Complex Care Nurse (Community)
Location: Community-based across with travel to clients’ homes
Reports to: Registered Manager
Role purpose
Provide specialist nursing in clients’ homes for adults and/or children with complex, long-term conditions. Lead on assessment, care planning, delivery, and review; train and supervise support staff; ensure safe, person-centred care in line with NMC standards and CQC regulations.
About the service
We support clients with high-acuity needs (e.g., tracheostomy, invasive/non-invasive ventilation, enteral feeding, seizure management, spinal injury, progressive neurological disease, complex safeguarding). Care is delivered 1:1 or within small packages, often as part of a 24/7 rota.
Key responsibilities
Clinical care
* Complete holistic assessments, risk assessments, and person-centred care plans (including ventilation/trach, PEG/PEJ/NG, bowel/bladder, skin integrity, catheter/ stoma care, suctioning, oxygen therapy, IV/SC therapies within scope).
* Deliver and evaluate evidence-based interventions; recognise and respond to deterioration (e.g., NEWS2/PEWS) and escalate per SOPs.
* Safely administer and manage medicines (including enteral and inhaled routes; IV/SC if competent and authorised).
Leadership, training & supervision
* Competency-assess and supervise Support Workers; provide bedside coaching and annual refreshers for tasks such as tracheostomy care, suction, ventilation checks, enteral feeding, seizure rescue protocols.
* Lead shifts; coordinate multidisciplinary input; act as clinical point of contact for families.
Care coordination
* Liaise with GPs, community teams, hospices, acute trusts, and AHPs. Attend/lead MDT reviews; contribute to EHCP/CHC reviews where applicable.
* Plan safe hospital discharges and step-ups/step-downs in care.
Quality & governance
* Document care contemporaneously in EHR; maintain auditable records (MARs, fluid/nutrition charts, ventilation logs).
* Report incidents/near misses (e.g., Datix), conduct investigations and implement learning.
* Uphold Duty of Candour, infection prevention & control, and safeguarding standards.
Safeguarding & legal
* Apply the Mental Capacity Act (incl. best-interest decisions), Deprivation of Liberty Safeguards/LPS, and children’s safeguarding procedures.
* Maintain robust lone-working and home-environment risk controls.
Essential criteria
* Registered Nurse (Adult / Child / LD) with current NMC registration.
* Post-registration experience delivering complex care in the community or acute setting.
* Verified competencies in at least two of: tracheostomy care, invasive/non-invasive ventilation, enteral feeding (PEG/NG), seizure management and PRN rescue meds, central/peripheral line care and IV/SC therapies, complex moving & handling.
* Confident in clinical assessment, escalation, and emergency response (BLS/ILS/PILS as appropriate).
* Strong teaching/supervision skills; able to sign off staff competencies.
* UK driving licence and ability to travel across [patch] (or clear statement if not required).
Desirable criteria
* Previous package leadership or case management experience; CHC/Personal Health Budget exposure.
* Paediatric high-dependency or ICU/HDU background (for children’s packages).
* Tissue viability, respiratory, neuro, or palliative care experience.
* Non-medical prescribing (V300) or PGD/PSD experience within scope.
* Quality improvement/audit experience.
Compliance requirements
* Enhanced DBS (child/adult barred list as applicable) and right to work in the UK.
* Occupational health clearance; up-to-date immunisations (per UKHSA guidance).
* Mandatory training: Life support (ILS/PILS), Safeguarding Adults L2–3 & Children L2–3, Infection Prevention & Control, Medicines Management, Information Governance, Moving & Handling, MCA/DoLS/LPS, Lone Working.
* Evidence of continuing professional development and annual NMC revalidation.
Working pattern & environment
* Rotas may include days/nights/weekends; lone working in clients’ homes; occasional shadowing/overlap shifts for training and reviews.
* Use of mobile EHR/apps and remote supervision tools.
Key performance indicators
* Care plan and risk assessment completeness and review cadence.
* Incident rates and time-to-escalation; learning actions closed on time.
* Staff competency sign-offs and refresher compliance.
* Client outcomes: ventilation hours stability, unplanned admissions, pressure-area prevalence, nutrition/hydration goals.
* Family satisfaction and MDT feedback.
Equipment & clinical skills (as applicable)
* Tracheostomy tubes and suction; humidification; ventilators (set-up, troubleshooting, daily checks); sats/ETCO₂ monitoring; oxygen delivery.
* Enteral feeding pumps/sets; catheter/stoma supplies; syringe drivers (within scope and training).
* Emergency grab-bag use; anaphylaxis/seizure rescue protocols.
Professional behaviours
* Uphold NMC Code; model compassionate, culturally competent practice.
* Maintain boundaries and confidentiality within clients’ homes.
* Contribute to service audits, policy reviews, and CQC readiness.