Care Home Accounts and the VAT Position
Written and reviewed by the Care Home Accountants editorial team. Last reviewed 28 July 2026.
The accounts of a care home tell you almost nothing unless they are read against occupancy, and the VAT runs backwards compared to a normal trade. This service handles both: the statutory and management accounts built around the beds, and the welfare-exemption position that decides whether you are charging VAT and whether you can reclaim any.
This is the service to ask for when you want the reporting and the VAT handled as one piece rather than by two firms who do not talk to each other. Preetesh Parmar FCCA at Tidy Money Ltd leads the work.
What the Accounts and VAT Work Covers
We prepare the statutory year-end accounts and file them, and through the year we produce management accounts that read the result against occupancy, so a dip in the numbers can be traced to empty beds rather than left as a mystery. We keep the bookkeeping current under Making Tax Digital and reconcile the funding routes into the income.
On VAT we establish and maintain the correct position for a regulated care provider, handle any registration where you have taxable income alongside the exempt care, and file the returns. If a purchase or refurbishment is in prospect, we flag the irrecoverable VAT cost before you commit to the spend.
Where the Welfare Exemption Gets Awkward
Welfare care from a CQC-registered provider is exempt from VAT, not zero-rated, and the distinction has teeth. Exempt means you charge no VAT on fees and you cannot reclaim the VAT you pay on refurbishment, agency staff or supplies, so that VAT is a permanent cost rather than a timing difference. Exempt income also does not count towards the £90,000 registration threshold. Our guide to VAT and the welfare exemption sets this out in full.
Reading the accounts by occupancy is the other half. A care home at 70% occupancy and one at 95% can show similar revenue in a given month for different reasons, and only the occupancy view tells you which. We build the management accounts so the driver of the result is visible.
How We Run Reporting by Occupancy
We keep the records live in cloud bookkeeping, which the Making Tax Digital timetable now requires: income tax reporting begins for those over £50,000 from 6 April 2026, over £30,000 from 2027 and over £20,000 from 2028. Our guide to Making Tax Digital for care providers covers what that means for you.
You get management accounts through the year with occupancy and the funding mix on the face of them, and a year end where the statutory accounts and any VAT return are agreed with you before filing.
What Accounts and VAT Support Costs
We work to a fixed fee agreed before we start, based on the size of the home, whether a VAT registration is in place, and the reporting frequency you want. The figure is fixed in advance.
Where the accounts, VAT and payroll run together with us, we quote the whole engagement as one rather than pricing each return separately.