Most families land in this situation the same way. A parent comes out of hospital, or a partner has a bad fall, or something happens on a Tuesday afternoon that makes it obvious the current arrangement is not going to hold. You type something into Google, you get back a long list of names, you start ringing them one by one. Some have an automated phone system. Some send you a PDF. Some promise a carer by the end of the week and then ring back on Thursday to say the carer they had in mind is no longer available. You keep going because you have to. Nobody stops to explain how any of this actually works.

That confusion is not your failing. The home care sector in this country uses the same words for different things, and the people selling their services are not always in a hurry to explain the difference. So here is a plain-English account of the two main shapes of arrangement, and where the introductory agency model fits in.

The managed agency model

The type of agency most people picture when they hear the word 'agency' is what the Homecare Association calls a managed or regulated provider. This is a business that employs carers directly or contracts them as workers, schedules their shifts, supervises them, and bills you for the total service. The Care Quality Commission regulates these providers and inspects them. If the carer who usually comes cannot make it, the agency sends someone else. You do not choose who comes. The agency does.

There is genuine value in this for families who cannot take on any coordination at all. But it comes at a cost that is not only financial. You may never meet the person before they walk through the door. You may find a different face each week because the underlying rota shifts. You pay a rate that covers the agency's wages bill, insurance, management overhead, and margin, and the carer themselves receives a fraction of what you are paying. If the arrangement goes wrong, your complaint goes to the agency, not to the person doing the care.

For some families, that structure works. For others, particularly those whose parent or partner has dementia, or who have specific language or cultural preferences, or who simply need to know that the same person will be there every morning, the managed model is not a good fit.

The introductory agency model

An introductory agency does something different. Instead of employing the carer or managing their shifts, it introduces the family to a self-employed carer, carries out the vetting work before the introduction happens, and then steps back. The carer works directly for the family. The arrangement, the hours, the day-to-day relationship: all of that is between the family and the carer themselves.

Because introductory agencies do not manage the ongoing care, they are not regulated by the CQC in the same way managed providers are. This surprises some families. It is worth understanding clearly. The CQC regulates businesses that are responsible for the delivery of regulated care activities. An introductory agency is not responsible for the delivery of care once the introduction is made; the carer is. This is a legal distinction, not a loophole. It is how self-employment in domiciliary care works in this country. You can read more about which activities require CQC registration at cqc.org.uk.

What this model gives the family, when it is run properly, is something that the managed model rarely can. You meet the carer before any arrangement begins. You choose the person yourself, on the basis of their experience, their rate, and whether you and your parent or loved one actually get on with them. If the carer is self-employed and professionally insured, the money you pay goes almost entirely to the person doing the work. The coordination layer that drives up costs in the managed model is gone.

What families should check in any introductory arrangement

Not every introductory agency operates to the same standard. The vetting work is the part the family cannot easily do themselves, so it matters that the agency has done it. Three things to confirm before any introduction happens:

If the answer to any of those is unclear, ask again. A carer who is operating professionally in someone's home should be able to evidence all three without hesitation. The family also has every right, in their own home, to say they want to meet the carer before agreeing to anything. That is not being difficult. That is how a good arrangement starts.

At Hibant, every carer we introduce to a family has had their DBS, insurance, and references verified by us before the introduction happens. The family then meets the carer in person before any commitment is made. That is the sequence we follow because it is the sequence that protects everyone.

What families often tell us, once they understand the difference between the two models, is that they wish someone had explained it to them at the start, before they had already signed something they did not fully understand.

What to do this week

If you are still at the research stage, the most useful call you can make is to the Carers UK Helpline on 0808 808 7777. They are free, impartial, and they have spoken to thousands of families navigating exactly this. Citizens Advice can also help you understand your rights if you are already in an arrangement that is not working. Their nearest bureau finder is at citizensadvice.org.uk.

If any of this feels confusing and you would rather talk through the introductory model with someone who runs one, we are here for that conversation. We are a London introductory care agency. Every carer we introduce has been DBS-checked, insurance-verified, and reference-checked before you ever meet them, and you meet them in person before any arrangement begins. There is no pressure, no automated matching, and no rota. You choose the person yourself. If you want to talk it through, you can email us at hello@hibantcare.com or have a look at how we work at hibantcare.com.

Hibant

Useful links to keep handy

Looking for care or thinking of joining Hibant?

Whether you are a family navigating care for a loved one or a carer looking for fairer, more meaningful work, we would love to hear from you.

Find a carer Join as a carer
← Back to Understanding Care Questions? Get in touch