Smart Support Services (Sheffield) Ltd.

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Payroll & Managed Accounts Specialists in Health & Social Care MANAGED ACCOUNTS APPLICATION FORM / SERVICE AGREEMENT & Ts & Cs Valid from 01/04/2014 (MA: V12, 11/07/2014) This form can be made available in other languages & formats. Service Descriptions Purchase Account 5 is only for purchases and initial invoices. This pays up to 5 invoices or purchases & is closed when this has been done. Monitoring Services: We support and monitor the end-user (or nominated person) as they run and manage an account up until the first audit. This includes an initial visit, an interim visit, then a sign-off visit plus telephone/email support for the first 3 months of the support plan. Regular Accounts: Over 12 months these pay regular invoices up to the number in the name plus 4 purchases or one-off invoices (13 up to 13 regular invoices; 38 up to 38; 52 up to 52, and 79 up to 79.) Home Visits to set up this service are only required if a postal set-up is not adequate. Cash Collect enables you to collect SDS money to pay for things on your plan in person. Quarterly Audits are sent to the Council. It is not essential for you to have copies. We can provide log sheets to help you keep track without ordering this option. There are 3 sections for you to complete - followed by the details and Key Facts about our services. 1) Please tick the account package you require staying within the descriptions. Service Required (see above for the description) Purchase Monitoring Regular Regular Regular Account 5 Services 13+4 38+4 52+4 55 110 155 226 280 360 Optional extras ( ) Circle your choices over the prices Home visit for set-up Cash collect Receive quarterly audits The total cost of your services: 40 NA 40 6 (one audit) 20 per collection by end-user / nominated person NA 24 2) Contributions to care: Please select the statement that applies to you. Regular 79+4 Statement about contributions to care I have been assessed and I am required to pay a weekly contribution of I will set up a standing order with Smart Support Services (Sheffield) Ltd for this amount. I have been assessed by Sheffield City Council and do not need to pay a contribution. I have not yet been assessed by Sheffield City Council but will pay the contribution due. Select one I do not know if I have been assessed, but will pay my contribution.

3) In applying for this service I give my permission for Smart Support Services (Sheffield) Ltd to receive a copy of my SPSOR from Social / Health Services. End-user s name. This information is correct and I do* / do not* have capacity to accept these terms and conditions. (If the end-user has a representative due to not having capacity to complete this form, please detail this person below): Name of representative accepting terms & conditions Signed by end-user / representative Date: Address: Phone number: Email: My Social or Health representative is: Their phone number is: They work at: My Support Planner s name is: Their phone number is: They work for: Application accepted* / rejected* by Signed: Date: *Delete as applicable, stating why the application was rejected. Copy and send to the end-user/rep.

Service Agreement for Managed Accounts General All levels of service aim to follow the requirements set out by Sheffield City Council regarding managing Direct Payments. We aim to answer all telephone and email enquiries within 24 hours (Monday to Friday (excluding Bank Holidays). Accounts are audited by The Company s own accountants each year as an additional quality measure. By signing this form, you are asking that the funds set aside by Sheffield City Council for your care and support are to be received by our Company into an account and that you wish the Council to allocate the appropriate fee for our service. Payments will be taken by bank transfer (not applicable to Monitoring Services). Where we receive funds, these cannot be used by Smart Support Services (Sheffield) Ltd in any event and are protected from the Company s activities. Regular accounts and their charges begin again after 12 months (subject to funds being available for the service) unless closed or payments cease. At renewal; the service will be reviewed to ensure that the correct charge is being made. You will be informed of any changes to the fee and have the choice not to renew. No representation, express or implied, is or will be made and no liability is or will be accepted by the Council in respect of the organisation and in respect of, or in any way arising out of the provision of, or failure to provide services by the organisation. No representation, express or implied, is or will be made and no liability is or will be accepted by Smart Support Services (Sheffield) Ltd in respect of any other organisation and in respect of, or in any way arising out of the provision of, or failure to provide services by any other organisation. Our packages & set-up services These are defined at the beginning of the document. Please select your requirements. If your requirements exceed the largest package available, or you feel that you have a unique situation. Please contact the Director to discuss it. Contributions to your support package Sheffield City Council will inform you of your contributions. You must pay these and you are advised to set this up as soon as possible with your bank. We will provide you with details or the holding account in order that you can do this (not applicable to Regular Accounts). If you don t pay your contributions; your providers and Social / Health Services will be notified in order to avoid a situation of unacceptable risk from occurring. Support to set up a standing order before your support plan has been accepted can be provided by post or phone for no extra charge You can use our home visit service (chargeable at 40, which will come from your Support Plan Budget) to help set up the standing order with your account. Support to set up a standing order after your support plan has been accepted can be provided by post, telephone. You can ask for a home visit after your plan has been put in place to help you to set up a standing order. A home visit at this stage may incur a fee of 40 and is payable by you personally and cannot come from your Support Plan Budget, unless a contingency has been set aside for it.

Regular manageable repayments for monies owed to an account in debt can sometimes be arranged (not applicable to Purchase Accounts or Monitoring Services). Cancellations of the services once they are set up Cancellations by clients (end-users, their representatives, or the Council) can be given verbally, but must be confirmed in writing. The service will be charged until the Direct Payments Team allows us to close the account and the length of time charged may be rounded up to the end of the current audit. We will work with the Direct Payments Team to end a service as quickly as possible in order reduce the running costs for the Council. We will assist with the transfer of your service to another provider, if you have one set up, for no charge. Changes to how you spend your money If you wish to make a change to your support plan, this has to be done under the rules within the contract that you signed with the Council. We are not responsible for brokering (finding and setting up) different providers if you make changes. If you do make changes, you are responsible for ensuring that you are within the same financial constraints of the original providers. We will confirm with new providers that we are the invoicing agent. Limitations to Accounts Managed accounts run by Smart Support Services (Sheffield) Ltd are run under the instruction of Sheffield City Council in agreement with end-users or their representative(s) by following the support plan. Smart Support Services (Sheffield) Ltd do not make decisions on the behalf of end-users, providers, or that of Sheffield City Council. The service is not a credit facility and payments are not made until money is in the account. We do not recommend starting support plans until the money is available. Smart Support Services (Sheffield) Ltd will make the attempts to recoup money for services from those responsible (individuals and organisations alike), but are not responsible for debts as a result of none-payments. Excessive communications to Smart Support Services (Sheffield) Ltd by end-users of their representatives may result in the need to add appropriate brokerage fees at 24.00 per hour upon renewal of their account. People to whom this applies do not have to renew with us if they prefer to use another service provider. If an account exceeds the description, we will contact the end-user and / or their Support Planner and Direct Payments to ensure that the situation can be resolved. Complaints about Smart Support Services (Sheffield) Ltd If you have a grumble or complaint about our service, please contact the Company directly - so that it can be investigated. If (following the investigation) you are not satisfied, you can appoint an external body of your choice to investigate the matter independently at your own cost: The outcome of which will be considered.

Complaints about other service providers on your plan If you have a grumble or complaint about your other service providers, please contact them and your health or social worker directly so that they can make a note of your concern. To keep our prices down, we do not police the service of your providers. We expect that your providers will invoice us honestly about the service they have provided and in the case of a dispute between you and them, we expect your providers to issue any appropriate refunds. Confidentiality We operate under Data Protection Law. Your information is confidential and will be shared only with the authors, yourself, the providers of your care & support who need to see it, in order to support you and people who you ask us to share it with. We will however share information about you if required by law, for Council auditing and for safeguarding purposes where appropriate. Late Payment Policy Our policy is below. Where it refers to the Payer : for all except Monitoring Services - this is Smart Support Services (Sheffield) Ltd We allow at least 8 weeks for payment of our services to end-users who are funded via the Council; which fits in with the speed at which payments are processed and which reduces the overall costs to end-users and the Council. In order to enable us to continue to provide this amount of goodwill we require full payment to be made by the Due date specified on your invoice by the account manager or the payee responsible. After each 28 days of none-payment; a reminder will be posted incurring a 20 administration fee. This fee pays for the cost of re-invoicing and the cost incurred when sending out the invoice reminder as a Special Delivery item at the Post Office. This and future parts of the process can be halted if the payee contacts the company in advance of the deadline - should there be a legitimate reason for the delay. In such cases we may be able to agree to extend the deadline. However any agreements regarding payment must be adhered to, in order to prevent the standard re-invoicing process from resuming. If no payment is made by the new agreed Due date, the late fee will apply and a new invoice will be sent out. Every 28 days of non-payment will incur a repeat late fee and due process. In cases whereby our efforts to resolve payment issues have been unsuccessful; Smart Support Services (Sheffield) Ltd reserves the right to commission a third party to recover debts & to add their fees to outstanding invoices, although we will do our utmost to avoid this outcome. RPS & Money Management Protocol This service has Recognised Provider Status and meets the Money Management Protocol Agreement as prescribed by Sheffield City Council.

Cancellation of services form Name: Care First Number: I do* / do not* have capacity to request this cancellation/transfer (If you have a representative due to not having capacity to complete this form, please ask them for help with this form): Name of representative accepting terms & conditions Signed by end-user / representative Date: Address: Phone number: *Please close the managed account service at your earliest opportunity / *Please transfer this account to (*delete and complete as applicable) I give my consent to you to share my information with the new service providers where applicable. Dear Sir / Madam, Account Closure/transfer acknowledgement form (Staff use only) Your request to end/transfer the managed account service has been received and accepted. I have contacted the Direct Payments team at Sheffield City Council (and where applicable the organisation or person who you want us to transfer the account to) and the end date of our service will be. Signed: Date: Kind regards

Quality Assurance Questionnaire for Managed Account Please answer the questions or rate the statements as best you can. Return it to Smart Support Services (Sheffield) Ltd, QA, 109 Burngreave Road, Sheffield, S3 9DF. You can also email it to feedback@smartsupportservices.co.uk This can be provided in other languages and it can be heard as an electronic PDF using the PDF reader. Instructions can be seen on-line by clicking here (available online only), or by searching for How to hear PDF files. 1. My calls and emails were replied to within 24 hours (Monday to Friday excluding Bank Holidays). 2. I thought the information was clear enough for me to understand. 3. The information pack was useful 4. I felt that I could talk to people at Smart Support Services if I was not satisfied with their service and felt that they would resolve any issues 5. I thought the charge for the service was fair. 6. I was treated with dignity and respect. 7. I would choose this company again for a managed account 8. I would rate the overall service so far as. Excellent very good good just ok not so good poor

9. I have the following ideas and / or comments to make about the service: My name is (optional):

Key Facts The most important parts of our service agreement are below. Business hours are Monday to Friday 9am 5pm excluding bank holidays and we are normally contactable during these hours. This service has Recognised Provider Status and meets the Money Management Protocol Agreement as prescribed by Sheffield City Council. The funds can only be used as per the support plan or with written permission from a representative of Sheffield City Council should a change be required. Full payment is to be made annually at the start of the service. A refund policy exists. The service will be renewed each year if funds are available. If they are not, we will alert Sheffield City Council (applies only to Regular Accounts). The support planner should ensure that they have checked how often each provider will invoice us and that the correct package has been requested. We will contact the end user if the wrong package is in place. End-users must pay all of their contributions. The Council will assess them for this. We can set up the service with end-users in their home for 40; otherwise the prices are based on end-users filling in this application form and any other paperwork by post or email. If you choose to transfer out or close the account; we will assist you by post / phone for no charge. Payments are made only when the money is in the account. We do not pay from our company funds unless we are making a card, cheque, or online payment and the funds are ready to transfer back to us (does not apply to Monitoring Services). We are not liable for unpaid contributions. We have a complaints policy; please ask us for this if you need it. Complaints about providers need to be directed to them. We operate under Data Protection Law. Where we receive funds into an account for a plan; these are protected from our business activities.