Home Care Agency vs Facility Staffing Agency - what should I choose?

home care agency vs facility staffing agency

Every week I receive lots of questions from all sorts of entrepreneurs who are considering starting a home care business in Canada and I love answering them!

Every once in a while I receive a question so many times that I decide to write about it to answer it once and for all and this question is one of those:

"Hi Alyssa, I'm trying to decide...should I start a home care agency or a facility staffing agency?"

To be honest, the first few times I was asked the question I was confused!

Why would anyone limit themselves to one or the other?!?  At my company we do both all the time!

I've been running a home care business for over 12 years now and in that time my small company has grown from just me up to providing thousands of hours of care per week.

But in all that time I never asked that question of myself and never limited myself by choosing one or the other.  

My company currently provides care in all sorts of different situations

  • Many of our clients live in their own homes and we visit there
  • Many clients have moved to facilities and we visit them at those facilities
  • Often the facilities themselves will see our staff and the professionalism with which they conduct themselves and then the facility director will reach out and voila!  Suddenly we're providing staffing for the facility
  • We have often provided care for people in hospitals who need more attention than the hospital staff are able to provide
  • We have also made connections at other types of facilities - ie group homes - serving individuals with physical or cognitive disabilities and provide care for clients there (or directly to the facilities)

In summary, at my company I believe that:

Our job is to provide care wherever home is for the client

For some people home is a house, for some it is an apartment, for some it is a facility, and for some it is a hospital (for a short time hopefully).  No matter where it is, we're able to help them!

With that said there are many pros and cons of providing 1:1 care in a home vs facility staffing

Although my company provides care in many settings there are significant differences between staffing for facilities and providing 1:1 care in someone's home.

Facility staffing - what you need to know

Many facilities have on-site nurses and personal support workers who are employed directly by the facility. 

Often those facilities will form relationships with community care companies (like mine and yours) and will then reach out for staffing needs when one of their own staff can't come to a shift.

The pros of facility staffing

Facility shifts are almost always 8 hours or 12 hours which your caregivers will love and it makes them easy to staff.

In addition once a facility learns to trust your agency they become a very reliable source of referrals and it can be a great long term relationship.

Lastly facilities are often part of larger companies which makes invoicing a much simpler process.

The cons of facility staffing

Most facility shifts involve a PSW or nurse seeing multiple clients in a short time frame (15-minute visits) or are set up for 'cluster care' where one caregiver is responsible for multiple residents. 

This makes for a very 'busy' shift for caregivers and many caregivers prefer the less frenetic pace of 1:1 care.

Also, a facility usually has their own staff and so if they are calling you asking for something it is most likely a sick call or last minute request which means you need to have a great 24-hour / 7-day systems to really become good at it.  1:1 care is often more predictable.

1:1 community care - what you need to know

1:1 community care (often in a senior's home) is very different for many reasons.

The pros of 1:1 community care

Many caregivers prefer a 1:1 setting because it allows them to really form strong relationships with their clients over long periods of time.

This in turn makes scheduling easier for you as you know that you are drawing from a set team when covering vacations and sick calls.

In addition clients schedules are usually much more predictable in the 1:1 setting where families have a set care plan and are following it (vs facilities that call last minute with sick calls).

The cons of 1:1 community care

Shifts tend to be much shorter in 1:1 care (often as little as 3hr or even 1hr shifts).  This is less attractive to caregivers who prefer longer hours and can make scheduling for those shifts very difficult when first starting with a client.

Also rates (both pay rates and bill rates) tend to be lower in community care due to the fact that it is perceived by caregivers as a less taxing shift than a facility shift.

Finally, working directly with families puts a lot of pressure on your business to provide great customer service.  But this isn't really a bad thing!  Remember that you already know the secret to success so you welcome the challenge and thrive under the pressure!


If I could sum up my answer to the question "should I start a home care company or a staffing agency" in one sentence it would be: 

It doesn't matter.  Provide great care for people wherever they are and let the rest take care of itself!

Thanks for reading and good luck!

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I am interested and will like to start Home care agency in Nigeria.


I need information regarding business registration . Do you think it should be sole proprietorship or corporative ? what would be the best type for registration of a business ?
HomeCare101 replied:
Hi Kulvir,

It’s really a matter of personal preference – I registered my business as a corporation but you could do it either way.

Cheers, Alyssa

Kulvir Kaur

I’m interested to start this Home care business. I need assistance please . Thanks
HomeCare101 replied:
Hi Milagros, you’ve come the right place! Have a look at our articles and you can always send me an email if you have any questions!

Cheers, Alyssa

Milagros Coronado

I am very appreciative for all your information.
My friend sent this information to me as she is aware of my actions to accomplish and advocate.
HomeCare101 replied:
That’s great Marilyn thanks!



Very much interested.

Josephine Afiawari

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