What a managed agency does
A managed home care agency employs its care workers, assesses your relative, writes a care plan, trains and supervises staff, arranges the rota, and covers absence. It is registered with and inspected by the Care Quality Commission in England, and it carries legal responsibility for the quality of the care delivered.
That is a substantial thing to buy, and for many families it is exactly right — particularly where needs are complex, where no family member is nearby, or where nobody has the capacity to take on organising anything.
What an introductory agency does
An introductory agency introduces families to self-employed helpers. It verifies who the helper is — identity, right to work, references, DBS — and makes the introduction. From there, the arrangement is between you and the helper: you agree what happens, when, and how.
Because there is no management structure to fund, more of what you pay reaches the helper. At Witho the helper keeps all of their rate, and our fee sits on top rather than coming out of their earnings.
What an introduction agency cannot do is manage the work. It cannot write a care plan, direct how the helper works, supervise them, or take responsibility for cover. And on Witho helpers provide practical support only — no washing, dressing or medication — which is a second reason CQC registration does not apply.
How to choose
Choose a managed agency if you want an organisation to carry responsibility, if needs are clinically complex, if there is no family member able to be involved, or if the thought of organising it yourself is more than you can take on. There is no shame whatever in that, and it is often the right answer.
Choose an introductory agency if continuity matters most, if you want to meet and choose the individual, if you would rather the money went to the helper than to an office, and if you or another family member can be the person the helper speaks to.
One practical point that surprises people: if your relative receives council funding as a direct payment, that money can usually be used to engage a self-employed helper. Choosing your own helper and receiving council support are not mutually exclusive.