UK care providers (care homes, domiciliary care, supported living): accounts, payroll, VAT and CQC-linked financial compliance
A care sector accountant handles the finance work that is specific to regulated care: the VAT exemption that locks input tax into your costs, sleep-in and travel-time National Minimum Wage compliance, the CQC financial viability statement, and the funding-mix accounting that separates self-funder, local authority, NHS-funded nursing care and NHS continuing healthcare income. A generalist firm handles none of these by default.
We work with care home owners, registered managers, domiciliary agency directors and supported-living providers across England. Each sub-sector carries its own finance risks; select yours for the detail that applies to your service.
Accountancy and financial compliance for UK care home operators
Domiciliary CareAccountancy for UK domiciliary care agencies: the real cost of a care hour
Supported LivingAccountancy for supported living providers: the rent and care split
Children's HomesAccountancy for UK children's homes: staffing costs, tax and the business finances
Care StartupsAccountants for new care businesses: the financial leg of CQC registration
CQC financial viability statement, prepared and signed
Payroll built for care rotas, not generic bureaus
Care VAT health-check: what you cannot recover and where you can
The financial due diligence and tax you need when buying a care home
Selling a care home: keeping more of the proceeds
Starting a domiciliary care agency: the financial setup done right
Most care operators come to a sector specialist at one of five points. Each one involves money that a generalist accountant is unlikely to handle correctly without sector-specific knowledge.
CQC-registered providers are VAT-exempt under Group 7 of Schedule 9 VATA 1994. Exemption is a cost, not a perk: you cannot recover input VAT on consumables, equipment, building works or professional fees used to make exempt supplies. That irrecoverable VAT is a permanent overhead that must be built into your fee model and budget. VAT review service →
For sleep-in shifts, only time awake for the purposes of working counts for NMW (Royal Mencap Society v Tomlinson-Blake [2021]). For domiciliary care, inter-call travel is working time and must be paid at or above the applicable rate. Rota models that pay only for face-to-face contact time create unlawful pay shortfalls. Care payroll service →
New providers must submit a financial viability statement using CQC's own template as part of registration. Trading before registration is a criminal offence under the Health and Social Care Act 2008. The statement is normally prepared or signed by an accountant. CQC financial viability service →
Local authorities have a statutory duty to pay fees that reflect the actual cost of care. The Care Act statutory guidance and the fair-cost-of-care framework are the provider's negotiating tools. Below-cost LA rates are a material revenue risk; challenging them requires accurate cost evidence.
Acquisitions involve capital allowances structuring: Annual Investment Allowance covers up to £1,000,000 of qualifying plant and machinery per year. Disposals are subject to Business Asset Disposal Relief at 18% from 6 April 2026 (down from 24% standard CGT rate), with conditions that propco/opco structures can break. Buying a care home →
Employers sponsoring overseas care workers must hold a Home Office sponsor licence and maintain ongoing HR compliance records. The immigration skills charge per sponsored worker per year is a cost-per-head that must be built into care fee models. Salary-floor requirements move regularly; content must be dated.
Care providers must account for fee income separately by source. Each carries different VAT, income-recognition and negotiation rules.
| Funding source | Who pays | Key finance risk |
|---|---|---|
| Self-funder | Resident or family | Debtors, fee review timing, top-up arrangements |
| Local authority | Council social services | Below-cost rates; challenge via Care Act fair-cost-of-care framework |
| NHS-funded nursing care (FNC) | NHS to nursing home direct | £267.68 standard / £368.24 higher weekly from 1 April 2026; must be accounted separately |
| NHS continuing healthcare (CHC) | NHS funds full package | Different VAT analysis; supply is to NHS, not individual; do not conflate with FNC |
A generalist accountant will prepare your accounts and file your returns. They will not, by default, know that your VAT exemption means you bear irrecoverable input tax as a permanent overhead, or that your sleep-in rota may have a latent NMW liability, or that your CQC registration requires a financial viability statement prepared to a specific template.
These are not edge cases. VAT, workforce pay compliance and CQC financial paperwork are the three highest-frequency finance issues across the sector. Getting any one of them wrong creates a cost or a liability that appears on no standard accounts template.
Sector-specialist accounting means the fee model, the payroll design, the CQC paperwork and the tax structure are all built around the regulatory environment your business operates in, not bolted onto a general-practice framework after the fact.
A CQC registration deadline
The financial viability statement has to be prepared on CQC's own template, and a generalist accountant may never have produced one. Registration timetables leave little room to learn on the job.
A latent NMW liability
Inter-call travel time in domiciliary care is working time for minimum-wage purposes. Agencies that pay contact hours only can build up back-pay exposure for years before anyone flags it.
VAT exemption treated as a perk
Welfare exemption means irrecoverable input VAT on every refurbishment, equipment purchase and professional fee. Budgets built as if that VAT comes back are systematically wrong.
Not legally, but practically the finance work is specialist. VAT welfare exemption, sleep-in NMW, CQC financial viability statements and funding-mix accounting are all sector-specific. A generalist firm will handle standard accounts and tax; they are unlikely to handle these without additional research.
Because CQC-registered providers make VAT-exempt supplies under Group 7 of Schedule 9 VATA 1994. Exempt means no VAT is charged on your fees, but it also means you cannot recover the input VAT you pay on purchases. That input tax becomes a permanent overhead. See the full position at gov.uk.
Yes. Domiciliary care agencies have specific NMW issues (inter-call travel, zero-hours holiday accrual), employer cost modelling requirements, and the same CQC registration financial paperwork if they are seeking registration. We have a dedicated section for domiciliary agencies.
Yes. CQC requires new providers to submit a financial viability statement using its own template as part of the registration process. This is a productised engagement. See our CQC financial viability service page for the scope.
Yes. Sleep-in NMW (the Mencap ruling means only time awake for work counts) and inter-call travel-time NMW are the two most common payroll compliance issues in care. Both require payroll design that reflects the regulatory position, not just a standard payroll run.
Our default jurisdiction is England, where CQC registration, NHS funding rates and business rates apply. Scotland, Wales and Northern Ireland operate different regulatory and funding regimes. We flag devolved-nation differences where relevant; we do not mix them silently.
Scenario and compliance tools built for care operators. No sign-up, no data stored. Run a true-cost model, check a sleep-in rota's NMW position, or model your funded-nursing-care fee mix.
Estimate the true delivered cost of a care hour for your service.
Check the national minimum wage position on sleep-in shifts.
Model staffing cost against fee income for a care home.
Model the mix of fee income across funding sources.
Sector data for UK care operators: quarterly Companies House incorporation and dissolution counts for SIC 87/88 companies by sub-segment from Q1 2021, net movement in residential, nursing and domiciliary care, and CQC registered-location counts alongside them. Company counts and register movement, not fee rates or margins.
Tell us about your care service: the type of provision, your CQC registration status and approximate headcount. We will come back within one working day with no obligation.
Plain English guides covering VAT welfare exemption edge cases, sleep-in and travel-time NMW, CQC financial compliance, the fair-cost-of-care framework, capital allowances on care-home fit-out, and Making Tax Digital for sole-trader operators.