24-hour nursing care at home: what it involves and what it costs

The phrase "24-hour nursing care" is used in two different ways, and it helps to know which one you mean before you ring anybody. A nursing home has registered nurses on site at every hour, and that is what the phrase describes in a care home. At home, a nurse at every hour is possible, but it takes more than four full-time nurses to cover one week. At home the phrase can also describe a person who needs nursing input every day and somebody with them around the clock, with the nursing and the round-the-clock presence coming from different people.

A registered nurse is somebody on the register kept by the Nursing and Midwifery Council (NMC). The NMC Code sets out what a nurse is responsible for, and section 11 covers handing tasks to other people: a nurse may only delegate a task that is within the other person's competence, must make sure they are supervised and supported, and must confirm the outcome meets the standard. The nurse stays accountable for the decision to delegate.

For somebody living at home, the NHS nurses who visit are the district or community nursing team, who care for people too unwell to leave the house. You reach them through the GP, or the hospital refers your relative when they come home. They visit to do the clinical work and to train and review anybody doing a task on their behalf.

If your relative's needs go beyond what a visiting team can do, for example a ventilator or a tracheostomy that needs skilled help at any moment, the care may need to be led by a nurse who is there for long stretches of the day. Nurse-led or carer-led complex care explains where that line falls, and what complex care means covers the conditions involved. Can you get live-in nurses? explains how a nurse living in differs from a live-in carer, and how to check a nurse is registered.

1. 1

   The nurse assesses your relative

   Always first

   The decision to hand over a task has to rest on your relative's own assessed needs. The principles do not give a national list of tasks a carer may or may not do, because a task that is safe for one person can be harmful for another.
2. 2

   Your relative agrees

   Their choice

   The person has the right to say no to a carer doing the task, or to change their mind later. If they cannot decide for themselves, the decision has to be made in their best interests.
3. 3

   The nurse teaches the named carer

   On your relative's own equipment

   The training is for this carer and this person. A certificate from a general course is a start, but the nurse still has to see the carer do the task safely for your relative.
4. 4

   The nurse signs the carer off and writes it into the care plan

   In writing

   The care plan should say what the task is, how far the carer can go, what to watch for and who to ring, including out of hours.
5. 5

   The carer does the task and reports back

   Every day

   The carer must not make clinical decisions. If something looks different from what the plan describes, they stop and call the nurse, the GP or 111.
6. 6

   The nurse reviews it

   As agreed

   Supervision can be watching the carer at work or checking in with them. The nurse stays accountable for whether handing the task over was right.

The principles give four examples of tasks that can be delegated: skin and wound care, giving insulin and monitoring blood sugar, catheter care, and using a mental health crisis plan. Tube feeding is not on that list, but it is handed over in the same way, with the nurse training and signing off the named carer, and PEG feeding at home and catheter and stoma care at home go into those two in detail. Who can train a carer to do a PEG feed or catheter care? covers the rules at more length, including who is answerable afterwards.

One practical point matters for families who choose their own carer. The guidance says the tasks a carer takes on can depend on the protocols agreed in each organisation and local area. Whether the local nursing team will train a carer the family has engaged privately, rather than one from an agency the council or NHS has commissioned, is something to ask the district nursing team early, before your relative comes home if you can. If they will, the carer you have chosen can do the task once signed off. If they will not, ask the team how the task will be covered between their visits.

That is an example day, not a set pattern.

When somebody is eligible for Continuing Healthcare at home, the government's information leaflet says the NHS pays for the package of care and support to meet their assessed health and associated social care needs. The integrated care board (ICB) decides how that package is put together. It should offer your relative a personal health budget, and the NHS says people getting Continuing Healthcare are entitled to one. A personal health budget is NHS money set aside for your relative's care, and it can give the family more say over who the carers are. Personal budgets and personal health budgets explains how they work, and NHS Continuing Healthcare covers the assessment and how to appeal.

The carer half of a package like this can be a live-in carer. If you are putting that part together yourself, privately or with a personal health budget, you can search for live-in carers near your relative and compare their rates. Then let the nurse decide whether the carer is ready for any delegated task.

The screening checklist can be completed by a nurse, a doctor, another healthcare professional or a social worker, so ask the GP, the district nurse or the hospital discharge team. A decision on whether a full assessment is needed should usually be made within 28 days. Where somebody's health is getting worse quickly and they may be nearing the end of their life, a clinician can use the fast-track route, and the NHS says care is then usually put in place within 48 hours; fast-track Continuing Healthcare explains when it applies.

If your relative is not eligible, the ICB can, with your permission, refer them to the council, and a joint package with both the NHS and the council paying is possible. The district nursing team still visits for nursing needs either way, because community nursing is an NHS service. How to get 24-hour care funded sets out the order to ask in, including the council and Attendance Allowance.

The last row is there to show why round-the-clock nursing at home is built the way it is. To have a registered nurse on duty at every hour of a week takes 168 hours of nursing, and each full-time nurse works 37.5 hours a week. A nursing home shares its nurses between residents; at home, every one of those hours is for one person.

Private nursing agencies set their own prices, and PrimeCarers does not publish a figure for nursing because introducing nurses is not what the platform does. If your relative needs a nurse at home for long stretches and you are paying, ask two or three providers for a written quote that says the nurse's hourly or weekly rate, who covers the nurse's breaks and nights, and what the agency adds on top. A provider that delivers nursing care itself should be registered with the Care Quality Commission, so check its rating on the CQC website. An agency that only supplies nurses may not need to be, so ask which kind it is.

Two other figures come up when families look into this. NHS-funded nursing care is a flat £267.68 a week from 1 April 2026, but the NHS pays it only to a nursing home for a resident's nursing, never for care at home; funded nursing care explains it. And Attendance Allowance, about £115 a week at the higher rate in 2026/27, is a benefit your relative can spend as they choose, including on care at home, and it is not means-tested. What 24-hour care at home costs has the monthly and yearly figures for each arrangement, and the cost of live-in care breaks down the live-in week.

Keep a notebook in the house where the carer writes what they did and noticed. The nurse can read it on each visit.

When you look at carers, ask what they have done before and how they will take their daily break. If one carer sleeping in will not be enough because the nights need somebody awake, waking night or sleeping night? explains the difference, and 24-hour complex care teams shows how a team of carers covers the week when one live-in carer cannot.

If you would like help with the carer side, our managed service adds help with scheduling and finding holiday cover for a 5% or 10% fee on top. It does not include nursing, and the clinical side stays with the nursing team.