There are two types of live-in care agency: a managed agency and an introduction agency.

Introduction agencies work by “introducing” self-employed carers to clients who need assistance at home. This is a model approved by the CQC and although it falls out of the scope of their regulations, it conforms to the Health & Social Care Act 2008. The carers are all suitably trained to be able help in whatever way is needed, and will have been vetted in the same way as a managed agency. The role of an introductory agent is as an advisor to the client. They will offer advice and support on the setting up and management of the care service, but the daily instructions will come from the client.

Both the carer and the client will have contact with the office to ask for advice or to mediate certain issues, and a good introduction agency will keep in regular touch with both. Often the client will have more choice as to the carer who comes and the length of time they will stay. The carer will generally be paid more than with a managed agency, and the introduction agency will take a lower fee. The carer is registered as self-employed and pay their own taxes.

difference between managed agency and introduction agency

Managed agencies employ the carers directly and are responsible for all the activities with regards to managing the carers. In addition, they are regulated by the Care-Quality-Commission (CQC). The agencies are responsible for paying the carers for sick pay, holiday pay, and to make national insurance and pension contributions. They usually determine which carer goes to which client and on which date. Managed agencies almost always cost more than introduction agencies and with this model, typically about half the money goes to the carer and half to the agency.

Which is better for my family?

In terms of recruitment, the processes and vetting are very similar. In terms of providing continuity of carers, both types of agency ensure there is always a carer in place. In theory, managed agencies provide a more active and engaged oversight of the carers. In practice this isn’t always the case. One main difference is the price; managed agencies usually charge significantly more. As managed services involve more layers of bureaucracy they are more expensive, usually at least £200 a week more than introduction agencies, which would add up to an extra care bill of over £10,000 a year on top of the price of an introduction agency.

In terms of accountability, managed agencies are accountable to the CQC, introduction agencies are accountable to the client, and every client is welcome to ask questions about each carer and to see relevant documentation upon request.

The most important things to consider when choosing an agency are the quality of carers provided, and the level of support from the agency. These will vary from agency to agency so it is important to find a good one!

We generally find self-employed carers have more care experience and are happy to be slightly more autonomous and to receive a better rate of pay. In our opinion, the only real difference between the two is whether the carers are employed or self-employed.

Ultimately the decision is up to your preference and your needs. But generally, introduction agencies offer a bit more independence and flexibility for both client and carer and managed agencies offer a more rigid, regulated structure.


How we can help

Careleaf is a live-in care introduction agency who can help your loved one live happily and independently at home. Do explore our website, call us on 01273 900262 or send an email to for more information.