What to know before you decide
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Specialist accountants for Buying a Care Home · Fixed fees · Free first call
Buying a care home: due diligence, finance and tax
Buying a care home means taking over residents, staff, a registered service and usually a property. Before you sign, an accountant checks whether the profit really supports the price and the loan.
What should I check before buying a care home?
Check at least three years of accounts, occupancy, the mix of local authority and private fees, staffing and agency costs, the latest CQC rating, the property condition and any debts. Due diligence confirms whether the earnings support the price and the borrowing.
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
- We check the figures behind the price; we do not list businesses for sale or act as a broker.
- Fixed fee for due diligence or sale planning, agreed in writing before work starts.
- One named accountant from first look to completion, and afterwards if you want us to stay on.
Buying a care home step by step
- Agree your budget and finance in principle
- Review accounts, occupancy and fee levels
- Make an offer subject to due diligence
- Complete financial, legal and CQC checks
- Agree the structure and complete
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
Financial due diligence
Accounts, management figures, payroll, contracts and liabilities tested, with a clear report of risks you can use in negotiation.
02
Deal structure and tax
Share or asset purchase, personal or company ownership, VAT on the transfer and Stamp Duty Land Tax modelled before you commit.
03
Finance support
Cash-flow projections and accountant's references prepared for your lender. We do not arrange loans or give regulated financial advice.
Your questions answered
How are care homes valued?
Usually as a multiple of earnings (EBITDA), adjusted for occupancy, fee levels, CQC rating and the property. A home relying heavily on agency staff or low local authority fees is worth less than its turnover suggests.
Want us to check this for you? Get a free review →Do I need CQC registration to buy a care home?
Yes. In England a new provider must register with the Care Quality Commission before running the service. Registration does not transfer with the business, so start early.
Want us to check this for you? Get a free review →Is VAT charged when buying a care home?
Care provided by a registered provider is generally VAT exempt. A business sold as a going concern is usually outside VAT, but property with an option to tax needs checking before completion.
Check the official guidance · www.gov.ukHelp with this question: VAT Registration & Returns for Doctors & Healthcare Professionals
Help with this question: Practice Purchase, Sale & Valuation for Doctors & Healthcare Professionals
Want us to check this for you? Get a free review →What happens to the staff?
Staff usually transfer to the new owner under TUPE on their existing terms, so wage costs, holiday owed and contracts must be checked in due diligence.
Want us to check this for you? Get a free review →Share sale or asset sale: which is better?
Sellers often prefer a share sale because the gain is taxed once. Buyers often prefer an asset sale because they avoid the company's past liabilities and can claim allowances on equipment. We model both so you can negotiate on the after-tax figure.
Want us to check this for you? Get a free review →What due diligence is needed?
Due diligence involves a thorough investigation of the financial health and liabilities of a medical practice before joining. This includes reviewing historical accounts, tax compliance, and NHS pension obligations. You should verify the accuracy of profit shares and any outstanding legal commitments. Medical.Accountants supports prospective partners by analysing these financial records.
Help with this question: Practice Purchase, Sale & Valuation for Doctors & Healthcare Professionals
Want us to check this for you? Get a free review →How can a purchase be funded?
Practice purchases are typically funded through a combination of personal capital and commercial lending. Many healthcare professionals utilise specialist medical loans or asset finance for equipment. Lenders often review historical financial performance and professional qualifications. Our firm assists in preparing the necessary documentation for these applications.
Want us to check this for you? Get a free review →Should I buy shares or assets?
The choice between buying shares or assets depends on your specific commercial objectives and risk appetite. Share purchases involve acquiring the entire legal entity, including all liabilities. Asset purchases allow you to select specific items like patient lists or equipment. Each method carries distinct tax implications for the buyer.
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 packageMedical accountants for care providers: limited company 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
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Book a free 15-min tax reviewRelated healthcare expertise
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: CQC: Registration; GOV.UK: Transfer of a going concern (VAT); GOV.UK: Business transfers (TUPE); GOV.UK: Non-residential SDLT rates.