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Introductory vs fully managed live-in care providers

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What is the difference between introductory and fully managed live-in care providers?

When deciding whether you need round-the-clock care in your own home, there are lots of different service providers and options for live-in care which can be quite confusing. We’ve put together some of the key differences for live-in care service providers, so that you and your loved ones can make the most practical and informed decision that’s right for you.

There are two main options for choosing a live-in care provider: either an ‘introductory’ agency or a ‘fully managed’ provider, such as Helping Hands. Both options offer live-in care to you in your home, but there are distinct differences between the two.

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Fully managed service Introductory agency
Regulated by the CQC and CIW. Unregulated by the CQC and CIW.
Care is contracted by the care service. Care is contracted by the customer.
Carer is managed by the care service, with support from a care manager and local team. Carer is managed by the customer.
All-inclusive cost. Pay for the services used.
Care service will provide a new carer if sick or unsuitable. Family or customer responsible for finding replacement carers if sick or unsuitable.

A fully managed service

Opting for a fully managed service like Helping Hands means that everything from your carer’s contract to their training is all taken care of by the provider. They are responsible for the entire process of live-in care and are the port of call for you and your family if you have any queries.

  • Recruit and train carers

A managed live-in care provider will recruit and select their live-in carers directly, ensuring that they are trained proficiently in supporting those with complex needs and health conditions. They will also undertake full background checks, including Disclosure Barring Service (DBS) screenings, ensuring the correct documents are in place and sourcing several references.

  • Manage carers

In addition to this, they will be accountable for paying their carers and providing sick pay, holiday pay and pension scheme. And if your carer is unwell or unable to fulfil their 24-hour care duties because of an emergency, a managed care service will be able to replace your carer at short notice.

  • Regulated by the CQC

Most importantly, a fully managed care service is regulated by the Care Quality Commission (CQC), meaning they are regularly inspected to ensure they provide a safe, effective and responsive service. They will also have registered care managers who are responsible for different elements of the care service, which are usually those who supervise and advise carers directly in your home.

  • All-inclusive prices

In terms of costings, managed service providers charge for all elements of care. So, if you have different needs throughout the day, you will pay a set price that is usually determined when you have an initial assessment. The price is all-inclusive; it won’t change depending on what your live-in carer does for you – it includes everything that you need support with.


An introductory agency

An introductory care service or agency will act as an advisory provision, whereby they will guide you through the process of selecting the right carer for you and your needs. As the name suggests, they will introduce you to a carer who is registered with their agency but won’t manage them once they begin working for you.

  • Self-employed carers

Carers from introductory agencies are self-employed and may be registered with a number of different agencies. Although agencies don’t train their carers, they do ensure that they have completed relevant training, have the correct paperwork to work as a carer in the UK and have completed the correct background checks.

  • Carers managed by the family

Due to the carers being self-employed, you or your family will have a direct contract with the carer and will therefore be responsible for their pay. This also means that should your carer fall ill, you will be responsible for finding a replacement to cover yours or your loved ones’ care. Some introductory agencies do help families to source new carers at short notice, but it’s best to check this with the agency you use.

  • Unregulated by the CQC

Due to introductory agencies not actually providing care, they do not fall under the remit of the Care Quality Commission (CQC) and are therefore not regulated under their guidelines. This means that they are not regularly monitored against any guidelines set by the Commission and are able to operate how they wish.

  • Only pay for what you use

Paying for care with a carer from an introductory agency is slightly cheaper than a fully managed service because you only pay for the services you use. This does mean that the amount you pay could change on a daily basis, but also that you are responsible for paying the carer directly. For example, there may be a set fee for personal care but additional fees for accompanying you to the shops or for a day out.

What are the key benefits of a fully managed live-in care agency?

Choosing a fully managed live-in care service like Helping Hands means that you will always have continuity of care. This is particularly important if you have complex health needs and require more than one carer to support you. Knowing that you have the option to choose carers from the same company gives you confidence and reassurance that everything will be dealt with in the same way, with efficiency and ease.

Live-in carers will also have managers that they can liaise with if they have any concerns or need extra support, taking the burden off you to manage your carer directly – you are also able to contact them too. Care managers tend to be very experienced in the care industry, with the ability to call upon several years’ worth of knowledge to support your carer, should they require it.

Being employed by a care provider means that your carer’s pay is dealt with by the care company. This also includes national insurance, tax, pension, sick pay and holiday pay. The care provider will also ensure that your carer is trained accordingly, and if you choose Helping Hands, they will undergo award-winning training that complies with the highest of standards set by the Care Quality Commission (CQC). Selecting a carer from a care provider ultimately takes any stress and hassle out of paperwork and payments that you would need to organise if your carer was from an introductory agency.

Additionally, the payments that you make for your care includes everything that you may need from your care package. So, if you need help with a stoma or catheter, support to get dressed, someone to make your meals and a companion to take you to your favourite café – the price you pay includes all of that and anything else you many need. Whereas the prices for care from an introductory service could change each day, depending on what you require.

Most importantly, the majority of fully managed services are regulated by the CQC or CIW, ensuring that the care you receive is fully compliant with the Commission’s strict guidelines. This includes providing a safe, effective and responsive service and making sure that all carers are thoroughly trained to the same industry standards. Helping Hands are regulated by both the CQC and the CIW, and we are regularly inspected to ensure we adhere to their guidelines.

Which option is right for me?

Both options aim to deliver live-in care that is tailored to the individual. However, it depends on what is important to you or your loved ones and also your situation when deciding on which type of provider to choose.

If you want to be closely involved with the management of your carer, then using an introductory agency could be a better option because it allows you and your family to directly manage your carer. You may also only require certain support from your carer and prefer to pay for additional care needs as and when they arise.

However, if you prefer to know that everything is taken care of from the day your care package is set up – from selecting a fully-trained carer who is managed by the care provider and knowing the price you pay covers everything you will need – then a fully managed care service could be a better option for you.

If you are vulnerable or have complex health needs, knowing that you don’t have to worry about paying for additional elements of care or who will take care if you if your carer is unwell, provides extra reassurance and peace of mind to you and your family.

Although using a fully-managed live-in care service is slightly more expensive, it includes all of the elements of support you may need. You are safe in the knowledge that you will receive quality care from a provider regulated by the CQC or CIW.

If you’d like to find out more about live-in care from Helping Hands, our friendly advisors are available seven days a week to discuss the different options available to you.

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