DIRECT PAYMENT (DP) AGREEMENT

Transcription

1 This Agreement is made between: DIRECT PAYMENT (DP) AGREEMENT The London Borough of Southwark (referred to in this agreement as we or the Council or us ), Adult Social Care of 160 Tooley Street, London SE1 2TZ And Name and Address (referred to as you or the Client ) We have assessed your needs for care and support services and you are eligible to receive support. You have chosen to receive a direct payment for your Personal Budget so you can arrange your own support providing you with more choice and control over your own care. 1. Your personal budget We agree to pay the Personal Budget specified in your care and support plan unless you do not fulfil your obligations in this Agreement. If you have to make a financial contribution then this will be deducted from the Personal Budget that we pay. You must spend your Personal Budget in accordance with this Agreement and to meet your care and support needs as set out in your care and support plan. We will review and re-assess your Personal Budget annually. You must let us know promptly of any changes to your circumstances which may affect your Personal Budget funding. If you would like to engage a third party to manage your Personal Budget you must make sure you pay the third party the relevant Client Contribution. You may top up your Personal Budget funding to buy additional or specific goods or services at your own expense. Your Personal Budget will be paid into a separate bank account or paid onto your pre-paid card account. We may require you to return to the Council any money in your Personal Budget account that is in excess of six weeks worth of Personal Budget payments if it is not being held for a specified purpose. 2. Managing your Personal Budget You can engage a chosen decision maker (a trusted friend or family member) or a third party to help you manage your Personal Budget. You must keep records of your Personal Budget expenditure which we will check every three months if you have a bank account or every six months if you have a pre paid card account. If you do not keep records for inspection Personal Budget payments to you will end and we will purchase your care services through our managed services. We may check Page 1 of 6

2 records at any time to ensure your Personal Budget is being spent in accordance with this Agreement and your care and support plan. If a third party or chosen decision maker is managing your Personal Budget they must explain the contents of this Agreement to you. If you change the third party or chosen decision maker you must notify us of this promptly. 3. Employing Staff If you employ staff with your Personal Budget you must comply with all applicable legal and regulatory requirements. You must notify the Pension Regulator if you use your Personal Budget to employ a Personal Assistant. The Council will factor pension contributions and the cost of administering them into your Personal Budget but you will be responsible for ensuring pension contributions are made to your employee s account. You will also need to ensure that there is an adequate employer s liability insurance policy in place at all times whilst you are employing staff using your Personal Budget. 4. Compliance and Complaints 4.1 If we find or suspect irregularities with the use of your Personal Budget, or if there is allegation of fraud or misuse of your Personal Budget, we may undertake an investigation. If an extended investigation is required we reserve the right to transfer the management of the Personal Budget to a third party or to the Council. 4.2 Where possible, you should try to resolve a dispute or complaint about your Personal Budget by contacting your social worker or other relevant contact at the Council. If the dispute or complaint cannot be resolved, you have the right to complain about any aspect of the Council s administration of your Personal Budget through the Southwark Adult Social Care complaints procedure. 5. Termination and suspension of your Personal Budget 5.1 Except as is set out in Clauses 4.1, 5.2 and 5.3, we will endeavour to notify you in writing at least four (4) weeks in advance of any change to your Personal Budget. 5.2 We may end this Agreement without prejudice to any other rights or remedies we may have by giving you five (5) days written notice: a) if we decide after a social worker review that you no longer need the care and support services or that termination of this Agreement is in your best interests; b) if there are regulatory or legal changes that necessitate the termination of this Agreement; or c) if you fail to resolve a material breach of the terms of this Agreement within five (5) days of being given written notice by us. Page 2 of 6

3 5.3 We may, without prejudice to any other rights or remedies we may have, suspend your Personal Budget payments and/or immediately terminate this Agreement (without the need to give you notice) in the following circumstances: (a) (b) there is evidence that you or a person purporting to act on your behalf has committed fraud or deliberately misused the Personal Budget. if, in the reasonable view of the Council, the third party arrangements that you have put in place are putting your interests at risk. 6. General We may review, vary or amend any of the terms and conditions of this Agreement at any time. We will, wherever practicable, let you know in writing of any such changes or variations. This Agreement constitutes the entire agreement between the Council and you and replaces any previous written or oral arrangement between the Council and you relating to your Personal Budget. 7. Signatures You Client I agree to the terms of this agreement Signature Date OR Chosen decision maker/third party (If applicable) Your third party or chosen decision maker by signing this agreement agrees to act in the best interest of you. Signature Date If this agreement is signed by a third party you will agree to terms and conditions set out in Schedule 1 Us Southwark Council (assigned social worker) Name Signature Date Please sign and return this agreement to the Personalisation Team, Adult Social Care, PO Box 64529, London, SE1P 5LX. A representative of the Council will sign and keep a copy for the Council s records and return the original to you for your records. Page 3 of 6

4 Client s Direct Payment Bank Account details The Direct Payment will be paid into the following Bank Account: Name of account holder: Name and address of bank: Account number: Sort code: The Direct Payment will be paid into the above bank account every four weeks. The first payment will be made on [insert date]. Page 4 of 6

5 Third Party Provider (Schedule 1) 1. The services provided by a third party may include any or all of the following: (a) (b) (c) managing the funds including paying bills and carrying out other transactions as required by the Client; payroll services; and/or providing advice to the Client on his/her responsibilities. 2. The third party may also be a direct provider of the services in the Client s support plan as well as managing the Client s Personal Budget. In this case, the third party will be required to make the arrangements to pay itself. The third party must take special care to ensure the Client is notified and aware of all payments and charges made from his/her Personal Budget. 3. The cost of managing the Personal Budget will be included in the Client s support plan. 4. The Client is required to ensure that his/her assessed Client Contribution is sent to the third party in a regular and timely manner. Failure to do this may lead to the cancellation of this Personal Budget Agreement. 5. The Client authorises the third party to supply the Council with any information the Council considers necessary to ensure that the Personal Budget arrangements are working properly. 6. The third party is responsible for informing Southwark Council promptly if Client Contributions are not made on time. 7. The Client will ensure that he/she has a written agreement with the third party that sets out the scope and cost of the services being provided. The Client agrees to provide a copy of this written agreement to the Council upon receiving a written request to do so. 8. The Client may at any time cease to use a third party but must promptly notify the Council of this. 9. Any funds held by the third party if the agreement with the Client is terminated must be used to pay any debts from the support plan and any charges owed to the third party by the Client. Any surplus funds shall be refundable to the Council. 10. The Council reserves the right to request return of any Personal Budget account money that is in excess of six weeks worth of Personal Budget payments if it is not held for a specified purpose. Page 5 of 6

6 Third party details Full name: Full address: Telephone Number: Address: Relationship to Client The Personal Budget will be paid into the following Bank Account: Name of account holder: Name and address of bank: Account number: Sort code: Page 6 of 6