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Care, nurseries and childminders
Domiciliary care agencies usually need employers’ liability, public liability with treatment or medical malpractice cover, abuse cover and a plan for care workers’ cars. Your clients are vulnerable and your staff work alone in private homes, so one incident can bring a claim, a safeguarding enquiry and a CQC notification at the same time.
Part of: Care home insurance
In short
Home care agencies in England that provide personal care must register with CQC, and insurers expect cover to match the care you actually deliver. The usual package is employers’ liability (compulsory once you employ staff, with a £5 million legal minimum), public liability, treatment or medical malpractice cover for care tasks such as medication, and abuse cover. Many agencies add employee fidelity, cyber and management liability. The gaps tend to be clinical tasks the insurer was never told about, abuse limits lower than the main limit, and care workers driving between visits on car policies without business use.
Any business that provides personal care to people in their own homes is a domiciliary care provider for insurance purposes, and in England it usually has to be registered with the Care Quality Commission (CQC).
CQC’s guidance on the personal care activity describes it as providing personal care for people who are unable to provide it for themselves because of old age, illness or disability, in the place where they live. Its examples are homecare services and housing with care or supported living. CQC also says it is the nature of the care being provided that determines the need for registration.
CQC’s exceptions include employment or introductory agencies that supply care workers without any ongoing responsibility for the care, and carers or personal assistants employed directly by the person they support. If you only introduce workers, our page on insurance for healthcare and domiciliary care recruitment agencies is the better starting point. This page covers England; Wales, Scotland and Northern Ireland have their own regulators and rules.
| Cover | What it is for | What to check |
|---|---|---|
| Employers’ liability | Injury or illness claims from your own staff. Usually compulsory; the 1998 Regulations set a minimum of £5 million. | That bank, part-time and zero-hours workers are all declared. |
| Public liability | Injury to clients or others, and damage to their property, caused by your business. | Whether it excludes injury arising from treatment, advice or care tasks. |
| Treatment risk or medical malpractice | Claims arising from care tasks such as medication, moving and handling or delegated health tasks. | Which tasks are listed and what happens if staff do something not declared. |
| Abuse | Allegations of physical, sexual, psychological or financial abuse, or neglect. | The limit, whether it is aggregate, and whether it is written on a claims-made basis. |
| Employee fidelity | Theft of money or property by staff. | Whether clients’ money and property is covered, not only yours. |
| Cyber | Care records, rostering apps, payroll and client data. | Data breach response costs and loss of systems. |
| Management liability | Claims against directors and many employment disputes. | Whether employment practices cover is included. |
All cover is subject to the insurer’s acceptance and the policy terms. Local authority and NHS contracts often set minimum limits, so check the contract before you buy. See also employers’ liability insurance, employee theft and fraud cover and management liability.
Many public liability wordings exclude or limit injury arising from professional treatment or advice. In home care the line between care and treatment is blurred: prompting or giving medication, applying creams, catheter and stoma care, PEG feeding and insulin support can all be treated as treatment by an insurer.
Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 requires care to be provided in a safe way. Among other things it covers staff competence and “the proper and safe management of medicines”. When a medication error injures a client, the claim usually falls under a treatment or malpractice section rather than general public liability, so the tasks you declare matter. Our guide to medication errors in care goes further, and treatment liability vs medical malpractice explains the two covers.
Regulation 13 of the same Regulations requires systems to prevent abuse and to investigate any allegation immediately. It defines abuse widely: sexual offences, physical or psychological ill-treatment, theft or misuse of a service user’s money or property, and neglect.
Insurers treat abuse as a separate risk. It is commonly excluded from the main liability section and given back under its own section, often with a lower limit that applies in the aggregate for the policy year. Some insurers write it on a claims-made basis. Read how the section defines abuse, whether neglect and financial abuse are included, and whether defence costs sit inside the limit. Our page on abuse and safeguarding cover for care providers explains the differences.
Where staff are accused of taking a client’s money, fidelity cover may respond to the money lost if the wording extends to clients’ property, while the abuse or liability section deals with any claim for harm.
Most care workers drive their own cars between clients. Personal motor policies limited to social, domestic and pleasure use and commuting do not usually cover driving between clients for work, so staff normally need business use on their own policy. If a worker turns out to be uninsured for a journey, the agency may be drawn into the claim as the employer.
The examples below are illustrative. They are not real claims or outcomes.
CQC expects providers to notify it of events including allegations of abuse and serious injury to a person using the service. Your insurer needs its own notification under the policy conditions; one does not replace the other. Our page on what CQC and Ofsted require on insurance sets out the regulators’ side.
Apex arranges insurance for domiciliary care providers, as well as care homes, nurseries and childminders. A broker reads each enquiry and comes back with options; there is no fee for a quote, and cover is subject to the insurer’s acceptance and the policy terms. To quote, we need your business activities, turnover, location and claims history, plus your CQC registration and latest rating, care hours per week, staff numbers, client groups and the care and health tasks your staff carry out.
Usually employers’ liability, public liability, treatment or medical malpractice cover for care tasks, and abuse cover. Many agencies add employee fidelity for theft from clients, cyber for care records and management liability for directors and employment disputes. Local authority and NHS contracts often set minimum limits, so check those before choosing cover.
In most cases, yes. The Employers’ Liability (Compulsory Insurance) Act 1969 requires employers to insure against injury and disease claims from their employees, and the 1998 Regulations set a minimum of £5 million. Declare every care worker, including bank, part-time and zero-hours staff, so the insurer has the full picture.
Often not on its own. Many public liability wordings exclude injury arising from treatment or professional services, and insurers may treat giving medication as treatment. Care providers usually need a treatment risk or medical malpractice section that names the tasks staff carry out. Check the wording and declare all delegated health tasks.
Usually, yes. Driving between clients is normally business use, which personal policies limited to social, domestic, pleasure and commuting use do not include. Ask staff for evidence of business use when they start and at each renewal, and ask your insurer whether contingent motor liability cover is available for the agency.
Some insurers will quote while a CQC application is in progress, subject to their acceptance, and you will need cover in place before you start providing care. Expect questions about your registered manager’s experience, your safeguarding, medication and recruitment policies, and the clients you plan to support.
Tell us what your business does, your turnover and any claims. A broker reads every enquiry and comes back with options. No fee for a quote. Or call 0117 325 0027.
Start a commercial enquiry Request a callbackApex Insurance Brokers Limited is authorised and regulated by the Financial Conduct Authority. Registered in England and Wales, company number 07014570. This page is general information, not advice on your individual circumstances, and it does not guarantee that cover will be available or on what terms.
