Nursing Care at Home: When You Need More Than a Care Worker Can Provide

Topic cluster: Supporting Your Parent at Home | Reading time: 5 min

For older people with complex health needs, standard domiciliary care — provided by trained care workers — may not be sufficient. Nursing care at home involves registered nurses providing clinical care in your parent's own home, allowing them to remain there safely even with significant health needs. This guide explains what nursing care at home involves, who it's for, and how to access it.

What Is Nursing Care at Home?

Nursing care at home (also called community nursing) is clinical care provided by qualified nurses in the home setting. It sits above the level of personal care (which care workers provide) and below inpatient hospital admission.

Community nurses are typically employed by the NHS and provide nursing care free of charge to eligible patients. In addition, private nursing agencies offer similar services for self-funding individuals.

What Nursing Care at Home Includes

NHS community nurses can provide:

Wound care — dressing complex wounds, surgical sites, leg ulcers, pressure sores
Catheter care — insertion, management, and monitoring
Continence assessment and management
Medication administration — injections, IV medications, complex medication management
Monitoring — blood pressure, blood glucose, fluid balance for complex conditions
Stoma care — managing colostomies and ileostomies
Palliative and end-of-life nursing care
Falls assessment — in conjunction with the GP and physiotherapy
Tissue viability — managing and preventing pressure sores

NHS Community Nursing vs. Private Nursing at Home

Feature	NHS Community Nursing	Private Nursing at Home
Cost	Free	£35–£70/hour typically
How to access	GP or hospital referral	Direct or via agency
Visit frequency	Based on clinical need (often weekly or less)	As required by the family
Who provides	District nurses, specialist community nurses	Registered nurses from private agency
Level of care	Clinical nursing tasks	Clinical nursing tasks
24-hour care	Not typically available	Available (at significant cost)

Accessing NHS Community Nursing

Your parent's GP, hospital discharge team, or specialist consultant can refer to the community nursing service. In most areas, the district nursing team is based at the local GP surgery or community health hub.

What to ask for:

District nurse — for general community nursing needs
Specialist community nurse — e.g., Macmillan nurse for cancer/palliative care, tissue viability nurse for wound care, continence nurse for bladder/bowel issues, diabetes specialist nurse
Community mental health nurse — for complex mental health needs including dementia

If referral is not being made and you feel nursing care is needed, ask the GP directly.

Private Nursing Agencies

For more intensive, continuous, or immediate nursing care at home, private nursing agencies offer nurses who can:

Provide daily or twice-daily nursing visits
Provide 24-hour live-in nursing care
Offer rapid response when the NHS cannot provide immediate care
Bridge between hospital discharge and establishing NHS community care

Private nursing at home is expensive but avoids a care home admission and maintains familiar surroundings.

Hourly rates (2026): Typically £35–£70/hour for a registered nurse; higher for specialist nurses

Live-in registered nurse: £1,400–£2,500/week depending on needs and location

NHS Continuing Healthcare (CHC)

If your parent has complex, significant healthcare needs, they may qualify for NHS Continuing Healthcare — which funds all their care, including nursing care at home, at no cost to them.

Eligibility is based on the nature and complexity of needs, not diagnosis. The primary health need test considers intensity, complexity, unpredictability, and risk.

If your parent has ongoing nursing needs, ask the GP or hospital team to arrange an NHS CHC checklist assessment.

Checklist: Is Nursing Care at Home Right?

☐ Does my parent have clinical needs beyond what a care worker can provide?
☐ Have I asked the GP for a district nursing referral?
☐ Has an NHS CHC assessment been considered?
☐ Is the level of care needed sustainable at home long-term?
☐ Have I compared the cost of nursing care at home vs. a nursing home?
☐ Are there specialist nurses available (Macmillan, tissue viability, dementia)?

Thinking about the right level of care? homeformum.com helps families find nursing care homes when home nursing is no longer sufficient.