What is complex care at home? A guide for families

Clinical practice · October 2026 · 4 minute read

Complex care at home is care for someone whose health needs go beyond help with washing, dressing and meals. It includes healthcare tasks such as tracheostomy care, support with a ventilator, tube feeding or giving epilepsy rescue medication, carried out at home by care staff who have been trained and assessed as competent for that specific person. The aim is simple: to let people with high health needs live at home, safely, instead of in hospital or a care home.

Who it's for

Complex care supports adults and children living with, for example:

• a tracheostomy, or who need ventilation at night or all day;
• epilepsy that needs rescue medication;
• feeding through a gastrostomy tube (PEG or RIG);
• acquired brain injury or spinal cord injury;
• progressive neurological conditions such as motor neurone disease or multiple sclerosis;
• high needs at the end of life.

What matters is the care someone needs, not the name of their condition.

Which healthcare tasks can carers do?

Some healthcare tasks can be safely delegated by a registered professional, such as a nurse or paramedic, to a care worker who has been trained and assessed for that person. Typical delegated tasks include:

• tracheostomy care and suction, including an emergency tube change;
• supporting someone on invasive or non-invasive ventilation, and using a cough assist machine;
• feeding and giving medicines through a gastrostomy tube;
• giving buccal or intranasal midazolam for seizures;
• oxygen therapy and checking oxygen levels;
• catheter and stoma care;
• recording observations such as heart rate, breathing and temperature, and acting on changes.

Each task is written into a protocol for that person, so everyone does it the same way, the way the person and their clinical team have agreed.

How carers are trained and signed off

Good complex care depends on competence, not just a certificate. Before a carer works alone with someone, they should have:

1. Training in the task and the equipment.
2. Supervised practice with the person, alongside someone already competent.
3. An individual competency assessment by a registered clinician, for that person and that task.
4. Regular reassessment, at least every year and whenever the person's needs or equipment change.

Higher-risk packages, such as tracheostomy or ventilation, should only start when a whole team has been trained and signed off, so care doesn't depend on one or two people.

What the first assessment involves

Before care starts, a clinician visits to understand the person, their routines and what matters to them, as well as their health needs. Expect them to:

• talk with the person, the family and, with permission, the NHS team involved;
• look at equipment, medicines and any existing care plans;
• assess risks in the home, such as moving and handling or oxygen safety;
• agree what a good day looks like, and what should happen when things change.

From this, the care plan, risk assessments and task protocols are written with you. The plan should be reviewed regularly and whenever something changes.

What a good service looks like

• Consistent teams. A small team that knows the person well, rather than a stream of new faces.
• Clinical oversight. A named clinical lead for each person, and a clinician available to carers at any time.
• Spotting deterioration early. Carers trained to notice when someone is becoming unwell and to escalate quickly.
• Working with your NHS team. Complex care sits alongside community nurses, specialist teams, GPs and therapists. It doesn't replace them.
• Honesty. A good provider will tell you if they can't safely meet a need, and help you find someone who can.

Eviqa Complex Care

Eviqa Complex Care is paramedic-led care at home for adults and children aged 3 and over, opening in April 2027. Every carer is trained and signed off for the person before they work alone, and a clinician is on call to our teams around the clock. If you'd like to talk through what care might look like for your family, get in touch.

Sources

• NHS: NHS continuing healthcare (opens in a new tab)
• NHS England: NHS continuing healthcare (opens in a new tab)

Eviqa Complex Care