In this Home Care Business Guide
What is a Home Care Business?
With people living longer and an ever-increasing life expectancy, it’s no surprise that the care industry in the UK is growing at a rapid pace.
A home care business is a great alternative to traditional residential care homes. Also known as domiciliary, home-based care businesses can offer a range of medical, care and daily living services to people with a variety of needs.
The main difference between a care business and a home care business is that home carers go into an individual’s home and provide care there. Many people think of residential care homes when thinking of what a carer does. However, this type of setting does not suit everybody. Many individuals who require care can be safely and effectively cared for at home.
Home care can be beneficial to people with a range of physical, mental and emotional needs and a variety of health conditions, including:
- Degenerative conditions such as dementia or Alzheimer’s.
- Cancer and tumours.
- Neurological conditions, such as Parkinson’s disease or Huntington’s disease.
- Long-term or lifelong conditions, such as cerebral palsy or Down’s syndrome.
- Strokes or other brain damage.
- Physical disabilities.
- Mental health difficulties.
- Cognitive difficulties.
- Learning disabilities and learning disorders.
- An elderly person.
- A person who is bedridden.
Home care can be beneficial to any person who is struggling to undertake everyday tasks independently.
Care can be provided on a short-term or long-term basis and the level and complexity of the care can vary, depending on the individual’s needs. Care can be provided as frequently as the individual requires, with some individuals requiring care only once or twice a week and others requiring 24 hours a day care.
A home carer can assist with a variety of tasks, including:
- Personal care, such as using the toilet, washing and dressing.
- Eating and drinking.
- Support with mobility.
- Administering or assisting with medication or medical care.
- Support with household duties.
- Support with running errands or shopping.
- Meal preparation.
- Companionship.
- Mental health and emotional support.
- Palliative or end-of-life care.
Home care usually falls into two categories:
Medical Home Care
This can only be provided by medical professionals, such as nurses or doctors. It is most frequently used by people who have recently been discharged from hospital, those with serious or long-term health problems or medical conditions, senior citizens, and those coming to the end of life. Medical home care could involve administering medication, monitoring blood pressure or heart rate and treating injuries.
Non-Medical Home Care
Carers do not need to be medical professionals to provide this type of care. It instead involves assistance with day-to-day activities, support with personal care, and support to help the individual live independently. Non-medical home carers can even assist individuals with activities outside of the home, such as shopping, attending appointments and even going on holiday.
The type of care your home care business is able to provide will depend on the type of staff you employ and their qualifications. For example, your business could employ carers, nurses and therapists.
A person may opt for home-based care instead of using the services of a care home for a number of reasons:
- Their medical needs are less severe.
- The individual may be on end-of-life care.
- The individual may have specified that they want to remain in their own home.
- The individual may be unable to cope with changes to their routine.
- Some care can also be provided by family members.
- Home care many have been chosen as it is more cost-effective.
- Home care will be more beneficial to their wellbeing.
As part of your home care business, you must ensure all employees are qualified, reliable, compassionate and empathetic. Your employees (and yourself) will need to undergo regular training to ensure their knowledge of safeguarding, first aid and different conditions is up to date.
Some customers may fund 100% of the care themselves, meaning you will be responsible for collecting payment. Others may receive grants or funding from the government, the NHS or charities.
To successfully start your own home care business, you will need to have a thorough understanding of the care industry and previous carer experience. You will also need the skills to successfully manage your employees, assess needs and create schedules.
Types of Customers
The types of clients you will target with your home care business will depend on the qualification, skills and training of your staff.
You may choose to focus on one specific type of client or offer care to a wide range of individuals with different needs and levels of care requirements.
For example, you could target clients who require:
- 24 hours a day care.
- Consistent care throughout the day, but not at night.
- Checks or support every hour.
- Checks or support every few hours.
- One visit per day.
- Care or support once or twice per week.
Many home care businesses choose not to specialise and will instead provide care to any individual who needs it. However, if you decide to focus on offering a specific type of care to your clients, this will mean you are likely to have a specific client base.
Some things you should consider when deciding the type of care you will offer, and your typical client base are:
Whether you accept government, NHS, grant or charity funded clients.
How many staff you employ.
The qualifications, skills, training and experience of your staff.
Your equipment requirements.
Any other home care businesses in your area and the type of care they offer.
How much care (per day) you will offer to each client.
Equipment You Will Need
Your equipment requirements will vary, depending on the type of care you provide and the complexity of your clients’ needs.
Your equipment will be a vital part of your business. It will help to ensure your clients’ wellbeing, safety and comfort. Some equipment may be provided directly to your clients and be kept at their homes at all times. Other equipment may be transported with your staff.
Some equipment may be provided by you and other equipment may be provided by the NHS or the local authority.
Under the Health and Social Care Act (2008), a home care business has a legal responsibility to ensure that any equipment is suitable for the purpose for which it is being used. To ensure that you are fulfilling your responsibility and providing the best possible care, you can request an assessment and receive recommendations from professionals, such as an Occupational Therapist.
Below is a list of the equipment typically required by home care businesses. Consider your business plan and your clients when determining which equipment you will need.
Personal care equipment
Many of your clients will require assistance with personal care. Some of the equipment and resources you may need for this include:
- Feeding equipment, such as specialist cutlery, bowls and cups.
- Bath lifts.
- Bath or shower grab rails.
- Shower seats.
- A shower or bath tray.
- Toilet frames.
- Bedpans.
- Continence products.
- Cotton cloths and towels.
- Disposable wipes.
Moving, handling and lifting equipment
This can be used in cases where the client is unable to get out of bed or move independently. This equipment can help to keep both your employees and the client safe.
- Hoists.
- Transfer boards.
- Wheelchairs.
- Walking aids.
- Bath hoists.
- Slings of different sizes.
- Standing hoists.
Medical equipment
If you employ trained professionals and provide medical care, you will need a huge variety of equipment to support different medical conditions and needs.
You will need to ensure your staff are specially trained to use this equipment and administer any medication. You may also need to apply for specific licences to allow your business to administer medical treatment.
Some equipment you may require could include:
- Medical administration equipment.
- Medical testing kits.
- First aid equipment.
- Monitoring equipment, for example, equipment for monitoring heart rate and blood pressure, thermometers and blood glucose meters. You may need monitoring equipment that consistently monitors or provides a one-time reading.
- Respiratory equipment, such as ventilators and oxygen masks.
- Treatment and therapy equipment, such as infusion pumps and dialysis equipment.
- Voiding equipment.
- A defibrillator.
- Specialist beds and mattresses.
Other care equipment
Some other equipment you may require for home care could include:
- Antibiotic creams and ointments.
- Antiseptic wipes and solutions.
- Cotton balls, cotton wool and cotton swabs.
- Assorted bandages.
- Scissors and tweezers.
- Safety pins.
- Medicine cups, spoons and syringes.
- Disposable wipes.
- Equipment for measuring body weight.
- Personal Protective Equipment (PPE), such as face masks, aprons or clothes coverings, hair coverings and gloves.
- Hand sanitiser.
- A personal alarm, so your clients can call for help in the event of an emergency.
Non-medical equipment
In many instances, the care your business provides will be non-medical. This could include supporting your clients with independent living and providing them with mental and emotional support and assisting them with activities.
Some of the equipment you may require for this type of care includes:
- Books, magazines and newspapers.
- Board games.
- Music and DVDs.
- Any equipment required to support the clients out of their homes, such as wheelchairs and an appropriate vehicle for transporting them.
- Calendars – providing your clients with calendars can be extremely beneficial. You can input information about your visits, any appointments and activities.
- Grooming beauty and pampering kits – such as hairbrushes, nail varnishes and beard grooming equipment.
Other equipment
Client files – These should include all necessary information about the client including age, health conditions, allergies, emergency contact information, power of attorney and medications.
A rostering system – You can utilise software or a website to keep track of your staff rota, holidays, sickness and absences. This can help ensure you have the necessary staffing levels to meet your clients’ needs.
Software for recording medication – Although some caring businesses still choose to write down medication using a physical Medicines Administration Record (MAR) chart, an online tool can be more reliable and result in fewer human errors. It also removes issues such as illegible handwriting. We will look more at MAR charts later.
Vehicles – In order to visit multiple clients, each of your employees will require a vehicle. You may choose to provide company vehicles to your employees or allow them to use their own vehicles.
Company mobile phones – So your employees are contactable.
A computer and printer – These can be used for making records, checking a customer’s medical history, making appointments and for research purposes.
A washing machine and dryer – For washing uniforms or staff clothing and other materials.
Typical Costs
There are multiple different costs associated with a home care business. Some of these costs will be associated with setting up your business and others will be ongoing costs you will need to pay in order to run your business.
Some of the typical costs associated with a home care business are:
Equipment
As you can see from the list above, your equipment requirements can be extensive. Your costs can vary depending on the type of home care business you run, the equipment needs of your clients and how much of the costs are covered by your local council or Community Health Services. Determine the equipment you need and contact your local council directly to find out what equipment costs you will be responsible for.
Staff
Your staff will be one of the most expensive but most important costs you will be responsible for. Depending on how many staff you employ and their role, the cost of paying your employees usually takes up between 40% and 60% of your business’s budget. When calculating the costs associated with your staff you should consider the number of staff you will employ and their hourly wage. You will also need to account for holiday pay, sick pay, National Insurance and any company pension.
Maintaining, repairing and replacing equipment
A lot of the equipment your business will use will be expensive. To reduce costs associated with replacing this equipment, and to ensure the health and safety of your clients and employees, you will need to maintain the equipment frequently. You may need to have any electrical equipment inspected regularly by a qualified professional. Any equipment that is showing signs of damage or may be unsafe should be repaired or replaced immediately. Equipment such as PPE, disposable products and first aid equipment will need to be replenished frequently. You can expect to pay between £1,000 and £20,000 per year, depending on the size of your business.
Business insurance
Business insurance can help to protect your business in the event of an accident or incident. Some insurance you may choose includes:
- Public Liability Cover
- Employers’ Liability Cover
- Professional Indemnity Insurance
- Business Equipment Insurance
- Medical Malpractice Cover
- Treatments’ Liability Insurance
Insurance costs can start at £10 per month, depending on your insurance provider and coverage levels.
Branding
Branding can help you to establish your business identity and set you apart from any local competition. Branding could include creating your business’s visual identity, a logo, your business name and your business website. You can hire a professional to help you with branding or do some of the work yourself. Branding can cost between £500 and £10,000, depending on the amount of branding you require.
Marketing and advertising
Marketing and advertising can help you to grow your business and maximise your profits. It is recommended that you spend between 1% and 3% of your annual turnover on marketing. For example, if your annual turnover is £200,000, it is recommended you spend between £2,000 and £6,000 per year on marketing and advertising.
Registration fees
You will need to pay the fees to register your business with the Care Quality Commission (CQC) or other relevant body. You will also need to pay an annual registration fee, which varies depending on the number of clients you have. Your registration fee will comprise a £239 overall fee + a £45.77 fee per client.
Once you have calculated your start-up and running costs, you can then determine your pricing policy.
Your pricing will depend on several factors:
- The level of care required.
- Whether the care is medical or non-medical.
- Any equipment requirements.
- Your location.
- How many carers are required per client at one time.
- Your operating costs.
- How much of the care is covered by your local authority.
- Your competitors’ pricing.
- Your acceptable profit margin.
On average, home care in the UK costs between £15 and £30 per hour.
Safely Running a Home Care Business
Safe practices are essential when running a home care business. It can help to ensure the safety of your clients and employees.
Safe practices can also help to protect your business.
Some safety protocols you can implement in your home care business are:
Conduct risk assessments
Risk assessments are only a legal requirement if your business has five or more employees. Even if you have fewer employees, risk assessments are recommended to ensure safe practices in your business. When conducting risk assessments, you should:
- Identify hazards.
- Determine who could be at risk.
- Evaluate the potential risks.
- Implement safety measures.
- Record the results of the risk assessment.
- Review the risk assessment on a regular basis.
Your risk assessments should also cover any additional risks related to individual clients.
Ensure all staff have high standards of personal hygiene
As part of your code of practice, ensuring the personal hygiene of you and your employees can help to protect vulnerable clients. Many viruses and illnesses spread through physical contact so ensuring frequent and correct handwashing can help to protect your clients.
Implement cleaning procedures
Although you will be in clients’ homes, it is still important that you implement cleaning procedures that are followed by all staff. This could include cleaning all equipment after use. You should also clean personal equipment, such as pens, files and mobile phones.
Personal Protective Equipment (PPE)
PPE is imperative to protect your clients and staff. The type of PPE required will vary depending on the tasks your staff are undertaking. It could include gloves, masks, aprons and hair coverings. PPE should be changed between each client and disposed of or washed properly.
Ensure staff are aware of manual handling procedures
Caring involves a lot of manual handling tasks, such as moving clients and carrying equipment. Manual handling tasks, when performed incorrectly, can result in injury. To protect the health and safety of your staff, ensure they are trained in manual handling regulations. You should also ensure they have the correct equipment to perform manual handling tasks safely.
Ensure the safety of equipment
Ensure all equipment is set up and used in accordance with the manufacturers’ instructions and that safety standards are being met. Equipment should also be inspected regularly.
Ensure all staff are first aid trained
Even if your business doesn’t provide medical care, your staff will still need to be first aid trained and carry a first aid kit with them at all times. This will allow them to administer emergency treatment if necessary.
Protect your staff from threatening or abusive behaviour
Threatening or abusive behaviour could come from clients, especially if they are in pain, on medication or confused, or from upset or worried family members. As the business owner, it is your responsibility to protect your staff from threats or abuse. Implement procedures for dealing with threatening behaviour, record any incidents and ensure you support your staff as much as possible.
Keep dangerous objects away from clients
This includes medication, medical equipment, cleaning products and scissors. Any potentially dangerous objects should be kept out of the reach of clients at all times.
Ensure your staff are contactable at all times
In many instances, your staff will be visiting clients alone, which can be risky. To ensure the safety of your staff, implement procedures for staying in contact at all times. For example, you should always have the location of each staff member’s appointment and your staff should contact you (or the shift manager) before and after visiting each client. This will allow you to identify any safety concerns quickly.
Legal Requirements
The care industry is highly regulated in the UK and adhering to all legal requirements is essential.
Some legal requirements you should be aware of are:
Register with the relevant governing body
Under the Health and Social Care Act 2008, you must register your home care business. You will need to complete your registration before you begin operating your home care business. The governing body you need to register with varies, depending on the country in the UK you live in:
- England: The Care Quality Commission (CQC).
- Wales: The Care Inspectorate.
- Scotland: The Care Inspectorate Wales.
- Northern Ireland: Regulation and Quality Improvement Authority (RQIA).
Obtain criminal record checks
As you will be caring for vulnerable individuals, you and your employees must undergo a criminal record check and obtain a certificate. The type of check required depends on the country you live in:
- England: Disclosure and Barring Service (DBS).
- Wales: Disclosure and Barring Service (DBS).
- Scotland: Protecting Vulnerable Groups (PVG) Scheme.
- Northern Ireland: AccessNI.
Medicines Administration Records (MARs)
You must keep up-to-date, accurate records about any medicines that were administered or when supporting clients in taking their medicines. These records can be on paper or electronic. To comply with regulations, the MARs must:
- Be legible.
- Be signed.
- Be accurate.
- Be timed and dated.
- Be completed as soon as possible.
- Include information such as who administered the medication and whether the medication was taken or refused.
- Report any problems or changes in medication.
Retain records
Any records, including MARs, must be kept for a minimum of eight years after the individual’s care has ended. When destroying records, ensure this is done in line with the policies of your local authority.
Retain records
Any records, including MARs, must be kept for a minimum of eight years after the individual’s care has ended. When destroying records, ensure this is done in line with the policies of your local authority.
Appoint a registered manager
By law, you must appoint a registered manager. This could be yourself or another qualified individual. The registered manager will be responsible for ensuring your business’s compliance, overseeing the care and the day-to-day running of your business. The registered manager will need to have the correct qualifications.
Acceptable qualifications include:
- A QCF Level 5 Diploma in Leadership for Health and Social Care.
- A Registered Manager’s Award (RMA).
- An NVQ Level 4 in Leadership and Management for Care Services.
Ensure staff have the correct training
According to the Care Quality Commission (CQC), home care workers must have the relevant training, knowledge and skills to provide support with medication. Their knowledge should be updated annually, and they should undergo regular competency assessments.
Comply with regulations when ordering or transporting medication
If you order and transport medication, you will need to:
- Record the name, strength and quantity of the medication.
- Record the date of the order and the date the medication was received.
- Complete a risk assessment for transporting the medication.
- Store the medication safely and securely.
Create a Statement of Purpose (SOP)
This is a legal requirement that you must fulfil when applying to register your home care business.
It includes:
- Your business details.
- Your business’s aims and objectives.
- Where you provide your care services.
- Details of your appointed manager.
Obtain food hygiene certificates
If your staff members are involved in preparing or cooking food, or feeding your clients, they will require a food hygiene certificate. Staff members who are involved in food handling, preparation, serving or another aspect of the food process, will require a Level 2 certificate. If you are cooking food, you will need a Level 3 Food Hygiene Certificate.
Positives of Owning a Home Care Business
A home care business can be a rewarding business in many ways. Many care business owners consider caring to be a vocation, making it emotionally rewarding, as well as financially rewarding.
Some of the main pros associated with owning a home care business are:
Unlimited income potential
A home care business can be extremely lucrative. Care businesses typically charge high prices to their clients. You will also have the opportunity to hire a lot of employees and grow your business across your area. You could also expand your business to other areas, growing your business further. With a strong business plan and implemented strategies to maximise your profits, the income potential for your business is unlimited.
You can build relationships with your clients and employees
If you choose a hands-on approach to your business, you can build deep and meaningful relationships. Your clients will usually spend a lot of time with you (or your carers) and will develop high levels of trust.
Really make a difference
Running a home care business can be extremely rewarding. Your business will provide care and support to vulnerable people or people coming to the end of their lives and you can make a hugely positive difference to their health, wellbeing and quality of life.
You can help people stay in their own homes
Leaving your home to live in a care home can be extremely distressing. A home care business can allow people to choose to stay in the comfort of their own home, while still getting the care and support they need.
Consistently growing industry
With an increasingly ageing population, the care industry is one of the fastest-growing industries in the world. This gives you the opportunity for further growth, either by extending your business to accommodate more clients or by expanding your business to other areas. Your business is always going to be in demand, which is a huge advantage for business owners.
Choose your clients
You can choose your clients based on who you think your business will be able to offer the best care and support to. If you think a potential client’s needs are too complex for your staff, you will have the ability to turn down their care or recommend another business to them.
You can screen and match your clients to their perfect carer
You can carefully choose the perfect carer for each client, based on their medical, emotional and personal needs. You can ensure your clients are receiving the best possible care, while still ensuring your business makes a profit.
Control your own workload
You can be involved as little or as much with the day-to-day running of your business. You can choose to work hands-on with your clients and employees or employ a care manager to allow you to take a step back from many of the responsibilities. Controlling your own workload is one of the biggest positives of running your own business.
Predictable income stream
A home care business will have the same clients they see daily and weekly. The consistency of work means that both your income and your outgoings are predictable. Even if you stop working with a client, people always need care, meaning you should never have to worry about a drop in your profits.
Face-to-face interaction
A home care business will involve a lot of face-to-face interaction – with your employees, your clients, their families and other healthcare professionals. If you are a people person who enjoys spending time with others, this can be very rewarding.
Become integrated into the local community
Many people in your community will have friends, relatives or neighbours requiring care. Carers and care businesses are usually well-respected in the local community. You will also have the opportunity to get to know families and other professionals in the local area.
Negatives of Owning a Home Care Business
Although owning a home care business can be rewarding in many ways, there are also some important cons you should be aware of:
It can be stressful
Not only will you have a lot of responsibility, but you will also witness some potentially distressing things, such as people coming to the end of their life, people in pain and distraught family members. This can be extremely stressful and emotionally exhausting. Ensuring your business is providing the best possible care, managing your employees and taking care of your administrative duties can all add to your stress.
Time commitment
Some of your clients will require 24 hours a day care and frequent visits throughout the day and night. Even if you are not involved directly in their care yourself, you may need to be available to assist your employees or answer questions from the client, their families and medical staff. As well as being demanding on your time, the care industry can also be emotionally demanding and can be difficult to switch off from, even when you are at home or taking time off for a holiday.
High liability
People who require home care are often considered extremely vulnerable, and many everyday activities can be a risk to their health and safety. Care home residents are at high risk of injury, illness, dehydration and other health issues. If a client becomes ill or injured under your care, your business may be considered liable.
High start-up costs and running costs
Although your costs will be lower than a residential care home, they are still relatively high and can cause financial strain. Your staffing, equipment, vehicles, marketing costs and administrative costs can all be substantial and can make it more difficult for your business to turn a profit.
Strict laws and regulations
The care industry is highly regulated and there are many laws and regulations you will need to abide by. You will need to research your legal requirements and ensure your business is operating in line with the law. Failure to do so could result in a fine, the forced closure of your business or even prosecution.
The job can be physically demanding
You (or your staff) will be on your feet for a lot of the day and be involved in manual handling activities, such as moving clients, carrying equipment and bending down. The physical strain can result in aches, pains and even injuries.
The motivation of your employees
Although you will have the power to hire your employees, it can be more difficult to control their motivation once they are working for you. Many carers are paid minimum wage even though their job can be physically and emotionally demanding, and this can have a negative impact on their motivation. If your staff are unmotivated, have a negative attitude, or don’t follow your business values, this can be harmful to your business and your clients.
It can be competitive
You will be competing with care homes, other home care businesses and NHS or government-funded carers. Having multiple businesses to compete with can make it more difficult for your business to succeed.
Planning Your Home Care Business
When starting up a home care business, you will need to create a business plan. Your business plan will help your business to succeed and grow.
It will need to include:
- Your company information.
- Your company description.
- The care services you will provide.
- Your branding, marketing and advertising plan.
- The structure of your business, including management and employees.
- The operational plan for your business.
- The financial plan for your business.
Some of the considerations you should make when creating your business plan are:
Will your business provide medical or non-medical care?
This is one of the first decisions you will need to make when setting up your business. The type of home care business you run will have a significant impact on your equipment and staffing requirements, your typical client base, your funding and your pricing strategy.
What are your equipment requirements?
Consult the list above to help you determine your equipment requirements. You will need to decide what equipment you require and research which equipment will be provided or funded by other sources, and which will need to be funded by your business directly. Consider your budget, the type of care you will provide, and your clients’ needs when determining your equipment requirements.
What are your staffing requirements?
The staff you will require depends on the type of care you provide. If you provide medical home care, you may need nurses, physician associates and therapists. You will need to ensure you have enough staff to meet your clients’ needs and that all of your staff are correctly trained. You will also need to decide whether you will be the registered manager, or if you are going to hire a registered manager.
How many clients can you provide care for?
Being aware of how many clients you are able to care for can help you ensure you maximise your business and influence your marketing strategy. The number of clients you can care for will depend on their needs and your staffing.
What is the level of care your business can provide?
Will you offer care to clients who require round-the-clock care or will your offer regular care visits? The level of care you are able to provide will affect your staffing requirements and client base.
What are your start-up costs and running costs?
Consult the list above to help you calculate your start-up costs and running costs. Being aware of your approximate costs allows you to determine how you will finance your business and when you are likely to start making a profit. Starting up a home care business can be expensive. Depending on your predicted costs, you may need to acquire investment, for example via a bank loan or an external investor.
What is your pricing strategy?
Once you have calculated your start-up costs and running costs, you can then calculate your pricing policy. Consider your location, facilities, experience, training, type of care home business you run and the pricing of your competitors. Your pricing policy should be transparent and easy to understand.
What are your business objectives?
Planning the future of your home care business and creating a one-year, three-year and five-year plan can be pivotal to the success and growth of your business. Having clear business objectives and a business plan can help to attract prospective investors and help you to identify which aspects of the care home require particular investment.
Your business objectives should be SMART:
- S = Specific
- M = Measurable
- A = Achievable
- R = Realistic
- T = Time-bound
Have you complied with all legal requirements?
Consult the list of legal requirements above to check you have complied with all requirements and regulations and that all your paperwork is accurate. Failure to comply with legal requirements could have a detrimental effect on your business or could result in a fine, the forced closure of your business or, in serious cases, prosecution.
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