Delivering appropriate care to patients within the community setting is complex, particularly for those who are at very high risk of a pressure ulcer (PU). The most frequent challenges include an inability to provide the same frequency of care as in a hospital setting, and the non-adherence of patients with the equipment, both resulting in poor outcomes. In this case study, Ms X has a complex medical history and was being managed on an alternating pressure air mattress because of her very high risk status and existing category 2 PU. Plans were being made to discharge Ms X, during which time her complex needs were discussed, including discomfort, pain, lack of sleep, poor appetite and concern of further skin deterioration. As there was no existing Trust equipment stock that was felt would provide a suitable support surface, the Carital Optima (Direct Healthcare Group, UK) was proposed as a suitable solution. The change to this surface improved Ms X’s comfort and sleep, while healing her category 2 PU. This improved Ms X’s quality of life, which was delivered through the provision of a specialised system that was well suited to her highly complex needs.