A care home may have a vacancy but still be unable to support a resident receiving parenteral nutrition. The admission decision depends on the venous-access plan, trained staff, delivery and refrigeration, pump and filter supplies, infection-control procedures, clinical oversight and the exact fees. Each point should be confirmed for the named resident before a deposit or discharge date is agreed.
On 2 September 2026, the Medicines and Healthcare products Regulatory Agency issued safety information for all care settings. It advises that every parenteral nutrition solution should be administered through a filter with a pore size no larger than 1.2 micrometres; for aqueous or lipid-free solutions, a 0.2 micrometre filter is good practice where available. That current requirement creates a specific procurement and competency check, not merely a general promise that the home can manage a drip.
Confirm that the treatment is genuinely parenteral
Ask the clinical team to state the nutrition route, formulation, volume, schedule and vascular access. Parenteral nutrition delivers nutrients into the bloodstream and is different from enteral feeding through a tube into the digestive system. The equipment, infection risks and responsible specialist team are not interchangeable.
Provide the care home with the latest prescription, administration protocol, line details, allergies, monitoring schedule and supplier contacts. Avoid shorthand such as “TPN overnight” when the provider needs precise information to assess staffing and storage.
Apply the September 2026 filter requirement
The MHRA advises a filter no larger than 1.2 micrometres for all parenteral nutrition solutions. Ask the specialist team to identify the correct filter and whether it is integrated into the administration set or added separately. The MHRA prefers integrated filters, while recognising suitable add-on filters when infection-control guidance is followed.
Request written confirmation that the home can obtain the specified set for every container. Check compatibility with the pump, tubing and formulation. A stock photograph or verbal statement that “filters are available” does not confirm the correct pore size or connection.
Price the filter and administration set supply
The MHRA says filters and administration sets should be changed with each new parenteral nutrition container, taking account of shelf life, local infection-control policy and filter shelf life. Calculate the required number per week from the actual schedule and add a contingency stock.
Ask who orders and pays for solutions, giving sets, filters, dressings, caps and flushes. Separate NHS-funded supplies, provider stock and privately purchased items. If the home proposes a supplement, require unit price, frequency, review point and authorisation process before purchase.
Verify trained staffing for every administration
Identify who connects, disconnects and monitors the infusion, and whether those staff are present on every relevant shift. Parenteral nutrition may run overnight, when fewer workers are available. Ask how the provider covers sickness, agency shifts and an unplanned late delivery.
The assessment should specify which tasks require a registered professional and which, if any, can be performed by a trained resident or carer under the clinical plan. Do not let an admission depend on a family member attending every evening unless that arrangement is genuinely voluntary, safe and written into the plan.
Inspect line-care and infection-control processes
Ask how staff prepare the area, perform hand hygiene, protect connections, change dressings and recognise line infection or occlusion. The home should know whom to call for fever, redness, leakage, pump alarms or a damaged line. Obtain the specialist team’s escalation numbers and out-of-hours route.
Confirm whether blood cultures, urgent review or hospital transfer can be arranged when required. The home is not expected to replace the intestinal-failure or nutrition team, but it must be able to follow the agreed pathway and escalate safely.
Check delivery, refrigeration and stock rotation
Map the journey from compounding or dispensing unit to the resident. Record delivery days, temperature requirements, refrigerator capacity, temperature monitoring, expiry dates and what happens after a missed delivery. Bespoke bags may not be replaceable from an ordinary community pharmacy.
Inspect whether the refrigerator has enough dedicated space and an alarm or contingency for power failure. Ask who checks every bag on arrival and how damaged, warm or incorrectly labelled supplies are quarantined. A room can be ready while the supply chain is not.
Confirm pump, stand and backup arrangements
List pump model, giving set, charger, battery, stand and carrying equipment. Ask whether the home already uses the model and who trains staff. Manufacturer instructions and the clinical protocol should be available at the point of use.
Find out what happens if the pump fails overnight. Is a replacement held locally, delivered by the supplier or obtained through the specialist team? Record response times and the clinical action while waiting. Do not treat a helpline number as a guaranteed replacement time.
Build the complete weekly fee
Request an itemised quote covering the room, assessed care band, registered-nurse time, overnight checks, storage, additional equipment, consumables, delivery handling, specialist transport and any escort. Separate recurring charges from one-off setup costs and refundable deposits.
Model the current schedule and a scenario with more frequent bags or monitoring. Ask what triggers a fee review, who performs the reassessment and how much notice the provider gives. A phrase such as “complex-care supplement” is not adequate unless the included tasks and calculation are stated.
Coordinate monitoring and specialist appointments
List required weight checks, fluid records, blood tests, line reviews and dietetic or medical appointments. Ask who books them, sends results and responds to changes in the prescription. If the resident must travel, include suitable transport and escort in the quote.
Clarify whether the specialist team can visit or support staff remotely. A home may manage routine administration but depend on hospital attendance for line complications. That can still be a viable placement if responsibilities and timing are explicit.
Set an admission sequence that can be verified
Agree the order: resident-specific assessment, specialist approval, staff competency check, supply account, equipment delivery, refrigerator check, care-plan sign-off and final confirmation of the bed. Do not book transport until the home confirms that the first bags, correct filters and trained staff are ready.
Send a handover containing prescriptions, recent results, line history, pump settings controlled by the clinical team, emergency plan and next delivery. Record who receives and checks the stock. Urgency does not remove the need for a safe first administration.
Compare care homes on one evidence sheet
For each candidate record: accepted access type, correct filter, supplier, delivery schedule, refrigerator, staff by shift, line-care competency, backup pump, monitoring, specialist link, emergency route, weekly fee, supplements and earliest safe admission date. Mark each answer confirmed, conditional or unavailable.
Ask the registered manager or clinical lead and the finance team to respond together. A marketer may know that the home has previously accepted parenteral nutrition, but not whether the new filter requirement, current rota and proposed price have been checked.
Disclose commissions and conflicts
A placement adviser, pharmacy, equipment supplier or transport provider may receive a referral payment or preferred-supplier benefit. Ask who pays, whether compensation depends on the chosen home and whether nonpaying alternatives were assessed. A commercial relationship may simplify delivery but cannot guarantee clinical suitability.
Verify treatment requirements with the specialist team and funding with the relevant NHS body or commissioner. An intermediary cannot authorise treatment, create funding or guarantee admission.
How Curalune can support the choice
Curalune can select care-home options using clinical capability, filter and supply arrangements, staffing, timing and contract criteria. Its fuller contact service can ask shortlisted homes about current availability, resident-specific assessment, correct consumables, delivery, refrigeration, staff competence, itemised fees and admission documents, then organise the replies for comparison.
Curalune does not guarantee availability, clinical approval, funding, supply delivery or admission. The home, specialist team, suppliers and commissioners retain their own responsibilities and decisions.
Frequently asked questions
What filter does the MHRA now advise for parenteral nutrition?
The 2 September 2026 safety information advises a filter no larger than 1.2 micrometres for all solutions, with 0.2 micrometres good practice for aqueous or lipid-free solutions where available.
Is parenteral nutrition the same as tube feeding?
No. Parenteral nutrition enters the bloodstream through venous access; enteral nutrition uses the digestive tract. Admission capability for one does not prove capability for the other.
Are filters and extra nursing always included in the weekly fee?
Not necessarily. Funding and contracts vary. Require an itemised quote showing supplies, staff time, equipment and any supplements before signing.
Can Curalune guarantee that a home will accept the resident?
No. Curalune can identify and compare options, but it cannot guarantee availability, clinical suitability, funding, supplies or admission.
