Treatment of disease, disorder or injury (TDDI)

Regulated Activity: Treatment of Disease, Disorder or Injury (TDDI)

Top Carers Nursing Agency is registered with the Care Quality Commission (CQC) to carry out the regulated activity Treatment of Disease, Disorder or Injury, in accordance with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Registration for this regulated activity is uncommon among home care providers. Top Carers Nursing Agency holds TDDI registration because the delivery of our service is governed by formal clinical leadership arrangements, with direct involvement from registered healthcare professionals. Our care delivery model incorporates registered nurses who provide clinical oversight, supervision, and lawful delegation of nursing tasks, enabling the safe provision of care to individuals with complex clinical needs in their own homes.

The provision of nursing and complex clinical interventions requires authorisation and oversight by a healthcare professional acting within their professional scope of practice. This clinical governance structure forms the foundation of our TDDI service and differentiates Top Carers Nursing Agency from non-clinical domiciliary care providers.

Nature and extent of the TDDI service

The TDDI service delivered by Top Carers Nursing Agency involves nurse-led clinical supervision for individuals requiring treatment, monitoring, or ongoing management of a disease, disorder, or injury.

Individuals with long-term, progressive, complex, or life-limiting conditions may require a coordinated and clinically managed approach to care. Our TDDI service is delivered through individualised care plans, developed, reviewed, and overseen by registered nurses and implemented by appropriately trained care staff. This service includes the following areas of support:

Management of long-term and complex conditions
We provide ongoing, structured home-based care for individuals living with complex, progressive, or terminal conditions. Clinical oversight ensures continuity of care, effective risk management, and timely response to changes in clinical need.

Support for physical and mental health conditions
Care is tailored to the individual’s diagnosed physical or mental health condition. Care plans are designed to ensure consistent support, reduce isolation, and promote safety and wellbeing within the home environment.

Supervision by a registered healthcare professional
All care delivered under the TDDI regulated activity is subject to direct oversight by a registered and experienced healthcare professional, who remains responsible for monitoring clinical outcomes, reviewing care delivery, and ensuring ongoing clinical appropriateness.

Palliative care provision
Our palliative care approach focuses on symptom control, comfort, and dignity, supporting individuals to manage pain and other symptoms while maintaining independence and quality of life wherever possible.

Professional accountability and protected titles

Professional healthcare titles are protected in law.
Where a professional title is used, it indicates that the individual is practising as a registered healthcare professional, applying their professional knowledge, skills, and qualifications in the delivery of care.

For professions specified within the regulations, registration with the CQC for the relevant regulated activity is ordinarily required in order to lawfully provide those services.

Clinical interventions delivered under nurse governance

Under the leadership of registered clinical professionals, Top Carers Nursing Agency oversees and supports the delivery of the following clinical and nursing-related interventions:

Catheter and stoma care
Support with the hygiene, maintenance, and monitoring of urinary catheters and stomas, including continence support.

Oxygen therapy support
Assistance with prescribed supplementary oxygen therapy within the individual’s home, in line with clinical guidance.

Pressure area care
Interventions aimed at reducing discomfort, maintaining skin integrity, and preventing pressure-related skin damage.

Administration of eye and ear medications
Support with the safe administration of prescribed eye drops and ear drops.

Inhaler and nebuliser assistance
Support from carers trained under nurse supervision to assist with the use of inhalers and nebulisers.

Compression hosiery support
Assistance with applying, removing, cleaning, and ensuring the comfort and correct use of compression stockings.

Complex clinical conditions supported

The following list is indicative and not exhaustive. Individuals or commissioners are encouraged to contact Top Carers Nursing Agency to discuss specific requirements and confirm suitability for home-based complex care support.

  • Anaphylaxis
  • Assisted cough
  • Autonomic dysreflexia
  • Bladder maintenance
  • Bowel care
  • Epilepsy support
  • Catheter and stoma care
  • All types of percutaneous endoscopic gastrostomy (PEG)