Form completion guidance
The following documents are available for you to download (under supporting documents):
- standard form of words for communication to staff
- response slip for return to shared lives scheme organiser
- shared lives member scheme managers’ form
Please do not send any personal information about staff with your form.
Name of person completing form on behalf of the shared lives scheme
This is the name of the person completing the form and who has authority to complete and submit the form on the behalf of the Shared Lives scheme.
Contact email address
This is the email address for us to use to contact you about the payment.
Contact phone number
This is the phone number for us to use to contact you about the payment.
National insurance number
This is one way we can ensure that the same people are not applying via more than one route
In total, how many Shared Lives Scheme members do you have?
This is the total number of carers funded via the Shared Lives scheme.
Your answers should include only shared lives carers registered with your scheme. Refer to the eligibility section of the guidance. You will be able to provide separate information about Shared Lives carers registered with your scheme during the qualifying period 17 March 2020 to 30 November 2020 but are no longer registered with you at a later stage in this process.
Total number of FTE self-employed Shared Lives carer requiring payment
This is the total number of FTE registered services Shared Lives carers requiring payment across all of the qualifying registered services. Please refer to the guidance as to how FTE should be calculated. Do not include numbers for eligible Shared Lives carers who have since left, please provide these separately.
Total number of Shared Lives carers funded during the qualifying period but no longer registered with you.
This is the total number of eligible members during the qualifying period but no longer registered with you. This should be a whole number i.e. headcount.
Total number of FTE Shared Lives carer funded during the qualifying period but no longer registered with you.
This is the total number of FTE eligible Shared Lives carers who have left your employment. Please refer to the guidance as to how FTE should be calculated.
Please read and tick the boxes to acknowledge that you have read and understood the terms and conditions for submitting the form for payment.