How to start a domiciliary care agency in the UK (2026)

Who this guide is for

This is for anyone planning to start a home care agency in the UK, and especially for the experienced carer going from employed to running their own service. You know the care; this guide is about everything wrapped around it — the business, the regulator, the paperwork that has to be real, the people you will employ, and the money. It is written for England, where the regulator is CQC. Wales, Scotland and Northern Ireland have their own regulators (Care Inspectorate Wales, the Care Inspectorate, and RQIA), so if you are there, treat the principles here as transferable and the specifics as England-shaped.

The journey, stage by stage

Here is the whole path at a glance, then each stage in detail. The stages overlap in practice — you will prepare policies and recruit while your CQC application is being assessed — but the order below is the sensible spine.

1. 1Set up the business
2. 2Register with CQC
3. 3Policies
4. 4Insurance
5. 5Recruit + DBS
6. 6Systems
7. 7First clients
8. 8Money basics
9. 9Why agencies fail

1. 1

   Choose a business structure and register the company

   Most domiciliary agencies operate as a limited company. It separates your personal finances from the business, and it reads as more credible to the local authorities and banks you will deal with than a sole trader. You can be a sole trader or a partnership instead, but weigh that against the personal liability you would carry in a sector where things can go wrong.

   Registering a limited company with Companies House is the quick part: it is done online, usually within about a day, for a small fixed fee. The slower, more important work is everything that sits around it — registering as an employer with HMRC for PAYE, opening a business bank account, lining up an accountant who understands care, and registering for the data protection fee with the ICO because you will be handling sensitive personal information from day one.

   Care delivered by a CQC-registered provider is generally exempt from VAT under the welfare exemption, but the detail depends on your set-up, so confirm your position with an accountant rather than assuming it.

   Do not skip the ICO step. Handling people’s care information makes you a data controller, so you must pay the data protection fee and meet UK GDPR duties. See the domiciliary care glossary entry for how the regulated activity is defined.

2. 2

   Register with CQC — and appoint a registered manager

   This is the gate everything else funnels through. In England, providing personal care in someone’s home is a regulated activity, and it is a criminal offence to deliver it before you are registered with the Care Quality Commission. You cannot take your first client until the registration is granted, so this stage sets your real start date.

   At the centre of the application is your registered manager: the person CQC holds legally responsible for the quality and safety of care. They have to be a fit and proper person under Regulation 19, and CQC will usually expect significant care experience plus the Level 5 Diploma in Leadership and Management for Adult Care. If you are a carer starting your own agency and you intend to be the registered manager yourself, your own experience and qualification become part of what is being assessed. An organisation also names a nominated individual who is responsible for supervising how the regulated activity is managed.

   The application itself is detailed: a Statement of Purpose describing exactly what you do and where, your registered manager application and evidence, your policies, DBS checks, references and evidence that the business is financially viable. CQC reviews applications in the order they arrive, usually arranges a fit-person interview, and the whole process commonly takes several months. There is no fee to submit the application; once you are registered you pay an annual fee that scales with how many people you support.

   Already running, and want to know what inspectors look for once you are live? Our CQC-defensible care plan guide and the free CQC Readiness Self-Check both help.

   A full step-by-step walkthrough of the application is its own guide:A step-by-step guide to CQC registrationGuide coming soon

3. 3

   Put the policies and procedures in place

   CQC expects a coherent set of policies that staff actually follow, not a folder bought to tick a box. The core set for a home care agency covers safeguarding adults, medication and MAR, infection prevention and control, health and safety, lone working, moving and handling, mental capacity and consent, data protection, complaints, whistleblowing, safe recruitment, equality and diversity, business continuity, and your duty of candour. Your Statement of Purpose sits on top of all of it.

   The trap is treating policies as paperwork. The agencies that pass are the ones where the policy and the daily practice match — where a carer can tell an inspector, in their own words, what they would do if they suspected abuse or found a medication error. Write or adapt the policies, then train people on them and keep evidence that you did.

   A ready-to-adapt policy starter pack is on our list:Care policies pack for new agenciesGuide coming soon

4. 4

   Get the right insurance

   Three covers matter from the start. Employer’s liability insurance is a legal requirement the moment you employ anyone — the law sets a minimum of £5 million of cover, and operating without it can be fined heavily per day. Public liability covers harm to clients and the public, and professional indemnity (often sold as part of a care-specific combined policy, sometimes including treatment or medical malpractice cover) protects you if your service is alleged to have caused harm.

   Premiums vary widely with your size, the cover level and your history, so get two or three quotes from insurers who understand domiciliary care rather than buying a generic small-business policy.

5. 5

   Recruit and DBS-check your first carers

   Your service is only ever as good as the people delivering it, and recruitment is the constraint most new agencies underestimate. Safe recruitment is also a regulated expectation: right-to-work checks, an enhanced DBS check with the adults’ barred list for anyone delivering personal care, full employment history with references, and a proper induction.

   Build training in from day one. New care workers should complete the Care Certificate-aligned induction, plus the mandatory training your policies require, before they work unsupervised. None of this is optional polish — it is the evidence that the people in your clients’ homes are safe and competent, and it is one of the first things an inspector triangulates.

   A practical walkthrough of safe recruitment is coming:Hiring your first carerGuide coming soon

6. 6

   Choose your systems and care management software

   You can start on a spreadsheet, but you will not stay there for long. As soon as you have a handful of carers and clients you need rostering, electronic care plans, an electronic MAR, visit and call monitoring, notes that families and inspectors can follow, and invoicing. Doing all of that on paper is where records drift out of step with reality, which is exactly the gap CQC looks for.

   Care platforms differ a lot in how they price and what they are built around, so it pays to compare before you commit. The point of a system is not the features list — it is whether your care plans, daily notes and compliance records stay matched to each other without heroic admin.

   Compare the main UK options honestly, including pricing models and what each is built around:

   • All comparisons
   • VircareOS vs Birdie
   • VircareOS vs CarePlanner
   • VircareOS vs OnCare
7. 7

   Get your first clients: local authority contracts vs private

   There are two main ways to fill your rota, and most agencies end up with a mix. Local authority work means getting onto a council’s approved-provider framework or winning spot contracts. It brings volume and a degree of stability, but the rates are set by the council, payment usually arrives in arrears, and frameworks only open periodically — so it can be slow to get on and demanding once you are.

   Private, self-funded clients (and NHS Continuing Healthcare packages) typically pay more and give you more control over how you work, but you have to find them, and trust is built slowly through reputation, referrals from district nurses and discharge teams, and word of mouth. A realistic plan secures at least some demand before you launch, rather than registering first and hoping the phone rings.

8. 8

   Pricing and the money basics

   Price from your true cost, not from what a competitor charges. Your real cost per hour of care is far more than the carer’s hourly pay: add employer’s National Insurance, pension, holiday pay, training, travel time between visits, mileage, and your office overheads. Getting this wrong is one of the quickest ways to fail — and underpaying for travel time can breach National Minimum Wage law even when the headline rate looks fine.

   Cashflow is the other half. You pay carers weekly or monthly, but local authority income often lands weeks later, so you need a working-capital buffer to bridge the gap. Many agencies that fold in year one were profitable on paper and simply ran out of cash. Budget for it deliberately.

   Work out your real cost per contact hour, including on-costs and the travel-time risk check, with our free True Cost of Care Calculator. Nothing is stored or sent anywhere.

9. 9

   The common reasons new agencies fail inspection — or fold in year one

   Most early failures are variations on a few themes, and all of them are avoidable if you design around them. On the regulatory side: a registered manager who is absent or stretched too thin; policies that exist on paper but are not lived; records that contradict each other, so the care plan says one thing and the daily notes show another; and weak safeguarding or medication practice. On the business side: underpricing (especially on travel time), thin demand secured too late, recruitment and retention that cannot keep pace, and the big one — running out of working capital before the contracts pay.

   The thread running through all of it is the gap between what you intend and what your records and your people can actually show. Close that gap early and most of the rest follows.