Starting and Growing a New Domiciliary Care Service: The Launch Checklist
An England-only, step-by-step guide for new and early-stage home care providers — from CQC registration to your first contracts, first staff and first inspection. Written for founders, nominated individuals and new registered managers.
Who this guide is for
You have decided to start a domiciliary (home care) service in England, or you registered recently and are working out how to grow safely. The biggest risks for new providers are rarely about the quality of care itself — they are about cash flow, recruitment, and building governance before the service grows faster than your systems. This guide takes you through each stage in the order you will meet it.
Stage 1 — Before you apply to CQC
Providing personal care to people in their own homes is a regulated activity. You must be registered with the Care Quality Commission before you deliver any personal care. Get these foundations right first — CQC will test every one of them.
- ☐ Choose your legal structure (sole trader, partnership or limited company) and confirm who will be the registered provider
- ☐ Appoint a nominated individual (for organisations) who will supervise the management of the regulated activity
- ☐ Identify a registered manager with the right experience and qualifications — they apply to CQC alongside you
- ☐ Secure a suitable office base where records can be kept securely and staff can be supervised
- ☐ Arrange employer's liability and public liability insurance, plus professional indemnity if relevant
- ☐ Register with the Information Commissioner's Office as a data controller
- ☐ Complete an enhanced DBS check (with adult barred list) for everyone applying to CQC
- ☐ Build a realistic 12-month business plan and cash-flow forecast (see Stage 5)
Stage 2 — Your registration pack
A well-prepared application is the single biggest factor in how smoothly registration goes. CQC wants to see that you understand what running a safe, effective, caring, responsive and well-led service involves — before you have any clients.
| Document | What CQC looks for |
|---|---|
| Statement of Purpose | Your aims and objectives, the people you will support, the service types, your locations and the legal entity — kept up to date |
| Policies and procedures | Service-specific, not generic: safeguarding, medicines, recruitment, complaints, infection control, lone working, consent and mental capacity, data protection |
| Recruitment process | Safe recruitment steps, including references, full employment history with gaps explained, right to work and DBS |
| Training plan | Induction aligned to the Care Certificate, mandatory training, and learning disability and autism training appropriate to roles |
| Governance plan | How you will audit, monitor and improve quality from day one |
| Business continuity plan | What happens if staff are unavailable, systems fail or severe weather hits |
- ☐ Statement of Purpose drafted and checked against your actual plans
- ☐ Full policy set reviewed and personalised to domiciliary care
- ☐ Registered manager can explain every policy in their own words
- ☐ Evidence of the registered manager's competence and fitness ready
- ☐ Answers prepared for the registration interview — safeguarding scenarios, medicines, staffing and governance
Stage 3 — Getting ready to deliver care
Registration is not the finish line — it is permission to start. Before your first client, make sure the operational basics are in place.
- ☐ Care planning and risk-assessment templates that are person-centred and outcome-focused
- ☐ A medication administration record (MAR) process and competency checks for staff who support with medicines
- ☐ A rostering system that allows realistic travel time between visits
- ☐ Electronic call monitoring or another reliable way to confirm visits happened on time
- ☐ An on-call rota so staff and families can always reach a senior person
- ☐ Spot-check and supervision schedule in place before staff start lone working
- ☐ Incident, safeguarding and complaints logs ready to use
Stage 4 — Recruiting and keeping your first team
Staffing is the constraint that limits growth for almost every new home care provider. Recruit for values, train for skills, and treat retention as seriously as recruitment.
- ☐ Pay at least the National Minimum or Living Wage for all working time — including travel time between visits, which is a common compliance failure
- ☐ Offer guaranteed hours or clear rota patterns where you can — unpredictable hours drive early leavers
- ☐ Complete every safe-recruitment check before anyone works unsupervised
- ☐ Deliver a structured induction and shadowing period before lone working
- ☐ Hold regular supervision and an annual appraisal, and record them
- ☐ Ask leavers why they are going and act on what you hear
If you are considering recruiting from overseas, check current Home Office rules carefully before making any plans — the routes available to care providers have changed significantly and cannot be relied on as a growth strategy.
Stage 5 — Money: pricing, cash flow and funding
Many new providers fail not because of poor care, but because they run out of cash while waiting to be paid.
| Income source | Key points for new providers |
|---|---|
| Self-funded clients | Paid by the person or family directly. Usually the fastest route to first income — agree clear terms, notice periods and invoicing dates |
| Direct payments | The person receives council funding and chooses you. Contract with the person, not the council |
| Local authority contracts | Larger volumes, but often slower payment, tighter rates and frameworks that open only at set times |
| NHS continuing healthcare | Higher-acuity packages with specific clinical requirements; usually commissioned through the integrated care board |
- ☐ Work out your true hourly cost: wages, holiday pay, employer National Insurance, pension, travel, training, supervision, office and management
- ☐ Set a minimum call length and a minimum rate below which a package is unsustainable
- ☐ Forecast at least 12 months of cash flow, including the gap between paying staff and being paid
- ☐ Keep a reserve for the months before you reach break-even
- ☐ Review your pricing at least annually and whenever wage rates change
Stage 6 — Winning work and growing steadily
- ☐ Build relationships with your local authority commissioning and brokerage teams — find out when frameworks open
- ☐ Register on the local authority's provider list or dynamic purchasing system where one exists
- ☐ Make sure your website clearly states your service area, the support you offer and how to contact you
- ☐ Collect honest reviews and compliments from clients and families from the start
- ☐ Grow in controlled steps — only accept packages you can staff reliably
- ☐ Update your Statement of Purpose and notify CQC of relevant changes as you grow
Stage 7 — Preparing for your first inspection
CQC will usually inspect a new service within its first year or so of providing care. New providers who do well are the ones that treated governance as a day-one habit rather than a pre-inspection scramble.
- ☐ Monthly audits running for care plans, medicines records, call times and training
- ☐ Every audit finding has an owner, a deadline and a record of what changed
- ☐ Feedback gathered from people using the service, families and staff — and acted on
- ☐ Notifications to CQC submitted on time for every notifiable event
- ☐ Evidence organised against the five key questions so you can find anything within minutes
Common mistakes new providers make
- Generic policies that do not match how the service actually works.
- Unpaid travel time, creating minimum-wage liabilities that grow with every new carer.
- Accepting every package early on, then being unable to staff them safely.
- No governance until inspection is announced — audits that start late are obvious.
- Underpricing to win work, then being unable to pay staff competitively.
Build your systems before you need them
MyCareAudit gives new providers an affordable, complete compliance system from day one — audits, action tracking, policies and evidence mapped to the CQC key questions — so your governance grows with your service instead of trailing behind it.