Care Assistant Application | CA1801 - Richmond House Social Care Services CIC Community Interest Company - Social Enterprise No 11154305 - VAT Registration Number 334 2361 28

Universal Job Application

Please download and return your completed application form indicating your post, declarations and any additional information sheets to Application@Rhscs.org.uk Or HR@Rhscs.org.uk or Post it to:

HR, Richmond House Social Care Services CIC
96 Main Street, North Frodingham
East Riding of Yorkshire, YO25 8LJ

Alternatively,

Fill out the online application and email your additional information to Application@Rhscs.org.uk

Download Job Description: Richmond House Carer Job Description Form

Download Job Application:

Richmond House Support Worker Application Form

Richmond House AP- 01 Staff Induction Programme 2025

Online Application

Title *

Post applied for (Job Title) *

Location *

Preferred Location: East Riding, North Yorkshire, City of York, or Others:

Name *

First

Middle

Last

Date of Birth *

DD/MM/YYYY

Phone Number *

Email *

Confirm Email

Address *

National Insurance Number *

Current Position *

Include Fulltime, Parttime, Casual

When you can start *

List down your availability, Time, Morning, Afternoon, Evening, Night, Overnight, Weekends.

Personal Statement – experience, skills and general comments *

NOTE: After reading the Job Description carefully, consider what skills and experience you have that are suited to this post. If you need additional space please use a separate sheet.

Education & Qualification *

Please record details of education attained and/or any further qualifications achieved. Use the format FROM - TO - QUALIFICATION OBTAINED. (please continue on a separate sheet if required)

Current / Previous Employment (please continue on a separate sheet if required) *

Please use the format POSITION - FROM - TO - MAIN DUTIES AND THE REASON FOR LEAVING

Employment History *

This may be paid or unpaid. Please put most recent job first. Reason for leaving must be clearly stated. All periods of unemployment or gaps must be explained. Please describe your work experience beginning with your current or most recent job. Please elaborate further on your cover letter and/or resume, and the reason for leaving. Use the following format: JOB TITLE - NAME AND ADDRES OF EMPLOYER - FROM - TO - BRIEF DESCRIPTION OF DUTIES - REASON FOR LEAVING, SALARY ON LEAVING

Education *

If offered a post you will be asked for original evidence of your qualifications and the House reserves the right to approach any number of education providers to verify qualifications stated. Use the format WHERE YOU STUDIED - SUBJECT - LEVEL - GRADE - DATE OF EXAM / AWARD

Further and Higher Education (Degree, Diploma, BTEC, City & Guilds, NVQ etc, or equivalent) *

Use the format WHERE YOU STUDIED - SUBJECT - LEVEL - GRADE - DATE OF EXAM / AWARD

Professional *

Professional Qualifications. Use the format Qualification Gained - Date of examination/award

Membership/Registration with Professional Bodies *

Use the format Professional Body - Membership status - Registration number - Renewal date

Professional Reference *

First

Last

Please name your current employer who can be contacted to provide references.

Address *

Position *

Relationship to you *

Phone Number *

Email *

Character Reference *

First

Last

Please name a personal reference who can be contacted to provide references e.g. former employer, college tutor, other professionals – not friends or relatives.

Address *

Position *

Relationship to you *

Phone Number *

Email *

I understand that if I am appointed, this application form will become part of my personal file and that if I am not appointed it will be stored for 3 months and then destroyed in accordance with the 1998 Data Protection Act. To the best of my knowledge, the information I have provided on this form is true and accurate. I understand that if the information I have supplied is false or misleading in any way, it will automatically disqualify me from appointment or may render me liable to dismissal without notice. (copy) *

Signed, Print name

Do you have a current Driver's Licence? *

Do you have access to a vehicle? *

I understand that appointment to Richmond House Social Care Services will be subject to DBS clearance . *

Agree
Disagree

Declarations of criminal records, cautions and convictions. Posts involving work which brings you in regular contact with children, vulnerable adults, people with disabilities and learning difficulties are exempt from the provisions of the Rehabilitation of Offenders Act 1974 (ROA). This means that you must disclose information about spent or unspent convictions or cautions when applying for this post, except where they are protected convictions and cautions as described in article 2A of the ROA Act 1974 (Exceptions) Order 1975. Richmond House will check information relating to prospective employees through the Disclosure & Barring Service (DBS). Having a criminal record will not necessarily prevent your employment. Please see the 'How to apply' guidance for further information about what you need to disclose to us.

If disagree, explain why?

Are you barred from working with children, young people or adults? *

Are you, or have you ever been, barred from working with, or been included on a list of people barred from working with, children, young people or vulnerable adults?

If Yes please give details

Investigations *

Have you ever been the subject of any proven/unproven investigation(s), complaints(s) in relation to your work with children, young people or vulnerable adults, whether in a paid or voluntary capacity of carried out privately?

If Yes please give details

Criminal background *

Do you have any convictions, cautions, reprimands or final warnings that are not protected as defined by the ROA 1974 (Exceptions Order) 1975 (as amended in 2013)?

If Yes please give details

Eligibility to work in the UK *

Do you need permission to work in the UK *

If your permission is limited, please provide full details of your immigration status, renewal dates and any other relevant information.

Equal Opportunities Monitoring (confidential) *

Richmond House Social Care Services is committed to equality and aims to ensure that everyone who works or applies to work for us is treated fairly and is not subjected to unlawful discrimination on grounds of their sex, age, race, ethnic or national origins, marriage or civil partnership, pregnancy and maternity, gender reassignment, sexual orientation, religion or belief, family responsibility, disability or political beliefs. Applications are welcome from all sections of the community. I understand my application may be rejected and/or I may be dismissed following appointment if I have given any false or misleading information or have withheld any relevant details. Print your name

Disability information *

The Disability Discrimination Act 2010 states that someone is disabled if they have a 'physical or mental impairment, which has a sustainable and long term adverse effect on their ability to carry out normal day to day activities'. Please see 'How to apply' guidance for further information. Print your name.

Do you consider yourself to be disabled? *

If you tick “Yes” ,please tick as many boxes below as apply:

Please give details

Availability for interview *

Whilst the dates you provide will be taken into consideration, please note that it may not be possible to accommodate everyone's request when arranging interviews.

Unavailable dates

Please indicate any dates on which it would be impossible for you to attend an interview.

Others – please give details

Decleration *

Name *

First

Last

Date *

DD/MM/YYYY

Phone

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