The meal limits in place for Creative Support staff when supporting a service user to eat in the community are specified in the corporate Service User Finances policy. If an exemption to these limits is requested, this form must be completed in full by a member of staff from the service, and passed to a manager for review. A copy of the form should be kept in the service user’s file at the service, whether or not the request is authorised.

Where no authorised copy of this form is kept on file, the staff supporting the service user will be subject to the meal limits as given in the corporate Service User Finances policy.

Service User Name:
What type of meal limit exemption is required? (Please circle one option, specifying in either case the length of the exemption period. Note that the exemption period, if authorised, will begin on the date of authorisation as given overleaf). Exemption start date _____________________________________ Exemption end date _____________________________________ What will the new meal limits be? Breakfast Lunch Evening meal Please give the reasons for requesting this meal limit exemption. These should include why it is in the best interests of the service user to amend the standard meal limits (e.g. if a service user has a favourite place to eat where there are no options on the menu that allow staff to keep to the standard maximum limits). Signed by staff member: Signed by service user: (if the service user has not signed, please state reason)

For completion by senior manager

Does this service user have an appointee? Yes / No (please circle as appropriate) If so, please attach confirmation from the appointee that this meal limit exemption has been approved as in the service user’s best interest. If a service user has an appointee, this exemption form will not be valid without proof that the appointee has authorised the amendment.

Please tick and complete the appropriate box below

The request for a meal limit exemption is: Refused □ Authorised □ Reason for refusal (if applicable):
Name of manager:	Signature of senior manager:
Job title:	Date: