Catheter and stoma care at home: what a carer can do, and what needs a nurse

Everything in the first tier is personal care, the same category as helping somebody wash and dress, and it is where most of a visit goes. What personal care covers sets out the wider list.

The second tier is the one to get in writing. Skills for Care, the Department of Health and Social Care and the Care Quality Commission publish guiding principles for delegated healthcare activities, which are tasks a registered professional such as a nurse hands to a paid care worker. Basic catheter care and basic stoma care appear among their examples. The principles ask for informed consent, appropriate learning and development so the activity can be carried out safely, and ongoing clinical oversight from the healthcare professional, who stays responsible for reviewing the healthcare plan. They also expect everyone involved to feel able to raise a concern if a task cannot be carried out safely, so a carer who says they have not been trained for something is following the guidance.

The third tier does not move, whoever is in the house. If your relative needs a lot of the second and third tiers, the arrangement is closer to nurse-led than carer-led care, and complex care at home explains how that is put together. Medication follows the same shape, and what a carer can and cannot do with medication is worth reading next.

Infection is the risk behind all of this, and hand washing and daily skin washing are most of the defence. Preventing infections at home covers the wider habits, and managing incontinence with dignity helps if a catheter is only part of the picture. If the hard part is the middle of the night, night care for falls and toilet trips sets out what an overnight carer covers that a visit cannot.

The stoma care nurse is the person to build the arrangement around. They know which appliance your relative is using, can change it if the skin is not tolerating it, and can teach a carer a specific task and write it down. Arrange for the carer to be in the house for the first few of those visits, so the same instructions reach everybody.

The NHS sets out what changes after a colostomy and the complications to watch for. If your relative is sitting or lying for long stretches, how pressure sores start covers checks a carer can make at the same time as the pouch, and privacy and dignity for an older person covers the part families find hardest to talk about. Two charities give free information and run helplines for people living with a stoma and their families: Colostomy UK and Bladder and Bowel UK.

What PrimeCarers does check is the same for every carer before they appear in a search: identity, the right to work in the UK, an enhanced DBS check on the Update Service, and an online interview. How we vet every carer sets out what that covers. Insurance is separate from the checks: cover is arranged for carers while they are working with a client. The contract between your relative and the carer also says a carer should not undertake work they feel unqualified to perform and should tell the client, so that other arrangements can be made.

When you are ready, search for carers near your relative, read what each one lists about their experience, rate and availability, then message two or three and ask the questions above. You compare the profiles and talk to the carers yourself. If the arrangement has to change later, notice is 48 hours for hourly care, and a visit cancelled by the client is payable in full unless it is unplanned hospitalisation, illness, or another reason the carer agrees; the client contract has the wording.