1. Reliability & continuity
Managed care
- Small, consistent team
- Guaranteed cover for sickness and holidays
- Clear communication
- Supervision and oversight
- No missed visits
Private hire
- Only one carer
- No backup if they're ill or unavailable
- Risk of cancelled visits
- You must find replacements
Managed care is far more reliable.
2. Training & safety
Managed care
- Carers fully trained
- PVG-checked
- Regular refresher training
- Medication competence assessed
- Supervised by senior staff
- Policies and quality controls in place
Private hire
- Training varies
- No supervision
- No regulatory oversight
- No formal quality monitoring
Managed care provides professional safeguards.
3. Legal responsibilities
Managed care
You have none. The provider is responsible for everything.
Private hire
You become the employer and must:
- Run payroll
- Provide holiday and sick pay
- Handle pensions
- Ensure safety
- Buy employer liability insurance
- Write contracts
- Conduct PVG checks
- Follow employment law
A significant burden for most families.
4. Risk & accountability
Managed care
- Regulated by the Care Inspectorate
- Complaints process
- Policies for safety and safeguarding
- Audited and inspected
- Clear accountability
Private hire
- No external regulation
- If something goes wrong, responsibility may fall on you
5. Flexibility & support
Managed care
- Increase or reduce visits easily
- Support with dementia, medication and mobility
- Cover arranged when your regular carer is off
Private hire
- Limited flexibility
- Changes may be hard to organise
- No management support
- No cover if they're off sick, have a family emergency or car trouble — leaving you suddenly without support
- If unregulated, no oversight — and they can be shut down or stop at any time
6. Cost comparison
Private hire often appears cheaper, but hidden costs include:
- Employer insurance
- Payroll services
- Holiday pay
- Sick pay
- Training
- Replacement cover
- Equipment
- Extra hours when care needs increase
When you add these together, managed care offers better value and far less stress.
Conclusion
Many of the families who come to us do so after private care let them down — unreliable over the long term, with carers who consistently turned up late or missed visits altogether. They come to us for care they can depend on, week in, week out.
Others come to us because council-funded care simply isn't available quickly enough. Scotland's health and social care partnerships face a funding gap of almost £500 million, and on an average day around 1,900 people are stuck in hospital when they are well enough to go home — roughly three quarters of those delays are due to a lack of available social care. Because we aren't tied to council budgets or waiting lists, private care can usually start within days.
Sources: Public Health Scotland and the Accounts Commission / Audit Scotland (2025).
Most families choose managed care because it provides:
- Safety
- Reliability
- Professional oversight
- Emotional reassurance
- Clear communication
- No legal responsibilities
- Regulated, accountable care
- Guaranteed cover if a carer is off
If you want the safest, simplest and most supportive care option — a managed provider is almost always best. With a regulated provider like Quality Care Scotland, your care never rests on one person: cover is arranged whenever a carer is off, and you're protected by Care Inspectorate oversight — so a sudden illness, family emergency or car breakdown never leaves you exposed. An unregulated private carer offers no such safety net.