Specialist accountants for care homes, domiciliary and live-in care.
You came into care to look after people, not to chase the NHS and the council for money you have already earned, run rota payroll with sleep-ins and travel time, and keep CQC-ready books. We do all of that for care providers every week, so you can get back to running care.
Care covers several very different businesses
The finance work behind a care home, a homecare agency, a children's home and a private clinician have almost nothing in common. Here is the quickest route to the page that matches what you run.
Care finance has its own rules. Generalist firms are out of their depth.
Multiple funders on different cycles. Carer pay rules that catch good employers out. Welfare VAT that works backwards. A regulator that expects financial evidence on demand. These four pressures show up in almost every care business that comes to us from a high-street firm.
"Getting paid has become a full-time admin job and the cash is still stuck."
Every funder wants a different format, through a different portal, on a different cycle. Remittances do not match invoices, duplicate payments and clawbacks appear, and disputed invoices pile up. Cash you have already earned sits there for weeks. Most providers are quietly losing real money to billing errors and slow payers.
"I am terrified of getting carer pay wrong on sleep-ins and travel time."
Sleep-in shifts, travel time between visits, and zero-hours rotas all affect national minimum wage compliance, and this is exactly where well-meaning domiciliary and live-in providers slip into accidental underpayment. Get it wrong and you face back-pay, penalties and reputational damage. It needs running properly, every single pay run.
"My accountant treats my care VAT like a normal business. It is not."
Most welfare and care services are VAT exempt, not zero-rated, so you cannot reclaim VAT on your costs and your margin has to be protected elsewhere. The treatment gets more nuanced with mixed services and staff supply. A generalist who does not know the care rules can cost you real money or land you with the wrong return.
"CQC and my funders can ask for financial evidence and I am not always ready."
Care is a regulated, public-facing business. Commissioners want confirmed-hours schedules, lenders and CQC viability reviews want accounts they can trust, and you need to know your real position between year-ends. Books kept loosely for a normal trade do not cut it in the care sector.
Getting paid for care you have already delivered. We run the whole thing.
This is what really sets us apart from a general accountant. One care provider can be billing an NHS Integrated Care Board, a Continuing Healthcare team, several local authorities, direct payment clients and private clients all at once, each on its own cycle and through its own channel. We absorb that complexity so the cash comes in. Tap a funder below to see what we handle.
NHS Integrated Care Boards & Continuing Healthcare
NHS packages are submitted through NHS Shared Business Services e-invoicing with the correct purchase order and package references and the backing schedules NHS finance teams expect. We prepare the per service user summaries and get hours confirmed before the invoice is raised where the payer requires it, so what we bill matches what they will approve. That single discipline stops the rejections that hold up NHS cash.
Local authority adult social care
Local authority billing goes through council provider portals, each with its own placement agreement and purchase order references and its own cycle, from weekly to four-weekly and beyond. We run them all in parallel without dropping or double billing anything, and we reconcile what the council actually pays back against what was placed, so underpayments and short payments get spotted and chased rather than quietly absorbed.
Direct payments
Direct payment clients pay from a personal budget, often on smaller and more varied cycles than the big institutional payers. These are easy to let slip because each one is small, but together they add up. We invoice them cleanly, keep the references straight, and chase them in a tone that protects the relationship with the service user and their family.
Private and self-funded clients
Private and self-funded clients are usually your fastest cash, but only if invoices go out promptly and are followed up. We bill them on time, allocate their payments correctly, and keep their accounts tidy alongside the public payers, so the private side of your book is never the bit that gets forgotten while you firefight the NHS and council billing.
Four funders, four cycles, four channels. We run them as one tracked process.
Delivered hours, not scheduled hours.
Public payers reimburse the care that was actually delivered, not the care that was merely planned. Many providers unknowingly bill on scheduled or rostered hours, which overstates invoices, triggers rejections and clawbacks, and damages trust with the commissioner. We bill on actual delivered hours taken from your care management and rostering system, at the agreed rate. It is often the difference between getting paid in full and getting an invoice bounced.
Invoices built from delivered care
We take verified visit and timesheet data from your care management and rostering system and turn approved, actually delivered hours into clean invoices, with the right references and schedules for each payer. The source of truth is what was delivered, not what was planned.
Invoice finance, kept clean
Where you fund cash flow through invoice finance or factoring, we manage the whole relationship: preparing and uploading funding schedules, applying the Notice of Assignment to each invoice, tracking advances, and recording factored receipts to a proper finance control account so the bank reconciliation always ties.
Every payment matched and chased
We match each remittance back to the invoice it pays, line by line, untangle duplicate payments and clawbacks, clear unallocated cash sitting on account, and resolve disputed items. Then we run real credit control, chasing the right payer at the right time in the right tone, with clear aged debt reporting.
A documented system and clean takeover
When we take over from a previous bookkeeper or accountant, we map every system and login, build a written procedure, and run a single submission tracker so nothing is ever lost, late or billed twice. Personal and patient-identifiable data is handled carefully and kept out of portals that do not need it.
The care receivables lifecycle, end to end
Every invoice, from the care round to the cash in your account, runs through one tracked process.
One specialist team for the whole picture. Not just year-end.
Most care providers come to us for one urgent thing and quickly hand over the rest, because it all connects. Payroll feeds the accounts, billing feeds cash flow, and the management accounts tell you whether the business is actually working.
Carer payroll for rotas
Weekly or 4-weekly runs for a handful of carers up to 50 and beyond. RTI, pension auto-enrolment, holiday accrual, statutory pay, sleep-ins and travel time treated correctly for minimum wage.
Outsourced credit control
The full receivables function above: multi-payer billing, NHS and council submission, invoice finance, remittance reconciliation and real chasing, so earned cash comes in.
Management accounts
Quarterly business performance reports so you can see occupancy, staff-cost margin and cash at a glance, and make decisions between year-ends instead of guessing.
Year-end & company compliance
Annual accounts, Corporation Tax, Companies House filings and confirmation statement, prepared to a standard lenders and CQC viability reviews take seriously.
Welfare VAT & bookkeeping
Care VAT treated correctly, with tidy cloud books in Xero or QuickBooks kept reconciled month to month so nothing is ever a year-end scramble.
Business mentor
Free for every client. Growth, funding conversations, tender and contract support, and our network, because we want your care business to grow, not just survive.
A domiciliary provider who needed far more than year-end accounts.
An anonymised picture of the kind of care engagement we run every week.
A London domiciliary care provider with a team of around 50 carers.
They came to us needing a proper finance function, not just a set of accounts once a year. We took on weekly carer payroll for the full team of around fifty, with sleep-ins and travel time handled correctly for minimum wage, RTI and pensions on every run, and pay queries answered the same day.
Alongside that we built their quarterly business performance reporting so the owner could finally see how the business was doing between year-ends, and we took over annual accounts and company compliance in full.
The hardest part, and the part most firms cannot do, was the complex accounts receivable: billing a mix of public and private payers on different cycles and channels, managing invoice finance with the correct Notice of Assignment on each invoice, reconciling every remittance back line by line, and clearing the disputed and unallocated items that were tying up cash. We turned a tangle of portals, schedules and chasing into one clean, tracked process.
Details are generalised and no client is identified. This is anonymised expertise drawn from our care sector practice.
Fixed monthly fees, quoted to your setup.
Care engagements are bespoke, because a five-carer domiciliary start-up and a multi-site operator billing five funders are very different businesses. So we quote to what you actually need.
What shapes your fee
Your monthly fee depends on three things: how many carers are on payroll, how many funders you bill (and whether you need full outsourced credit control), and how complex your year-end and compliance are. We bundle it into one predictable monthly figure, with no surprise bills.
From £995 / month for payroll and compliance · full finance department from £1,495 · multi-site operators quoted on scopeBook a free 15-minute call and we will send a written fixed-fee quote within 24 hours, covering exactly the services you need and any current offers. No obligation, and if we are not the right fit we will tell you.
Guides for care providers
- How much does an accountant cost for a care home?
- Accountant costs for domiciliary care 2025/26
- NHS contract accounting for care providers
- Sleep-in shifts and minimum wage
- Is care home work VAT exempt?
- Specialist vs high-street accountant for care
- When to switch to a specialist accountant
- Choosing the best accountant for domiciliary care
Let us take the billing and payroll off your plate.
Tell us your care setup, your team size and which funders you bill. We will send a written fixed-fee quote within 24 hours covering exactly what you need, including any current offers.
Frequently asked questions.
If your question is not here, message us on WhatsApp or book a free 15-minute call.
Do you work with care homes, domiciliary care and live-in care providers?+
What is outsourced credit control for care providers, and what does it involve?+
Can you bill the NHS (ICB and CHC) and local authorities for us?+
Can you run carer payroll, including sleep-in shifts and travel time?+
Do you handle invoice finance and factoring for care providers?+
Is care VAT exempt, and what does that mean for us?+
How much does a specialist care accountant cost?+
Can you take over from our current accountant or bookkeeper without disruption?+
Care sector accountants in King's Cross, London.
Our office sits at 39-41 North Road, London N7 9DP, five minutes from Caledonian Road tube. We act for care homes, domiciliary and homecare agencies, live-in care and supported living providers across Islington, Camden, Hackney, Newham, Brent, Croydon and Greater London, with a secondary presence in Wickford and Basildon, Essex.
Care is delivered everywhere, so most of our care engagements run remotely across England via video call, secure portal and cloud accounting, which suits busy registered managers and owners perfectly. For those who prefer to meet, the King's Cross office is open Monday to Saturday, 10am to 7pm. No appointment fee, no travel charge.
London N7 9DP
10am to 7pm
Ready for an accountant who already knows care?
Book a free 15-minute call. We will quote your engagement in writing within 24 hours, including any current offers. If LOYALS is not the right fit we will tell you that too.
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