APPENDIX B I ROCH DALE BOROUGH COUNCIL REF CE/02/15 If you need advice or support to Please read the Terms & Conditions and Guidance for Applicants. Office. complete your application form, please contact Rochdale Township 1 Name of project Recovery Capital — 0 a) Name of organisation High Level (Northern) Trust b) Type of organisation El Voluntary! community El Registered charity Sports! leisure club El Limited company El Private company El Social enterprise El Other type s it provides c) Aims and objectives of your organisation and activities or service , High Level is commissioned by the Drug As the borough’s recovery and reintegration service for substance misuse s service users which include a counselling and Alcohol Action Team. High Level provides many different service to s psychological issues. Our therapy service service which provides 36 appointments per week that addresses variou unity services in the Pennines, Middleton provides 59 appointments per week for various holistic therapies. Comm m trains up to 70 volunteers annually. and Heywood provide individual support and groups. Our volunteer progra qualifications for service users, es Alongside our training, education and employment program which provid NVQ onary activities are provided 7 days a week volunteers, staff and trustees. Various psychosocial groups and diversi g, Relapse Prevention, Psychosocial , with our closing time of 9.OOpm, these include Cook and Taste, Boxing Walkin Pool Group, Music, Women’s Groups and Interventions, Tai Chi, Art, Relaxation and Meditation, Anger Management, works both in groups and individually to Men’s Groups. All service users have a specific recovery worker who facilitate the Service Users recovery. offer a Homestraight Service in In addition to these services we offer crises intervention and advocacy. We rate into the community. On our re partnership with Early Break to help offenders and their families reinteg ry café and play Centre. integration floor we have a Social Enterprise which includes a recove d) Contact name Tracy Holden/Callum Jones e) Contact telephone 01706 860247 f) Contact address and postcode Great George St/Drake St Rochdale OL161PA g) Email address highlevel©btconnect.com h) Web address www.highlevel.org.uk Form RTO2 a) Have you applied for or received a Township grant before? LI Yes No b) If you have answered yes to question a), please give details below c) Does more than 50% of your annual base budgetlincome come from Rochdale Council? Yes LINo If yes, detail below the amounts received and Council Services providing budgetlincome to your orqanisation (a copy of your application will be forwarded to your relevant Link Officer for their comments) Drug and Alcohol Action Team via Public Health England Details of the proposed project and what bc oraanisation. qroup or wider community? project bring for par We are based adjacent to Champness Hall, which is an older building. We have not been in a position to decorate and re-furbish our Common room for some years. This is the first point of contact for our service users each time they access our service. We would like to decorate/paint the common room, re-carpet and purchase fresh seating and tables. We would also like to purchase an overhead projector and screen. We run a 7 session training course for our volunteers and feel this would greatly enhance the quality of the sessions we are able to offer. We feel that by enhancing the environment for our volunteers and service users will feel valued. This will enhance outcomes as work group work is run in the evenings in this room and at times during the day. Rochdale Borough Geography we are one of the 10 LA’s in Greater Manchester area. Rochdale has 4 Townships divided into 20 Wards. Rochdale is the 29th Most deprived (IMD 2010) and 16 LSOAs are in the 3% most deprived LSOA5 in England. Rates of unemployment have increased and were highest among males. Rochdale has higher rates of unemployment and long-term unemployment among 16-24 year olds than both the Greater Manchester and England & Wales averages. The proportion of residents on out of work benefits remains above North West and national comparators. In addition rates of unemployment increased and were highest among males. The proportion of residents on out of work benefits remains above North West and national comparators. - We know this work is needed because we have a service users base of 300 or over at all times of the year. This has been the case for the 14 years we have been open. Although our service users do move on from our service there is always a new influx of service users. High Level supports people recovering from addiction by building visible recovery in the community taking into consideration many factors such as physical, psycholigical and biological issues by Form RTO2 building cultural, social, human and physical capital. Examples of this would be prevention of homelessness, dual diagnosis and mental health issues, domestic violence, criminal activity and anti-socail behaviour. Thereby reducing costs to statutory systems such as the NHS, criminal justice, mental health and welfare. Enabling people to make effective lifestyle choices, which benefit themselves and our community. Form RTO2 a) Cost of project 3125.76 b) Amount of grant required 3125.76 c) Amount from other sources 0.00 d) Details of other funding Funder Duchy of Lancaster What they may fund Decorating Dates of funding decisions Unknown e) Breakdown of proposed expenditure relating to the amount of grant required (enclose quotations, cost estimates or extracts from catalogues. At least two quotations will be that will cost £1,000 or more to demonstratevaiuefqpy Expenditure item Cost 49.99 569.95 335.84 699.98 410.00 659.00 Hot water urn Tables (5) Chairs (16) Sofax2 Carpeting and filling Overhead projector, screen and fitting TOTAL 2,724.76 Form RTO2 Please supply the following documents when you submit your application. IF YOU DO NOT SUPPLY THESE DOCUMENTS, WE WILL NOT BE ABLE TO PROCESS YOUR APPLICATION. Please tick the boxes to confirm which documents you have attached to this application. a) Annual accounts and bank statement(s) b) Constitution/governing document c) If your project works with children and young people under 18 years old or vulnerable adults, please confirm your organisation has the following in place: Yes Child protection policies and procedures LI N/A Disclosure and Barring Service (DBS) checked staff and Yes LI N/A volunteers d) Quotes/estimates/extracts from catalogues for proposed expenditure We, the undersigned agree to: • • • • • • • • Abide by Rochdale Township Fund’s Terms and Conditions. No expenditure being incurred on this project prior to the grant decision being given. Certify that the information contained in this application is correct and that we are authorised by the organisation to accept these conditions on their behalf. Use funds, if granted, only as specified in this application, unless receiving authorisation from Rochdale Township Office to make changes. Send the invoiceslreceipts for all payments made with this grant along with the completed Project Evaluation Form to the Rochdale Township Office. Agree to participate in monitoring, auditing and evaluation related to this fund. Highlight the support of Rochdale Township in all publicity material and agree to Rochdale Council’s use of the organisation’s name and photographs for promotional purposes. Inform Rochdale Township Office immediately if either signatory leaves the organisation or can no longer fulfil their responsibilities, or someone else takes over responsibility for the ejf of thenisation. — Organisation Chair or Treasurer jpifferent from Contact Person) Contact Person Signature Tracy Holden Signature John Beasley Full name Tracy Holden Full name John Beasley Position Service Manager Position Chair of Trustees Date 05.06.15 Date 05.06.15 Before you send your application to us, please check that you have: • • answered all the relevant questions and enclosed all the information requested: Constitution/governing document Annual accounts Bank statement(s) Quotations/cost estimates/extracts from catalogues BACS form - - - - - We will return incomplete application forms. Form RTO2