YOUR Support Agreement with The Mungo Foundation

This is a contract between ______and The Mungo Foundation.

This contract tells you what to expect from The Mungo Foundation and what you need to do.

It tells you how much your service from The Mungo Foundation will cost and how and when you can pay your personal contribution and payments due using an Individual Budget.

It also tells you what you should do if you want to change or end your agreement with The Mungo Foundation.

YOUR RESPONSIBILITIES ARE

-To let us know if you need tomake any changes to your support

-To give us the following periods of notice of needing to cancel a planned support, otherwise you will still be charged

  • 3 days notice if you want to cancel 1 day
  • 4 weeks notice if you want to cancel 7 days or more

-To help us write your support plans so we know how best to support you

-To pay your personal contribution on time

-To pay for your service on time using your Individual Budget if you have one

-To always treat the staff who support you with respect

THE MUNGO FOUNDATION’S RESPONSIBILITIES

-To always act in your best interests

-To make sure you have an up to date support and care plan that tells us how you want to be supported.

-To make sure you have an up to date Outcome Based Support Plan which tells us

  • the things you need support with
  • the times you need support
  • the outcomes in life you want to achieve
  • how much each part of your service will cost

-To let you know who is supporting you and when

-To let you know what to do if you are unhappy with any part of your service

-To make sure you are supported by trainined staff

-To make sure there are risk assessments in place wherever needed

-To let you know how much your support costs and how to pay for it

-To ensure your service is reviewed at least every 6 months and that this agreement is reviewed at least annually.

-To let you know if there are any changes that need to be made to how much the service costs and how to pay.

HOW MUCH WILL YOUR SERVICE COST?

The amount your service costs depends on how much support you need. An assessment is carried out by Social Work that says how much money you need to pay for the support you need.

A financial assessment will be carried out by Social Work that tells you and us how much you need to pay towards your service.

Your Individual Budget is £ per year
Social Work will pay £ per years
ILF will pay £ per year
YOU will pay £ per year
This will buy you _____ hours of support per week/year (delete as required)

HOW WILL I MAKE MY PAYMENT?

Whether you only have to pay a personal contribution or if you or someone is managing your Individual Budget for you, The Mungo Foundation will help you to make the decision that suits you best. You can –

-Pay monthly by direct debit or standing order

-Give the money directly to designated members of staff. They will make sure it is passed on to the right people.

HOW TO CHANGE OR END YOUR AGREEMENT

Remember, having an Individual Budget puts you IN CONTROL. You can ask for your service to be reviewed at any time.

If you want to change your support arrangements talk to your keyworker as soon as possible. If they are not available any other member of staff or the Housing Support Management Team will be able to help you with this.

If you need to end your agreement for any reason we will arrange for a member of the Housing Support Management Team to speak to you. They can discuss the best way to go about this with you. A Welfare Guardian or Social Work representative could also talk to us on your behalf.

SIGNED AGREEMENT

Print NameSignatureDate

Service User:

Legal Guardian:

Social Work:

TMF Manager: