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How to start a care agency

Thinking of starting a care services business? Startups forum users discuss getting started from securing contracts to care software packages

With people living longer than ever, demand for care agencies is on the rise. If you’re thinking about entering the care sector, our Startups Forum users discuss a number of elements involved in getting started below.

What do you need to set up a health care agency and secure contracts?

I wish to set-up a nursing and care agency, supplying temp nurses and healthcare assistance to private nursing/care homes, private hospitals etc. I currently work as a health care assistant for the NHS – I need help with starting off setting up my own agency, who would I approach to get contracts? How do you go about this? And the overall pay rates mark given to us as an agency and in turn how much on average to pay HCA and RGN?

Forum user Hannah says:

“Many people go about starting healthcare/nursing agencies with varying degrees of success and the majority of start-up businesses fail within their first year, you would need a strong factoring company to support cashflow and a strong business plan.

“Ideally, you would have some recruitment/HR experience as tendering for and supporting new contracts is certainly one of the hardest parts for any new start-up business. The key to a successful agency in the start-up phases is to have strong contracts which have been negotiated with the key decision makers and stakeholders within the business, have positive cashflow and a fantastic understanding of the recruitment process.”

See more: How to open a care home

What care software packages do you need?

I’ve started a care agency registered with csci , insured and ready to run but due to unforeseen circumstances am out of sufficient funds to get care package software so am trawling the net and googling for templates for all aspects of the business from application forms, accounting, invoicing software, hr software, advertising ideas etc.


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A care compliance and CQC expert on the forum says:

“I worked as an inspector for CQC for eight years registering and inspecting care services. I have also worked with some of the big care providers such as Carewatch
Affinity Trust and St Annes in the north.

“There are a number of software packages on the market for call scheduling, rotas, invoicing and call monitoring. You would need to look at what functionality you require.

“I would strongly advise new providers to be very wary of off the shelf packages for policies as many of them are not compliant with the Health and Social Care Act 2008 essential standards. You have to ensure that the policies and procedures reflect your business and your name is not just copied and pasted in.

“As far as registration goes you do need to know the standards, it is still possible to get hold of a bound copy for free.

“In terms if developing your market there is the independent or private market which does mean using social and other media , managing relationships with brokerage teams, carers groups etc. Or there is the traditional market of referrals from social services or health. These require you more often than not to be on a preferred provider list which is achieved through tendering.

“Once up and running agencies need to meet contractual obligations and monitoring requirements of both commissioners and CQC.”

I have set up my own Domiciliary Care Agency we are having trouble trying to find a rostering software program to use, most we found cost around £30 a week and as we have only just started we want to keep outgoings to a minimum does any one know of a free program we can use that is suitable for Domiciliary care that is free until we need a bigger program?

A care compliance and CQC expert on the forum continues:

“I have worked in social care for 20 years and currently work as a care consultant with a number of large domiciliary care providers and start-ups.

“There are, as you will have found some large system providers like staffplan tagtronic etc. Key considerations are the cost of each licence, the level of ongoing support and the cost if any of upgrades to the system.

“My advice to start-ups is to keep the costs down in the first year if at all possible. A number of small agencies use excel.

“There is a lot to focus your time on in the first year. Critical success factors are the recruitment of good staff and business development that reaches all potential markets.”

What should you consider when starting a care recruitment agency?

I am planning to start up a healthcare recruitment agency and I need advice from people who have set up a similar company.

Forum user and founder of Social Care Hub Shaun Louis suggests:

“The key is to be flexible, contactable and able to fulfill shifts at short notice.

“To start off, on a small budget:

– A quality website is key with seamless contact processes for current and new customers.

– Solid branding, promotional materials, legal agreements and clear outlined USP’s.

– Make initial contact with the relevant people (directors/care managers) at all local Care Homes, Day Centres, Hospitals. The best way to go about this is to send an initial letter and a services brochure twinned with an initial email. You can then follow up with a phone call.

“Many of these providers will currently work with another agency, the key is to prove the reliability of the service. The only reason a provider would use a recruitment agency is to take away the headache of staffing.

“Starting on these points above, servicing customers well and continuing the process will ensure your recruitment agency grows.”

Do you need to hire a registered care manager?

I understand that I need to get a registered care manager in order to comply with cqc regulations. However, as I do not have a client base I do not have a way to pay for my registered care manager. 

Forum user Marie says:

“I don’t know how much research you’ve done to open your own Dom care company.

“Firstly you do not need to employ a registered manager, you could be the Dom care service provider as well as the registered manager.

“First 3 basic step to start up your own Dom care company.

1. Register your Dom care with companies house

2. Register your Dom care company for DBS countersigned with CQC (a must)

3. Applying for CQC registration.

4. Domiciliary care business Insurance

“You will need to have bespoke policies and procedures in place relate to your Dom care company only. CQC is now refusing generalised care management policies and procedures.

“Clients come either privately or through the Local authorities. You must also take a care management course such as NVQ5 if you decide to be the registered manager yourself.”

How can I secure contracts?

Do local authorities give contract to new care providers?

Forum user Marie suggests:

“Local authorities do give contract to new care providers especially those in their own borough, I’ve managed to secure several mini tenders to my new dom start-ups clients. Some Local Authorities are allowing new dom care providers to bid for tender even those who has not yet been inspected by cqc and are new care service providers.

“Service user clients are growing all the time and there are only so many existing service providers in one borough. If the existing service providers do not have the capacity to accommodate new service users the LA or SC would gladly take on new service providers and keep business in their borough otherwise they go for their neighbouring areas for new service providers.

“There are certain rules and regulations within the public organisation about making space for new start-up business and not always to go for the big fish to give new start-ups a chance but as mentioned different LCs work in different ways whether they follow that rule or not.

“Private service user clients are not difficult to get either.

“Have you tried to get private clients and in what way did you try?

“The market is very good at the moment for new dom care providers as local authorities are having difficult to re-allocate service users to private providers are there are lots of existing private providers are failing their cqc ratings due to staff recruiting and staff retention problems, medications management and the management of the dom care itself.

“Five most important to run a successful dom care.

1. Staff recruiting
2. Staff retention
3. Medication management
4. Bespoke policies and procedures in place (it’s a must)
5. Financial and dom care business contingency.”

What marketing should I be doing?

I have a website and l have already set up my facebook ads. Is there any other marketing l should be doing?

Forum user Marie says:

“I would say before you do any marketing the most important thing is to familiarise yourself with the care sector. Although marketing is important, experience and qualifications are a must to succeed. Another tip which many others have done completely unaware, do not make your registered manager THE Nominated Individual for your dom care business unless they are a manager, secretary or director of (THE/YOUR) dom care business. A registered manager is only a member of staff and not the manager of your company.

“Have you checked out other dom cares on Facebook to see how it’s working for them because the thing with Facebook is that whilst there are million of people on FB they will not automatically find your dom care Facebook profile unless they know about you, and the same for your website.”