquisition.

Where major works are required, the project should also be assessed for planning, building regulations, temporary relocation requirements and the effect of works on the operating business.

Nursing home property for specialist care

Some nursing home properties may be suitable for more specialised resident groups.

Possible specialist models include:

• Dementia care

• Complex care

• Physical disability care

• Neurological care

• Acquired brain injury care

• Rehabilitation

• Respite care

• Mental health-related nursing care

The property's design should be matched to the intended service.

For example, a property designed around residents with significant mobility needs may require more extensive accessibility infrastructure than a conventional nursing home.

What buyers should check before purchasing

Before making a commitment, buyers should consider requesting:

• Title documents

• Planning history

• Current planning permission

• Building survey

• Fire risk assessment

• EPC

• Gas and electrical certificates

• Lift inspection records

• Asbestos information where applicable

• Maintenance records

• CQC registration information

• CQC inspection history

• Financial accounts where an operating business is included

• Occupancy information

• Staffing information

• Existing contracts

• Insurance information

• Details of planned capital expenditure

CQC also expects providers to demonstrate that their premises are legally authorised and suitable for the intended service.

Working with Fraser Bond

Finding suitable nursing home property requires specialist property knowledge as well as an understanding of the intended care model.

Fraser Bond can support care operators, investors, landlords and developers with:

• Nursing home property sourcing

• Acquisition advice

• Healthcare property investment

• Planning coordination

• Refurbishment planning

• Building works

• Contractor coordination

• Property management

• Specialist care property requirements

• Development consultancy

Whether you are looking for an existing nursing home, a vacant care property or a building that could be converted for nursing care, Fraser Bond can help assess the property's potential against the intended use.

Finding suitable nursing home property

Nursing home property needs to work on several levels. It must provide appropriate accommodation for residents, support staff and care delivery, comply with relevant planning and regulatory requirements and make commercial sense for the owner or operator.

The right property may be an existing nursing home, a former care facility, a purpose-built healthcare building or another property with conversion potential.

Fraser Bond can help investors, care operators and developers identify and assess nursing home and specialist care properties across London and the wider UK.

If you are looking for nursing home property to buy, lease, refurbish or develop, Fraser Bond can help you assess the building, understand the property requirements and develop a practical acquisition or development strategy.