Introductory agencies vs managed live-In care providers

When it comes to arranging live-in care for yourself or your loved one, there are a number of things to consider, such as how much help is needed, how many live-in carers should be working on rotation, what kind of person you would like living with you, and much more.

If you are trying to decide between live-in care from an Introductory Agency or a Managed Care Provider, we are comparing the two by looking at what they both do, what the difference is, and how to choose the right one for your specific situation. 

At Home Instead, our aim is to help people age positively and in place by bringing expert care to their home. For nearly 20 years, we have been providing the highest standard of care, and creating industry-leading training programmes for our Care Professionals that are accredited by nursing and medical professionals. Today, we are the world’s largest global home care network, supporting over 100,000 older adults with personalised, tailored care at home. So whatever questions you have about home care, we can help. 

What is an Introductory Agency?

Both Introductory Agencies and Managed Live-in Care Providers offer live-in care services for older people and disabled people, but an Introductory Agency focuses on finding you an appropriate carer and setting up their employment with you, rather than the ongoing care being delivered. 

Introductory Agencies will perform background checks on all of the carers they recommend, which typically includes collecting references, ensuring the carer is DBS checked (if you live in England) or PVG checked (if you live in Scotland), and conduct interviews and assessments to make sure all carers on their roster are qualified and ready to deliver the necessary care. 

An Introductory Agency will not be registered with the Care Quality Commission (CQC), who oversee the quality of care in the adult social care sector, but may still be recognised by them. 

With an Introductory Agency you or your family will likely be in charge of arranging and managing your carer’s daily tasks and workload from the point of employment, but these agencies can help you with the process of finding the right self-employed carer for your needs. To be clear, the carer will become your employee and you will pay them directly, so once they start working for you it will be up to you to manage their employment. 

introductory agency

What is Managed Live-In Care?

Unlike an Introductory Agency, Managed Live-in Care can manage every aspect of home care, from the initial search for the best carer, to finding cover when your regular carer goes on holiday, to being on call for any questions you have. 

Managed Live-in Care services are registered with the Care Quality Commission so they must adhere to certain standards, and as a result they train their staff in order to develop a certain standard of care for all clients. 

In most cases, Managed Live-in Care is offered to the client as part of a package including everything they need, which is created based on the client’s specific care needs and life preferences. 

A Managed Live-in Care service like Home Instead will take on most of the burden of:

  • Performing background checks on carers
  • Fully training carers so they have the skills to address your needs 
  • Ensure the correct employment documents and insurances are in place 
  • Pay your carer each month, and handle things like sick pay, holiday pay and their pension contributions 
  • Ensure continuity of care by bringing in respite carers or replacement care while your usual carer is away 

Managed Live-in Care could be a good option for anyone who would like a fully managed service where they do not have to think about the administration and stress of employing someone. 

introductory agency

What are the differences between managed care and introductory agencies?

There are a few benefits and disadvantages to both options, so if you are weighing up the pros and cons of Introductory Agencies versus a Managed Live-in Care service, the following list may help: 

Introductory Agencies 


  • With an Introductory Agency your carer would be self-employed, and may offer a consistently good service to ensure they remain employed by you 
  • You will only pay for the care you use with an Introductory Agency, which could work out more affordable than other options in some cases, so long as your carer does not increase their fees over time 
  • By being your carer’s direct employer, you may feel you have more control over the specifics of the care you receive, and feel more free to voice your preferences 


  • One of the main downsides of an Introductory Agency for most people is that you will become an employer, which means you are fully responsible for the employment administration involved in having a carer. As a result you will need to handle things like insurances, sick pay, and more
  • There may not be a helpline or support once you are matched with your carer, so if you have any questions or concerns you will need to handle them yourself 
  • You will be responsible for organising your own respite care or replacement should your usual carer go off sick or on holiday 
  • If you need to update the care services you receive to reflect your changing health, you may need to go back to an Introductory Agency to find a new carer, which could mean you incur further costs
  • Some Introductory Agencies are recognised by the Care Quality Commission but are not registered with them 

Managed Live-in Care Providers


  • With a Managed Live-in Care service, the training of care workers and employment administration (such as paying wages and handling pension contributions) is taken care of so you never need to worry about this 
  • While the live-in carer is in your home, a Managed Live-in Care service will oversee the care they are providing, so if there are any issues they will rectify them so you have no additional stress
  • Managed Live-in Care services are regulated and continually assessed by the Care Quality Commission (CQC) so you can rest assured the quality of care you receive is always acceptable, safe and high quality 
  • When using a Managed Live-in Care service, your needs are taken into account and you will often be offered an all-inclusive cost which makes it easier to budget
  • If you need to update the care services you receive to reflect your changing health, a Managed Live-in Care service will be able to adapt your care package and bring in other carers with additional training or skills if needed 
  • A Managed Live-in Care service will provide you with a new carer if your regular carer takes sick leave or is unavailable for any reason, so you always have continuity of care 
  • Due to being regulated by the Care Quality Commission, carers within a Managed Live-in Care service are typically highly trained, and continue to be trained and upskilled on a regular basis 


  • This option can be slightly more expensive in the beginning as it offers a full package of services depending on your care needs (but over time this is likely to balance out)
  • You do not oversee the employment administration. Although most people may consider this a positive as there is nothing to stress over, others prefer to be more involved in this area 
  • Not all Managed Live-in Care services will spend time matching you with the best carer based on your needs, preferences and character (at Home Instead, we take great care in making sure your initial match is an excellent fit for you so you get off to the best start)

Which option is safer?

There are positive and negative aspects to both Introductory Agencies and Managed Live-in Care services, and both will endeavour to do background checks on carers and ensure they are fully qualified, experienced and trained in the areas of care in which they are being employed. 

We always aim to offer an unbiased view of all care options so you and your family can make an informed decision on the best one for you, however, if you are looking for an option that is regulated by the Care Quality Commission to protect you from a potentially substandard quality of care, a Managed Live-in Care service may be the best option for you.

introductory agency

How to choose which is right for you

When researching care options, the best one for you depends on your individual circumstances, care needs, and personal priorities. To summarise the positive and negative elements of both options, an Introductory Agency could be the best choice for you if you would prefer to feel more in control of the service your care worker provides for you and when, and keep your costs low by only paying for the care you need on an ad hoc basis. Or, if you believe you could benefit from having the whole care process taken care of with no administration to handle – from initial employment to day-to-day support – and pay an all-inclusive cost, a Managed Live-in Care service could be the best choice for you. 

We’re an award-winning home care provider and part of a worldwide organisation devoted to providing the highest quality relationship-led care for older people in their own homes. Arranging care for yourself or your loved one shouldn’t be stressful, so whatever questions you would like answered, feel free to reach out to the Home Instead team to discuss your needs.

introductory agency