Free & Chargeable Services. Order Form. Contract. Part 1
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1 & Chargeable Services Order Form & Contract Part 1 fact sheets: Page 1 and Chargeable services: Page 2 Our terms of business: Page 4 Your contact details: Page 5 My Care My Home - Request for further information 1
2 and Chargeable Services: Contract Part 1 fact sheets - Order form Deciding what care lifestyle you want 1. What is My Care My Home? 2. What is an Initial Care Needs Assessment. How do you get one? 3. Choosing the care lifestyles you want 4. Do you want to employ your own carer or to employ a Care Agency? 5. Do you want to adapt your own home for your care needs or move to a purpose designed apartment or into a care home? Finding what you want 6. How do you find the right Care Provider? 7. How can you be sure that the Care Provider really cares? Making sure you get the care you want 8. Negotiating the terms of your care contract 9. Monitoring your care Paying for the care you want 10. What will your local Council or the NHS pay towards the cost of your care? 11. What will your care cost? 12. How can you afford to pay for your care? (Example of comparison costs) 13. Care fees insurance policies 14. What are the benefits of renting out part of your home? 15. Do you need to sell or rent part of your home to pay for your care? 16. The Care Property Bond: Use the value of your home to pay for your care without having to sell your home ever Put a tick in the right hand column against any fact sheet you would like us to send you. Be sure to complete your contact details on Page 6 before returning this form in the pre-paid envelope supplied. 1
3 and Chargeable Services: Contract Part 1 and Chargeable Services - Order Form If you wish to receive any of the services listed below, free or charged, please tick the column on the right hand side and complete the contact details on Page 6 so we can provide more information. Immediate Charge due Deciding what care lifestyle you want 1. Initial care needs assessment and review of your care lifestyle options. accompanying booklet and Chargeable services; Contact Part 2 2. Measured assessment in your own home of the number of care hours you need. accompanying booklet and Chargeable services; Contract Part Help with web search and short list of potential Care providers in your chosen area. accompanying booklet and Chargeable services; Contract Part 2 Arranging the care lifestyle that you want 4. Find a suitable Domiciliary Care Service, Respite or day care service. accompanying booklet and Chargeable services; Contract Part 2 Searching for and finding a service that meets your needs Employing your own carer accompanying booklet and Chargeable services; Contract Part (+ cost of any agreed advertising if required: however it may not be necessary if advertising on free web sites give adequate responses) per hour: minimum 10 hours per week + hourly rate paid to carer + National Insurance (NI). Providing a comprehensive report of three possible care providers and Quality auditing one of them. accompanying booklet and Chargeable services; Contract Part 2 for report on one provider 450 for report on two providers 550 for report on three providers 650 Conduct a Quality audit of your selected Care provider
4 and Chargeable Services: Contract Part 1 Immediate Charge due Preparing an initial report on your property to identify the cost of adaptations to facilitate you receiving care at home; the potential for sub letting part of your home; indicative rental and sales values. accompanying booklet and Chargeable services; Contract Part 2 Part 1. Adapting your home for supporting and facilitating your care 350 Part 2. Adapting your home for sub letting a part of it 450 (inc VAT for Part 1 & 2) Part 3. Report on potential for letting or selling your house 550 (inc VAT for Part 1,2 &3) Finding and negotiating the rent or purchase of a suitable Extra Care or similar property 350 accompanying booklet and Chargeable services; Contract Part Completion Charge: 1% of value of property on completion your 550 Immediate Charge will be reimbursed Negotiating the terms of your care contract with your chosen Care provider accompanying booklet and Chargeable services; Contract Part Periodic charge : 550 Making sure that you get the care you want 10. Monitoring your Care: and in addition, providing written reports to you and your family if required. accompanying booklet and Chargeable services; Contract Part 2 N/A 150 inc VAT per visit: minimum of 6 visits (inclusive of written report) N/A Helping you pay for the care you want 11. Letting part or all of your home and managing the letting, rent collection and the insurance and maintenance of the property. accompanying booklet and Chargeable services; Contract Part 2 Finding and selecting a tenant and arranging tenancy agreement; One months rent One months rent Collecting and accounting for rent due, insuring, repairing and maintaining your property 12. N/A 12.5% of rent per month + VAT Arranging for the sale of your house and clearance and transfer/ storage or other disposal of contents. N/A accompanying booklet and Chargeable services; service descriptions and terms on which My care My Home offers these For selling the property: 1.5% - 2% of the value of the house + VAT plus advertising costs. For arranging and overseeing clearance of the house: VAT plus removal company costs. Periodic charges: See Text 3
5 and Chargeable Services: Contract Part 1 Immediate Charge due 13. Arranging a Care Property Bond so that you can use the value in your house to buy lifetime care without having to sell your house ever. accompanying booklet and Chargeable services; service descriptions and terms on which My care My Home offers these Between 1.5% and 3.5% of the value of the house + VAT. See Text NB This service is not yet licensed by the Financial Conduct Authority. It is planned to launch in April Obtaining quotations for Care Fees Insurance Policies: Introduction to a Specialist Independent Financial Advisor. accompanying booklet and Chargeable services; service descriptions and terms on which My care My Home offers these Introduction to specialist legal and Financial advisors 15. Introduction to Specialist Legal Advisor. 16. Introduction to Selected suppliers of home delivered meals. Total of Initial Charges due for those services ticked To complete your, please complete contact and payment details overleaf Your Contract with My Care My Home: Part 1 THE TERMS ON WHICH WE OFFER FREE ADVICE is at 1 Links Court, Links Business Park, St Mellons, My Care My Home Ltd,(MCMH) registered number , whose registered Cardiff CF3 0LT, provides advice about care, care providers and care related matters as well as advice about the costs of care and care adapted accommodation and ways of paying for both the care and the accommodation. We (MCMH) offer this advice through our website at no charge to the user, through free fact sheets sent to any enquirer s home address and through Care Advisors who will visit anyone in their own home again at no charge to the individual customer. While My Care My Home takes care to ensure that its advice is accurate and up to date it does not accept liability for any inconvenience, loss or distress which any user of this free advice service may suffer as a result of following this advice. THE TERMS ON WHICH WE OFFER FREE AND CHARGEABLE SERVICES The terms on which we offer free and chargeable services are set out in full in the separate booklet The terms on which My Care My Home offers free and chargeable services which you will have received together with this form. Part 1 describes in more detail what My Care My Home agrees to do within any particular service which it offers and the price which it charges for that service. Part 2 describes the general terms which apply to all services that we offer. Some services require only an Initial Payment and no further payment (for example; Report on preferred Care provider(s) or Negotiation with of your contract with your preferred Care Provider) while other services (for example Care Monitoring or Employing your own carer )will also require you to make periodic payments in addition to an Initial payment. If you are purchasing a service for which a periodic payment is required then you must complete the Direct Debit section of the enclosed payment details form. OUR CONTRACT WITH YOU If you have requested My Care My Home to provide you with those free and chargeable services which you have ticked from the list on page 3, 4 & 5 of this then by signing this form you are inviting us (MCMH) to contract with you to provide the services as the Initial Payment. which you have indicated that you wish to receive and are agreeing to pay the price that we have agreed to When we also sign and return to you (by post or ) a copy of your signed we are provide you with the services which you have ticked for the price shown in the Initial Payment column on page 3, 4 & 5 and that we will provide these in accord with the detailed and prices for the selected services as these are described in the accompanying booklet The terms on which My Care My Home offers free and chargeable services 4
6 and chargeable Services: Contract Part 1 YOUR CONTRACT WITH MY CARE MY HOME: Part 1 Your Name: and contact details Address: Post Code Tel No E mail I...(Name) wish to purchase the chargeable services which I have ticked on this form and agree to pay My Care My Home the Immediate Payment and (if applicable) the periodic payments for some services ) which are set out on the & Chargeable Services form and Contract Part 1 which I have also completed and returned with this signed contract. I understand that the terms under which My Care My Home agrees to provide me with the services which I have requested are fully described in My Care My Home booklet & Chargeable Services Contract Part 2. I that I have read and that I accept the terms which relate to the service(s) which I have ed (as indicated by tick on in part 1) and the terms which apply to all services and which are set out in & Chargeable Services Contract Part 2. I that I understand that a legally binding contract between me and My Care My Home will be created when I have received back a copy of this signed form which has been counter signed by an authorised representative of My Care My Home. Signed by customer placing the on / / (date) Signed by (authorised representative of My Care My Home) on / / (date) YOUR PAYMENT DETAILS Note that some services require an immediate payment only whereas others may also require periodic payments e.g. Care Monitoring service(s). If the service(s) you have requested require only Immediate payment(s) you need only complete the Immediate payment sections below. However if the service(s) you require include a periodic payment (whether with or without an Immediate payment) then you must also complete the standing form details. The payments (whether Immediate or periodic) required for any service are specified in this booklet & Chargeable Services: Order Form and Contract Part 1. To make an Immediate Payment Enclose a Cheque for thetotal amount of the payment due. Please make payable to My Care My Home or To Pay by Debit/Credit Card Telephone - (029) Periodic Payments To make a periodic payment please complete the enclosed Direct Debit form and send to; My Care My Home, 1 Links Court, Links Business Park, St Mellons, Cardiff CF3 0LT Receipt We will write to confirm when we have recieved your immediate payment or completed Direct Debit form. Registered Office: My Care My Home, 1 Links Court, Links Business Park, St Mellons, Cardiff, CF3 0 LT My Care My Home 2013 My Care My Home Limited. Registered under the Companies Act Registration No Registered in England and Wales. 5
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