UK Care Home Design Requirements: Essential Guidelines for 2025

Regulatory Framework and Compliance Standards

When designing care homes in the UK, there's a complex web of regulatory requirements to navigate. The Care Quality Commission (CQC) stands at the forefront of this regulatory landscape, setting clear expectations for care environments. They're not just looking at the clinical aspects but at how the physical environment supports dignity, independence, and quality of life.

"The physical environment is fundamental to delivering person-centred care. It's not just about compliance, but about creating spaces where people can truly thrive despite their care needs," notes Caroline Baker, a leading care home design consultant.

Building Regulations Part M is particularly significant when designing care facilities. This regulation goes beyond basic accessibility to ensure that buildings are usable by everyone, including those with mobility issues, sensory impairments, or cognitive challenges. For care homes specifically, this means wider doorways, accessible bathrooms, and carefully considered circulation spaces.

The Health and Safety Executive provides additional guidance for care environments, focusing on risk assessment and mitigation. Their guidelines cover everything from preventing falls to managing hazardous substances, all of which influence design decisions in care settings.

The Equality Act 2010 has profound implications for care home design. It requires 'reasonable adjustments' to be made to ensure that people with disabilities aren't disadvantaged. In practical terms, this means designing environments that don't just accommodate disabilities but actively promote independence and equal access to all facilities and services.

For more technical specifications, designers turn to Health Building Notes (HBNs) and Health Technical Memoranda (HTMs). These documents provide detailed guidance on specific aspects of healthcare building design, including specialised information for residential care facilities. They cover everything from room sizes to mechanical systems, ensuring that buildings meet clinical needs while supporting wellbeing.

Fire safety regulations are particularly stringent for care homes, given the vulnerability of residents. These include requirements for compartmentation, fire detection systems, evacuation procedures, and fire-resistant materials. Progressive horizontal evacuation is often a key strategy, allowing residents to move from one fire-safe area to another without necessarily evacuating the building entirely.

Spatial Requirements and Room Dimensions

Getting the spatial requirements right in care homes isn't just about ticking regulatory boxes – it's about creating homes that respect dignity and support quality of life. Bedroom sizes have increased over the years, with current standards generally requiring a minimum of 12-14 square metres for single occupancy rooms. This ensures residents have enough space for personal belongings, receiving visitors, and using mobility equipment if needed.

Bathroom facilities have evolved significantly too. En-suite bathrooms are now the norm in newer care homes, providing privacy and dignity. These must be wheelchair accessible, with sufficient transfer space around toilets and level-access showers with appropriate seating and grab rails.

Communal spaces are the heart of any care home. The guidelines typically recommend a minimum of 3.5-4 square metres of communal space per resident. These areas aren't just nice-to-have extras – they're essential for preventing isolation and supporting mental wellbeing through social interaction.

Corridor width is a critical consideration, with 1800mm generally considered the minimum to allow two wheelchairs to pass comfortably. However, many designers now opt for wider corridors where possible, creating passing places and rest points to support residents with limited mobility or stamina.

Staff facilities sometimes get overlooked, but they're vital for operational efficiency. These include nursing stations, medication rooms, staff rooms, changing facilities and adequate office space. Well-designed staff areas support better care by reducing staff fatigue and improving operational efficiency.

Storage is another often-underestimated requirement. Care homes need substantial storage for mobility equipment, medical supplies, linens, activities materials, and residents' seasonal belongings. Inadequate storage quickly leads to cluttered corridors, creating both safety hazards and an institutional feel.

Outdoor spaces complete the picture, with guidelines recommending accessible gardens that all residents can enjoy. These should include level or gently sloping paths, raised planting beds, comfortable seating with shade options, and secure boundaries that don't feel institutional or prison-like.

Accessibility and Inclusive Design Features

Doorways in care homes need careful consideration, with a clear width of at least 800mm recommended for general use and 900mm for bedrooms and bathrooms to accommodate wheelchairs and mobility equipment. Thresholds should be flush or have a maximum lip of 15mm, with chamfered edges to prevent trips and allow easy wheelchair passage.

For multi-storey facilities, lift specifications go beyond basic building regulations. Care home lifts should be large enough to accommodate a stretcher or bed, typically 1800mm x 2700mm internally. Controls need to be accessible from a seated position, with tactile buttons and both visual and audible floor indicators.

Handrails provide essential support throughout care facilities. They should be positioned at 900mm height, extend 300mm beyond the top and bottom of staircases, and offer good grip with a diameter of 40-45mm. Colour contrast between handrails and walls helps residents with visual impairments navigate safely.

Lighting deserves special attention in care environments. Standards recommend higher illumination levels than in typical residential settings – around 300 lux in living areas and 400-500 lux for task areas. Consistent lighting levels without pools of darkness or harsh shadows help prevent falls and reduce confusion.

Floor surfaces need to balance several requirements: they must be slip-resistant, particularly in wet areas, but not so textured that they impede wheelchair users or create trip hazards for those who shuffle or use walking aids. Transitions between different flooring types should be smooth, without lips or significant changes in resistance.

Signage systems in care homes need to support those with visual impairments and cognitive challenges. Best practice includes large, high-contrast text, consistent use of symbols, and positioning signs at eye level. For people with dementia, picture-based signage often works better than text alone.

Colour contrast is a powerful tool in accessible design. Door frames contrasting with walls, toilet seats contrasting with sanitary ware, and furniture edges contrasting with floors all help people with visual impairments navigate the environment safely and independently.

Dementia-Friendly Design Considerations

Designing for dementia requires understanding how the condition affects perception and cognition. Evidence-based principles focus on creating environments that compensate for cognitive difficulties while supporting remaining abilities. This means clear layouts, familiar domestic styling, and distinctive spaces that help with orientation.

Wayfinding becomes particularly challenging for those with dementia. Effective strategies include creating distinct zones with different colours and themes, using landmarks rather than relying solely on signage, and ensuring that important destinations like toilets and dining areas are visibly obvious from communal spaces.

Sensory stimulation plays a vital role in dementia care environments. Design should incorporate controlled opportunities for different sensory experiences – tactile wall features, sound absorption to reduce overwhelming noise, pleasant scents in appropriate areas, and visual interest through artwork and views to nature.

Colour schemes require careful consideration. Research suggests avoiding busy patterns that can appear to move or create visual illusions. Strong contrast is helpful for identifying important features like doors and handrails, but overly bright or clashing colours can be overwhelming or agitating for some residents.

Lighting approaches should support natural circadian rhythms, with brighter, cooler lighting during daytime hours and warmer, dimmer lighting in the evening. This can help reduce 'sundowning' – the increased confusion and agitation often experienced by people with dementia in the late afternoon and evening.

Design features that promote independence include clear sight lines to important destinations, bathroom doors that are visibly different from other doors, and domestic-style fixtures and fittings that feel familiar. Memory boxes or personal items near bedroom doors help residents identify their own rooms.

Gardens designed for people with dementia provide crucial access to nature and sensory stimulation. These should feature circular paths that always lead back to the building, raised planting beds for touch and smell experiences, and secure boundaries that don't feel institutional or prison-like.

Safety and Security Design Requirements

Balancing safety with dignity presents one of the greatest challenges in care home design. CCTV and monitoring systems need careful implementation, with clear policies about where cameras are appropriate (generally limited to entrances, exits and external areas) and how footage is managed to protect privacy.

Call systems have evolved significantly, with modern systems offering multiple alert types, mobile notification for staff, and integration with other monitoring technologies. These need to be easy to use for residents with limited dexterity or cognitive impairment, with consideration given to both pendant/wearable calls and fixed position buttons.

Secure entry and exit solutions have moved beyond simple locked doors to more sophisticated approaches. These include keypad or fob systems, delayed egress doors that allow free movement within the home but prevent unsupervised exits, and disguised exits where appropriate for residents prone to wandering.

Window restrictions are essential safety features, limiting opening to 100mm to prevent falls while still allowing ventilation. Modern solutions include restrictors that can be overridden by staff in emergencies and toughened glass that reduces the risk of injury if broken.

Bathroom safety features include appropriately positioned grab rails (typically contrasting with wall colours for visibility), level access showers with non-slip flooring, thermostatic mixing valves to prevent scalding, and emergency call systems within easy reach of toilets and showers.

Medication storage requires secure, well-lit areas with appropriate temperature control. Design considerations include sufficient counter space for preparation, handwashing facilities, and clear visibility to support accurate dispensing while minimising disturbance.

Infection control has gained even greater prominence following the COVID-19 pandemic. Design considerations include sufficient handwashing/sanitising stations, easily cleanable surfaces, good ventilation, and spatial arrangements that allow for isolation if needed. Material selection increasingly favours antimicrobial properties in high-touch surfaces like handrails and door handles.

Sustainable and Future-Proof Design Elements

Care homes face increasing pressure to improve energy efficiency, both for environmental reasons and to control operating costs. Building performance standards now typically demand high levels of insulation, efficient heating systems, and careful consideration of solar gain through appropriately designed glazing.

Renewable energy integration is becoming more common, with solar photovoltaic panels, air or ground source heat pumps, and biomass boilers all finding applications in care settings. The initial investment in these technologies is increasingly offset by long-term energy savings and various incentive schemes.

Adaptability is a key principle in future-proofing care environments. This means designing rooms that can easily accommodate changing care needs – for example, ensuring bedroom dimensions and doorways can accommodate hoists if needed in future, or designing en-suites that could be adapted for full assistance.

Smart technology integration is transforming care delivery. From environmental controls that residents can operate regardless of mobility, to monitoring systems that detect falls or unusual patterns of movement, technology can enhance both safety and independence when thoughtfully integrated into the built environment.

Thermal comfort standards in care homes need to recognise that older people often feel the cold more acutely. Guidelines typically recommend slightly higher ambient temperatures (around 23°C in living areas) and careful control of draughts while ensuring adequate ventilation.

Water efficiency measures include low-flow taps with thermostatic controls, dual-flush toilets, and water-efficient laundry equipment. These not only reduce environmental impact but also control utility costs, which can be substantial in care settings with high water usage.

Material selection involves balancing multiple considerations: durability to withstand intensive use and frequent cleaning, maintenance requirements that fit with operational capabilities, environmental impact including embodied carbon, and the sensory qualities that make a space feel homely rather than institutional.

Conclusion

Designing a care home in the UK requires careful attention to a complex web of regulations and best practices that go far beyond basic compliance. The most successful care environments balance technical requirements with a deep understanding of residents' needs, creating spaces that feel like home while providing necessary support. As we move into 2025, the focus on person-centred design continues to grow, with increased emphasis on dementia-friendly features, sustainability, and technology integration. By thoughtfully addressing each aspect covered in this guide, designers and operators can create care environments that truly enhance quality of life. Remember—great care home design isn't just about meeting standards; it's about creating places where people can live with dignity, comfort and joy in their later years. Ready to start planning your care home project with these essential requirements in mind?