how the increase will be paid. Any increases will be discussed with Care Professionals following a review of the Resident’s personal budget. I understand that if I default on the top-up payment the East Lincolnshire Clinical Commissioning Group may take action against me. Defaulting on payment may result in the Resident’s accommodation being terminated and alternative accommodation arranged. The top-up payment must not normally be derived from the Resident’s savings or capital unless property is subject to a 12-week disregard or the costs of their care are being met through a Deferred Payment Agreement. A top-up payment must be paid in addition to any assessed contribution, the contribution the Resident may be assessed as due to make following a financial assessment (where a financial assessment is appropriate). I understand my responsibilities, as set out within this Declaration, and the Top-up Contribution Agreement dated [ ]. enter date Signed…………………………………………………. Dated______/______/______ Print name……………………………………………… Address………………………………………………… TOP-UP CONTRIBUTION AGREEMENT FOR SOCIAL CARE ACCOMMODATION THIS AGREEMENT is made on the [ date ] between North East Lincolnshire Clinical Commissioning Group (hereinafter referred to as ‘the NELCCG’) of Athena Building, 5 Saxon Court, Gilby Road, Grimsby DN31 2UJ of the first part and [ ] (hereinafter referred to as Provider”) of “the [ provider’s address ] of the second part and [ top-up ] of [ address ] of the third part (hereinafter referred to as Third Party” delete if appropriate). “the – WHEREAS [ ] of [ ] name of the person with needs address (hereinafter called Resident”) wishes (or a representative on his/ her behalf “The wishes it- delete if not relevant) to reside in a care home/ supported living accommodation (delete as appropriate) called [ ] (hereinafter referred to as Home”) which is operated by the Provider. “The The Provider is willing to provide the Resident with care under and in accordance with the terms and conditions of the Contract (as hereinafter defined).
how the increase will be paid. Any increases will be discussed with Care Professionals following a review of the Resident’s personal budget. I understand that if I default on the top-up payment the East Lincolnshire Clinical Commissioning Group may take action against me. Defaulting on payment may result in the Resident’s accommodation being terminated and alternative accommodation arranged. The top-up payment must not normally be derived from the Resident’s savings or capital unless property is subject to a 12-week disregard or the costs of their care are being met through a Deferred Payment Agreement. A top-up payment must be paid in addition to any assessed contribution, the contribution the Resident may be assessed as due to make following a financial assessment (where a financial assessment is appropriate). I understand my responsibilities, as set out within this Declaration, and the Top-up Contribution Agreement dated [ enter date ]. Signed…………………………………………………. Dated______/______/______ Print name……………………………………………… Address………………………………………………… TOP-UP CONTRIBUTION AGREEMENT FOR SOCIAL CARE ACCOMMODATION THIS AGREEMENT is made on the [ date ] between North East Lincolnshire Clinical Commissioning Group (hereinafter referred to as ‘the NELCCG’) of Athena Building, 5 Saxon Court, Gilby Road, Grimsby DN31 2UJ of the first part and [ ] (hereinafter referred to as “the Provider”) of [ provider’s address ] of the second part and [ top-up ] of [ address ] of the third part (hereinafter referred to as “the Third Party” – delete if appropriate). WHEREAS [ name of the person with needs ] of [ address ] (hereinafter called “The Resident”) wishes (or a representative on his/ her behalf wishes it- delete if not relevant) to reside in a care home/ supported living accommodation (delete as appropriate) called [ ] (hereinafter referred to as “The Home”) which is operated by the Provider. The Provider is willing to provide the Resident with care under and in accordance with the terms and conditions of the Contract (as hereinafter defined).
top-ups_implementation_toolkit_nel_final_summer_2016.docx