When families compare introductory agency vs managed care, the question that matters most is: who is responsible for the carer? With a managed (fully regulated) agency, the agency employs and supervises the carer and answers to the Care Quality Commission. With an introductory agency, the agency finds you a self-employed carer and then steps back — you, not the agency, manage the arrangement.
There is also a third option: finding and employing a carer yourself. Each model can work well. They differ in cost, legal responsibility and what happens when something goes wrong.
In short: managed care costs more but hands over most of the responsibility; introductory agencies and direct employment can cost less but leave more of the risk and paperwork with the family.
The three models of home care
1. Managed (regulated) home care agency
The agency recruits, vets, trains, employs and supervises the carers. It writes the care plan, arranges the rota, covers sickness and holidays, and deals with problems. Because it provides personal care, it must be registered with the CQC, which inspects it and publishes a rating. You have one contract, with the agency.
2. Introductory agency
The agency matches you with a self-employed carer, and you usually pay the carer directly for the hours worked plus a fee to the agency. After the introduction, the carer works under your direction. According to the CQC, introductory agencies that have no ongoing role in the care do not need to register. If the agency keeps directing the care — monitoring it, arranging rotas or managing replacements — it must register.
In practice, many introductory agencies offer some ongoing help, such as finding a replacement if the carer is ill. Ask exactly what they do and whether they are CQC-registered.
3. Directly employing or engaging a carer
You find a carer yourself — through word of mouth, a local advert or an online platform — and pay them directly. The CQC says an individual care worker does not need to register if they work for one person or family, without an agency involved, and wholly under that person’s direction. That means no inspection and no regulator to go to if things go wrong.
Introductory agency vs managed care: side-by-side
| Managed agency | Introductory agency | Employing directly | |
|---|---|---|---|
| Who employs the carer? | The agency | Carer is usually self-employed | You, or the carer is self-employed |
| CQC-registered? | Yes, must be | Often not, if no ongoing role | No |
| Who checks DBS, references and training? | Agency (and CQC inspects this) | Agency at introduction; check what it covers | You |
| Cover for sickness and holidays | Agency arranges | Varies; may be extra | You arrange |
| Typical cost | Highest per hour (around £28–£38 in West Sussex) | Often lower per hour, plus agency fees | Often lowest per hour, plus employer costs |
| If something goes wrong | Agency complaints process, then the Ombudsman; CQC can act on concerns | Mainly between you and the carer | Between you and the carer |
Who is the employer?
This is where families get caught out. Calling a carer “self-employed” does not make them self-employed. Employment status depends on how the work is actually done: who decides what tasks are done and when, whether the carer can send someone else in their place, and whether they work for other clients.
A carer who works set hours for one family, doing what the family asks, may legally be an employee — which makes the family, or the person receiving care, their employer. HMRC has an online tool, Check employment status for tax, and it is worth using it if you are unsure. Getting this wrong can mean unpaid tax and National Insurance, plus claims for holiday pay.
Your responsibilities if you employ a carer
If you are the employer, the legal duties are the same as for any other employer. Carers UK lists the main ones:
- Payroll: registering as an employer with HMRC if needed, running PAYE and deducting tax and National Insurance.
- Pay and leave: at least the National Minimum Wage or National Living Wage, paid holiday, and statutory sick, maternity and paternity pay where they apply.
- Pension: workplace pension auto-enrolment duties.
- Insurance: suitable employer’s liability and public liability cover. Specialist policies exist for people employing their own care workers.
- Checks: right to work in the UK, references and a DBS check.
- Health and safety: assessing risks in the home, such as moving and handling.
There is one useful saving: GOV.UK guidance confirms that people who employ a care and support worker for someone with a disability or long-term condition may be able to claim Employment Allowance, which reduces the employer’s National Insurance bill.
If the care is paid for through council direct payments, West Sussex County Council can point you to support with payroll and employing a personal assistant. Ask your social care practitioner.
How the costs compare
A managed agency’s hourly rate covers the carer’s wages, holiday pay, training, travel time, supervision, insurance, the office team, out-of-hours cover and CQC registration. In West Sussex that typically comes to £28–£38 an hour in 2026. The Homecare Association calculates a minimum price of £34.42 an hour for England in 2026/27 for an agency paying carers legally and operating sustainably.
Introductory agencies and self-employed carers can look cheaper per hour because the family carries some of those costs and risks instead. When you compare, add up:
- The agency’s introduction or weekly fee, and whether VAT applies
- Paying for cover when the regular carer is off, often at short notice
- Payroll, insurance and pension costs if you are the employer
- Your own time managing rotas and dealing with problems
For full price guidance see our home care cost guide for Worthing, and check what financial help is available with our funding checker.
When each model suits
A managed agency suits people who need personal care, especially several visits a day; families who live at a distance or work full time; and anyone who wants a regulated service with a clear complaints route. It is usually the safest choice for someone with dementia or complex needs.
An introductory agency suits families who want more say over who the carer is, are comfortable managing day-to-day arrangements and have a plan for when the carer is unavailable. It is common for live-in care.
Employing directly suits people who are organised, have a trusted carer in mind, and are ready to take on employer duties — often through direct payments, with support.
Whichever model you choose, do your own checks. Our guide to how carers are vetted, contracts and complaints sets out what to ask, and our guide on how to choose a home care agency covers the rest.
Find care near you
Tell us your postcode and what you need help with. We pass your details to one vetted CQC-registered agency in your area — you are told who they are, and that they pay us a fee, before anything is sent.
Frequently asked questions
Are introductory agencies regulated by the CQC?
Often not. The CQC says introductory agencies do not need to register if they have no ongoing role in the care after making the introduction. If an agency continues to direct the care, it must register, so always check the CQC website.
Is a self-employed carer cheaper than an agency?
The hourly rate is usually lower, but you carry more of the cost and risk: finding cover, insurance and possibly employer duties. Compare the total weekly cost, including cover for holidays and sickness.
Who is liable if a self-employed carer has an accident in my home?
It depends on the arrangement and the carer’s own insurance. Ask to see the carer’s public liability insurance, check your home insurance, and take advice if you may be their employer.
Can I use direct payments to pay an introductory agency?
Often yes, but the council must agree that the arrangement meets the person’s assessed needs. Speak to West Sussex County Council before you sign anything.
Do I need to run payroll for a carer who works a few hours a week?
Possibly. If the carer is legally your employee, you may need to register with HMRC depending on their pay and other circumstances. Check the GOV.UK guidance on becoming an employer or ask a payroll service.
The Care Panel is an independent publication. We are not a care provider and are not regulated by the Care Quality Commission, because we do not deliver care. Always check a provider’s own CQC registration and inspection report before you commit.
Written and fact-checked by The Care Panel. Last updated September 2026. Sources: Care Quality Commission guidance on introductory agencies and individual care workers, Carers UK guidance on employing a care worker directly, GOV.UK Employment Allowance guidance for employers of care and support workers, HMRC Check employment status for tax, Homecare Association. General information, not financial, legal or medical advice — figures are indicative and subject to change.