Choosing a Dementia Care Home in Northern Ireland: RQIA Registration, DE Category, and What to Check

Your parent needs to move into a care home, and they have dementia. Not every care home in Northern Ireland is equipped to manage cognitive impairment safely. The difference between a good placement and a dangerous one often comes down to one regulatory detail that most families overlook: the RQIA registration category.

The DE Category: Why It Matters

Every care home in Northern Ireland must be registered with the Regulation and Quality Improvement Authority (RQIA). Each home is registered under specific categories that define which types of residents it can accept.

For dementia care, the critical designation is DE (Dementia):

• NH-DE — Nursing home registered for dementia care (nursing staff on site 24/7)
• RC-DE — Residential care home registered for dementia care (personal care staff, no nursing)

A home without the DE registration category is not legally required to have the specialised environment, staffing ratios, or training needed to manage dementia safely. Placing a parent with moderate-to-advanced dementia in a non-DE home creates risks: staff who are not trained to manage sundowning or resistance to personal care, environments without secure boundaries for wandering, and no protocol for the behavioural and psychological symptoms of dementia.

Check a home's registration category on the RQIA online register before visiting.

Reading RQIA Inspection Reports

RQIA publishes inspection reports for every registered care home. These are publicly available and cover:

• Staffing levels and qualifications — are there enough staff, and are they trained in dementia care?
• Quality of care — how well are care plans maintained, are medications managed properly, are residents treated with dignity?
• Environment — is the physical space safe, well-maintained, and appropriate for people with cognitive impairment?
• Governance — is the home well-managed, are complaints handled properly, are safeguarding procedures in place?

Read the most recent inspection report before visiting any home. Pay particular attention to any "areas for improvement" or enforcement actions. A home with repeated issues in the same area across multiple inspections is a red flag.

What to Ask During a Visit

When you visit a potential care home, ask specifically about dementia:

Staffing: What is the staff-to-resident ratio on the dementia unit during the day? At night? What dementia-specific training have staff completed?

Environment: Is the dementia unit on a separate floor or wing? Are there secured outdoor spaces where residents can walk safely? How are rooms personalised to help residents with wayfinding?

Care approach: How does the home manage sundowning? What happens if a resident becomes distressed or resistive to personal care? Is there an activities programme designed for people with dementia?

Safety: What is the protocol if a resident attempts to leave the building? Is the home registered with the Herbert Protocol? Are there door sensor or alarm systems?

Communication: How will you be kept informed about your parent's condition? How often are care plan reviews conducted, and are families invited?

Trust Tariff Rates and Third-Party Top-Ups

HSC Trusts pay care homes at standard weekly tariff rates: £980 for nursing care and £808 for residential care (2025–26 rates). Many specialist dementia homes charge above these rates. If the home your parent needs costs more than the Trust tariff, a relative must sign a third-party top-up agreement to cover the difference. This is a long-term financial commitment — understand the gap before signing.

The Northern Ireland Dementia Care Guide includes a care home evaluation checklist with scoring criteria for dementia-specific factors, a comparison worksheet for shortlisted homes, and guidance on negotiating top-up fees with Trust care managers.

See more Northern Ireland guides →