Thank you for taking time to provide this information which will help us to process the referral.
We are unable to process your referral until we have received this form
We will try to respond to you within two weeks to tell you about progress with this referral.
We will remain in touch while supporting this family and will contact you when the support ends
If you have any issues or concerns about the referral process or the support for the family please contact
0151 480 3910
In the course of the scheme and Home-Start UK (“we”/”us”) providing support and friendship to your family and monitoring and evaluating your needs, we collect and hold certain personal information about you. We will only do so with your explicit consent and in accordance with all applicable data protection legislation, including the General Data Protection Regulation.
The personal information collected by us will be limited to that which is essential to allow us to provide the support you require and deserve. This will include:
We may also collect information from any individual/agency that has referred your family to us.
How we will use your personal information and who it will be shared with
Our volunteers discuss your support with the appropriate organiser/co-ordinators, who in turn discuss your support with their line managers. Discussions take place in a confidential setting, for the purposes of supervision and to ensure the best possible support to your family. Volunteers meeting together for peer support do not share information that may identify, or breach the confidentiality of your family.
All information provided to our board of trustees for the purpose of assessing the level of referrals, local trends or case studies shall be anonymised.
We will, on an anonymised basis, use your personal information to demonstrate the impact of our services. Any case study information shared will always be on anonymised basis unless we have further explicit consent from you.
We will inform funders and your health visitor (and other agencies involved with your family) that you have sought support from us (including the nature and level of such support) and provide them with general information. In the event your family has been referred to us, we shall share the same information with your referrer (this will include any changes to the support and informing the referrer when the support comes to an end).
We may share your personal information with Home-Start UK for the specific purposes of statistical analysis and the promotion of our work nationally as well as any reporting requirements for funders who support the network on a national level. This will be on a pseudo-anonymised basis (meaning that we will take steps to limit the ability to for your personal information to be identified. This will normally include the anonymization of names and full addresses).
We may share your personal information with our external auditors for quality auditing purposes but only in the presence of your organiser/co-ordinator and only after the auditors have providing us with all necessary written undertakings to preserve the security and confidentiality of your information.
We will share personal information with law enforcement or other authorities if required by applicable law (including, in line with our Safeguarding and Promoting the Welfare of Children/Safeguarding Adults at risks policies, where there are concerns about the safety or wellbeing of a child or adult at risk and it is considered necessary for their welfare and protection).
We will not share your personal information with any other third party without first obtaining your explicit consent.
How long your personal information will be kept
We will keep your personal information after we have finished providing our support to respond to any questions, complaints or claims made by you or on your behalf, to show that we treated you fairly and/or to keep records required by law. We will not keep the information for longer than necessary. We keep different types of information for different lengths of time (further details can be found in our Information Governance Policy which is available on request).
Keeping your personal information secure
We have appropriate security measures in place to prevent your information from being accidentally lost or used or accessed in an unauthorised way. We limit access to your personal information to those who have a genuine need to know it. Those processing your information will do so only in an authorised manner and are subject to a duty of confidentiality. We also have procedures in place to deal with any suspected data security breach. We will notify you and any applicable regulator of a suspected data security breach where we are legally required to do so.
You have a number of important rights which you may exercise in relation to your personal information free of charge. In summary, those include rights to:
For further information on each of these rights, including the circumstances in which they apply, visit the Information Commissioner’s Office (“ICO”) website at https://ico.org.uk/for-the-public/.
If you would like to exercise any of the rights, please email, call or write to us using the details in ‘How to contact us’ below, let us have enough information to identify you, let us have proof of your identity and address, and let us know the information to which your request relates.
How to complain
Please report any complaint to the details set out in ‘How to contact us’ below. We hope we can resolve any query or concern you raise about our use of your information. You also have the right to lodge a complaint with the ICO who may be contacted at https://ico.org.uk/concerns/ or telephone: 0303 123 1113.
How to contact us
Please contact us if you have any questions about this Privacy Notice or the information, we hold about you as detailed below:
By signing this form, you confirm you have read and understood the contents of this Privacy Notice and Consent Statement and consent to us processing your personal information in accordance with this Privacy Notice. You may withdraw your consent at any time by using the contact details set out in ‘How to contact us’ above.