PATHWAY 01 · START A CARE AGENCY
How to start a domiciliary care agency in England
Define your service, check whether CQC registration applies, choose accountable leaders, test viability and follow the correct route to opening a domiciliary care agency in England.
Applies to: Providers establishing a domiciliary care service in England. CQC does not regulate services in Wales, Scotland or Northern Ireland.
- Practical guide
- 28 min read
- Reviewed 20 July 2026
- 8 official sources checked
What this guide covers
- Define the service
- Confirm whether registration applies
- Establish the provider, leadership and location
- Design the service and prepare evidence
Quick answer
Make four decisions before you build the agency.
Starting a domiciliary care agency is not one registration task. You must define the service, check whether the proposed activities require CQC registration, choose the accountable provider and leaders, and test whether the model can operate safely and financially.
By the end of this guide, you will have a draft service model, an initial CQC scope decision, a proposed provider and leadership structure, and a list of assumptions to validate before preparing an application. This is educational guidance, not legal or regulatory advice.
Build the first record
Define the people, support and area you will serve
Write one page that another person could use to understand the proposed service without relying on the phrase “care agency”. Keep the launch offer deliberately narrower than the service you may eventually build.
- Will you support adults, children or both—and which needs or specialisms can you serve competently?
- Will visits include washing, dressing, toileting, eating support or other personal care?
- Will workers administer, prompt or supervise medicines?
- Will you offer companionship, shopping, cleaning or domestic support without personal care?
- Will the service include daytime visits, nights, live-in care, emergencies or on-call cover?
- What initial postcode area can you cover safely with realistic travel time?
- Who is likely to purchase the service: private clients, commissioners, direct-payment recipients or another provider?
- Which client groups, tasks, hours or risks will you explicitly exclude at launch?
Activity, not label
Check whether the proposed activity requires CQC registration
The activity and the agency’s ongoing role determine the position—not the name used on the website. These examples are indicative only: compare the complete model with current CQC scope guidance and obtain advice where the boundary is unclear.
| Proposed service | Indicative position |
|---|---|
| Shopping, cleaning and companionship only | Personal care registration may not apply if no activity within the definition of personal care is provided. |
| Washing, dressing, toileting or help with eating | Likely to involve the regulated activity of Personal care when provided to people in the place where they live. |
| Introduction-only service with no ongoing direction or control | May fall outside provider registration if the person takes full responsibility after the introduction. |
| Agency continues to organise, monitor, direct or control care workers | May amount to an ongoing role in providing personal care and require registration. |
| Personal care delivered in people’s own homes | Commonly requires registration for the regulated activity of Personal care. |
Legal responsibility
Understand the provider, nominated individual and registered manager
These roles are related but not interchangeable. Decide who will hold each responsibility before names are repeated across applications, policies and business records.
- Provider
- The legal person, partnership or organisation carrying on the regulated activity and responsible for meeting the regulations.
- Nominated individual
- The person who represents an organisation and supervises management of the regulated activity on its behalf.
- Registered manager
- The person in day-to-day charge of regulated activities who shares legal responsibility with the provider.
Example: Amara Care Ltd is the provider. Amara is its nominated individual. Daniel runs the service day to day and applies as its registered manager.
Early viability test
Test whether the service works when every hour is not billable
Estimate a fully loaded cost per care hour and the cash needed before revenue becomes reliable. Use conservative assumptions and record what still needs evidence.
- Expected hourly selling price by client route
- Care-worker wage and pay enhancements
- Employer National Insurance and pension costs
- Holiday pay, sickness and other employment on-costs
- Induction, training, supervision and shadowing time
- Travel time, mileage and scheduling gaps
- Registered-manager and office-management cost
- Software, insurance and professional fees
- Cancelled, shortened or unfilled visits
- Commissioner or private-client payment delays
- Working capital before recurring income stabilises
- Contingency for slower recruitment or client growth
How work reaches the agency
Choose an initial route to clients and revenue
The route affects pricing, contracting, evidence, cash flow and how long it may take to win work. Select a realistic first route rather than assuming every market will open at once.
Private-pay clients
Usually require local trust, responsive assessment, clear terms and a price that reflects the complete service cost.
Local-authority commissioned care
May require framework access, tender evidence, specified rates, reporting and tolerance for payment cycles.
NHS or integrated-care work
Can involve procurement, clinical interfaces, information requirements and service-specific assurance.
Direct-payment recipients
The person controls an allocated budget; clarify who contracts with the agency and what evidence is required.
Subcontracting or frameworks
Can create an earlier route to volume but may constrain price, territory, reporting and operational autonomy.
Decision process
Follow the correct route from idea to regulated care
Preparing an application and submitting it are separate stages. CQC says to submit only when the locations and staff are ready to provide the service.
- 01
Define the service
Choose the service model, regulated activities, client groups, launch offer, geography and initial capacity.
- 02
Confirm whether registration applies
Compare the actual activities and ongoing control with current CQC scope guidance; record the initial decision and uncertainty.
- 03
Establish the provider, leadership and location
Confirm the legal provider, nominated individual, registered manager and genuine operating base.
- 04
Design the service and prepare evidence
Build the statement of purpose, policies, training plan, governance controls and supporting records around the defined model.
- 05
Recruit enough suitable staff
Complete safer recruitment, right-to-work, DBS, induction, competence and staffing-readiness controls.
- 06
Submit complete linked applications
Submit provider and manager forms together only when the service, staff, location and required evidence are ready.
- 07
Respond to CQC assessment
Support completeness checks, evidence requests, interviews and any site or nominated-individual discussions.
- 08
Begin regulated activity after registration
Do not carry on or manage the regulated activity until CQC confirms the relevant registrations.
Practical checklist
Agency-start completion checklist
You should be able to answer each item with evidence or a named assumption to validate.
- I can describe the people we intend to support.
- I have listed the care tasks we will and will not provide.
- I have checked our model against CQC’s current scope-of-registration guidance.
- I can identify the legal entity that will carry on the regulated activity.
- I can name the proposed nominated individual and registered manager, where required.
- I have defined an achievable initial service area.
- I have identified our likely first client-acquisition route.
- I have estimated our fully loaded cost per care hour.
- I have recorded the assumptions that still need validation.
- I understand that regulated activity cannot begin before registration is granted.
Records that should grow with the launch
- Service-definition record
- Registration-scope decision and sources checked
- Provider and ownership record
- Leadership-role decision
- Location and occupancy evidence
- Application document register
- Client-acquisition route and contracting assumptions
- Fully loaded hourly-cost estimate and working-capital assumptions
- Launch readiness plan
- Assumption, risk and decision log
Where new-provider plans commonly drift
Starting with templates
Policies are downloaded before the actual service, people and risks have been defined.
Treating CQC as UK-wide
CQC regulates England; the other UK nations have different regulators and routes.
Mixing provider identities
The company, trading name, manager and address differ between documents.
Recruiting before the model is stable
Roles and training are designed around an offer that later changes.
Promising a launch date too early
Clients or workers are committed before registration and operational readiness are secure.
Check the source
Official guidance for the starting route
Use current CQC pages to confirm the route for the service you intend to provide in England.
- CQC: Register as a providerWhen to apply, readiness expectations and the rule against carrying on regulated activity before registration.
- CQC: Personal careDefinition, common home-care examples and activities that do not fall within Personal care.
- CQC: Introductory agencies and ongoing controlHow an ongoing role in directing or controlling personal care affects registration.
- CQC: Types of service provider or legal entityHow the individual, partnership or organisation carrying on the activity is identified.
- CQC: Register as a new managerWho needs a registered manager and the manager’s day-to-day and shared legal responsibility.
- CQC: Applying as a new providerCurrent application guidance, regulated activities, provider types and manager requirements.
- CQC: Scope of registrationGuidance for deciding whether an activity and provider must be registered.
- CQC: What is a location?How CQC identifies the operational base from which regulated activity is managed.
Continue learning
Continue the agency-start pathway
The three lessons turn the first three stages into concrete decisions and evidence.
- Define the care service
- Set up the provider, manager and location
- Prepare the CQC application
- Recruit and onboard staff
- Build the care operating model
- Prepare for first clients
WHERE WORKMAX FITS LATER
Choose operating systems after the service model is clear
At this stage, focus on the service, registration scope, accountable people and viability assumptions. Workmax becomes relevant later when the operating model needs to connect workforce, rota, visit and payroll records; it does not decide registration scope or guarantee registration.