How to start a care services franchise

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It’s a well-known fact that the human race is getting older. With medical advances and better standards of living we’re all living longer than before and the implications are manifold. Not only will the Queen have to send out a few more telegrams but a nation of old people needs looking after. And this is where the nursing and care industry steps in.Franchises that provide such care are growing businesses and you don’t have to be Florence Nightingale to get involved. In fact most franchisees don’t have a medical background.

But even if you aren’t looking after patients yourself, this is still very much a ‘people’ business and you will be making a difference. So if you want to get in touch with your caring side, a nursery and domiciliary care franchise may be just the job.

What is it?

Our three featured franchisors, Carewatch, Everycare and Kare Plus all offer the same service: that of care providers. They place care workers, and in some cases nurses, with both private and public clients from individuals to hospitals, although Carewatch specialises in home care.

As Debbie Ashmore, franchise manager at Kare Plus explains, “Our franchisees can cover everything from providing healthcare assistants – which can include ward cleaners – to ward nurses to specialist nurses. If the market is there they can do anything.”

Standard work could literally be making breakfast or running errands for a house bound person or doing anything a terminally ill person needs doing day to day. Contracts might run for just a few days to fill in for someone off sick or for several months – perhaps to cover maternity leave.

Carers are generally recruited through local advertising or the job centre. Some franchisees send out fliers or even put cards in the windows of newsagents. But the main point is that the advertising as cheap as possible. Franchisees should aim to have upwards of 100 carers to run a realistic business and you will need to recruit constantly.

Also you will need people to run the office. Mary Cottrell founder of Everycare explains, “At the start, this will ideally be one qualified nurse manager, one admin support and another assistant.” You as the franchisee would tend to take on the marketing role.

But this isn’t marketing in the sense of selling. It will be your job to know what’s happening with social services, whose moving where and what all the current health issues in your area are. It’s also about letting people know what you do and finding out what they want out of your carers. This isn’t really about cold calling, though.

Andrea Moran is the Kare Plus franchisee in Luton. “I’ve worked as a nursing manager in care homes and you don’t want people turning up on your doorstep unannounced when you’re busy and probably stressed. I telephone people first, then follow up with a letter detailing rates and terms, then telephone again. I won’t go and meet them unless invited.”

Franchisees are strongly advised to get accreditation with the social services and relevant local authority. Barbara Garrett from Carewatch in Rugby says that 70% of their business comes from the local authority. Accreditation doesn’t mean you will definitely get work but equally, you can’t get it without.

Once you’ve placed carers is it a good idea to do spot visits to get client feedback on your service and to check everyone is happy with the arrangement. That way, both clients and carers will hopefully want to work with you again.


Opinions vary as to the most expensive running costs in care franchising. Some franchisees maintain their day to day administration is the most expensive in terms of advertising, telephone calls and so forth.

In any case, the office itself tends to be a reasonable cost since you don’t need a high street location. All you really need is somewhere with easy access and car parking that is near to your main clients.

It is staff and the training of staff that is likely to be your biggest expenditure – largely because it is an essential one. All carers must have first aid, moving and handling and – where applicable – food handling training.

Some of this can be done in house if you are properly trained. But it can prove expensive if done externally. Additionally, in accordance with the Care Standards Act all healthcare workers will have to train to NVQ level 2 by 2005. You will need to start putting this into place immediately and it will obviously cost you.

On the plus side, staff are more likely to be loyal if they feel they are getting something out of it and if you use it as an incentive, rather than offering it immediately, it will be money well spent when they stay with you after.

How much can I earn?

By the end of the second year Carewatch, Everycare and Kare Plus all estimate you could be making a profit of between £60,000 and £100,000. This is based on the number of care hours a week you are supplying. Long term nursing contracts will make more than caring contracts as they require more specialised staff.

For example, a healthcare worker might earn between £5 and £8 and hour depending on the level of skill – from simply fetching shopping up to a trained disability carer. A trained nurse can command anything from £9 to £25 – ranging from a nursing auxiliary to experienced sister.

“And like everything else it varies according to the area of the country,” says Debbie Ashmore at Kare Plus. “A qualified nurse in London wouldn’t get out of bed for less than £18 an hour.”

A client will have to pay you proportionally more for these kinds of contracts, as specialist staff is in short supply. You don’t have to just get the big contracts to make money, though – day to day work is still lucrative.

The franchisor won’t dictate how much you charge clients. However, to give an idea, Carewatch recommends that your profit margin shouldn’t be below £3. Typically, if you were paying £5 an hour to the carer, you would bill the client for £9.

Inevitably, your potential income will be affected by your ability to expand the business. As Mary Cottrell of Everycare explains,

“If any one of these four scenarios happens, the business could be affected. If you can’t recruit one, nurses or two, carers it will block growth. Then if you achieve these but can’t sell three, nurses or four, carers to your clients it will again block growth.”

But this is an all or nothing business. Judy Paterson of Everycare, Chatham explains, “I get too many staff on the books and work doesn’t come in so they leave. Then work picks up and I don’t have enough staff. You just have to put up with it.” And work round it as best you can.

Tips for success

  • As a care provider, you will be made – or broken – by the quality of the staff you provide. Care workers tend to move around a lot as many are part time, do several jobs and are, of course, in demand. Make sure you maintain staff numbers at all costs. 
  • It is much less easy to get good staff than it was 10 years ago, but don’t be forced to take anyone you can get. This isn’t just about your reputation as a provider it is about being responsible for caring for some of the most vulnerable people in society. Check everything about a potential employee – verbal testimonials, references and so on – no matter how long it takes.  
  • One franchisee advised against recruiting family and friends. This obviously depends on your family but in a business where reputation is so important, in the interests of harmony it’s probably best to recruit strictly by merit.  
  • This is not an industry that will bring passing trade, so you need to get out and make your name known. Advertising is expensive and most franchisees say that it isn’t cost effective. However, you definitely need to get accreditation with social services and the local authority – there is no guarantee of business but you can’t get any from them without.  
  • This business is about legwork. Initially, you will need to do your homework on your chosen area to make sure there is enough work to be had there. And then there will be continual appointments to see potential or existing clients to ensure business keeps coming in. Be prepared for the long haul since getting your name known won’t happen overnight.  
  • It is essential to maintain client feedback, finding out what the client wants and whether they are satisfied with the level of service. Everyone from the old lady at home to the hospital matron needs to feel that they are being listened to – or they will take their business elsewhere.  
  • You have to care about the business without getting too close to the operating level. Obviously, if one of your carers can’t turn up for some reason you will need to deal with it. But this is no reason for everyone in the office to drop everything to fill in. You need to remember your other responsibilities
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