Caregiving for Older and Disabled People Level 3

Who it is for. People who have finished Caregiving for Older and Disabled People Level 2, or who already lead carers, run a care service or manage a family's care and can show the same skills. In Ghana's framework, National Proficiency II leads to National Certificate I, which covers complex work with minimum supervision. This module sits at about that level.

Bridge from Level 2: what you already know

Level 2 left out assessing needs and writing care plans yourself, setting up escalation systems, writing policies, auditing quality, recruiting and supervising staff, the law and paperwork of an agency, and the books. Level 3 covers all of these. For general bookkeeping and business skills, see the Hub's Money Skills Level 2 and Entrepreneurial Thinking Level 2; this book goes deeper and is specific to home care.

How the module works

Each unit has learning outcomes, performance criteria, the range and the evidence your assessor needs. You are judged Competent or Not Yet Competent. About 60% of the time is practical (care planning with real or case-study clients, audits, supervision, books), close to CTVET's Oil Palm programme split of about 30% school and 70% workplace.

Where the guidance comes from. Ghana-specific standards for care agencies were not found. International guidance is used and labelled (WHO, UK NICE, UK NHS, St John Ambulance). Ghana law is used for business, tax and employment, mostly from facts read on official pages on 7–8 October 2026.

Honesty rule. Numbers marked example were invented to teach the method. Where a Ghana fact could not be found, the book says not verified. Every worked sum was checked by a computer script.

Competency standard

Range. Two case-study clients and, with permission, one real client under supervision. Evidence. Assessment form; care plan; risk assessments; minutes of a family meeting; review record.

The assessment visit

Before the visit: agree the time with the family; ask for any hospital discharge letter, clinic book or nurse's notes (with the person's consent); take the assessment form, a pen, a torch, and an ID card.

During the visit (about 60–90 minutes):

1. Introduce yourself and the agency; explain what will happen and ask the person's consent. If the person cannot decide, involve the family member who usually decides and record it.
2. Talk first with the person, then the family. Use the person's language.
3. Work through the assessment areas below. Watch the person move, eat, drink and talk if possible.
4. Walk through the home: bedroom, bathroom, toilet, kitchen, compound, gate.
5. Ask: "What matters most to you? What would a good day look like?"
6. Explain what the agency can and cannot do (the hard gate), and what the price would be.
7. Agree the next step.

Assessment areas. WHO's ICOPE programme for older people works through cognition, locomotor capacity (mobility), vitality, vision, hearing and psychological capacity, and aims at person-centred, coordinated care. Combine these with daily living:

Many older people live with several chronic conditions at once: a CDD-Ghana fellow, citing international research, wrote that on average 60% of people over 60 live with two or more chronic diseases. Each condition changes the risks.

Writing the care plan

Write in plain words, in the first person where you can ("I like to wash at 7, after prayers"). Every task has who, what, when and how.

Risk assessments a leader must write

The family meeting

1. Agree who comes: the person, the family member in charge, others the person wants; invite the nurse if possible.
2. Share the draft plan; read it aloud in the person's language.
3. Agree goals, tasks, hours, price, the hard gate and who to call.
4. Write short minutes: date, who was there, decisions, who does what by when.
5. Everyone signs the plan; give a copy to the family; keep one in the home folder and one in the office.

Check yourself

1. Name four of the ICOPE areas you assess.
2. What four things must every care task in a plan say?
3. When must a care plan be reviewed, besides the review date?

Competency standard

Range. Three case studies; the agency's own policies. Evidence. Escalation protocol; medicines-support policy; incident review; outbreak checklist.

Coordinating complex care

The escalation protocol

Every agency needs a one-page escalation protocol in every client's home folder and on every carer's phone.

Sources for the signs: stroke; heart attack; sepsis; low blood sugar; dehydration; pressure ulcers; choking.

On-call rota. Someone senior must answer the phone at all hours that carers work. Write the rota, test it (call it at random), and record calls.

Writing a medicines-support policy

Ghana guidance for care agencies on medicines was not found. Use UK NICE NG67 (international) as the model, and keep inside the hard gate. NG67 says a care provider should not take responsibility for managing a person's medicines unless an assessment shows the need and it is agreed; carers give only the medicines support agreed in the care plan; carers give a medicine only with authorisation and clear instructions and when the six rights are met (right person, medicine, route, dose, time, and the right to decline); carers check whether the dose was already taken; every dose of support is recorded on a medicines administration record; covert administration is not done without lawful authorisation; changes to medicines received verbally from a prescriber are recorded, read back and confirmed; and advice is sought from the prescriber or a pharmacist when needed.

Your agency's policy should state:

Infection: preventing spread between clients

Your carers visit several homes. One carer can carry an infection from one client to the next.

Learning from incidents

After every incident (fall, error, injury, near miss, complaint):

1. Make the person safe; record the facts the same day.
2. Tell the family and the nurse as agreed.
3. Review within a week: what happened, why (look for system causes, not just blame), what will change.
4. Update the care plan, risk assessment and training.
5. Share the lesson with all carers (without names).
6. If a worker is injured at work, the Labour Act requires the employer to report occupational accidents to the appropriate agency within seven days.

Check yourself

1. Give two examples each of red and amber signs.
2. Name three things a medicines-support policy must forbid carers to do.
3. Within how many days must an employer report an occupational accident under the Labour Act?

Competency standard

Range. The trainee's own agency or a case-study agency. Evidence. Safeguarding policy; complaints procedure; one audit; data protection checklist.

Why a safeguarding policy

WHO estimates that about 1 in 6 people aged 60 and over in the community experienced abuse in the past year, and that in institutions 64.2% of staff reported committing some form of abuse in the past year. Dependence, disability, poor health and memory problems raise the risk. Ghana's Persons with Disability Act forbids discrimination, exploitation and abusive or degrading treatment of a person with disability. The Ministry of Gender, Children and Social Protection says it will strengthen protection against neglect, abuse and exploitation of older persons, including through the Orange Support Centre.

What your safeguarding policy contains

The contact routes for reporting abuse of an older person to the Department of Social Welfare or the Orange Support Centre in the Western Region were not verified. Phone the regional social welfare office before you finalise the policy, and write the numbers in.

Complaints procedure

1. Every family gets the procedure in writing on the first day.
2. Anyone may complain by phone, WhatsApp, letter or in person, without fear of losing the service.
3. Acknowledge within 2 working days (example standard).
4. Investigate fairly: talk to the client, family and carer; check records.
5. Reply in writing within 14 days (example standard): what you found, what you will change, an apology if you were wrong.
6. Record every complaint and the outcome; review all complaints monthly for patterns.
7. A complaint that suggests abuse goes to the safeguarding procedure at once.

Quality checks (audits)

Turn every audit into an action list with names and dates, and re-check.

Data protection

Your agency holds sensitive information: names, addresses, health conditions, photos of ID, family phone numbers. The Data Protection Commission says all entities that process personal data must register, and an unregistered data controller may not process personal data (section 53 of the Act, as quoted on the page). Applicants must say whether they process special categories of personal data, pay a fee based on their sector, and renew with a compliance report. The fee for a small care agency was not verified.

Check yourself

1. Name five things your safeguarding policy must contain.
2. What does the DPC say about registration?
3. Name three quality audits and how often you do each.

Competency standard

Range. Recruitment for one carer post; a team rota for a month. Evidence. Job description; interview record; induction checklist; supervision record; rota.

Safer recruitment

1. Job description: duties, hours, pay, the hard gate, qualities needed (kindness, honesty, reliability, reading and writing simple notes).
2. Advert: WhatsApp, churches and mosques, the Hub, training centres; include "persons with disabilities are encouraged to apply".
3. Application: name, Ghana Card number, training, work history, two referees (not family).
4. Interview: scenario questions ("A client offers you money. What do you do?"; "A family asks you to give an injection.").
5. Practical test: hand-washing; a bed-to-chair transfer on a partner; a short note.
6. Checks: Ghana Card; references by phone (ask about honesty and reliability); certificates. A police clearance process for carers was not verified; ask the police service.
7. Offer in writing, with the contract (see Unit 5 for the law).

Ghana's Disability Act says an employer must not discriminate against an applicant or employee on grounds of disability unless the disability is relevant to the job, and must provide the tools and facilities a disabled worker needs.

Induction and competency sign-off

No new carer works alone until they have been signed off. A sample induction (example: one week):

Employers must give workers the information, instructions, training and supervision they need for health and safety, taking into account their literacy and circumstances.

Supervision

• One-to-one supervision every month (example): how are you; each client; what went well; concerns; training needs; welfare. Write it down; both sign.
• Spot checks (Unit 3).
• Annual appraisal: skills, goals, pay review.
• Poor practice: talk privately and early; give clear expectations and support; record; repeat or serious problems follow a written disciplinary procedure. Abuse is never "poor practice": it goes to safeguarding.
• Praise in public, correct in private.

Rotas and safe staffing

Protecting your workers (Labour Act 2003, read on the Act):

• Employers must ensure safe and healthy working conditions, provide training and supervision, and supply personal protective equipment at no cost to the worker (section 118).
• A worker who reasonably believes a situation presents imminent and serious danger must report it and may remove themselves; the employer must not dismiss or withhold pay for that (section 119).
• Occupational accidents and diseases must be reported to the appropriate agency within seven days (section 120).

Lone working: carers text or call at arrival and departure; a missed check-in is followed up within 30 minutes (example standard); carers may leave a home where they are threatened, and report it.

Carer welfare: WHO says carers need regular breaks, support and attention to their own health and stress. Debrief after deaths and incidents; arrange days off fairly; watch for burnout.

Check yourself

1. Name four recruitment checks before a carer starts.
2. What does section 118 of the Labour Act require about PPE?
3. Three clients need 8 hours a day, 7 days a week. How many carer-hours a week is that?

Competency standard

Range. Own business plan for a small home-care agency. Evidence. Registration checklist with costs; start-up budget; payroll sheet; one-page plan.

Choose a business model

Home care agencies in Accra have operated since the 1990s and were described as completely unregulated, with cheaper operators undercutting careful ones. That may change: the Ministry says the 2010 National Ageing Policy is being updated, with emphasis on care, and that it is working with the health sector on geriatric, long-term and home-based care. Build your agency to a standard you would be proud to show an inspector.

Choose a legal form

Companies file an annual return (GH¢175 a year; late fees GH¢1,000 for 1 to 4 years and GH¢2,000 for 5 or more), and the first return is due 18 months after incorporation. A care agency holds the safety of vulnerable people and employs staff; a company limits what the owners can lose in a claim, and a placement agency must be a corporate body (teaching advice, not a legal opinion; ask a lawyer). A church or NGO care service may suit a company limited by guarantee.

Registration steps

1. Tax number. Your Ghana Card number is your individual TIN since 1 April 2021; a company receives a GRA TIN after ORC registration.
2. ORC. Register the business name or company (fees above). Business-name renewal can be done on USSD *222#.
3. HeFRA. Write to HeFRA (copy the Regional Health Directorate) describing exactly what your agency will and will not do, and ask whether a licence or registration is needed. HeFRA licenses health facilities under Act 829. Keep the reply. If you plan any nursing, you will need HeFRA licensing and registered nurses.
4. Labour. If you place carers with families (placement model), apply for a private employment agency licence. If families employ carers directly, the domestic-worker regulations (L.I. 2408) may apply to those families: a summary says contracts are deposited with the District Labour Officer within a month.
5. Assembly business operating permit. The Sekondi-Takoradi Metropolitan Assembly runs a permit portal (tcc.stma.gov.gh), with fees in its 2025 fee-fixing resolution. The category and fee for a care agency office were not verified.
6. Data Protection Commission. Register as a data controller before you hold client data.
7. SSNIT employer registration before you hire.
8. Tax scheme and VAT (below).
9. Insurance. Use only insurers licensed by the National Insurance Commission; check at nic.gov.gh. Which covers are compulsory was not verified. Ask about public liability (injury or damage in clients' homes), employer's liability or workmen's compensation, professional indemnity, fidelity (staff dishonesty) and office contents.
10. Social welfare. Ask the regional Department of Social Welfare whether care agencies must register with them (not verified).

Tax choices for a care agency

• VAT on services. Under the Value Added Tax Act 2025 (Act 1151), VAT is 20% in total (15% VAT plus 2.5% NHIL plus 2.5% GETFund) from 2026. For services there is no turnover threshold: a taxable person making taxable supplies of services must register, unless the Commissioner-General permits otherwise. Whether non-clinical home care is a taxable service, or exempt as a medical or welfare service, was not verified: ask the GRA in writing before you set prices. If care is taxable, your price must include VAT, and you cannot use the Modified Taxation Scheme.
• Modified Taxation Scheme (sole traders not VAT-registered). Turnover GH¢20,001 to GH¢750,000: 3% of turnover. Professionals, owners of several businesses and partners are excluded.
• Companies. 25% standard company tax; quarterly provisional tax and an annual return within four months after year-end.
• Withholding. A large client (a company, NGO or government body that is a withholding agent) may withhold 7.5% of what it pays you for services; ask for the certificate and keep it.

Premises and location settings that give good returns

Start-up budget (all figures example)

Equipment prices for care aids are from Jiji Ghana asking prices seen on 8 October 2026: commode chairs about GH¢400–2,500; long-back or commode wheelchairs about GH¢2,450–2,500. Other lines are invented examples; replace them with quotes.

(Arithmetic checked by script: 6,000 + 2,000 + 6,000 + 4,000 = 18,000; 18,000 + 2,500 + 1,500 + 1,000 + 20,000 = 43,000.)

Funding (example): owner's savings GH¢30,000 and an interest-free family loan GH¢13,000, repaid GH¢1,000 a month from month 4.

Finance options

• Own savings and family, with a written agreement.
• Savings groups and susu (terms not verified).
• Microfinance and banks. The Bank of Ghana policy rate was 14.00%; loan rates were not verified. Lenders will ask for records (Unit 6).
• Ghana Enterprises Agency. Programmes include SME GO, Business-in-a-Box, SME High Growth and Kaizen; Business Advisory Centres operate in Takoradi, Shama, Effia-Kwesimintsim, Mpohor and Ahanta West.
• 2026 Budget lines include GH¢401 million for a Women's Development Bank and GH¢170 million for a National Apprenticeship Programme. Eligibility was not verified.
• Assemblies' disability fund. The share rose from 3% to 5% in 2026 and now favours skills, assistive devices and start-up capital. Owners with disabilities should ask their Assembly's disability desk.

Employing carers: pay and law

• The 2026 minimum wage is GH¢21.77 a day.
• Written contract for work of six months or more (section 12); written statement of terms within two months (section 13); 15 working days' paid leave (section 20); 12 weeks' maternity leave (section 57).
• SSNIT: worker 5.5% and employer 13% of basic pay, 18.5% in all; paid by the 14th of the next month; register workers when hired.
• PAYE monthly bands from 1 September 2026: first GH¢588 at 0%; next 80 at 5%; next 100 at 10%; next 2,900 at 17.5%; next 16,000 at 25%; next 30,332 at 30%; above that 35%; SSNIT deducted first; due by the 15th.

Worked example (pay figures example, 2026 rates). A carer earns GH¢1,500 basic a month. SSNIT deducted 5.5% × 1,500 = GH¢82.50. Taxable pay = 1,500 − 82.50 = GH¢1,417.50. PAYE: first 588 at 0 = 0; next 80 at 5% = 4.00; next 100 at 10% = 10.00; the rest, 1,417.50 − 768 = 649.50 at 17.5% = 113.66. PAYE = GH¢127.66. Net pay = 1,500 − 82.50 − 127.66 = GH¢1,289.84. Employer SSNIT 13% = GH¢195. Total employer cost = GH¢1,695. SSNIT to pay for this worker = 82.50 + 195 = GH¢277.50.

Market yourself honestly

• WhatsApp Business: catalogue of services with clear prices; quick replies; business hours and an emergency line for existing clients. Never post client photos.
• Google Business Profile: address, hours, phone and services so families searching online can find you; ask for honest reviews.
• Referrals: hospital social workers and ward nurses, private clinics, pharmacies, churches and mosques, diaspora associations, funeral and welfare committees.
• Signage and print: a signboard at the office; a family leaflet with services, the hard gate, prices and the complaints procedure.
• Promises you can prove: trained and supervised carers, records, spot checks, safeguarding policy. Never "nursing care" unless licensed.

Accessibility

Ghana's Disability Act bans discrimination against employees and applicants on grounds of disability unless relevant to the job, requires employers to provide the tools and facilities a disabled worker needs, provides for a tax rebate for employers of persons with disabilities (amount left to regulations), and requires places and services open to the public to be accessible.

• Staff with disabilities: office roles (rota, records, phone check-ins, quality calls), companionship and reading visits, sign-language support for deaf clients, training families, leading audits. Adjust: ground-floor office, accessible toilet, screen reader or large print, vibrating alerts, flexible hours, paired visits for heavy tasks.
• Clients with disabilities: ask the person, not just the family; written, large-print or audio care plans; sign-language interpreters for assessments of deaf clients; respect independence.
• Include a person with a disability on your advisory group or as a staff member when you design services.

Check yourself

1. What does the Labour Act require of a private employment agency?
2. Why must you ask the GRA about VAT before setting prices?
3. What are the net pay and employer SSNIT for a carer on GH¢1,500 basic?

Competency standard

Range. One month of real or example records. Evidence. Books; invoices; statements; reconciliation; break-even; debtors list.

The records

Keep records in Ghana for at least 6 years from the end of the year of assessment or VAT period. Assets = liabilities + owner's equity; a debit increases assets and expenses, a credit increases liabilities, capital and income; a trial balance is only a partial check. Small businesses' accounts follow IFRS for SMEs, with a new edition from 1 January 2027. Straight-line depreciation = (cost − salvage value) ÷ useful life.

Match hours every week: hours paid to carers (from timesheets) should equal hours invoiced to families, plus any unpaid training or travel time you have decided to pay. A gap is lost money.

Cost per hour, margin and mark-up (all figures example)

Price to families: GH¢25 per carer-hour (example; VAT left out, see Unit 5). In month 1 the agency sells 640 hours with 4 carers.

Margin is a percentage of the price; mark-up is a percentage of the cost. Be clear which one you mean.

Worked month: October (all figures example)

Break-even

Debtors: families who pay late

Late payment is the biggest cash risk for a care agency. Rules (example policy): a deposit of two weeks' fees for new clients; invoices weekly; payment within 7 days; a polite reminder at day 8; a call from the owner at day 14; services reviewed (with safe handover, never abandoning a vulnerable person suddenly) if 30 days late. Keep an aged debtors list every week.

Reconciliation: MoMo and bank

Every week, match the MoMo and bank books to the statements line by line. Example: the MoMo book shows GH¢9,000 received in October; the statement shows GH¢8,910 after GH¢90 charges. Record the charge as an expense; then both agree at GH¢8,910. Never let a carer collect fees into a personal MoMo number.

Taxes in the books

• PAYE and SSNIT: PAYE by the 15th, SSNIT by the 14th of the next month. Late SSNIT is charged at 3% a month.
• VAT (if your care service is taxable): charge 20% on fees and pay it by the last working day of the next month. Example only: if October's GH¢16,000 were taxable, output VAT would be 16,000 × 20% = GH¢3,200, so families would pay GH¢19,200 in total; or, if GH¢25 were VAT-inclusive, the agency would keep only 25 ÷ 1.2 = GH¢20.83 an hour. Ask the GRA first (Unit 5).
• Withholding tax: institutional clients may withhold 7.5% on services; keep the certificates.
• Income tax: a sole trader not VAT-registered with turnover GH¢20,001–750,000 may pay 3% of turnover under the Modified Taxation Scheme. Companies pay 25% and file provisional tax quarterly.

Software and the calendar

Use a spreadsheet, or a free plan such as Zoho Books or Wave.

Month-end routine

Check yourself

1. Why must hours paid to carers match hours invoiced to families?
2. In the worked month, why is cash lower than profit suggests?
3. What is the difference between margin and mark-up?

Competency standard

Range. Own business plan. Evidence. Business plan; contract outline; cash forecast; pitch.

The market

• People aged 60 and above numbered 1,991,736 in the 2021 census and are projected to reach 5.7 million by 2050.
• ISSER argues that formalising adult caregiving could create thousands of jobs, and calls for a national elder-care policy, a specialised caregiver training curriculum and sustainable financing, with Assemblies mapping older residents' needs.
• Agencies have tended to recruit young women and some young men with secondary education, and quality varies because the sector is unregulated.
• Training is growing: KNUST's short course in caregiving for the elderly is NMC-accredited for CPD. Your agency can stand out by training and supervising well and proving it.

Quality and customer care

• Keep the audits from Unit 3 and show families the results.
• Same carers for each client wherever possible; introduce new carers in person.
• A named coordinator for every family; a monthly call to each family.
• Log every complaint; reply on time; tell the family what changed.
• Celebrate carers: recognition, fair pay, training, a path to senior carer.

Pricing strategy

• Cost-plus: cost per hour (Unit 6) plus a margin that covers overheads, growth and a reserve.
• Know the market: ask families and other agencies what they pay; do not compete on the lowest price by underpaying carers.
• Packages: morning-only, day, night, live-in, respite weekends, post-discharge fortnight; each priced from cost.
• Clear terms: deposit, weekly invoice, 7-day payment, cancellation notice, annual price review.
• VAT: settle the VAT question before you print prices (Unit 5).

Scale carefully

1. Fix quality, books and cash first.
2. Fill your carers' hours before you hire more (Unit 6 break-even).
3. Promote a senior carer to supervise; then add a second team in a new area.
4. Add services that fit: night sitting, respite, post-discharge support, family carer training, equipment hire.
5. Add a partner nurse or a licensed nursing service only with HeFRA licensing and registered nurses.

Partnerships and contracts

Partners: hospitals and clinics (discharge referrals), community and palliative nurses, physiotherapists, pharmacies, churches and mosques, diaspora associations, insurers, the Assembly social welfare office, disability organisations, the Hub, and the GEA Business Advisory Centre.

A client contract should say: parties; the care plan (attached); hours and days; price, deposit and payment terms; what is included and excluded (no medical acts); how carers are chosen and replaced; emergencies and the escalation protocol; safeguarding and complaints procedures; confidentiality and data protection; cancellation and notice (including safe handover); insurance; signatures. Have a lawyer check your standard contract.

Institutional contracts. NGOs, churches, companies (for retired staff) and government programmes may buy care in bulk. Prepare your registration papers, TIN, SSNIT compliance, policies, insurance, references and audit results.

Records for loans. Lenders want: registration papers; 12 months of bank and MoMo statements; profit and loss and balance sheets; debtors list; payroll and SSNIT records; a cash-flow forecast; and a plan.

Ethics and succession

• Never sell "nursing" you cannot legally give; never let a carer do medical acts to win a client.
• Never underpay carers or skip SSNIT to cut prices.
• Never abandon a vulnerable client suddenly over a payment dispute: give notice and a safe handover.
• Report abuse, even when the abuser is a paying family member.
• Succession: name who runs the agency if you are ill or away; train them; keep contracts, policies, passwords and client files where they can be found; update company papers and your will.

A 12-month cash forecast (all figures example)

Assumptions: the agency of Unit 6; GH¢25 an hour; 70% of each month's fees collected the same month and 30% the next; carers paid GH¢1,500 basic (net pay in the month, SSNIT and PAYE the next month); 4 carers in months 1–4 and 5 carers from month 5 (capacity about 880 hours); transport GH¢400 per carer; supplies GH¢0.9375 per hour; overheads GH¢1,850 a month; drawings GH¢2,000 a month; family loan repaid GH¢1,000 a month from month 4; recruitment and uniform for the fifth carer GH¢800 in month 5; permit, ORC and DPC renewals GH¢1,500 in month 6 (example); opening cash GH¢20,000. Tax and VAT are left out. (Arithmetic checked by script.)

Reading the forecast.

• Year total: 9,440 hours; fees GH¢236,000.
• Costs for the year: staff (gross pay and employer SSNIT) GH¢94,920; transport GH¢22,400; supplies GH¢8,850; overheads 12 × 1,850 = GH¢22,200; depreciation 12 × 500 = GH¢6,000; recruitment and renewals GH¢2,300. Profit before tax and before drawings = GH¢79,330. Ama's drawings of GH¢24,000 come out of this, and tax is still to pay.
• Month 1 is the tightest: cash dips slightly while families' first payments come in. A two-week deposit from new clients would remove the dip.
• Month 5 shows the hiring step: a new carer costs money before her hours are full.
• Cash at the end of month 12 includes about GH¢2,026 of SSNIT and PAYE still to be paid for month 12 (5 × 405.16), and the family loan still has GH¢4,000 outstanding (13,000 − 9 × 1,000).
• Tax questions. Turnover of GH¢236,000 is below the GH¢750,000 MTS ceiling; a sole trader not registered for VAT would pay 3% = GH¢7,080. But if home care is a taxable service, VAT registration is required with no threshold, and the MTS would not be available. Settle this with the GRA before launch.
• Test it: what if two families pay 60 days late? What if you lose one 8-hour client? What if pay rises 10%?

Business ideas

Capstone

Present to a panel: a one-page business plan and a 12-month cash forecast. Include your care-quality plan, safeguarding policy summary, medicines-support policy summary, registration checklist (with gaps) and a risk list.

Check yourself

1. Name three things a client contract must include.
2. In the forecast, why does cash dip in month 1 and slow in month 5?
3. Name two ethical lines an agency owner must never cross.

1. Name the six ICOPE areas.
2. What four things must every care task in a plan say?
3. Give one red and one amber sign in an escalation protocol.
4. Under NICE NG67, when may a care worker give a medicine?
5. What does the DPC say about who must register?
6. Name three parts of safer recruitment.
7. What does section 119 of the Labour Act allow a worker to do?
8. What must a private employment agency have under the Labour Act?
9. Why must a care agency ask the GRA about VAT before setting prices?
10. A carer earns GH¢1,500 basic. What are the SSNIT deducted, PAYE and net pay?
11. Fixed costs are GH¢10,730 a month and the contribution is GH¢24.0625 an hour. What are the break-even hours?
12. Name three things a 12-month cash forecast for a care agency must show.

Best next reads: WHO ICOPE handbook and training; NICE NG67 on medicines support (UK); WHO iSupport; the WHO elder abuse fact sheet; the Labour Act 2003 (Act 651); the Hub's Money Skills Level 2 and Entrepreneurial Thinking Level 2.

What this module does not cover: nursing or clinical care of any kind; HeFRA licensing for clinical services; running a residential care home (premises, fire and health licensing were not researched).

Every source used in this manual is listed, with links, in the Teacher Copy.