Role Details

Please select from the drop-down boxes below which role you are applying for and the home where you will be based.

Role applying forKitchen AssistantLaundry AssistantHousekeeperCookWell Being WorkerEssential Maintenance WorkerAdministratorCare WorkerHairdresserOtherSummer Work

LocationKingsleigh House Care Home, BirminghamOlivet Care Home, BirminghamFair Haven Care Home, BournemouthEden House Care Home, CoventryGarswood Care Home, SouthportGowanlea Care Home, StirlingNewton Court Care Home, SwanseaChesswood Lea Apartments, WorthingWest Royd House Apartments, Mirfield

Personal Details

Please provide your contact details below. We will use this information to create your employee profile.

Date Of Birth

Do you require a work permit or visa to work in the UK?YesNo

Training and Qualifications

Please list any relevant training or qualifications you currently hold.

Click here to add another training/qualification

Do you hold a Care Certificate?YesNo

Employment History

Please include any previous employment both paid and unpaid, starting with the most recent first. If you have worked in a Care Home before, please include your reason for leaving.

Medical History

Please answer the questions below about your health and medical history. We ask these questions to help us understand if we need to make any reasonable adjustments, for example this might include an adapted work environment, flexibility during the working day or extra resources to help perform your job role.

Do you have any medical conditions that we need to be aware of?YesNo

Is your ability to perform physical work limited in any way?YesNo

Are there any adjustments we need to make to support you in carrying out your work effectively?YesNo

Do you have any mental health conditions that you would like us to be aware of or merit extra support?YesNo

Are you restricted for health reasons from carrying out any specific type of work?YesNo

Do you have any allergies that we need to be aware of?YesNo

Criminal Record Declaration

You have been asked to complete these questions because the role you have applied for is exempt from the Rehabilitation of Offenders Act 1974. The information disclosed will be treated in the strictest of confidence and will only be disclosed to the Home Management team and/or the HR Team.

Do you have any unspent convictions or conditional cautions?YesNo

Do you have any spent adult cautions or convictions that are not 'protected' as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended)?YesNo

References

Please give the names and contact details of two referees, one of which should be a professional reference, ideally your most recent employer. A professional reference can also include a teacher, lecturer or landlord.

Please select the type of referenceProfessionalCharacter

Please select the type of referenceProfessionalCharacter

Colleague Referral

If you have been referred to this position by a current member of staff, please enter their details in the fields below as you may be eligible for our Recommend a Friend bonus scheme.

Declaration

I understand that my employment is conditionally based upon a satisfactory Disclosure Certificate, medical suitability, and a right to work in the UK.

Yes

I agree that Christadelphian Care Homes can create and maintain computer records of my personal data and that this will be processed and stored in accordance with the General Data Protection Regulations (GDPR)

Yes

I certify that the answers to the above questions are correct to the best of my knowledge and belief. I understand that if I have withheld information, this may adversely affect efforts to place me in suitable employment. I understand that any omissions or false statements may disqualify me from employment or lead to dismissal

Yes