Thank You for Your Interest in Our Vacancy Within Pebbles Care, Partners in Care and Radical

Dear

Thank you for your interest in our vacancy within Pebbles Care, Partners in Care and Radical Services Ltd.

I would like to give you some further details about us. Pebbles Care, Partners in Care and Radical Services Ltd is a family orientated company and our homes cater for young people of either gender from the ages of 8 to 18. The main aim at Pebbles Care, Partners in Care and Radical Services Ltd is to offer stability, security and opportunity. The young people may have experienced difficulties in their lives and as a consequence have emotional and/or behavioural difficulties.

Please find enclosed the application form and job description which you requested, please note that you should possess a full driving licence and your minimum age should be 22. If you are successful, you will be working with vulnerable children and full training and an induction course will be provided.

We are required to check all potential employees with the Criminal Records Bureau. A past conviction will not necessarily debar you from working with us. You are therefore, required to declare any prosecutions, convictions or cautions you may have even if they would otherwise be reported as spent under the Rehabilitation of Offenders Act 1974 or if they are pending, on the separate declaration form and place in this in the separate envelope marked “Private & Confidential – Luiz Guilherme”. Please ensure all forms are completed correctly. This information will be treated with the utmost confidentiality.

Please read all documents carefully and return your application form (in the self addressed envelope provided) If you are short-listed for an interview, you will be required to produce original ID documents (for a DBS check) along with any original certificates as specified in your application.

Interview dates will be confirmed in due course, if you are selected, in writing

Yours sincerely

Laura Standish

HR department

Encs

Application for Employment

Please complete this form in full (incomplete application forms will not be accepted) and in writing using black ink. Where necessary please use the continuation sheets provided at the end of this form. CV’s will not be accepted.

Position Applied For / Ref No
Location
Preferred Working Pattern (please tick where appropriate) / Full Time / Part Time / Bank
Date of Application
Please state where you heard about the vacancy

Please return to:-

HR Co-ordinator

HR Department

Pebbles Care Ltd

2 Wyther Lane

Leeds LS5 3BT

Tel: 0113 2653340

Fax: 0113 2782486

PART 1 - PERSONAL DETAILS
Surname
Forename(s)
Title / Preferred Name
Are you now, have you ever been, or were you at birth known by a different name? if so can you date when the name has changed, Please give details
Nationality
Are you required to have a work permit?
Address (in full)
(Last 5 years of addresses required including dates with months & years)
Please attached separate sheet if required
From / To / From / To
Postcode / Postcode
From / To / From / To
Postcode / Postcode
Email Address
Telephone No
Mobile No
Evening No
National Insurance No
CRB No
Date of CRB
PART 2 – DRIVING DETAILS
Do you hold a full driving licence valid in the UK? (Yes/No)
Please give any details of penalty points with dates
Do you have the use of, or own a motor vehicle?
PART 3 – PRESENT EMPLOYMENT
Job Title
Name & Address of Employer
Postcode
Date commenced with employer / Month / Year
Salary/wage/benefits
Briefly describe your present duties and responsibilities
Reason for leaving
PART 4 – EMPLOYMENT HISTORY SINCE LEAVING FULL-TIME EDUCATION
All gaps in your employment must be accounted for
Dates / Name & Address of last employer, nature of business and your reason for leaving / Position Held / Salary on leaving
From
(mm/yy) / To
(mm/yy)
PART 5 – EDUCATION/QUALIFICATIONS
Please complete Part 5 (Education) from age 11. Please enclose copies of any certificates relevant to the position along with the application form. Continue on a separate sheet if necessary.
Dates / School/College / Certificates/Qualifications Awarded / Date
From
(mm/yy) / To
(mm/yy)
PART 6 – PROFESSIONAL QUALICATIONS & MEMBERSHIPS
Professional Qualifications & Memberships / Date Achieved or Date Attended
PART 7 – RELEVANT TRAINING/STUDIES
Date / Name of Course
PART 8 – INTERESTS/HOBBIES
PART 9 – SUPPORTING INFORMATION
Please give your reasons for applying for the post and any additional information in support of your application and any relevant experience
PART 10 - REFERENCES
Please give details of two referees, the first of whom must be your past or present employer. The other referee must have known you for at least five years and should not be a member of your family.
Name / Name
Address / Address
Postcode / Postcode
Position Held / Position Held
Tel No / Tel No:
Email Address / Email Address

Please tick here if you do not wish your present employer to be contacted prior to interview

Please supply any other names and contact details for all other care jobs you have had previously.

Name & Address of Employer / Position Held

Do you have any family members or relations who have worked or who are existing employers within the company?

Please state ……………………………………………………………………..

Care Warnings/Disciplinary Issues

Please circle answer as applicable

Have you ever been dismissed or have you ever resigned in the face of a dismissal or warning? / YES/NO
Has an order been made at any time for the purpose of removing a child from your care or preventing a child living with you? / YES/NO
Have you ever been the subject of any allegations in relation to the safety and welfare of children, young people and/or vulnerable adults, either substantiated or unsubstantiated? / YES/NO
Has an application made by you for registration of a voluntary or registered home ever been refused? / YES/NO
Have you ever been prohibited from being a private foster parent? / YES/NO
Have you ever been refused registration to be a child-minder or provider of day care, or had your registration as either of these cancelled? / YES/NO
If you have answered yes to any of the above questions, you must supply details on a separate sheet of paper, place it in the sealed envelope marked confidential and attach it to your application form.
I have attached details as requested / YES/NO

Declaration

I confirm that all information submitted is true and accurate, that there are no medical or other reasons that I know of which prevents me from undertaking the duties of the post and I understand that any misrepresentations may invalidate my application and if appointed may result in subsequent dismissal.

I also understand that this declaration must include details of any criminal convictions, cautions, reprimands and final warnings and any other information that may have a bearing on my suitability for the post. I understand that an enhanced disclosure from the Criminal Records Bureau will be sought in the event of a successful application.

I confirm that the information provided in this application is truthful and. I have omitted no fact that could place any subsequent employment in jeopardy. I understand that any employment entered into is subject to documentary evidence of my right to work in the UK, declared CRB matters and satisfactory references. I expressively consent to personal data contained within this application being recorded for the purpose of accessing suitability of the post and may form the basis of any subsequent personnel file.

Signed:……………………………………………………

Print Name:……………………………………………………

Confidential – Equal Opportunities in Employment – Monitoring Form

We maintain the belief of equal opportunities and oppose all forms of unlawful and unfair discrimination on the grounds of colour, race, nationality, ethnic or national origin, sex, marital status, disability, sexual orientation, religious or belief or age. As part of this process, we need to monitor our recruitment process. However, please note that completion of this form is optional.

It would be very helpful if you could complete the following information which relates only to monitoring purposes and is not used in the selection process. This information is treated as confidential.

On receipt it will be separated from the application form before short listing takes place.

Ethnic Origin

This is the origin of your family rather than your nationality. For example, you could be British and your ethnic (family) origins could be any of the ones listed below, or a combination of them.

Please identify your ethnic origin by putting a tick in ONE of the boxes below, or by giving your own description in the space provided.

White / British / Irish / Gypsy/Romany / Other White background
Mixed / White & Black Caribbean / White & Black African / White & Asian / Other Mixed background
Black or Black British / Caribbean / African / Any Other Black background
Asian or Asian British / Indian / Pakistani / Bangladeshi / Other Asian background
Other ethnic groups / Chinese / Other (please specify)

Disability Guidance

Where an applicant has a disability and they meet the essential criteria of the post they are automatically short-listed for interview This positive action helps ensure people with disabilities get their fair share of jobs.

The Disability Discrimination Act 2005 says that a person is disabled if they have a mental or physical impairment or long term health condition which has a substantial adverse effect on their ability to carry out normal day-to-day activities.

If you consider yourself to be disabled please let us know We would appreciate advice on help we can give you to enable you to attend, or participate in the interview At the interview you will be asked if you have any disability which could affect your ability to do the job, and, in compliance with the Disability Discrimination Act 1995, you will be asked what reasonable adjustments we might arrange to assist you.

Do you consider yourself to be disabled as set out in the Disability Discrimination Act? (select as applicable) / YES/NO
If YES, please describe your disability
If you need any assistance to attend or participate in the interview, please give details.

Gender

Please identify your gender by putting a tick in ONE of the boxes below.

Male
Female
Prefer not to say

If you are undergoing the process of gender reassignment, please tick the box that applies to your future gender.

Age

Please identify your age range by putting a tick in ONE of the boxes below.

18-25
25 – 35
35 – 45
45 – 55
Over 55
Prefer not to say

Religion

Please identify your religion by putting a tick in ONE of the boxes below

Christian
Buddhist
Hindu
Jewish
Muslim
Sikh
Other religion
No religion
Prefer not to say

Sexual Orientation

Please identify your sexual orientation by putting a tick in ONE of the boxes below

Bisexual
Gay man
Gay women/lesbian
Heterosexual/straight
Other
Prefer not to say

Criminal Convictions Declarations

(Rehabilitation of Offenders Act 1974)

Details of Criminal Record

As all posts within the Company will involve contact with vulnerable children, you are required to disclose details of any criminal record and declare all convictions and cautions whether or not they would be spent under the Act. Only relevant convictions and other information will be taken into account, so disclosure of a criminal record may not necessarily be a bar to obtaining this position.

Have you ever been convicted by the court, cautioned, reprimanded or given a final warning by the police?

(Note that the post you have applied for is exempt from the Rehabilitation of Offenders Act 1974; this means that all convictions, cautions, reprimands and final warning on your criminal record must be disclosed).

Please tick as appropriate: □Yes□No

Please use the envelope provided marked ‘Private & Confidential – Luiz Guilherme’.

Are you aware of any police enquiries undertaken following allegations made against you, which may have a bearing on your suitability for this post?

Please tick as appropriate: □Yes□No

Working Time Regulations – 48 Hour Week Opt Out

The Working Time Regulations Act 1998,effective from 1st October 1998,state that a workers average working time shall not exceed 48 hours per week unless the worker agrees in writing that the limit shall not apply in his/her case.

You have indicated your agreement to work in excess of an average 48 hours per week.

Please sign the declaration below and return the form to Pebbles Care/Partners in Care/Radical Services Ltd*, 2 Wyther Lane Leeds 5 LS5 3BT.

Pebbles Care, Partners in Care & Radical Services Ltd is required to retain this form to allow for inspection by the enforcing authority.

DECLARATION

I agree to work,when necessary,in excess of 48 hours per week.I understand that I may terminate this agreement at any time subject to giving 13 weeks notice,by requesting and completing a cancellation form.

Name______

Location______

Signature______

Date______

To be retained in the individual’s personnel file

*please delete as appropriate

1