How to start a care agency in the UK?

How to start a care agency in the UK?

Reading this article, you will find out about:

First, let’s clarify what a “care agency” is. We noticed that this is a broad term that people use for either a Nursing Agency or a Domiciliary Care Service. We will cover both. People also refer to Nursing Agencies as: Healthcare Recruitment Agency, Care Staff Agencies, Temporary Staffing Agency etc but their business aim is the same: to supply staff to care homes and hospitals, or other care providers. Domiciliary Care Agencies are also known as Homecare Agencies.

This article is full of resources so please read till the end. It will give you a good understanding on how to start a Nursing Agency or a Domiciliary Care company. Once you finished reading this blog, and you want more questions answered we wrote a more in-depth blog for each of the business models. You can find them here:

How to start a Nursing Agency in the UK

How to Start a Domiciliary Care business in the UK

What experience or qualification do I need?

To start a Nursing Agency (supplying temporary staff to care homes) you don’t need to have a specific qualification or experience in this sector. You can learn as you go along, have a business partner or a business consultant that can give you advice.  However, having experience in the healthcare industry gives you a huge advantage. You don’t need to register with the CQC for a Nursing Agency.

If you want to start a Domiciliary Care or Homecare Service (depending on what you want to call it) it is mandatory to have experience in care and suitable management qualifications to be able to start this type of business. This is because you will be solely responsible for the care provided and the welfare of your clients. You need to register your business with the CQC (Care Quality Commission). This can be the owner, or the owner can employ/appoint a qualified person (a Registered Nurse or a Social Worker with an NVQ Level 5 Qualification). 

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

– how to run a business

– marketing

– recruitment 

– using technology (this is quite important as everything has shifted towards technology these days)

– payroll

– 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.

How to register with CQC?

cqc-logo

Nursing Agencies do not need to register with CQC, only Domiciliary Care Providers. You can access below the CQC guidelines on how to register.

I will direct you to two useful CQC forms:

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

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)

What other things do I need to consider?

A care agency (Nursing Agency or a Domiciliary Care Service) can be extremely rewarding if done properly but also, no doubt, incredibly challenging.

Cash flow

You need to consider cash flow. How will you manage your money? Your income?

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

Consider that the care settings you will supply staff for might not pay you on a 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 truly 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.

If we are talking about Domiciliary Care, in this case you will usually be paid monthly. Look for private clients, if possible.

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 a weekly basis!

Training

Nursing Agency

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

Domiciliary Care

Running this type of business means that from a training point of view there are no if’s or but’s. All your staff must complete their mandatory training. And you need to evidence that during CQC inspections. 

You can use ACSTRA Training to offer all the online mandatory training your staff needs.

DBS checks

Part of your duties will be DBS checks. This is a legal requirement for all staff. You can use companies like uCheck  to check the DBS of new or existing employeess. Existing employees must renew their DBS every 3 years.

Interviews

interview care staff

The way you interview your staff will affect the future of your agency. If you recruit, and retain competent staff, your business has more chances of being a successful one. If you start to compromise on the quality of your staff, then the image of your care agency will suffer. It will be difficult for you to find contracts as care settings will refuse to work with you. Care settings must pay a lot of money when working with a Nursing 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. If they don’t have experience, it’s fine, but make sure you offer all the training they need.

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 against during the interview (for several reasons). You need to be able to clearly show 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.

Documents

This is a list with some of the most common documents you will need to start a Nursing Agency or a Domiciliary Care Agency:

– Business plan

– Policies and Procedures (buy here)

– Job Application form

– Contract with the staff

– Staff Handbook

– Contract with the clients

– Interview questionnaire

– Price list

– Reference request form

– Staff Profile

– Statement of purpose (Domiciliary Care) 

– Appraisal and supervision forms

– Time sheet

You will have to provide time sheets for your staff. Time sheets 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.

Domiciliary Care Providers can use QR code check-in and check-out systems for their staff when visiting a client in their own home.

Don’t forget that these are the ones that you will use the most but there are other documents that you will need. Don’t worry as they are included in the pack.

Policies and procedures

Something we strongly advise Nursing Agencies or a Domiciliary Care Service 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 make mistakes. In the healthcare industry we are held accountable for those mistakes. As a manager of the agency, you will need to have clear details 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 the 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, jewelry, punctuality, professionalism/care ethic etc.

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

Franchise, limited company (Ltd) or business partnership?

You have a variety of options on how to structure your new care agency. Which is good. Below you will find some information about franchises, business partnership, or limited companies, but you will have to decide which one is more suitable for you.  In most cases people go for a Company Limited by Shares (the classic LTD).

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 franchise. The downside is that you must operate following their rules, buy the franchise which is anything between £20k to £50k and you must pay them a percentage of your earnings.

Limited Company

The most popular option. All money is yours after you paid the taxes. You are the director of the company.

Click the link below to find out more about how to set up a limited company:

https://www.gov.uk/limited-company-formation

Business partnership

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

https://www.gov.uk/set-up-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. Alternatively you can contact us directly as we can recommend to you a few insurance companies our previous clients worked with. This will protect your wallet in case of any accidents/incidents, deaths, or serious complaints. You must know very well that accidents happen in the care industry and sometimes they are profoundly serious. What I suggest is that you purchase it once you have a contract. Otherwise, you will pay monthly fees even if your business is not making any money.

Feedback

After you start 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 about how you can improve. Demonstrate your improvement by going 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 in providing 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 particularly key 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

We can help you find out what to charge your clients. This is included in our Starter Pack. Essentially, we research what other agencies pay their staff in a specific area. You can find this out by looking on websites like Indeed. Once you know an average of how much other agencies offer to their staff, you add £7-£10 for nurses and £4-£7 to care assistants. This is a way of calculating your fees.

Care settings (care homes, private hospitals etc.) choose wisely when it’s about staff agency. They must, 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 choose.

Care settings consider your fees but also the caliber of your staff. Even if they use agency staff the quality of care must be kept high or their reputation will go 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 for a good service.

For the staff money is 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 in starting a Nursing/Recruitment Agency or a 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 rewarding at the same time.

Please comment below 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 vulnerable people first! Thank you.

If you are looking to start any other type of business, please visit Massive Startup

They offer comprehensive Business Starter Packs to help you start your business the right way and be ahead of your competition. 

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