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Background Over 25,000 older adults live in Irish nursing homes. Despite comprehensive regulation, many nursing home residents continue to experience care that limits autonomy and dignity - issues that have direct implications for population health and equity in ageing. Addressing these systemic challenges requires practical, rights-based approaches that strengthen person-centred, health-promoting care. This 2025 study, commissioned by Nursing Homes Ireland and led by the Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, aimed to develop implementable guidance to embed a Human Rights-Based Approach (HRBA) within nursing home care, grounded in the FREDA principles of Fairness, Respect, Equality, Dignity and Autonomy.Methods A three-phase mixed-methods study was undertaken: (1) a rapid review of international evidence (n=86 studies) on human rights in long-term care; (2) stakeholder consultations with 29 participants, including providers, advocates, and policymakers; and (3) co-design and development of practical implementation guidance informed by public health and implementation science frameworks. This paper focuses on the co-development process to produce contextually relevant guidance aligned with legal, regulatory and human rights frameworks.Results Stakeholders identified key barriers to rights-based, person-centred care, including institutional routines, workforce shortages, and limited resident voice. Findings highlighted the need to move from risk-averse, compliance-driven models to a ‘homeliness culture’ based on partnership, involvement in decision making, and respect. The resulting guidance provides tiered recommendations (Starting Out, Progressing, Advancing) and practical tools such as positive risk-taking frameworks and scenario-based learning to facilitate cultural and organisational change.Conclusion Embedding human rights within nursing home care is essential to advancing equity and wellbeing in later life. The guidance offers a structured, evidence-informed framework to support health-promoting, inclusive, and dignity-centred practice across the sector. The guidance information that has been developed offers a roadmap for transforming care environments into spaces where human rights are actively protected and promoted.