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. Most of it can be done by carers who have done it before, with the NHS nurses for the rest. This page sets out which is which, and how to find the right person.
3,500+ vetted 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. Most of it is delegated to carers by the community nursing team, with a written plan, and 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 are routine for an experienced carer. 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. Emergencies are nursing. |
| 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 | Insulin pens can be delegated to trained carers; most injections and all IV care are nursing. |
| 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 | Managing equipment and concentrators is routine once shown. Prescribing and review is medical. |
Training and sign-off come from the NHS community team or the specialist nurse for the condition, and are free. What a carer may not do without it is listed in what carers are not allowed to do.
Finding the right person
How we match experience to the task
With complex needs, a carer without the right experience can do more harm than good. These five things are what make the match a good one.
- 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. Some carers on PrimeCarers are also registered nurses working privately.
- 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.
Some carers on PrimeCarers are registered nurses working privately. 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 with no commitment. A lot of families have a good idea within the first ten minutes.
Book, and change it as needs change
Contract, insurance and payment run through us. You can add visits, add nights, or move to live-in care as things change, and you only pay for care that happens.
Safety first
Someone coming into their home? We take that seriously.
Letting a carer into the home of someone you love takes trust. We've built every layer of protection so that trust is earned, not assumed.
Vetting that never stops
Enhanced DBS, ID and right-to-work checks and an online interview before a carer appears, then continuous DBS monitoring for as long as they work. We check that a carer is caring; their skills and training are for you to check with them.
Insured and above board
Every visit is insured, contracted and paid securely online after care happens. There is no cash and no informal arrangement to manage.
A real person who knows you
Your own account manager and a UK support team who know you, your carer and your situation, not a call centre script.
Help when plans change
If your carer is unwell or away, our team will always do their best to find you vetted cover at short notice.
What clients say
Our Latest Carer Reviews
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.
Usually. The nursing comes from the NHS community team, who visit; the hours of hands-on care come from carers trained for the tasks. Together they cover most of what a nursing home does, in the person’s own home, one-to-one.
Yes, once trained and signed off by the community or specialist nurse, with a written care plan in the house. Insertion, replacement and emergencies stay with the nurses. The task-by-task list.
The NHS provides district and specialist nursing at home free of charge. Some carers on PrimeCarers are registered nurses working privately, which helps where the NHS visits are not enough. 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 £150 to £160. 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.
You book two. Some transfers need two people, and live-in complex care is usually two carers in rotation so that someone is always rested. We help you arrange the pair.
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?
- 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
- 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.