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Agreement between (client) Mr. John Example
and Mount Olivet Nursing Home, a division of GrayAreas Limited, registered
in England No. 04427026 at 2 Great Headland Road, Paignton, Devon, TQ3 2DY
Dated 31
December, 2009
Date of admission 31 December, 2009 or
shortly thereafter
Room 99
Fee per week excluding
Registered Nursing Care Contribution £ 0.00
Plus Registered Nursing Care
Contribution at Band 2 (minimum) £87.00
The acceptance of a person to stay in our home involves a
special relationship of intimate care. You are assured that we do our utmost to
care for and nurse any client in all circumstances. Listed below are our basic
conditions of admission for our mutual benefit. Please read them carefully
before signing this form as failure to do so does not excuse you from compliance
with them.
1.
Interpretation
a)
All references to the Home shall mean Mount Olivet Nursing
Home and the grounds thereof.
b)
The words “we” and “our” shall, where the context implies,
include the Proprietors, Management or other duly authorised member of staff.
c)
The words “you” and “your” shall, where the context implies,
include or refer to the client or his/her next of kin or other representative.
d)
“Accommodation” shall mean the single/twin room allocated to
you.
2.
Medical Representation and Treatment
a) You
may remain registered with your own doctor if he/she agrees or you may register
with any GP in the Paignton Area.
b) We
shall undertake to supervise the dispensing of all prescribed medicines and the
application of all treatments subsequent to your taking up residence and we
request that you do not take any further drugs or medication subsequent to your
taking up residence without our prior knowledge and approval of your doctor.
3.
Payment of fees and notice required
a) Our
fees are charged per calendar month calculated per person per week for four or
five weeks from the Sunday closest the start of the month to the Saturday
closest the end of the month and are payable in advance in return for which we
undertake to provide such nursing care, food, utilities and laundry as are appropriate
to meet your needs. Registered Nursing Care Contribution is assessed by the
paying authority and until such assessment will be charged to you at Band 2.
Should you be assessed less than Band 2 you will be required to pay the
difference between such assessed payment and the then current Band 2 payment.
Any backdated payments received from the paying authority and due to you will
be refunded to you at the appropriate rate.
b) We
reserve the right to increase our fees from time to time at one month’s notice
and any increase will be with reference to the cost and value of our services.
While the Retail Price index is below 5% this will be no more frequently than
once in any calendar year. Should you change room at your request the fees will
be adjusted at the date of move to the then current fee for that room as
published in the schedule available for inspection in the office.
c)
If at any time we feel that your needs would be best served
elsewhere we shall give you two weeks notice in writing to vacate your
accommodation.
d)
Should you wish to vacate your accommodation at any time we
will require four weeks notice in writing except for an initial trial period of
four weeks during which period notice may be given at any time to expire at the
end of that period. Minimum stay is four weeks unless otherwise agreed and
confirmed in writing.
e)
We may give you two weeks notice in writing requiring you to
leave the home should any of the following circumstances arise:
·
Our fees remain unpaid for any period exceeding three
weeks.
·
If in our opinion we are unable to provide the degree
of care and attention required by you.
·
Any behaviour or act committed by you, which we feel
maybe detrimental to the well-being of other residents, or to the welfare of
the home.
f)
In the event of death in residence any outstanding fees due
shall be chargeable to your estate or recoverable from your next of kin or
other representative. No fees are refundable.
g)
We shall make a charge for any additional or extra services
carried out for you or supplied to you but no such charge will be made for, nor
will the extra services include, any essential facility.
h)
Should fees not be paid by the proper date we reserve the
right to charge interest at 4% over base rate on the balance due.
4.
Absence from the Home
a) If
you notify us of any intended temporary absence from the Home not exceeding
fourteen days duration the fees payable during that absence will be charged at
90% of the full weekly rate.
b)
Should you require hospitalisation no notice will be required
and your accommodation will be reserved for you for four weeks at a charge of
90% of the full weekly rate and thereafter at the same rate unless we shall
give you four weeks notice to vacate the accommodation.
c)
In all other absences the full weekly rate will be payable.
5.
Personal effects.
a) You
may provide from your resources for your personal use items of a luxury or
personal nature.
b)
Any items to be brought into the home must be inspected by us
to ensure that they are safe for use.
6.
insurance
a) Our
existing insurance policies cover personal effects up to a maximum of £500 per
person. If property of greater value is retained it must be covered by your own
insurance.
b) A
detailed list of all your possessions should be handed in to us and this list
should be brought up to date at regular intervals.
c) Valuables
may be locked away for safe keeping when not in use but we cannot accept
responsibility for large amounts of cash or valuables retained in your
accommodation.
d) No
responsibility can be accepted for personal possessions, which are not clearly
and permanently marked.
7.
Visiting
a) Visiting
is allowed at all reasonable times but we do reserve the right to restrict
visiting when necessary, and we would request that meal times and early
mornings are avoided.
8.
General
a) The
Home is registered with the Commission for Social Care Inspection as a Nursing
Home.
b) All
information on this form relating to you shall be kept by us in absolute
confidence and shall not be disclosed to any other person or organisation
without your authority.
c) You
confirm that you have adequate funds to cover the fees for a minimum of one
year from your admission date.
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Financial & Contractual