Launching a new business can be daunting, even with extensive industry experience and knowledge of your market.
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When considering how to start a private home care business in the UK, there will be many factors to think about as you shape your company and its offering.

We have created the guide below to outline how to set up a domiciliary care agency and all this entails—from the research stages to the moment you welcome your first clients.

In this guide, we cover:

What is a domiciliary care agency?

Domiciliary care is an alternative to traditional residential care. The services provided by a home care business can include a range of medical and personal care to help people with their daily living, within the comfort of their own home. The type of care a domiciliary care business provides will depend on the type of staff it employs, such as carers, nurses and therapists—as well as their qualifications.

How to start a domiciliary care agency

When considering how to set up a domiciliary care company, it’s important to plan out the finer details of your business from the word go. The following steps can provide a useful structure.

Research and market analysis

Before fleshing out your business plan, explore your market.

  • Look at what your competitors are doing, where they are located, their pricing plans, etc.
  • Research the area you plan to serve and whether there is enough population density to support your business, taking into account socio-economic information and age demographics.
  • Familiarise yourself with the appropriate care legislation and regulations, including the Domiciliary Care Agencies Regulations 2002 and the requirements of the Care Quality Commission (CQC).

Choosing the services you will offer

Your research will help you decide on the types of services your business will provide. These may be medical or non-medical home care or a mixture of both:

  • Nursing and healthcare—changing dressings, administering medications
  • Personal care—washing and dressing, using the toilet, getting in and out of bed
  • Home help—day-to-day domestic tasks such as cleaning, preparing meals, washing up, laundry, gardening
  • Companionship
  • Additional tasks such as grocery shopping and collecting prescriptions.

How to find your clients

Decide how you want to secure business for your home care agency. Will you provide your services to self-funding clients? Or, will you enter local authority tenders to build your business? You might wish to do both. Again, your research can help you determine your choice.

Appointing a registered manager

Every home care agency must have a registered manager. This person manages the day-to-day running of the agency and oversees its activity, ensuring it complies with regulations. The registered manager could be the business owner if they intend to be in charge full-time, or a senior staff member recruited from the outset to manage the agency.

In England, the required qualifications for a registered manager are:

  • QCF Level 5 Diploma in Leadership for Health and Social Care (Management of Adult Services) or
  • Registered Manager’s Award (RMA) or
  • NVQ Level 4 in Leadership and Management for Care Services.

Start-up costs to consider

Calculating your upfront costs and your outgoings for your first year of trading can be vital to ensuring you get the business off to a good start. Consider the following:

  • Equipment costs
  • Recruitment costs
  • Marketing investment
  • Training requirements
  • Business rates
  • Annual CQC fees (there is no initial registration fee)
  • Specialist domiciliary care insurance, including public and employers’ liability, and professional indemnity.

Creating a business plan

Your business plan should cover every part of your journey, from competitor analysis to cash forecasts and operational costs. You can then use your business plan to apply for business funding. Your plan doesn’t have to be set in stone, but it does need to present realistic predictions of what you are hoping to achieve.

How to decide on your pricing

Your pricing will depend on a number of factors, including:

  • Whether the care is medical or non-medical, and the level of care required
  • Equipment you will need
  • How many carers are required per client at one time
  • Day-to-day operating costs
  • Whether a client is 100% self-funded or receiving a grant from their local authority, NHS or a charity
  • Your location, your closest competitors and their pricing
  • Your expected profit margins.

Creating a marketing strategy

Your marketing strategy will depend on who you are selling to but also how you want to position your brand. What is your unique selling proposition (USP)? This is what makes you stand out from the competition. It may be a certain service you offer, the level of expertise your team provides, the geographical area(s) you serve, or your pricing structure.

Once you are clear on your USP and messaging, consider how you will market your business.

  • If you haven’t already, decide on a name for your agency—something simple, unique and memorable that reflects your values.
  • Create your own website—use a simple website builder or enlist the services of a local marketing agency.
  • Use social media—set up social media accounts and keep a consistent flow of content to build your online presence.
  • Printed literature—post leaflets and flyers through doors, display them in newsagents’ windows, etc.
  • Word of mouth—spread the word to friends and family, local community groups and other businesses.

Outlining your policies and procedures

Your policies and procedures will act as internal guidelines to govern how you and your staff will provide your services. Various templates and toolkits are available online to help you create domiciliary care policies and procedures documentation that are written to reflect the CQC regulatory, legislative and good practice guidance.

Exploring financing options

Before making any financial commitments or purchases, you must set up a business bank account for your home care agency. Decide where your initial financing will come from, whether you will use your own money or take out a start-up loan or business loan.

Applying for a countersigned DBS check

Disclosure and Barring Service (DBS) checks are a legal requirement for domiciliary care agencies, and as an employer, you must keep on top of your DBS checks. If you are applying to be a registered partner, registered manager or individual provider, you must have an enhanced DBS check that is no more than 12 months old when you apply for CQC registration.

If you are not already a registered healthcare professional, you will need to apply for a CQC countersigned enhanced DBS check (CQC-CE-DBS), which authorises the CQC to carry out extra checks to confirm your identity as part of the DBS process.

Your CQC registration inspection

All domiciliary care providers must register with the industry regulator, the Care Quality Commission, before they start trading. To grant registration, the CQC must be satisfied that the business is fit to trade as per the requirements set out in the Health and Social Care Act 2008 and compliant with the requirements of the relevant regulations and enactments. Our guide to the CQC explains more, including the five key questions they use to structure their inspection.

You can register with the CQC as a new provider here. While you won’t need to pay an application fee, once registered you must pay an annual fee towards ongoing monitoring.

Registering your business with HMRC

Setting up your domiciliary care business as a sole trader means you must register for self-assessment with HMRC for your annual tax returns. If you’re registering as a partnership, each partner must register separately.

You may choose to set up a limited company rather than take the sole trader or partnership approach, in which case you must register your company with Companies House and can be registered for Corporation Tax simultaneously.

Start trading and building your business

Once your domiciliary care business is up and running, you can determine what is working well in terms of staffing, service provision, marketing and general operations, and where your business plan might need tweaking. As your business begins to grow, remember to make the most of the resources available to you, from government advice and support to industry-specific events such as roadshows and conferences for care managers.

The CQC will undertake regular inspections of your agency to ensure ongoing quality and compliance, and provide you with a rating, which you can use to help market your business and instil confidence in your clients.

If you are in the process of planning or starting our own domiciliary care business, we wish you the very best. If you would like specialist advice on your domiciliary care insurance and risk management requirements, please do not hesitate to get in touch with our team.

  • Gallagher Care Team

Disclaimer

The sole purpose of this guide is to provide guidance on the issues covered. This article is not intended to give legal advice, and, accordingly, it should not be relied upon. It should not be regarded as a comprehensive statement of the law and/or market practice in this area. We make no claims as to the completeness or accuracy of the information contained herein or in the links which were live at the date of publication. You should not act upon (or should refrain from acting upon) information in this publication without first seeking specific legal and/or specialist advice. Arthur J. Gallagher Insurance Brokers Limited accepts no liability for any inaccuracy, omission or mistake in this publication, nor will we be responsible for any loss which may be suffered as a result of any person relying on the information contained herein.

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