The ranch hand, p.1
Getting into Care, page 1
PRAISE
‘As well as being a very successful care provider, whose attention to detail is second to none, Kemi has written a book that comes just at the right time to de-mystify the entire CQC registration process and provide much-needed guidance to prospective care providers wishing to go/going through CQC registration. It provides information in an easy-to-understand and follow format to support qualified candidates on their journey to becoming registered care providers in England. I encourage you to go through this book alongside the guidance provided by the CQC to make the entire process as stress-free as possible and increase your chances of being registered with the CQC.’
Nya Mabu Ngwashi
Owner of Connect Care Consultancy and coach
‘An indispensible guide to navigating the many considerations in becoming a good/outstanding care provider.’
Nana Banton
Abacus Care & Support
‘This book is full of useful and essential information that deals with the minefield of CQC registration. It covers all the different aspects that are needed to start a business in the sector and for anyone contemplating a business in the care sector, this book will be indispensable. Recognising that there has never been a better time to start a business in care, this book will help anyone who is considering working to provide care, to start strongly and pave their way to success.’
Abimbola Ladipo-Aridegbe
Parent and Child Fostering Services
First published in 2022 by
Panoma Press Ltd
www.rethinkpress.com
www.panomapress.com
Copyright 2022 © Kemi Madumere
The right of Kemi Madumere to be identified as the author of this work have been asserted in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this book may be reproduced in any material form (including photocopying or storing in any medium by electronic means and whether or not transiently or incidentally to some other use of this publication) without the written permission of the copyright holders except in accordance with the provisions of the Copyright, Designs and Patents Act 1988. Applications for the copyright holders’ written permission to reproduce any part of this publication should be addressed to the publishers.
Cover design and book layout by Neil Coe
978-1-784525-88-0
I would like to dedicate this book to my biggest supporters, my amazing husband, Chris, and daughter, Ashlynn, who have always been my biggest fans, and to the people who inspire me to do better to serve them each day.
Contents
Introduction
Chapter 1 The Care Industry
Chapter 2 Setting Up Your Company
Chapter 3 Your Business Plan
Chapter 4 The CQC Registration Process
Chapter 5 The CQC Application
Chapter 6 Registered Manager’s Application
Chapter 7 Statement Of Purpose
Chapter 8 The CQC Interview
Chapter 9 Marketing And Acquiring Clients
Chapter 10 Client Care
Chapter 11 Compliance, Feedback And Review
Conclusion
The Author
Introduction
You are choosing a good time to to start a business in care: demand for all kinds of care is high and is only likely to increase. If you are considering setting up a business in this sector, this book will get you started on your journey and provide you with the tools and resources you need to succeed. It will support you to navigate the processes and requirements of Care Quality Commission (CQC) registration and covers everything else that is needed to start a business in the care sector.
The information provided in this book draws on my knowledge of and experience in the industry, gathered over the course of setting up my care company and property management firm. This book also features expertise from industry specialists, both from the care sector and, to some extent, the property industry, who have agreed to share their insights, knowledge and business skills with you.
My story
I come from a family of business owners and, over the years, my love of running businesses has developed. I have enjoyed periods of great success and, equally, times where things didn’t go so well. In each circumstance, I took everything, the good and the bad, as an opportunity to learn, grow and identify areas for improvement.
I launched my first business when I was just eleven, setting up a local kids’ club, followed by a string of businesses funded by various organisations including the Prince’s Trust. Up until a few years ago, over a period of seven years, Chris (my husband) and I successfully ran a property company specialising in providing flatshares for young professionals in central London. The business was based on a rent-to-rent model, where we leased properties long term from landlords and re-let them to university students and interns who were new to the UK. When the UK decided to leave the EU and several property and tax laws were changed, our business, like many others, suffered a serious downturn. We recovered, but not to the level at which we had previously been operating. Of course, this was then further impacted by the coronavirus pandemic. We did learn a valuable lesson, however: never put all your eggs in one basket.
In 2018 we were attending a property seminar that covered a small segment of the care industry, specifically supported living premises or transforming properties into such. I felt it was a niche area of the property world but it struck a chord with us. Sourcing and providing supported living homes felt similar to the business we were already running, except in this case we would be providing support as well as housing for vulnerable adults.
We obtained our CQC licence registration swiftly. The challenging part was getting clients on board, especially from the local authority – and during a pandemic. Like most new providers, we had no CQC rating yet and so were regarded as inexperienced. Nevertheless, we persisted and successfully negotiated contracts and secured local authority clients within twelve months of our registration. Our care business has since grown from strength to strength and we have ambitious plans for it.
With some business acumen, passion for what you do and a deep understanding of your target clientele, there is no reason you can’t achieve the same level of success, and more. I want to help you build a thriving business of which you are proud. In this book, I will walk you through the different stages of establishing and registering a CQC-qualified business, step by step, explaining the entire process from the initial application through to getting your first clients. I share the key actions and assets that have led to our success: the systems, scripts, sample letters, general costings, tools, apps, software and websites that you need to move forward. Each chapter will introduce you to a new facet of the knowledge necessary to starting a business in this sector, with lots of tips along the way. Wherever possible the book is action-oriented, and I suggest tasks that will support you in applying the information presented. As you progress through the book, I recommend you note down key learning points and ideas, and always monitor the most up-to-date information provided by the government and the NHS.
Let’s get started.
CHAPTER 1
The Care Industry
What kind of business is a care agency? In this chapter, we will explore what a care agency is, the different forms it can take and what kind of work it entails.
By the end of this chapter, you should have a good understanding of:
The care industry, the work it involves and the opportunities that exist within it
What a care agency looks like and the different types of care available
The differences between domiciliary care and supported living
The business opportunities that exist in care
The various elements that you should consider when setting up a business in the care sector
Why the care sector?
No matter what business you’re in, you need to have a powerful reason why you are doing it – ‘to make money’ is not enough, particularly in the care sector. Working in a care business can be challenging. On tough days (and there will be many of these) when the mundane but essential tasks are pressing – such as making that sales call, dropping those leaflets or sending out another load of repetitive sales emails – your ‘why’ is what keeps you going, because only you can see the bigger picture, giving you the energy to push through.
You can have one ‘why’ or many. Examples are ‘I hate my current job’, ‘I want to improve my family’s life’, or maybe you have had a personal experience with the care sector that is motivating you. The ‘why’ must be personal and there is no right or wrong answer.
What is a care agency?
A care agency is an organisation – public or private – that is primarily engaged in providing skilled or professional care, treatment and support to individuals, their families and carers. This care, treatment and support can be provided in residential accommodation, which is usually in a non-hospital setting, such as private care homes, hospices, shelters or supported living services. Care agencies can take various forms, but the main two are home care and supported living.
Home care versus supported living
Home care, also known as domiciliary care, is one of the largest sectors in the care industry, and the ‘front line’ of social care delivery. Domiciliary care is provided to people who still live in their own homes but require additional support with activities such as household tasks, personal care and any other tasks to enable them to maintain
Supported living is a service designed to help people with a wide range of support needs to retain their independence by providing support in a residential home that is often shared with other like-minded individuals and will typically have 24-hour staff on site.
It is important to differentiate between domiciliary care and supported living because they are very different types of care provision. With domiciliary care, the clients continue to live in their own homes, whether that’s a property they own or rent, or one they live in with family. By contrast, a supported living home is a residence designed to be shared with individuals requiring similar levels and types of support. It is important to note that supported living homes are not considered care homes or nursing homes and so are not inspected by the Care Quality Commission (CQC). These homes are deemed to be the clients’ own homes, as they involve a tenancy agreement held directly between the tenant and the landlord.
Other types of care agency include residential care homes and nursing homes, which have a similar set-up to supported living, except that the homes in these cases are not regarded as the tenants’ own homes; rather, they are residents of the home. These types of home often have more restrictions placed on them and will also be inspected by the CQC. (This level of restrictions does not apply to care businesses not regulated by the CQC, such as homes for 16–18-year-olds who do not require personal care.)
Before setting up your care business, you will need to decide the target audience you wish to serve, the type and level of services you will be providing (eg elderly clients, children, adults with learning disabilities, etc) and where and how you will provide these services. Think about the different types of care services you are able to supply, how these fit into your business model and how you can provide quality care in the best possible way.
The business opportunity
The United Kingdom Homecare Association (UKHCA) estimates that around 249 million hours of home care are delivered in England each year.1 The care industry is constantly evolving and, as it does so, more and more business opportunities arise.
In 2015, more than 350,000 older people in England were estimated to use home care services, 257,000 of whom had their care paid for by their local authority. A further 76,300 younger people with learning disabilities, physical disabilities or mental health problems were also estimated to be using publicly funded home care.2 These represent substantial numbers of people requiring different forms of care, which is indicative of how important the domiciliary care market is in the delivery of care. Those needing care is set to rise further as people live longer and more of us require care in the community, and the demand for mental health support is similarly increasing.
Over the past two years, three of the biggest national providers of home care (Saga Care UK, and Housing 21) have withdrawn from the publicly funded home care market, while two others (Mears and Mitie) reported losses in their home care divisions. Mitie subsequently sold its home care business for just £2.3
Currently over 950,000 adults in the UK receive home-based care,4 and the domiciliary care industry is currently worth approximately £5 billion per year.5 There are more than 10,000 homecare providers in England registered with the CQC, with the Department of Health & Social Care (DHSC) predicting that 57% more adults over 65 will require care over the next 15 years.6
What does all this data mean, and what is the opportunity for those seeking to build a successful business in this sector? The care industry is evolving rapidly and the departure of larger healthcare companies creates a vacuum that needs to be filled, providing opportunities for newcomers.
From a financial perspective, the level of income that can be created from running a successful care business will depend on how quickly you scale up and how large you want your organisation to be. The beauty of the care industry is that even smaller businesses can do well financially. You don’t need to be a vast organisation with endless resources and hundreds of staff to be hugely successful in this sector.
The care sector has many facets and so there are numerous business avenues you can take and a wide variety of specialties, all of which can be lucrative businesses if you adopt the right approach and systems. Examples of businesses within the care industry include:
Domiciliary care
Respite
Recruitment agency
Training company
PPE supplier
Professional services/consultancy
Residential home/nursing home
Children’s home
Supported living
In this book we focus on domiciliary care agencies and supported living services, which are CQC-regulated businesses. (The set-up processes for nursing and residential care agencies are quite different to that for domiciliary care and supported living, though they are also CQC regulated.)
Between 2016 and 2017, the CQC registered 8,500 domiciliary care services. Every quarter, at least 500 agencies register with the CQC – quite a sizeable figure; however, data illustrates that an almost equal number, around 400 agencies, deregister in the same period.7 Many of these agencies deregister before they have even begun to offer any services.
This rate of deregistration may seem alarming, but there are many reasons as to why a care business doesn’t work out and they take the costly steps of deregistering. Understanding what makes a successful agency is important, as is being able to recognise a failing one, so that you can avoid this and stay on the path to success.
Some of the biggest challenges that new care businesses face include:
A lack of clients
Insufficient funding
Poor or absent marketing strategy
Inadequate operations
In the following chapters, we will look at the elements of a good, profitable care business, walking you through what’s involved to give you the best chance of success.
Task
Earlier I mentioned that it is important to set your ‘why’, as this helps to shape your goals. Get a pinboard and some pins. Then, sit in a quiet place and start thinking about the life you want – this is your ‘why’. Search online and in magazines for images that represent those dreams and the life that you want to create and use them to create a vision board. Place this somewhere you will see it every day so that it will provide daily inspiration to keep you on track as you work through this book and toward building a successful care business.
Decide on the kind of care business you want to operate, for example whether you intend to offer domiciliary care or a supported living service. We will explore what these involve in more detail later on, but for now think about whether you like the idea of supporting people in their own homes or would rather provide support in one location.
Decide what kind of clients you wish to serve – for example will you specialise in care of the elderly, adult mental health, children, or those with dementia? To start with, I would suggest you work with a group that you are familiar with, whether that’s through your work or personal experience. A familiarity will make things easier, but is not essential – I started out working with adults with learning disabilities with no prior experience – it will just be a steeper learning curve.
1 J Holmes (2016). ‘An overview of the domiciliary care market in the United Kingdom’, United Kingdom Homecare Association website. Available at: www.ukhca.co.uk/downloads.aspx?ID=109
2 R Wittenberg and B Hu (2015). ‘Projections of demand for and costs of social care for older people and young adults in England, 2015 to 2035’, PSSRU discussion paper No 2900. London School of Economics and Political Science. Available at: www.pssru.ac.uk/publications/pub-4992
3 (2017) ‘Mitie sells home care business for £2’, BBC News. Available at: www.bbc.co.uk/news/business-39126019
4 National Audit Office (2021). ‘The adult social care market in England’, Department of Health & Social Care. Available at: www.nao.org.uk/wp-content/uploads/2021/03/The-adult-social-care-market-in-England.pdf
5 ‘Domiciliary care in the UK statistics’, Ibisworld. Available at: www.ibisworld.com/united-kingdom/market-research-reports/domiciliary-care-industry/
