the job

Our organisation is committed to safeguarding and promoting the welfare of adults at risk and expects all our staff to share these values. We are also committed to treating all applicants equally and fairly based on their skills, experience, and ability to fulfil the duties required of the role applied for. This is regardless of any protected characteristics (ethnicity, gender or gender re-assignment, religion or belief, sexual orientation, physical/mental disability, age, pregnancy or maternity, marriage, or civil partnership).

Applicants must share with us all the relevant information that we have requested in this application form, but we would like to reassure applicants that they will not be refused employment because of offences or conduct which are no longer relevant, and do not place them at, or make them a risk in the role for which they are applying.

Full or part time
Where did you hear about us?

about you

Preferred contact method

education and training

Please include all periods of any post-secondary education or training.

Course 1
For example, Sept 2018 to June 2020
Full or part time study

Only if you’re registered with a professional body, such as the NMC.

current job

Are you currently in employment?
For example, permanent or temporary

employment history

Please give your full employment history since leaving secondary education, newest first. Include periods of post-secondary education or training, and part-time and voluntary work as well as full-time jobs, with start and end dates. When giving your reason for leaving each role, please confirm that you were not under investigation for, or subject to, any disciplinary sanctions in relation to your conduct at the time of leaving or dismissal. If you were, please give details.

Job 1
For example, March 2021 to May 2023

gaps

Please tell us about each period of more than four weeks when you were not in work, education or training. If there weren’t any, just carry on.

further information

If you’re not working, just say none
Are you legally eligible for employment in the UK or have settled status?
Do you require a work permit?
Do you hold a current driving licence?
Do you own a car?
Are you confident to drive clients’ cars?

your experience

I have worked with the following people:

People with learning disabilities (for example, autism or Down syndrome)
People with mental health problems (for example, schizophrenia or bipolar)
People with dementia
People with physical disabilities (for example, multiple sclerosis or spina bifida)
Older people
People with sensory disabilities (for example, blind or deaf)
Please give details of your skills, abilities, experience and personal qualities to show how you meet the criteria in the person specification, using examples wherever possible.

referees

Please give contact details for at least two referees who can comment on your suitability for the job. You are responsible for giving accurate contact details so that referees can be contacted.

The first referee MUST be your current or most recent employer (or your course tutor if you are currently in, or have just left, full time education).

Professional references will not be accepted from work colleagues who are not authorised to give professional references in an official capacity on behalf of the organisation, or from people writing only as friends, or from relatives.

Referee 1
Referee 2

Our organisation will seek references on successful candidates, and will approach previous employers for information to verify particular experience or qualifications. If you are currently working with adults at risk and/or children, your current employer will be asked about disciplinary offences relating to adults at risk and/or children (including any conduct related to safeguarding concerns where the penalty is time expired), and whether you have been the subject of any safeguarding related investigations or concerns, and if so, the outcome of any enquiry or disciplinary procedure including any referrals to the Disclosure and Barring Service (DBS), other professional bodies or the police. If you are successful at interview, any offer of employment will be subject to two satisfactory references and any additional pre-employment checks.

declarations

Are you a relative or partner of, or do you have a close personal relationship with, any employee of My Support Worker?
Have you previously been employed by, or sought employment with, My Support Worker?
Do you require permission to work in the UK? (You will be asked for evidence of your right to work in the UK.)

Criminal record checks

We will only ask candidates selected for interview to complete a criminal record self-declaration form or give a written disclosure statement, to give them the opportunity to provide enough information. At interview, or in a separate confidential discussion, we will make sure an open and measured discussion takes place about any offences that might be relevant to the position. We will only carry out criminal record checks with the DBS on successful candidates, at the right level for the role. Failure to provide accurate and truthful information is a serious matter. If it becomes apparent that inaccurate or incomplete information has been given, we will need to establish why. Any finding of serious misdirection or intent to deceive will result in an application being disqualified or, if appointed, disciplinary action and/or dismissal.

DBS barred lists

This post involves working in Regulated Activity under the Safeguarding Vulnerable Groups Act 2006 and is subject to an enhanced DBS check with barred list check. It is a criminal offence to apply for or accept a position working with adults at risk and/or children if you have been barred from engaging in regulated activity with the relevant group.

Are you included in the list of people barred from working with adults, kept by the Disclosure and Barring Service (DBS) under the Safeguarding Vulnerable Groups Act 2006?
Are you included in the list of people barred from working with children, kept by the DBS under the Safeguarding Vulnerable Groups Act 2006?
If you are not currently barred, have you been referred to the DBS for consideration to be added to one of the barred lists?
Have you ever had any sanctions placed on your professional registration by a regulatory or licensing body in any country? (Sanctions include warnings, conditions, limitations, suspension, removal or any other restrictions.)
Have you ever been dismissed for misconduct from any employment, volunteering, office, or other position?
Have you ever been under investigation for, or subject to, any disciplinary sanctions in relation to your conduct at the time of your dismissal or leaving any employment, volunteering, office, or other position?

check and send

I declare that the information I have given in this application is correct and complete. I understand that any false statements or failure to disclose information requested on this form may result in my application being disqualified or may lead to my dismissal or disciplinary action if appointed.

I understand that if I am appointed, personal information about me may be stored for personnel and employee administrative purposes in line with Data Protection law, including UK GDPR, the Data Protection Act 2018 and any other UK law which supports it.

Our organisation will process the data you give us to decide whether you are suitable for the role you have applied for, as part of the recruitment process, and for the ongoing employment relationship if you are appointed. All information on this form will be treated in strictest confidence and used to process your application. If you are appointed, this application will form the basis of your personal file, and information from it may be held in an electronic database. If your application is unsuccessful, your details will be kept for 6 months and then destroyed.

Your application goes to our office as a PDF, and a copy is kept securely in our admin area for up to six months. See our privacy policy. Your answers are saved on this device as you go, apart from your National Insurance number, and cleared once you send them. To carry on from another device, choose save and finish later and we’ll email you a link.