Job Application

We are committed to providing equal opportunities for all applicants, including those with previous convictions, and we recognise the value of a diverse workforce. Our approach ensures that candidates are treated fairly and are assessed on their skills, qualifications, and suitability for the role, in line with the Rehabilitation of Offenders Act 1974 and the Children’s Homes (England) Regulations 2015. All roles within our organisation involve working with children and young people and are therefore subject to an enhanced Disclosure and Barring Service (DBS) check. Any information disclosed will be handled confidentially and in accordance with data protection legislation. A criminal record will not automatically prevent someone from working with us. We consider:
•    The nature of the offence
•    Its relevance to the role
•    The time elapsed since the offence
•    Evidence of rehabilitation Where appropriate, we may request further information from the applicant to ensure that we can make a balanced and informed decision that safeguards the children in our care. By adopting this approach, we aim to balance safeguarding responsibilities with our belief in rehabilitation, inclusion, and second chances

If you need this form in large print, please contact the local office. Please complete all fields in black or blue ink and using block capitals. You may also complete the form as a Word document in your browser. Please let us know if you need any assistance. Details entered in this part of the form will be held in the HR department of GROMODEL CARE.

Title

First Name

Surname

Sex

Address

Postcode

Phone

Mobile

NI Number

How did you hear about this job?

If you were told about this job by someone who works for us, please tell us their name:

Do any other of your close friends or relatives already work for us?

If yes, please list their name(s) here:

Date of Birth

Gender

Please select your ethnicity from the following list (check one only):

Disabilities

If Yes please specify below

What is your sexual orientation?

Heterosexual (straight) Gay man Lesbian Bisexual Prefer not to say

Languages

If Yes please specify below

What is your marital status?

What is your religion?

College or University Course Qualifications and Grades obtained

Course

Qualifications and Grades obtained

School

Subjects

Qualifications and Grades obtained

Training Course (Relevant to the post and that supports your application)

Course Details (Including length & Nature of Training)

Relevant Experience Please state how your skills, experience and training will enable you to successfully perform this job.

Employer and location (or educational establishment)

From (Month and Year)

To (Month and Year

Your Role (or, if studying, your Course)

Reason for Leaving (If applicable)

If you have any gaps within your employment history, please state below

First Referee (Should be current or most recent employer)

Referee’s Name

Position

Name of Organization, School or College

Address and Postcode

Phone

Dates of Employment or Study (Month and Year)

2nd Referee (Should be current or most recent employer)

Referee’s Name

Position

Name of Organization, School or College

Address and Postcode

Phone

Dates of Employment or Study (Month and Year)

Your appointment will depend on the satisfactory completion of a criminal records disclosure (see policy statement below), but at this stage, we need you to answer the following questions truthfully and honestly:

Have you received any convictions, cautions, reprimands or final warnings that are not ‘protected’ as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013 by SI 210 1198)?

To your knowledge, are you currently the subject of any criminal proceedings (for example, charged or summoned but not yet dealt with) or any police investigation?

Is there any reason that you cannot work in a regulated activity?

If you answered ‘yes’ to any of the three previous questions, please provide details:

Do you consent to our applying for an enhanced criminal records disclosure on you and to our retaining a copy of your disclosure certificate during the period of your employment or until a new disclosure is completed (whichever occurs first)?

Yes (Note that if, once a criminal records disclosure has been completed, it is discovered that you have failed to accurately disclose the information requested above, the company reserves the right to terminate your employment without notice. Please be aware, however, that you having a criminal record will not necessarily mean we cannot employ you – if you would like to know more about our policy on the recruitment of ex-offenders, please contact us.)

As an organization assessing applicants’ suitability for positions which are included in the Rehabilitation of Offenders Act 1974 (Exceptions) Order using criminal record checks processed through the Disclosure and Barring Service (DBS), we comply fully with the Code of Practice and undertake to treat all applicants for positions fairly. We will not discriminate unfairly against any subject of a criminal record check on the basis of a conviction or other information revealed. We can only ask an individual to provide details of convictions and cautions that we are legally entitled to know about. Where a DBS certificate at either standard or enhanced level can legally be requested (where the position is one that is included in the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 as amended) and where appropriate Police Act Regulations (as amended), we can only ask an individual about convictions and cautions that are not protected.

Please read the care worker job description and answer the following questions.

Have you read and understood the care worker job description?

The position for which you are applying requires physical effort (including sitting, standing, carrying, walking, moving and handling people), mental effort (including dealing with emergencies and short-notice changes to work in a fast-paced environment) and possible emotional/psychological effort (including dealing with bereavement and challenging behavior in a potentially stressful environment)

Do you have any health conditions that would prevent you from meeting these intrinsic requirements for which the company might need to make reasonable adjustments? (If yes, please be aware that we may need to discuss these with you at your interview).

If you answered ‘Yes’, please provide further details:

I, the job applicant named on the front of this form, confirm that the information I have given in this application is accurate and true to the best of my knowledge. I also understand and agree that: • The company may make checks to verify the information I have provided; • Providing misleading or false information in this form or at any other time during the application process may disqualify me from appointment or, if I have already been appointed, may result in my dismissal; • The personal information I have provided in this form (and any other personal information that I or my referees may provide) is confidential and will be handled in line with the Data Protection Act 1998; • The company will use the personal information I have provided to decide if I am suitable for the job I have applied for; • Until I am employed, the company will not use my personal information for any purpose other than monitoring its own recruitment processes and that if the company does use my personal information for statistical analysis, it will be anonymized; • If my application is unsuccessful, the company will keep only basic information about me and destroy the rest; • If my application is successful, my personal information will be used for legitimate purposes in relation to my work (my contract of employment, which I will sign before I start work, will include further detail on how my information may be used); • The company may process my personal information for the purposes described above or as otherwise permitted or required by law in line with its registration with the Information Commissioner; • Any offer of employment will depend on the receipt of satisfactory employment references and the satisfactory completion of a criminal records disclosure (see part six above); • I will be liable for the cost of my initial criminal records disclosure but that the company will bear the cost of any future disclosures that need to be made; • I will be required to complete a pre-employment induction training program prior to my starting work with the company; • My attendance on the induction training program will not indicate any offer (on the part of the company) or acceptance (on my part) of employment and that the time I spend on the induction program will therefore not count as working time for the purposes of calculating the company’s compliance with National Minimum Wage regulations; • I will be liable for the cost of my induction training (£85) and any uniform given to me (£15) if I leave the company’s employment within six months and that this sum may be deducted from my wages.

Signed Dated

What happens now? • If you received this form by post, return to us along with your completed Equalities Monitoring Form. We will be in touch with you to inform you whether you will be invited to an interview. • If you downloaded the form from the internet, post it to the branch from which you would like to work (you will find the address on our website), making sure that you also download and complete the Equalities Monitoring Form. We will be in touch to inform you whether you will be invited to an interview. • If you completed the form at one of our offices, hand it to the person that gave it to you, along with your completed Equalities Monitoring Form. It will be explained to you what will happen next. • If you received this form by email, please complete same and save as Word document along with the other forms in the Application Pack. Please email the completed forms back to us and we will be in touch with you in due course.

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