CSW Application Form Gen

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CSW Application Form Gen Powered By Docstoc
					                 CROSSROADS CARE                 SOUTH THAMES

                                Application for the post of
                               Care Support Worker

SECTION A: Personal Details




4.   Do you have a current driving licence?                   Yes/No.

     Do you have use of a vehicle?                            Yes/No


6.   Referees

     Please give two referees, one of whom should be your present or most recent
     employer. References will only be taken up if you are offered the post.



7.   I declare that to the best of my knowledge the information provided by me on this
     application form is correct.
SECTION B: Employment History

Please complete in reverse historical order, i.e. starting with your current/most recent
employment (providing address and period of notice required) and ending with your first
employment. Please include both paid and unpaid jobs, and continue on a separate sheet if

Employer                         Post Held                         From          To

SECTION C: Knowledge Relevant to the Job
List below examination results and professional qualifications and courses attended (include
specialised knowledge and training). Please continue on a separate sheet if necessary.

Education and qualifications (Secondary School and beyond)

Establishment                    Course               Qualifications      Dates
attended                         attended             (if any)            attended
Other courses attended which you consider relevant to this post

Title & nature                    Organised by:                      Dates attended

SECTION D: Experience

Please use this section to give details of any experience and/or training, which you believe
may be relevant to this post. Please continue on a separate sheet if necessary.
SECTION E: About Yourself

Please add any other information about yourself that you feel may be relevant and which has
not been covered elsewhere in the application and also explain your reason for applying for
this post. Include any skills or personal qualities you have which you feel could be important
in doing the job. Please continue on a separate sheet if necessary.

SECTION F: What days are you available to work every week?

                               Morning                  Afternoon                 Evening
                              Availability              Availability             Availability

SECTION G: Are you an ex-offender?                                Yes / No
(If you selected YES, please refer to the enclosed policy of recruitment of ex-offenders)

The personal data will only be used in connection with processing your application for employment and
       in compliance with the Data Protection Act 1998

Please return your completed application form to:
                                                              CROSSROADS CARE        SOUTH THAMES
                                                                                       The Vestry Hall
                                                                                        London Road
                                                                                            CR4 3UD
(August 2010)
             Home Care Support Worker - Job Description

Job Title:           Home Care Support Worker

Hours:               The distribution of hours will be flexible by arrangement
                     with the Operational Manager, and payment will be based
                     on hours worked.

Salary:              £7.93 per hour (including Outer London Weighting).
                     The rate is applicable for hours worked between 9 a.m.
                     and 8 p.m. Monday to Friday. Hours worked between 8
                     p.m. and 9 a.m. are paid at time and one quarter (£9.60
                     per hour) and for Saturdays, Sundays and Public
                     Holidays at time and one half (£11.28 per hour).

Responsible to: Operational Manager

Overall purpose
Care Support Workers are to provide help and relieve stress on:-
      a)    the carer of a person with a disability living in their own home in
            order to prevent breakdown in care.
      b)    in exceptional circumstances a person with a disability who may
            live alone.

This will involve the provision of personal, social and domestic, care similar to
that given by the carer, as advised by the Operational Manager, respecting
confidentiality at all times.

Principal duties and responsibilities

Family/Individual related tasks:-

1. Attend the homes of families/individuals at the specified times and perform
   duties as set out in the care plan respecting client confidentiality at all

2. Listen to the directions and requests of both the person with a disability
   and the carer/parents, and, wherever possible, perform the duties in the
   care plan consistent with their own wishes.

3. Personal and Social Care Tasks:-
             • Bathing in bed/bathroom/chair to include essential aspects of
                personal hygiene.
             • Assist in the management of continence of bladder and
             • Assist with dressing and undressing.

                                    Page 1 of 2
              •   Assist with mobility and transfers, using correctly any
                  specialised equipment provided.
              •   Assist with feeding.
              •   Assist with therapeutic programmes designed, under medical
                  direction, to help an individual's progress, as advised by the
                  relevant professional, and under the direction of the
                  Operational Manager.
              •   Provide a safe environment for those who need constant
                  supervision and help.
              •   Provide emotional support to the family as part of a caring
              •   Supervise the person with a disability outside the home as
                  advised by the Operational Manager, with written permission
                  from the disabled person or responsible carer.

4. Domestic tasks:-
         Some light domestic duties may be carried out as follows:-
             • making and changing the disabled person's bed.
             • essential laundering for the disabled person.
             • essential shopping (receipts should be obtained for all
             • preparing meals and washing up.

Administration and Training

5. Notify the Operational Manager immediately of any change in availability to

6. Observe and report back promptly to the Operational Manager any
  alteration in the family circumstances affecting the service provision.

7. Liaise regularly with the Operational Manager and colleagues.

8. Provide flexible cover for colleagues in the event of holiday and sickness,
  working as part of a caring team.

9. Attend regular meetings as convened by the Operational Manager and/or
   Management Committee.

10. Complete and submit to the Operational Manager signed weekly time
   sheets and expense claims.

11. To complete report form accurately and concisely after each visit.

12. Complete incident forms accurately, and submit promptly to the
    Operational Manager.

13. Participate in an induction programme, and attend ongoing in-service
    training and demonstrations as determined by the Operational Manager

                                                                      (Jan 2010)

                                    Page 2 of 2
                        Care Support Worker

Person specification


      NVQ Level 2 or the commitment to undertake NVQ Level 2 within two
      years of appointment

Knowledge and skills

      An understanding of the needs of Carers.

      An understanding of the effects of disability

      The capacity to behave sensitively to the needs of the Carer and the
      person being cared for.

      An awareness of, and sensitivity to the needs of people from ethnic
      minority groups and readiness to work with all Clients and Families.

      An understanding of Equal Opportunities.

      An understanding of the need for good time-keeping and reliability


      The proven ability to confidently work alone in stressful situations.

      The ability to use own initiative and respond in a practical manner.

      The ability to display a flexible response to the Operational Manager’s,
      Carer's or Cared For Person's requests.

      The ability to communicate (orally and in writing) effectively.

      Ability to undertake practical care tasks on behalf of the client

      Be able to observe, and report any significant changes in the physical
      and/or emotional well-being of service users.

      To be able to work well as part of a team.
      The ability to respect and maintain Clients' confidentiality.

      Access to a telephone to enable contact at short notice and the ability
      to contact the Operational Manager or Clients at short notice



      NVQ Level 2/3


      Previous experience in a caring role

      Experience of working with children who have special needs

Knowledge and skills

      An understanding of the effects of disability or learning difficulties


      Able to communicate effectively in ethnic language/s.

      A full driving license and access to a vehicle.

                                                                         (Jan 2010)
                       RECRUITMENT OF EX-OFFENDERS


1.1 As an organisation using the Criminal Records Bureau (CRB) disclosure
service to assess applicants’ suitability for positions of trust, Crossroads Care
complies fully with the CRB Code of Practice and undertakes to treat all
applicants for positions fairly. It undertakes not to discriminate unfairly against any
subject of a disclosure on the basis of conviction or other information revealed.

1.2 Crossroads Care is committed to the fair treatment of its staff, potential staff
or users of its services, regardless of race, gender, marital status, sexual
orientation, gender re-assignment, age, ethnic origin, disability, religion or belief,
lack of religion or belief, political opinion or offending background.

1.3 This written policy on the recruitment of ex-offenders is made available to all
disclosure applicants at the outset of the recruitment process.

1.4 We actively promote equality of opportunity for all with the right mix of talent,
skills, and potential and welcome applications from a wide range of candidates,
including those with criminal records. We select all candidates for interview based
on their skills, qualifications and experience.

1.5 A disclosure is only requested after a thorough risk assessment has
indicated that one is both proportionate and relevant to the position concerned.
For those positions where a disclosure is required, all application forms, job
adverts and recruitment briefs will contain a statement that a disclosure will be
requested in the event of the individual being offered the position.

1.6 Where a disclosure is to form part of the recruitment process, we encourage
all applicants called for interview to provide details of their criminal record at an
early stage in the application process. We request that this information is sent
under separate, confidential, cover to a designated person within Crossroads
Care, and we guarantee that this information is only seen by those who need to
see it as part of the recruitment process.
Crossroads Care                                                Recruitment of ex-offenders

1.7 Unless the nature of the position allows Crossroads Care to ask questions
about an applicant’s entire criminal record we only ask about "unspent"
convictions as defined in the Rehabilitation of Offenders Act 1974.


2.1 We ensure that all those in Crossroads Care who are involved in the
recruitment process have been suitably trained and have adequate support and
guidance to enable them to identify and assess the relevance and circumstances
of offences. We also ensure that they have received appropriate guidance and
training in the relevant legislation relating to the employment of ex-offenders, such
as the Rehabilitation of Offenders Act 1974.


3.1 At interview, or in a separate discussion, we ensure that an open and
measured discussion takes place on the subject of any offences or other matters
that might be relevant to the position. Failure to reveal information that is directly
relevant to the position sought could lead to withdrawal of an offer of employment.

3.2 We make every subject of a CRB disclosure aware of the existence of the
CRB Code of Practice and make a copy available on request.

3.3 We undertake to discuss any matter revealed in a disclosure with the person
seeking the position before withdrawing a conditional offer of employment.

3.4 Having a criminal record will not necessarily bar anyone from working
with us. This will depend on the nature of the position and the circumstances and
background of the offences.

                          ersity and Equality Policy
                       Divers                   licy
Crossroads Care is opposed to all forms of discrimination and values diversity.

                             ople as
Diversity is about valuing people a individuals.

Crossroads Care recognises that p                                        br
                                people from different backgrounds can bring fresh ideas and a
different approach which can make the way it works more efficient, creative and innovative.

Crossroads Care recognises that i                                          gende
                                      inequality does not just come from gender or ethnicity, sexual
                                  religion or belief. Individuals are also disadva
orientation or disability, age or relig                                     isadvantaged by inequality
                               ere born                                      Cros
of social class, where they were bo or their family’s circumstances. Crossroads Care seeks to
                                utting                                      epresentation of specific
redress social inequality by putting in place actions to reverse under repres
                               es, volunteers, trustees and clients.
groups amongst its employees, vo

                              eating                                   s w
Equal opportunity is about treating people fairly and equally regardless of who they are, their
background or their lifestyle.

Crossroads Care is committed to p                                             unds
                                  d preventing discrimination on the grounds of race, gender,
                                 tion, gender re-assignment, age, ethnic origin, disability, religion or
marital status, sexual orientation, g
                                    status as a carer, political opinion or offendin background.
belief, lack of religion or belief, sta                                      ffending

                                 legislation on discrimination and equality.
Crossroads Care will comply with l                                   uality.

                                 rustees                                         n
Employees, volunteers and trustee will treat carers and people with care needs with respect
and ensure no one receiving a ser                                           s
                                    service from Crossroads Care receives less favourable treatment
                                 r, marital status, sexual orientation, gender re-assignment, age,
because of their race, gender, mar                                          er re
                                 on belief, status as a carer, political opinion, offending
ethnic origin, disability, religion or b                                    inion,
background or any other personal characteristic or circumstance.

Employees, volunteers and trustee of Crossroads Care will show commitm       mmitment to promoting a
                                ment and                                    y emp
harmonious working environment a will not harass or intimidate any employee, volunteer or
                                , gender,                                    n, gen
trustee because of their race, gend marital status, sexual orientation, gender re-assignment,
                                religion                                     al opi
age, ethnic origin, disability, religio or belief, status as a carer, political opinion, offending
background or any other personal characteristic or circumstance.

                             ployees, volunteers and trustees to cooperate with measures
Crossroads Care expects employe                                      perate
                                 opportunity and increase diversity.
introduced to ensure equality of op

                                 aims of this policy through monitoring, action planning and
Crossroads Care will achieve the a                                    g, ac
                            nstrating a willingness to tackle problems which arise in a fair and
regular reviews and by demonstra                                     s whic
consistent manner.
Crossroads Care                                                      Diversity and equality policy

Crossroads Care will make reasonable adjustments to its premises and working practices to
ensure employees, volunteers and trustees can take a full and active part in its work.

Crossroads Care will provide training and guidance on equal opportunities and diversity for
employees, volunteers and trustees.

Crossroads Care will endeavour to deliver services in a way that recognises the importance of
an inclusive society and which gives access and opportunities rather than maintaining barriers.

Responsibility for implementing and reviewing the success of the policy rests with the trustees.
Overall responsibility for putting in place procedures to ensure equality of opportunity and
increase diversity rests with the most senior member of staff.

Breaches of policy will be dealt with as follows:
• a breach of this policy by an employee will be regarded as misconduct and dealt with under
   the disciplinary policy
• a breach of this policy by a volunteer will be dealt with under the procedure for dealing with
   inappropriate behaviour by a volunteer
• a breach of this policy by a trustee will lead to the following procedure:
   o a panel of at least two board members will review the evidence and meet with the trustee,
      who will have the opportunity to have their case heard
   o the panel will make a decision on whether the trustee is to be removed from the board
   o the trustee will have the right of appeal to a panel of at least two trustees not previously
      involved in the situation.

Crossroads Care will comply with the following legislation:
• Equal Pay Act 1970 (Amended)
• Sex Discrimination Act 1975
• Employment Equality (Sex Discrimination) Regulations 2005
• The Sex Discrimination (Gender Reassignment) Regulations 1999
• Gender Recognition Act 2004
• Employment Equality (Sexual Orientation) Regulations 2003
• Civil Partnerships Act 2004
• Employment Equality (Religion or Belief) Regulations 2003
• Equality Act 2006
• Race Relations Act 1976 as amended by The Race Relations (Amendment) Act 2000
• Race Relations Act 1976 (Amendment) Regulations 2003
• Race and Religious Hatred Act 2006
• Disability Discrimination Act 1995 and Disability Discrimination (Amendment) Act 2005
• Employment Equality (Age) Regulations 2006

Policy/Diversity&equality/2010/02/APe005a                     Last updated January 2010     2 of 2
© Crossroads Care 2010                                         Review due January 2011
              Equal Opportunities Monitoring Form
This questionnaire will not be seen by the recruitment panel. All information received will be
treated in strict confidence. Crossroads Care strives to be an equal opportunities employer
and has a clear policy in terms of challenging discriminatory practices. In order to have
accurate information about our performance we would be grateful if you would complete this
monitoring form and return it with your application form. If you feel that our recruitment
procedure has unfairly discriminated against your application to work with us, please take this
opportunity to tell us.

Post applied for:

1   How would you describe your ethnicity?
                     White                                 Asian or Asian British
    British                                    Bangladeshi
    Irish                                      Indian
    Any other white                            Pakistani
    (please specify:)
                                               Any other Asian
                                               (please specify:)

              Black or Black British                               Mixed
    African                                    White and Black Caribbean
    Caribbean                                  White and Black African
    Any other black                            White and Asian
    (please specify:)
                                               Any other mixed
                                               (please specify:)

                    Chinese                                 Other ethnic group
    Chinese                                    Other ethnic group
                                               (please specify:)

    If you would like to further describe your ethnicity, please do so here:
Crossroads Care                                                   Equal Opportunities Monitoring Form

2   Which age category do you fit into?
    18 - 24 years                             49 - 56 years
    25 - 33 years                             57 - 65 years
    34 - 40 years                             66 - 70 years
    41 - 48 years                             Over 70 years

3   Are you male or female?
    Male                                      Female
4   Do you consider yourself to be a person with a disability? This includes people
    with long term health conditions. If you tell us you have a disability we will make
    reasonable adjustments to where you work and to your work arrangements and
    at interview.

    Yes                                       No
5   Are you a carer? “A carer is someone, who, without payment, provides help and
    support to a partner, child, relative, friend or neighbour, who could not manage
    without their help. This could be due to age, physical or mental illness, addiction
    or disability.”
    Yes                                         No

Please tell us how you heard about the job you are applying for so we can find out how good
our advertising is

     Newspaper (which one)                                    Web site (which one)               ...

     Other (please give details)                                                                  ..

Name: _________________________________________ Date: ________________


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