Section a Information from the Service Provider for the Child
SECTION A –INFORMATION FROM THE SERVICE PROVIDER FOR THE CHILD:
(To be completed by the potential Service Provider)
a) PRICE STRUCTURE for the Provision of a residential service including social care needs, education services and health care needs:
Please complete the following information as fully as possible and return the whole document. It will be used as a guide and will inform and help the Local Authority to understand and apportion your costs. If a placement is to be made Section B will be completed and this IPC will be returned to you.
Weekly cost perChild1 / Accommodation Charges:
The charge for 24 hour residential board and lodging for a child/young person: This cost will include accommodation costs, services, meals and any overheads for maintenance (eg. gardens, non-care staff such as administration apportioned to each child/young person).
2 / The costs of meeting social care needs of a child/young person:
(a)Your average costs for social care of a child/young person ie. care staff, sessional activities etc.
Your average individual allowances for the child/young person for pocket money, transport, clothing, trips out, holidays, equipment etc. / (a)
(b)
3 / The cost of providing educational services:
(a)This will include the costs of providing education in-house eg. staff costs.
(b)Additional costs for the child eg. tutoring.
(c) Equipment and material costs. / (a)
(b)
(c)
4 / The costs of meeting health care needs:
(a)The PPC and specification require that the child/young person’s health needs are met. What are the average costs that you expect to incur ?
Cost of specialist staff to meet individual needs as specified by the child/young person’s consultant. / (a)
(b)
Total Price: / £
5 / Additional information relating to a placement:
For the avoidance of any doubt please indicate whether the following items are included in the ‘prices’ stated above.
Deleteas appropriate / Delete as appropriateAdditional tutoring for special needs / Yes / No / Pocket Money / Yes / No
Additional tutoring for aptitude / Yes / No / Toiletries and items for personal hygiene / Yes / No
Additional tutoring for interests / Yes / No
Fees for medical examinations / Yes / No
Basic clothing on admission (inc. school uniform) / Yes / No / Assessment by external consultant(s) / Yes / No
Replacement & Maintenance of clothing (wear & tear) / Yes / No / Medical supplies / Yes / No
Clothing for special needs (disability, unusual sizes) / Yes / No / Optical costs / Yes / No
Sports Clothing / Yes / No / Dental treatment / Yes / No
Specialist Input (eg. Speech therapy) / Yes / No
Individual sports equipment / Yes / No
Hobbies, materials / Yes / No / Add any other relevant items not stated:
Recreational outings / Yes / No
Travel expenses to visit family / Yes / No / Yes / No
Holidays arranged by Service Provider / Yes / No / Yes / No
(b)Having received a copy of the South West’s Pre-Placement Contract and Schedules, is your organisation prepared to sign the Pre-Placement Agreement? YES / NO (delete as appropriate)
Signed by………………….………………………………………………… on behalf of ……………………………………….……………………
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