Complex care
Care that needs experienced hands at home
Hoists, PEG tubes, stomas, catheters, advanced dementia and spinal injury are all managed at home every day. Much of it can be done by carers once the NHS team has trained and signed them off for your relative, with the nurses keeping the rest. PrimeCarers does not check carers' training, so this page sets out which is which and what to ask.
3,500+ DBS-checked carers, conditions and tasks on every profile
Not sure what counts as complex? See the list or call 0203 369 3624
What counts as complex
Twelve tasks, and who can do each one at home
Complex care is care that needs specific experience or training, not a different kind of person. Some of it can be delegated to a carer by the community nursing team, with a written plan, if the team agrees; some teams will not delegate to a carer the family engages directly. The nurses keep the parts that have to be done by a nurse.
| Task | Who | How it works at home |
|---|---|---|
| Hoisting and transfers | Trained carer | A carer trained on the hoist in use. Two carers for some transfers. |
| PEG feeding | Carer, once trainedNurse oversees | Carers can be trained and signed off by the community team; the nurses manage the tube and any problems. |
| Stoma care | Trained carer | Bag changes and skin care, once the stoma nurse has shown the carer how. The stoma nurse reviews. |
| Catheter care | Carer, once trainedNurse oversees | Bag changes, hygiene and flushing by a trained carer; insertion and replacement by a nurse. |
| Tracheostomy and suction | Carer, once trainedNurse oversees | Carers can be trained for suction and routine care under a nurse-led plan. In an airway emergency, ring 999 and follow the emergency plan the team wrote for your relative. |
| Ventilator support | Carer, once trainedNurse oversees | Only with specific training and a written care plan from the respiratory team. |
| Advanced dementia | Trained carer | Experience matters more than certificates here: helping with distress, with food being refused, and with wandering at night. |
| Spinal injury | Trained carer | Bowel and bladder routines, pressure care and transfers. Carers with spinal experience say so on their profile. |
| Injections and IV medication | Nurse | Injections, insulin and all IV care are nursing tasks. Whether any of it is handed to a carer is the nursing team’s decision, with their training and written instructions; PrimeCarers does not assess this. |
| Wound dressings | Carer, once trainedNurse oversees | Simple dressings by a carer; complex or infected wounds by the district nurses. |
| Epilepsy rescue medication | Trained carer | With training from the epilepsy nurse and a written protocol in the house. |
| Oxygen | Trained carer | Using the equipment as the respiratory team has shown the carer. Prescribing and review is medical. |
Where the team agrees, training and sign-off come from the NHS community team or the specialist nurse for the condition; who pays for training is agreed locally. Each of these tasks needs training and sign-off from the NHS team for your relative, and a written plan. PrimeCarers does not check or train carers for any of them, and the insurance we arrange does not cover clinical procedures. In an emergency the carer calls 999. What a carer may not do without training is listed in what carers are not allowed to do.
Finding the right person
Finding experience for the task
With complex needs, a carer without the right experience can do more harm than good. Experience on a profile is the carer's own account and we do not check it, so these five things are how you judge it.
- 1
Experience is on the profile
Carers list the conditions and tasks they have worked with. You can filter for them, and you can ask.
- 2
You interview them
The interview is free, and it can be by phone, by video or in the house. Ask how many people with the same condition they have cared for, and for how long.
- 3
Nurses where nurses are needed
The NHS community team provides the nursing at home free. PrimeCarers does not introduce nurses and does not check nursing registration, so anything clinical comes from the NHS or a nursing agency.
- 4
Two carers when it takes two
For hoisting or a rotation, book a pair. For live-in complex care, carers usually work in rotating pairs so someone is always fresh.
- 5
A plan in writing
The care plan comes from the clinical team; the carer works to it and reports changes. That is what keeps everyone, including the carer, safe.
Conditions we see most
Each has its own guide to what a carer does day to day.
PrimeCarers does not introduce nurses or check nursing registration. Anything clinical comes from the NHS community team or a nursing agency. Can you get live-in nurses?
What it costs
Live-in complex care, typically
£1,340/week
From £1,260 a week, with our fee included, from what families paid over the last six months. Complex needs are the most likely of any to qualify for NHS Continuing Healthcare, which can fund the whole package at home.
How it works
From “something has to change” to a carer at the door
No assessment visits, no waiting list. Some families are talking to a carer the same day.
Search your postcode
See the carers who cover it, with photos, rates, experience and reviews. Filter by hourly, live-in or overnight.
Talk to the ones you like
Message them directly, or tell us what you need and we can suggest some carers to look at. The choice is always yours.
Meet before deciding
A call, a video chat or a visit, free and before anything is booked. A lot of families have a good idea within the first ten minutes.
Book, and change it as needs change
The contract and payment run through us, and visits booked here are covered by the carer insurance policy we arrange, within its terms. You can add visits, add nights, or move to live-in care as things change, and you only pay for care that happens.
Before a carer appears
What we check, and what we don't
Letting a carer into the home of someone you love takes trust. These are the checks every carer passes before their profile appears; their skills, training and references are for you to ask about.
Checks before a carer appears
An enhanced DBS check issued within the last 2 years (or Scottish PVG or Access NI), ID and right-to-work checks, and a recorded online interview, all before a carer appears. We do not check qualifications, training or references: their skills, training and references are for you to check with them.
Contracted and paid online
Visits booked through PrimeCarers are on our standard contract and paid securely online after the care happens, with no cash to hand over. Insurance for platform visits, within the policy’s terms (no clinical procedures).
A real person to talk to
A UK support team you can call about finding carers, bookings and payments, not a call centre script. The care itself is agreed between you and the carer.
Help when plans change
If your carer is unwell or away, call us and we will help you look for another carer. We cannot guarantee cover at short notice, so it is worth having a second carer you have already met.
Reviews
What families say about their carers
Margaret N
"Excellent - Lovely lady. My mother is so pleased with the work she does in helping her."
Read the full review
Julia S
"Julia is a highly skilled and companionate carer who is able to give so much of herself and adapt to any situation."
Read the full review
Andres Felipe C
"My son who he is caring for automatically welcomed Andres and can be heard laughing & having fun with Andres."
Read the full reviewQuestions families ask
Complex care, answered
Care for someone whose needs go beyond everyday personal care: a hoist, a feeding tube, a stoma or catheter, a tracheostomy, advanced dementia, a spinal injury, or several long-term conditions at once. It needs carers with specific experience or training, working to a plan from the clinical team. Twelve tasks, and who can do each.
Often. The nursing comes from the NHS community team, who visit; the hands-on care comes from carers, with any healthcare task trained and signed off by that team. It is not the same as a nursing home: there is no nurse on site, and PrimeCarers does not supervise the care.
Yes, once trained and signed off by the community or specialist nurse for your relative, with a written care plan in the house, and only if the carer is willing. PrimeCarers does not assess or supervise this, so ask to see the training record. The insurance we arrange does not cover clinical procedures like these. Insertion and replacement stay with the nurses, and in an emergency the carer calls 999. The task-by-task list.
No. PrimeCarers introduces self-employed carers for personal care and company. It does not introduce nurses, does not record who holds nursing registration and does not check it, so treat any claim a carer makes about being a nurse as something for you to verify yourself. District and specialist nursing at home comes from the NHS free of charge, and a nursing agency is the route to paid-for nursing. Can you get live-in nurses?
Live-in complex care starts from £1,260 a week and is typically £1,340, with our fee included. Daily visits are £18 to £25 an hour and waking nights £165. The full cost guide.
Complex needs are the most likely of any to qualify for NHS Continuing Healthcare, which funds the whole package at home where the primary need is health. Ask the GP or hospital for a checklist assessment. Funding explained.
It is on their profile, with reviews from other families, and you interview them for free before booking. Ask how many people with the same condition they have cared for, for how long, and what training they hold. How experience is matched.
If the agreed care plan requires two people for a task, both must be booked to attend at the same time. Two live-in carers rotating longer stays does not provide two-person assistance, daily break cover or continuous waking supervision. Agree the staffing, relevant skills and backup arrangements before care starts.
Hoists, profiling beds, pressure mattresses and feeding pumps are usually supplied by the NHS or the council after an occupational therapy assessment. The carer works with what the OT has put in place. Home adaptations for a carer.
Visits within days if the training and plan are already in place; live-in complex care usually within a week or two, because the pool of carers with the right experience is smaller. Call 0203 369 3624 and we will look. Emergency care.
Guides
Read next
The pages families with complex needs read alongside this one.
- Can you get live-in nurses?
- Huntington's disease care at home
- Ventilator support at home
- PEG feeding at home
- Tracheostomy care at home
- Epilepsy care at home
- Acquired brain injury care at home
- Motor neurone disease care at home
- Spinal cord injury care at home
- 24-hour complex care teams
- The cost of live-in care
- Free live-in care with dementia?
- Can home carers give medication?
- What carers are not allowed to do
- Home adaptations for a private carer
- Post-operative rehabilitation at home
- Signs that dementia is getting worse
- Overnight care
- Help paying for care
- The different types of care funding
- The cost of care
- What complex care means
- Delegated healthcare tasks
- Nurse-led or carer-led care
- Bedbound or hoisted
- End of life care
- Care by condition
- Disability care
- Health conditions
The right person for the tasks, at home
See carers near you with the experience your relative needs, and talk to them before deciding anything.