Looking for satisfying work and being able to work with a diverse range of clients? Apply today.
This document sets out the key information about your relationship with us, should your application be successful, including details about pay, holiday entitlement and other benefits.
Further information can be found on our website, by following this link: Cheriton Homecare.
The Employment Agency Standards (EAS) Inspectorate is the government authority responsible for the enforcement of certain agency workers rights.
You can raise a concern with them directly or through Acas helpline.
Your name (please fill out this field): Your email (please fill out this field): Name of Employment Business: Cheriton Homecare Limited Your employer(if different from the employment business):Cheriton Homecare Limited Type of contract you will be engaged under: Contract for Services Who will be responsible for paying you (if different from the employment business): Cheriton Homecare Limited How often will you be paid?: Weekly Expected or minimum rate of pay: £100 per day / £700 per week Deductions from your pay required by law: None Any fees for goods or services: None Holiday entitlements and pay: None Additional benefits: None
Example rate of pay: £100 per day Deductions required by law: £0 Any other deductions or costs from your wage: £0 Any fees for goods or services: £0 Example net take home pay: £700 per 7 day week
If successful in your application are you able to attend induction and training in Brighton? YesNo
Current CV (pdf): Attach copy of your current CV (15MB max.).
Current Photo: Attach a recent photo for identification purposes (15MB max.).
Title
Surname
Forenames in full
Previous Surnames (optional)
National Insurance Number
Telephone Number
Mobile
Email
Do you have a current passport? yesno
Do you have a Work Permit/Visa? yesno
Are you registered as self-employed in the United Kingdom? yesno
If ‘Yes’ what is your Unique Taxpayer Reference (UTR) Number:
Passport Details: Attach copy of your passport showing details (15MB max.) or complete below
Place of issue:
Passport number:
Date of Issue:
Expiry Date:
Known restriction on use:
DBS Details: Attach copy of your DBS certificate showing details (15MB max.) or complete below
Do you have a current DBS certificate? yesno
Do you use the update service? yesno
What is your certificate number?
What is the date on your certificate (date of issue)?
Do you hold a current driving license? yesno
Is your license valid in the UK? yesno
Do you have a car available? yesno
Driving license details: Attach copy of your driving license showing details (15MB max.)
Please specify which types of work you would prefer. You should tick all appropriate boxes. Positions Full timePart time
Which areas of work do you wish to exclude?
Do you have any other work commitments?
Please give the names, occupation and contact addresses / details of 3 people we can contact for references. One of which must be your current or most recent employer. If you have not been employed please provide the name of a professional person who can comment on your suitability for this position.
Reference contact name
Job title
Do we have your consent to contact your references? yesno
Phone number
Mobile number
Email address
Your job title
Length of employment (including from/to dates)
Responsibilities
Reasons for leaving
Bath / shower / strip washCare of hairCare of feetDressing / undressing
Bed bathCare of eyesCare of fingernailsMouth careUse of bath aids
Applying a conveenAttaching a night bagBedpans / commodesChanging a catheter bag
Continence careEmptying a catheter bagStoma careOther (please specify below)
Assisting with medicationPressure area carePhysical restraint skills
Simple dressing proceduresPalliative careOther (please specify below)
FeedingPreparing meals
Food handlingOther (please specify below)
Moving and handling clientsUse of hoists
Use of walking aidsOther (please specify below)
BedmakingCollecting benefitsLight housework
Recording temperatureShoppingOther (please specify below)
ConfidentiallityObserving/recording changesSign language
Report writingArranging appointmentsRecording instructions from GP
Do you have the certificate available? YesNo
Signature
Date
Name
Position applied for
Location
After submitting this form, please remember to email the following documents to recruitment@cheritonhomecare.co.uk.
We cannot proceed with your application until you do.
1. Your current CV.
2. A current photograph of yourself for identification purposes.
3. A copy of your current passport (scan or photograph).
4. A copy of your current DBS certificate.
5. A copy of your current driving license (if applicable).
