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Management Accounts & Cash Flow for Care Homes
Management Accounts & Cash Flow for care homes. No clear view of profit? We fix it: fixed fees, ICAEW-regulated specialists. Free quote.
What does management accounts & cash flow for care homes involve?
Our management accounts & cash flow service for care homes covers monthly/quarterly management accounts, kPIs, cash-flow forecast. It solves the problems we see most often — care homes: No clear view of profit, margins or cash; lender and CQC information requests — on a fixed monthly fee agreed in writing before any work starts.
Fixed fees, specialist healthcare accountants, and every HMRC and NHS Pensions deadline handled.
- Fixed monthly fee — no surprises
- Specialist in NHS pension and healthcare tax
- Onboarding within 48 hours
- ICAEW & ACCA regulated
- 5,000+ clients served by ACCOTAX
- Specialist healthcare accountants
Reviewed by Waqas Sagar ACA FCCA FMAAT, Founder of ACCOTAX, 18+ years' experience · Last reviewed: 8 October 2026 · Updated for the 2026/27 tax year
Medical.Accountants by ACCOTAX, ICAEW/ACCA-regulated chartered accountants, London, serving clients across the UK. Over 5,000 clients served.
Key takeaways
- Problems solved: Care homes: No clear view of profit, margins or cash; lender and CQC information requests.
- Included: Monthly/quarterly management accounts.
- Included: KPIs.
- Included: cash-flow forecast.
Which accountancy support fits your income?
Start with how you are paid. Different income sources can need different accounts, returns and expense checks.
| How you work | What we check | Support to explore |
|---|---|---|
| Employed or umbrella (PAYE) | Tax codes, eligible employment expenses and whether a tax return is needed. | Healthcare tax refund support |
| Genuinely self-employed | Business income and expenses, Self Assessment and MTD eligibility. | Healthcare Self Assessment service |
| Your own limited company | Company accounts, Corporation Tax, director income and off-payroll status where relevant. | Healthcare limited company accounts |
| Partnership | Practice accounts, allocated profit and each partner’s personal tax position. | Healthcare partnership accounts |
Sound familiar?
Problems we fix for care providers
- "National Living Wage and employer NIC rises are squeezing us."
- "Travel time and sleep-in pay compliance worries me."
- "I'm unsure about VAT on welfare services versus staff supply."
- "Local authority payments are always late."
- "CQC or Ofsted want financial viability evidence."
What it's costing you
Leaving it unfixed is rarely free
- Overpaid tax
- Unclaimed expenses and wrong tax codes mean paying more than you owe, year after year.
- HMRC penalties and interest
- Late returns attract automatic penalties, plus interest on tax paid late.
- Lost evenings
- Hours spent on forms, invoices and spreadsheets after a long shift.
General examples — your position depends on your own figures.
How we solve it
What we actually do for you
Care payroll
Payroll that handles travel time and sleep-ins correctly.
Cash-flow forecasting
Forecasts that plan around late local authority payments.
VAT review
A clear view of which services are exempt.
Viability statements
Financial evidence prepared for CQC or Ofsted.
How we help
01
Monthly/quarterly management accounts
Part of our management accounts & cash flow service for care homes, delivered on a fixed fee.
02
KPIs
Part of our management accounts & cash flow service for care homes, delivered on a fixed fee.
03
cash-flow forecast
Part of our management accounts & cash flow service for care homes, delivered on a fixed fee.
04
budget vs actual
Part of our management accounts & cash flow service for care homes, delivered on a fixed fee.
Your questions answered
What are management accounts?
Management accounts are financial reports produced regularly to reflect the current performance of your healthcare business. They typically include a profit and loss statement and a balance sheet. These reports differ from statutory accounts by focusing on internal decision-making. They help clinicians monitor their financial health in real-time.
Want us to check this for you? Get a free review →How often should I get them?
The frequency of management accounts depends on the size and complexity of your healthcare practice. Many clinicians opt for monthly or quarterly reports to maintain tight control over their finances. Regular reporting helps identify trends and potential tax liabilities early. Medical.Accountants provides these reports based on your needs.
Want us to check this for you? Get a free review →Which KPIs matter for my healthcare business?
Key Performance Indicators for healthcare businesses often include staff cost ratios and average revenue per patient. Monitoring clinical room utilisation and overhead percentages is also essential for profitability. These metrics provide insights into operational efficiency beyond simple bank balances. We help you identify the most relevant data for your specialty.
Want us to check this for you? Get a free review →How do cash-flow forecasts help?
Cash-flow forecasts help you predict future bank balances by timing anticipated income against planned expenditure. They are vital for planning large tax payments or equipment upgrades. These projections allow for informed decisions regarding recruitment and expansion. Maintaining accurate forecasts reduces the risk of unexpected liquidity issues.
Want us to check this for you? Get a free review →What do lenders expect to see?
Lenders typically expect to see historical accounts and detailed financial projections. They require evidence of consistent clinical income and sound debt management. Management accounts and tax returns are standard requirements for healthcare financing. Medical.Accountants prepares professional financial packs to support your lending applications.
Help with this question: Mortgage References & SA302s for Doctors & Healthcare Professionals
Want us to check this for you? Get a free review →Can management accounts support CQC applications?
Management accounts can demonstrate financial viability during the Care Quality Commission registration process. They provide evidence that the provider has sufficient resources to maintain safe and effective services. Accurate financial reporting supports the 'Well-led' domain of the inspection framework. We assist in generating reports that reflect your business stability.
Want us to check this for you? Get a free review →How much do management accounts cost?
The cost for management accounts is determined by the complexity and frequency of the reporting required. Medical.Accountants operates on a fixed-fee basis, which is always agreed in writing before work commences. This ensures full transparency and aids your practice budgeting. Fees are tailored to the specific needs of your healthcare business.
Want us to check this for you? Get a free review →Can you work with Xero or QuickBooks?
We work with doctors, dentists, nurses, pharmacists, allied health professionals, aesthetic practitioners and healthcare businesses including care homes, clinics and agencies across the UK.
Want us to check this for you? Get a free review →Are care services exempt from VAT?
Welfare services such as residential and domiciliary care are VAT exempt when supplied by a provider regulated by the relevant state regulator, such as CQC in England or Ofsted for children's homes. Unregulated elements, introductory agency fees and some supported living services can be standard-rated. HMRC Notice 701/2 explains the conditions.
Check the official guidance · www.gov.ukHelp with this question: VAT Registration & Returns for Care Homes
Want us to check this for you? Get a free review →How can care providers manage the employer NIC increase?
Care providers can mitigate rising payroll costs by ensuring they fully utilise the Employment Allowance, which is £10,500. Reviewing staffing structures and salary sacrifice arrangements may also provide efficiencies. Efficient tax planning helps maintain margins while meeting legislative obligations. We work with healthcare businesses to model the impact of National Insurance changes on their profitability.
Want us to check this for you? Get a free review →How do care agencies pay National Minimum Wage for travel time?
You can claim tax relief on costs incurred wholly and exclusively for your work: HMRC-approved professional fees such as GMC, NMC, GDC or HCPC registration and approved royal college and union subscriptions, uniform laundering, and business mileage between workplaces. Ordinary commuting and most exam or training costs for new qualifications are not allowable. Employees can claim back up to four tax years.
Help with this question: Payroll & Pensions for Care Homes
Want us to check this for you? Get a free review →What is RTI?
Real Time Information (RTI) requires employers to report payroll data to HMRC on or before every payday. This process ensures tax and National Insurance calculations remain accurate throughout the year. You must submit a Full Payment Submission for each pay period. Our team manages these digital filings for medical practices to ensure compliance.
Help with this question: Payroll & Pensions for Care Homes
Want us to check this for you? Get a free review →What is the National Minimum Wage rule for my staff?
Employers must pay staff at least the statutory minimum rate based on their age and apprenticeship status. These rates typically increase every April. You must maintain accurate records of hours worked to prove compliance. Failure to pay the correct rate can result in significant penalties and public naming by the government.
Help with this question: Payroll & Pensions for Care Homes
Want us to check this for you? Get a free review →What year-end forms do employers send?
Employers must submit a final payroll report and provide employees with a P60 by 31 May. You may also need to file P11D forms for taxable benefits by 6 July. These documents summarise total pay and deductions for the tax year. Medical.Accountants handles these filings as part of our payroll service.
Want us to check this for you? Get a free review →Quick quote
See what you could save — get a fixed fee in one working day
Three fields. No obligation. A specialist replies, not a sales team.
Packages for your working life
Accountancy packages for care providers
Self-employed income, a limited company, PAYE or a mixture: start with the support that matches how you actually work. We check your status and agree the scope and fee before starting.
Self-employed accountants for care providers packages
For genuine sole-trader income. We prepare your business accounts and Self Assessment, review allowable expenses and explain payments on account.
- Sole-trader accounts and personal tax return
- Allowable business expenses reviewed
- Tax reserve and payment deadline guidance
- MTD support scoped separately where required
Fixed fee quoted after a review
Discuss this packageLimited company accountants for care providers packages
For clinicians working through their own company. Choose Essential/Compliance, Core/Complete or Growth according to your accounts, bookkeeping and payroll needs.
- Statutory accounts and Corporation Tax return
- One director return for salary and dividends from the same company
- Confirmation statement support; filing fee extra
- Bookkeeping, VAT and payroll according to your chosen plan
Company packages from £45.83 + VAT / month
Compare company packagesPersonal tax return packages for care providers
For employed clinicians, partners and people with mixed income who need a return. We check whether Self Assessment is required and reconcile the relevant income, expenses and pension tax information.
- Self Assessment requirement checked
- PAYE and other income reconciled
- Eligible employment expenses reviewed
- Pension tax work agreed separately where needed
Fixed fee quoted after a review
Discuss this packageEmployment status is determined by the facts, not the package you choose. PAYE, umbrella and partnership arrangements may also apply. A limited company does not override IR35 or off-payroll rules, and not every employed clinician needs a tax return.
Overpaid tax?
Tax refund support for care providers
We review tax codes, eligible professional expenses and overpaid tax, then prepare a claim where you qualify. A refund is not guaranteed; HMRC decides the claim.
£249 + VAT
For refunds up to £5,000, our fee is £249 plus VAT. For refunds above £5,000, add 5% of only the amount above £5,000 to the £249 fee. VAT applies to the total professional fee.
Example: a £6,000 refund means £249 + £50 = £299 plus VAT.
Professional fee, excluding VAT
£249
This illustrates the fee only, not whether you qualify or how much HMRC will refund. We agree the claim scope and payment terms before work starts.
What's included
Limited company packages — compare what's included
Essential/Compliance
For locums, salaried GPs and dentists with a limited company
from £45.83 + VAT /month
- FRS 105 or FRS 102 1A statutory accounts
- Corporation tax return (CT600) and tax computation
- Confirmation statement preparation and filing support
- One director Self Assessment return
- Deadline reminders ahead of every filing date
Core/Complete
For private practice, consultants and associate dentists
from £62.50 + VAT /month
- Everything in Essential/Compliance
- Monthly bookkeeping and bank reconciliation
- Quarterly Making Tax Digital VAT returns
- Director payroll with RTI filing and pension submissions
- Quarterly review call on numbers and tax position
Growth
For clinics, dental practices and growing medical teams
from £75.00 + VAT /month
- Everything in Core/Complete
- Payroll for up to five employees
Prices exclude VAT. Making Tax Digital quarterly updates available as an add-on. Compare fees
Why clinicians trust us
Chartered accountants who know the NHS
- ACCOTAX has served over 5,000 clients.
- Regulated chartered accountants (ICAEW and ACCA).
- Founded by Waqas Sagar ACA FCCA FMAAT, with 18+ years' experience.
Reviewed by Waqas Sagar ACA FCCA FMAAT
Chartered accountant and founder of ACCOTAX. Last reviewed October 2026.
Get my fixed-fee quoteHow it works
- 01
Free call
A 15-minute chat about your income, structure and deadlines.
- 02
Onboarding in 48 hours
We set up your records, software and HMRC agent access.
- 03
We handle the rest
HMRC, NHS Pensions and every deadline, with reminders before each one.
Free resource
Get the care provider cash-flow template free
Tell us where to send it and we'll email it to you.
Your questions, answered
- Do care homes need management accounts & cash flow?
- It depends on your circumstances. Our team reviews your income, structure and records and confirms the right approach for care homes in writing as part of your fixed-fee service.
- What does management accounts & cash flow for care homes include?
- It depends on your circumstances. Our team reviews your income, structure and records and confirms the right approach for care homes in writing as part of your fixed-fee service.
- How much does it cost for care homes?
- Our packages for care homes start at £45.83 + VAT a month, with Core at £62.50 and Growth at £75 + VAT. The right package depends on your income sources, whether you trade through a company and any payroll, VAT or pension work. We confirm the exact fee in writing before any work begins, so there are no surprise invoices.
- What are the deadlines for care homes?
- Many care homes must file a Self Assessment return: you need one if you have untaxed income such as private, locum or self-employed work. A high PAYE salary alone does not require Self Assessment for 2026/27; check HMRC's current criteria and any notice to file. The online filing and payment deadline is 31 January after the tax year ends. Under the non-MTD rules, late filing normally triggers an initial £100 penalty, with further penalties for longer delays. A different regime applies from the tax year you join MTD for Income Tax.
- Can I switch to you mid-year?
- Switching takes minutes on your side. You sign our engagement letter, we contact your previous accountant for professional clearance and records, and we take over HMRC and Companies House authorisations. You can switch mid-year; we pick up from the last filed return.
Speak to a specialist today
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Book a free 15-min tax reviewRelated healthcare expertise
VAT Registration & Returns for Care HomesPayroll & Pensions for Care HomesMortgage References & SA302s for Doctors & Healthcare ProfessionalsCare home accountants for residential and nursing careManagement Accounts & Cash Flow for Doctors & Healthcare ProfessionalsLimited Company Accounts & Corporation Tax for Care Homes
General information for the 2026/27 tax year, prepared from the official guidance linked below. It is not personalised tax or regulated financial advice. Rules and circumstances can change; confirm your position before acting.
Official sources referred to on this page: HMRC VAT Notice 701/2 (welfare services); GOV.UK National Minimum Wage (travel time, sleep-ins); HMRC Employment Allowance; CQC registration guidance.