Background: People requiring palliative care should have their needs met by services acting in accordance with their wishes. A hospice in the south of England provides such care via a 24/7 hospice at home service. This study aimed to establish how a nurse-led night service supported patients and family carers to remain at home and avoid hospital admissions. Methods: Semi-structured interviews were carried out with family carers (n=38) and hospice-at-home staff (n=9). Through night-time phone calls and visits, family carers felt supported by specialist hospice staff whereby only appropriate hospital admission was facilitated. Results: Staff provided mediation between family carer and other services enabling more integrated care and support to remain at home. Conclusions: A hospice-at-home night service can prevent unnecessary hospital admissions and meet patient wishes through specialist care at home.