Recruitment insurance

Healthcare and domiciliary care recruitment agency insurance

Reviewed by the Apex broking team · Last reviewed 2026-10-19

Healthcare and domiciliary care recruitment agency insurance is the set of covers a nursing, care staffing or introductory agency needs for vetting errors, injured workers and harm to service users. It matters because the right mix depends on whether you introduce, supply or provide care.

Part of: Professional indemnity for recruitment agencies

In short

Healthcare and care staffing firms are regulated by the Employment Agencies Act 1973 and the Conduct Regulations 2003, which require extra checks where workers will care for vulnerable people. CQC registration usually depends on whether the agency manages or directs the care, rather than only introducing carers. Workers in personal care can be asked for enhanced DBS checks, and right to work failures can cost up to £60,000 per illegal worker. Most firms need professional indemnity for vetting and placement errors, employers' liability for staff they employ, public liability, and, where care is delivered, treatment and abuse cover. NHS and local authority contracts often add requirements.

Agency or employment business: the regulatory starting point

Staffing firms in this sector are governed by the Employment Agencies Act 1973 and the Conduct of Employment Agencies and Employment Businesses Regulations 2003. Section 13 of the 1973 Act draws the key line:

an employment agency provides services to find people employment with employers, or to supply employers with people for employment by them. Government guidance describes these as finding work-seekers permanent placements, where the worker is employed by the hirer;
an employment business participates in employment arrangements, typically employing temporary or contract workers and supplying them to work under a hirer's direction and control.

Many nursing and care staffing firms do both. The distinction matters for insurance because it decides who employs the worker.

Two parts of the Conduct Regulations stand out. Regulation 22 applies where a role involves working with, caring for or attending a vulnerable person: before introducing or supplying the worker, you must obtain copies of relevant qualifications or authorisations, obtain two references from people who are not relatives, and take all other reasonably practicable steps to confirm the worker is suitable. If you cannot fully comply, you must tell the hirer and explain the steps taken. The guidance adds that work-seekers cannot opt out where the role involves vulnerable people. Regulation 30 makes a breach of the Act or Regulations actionable so far as it causes damage, which includes death, injury and disease.

Enforcement now sits with the Fair Work Agency, which replaced the Employment Agency Standards Inspectorate from 7 April 2026.

When CQC registration is required

The Care Quality Commission says it is the nature of the care being provided that determines the need for registration. Its personal care guidance excepts an employment or introductory agency that supplies care workers to another organisation which is then responsible for directly providing the care, or to a person who takes whole responsibility for arranging their own care under a personal budget or private arrangement. It also excepts those who introduce a care worker and then have no ongoing role in the personal care provided.

CQC's exceptions guidance puts it as two conditions: the agency only helps people find registered nurses, nursing associates or care workers, and it has no role in managing or directing the nursing or personal care. For nurses' agencies supplying agency or locum registered nurses, the nursing care guidance says the exception only applies where the agency is not responsible for directing or supervising the nurse's role in any way.

In short, a domiciliary care agency that itself provides, manages or directs personal care in people's homes falls outside these exceptions and would normally need to register. A pure introductory agency may not. The line can be fine, so check the CQC guidance against how you actually operate.

DBS and right to work checks

Care workers who provide personal care are in regulated activity with adults, and government DBS guidance says they can be asked to apply for an enhanced DBS check with an adults' barred list check, whether the care is in a person's home, a hospital or a care home. Personnel suppliers that provide individuals to organisations to carry out regulated activity also have a legal duty to refer to the DBS when someone is removed from regulated activity and the relevant conduct or harm test is met.

Right to work checks carry a civil penalty of up to £60,000 for each illegal worker. A new code of practice came into force on 1 October 2026: it sets a starting point of £45,000 per worker for a first breach and £60,000 for repeat breaches, says an employer must not delegate responsibility for checks to a third party, and addresses certain labour supply chains. Where you are the employer, the check is yours. Where you only introduce, the hirer cannot rely on your check for its own statutory excuse, which can create a contractual dispute if something goes wrong. See right to work checks and recruiter PI.

What it means in practice

These scenarios are illustrative only.

Vetting failure: an agency introduces a nurse whose registration had lapsed. The hospital trust alleges the agency failed to check and claims its costs. This is a typical professional indemnity allegation, similar to the bad hire and vetting claims seen across recruitment.
Injured temporary worker: a healthcare assistant employed by an employment business is hurt moving a patient at a client site. The hirer remains responsible for health and safety, but the worker may also claim against the employment business as employer.
Harm to a service user: a carer supplied by a domiciliary agency that manages the care drops a client during a transfer. The claim is about care delivered, so treatment or care liability is usually needed; PI alone is unlikely to respond.

What cover is usually needed

The mix depends on whether you introduce, supply or provide care. All cover is subject to the policy terms.

Cover	Usually responds to	Watch for
Professional indemnity	Negligent introductions, placements or vetting; failure to check qualifications or references	Exclusions for bodily injury, or for supplying staff you employ
Employers' liability	Injury or disease claims from people you employ, including temporary workers employed by an employment business	How the policy defines employee, and declared temporary payroll
Public liability	Injury to third parties or damage to property caused by your business or workers	Treatment and professional exclusions
Treatment or medical malpractice liability	Injury caused by care or clinical work your staff deliver	Scope of procedures covered; usually needed where you provide or direct care
Abuse cover	Allegations of abuse of service users	Often excluded or sub-limited unless specifically added
Cyber	Data breaches involving candidate and patient records	Response costs versus third-party claims

On EL, the Employers' Liability (Compulsory Insurance) Act 1969 requires every employer carrying on business in Great Britain to insure against liability for bodily injury or disease sustained by employees in the course of their employment, and defines an employee as someone working under a contract of service or apprenticeship. Government guidance sets the minimum at £5 million and fines of up to £2,500 for every day you are not properly insured. Whether supplied temps are your employees for this purpose depends on their contracts, so an employment business will usually treat EL as essential and confirm with the insurer that temporary workers are included. More in our EL Act guide.

NHS frameworks, trusts and local authorities commonly set minimum insurance levels and indemnity clauses in their contracts. Check those terms against your policies, because liabilities you accept under contract may go beyond what the policy covers; see how PI treats contractual liability and when a contract requires public liability.

What to have ready for a quote

A split of turnover between permanent introductions, temporary supply and any care you provide directly.
Roles placed: registered nurses, healthcare assistants, carers, support workers and settings (NHS, care homes, private homes).
Whether you are CQC-registered, and for which regulated activities.
Temporary payroll and headcount, and how temps are engaged.
Your vetting process: DBS, references, qualification and registration checks, and right to work checks.
Key client contracts or framework terms, including insurance and indemnity clauses.
Claims, complaints and safeguarding incidents for the last five years.

What to check

Status: your policies reflect whether you act as an agency, an employment business or a care provider, and change them if your model changes.
Bodily injury: PI wordings for recruiters often exclude it, so make sure EL, PL and treatment liability fill the gap.
Abuse: whether abuse allegations are covered, and on what terms.
Contracts: limits and indemnities required by each framework or local authority.
Need PI at all? See do recruitment agencies need PI, and for providers, PI for CQC-registered care providers.

Sources

Frequently asked

Does a domiciliary care introductory agency need to register with CQC?

Not if it only introduces care workers and has no ongoing role in managing or directing the personal care, according to CQC guidance. An agency that provides, manages or directs personal care itself falls outside that exception and would normally need to register. CQC says the nature of the care being provided decides the need for registration.

What is the difference between an employment agency and an employment business?

An employment agency finds people work with employers, typically permanent roles where the hirer employs the worker. An employment business employs or engages workers and supplies them to work under a hirer's direction and control, typically temporary or locum staff. Many healthcare staffing firms act as both, and their insurance should reflect each activity.

Do care staffing agencies need employers' liability insurance?

If you employ anyone, yes: the Employers' Liability (Compulsory Insurance) Act 1969 requires cover of at least £5 million. An employment business that employs temporary nurses or carers will usually need EL for them. Whether particular temps count as employees depends on their contracts, so confirm with your insurer that they are included.

Who must carry out right to work checks for agency workers?

The employer. If your employment business employs the worker, the check is yours, and the code of practice in force from 1 October 2026 says an employer must not delegate that responsibility to a third party. A hirer taking on a permanent candidate through an introduction must do its own check.

Does recruitment PI cover a carer who injures a client?

Not usually. PI responds to negligent introductions, placements and vetting, and recruiter PI wordings commonly exclude bodily injury. Harm caused while delivering care is normally a matter for public liability, treatment or medical malpractice liability, and possibly abuse cover, particularly where the agency provides or directs the care.

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Apex 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.