The following consists of an agreement made between [________________] as a registered care provider and [________________] as an individual who has applied to live in the home.

[The details will need to be adapted to individual circumstances and to the purpose of the period of residence, ie permanent or semi-permanent care, respite or phased care, rehabilitation, intermediate care, etc.]

Care home name:


Service user name:



This document sets out the respective rights and responsibilities of we, the staff and management of [name of home] and you, [name of service user], relating to your prospective residence in the home.

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