How to Start a Care Agency in the UK: 7 Proven Steps

Running a care agency is a calling. Many who start in this field have been caregivers themselves or watched a loved one struggle to get the support they needed.

This guide is here to help you channel that experience into building something better: a care agency that treats people with the dignity they deserve and does it while staying fully compliant and sustainable.

Step 1: Define your niche and business model

Every care agency begins with a vision. For some, it’s rooted in personal experience – perhaps you’ve looked after a parent with dementia, or worked in a care home and felt you could do it better. That drive to improve lives is where your business model starts.

Rather than trying to serve everyone, focus on where you can provide the most value.

🔸Popular care models:

• Domiciliary (Home) care: Personal care, medication reminders, and companionship at home.
• Live-in care: 24/7 support where a carer resides in the client’s home.
• Nursing agency: Supplying qualified healthcare staff to hospitals and care homes.
• Specialist care: Dementia, mental health, palliative, or complex needs care.

🔸 Why your niche matters:

Your niche defines everything – how you market, who you hire, and what kind of systems you need. A clearly defined niche allows you to:

• Build real expertise and a strong reputation
• Design staff training that aligns with client needs
• Avoid spreading resources too thin

🔸 Real-world considerations:

• In urban areas, live-in care might be more viable due to housing constraints.
• In coastal towns with aging populations, elderly care and fall-prevention services could be crucial.
• Working with children or vulnerable adults requires strict safeguarding measures.

Step 2: Write a business plan

When you decide to open a care agency, you’re committing to delivering services that affect people’s health, well-being, and dignity. That’s why a care agency business plan is your compass, your accountability partner, and the framework you’ll fall back on during hard decisions.

🔸 What your business plan should include:

1. Your mission, vision, and values

• Define your long-term goal. What change do you want to see in your community?
• Clarify the values you’ll expect from your staff and managers.

2. Market analysis

• Who are your clients? Are you targeting private-paying individuals, council-funded clients, or both?
• What’s the demographic makeup of your area? Is there a shortage of dementia care? Mental health support?
• What are other agencies charging, and how are they positioning themselves?

3️. Your services and business model

• Will you offer short visits, overnight care, or 24-hour live-in care?
• Will you take on complex cases, such as PEG feeding or palliative support?
• How will you charge – hourly rates, packages, or a mixture?

4. Financial plan

• Start-up costs (e.g., CQC registration, insurance, staff recruitment, software)
• Running costs (e.g., payroll, PPE, travel, marketing)
• Revenue forecasts (both optimistic and conservative)
• Break-even analysis and contingency planning

💬 Additional advice:

• Don’t forget delayed payments. If you’re relying on local authority contracts, payments might take 30 – 60 days to come through.
• Be realistic about staff availability. Will you have enough people to fulfil your visits if someone quits unexpectedly?
• Include your own wage. You’ll work hard for this business, so don’t plan to go unpaid indefinitely.

5️. Operational plan

• Office setup: Will you start from home or lease an office?
• Staffing structure: How many carers per client? Who will supervise them?
• Scheduling: Will you use software or manage manually? How will you ensure carers get breaks and travel time?

6️. Marketing and growth strategy

• Online presence: What will your website and social media offer?
• Referral strategy: Will you partner with GPs, hospitals, or local charities?
• Brand identity: What makes you different? What emotional message are you sending clients?

Treat your business plan as a living document. Schedule time every 3–6 months to revisit and adjust it.

Step 3: Register your business

Choosing the right business structure sets the foundation for how you’ll handle money, risk, taxes, and credibility.

Let’s say you’re starting small, maybe even from your kitchen table. You might be tempted to register as a sole trader. 

But stop and consider: you’ll be employing staff, working in people’s homes, and handling sensitive data. Liability matters.

That’s why most care agencies opt for a limited company structure – to separate personal assets from business ones.

🔸Set up your legal structure:

• Register with Companies House as a limited company (you’ll need a unique business name, director details, and registered address).
• Register with HMRC for Corporation Tax.
• If you plan to exceed the VAT threshold (£85,000/year), register for VAT early to avoid penalties.

🔸Data and compliance registrations:

• Register with the ICO (Information Commissioner’s Office) – a legal requirement if you’re handling personal data (which you will be).
• Consider opening your business bank account immediately after Companies House registration. Many banks ask for your company number and proof of identity.

🔸ANNA pro tip:

Want to simplify the setup process?

If you’re overwhelmed by registering your care agency and getting all the pieces in place, ANNA can help. 

ANNA will register your limited company, set up your business bank account, and support you with key admin tasks like VAT registration, PAYE setup, and tax submissions.

Need to keep your home address private? ANNA also offers a virtual office address and daily mail scanning, helping you present a professional image and stay on top of legal updates. 

Ideal for care agency founders who want to start strong without drowning in paperwork.

💬 Additional advice:

• Consider the long-term implications of your business name. Make sure it sounds professional, is easy to remember, and doesn’t overlap with existing providers.

• Think about your organisational chart from day one, even if you’re wearing all the hats now. How will your team grow, and who’ll take on what responsibility?

Step 4: Register with the CQC (or other UK regulators)

If you’re offering personal or nursing care in England, you must be registered with the Care Quality Commission (CQC) before delivering a single hour of care. 

🔸 What is CQC registration?

The CQC regulates all health and social care services in England. If you're delivering personal care in someone’s home, like helping with washing, dressing, or medication, you’re legally required to register.

Other UK nations have their own equivalent bodies:

• Scotland: Care Inspectorate
• Wales: Care Inspectorate Wales (CIW)
• Northern Ireland: Regulation and Quality Improvement Authority (RQIA)

🔸 Key components of the CQC application:

1️. Statement of purpose

This is your manifesto. You’ll describe:

• The types of care you’ll deliver
• Your aims and objectives
• The needs you’re addressing
• Your values and approach

2️. Registered manager

• You must appoint someone with both the qualifications (usually a Level 5 Diploma in Leadership for Health and Social Care) and the experience to run the day-to-day services. This person must also pass a “fit person” assessment.
• If you’re both the provider and the manager, you’ll be assessed on both roles.

3️. Fit and proper person interview

• This is a formal conversation with a CQC inspector.
• Expect questions about safeguarding, complaints handling, your knowledge of the Health and Social Care Act 2008, and how you plan to uphold CQC’s fundamental standards.

4️. Policies and procedures

You must submit a comprehensive set of operational documents, including but not limited to:

• Safeguarding
• Infection control
• Medication management
• Risk assessments
• Complaints handling
• Business continuity

5️. DBS and references

You and your staff must complete enhanced DBS checks. You may also be asked for a GP reference, especially for the Registered Manager role.

💬 Additional advice:

• Attend at least one CQC preparation webinar or training session. Many care associations offer these for free or at a low cost.
• Use existing CQC reports to your advantage. Read how other agencies describe their Statement of Purpose. Look at what the inspectors praised and what they penalised.
• Allow time for feedback. Submit your documents to a peer or consultant to review before you apply.
• The registration process can take between 3 to 5 months, and often longer if your application has gaps or unclear information.

Step 5: Secure the right insurance

Let’s be honest: no one wants to think about worst-case scenarios. But the care industry, by its nature, involves risk. A slip during a home visit. A safeguarding complaint. A medication error. These things can happen even in the most well-run agency. 

Insurance is there to protect you, your staff, and, most importantly, your clients.

🔸 The essentials:

1️. Public Liability Insurance

This covers injury or property damage caused by your business activities. For example, if a client trips over a hoist or a carer accidentally knocks over valuable belongings, this is the policy that protects you.

2️. Employer’s Liability Insurance

Legally required as soon as you hire even one employee. It covers claims from staff who might suffer illness or injury while working for you.

3️. Professional Indemnity Insurance

This protects you if a client alleges that your advice, service, or lack of it caused them harm. It’s especially important if your carers are administering medication, handling health-related tasks, or offering emotional care that could be misinterpreted.

🔸Optional but sensible cover:

• Medical malpractice insurance – Critical if you're delivering clinical care (e.g., catheterisation, wound care).
• Cyber Insurance – With digital care plans, staff apps, and sensitive data on the line, cyber protection is also another thing to think about.
• Business interruption insurance – Can help keep your agency afloat if you're unable to operate due to unforeseen events (fire, flood, etc.).

Step 6: Recruit and train staff

What truly shapes the success of your care agency is the team on the ground. Your staff are the ones clients interact with daily, and their professionalism, consistency, and empathy directly influence your agency’s reputation and impact.

🔸 Recruitment checklist:

• Enhanced DBS check (mandatory for all care roles)
• At least two written references (one must be from a former employer)
• Proof of right to work in the UK
• Identification and proof of address
• Health declaration and (if requested) a GP reference

Many agencies create a structured onboarding pack, complete with induction, training materials, a welcome handbook, and a shadowing schedule.

🔸Essential training topics:

• Safeguarding vulnerable adults and children
• Infection prevention and control
• Manual handling (with practical demonstrations)
• Medication awareness and documentation
• First aid and emergency response
• Communication skills and dignity in care

In England, new staff must complete the Care Certificate, a set of 15 minimum standards introduced by Skills for Care. This training helps carers understand their responsibilities and sets a baseline for safe care delivery.

🔸 Ongoing support and retention:

Recruiting carers is hard, but keeping them is harder. Carers often leave agencies not because the work is difficult (they expect that), but because they don’t feel supported or respected.

You can build retention by:

• Holding regular supervisions and one-on-ones
• Recognising good work publicly and privately
• Offering flexible hours or guaranteed-hour contracts where possible
• Encouraging open communication about schedules and well-being
• Conducting spot checks and client feedback calls. Use this data to reward good performance and identify issues early.
• Creating development paths, even if it’s just a Lead Carer role or training mentor. Show staff there’s room to grow.
• Being consistent and fair in enforcement. Your carers are watching how you respond to lateness, errors, and conflict.

Great care comes from carers who feel trusted, supported, and trained. Invest in your people, and they’ll take care of your clients.

Step 7: Build your operational systems

Operational systems are what hold your care agency together when everything gets busy, which it will. 

When you’re managing multiple carers, unpredictable rotas, emergency calls, and ever-changing client needs, trying to handle everything manually is a recipe for burnout. Good systems reduce human error, support compliance, and free you up to focus on care quality, not admin.

🔸Essential operational tools:

1️. Care planning and visit scheduling software

Look for platforms designed specifically for domiciliary care. These allow you to create detailed care plans, assign tasks to carers, set up alerts, and ensure nothing is missed during visits. Some systems offer real-time updates via mobile apps.

2️. Digital rostering and timesheets

You’ll need to match carers to client preferences, skills, and availability. The right software helps you avoid conflicts, track hours, and keep costs under control. Integrated payroll functionality can make your life easier come payday.

ANNA Payroll is just £3/month for the first 3 months. After that, it’s £20 + VAT. 

File payroll for up to 5 employees, generate payslips and P60s, stay HMRC-compliant, and get support 24/7. It’s quick to set up and easy to switch from your current provider.

3. Staff compliance tracker

Store and monitor training certificates, DBS renewal dates, and supervision records. If the CQC shows up unannounced, you’ll want this data accessible in seconds, not buried in a spreadsheet.

4️. Incident and complaint logging system

Whether it’s a missed visit, a fall, or a complaint from a family member, every incident must be recorded, followed up, and learned from. Having a structured reporting process helps demonstrate transparency and improvement.

🧾 Must-have documentation (Physical or digital):

• Individual care plans (reviewed at least every six months)
• Risk assessments (especially for moving and handling)
• MAR charts (Medication Administration Records)
• Safeguarding referrals
• Client agreements and consent forms

💬 Additional advice:

• Run monthly audits on care notes, medication records, and visit logs. Spot inconsistencies early.
• Consider working with a care consultancy in your first year to audit your processes before the CQC does.
• Automate where you can, but always train staff properly on new systems. Tech can’t replace common sense.

Final thoughts

Running a care agency is deeply rewarding, but it's also complex, emotional, and challenging. You’ll be balancing compassion with compliance, growth with governance. But when you walk into a home where someone is safe, clean, and smiling because of your team’s work, it all makes sense.

Want help managing the business side of things while you focus on care?

ANNA can take care of company filings, tax submissions, VAT, and payroll, so you can focus on improving care quality, supporting your team, and growing your agency. It’s a simple way to stay on top of compliance and avoid getting buried in admin as your agency scales.

👉 Sign up to ANNA to set up your care agency the smart way  – from business registration to staying HMRC-compliant.