There are two main ways to arrange live-in care at home. One is an introduction agency, which matches you to a self-employed carer. The other is regulated live-in care from a registered provider, who employs and manages the carer. Both are lawful. The difference is structural: who employs the carer, who arranges cover, and who is accountable if something goes wrong.
Starling Homecare provides regulated live-in care across Hertfordshire. This guide explains how the two routes differ, honestly, so you can choose with your eyes open. We will still say plainly where an introduction agency might suit a family better.
You are welcome to call us on 01727 324 127 whenever you would like to talk it through.
In this guide
- The two ways to arrange live-in care
- How they compare
- Why cover matters most with live-in care
- Who employs the carer
- When an introduction agency might suit you
- Regulated live-in care across Hertfordshire
- Questions to ask either provider
The two ways to arrange live-in care
An introduction agency introduces a self-employed live-in carer to your household. You, or the carer, take it from there. The agency's role usually ends once the introduction is made.
A regulated provider, like Starling Homecare, employs the carer, trains and supervises them, arranges cover, and is registered and inspected by the Care Quality Commission. The responsibility sits with us, not with you.
How they compare
Both arrangements are lawful. The question is simply who carries each responsibility. The facts below are checked against CQC and gov.uk guidance, June 2026.
| Regulated live-in care with Starling | A live-in introduction agency | A carer you employ directly | |
|---|---|---|---|
| Regulation | CQC registered and inspected | Typically exempt from CQC registration, where its role ends at the introduction | Exempt from CQC registration when working wholly under your direction |
| Who employs the carer | We employ, train and supervise the carer | Usually you, or the carer is self-employed; the agency is not the employer | Usually you, in law, unless the carer is genuinely self-employed |
| Cover when the carer is away | Arranged as part of the service, so support does not stop | A replacement may carry a further fee; ask | Yours to arrange |
| Background checks | Fit-and-proper recruitment, including criminal record checks, required by regulation | Ask exactly which checks the agency verifies | Since January 2026 the carer can obtain an enhanced DBS check on themselves for you to view |
| Training and supervision | Required by regulation, with a registered manager accountable | Ask what is verified at introduction | Yours to arrange and judge |
| Insurance | We carry employer cover for our staff | Ask the carer about their own cover; it is not guaranteed | Employer’s liability insurance is legally required, minimum £5 million |
| If something goes wrong | A complaints process required by regulation, with CQC oversight | The agency usually has no ongoing role once the introduction is made | Limited by one person’s availability and skills |
Sources: CQC scope of registration guidance and gov.uk employment guidance, checked June 2026. Individual arrangements vary.
Why cover matters most with live-in care
Live-in care has one feature that makes this choice especially important. A live-in carer lives in the home, but they still need proper rest and breaks each day, time off, and the occasional sick day. So cover is not a rare event. It is part of how live-in care works.
With an introduction agency, arranging that cover is usually your responsibility, and a replacement introduction may carry a further fee. With regulated care, we arrange cover as part of the service, so support does not simply stop. For many families, that is the deciding point.
Who employs the carer
Gov.uk is clear. If you pay a carer directly and they are not genuinely self-employed, you become their employer, even with an agency introduction. That brings real duties: a contract and payslips, at least the National Living Wage, payroll and tax, paid holiday, statutory sick pay, a workplace pension, and employer's liability insurance.
None of this is a reason against an introduction agency. It is simply worth knowing who carries it. With regulated care, we are the employer, so those duties are ours. You can check a carer's status with HMRC's employment status tool.
When an introduction agency might suit you
If you are comfortable being an employer, want to choose and manage one carer directly, and have planned for cover and checks, an introduction arrangement can work well and may cost less. The risk is not in the model. It is in taking it on without knowing what it involves.
Our guide on private carers and regulated home care goes deeper into all three routes, and our questions to ask any provider helps you compare like with like. You may also find our guide on live-in care or a care home useful.
Regulated live-in care across Hertfordshire
We provide regulated live-in care across Hertfordshire, with one dedicated carer at home and the full support of a registered team behind them. You can read about live-in care in St Albans, Harpenden, Hemel Hempstead, Berkhamsted, Tring, Radlett and Shenley, Hitchin and Hertford, and the towns and villages around them.
Wherever you are in the county, you can read what live-in care costs, and how to fund it in our care funding guide.
Questions to ask either provider
For an introduction agency: exactly which checks do you verify before introducing a carer? What does your fee cover, and is there a further fee for a replacement? Who arranges cover when the carer rests or is unwell? Where does your role end once the introduction is made?
For a regulated provider, including us: ask to see the current Care Quality Commission rating, and read our questions to ask any home care provider, which sets out all thirteen with what good answers sound like.
Common questions about regulated live-in care and agencies
Are live-in care introduction agencies regulated by the CQC?
A genuine introduction agency, whose role ends at introducing a self-employed carer, is generally exempt from CQC registration. A provider that organises, manages or supervises the care must register and is inspected. Both are lawful; the difference is who carries the oversight.
If I use a live-in care agency, am I the carer's employer?
Often, yes. Gov.uk is clear that if you pay a carer directly and they are not genuinely self-employed, you become their employer, with duties including payroll, holiday pay, a pension and employer's liability insurance. HMRC's employment status tool can help you check.
Who arranges cover when a live-in carer takes a break?
With a regulated provider like Starling Homecare, cover is arranged as part of the service. With an introduction arrangement, cover is usually your responsibility, and a replacement introduction may carry a further fee, so it is worth asking before you commit.
Reviewed by the Starling Homecare care team, led by our CQC registered manager. This is general information rather than advice for your situation, and the rules around care and regulation can change, so some details may move on. Please take your own independent advice before deciding.
Choosing how to arrange live-in care is a big decision, and we are glad to help you weigh it up honestly, including when an introduction arrangement might suit you better. Call us on 01727 324 127, or read more about our live-in care service.
Arranging Care Is Simple
Starting care can feel like a big step. We keep it calm and straightforward, and we are here to guide you from your very first call.
1. Talk to us
Get in touch by phone or request a callback. We will listen, answer your questions and help you understand the options, with no pressure to decide anything straight away.
2. A home visit and initial consultation
We arrange a visit to understand your routines, your home and what matters most to you. Together we agree an initial consultation and shape the support that feels right.
3. Your care begins
A small, familiar team starts your care, arriving at the agreed times and staying involved as your needs change. We remain your trusted adviser throughout.
Whenever you are ready, we are here to help.