We have a nanny who used to come in to our home 5 days a week. Mine is older now and going to preschool, so that's down to 2 days. We have on occasionally split the cost with another family we know so the sitter watches two kids instead of one. From time to time, we've even had 3 running around here. You end up having to provide the place this way, but you have ultimate control over everything.

Our offices are in our home so it's works well for us, but maybe there's another family or two you know with whom you could work out a similar deal? Just an outside the box thought.