Individual Service Funds (ISFs) Provider Declaration

On behalf of Angels by Classic (Healthcare at Home) Limited, I confirm that we:

·  Are offering ISFs to customers in Suffolk. AND

·  Will operate an ISF service in line with the Suffolk ISF principles as set out by Suffolk County Council. .AND

·  Will register details of our ISF offer on Suffolk Infolink ( see attached for details about how to do this)

I confirm that I am authorised by Angels by Classic (Healthcare at Home) Limited to make this commitment for Angels by Classic (Healthcare at Home) Limited

Date of this declaration: 3rd September 2015

My Details ( name, position and company address):

Loraine Williams-Jasaitis / Director / Deben 5, Three Rivers Business Centre, Felixstowe Road, Foxhall, Ipswich, Suffolk, IP10 0BF

Position, phone and e mail details of contact person in your company for any confirmation or queries about any individual customer ISF agreements

Naomi Chan-Jackson Director’s PA / 01473 655502 /

Details of areas of Suffolk where ISFs will be offered by your company

All areas in Suffolk ? / NO
If “NO” which areas ? / Ipswich to include Chantry, Whitton, Castle Hill, Gainsborough, Whitehouse.
Rushmere
Kesgrave
Central Woodbridge and Melton
Leiston
Aldeburgh
Saxmundham
Felixstowe
Central Sudbury and Great Cornard

The company bank account details for BACs transfer of customer ISF payments[1] are:

Angels by Classic (Healthcare at Home) Limited
53-61-24
68825013

Please complete this form electronically and return an electronic copy to:

You should retain an electronic copy and send an updated version if at any time personnel making this declaration change.

Once we have received and verified your declaration we will send you confirmation that your company is able to state on any communications and materials that it is signed up to the Suffolk ISF principles.

Suffolk Infolink

As part of our commitment to customers and residents of Suffolk to provide clear information to enable informed choices to be made, below is information to enable you to register and add your ISF offer on Suffolk Infolink and keep this updated. Please state that you have made this declaration and upload your declaration ( which you can do on Infolink) as evidence.

To add your record to Suffolk InfoLink, you will first need to register

How to register
1. Go towww.suffolk.gov.uk/infolinkand click on 'Register' (at the top right of the screen)
2. Add your details using your email address and click on the blue 'Register' button
3. An email will be sent to your email inbox. Please open it and verify your email address by clicking on the link provided. (You may need to look in the junk folder.) This will complete the registration process
How to add a new record
1. Go to www.suffolk.gov.uk/infolink and click on 'Sign in' (at the top right of the screen) using the email address you registered with and click on “Add new record”.
2. A form appears which you can edit. Click on the + (plus sign) to open up each box to add your details
4. Once you have finished making changes to your record, click on 'Save Service' at the bottom of the page.

Please note that all new records are moderated by the Council, which means there is a short delay before the record appears on the live site.

Once customers and Social Work teams start to arrange payment to your company of ISF monies you may wish to be aware of the contact details for the Suffolk County Council Direct Payment team who will be administering the payments.

The Direct Payments telephone number is: 01473 264853

[1] Any bulk payments made will need to be credited by you to the individual ISF customer accounts if your company has a number of ISF customers.