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Nurse-led complex care at home

Our Services

Safehands Nursing Care provides flexible, clinically overseen care for adults with complex health needs. Following a clinical assessment, support may be delivered by trained care professionals, registered nurses or a combined team, depending on the person’s needs and the clinical interventions required.

Clinical care at home

What can we support with?

We support adults with a range of complex health needs. Each package is planned around the person’s diagnosis, clinical requirements, risks, routines, goals and preferences. The examples below are not a complete list.

Airway and respiratory care

  • Tracheostomy care
  • Invasive ventilation
  • Non-invasive ventilation
  • Oxygen therapy
  • Oral and tracheal suctioning
  • Cough assist
  • Nebuliser support
  • Respiratory observations and monitoring
  • Tracheostomy emergency planning
  • Airway equipment checks
  • Support with secretion management

Neurological and acquired brain injury care

  • Acquired brain injury
  • Progressive neurological conditions
  • Seizure management
  • Buccal rescue medication where prescribed
  • Changes in cognition, communication or behaviour
  • Postural support
  • Spasticity management
  • Temperature regulation support
  • Rehabilitation-focused support
  • Support with daily routines and independence

Spinal cord injury care

  • Spinal cord injury
  • Autonomic dysreflexia awareness and emergency response
  • Bowel management
  • Bladder management
  • Catheter and suprapubic catheter care
  • Pressure area prevention
  • Skin integrity monitoring
  • Postural support
  • Spasticity and contracture management
  • Moving and handling
  • Respiratory support where required

Nutrition and enteral feeding

  • PEG care
  • PEJ or JEJ care
  • Gastrostomy button care
  • Enteral feeding
  • NG and NJ feeding where clinically appropriate
  • Tube care and monitoring
  • Feeding and hydration plans
  • Fluid balance monitoring
  • Medication administration through an enteral tube where prescribed
  • Recognition and escalation of tube-related concerns

Continence and bowel care

  • Urinary catheter care
  • Suprapubic catheter care
  • Catheter valve and drainage-bag care
  • Bladder irrigation where prescribed and clinically appropriate
  • Stoma care
  • Prescribed bowel-management programmes
  • Suppositories and enemas where prescribed
  • Bowel irrigation where assessed and agreed
  • Digital rectal interventions where clinically assessed, appropriately delegated and included in the care plan
  • Monitoring and escalation of changes in bowel or bladder function

Daily clinical support

  • Medication support and administration
  • Diabetes monitoring
  • Insulin administration where prescribed
  • Recognition and management of hypoglycaemia
  • Pressure-area care
  • Skin integrity monitoring
  • Wound care within the agreed scope of the package
  • Clinical observations
  • Moving and handling
  • Positioning and repositioning
  • Pain and symptom monitoring
  • Coordination with community and specialist teams

Palliative and end-of-life care

  • Personalised palliative support at home
  • Comfort-focused care
  • Symptom observation and escalation
  • Medication support
  • Pressure-area and personal care
  • Emotional support for the person and family
  • Support with advance wishes and preferred routines
  • Coordination with GPs, district nurses, palliative-care teams and hospices
  • Registered nursing input where required
  • Care during the final days and hours of life, within the agreed care plan and professional scope

The right team for your needs

How your care package can be delivered

Following a clinical assessment, we agree the staffing model that can safely meet the person’s needs. A package may be delivered by trained care professionals, registered nurses or a combined team. The model can be reviewed if the person’s condition or clinical requirements change.

Trained care team with registered nurse oversight

For people whose care can be safely delivered by trained care professionals following person-specific training, competency assessment and an agreed care plan.

Registered nurse oversight does not mean that a nurse is present on every shift.

  • Initial clinical assessment
  • Individual care planning
  • Person-specific staff training
  • Competency assessment
  • Registered nurse reviews
  • Supervision and spot checks
  • Clinical escalation pathways
  • Review after incidents or changes in condition
  • Coordination with the wider clinical team

Combined registered nurse and care team

For packages where trained care professionals provide ongoing daily support while registered nurses deliver specified interventions, clinical reviews or selected shifts.

  • Planned nursing visits
  • Registered nurses covering identified shifts
  • Nurse-delivered clinical interventions
  • Trained carers providing ongoing daily care
  • Shared care records
  • Clinical review and escalation
  • Coordination with GPs, community nurses and other professionals
  • Staffing adjusted to the person’s changing needs

Registered nursing care

Registered nurse-delivered care

For people whose needs require ongoing registered nursing assessment, clinical judgement or interventions that cannot safely be delegated to a care professional.

  • Packages delivered fully by registered nurses
  • Packages where nurses provide most shifts
  • Complex clinical assessment and monitoring
  • Advanced respiratory care
  • Tracheostomy and ventilation support
  • Complex medication management
  • Complex diabetes care
  • Complex enteral-feeding support
  • Complex wound care within SHNC’s agreed scope
  • Palliative and end-of-life nursing
  • Hospital-discharge support
  • Clinical deterioration recognition and escalation
  • Ongoing nursing review
  • Coordination with the multidisciplinary team
Discuss registered nursing care

The staffing model is agreed following clinical assessment and may change if the person’s needs change.

Registered nursing at home

When care needs to be delivered by a registered nurse

Some people require a registered nurse to provide part or all of their care at home. This may be because their needs require ongoing assessment, clinical judgement, complex medication management or interventions that cannot safely be delegated. SHNC can provide nurse-delivered packages or combine registered nursing care with support from trained care professionals.

Examples of registered nursing support

  • Advanced respiratory assessment and monitoring
  • Tracheostomy management
  • Invasive and non-invasive ventilation support
  • Complex medication administration
  • Diabetes care, insulin administration and hypoglycaemia management
  • Complex enteral-feeding care
  • Complex wound assessment and care within the agreed service scope
  • Palliative and end-of-life nursing
  • Clinical observations and deterioration monitoring
  • Hospital-discharge and step-down support
  • Ongoing clinical review
  • Liaison with GPs, community teams and other clinicians
  • Training and competency assessment for the wider care team

How the package is managed

  • A clinical assessment before the package starts
  • Review of the person’s diagnosis, risks and required interventions
  • Identification of which tasks require a registered nurse
  • Selection of nurses with suitable experience
  • Person-specific induction and competency checks
  • Clear escalation and emergency plans
  • Regular nursing review
  • Review when needs or risks change

Other registered nursing interventions may be considered following clinical assessment and confirmation that SHNC can safely meet the person’s needs.

Where registered nursing care is required, we match the package with nurses who have relevant experience and have demonstrated competence in the care being provided.

Discuss a nurse-delivered package

Flexible support at home

Ways we can support you

Support can be arranged for planned visits, overnight care, short-term cover or continuous care. The frequency, staffing and level of nursing input are agreed following assessment.

Visiting care

Planned visits at agreed times for personal care, medication support, clinical tasks, monitoring or help with daily routines.

Overnight care

Waking-night or sleeping-night support for people who need observation, reassurance, repositioning, personal care or clinical monitoring overnight.

Live-in care

A care professional living in the home to provide ongoing support and continuity. Nursing visits or a combined staffing model can be arranged where registered nursing interventions are required.

24-hour care

Round-the-clock support delivered by a coordinated team across day and night shifts. The team may include trained care professionals, registered nurses or both.

Respite care

Short-term support that gives family carers time to rest or provides cover during holidays, illness, emergencies or changes in circumstances.

Palliative and end-of-life care

Comfort-focused support that respects the person’s wishes, routines and dignity. Care may be delivered by trained care professionals, registered nurses or a combined team according to clinical need.

Every care package starts with a clinical conversation

No two people have the same needs. Speak with our clinical team about the person’s diagnosis, daily support, clinical interventions, risks and preferred outcomes. We will consider whether SHNC can safely provide the required care and explain the next steps.

Arrange a clinical discussion