How to start a care agency in the UK?

care agency

How to start a care agency in UK?

Reading this article, you will find out about:

  • what do you need to start an agency
  • things you have to consider
  • policies and procedures
  • structure of your business
  • tips on how to be successful
  • our Starter Pack

What experience or qualification do I need?

To start a care agency in the UK I recommend that you have experience in the healthcare industry.

This can be the owner, CQC registered person (if you decide to register with CQC) or one of the business partners (if the agency has more than one owner).

You can be a care assistant, a nurse, you can have admin experience in a care setting or have the relevant qualification, a QCF Level 5 Diploma in Leadership for Health and Social Care.

Apart from the care side you will need to have basic understanding on:

-how a business runs


-HR and UK employment legislation

The above are our recommendations only. If you have the experience or qualifications mentioned above it will make things a lot easier for you. Read the full article to understand why.

Do I need to register the agency with CQC?

CQC has 14 regulated activities. For a more detailed explanation of who is covered by the registration system and a description of each regulated activity, you should refer to the Scope of Registration document.

The scope of registration form link  (a very in dept form that explains who needs to register)

How to register with CQC?

You can access bellow the CQC guidelines on how to register.

I will direct you to two very useful CQC forms:

  1. New provider application
  2. What is registration? An in-depth guideline

What other things do I need to consider?

A care agency can be very rewarding if done properly but also, no doubt, very challenging.

Cash flow

You definitely need to consider cashflow. How will you manage your money? Your income?

How will you pay your employees?  Do you have all processes in place to manage that?

Consider that the care settings you will supply staff for might not pay you on weekly basis (weekly payments are ideal for you). Care settings have policies in place regarding payment of contractors. Some pay weekly and some have a 30 days or 60 days payment policy. You need to be very clear on these terms when you sign the agreement with the care setting (as an agency you must have your own agreement form with terms and conditions which you will present to be signed).

Basically, it means you need to have quite a substantial amount of money when you start a care agency, to be on the safe side.  The staff must be paid and it is usually on weekly basis!


Can you provide training for the staff? There will be instances when you might be required to provide training for you staff and you will also need to evidence that. This is usually part of the reflective practice after a complaint, error or concern.

DBS checks

Part of your duties will be DBS checks. These days most of the care providers require a clear DBS from the staff that work in their care setting. Most of agency staff have a live DBS which means the waiting time is shorter.


The way you interview will affect the future of your agency. If you recruit and retain good staff your business has more chances to be a successful one. If you start to compromise on the quality of your staff then the image of your agency will suffer. It will be very difficult for you to find contracts as care settings will refuse to work with you. Care settings have to pay a lot of money when working with a staff agency so they expect good service in return. When recruiting you need to be sure the person is qualified for the job. Ask for evidence of their qualification if necessary, ask for references from previous jobs.

I advise that you have formal interviews with candidates. Document everything discussed during the interview, especially the terms agreed. Keep the interview notes archived, including the ones you have declined! On many occasions applicants claimed that they have been discriminated during the interview (for various reasons). You need to be able to clearly evidence that you declined a staff member due to the lack of skills and knowledge.

If you interview nurses for a Registered Nurse position I advise that the person that interviews the nurse has solid knowledge about NMC guidelines.

Time sheets

You will have to provide time sheets for your staff. They need to be signed by the person in charge of the shift or manager of the care setting where you deployed the staff. Without them you will not be paid.

Policies and procedures

Something we strongly advise care agencies to have.

See our Policies and Procedures.

How would you deal with complaints? Because I can assure you that they will come, no matter how good you are. We are humans and we do mistakes. In the healthcare industry we are hold accountable for those mistakes. As a manager of the agency you will need to have clear processes on how you deal with complaints.

How do you address concerns with your staff? Do you have a “Concerns meeting form” in place?  Do you have written evidence that you addressed the concerns raised by people you supply staff for? In some instances, you will be required to provide that evidence. Example of complaints: medication errors, uniform policy, long nails, make-up, hair not tied up, jewellery, punctuality, professionalism/care ethic etc.

We covered a few things you need to consider to have in place to run a care agency. Now we will move on to talk about the structure of your business.

Franchise, sole trader, limited company (Ltd) or business partnership?

You have a variety of options on how to structure your new care agency. Which is good. Bellow you will find some information about what franchise, sole trader or limited companies, but you will have to decide which one is more suitable for you.  In most cases depends on the initial budget.

What is a franchise?

Franchising is a method of expanding a business. Some well-established care agencies can offer you a license which allows you to use their brand, resources and systems. Less hassle for you as they offer you a boost starting up the agency. They offer advice, branding materials, marketing support (you can advertise your agency for free on our website), payroll systems etc. You can get contracts more easily if you are part of a well-known, national care agency. The downside is that you have to operate following their rules and you have to pay them a percentage of your earnings.

Sole trader

Or also known as self-employed. In this case all money is yours after you paid the taxes. You are your own boss. Check this link for more details about how to register as a sole trader.

Limited Company

In this case you will need an accountant. All money is yours after you paid the taxes. You are the director of the company.

Click the link bellow to find out more about how to setup a limited company:

Business partnership

The earnings are split between the partners. Click the link bellow to find our more about business partnership

Choose wisely as the future of your business depends on the initial decisions. Try not to take risks. Grow your business slowly by taking small steps at the time. For example, do not rent a big office unless you are sure you have the money to cover the expenses.

Public liability insurance

It is something you MUST purchase. There are a lot of insurance companies out there that offer this type of service for you. Just type in Google “public liability insurance for care agencies”. Find out what it is and how much it costs. This will protect your wallet in case of any accidents or complaints. You must know very well that accidents happen in the care industry and sometimes they are very serious. 


After you started the business and you deploy staff in care settings it is good practice to ask for feedback from your business partners (care settings). Take everything on board and think on how you can improve. Demonstrate you improved by go back to the care settings and talk about what changes you implemented to improve your service. You don’t have to visit or call, they are busy as well. The best thing to do is to send a short email.

Do spot-checks. The care settings will appreciate that, it shows that you are interested to provide a good service. Look at the uniform policy, attitude and get feedback on punctuality and professionalism. Follow up with any negative feedback.

Leadership skills

A very important factor in today’s healthcare business environment.

The options for the staff are unlimited. They can choose to move when they want and where they want. It is up to each manager what tactics and management style uses to recruit and retain the staff. A skill that businesses must have, learn or develop.

Fees and pay rate

From my experience care settings choose wisely when it’s about staff agency. They have to, otherwise the impact on their business will be huge. First, they don’t want to pay a lot of money and second, they want skilled agency workers.  So, they must find that balance: best quality for less money. As there are quite a few agencies out there, care settings can pick and choose.

Care settings consider your fees but also the calibre of your staff. Even if they use agency staff the quality of care must be kept high or their reputation is going down.

Choose the rates you charge wisely. Consider the quality of the service you can offer. Sometimes the care settings prefer to pay more in return of a good service.

For the staff money are very important but so is the security of a job. It means that the staff will settle for the average pay rate if you offer them shifts constantly.  It doesn’t help them if they register with an agency that pays the maximum hourly rate but has no contracts and can’t offer shifts constantly.

We offer a starter pack for those interested to start a Nursing/Recruitment or Domiciliary Care Agency. The pack includes everything you need to run your business, even from home.

Click here or tap on the image to see our Starter Pack.

I hope this article helps. As I said, having a care agency is challenging but very rewarding in the same time.

Please comment bellow if you want me to add anything else. You can also contact me using the Contact form on our website.

Whatever you do, do not compromise on the standards of care! Always put the safety of the vulnerable people first! Thank you.

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