How to start a Home Care Business: providing a well-led service

This week brings us to the end of our journey through the Care Quality Commission’s (CQC) Five Key Domains, which run through the regulation and assessment of care services and provide the foundation for any home care business. Over the past four blogs, we have considered how to provide a safe, effective, caring and responsive service. We conclude here with the requirement to be well-led. But if you’ve missed any of the previous blogs, we recommend you go back and read through before going any further.

This last foray into the key domains also brings us towards the end of our series looking at how to start a Home Care business. In addition to the blogs mentioned above, we’ve also considered how to register with the Care Quality Commission (CQC) and some of the business fundamentals of running a care service. Next week will see us conclude this series – but more on that below!

How to start a Home Care Business

Key domain 5: a well-led service

The requirement for a service to be well led simply means that your leadership, management and governance is set up to ensure the delivery of high-quality, person-centred care, to support learning and innovation, and to promote an open and fair culture.

As with the previous key domains, it sounds so simple! But this is the one that is of most importance as you plan to get started. Knowing care is one thing; putting the business structures in place to meet the regulatory framework requires time and a good working knowledge of the CQC’s remit and inspection regime. Understanding the CQC remit is important because it answers only to parliament and, from time to time, its remit is changed or added to, by way of a commissioned activity or theme, within a specific timeframe, followed by a written report.

Starting a home care business also requires a solid financial and business plan, which is based on a thorough assessment of market need. There is no point starting a business, if there are few customers. Decisions need to be taken with regard to how your service users will be funding – and for that, you need to know your local authority fee structures, as well as the market rate for fully-funded individuals. Only when you are confident in the financial viability of the business, should you invest the time in the regulatory set-up.

At this point it is worth finding a good accountant! They will be able to advise you of the most tax-efficient structure for the business and you will need to register accordingly, as detailed by CQC Regulations 4, 5 and 6. Regulation 7, meanwhile, will tell you if need a Registered Manager. These regulations are the foundation on which to build good governance. They will help ensure that the necessary qualifications, experience, knowledge and competencies are in place to take the business forward.

Setting your values

The values, ethos and philosophy of the business are what makes the difference within any care setting. Without a clear understanding of what these mean and, more importantly, how they are going to be embedded in the delivery of care, it will be difficult to meet the CQC regulations.

Values are individual beliefs that motivate people to act in specific ways. Ethos is a personal framework for making moral choices: it informs where you stand and why you stand there, within any given situation. Philosophy is the theory or attitude that acts as a guiding principle for behaviour.

Providing a well-led service means leading from the front. It means valuing staff and fostering an ‘open-door’ culture that listens and learns from everyone, no matter what their role or responsibilities are. It means that senior management practice what they preach, without fear or favour.

Person-centred care is a reality, not an aspiration, where strengths, not deficits, are emphasised. It means that the individuals who will use your service will be encouraged to share their experiences and views, knowing it will be worthwhile because these are acted upon, not just noted. Meanwhile, multi-agency partners will trust that anything brought to your attention is treated appropriately, investigated if necessary, and shared with those who need to know.

Evaluate, evaluate, evaluate

As a business, processes to monitor and evaluate systems, people and outcomes should be in place from the beginning. As the business develops, these processes provide the links to sustained learning: they make it more likely you will get things right but provide the framework to deal with things in the most timely and appropriate manner if they go wrong.

Innovation is a word heard time and again in social care – but is perhaps the hardest to action. Yet innovation is simply a good idea that has been transformed into good practice. An Outstanding Rating in the well-led domain usually identifies with an innovative action: an idea that has been heard, shared, and made to work through a process of involvement, discussion and decision making – for the benefit of all.

It is always a good idea to re-look at why, how and when things are done – especially with the continual evolution of technology. Tele-care has increased both in its use and uses, and is always worth exploring, to keep up to date, if nothing else. But it may also make a contribution to innovative care, especially when it comes to falls management, even at home.

Conclusion

Being well led is more than more than a statement of intent; it needs to visible through the organisation with employees who gain pride in working for a well-managed, reliable, listening and learning service. A service that is built on people’s needs. And that is delivered by trained and competent staff.

As part of W&P’s offering to aspiring social care providers, our care agency policies and procedures packages, with associated forms, provide an accessible template for establishing a well-led practice. We also offer a Care Agency Business Start-up Package that provides support, necessary guidance and direction to help you get started as a business with CQC compliance.

Next week, we will draw together all you need to know to start-up your care agency, including ideas to consider, where to go for free advice, and a look at current government help schemes for those new to business.