Suffolk Information Standard Application Form

Please complete all of the fields below.

You should refer to the Suffolk Information Standard criteria and guidance available on the Healthwatch Suffolk website (or call 01449 703949). It will help you to complete your application.

About you
Name:
Position:
Telephone:
Email:
Please tell us about your organisation:
  1. Organisation name

  1. Address

  1. Type of organisation
/ Charity☐ Not for profit☐
Statutory☐ Commercial☐
Other, please state:
  1. Please outline the nature of the business and also the type of information that is given to the public.

  1. How many people work for your organisation?
/ Paid staff (approx.):
Volunteers (approx.):
Information formats and processes
  1. How does your organisation make information available to people?
/ Website ☐
What is your website address?
Leaflets☐ Social media☐
Newsletter☐
Other, (e.g. audio material, large print) please state:
  1. Do you hold a quality assurance accreditation from another organisation?
/ Yes☐
No☐
  1. If yes, please say which and give brief details of the scheme. Please also tell us how long you have been accredited.

  1. Who is/are responsible for creating, producing and maintaining your information?

  1. Does your printed information have contact details and a date of publication?You must include examples of your printed information for consideration by our panel.
/ Contact Details ☐
Date of Publication☐
  1. How frequently do you check the accuracy of the information on your website and / or leaflets?

  1. What process do you have for checking and updating your information?

  1. Please tell us about how you provide information to people that may need alternative forms of communication.
  1. How do you provide information to people who may have accessibility, language or communication requirements?
  1. How do you ensure that your information is appropriate for the communication needs of the people you support or provide information to?

Training and information awareness raising
  1. Briefly explain your training procedures for staff and / or volunteers giving and handling information.

  1. How do you ensure staff / volunteers are aware of other organisations that can support your customers?

  1. How do you check the quality of information giving by your staff / volunteers to the public?

Customer contact
  1. Please tell us how the public can contact you.
/ Telephone☐ Email☐
Contact us form ☐ Post☐
Face to face☐ Social media☐
Other, please state:
  1. What process do you have for encouraging customer compliments, comments and complaints?

  1. If you hold customers’ personal information what measures do you have in place to protect it?

Policies and guidance
  1. Does your organisation have its own policies or guidance on:
/ Equality and diversity☐ Data protection / confidentiality☐
Staff / volunteer training and development ☐ Comments, Compliments and Complaints☐
Safeguarding☐
  1. If yes, please give examples of how you use them (and enclose copies of the documents with your application).

  1. If not, how do you deal with these procedures and what guidelines do you follow?

  1. Does your organisation have any other policies relating to information that you feel are relevant to your application?

  1. Is there any other information you would like to give?

Signature

Print name: Date:

And finally…

Thank you for completing your application for the Suffolk Information Standard. Please attach extra sheets if you need to.

Your application should be supported with the following documents:

  • A selection of your public printed information.
  • Links to your publications online
  • Copies of your policies or guidelines for staff and volunteers regarding information provision and practices
  • Any other relevant evidence (e.g. a staff training record or checklists)

All supporting evidence should be clearly referenced in your application. We suggest that numbering the documents themselves and referencing these numbers in your descriptions will enable our Information Panel to locate the documents more easily when considering your application.

Submitting your application

Please sign and date your application; ensuring that you have the authority to do so. You can then submit your completed form and documentation by email to.You can also send it by Freepost (no stamp required) to:

Freepost RTTY-CEUT-LCRH

Healthwatch Suffolk

14 Hill View Business Park

Old Ipswich Road

Claydon

Suffolk

IP6 0AJ

If you have any questions about submitting your application or about the Suffolk Information Standard then please refer to our information pack or contact the Healthwatch Suffolk team on 01449 703949.

Suffolk Information Standard Application Form

2016/17