Tracheostomy tubes, PEG feeds and ventilators no longer tie people to a ward.
With the right nurse‑led package, complex care at home keeps adults and children safe where they thrive.
A recent NHS England audit found that children and adults receiving complex care at home spent 64 % fewer nights in hospital compared with those in long‑stay wards. Families reported higher sleep quality, better school or work attendance and a significant drop in respiratory infections. By moving clinical tasks—tracheostomy changes, ventilator weaning and PEG management—into the comfort of home, we turn hospital hallways into family living rooms and free up NHS beds for acute patients who really need them.
Ultimately, choosing complex care at home keeps families together while ensuring hospital‑grade safety.
This guide explains:
- Which clinical tasks count as complex care
- Safety standards, staffing and equipment
- Funding routes (CHC, joint packages, PHB)
1. What is complex care?
Complex care (continuing healthcare) means daily support that includes one or more clinical interventions.
| Clinical Task | Delivered by |
|---|---|
| Tracheostomy changes & suction | RGN / trained HCA |
| Ventilator monitoring & weaning | RGN / resp physio |
| PEG / JEJ feeding & flushes | Competency‑assessed staff |
| Rescue medication for seizures | Registered nurse |
| Complex wound dressings | Tissue‑viability nurse |
Key point: Every package is overseen by a named Registered General Nurse (RGN) who trains carers, audits skills and updates protocols.
2. Home vs hospital – proven benefits
NHS audits show a 50‑70 % drop in unplanned admissions when ventilated children receive 24 / 7 nurse‑led support at home.1
- Lower infection and pressure‑area risk
- Better sleep and behaviour scores
- Family life, school and hobbies continue
3. Complex Care at Home Pathway
- 48‑hour nurse assessment at home or ward
- Draft care plan & quote sent within 24 h
- Funding meeting with ICB panel
- Team matching & shadow shifts on ward
- Go‑live with digital notes & remote vitals
Already using supported living? We dovetail with daily‑living carers – see our Supported Living guide.
4. Governance & safety
- Enhanced DBS & Care Certificate for every carer
- 24/7 on‑call RGN & duty manager
- Weekly audits: trach care, enteral feeding, MAR
- CQC‑registered – rated Good for Safe, Caring, Responsive
5. Funding routes
| Route | What it covers | Approved by |
|---|---|---|
| Continuing Healthcare (CHC) | 100 % health & social‑care costs | ICB panel |
| Joint Package | Split between Local Authority & NHS | LA + ICB |
| Personal Health Budget | Family manages staff & payroll | ICB |
Tip: Combine a PHB for clinical hours with Direct Payments for community support.
6. Red‑flag signs you need extra help
- Frequent ventilator alarms or infections
- Overnight hospital stays in last 6 months
- Carer fatigue or lost work hours
- Therapy goals stalled in hospital
7. Next steps
- Book a free nurse assessment
- Receive plan & quote in 24 h
- Meet your team and choose a start date (often within 7 days)
8. Evidence for complex care at home
A 2023 NHS England report found that adults receiving complex care at home experienced a 57 % drop in hospital readmissions. Families reported higher sleep quality, fewer infections and the freedom to resume work or education. When ventilator support was combined with overnight nursing, ICU bed days fell by 38 %, saving the NHS £124 million per year.
Book your complex‑care assessment →
FAQs
Can we keep our current carers?
Yes – we upskill them or blend our nurses with your team.
Do you support children and adults?
Absolutely. Paediatric and adult divisions share best practice.
Which areas do you cover?
Greater Manchester, Cheshire & West Yorkshire (more regions soon).
1 · Source: NHS England Long‑Term Ventilation Audit 2022.