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Online Application Form

Family Care Agency Carer Application Form

Complete the application form if you would like to apply for a carer role.

Step 1 of 8 - Personal Information

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  • FCA APPLICATION FORM

    Please complete all details in the application and submit. Once completed we shall get back to.
  • Personal Information

  • Have you ever changed either your forename or surname at any point in your life?
  • NameUsed From:To: 
  • Have you lived at your current home for more than 5 years?
  • Add your previous addresses for the past 5 years. To have an option to add an additional address, click on the (+) icon on the right.
    Street AddressCityPost CodeDate of moving InDate of moving out 
  • Date Format: DD slash MM slash YYYY
  • Select one option below
  • Are you free to remain and take up employment in the UK with no current immigration restrictions?
  • If relevant to post applied for
    Do you hold a full, clean driving license valid in the UK?
  • Employment History

  • Click on the (+) sign on the right of End Date to add an additional work experience row. We are looking for 10 years of employment history. If you haven’t worked for 10 years, please add all relevant experience to date.
    EmployerRoleStart Date (dd/mm/yyyy)End Date (dd/mm/yyyy) 
  • List key duties and responsibilities from your previous work roles above
  • Education

  • Include all desireable/relevant qualifications. Please also include subjects currently being studied. Click on the (+) sign on the right of the row to add an additional row for your qualifications.
    Subject/QualificationPlace of StudyGrade/ResultYear of qualification 
  • Include any relevant training courses that you have attended or details of courses you are currently undertaking. Click on the (+) icon on the right to add another row for additional training courses
    Course TitleTraining ProviderDurationDate Completed 
  • References

    The Family Care Agency will require 2 references. If possible, one should include your most recent employer
  • Professional Reference

    Please provide details of your Professional Reference. This should be your last employer if possible.
  • Character Reference

    Please provide details of your Character Reference. This could be another employer
  • Next of Kin Details

    In case of emergencies it is vital that the Family Care Agency have these details on file. Please take the time to complete all sections of this form and if any details change in the future then contact your local Family Care Agency branch.
  • Terms of Engagement

    Please read through the contract below and sign in the location below using your computers mouse or touchpad.

    1. DEFINITIONS

    1.1 In these Terms of Engagement the following terms apply:

    “Assignment” Means the period in which the Temporary worker is supplied to render services to the Client.

    “Client” Means the business or person requiring the services of the Temporary Worker.

    “Employment Business” Means “ Family Care Agency Ltd”

    “Temporary Worker”may be employed on a fixed-term contract which allows them to work either until the task is complete or up until a specified termination date.

    1.2 Unless the context otherwise requires, references to the singular include the plural.

    1.3 The headings contained in these Terms are for convenience only and do not effect their interpretation.

    2. THE CONTRACT

    2.1 These terms constitute a Contract for services between the Employment Business and the Temporary Worker and they govern all Assignments undertaken by the Temporary Worker.

    2.2 For the avoidance of doubt, these Terms shall not give rise to a contract of employment between the employment Business and the Temporary Worker.

    2.3 No variation or alteration to these Terms shall be valid unless the details of such variations are agreed by the Employment Business and the Temporary Worker in writing stating the date upon which these variations or alterations were made.

    3. ASSIGNMENTS

    3.1 The Employment Business will endeavor to find suitable Assignments for the Temporary worker within the parameters of the Temporary Workers skills set and qualifications.

    3.2 The Temporary Worker acknowledges that the nature of Temporary Work means there are periods when no suitable work is available and agrees: that the suitability of the work offered shall be determined solely by the Employment Business: that the Employment Business shall incur no liability to the Temporary Worker should it fail to offer opportunities to work within suitable assignments.

    3.3 At the same time the Assignment is offered to the Temporary Worker the Employment Business shall inform the Temporary Worker of the identity of the Client including full addressees, the time of the Assignment including the number of hours, the remuneration and any applicable expenses if appropriate. In addition, the Employment business shall make clear any risks to health and safety and take steps to ensure reasonable precautions are taken. Please refer to Handbook for further details.

    3.4 If, before the first Assignment, during the course of an Assignment of within the Relevant period the Client wishes to employ the Temporary Worker direct or Through another employment business, the Temporary Worker acknowledges that the Employment Business will be entitled to charge the Client a fee. In addition, the Employment Business will be entitled to charge a fee to the Client if the Client introduces the Temporary Worker to a third part who subsequently engages the Worker within the relevant period.

    3.5 All employees are under an obligation not to disclose to anyone, unless that person is under a duty to receive it, any information coming to them while exercising their duties concerning a service user, their illness, their treatment or affairs relating to their families. Only when instructed by either a line manager or explicit consent has been given by the data subject, i.e. the service user or their nominated advocate, should confidential information be passed forward.

    3.6 Employees who have access to confidential reports, records or documents, whether relating to staff, clients or service users, are expected to ensure that they are securely kept and not left anywhere they can be seen by unauthorized persons.

    3.7 Employees are to respect confidentiality at all times. This is achieved by never giving personal information relating to service users or staff to any unauthorized person. Never answer questions relating to individual policies or organizational policies.

    4. REMUNERATION

    4.1 The Employment Business shall pay the Temporary Worker remuneration at a minimum of the National Minimum wage but in accordance with agreed rates with at the time of booking.

    4.2 The actual rate will be notified on a per assignment basis, for each hour worked during an assignment to be paid weekly upon receipt of completed timesheets.

    4.3 Holiday pay is included in the hourly rate and is therefore dependant on actual hours worked. This is paid quarterly and must be claimed before the end of the financial year by contacting payroll.

    4.4 If an applicant cancels a shift within 24 hours of the start time or if you do not attend a booked shift Family Care Agency Ltd reserves the right to charge £20 for an administration fee.

    4.5 The cost of a DBS will either be deducted from a wage packet or paid at registration

    5. SICKNESS ABSENSE

    5.1 The Temporary Worker may be eligible for Statutory Sick Pay provided the relevant statutory criteria are met.

    5.2 All Temporary Workers are required due to the nature of the Assignments give at least 4hours notice to cancel any shifts as to not do so may endanger Service User’s due to insufficient staffing numbers.

    5.3 Last minute cancellations may result in the Temporary Worker being subject to dismissal should a valid reason not be provided.

    6. TIMESHEETS

    6.1 At the end of each assignment, the Temporary Worker shall deliver a time sheet completed to indicate the number of hours worked including deductions for breaks as these are not paid unless otherwise indicated.

    6.2 Where the Temporary Worker fails to deliver a properly authenticated timesheet the Employment Business shall, in a timely fashion, conduct further investigations into the hours claimed by the Temporary Worker. This may result in delays in payment due to the Temporary Worker. The Employment Business shall make no payment for hours not worked.

    6.3 For the avoidance of doubt and the purposes of the Working Time Regulations, the Temporary Worker’s working time shall only consist of those periods where they are carrying out duties for the Client as part of the Assignment. Traveling to and from, lunch and all other breaks shall not be included unless otherwise indicated.

    6.4 It is the Temporary Workers responsibility to ensure the Timesheets reach the finance office in good time and to ensure its arrival.

    6.5 Temporary workers who wish to work 48 hours or more in any week must sign the declaration below. Once signed it is not compulsory to work over those hours, it will allow the Temporary Worker the option.

    CONDUCT OF ASSIGNMENTS

    7.1 The Temporary Worker will be obliged to co-operate with the Clients reasonable instructions and accept direction, supervision and control of any responsible person in the Client’s Organization.

    7.2 All rules, regulations, policies and procedures are to be followed both relating to the Client and the Employment Business

    7.3 The Temporary Worker is to take all reasonable steps to safeguard their Health and Safety and report any incidents to the Employment Business in accordance with the Employment Handbook.

    7.4 The Temporary Worker will not engage in any conduct detrimental to the interests of the Client or Employment Business.

    7.5 At no time should the Temporary Worker divulge confidential information relating to the Client or the Employment Business. Such action would be subject to action as outlined in the Employment Handbook.

    TERMINATION

    8.1 The Employment Business may terminate the Temporary Workers Assignment without any prior notice or liability

    8.2 If the Temporary Worker does not report to the Employment Business their availability for a period of 4 weeks, then the Employment Business will forward a P45 to the Temporary Workers last known address.

    8.3 Family care agency may validate Home Office documents provided by an applicant by sending them to the Home Office.

    I have read understood and agree the standard terms of engagement. I also agree that I may work for more than an average of 48 hours a week. If I change my mind, I will give my employer 1 months notice in writing to end this agreement.
  • Re-type your name in full to agree to the terms above.
  • Please use the mouse or if using a tablet or phone, use your finger to sign.
  • 19/01/2021
  • Health History Questionnaire

    All questions contained in this questionnaire are strictly confidential and become part of your employment record.
  • Please select the illnesses you had as a child
  • Select the immunisations you've had. Once selected a date option will appear below for the selected Immunisation.
  • Date Format: DD slash MM slash YYYY
  • Date Format: DD slash MM slash YYYY
  • Date Format: DD slash MM slash YYYY
  • Date Format: DD slash MM slash YYYY
  • Date Format: DD slash MM slash YYYY
  • Date Format: DD slash MM slash YYYY
  • Please select all options which are true
  • If you've selected any option in the Health Questions above, please provide further information.
  • Declaration

    The information in this form is true and complete. I agree that deliberate omissions, falsification or misrepresentation in the application form will be grounds for rejecting this application or subsequent dismissal if employed by the organisation. This applies equally to any medical questionnaire/forms I may complete.
    I understand that giving false information with regards to my medical history and fitness may lead to termination of my contract and services.
    To the best of my knowledge the above information is correct.
  • Additional Information

  • Please add any supporting information for your application here if you wish to do so.
  • Data Protection (GDPR)

    1. We are aware of our obligations under data protection legislation, including the obligation to collect only the data that is required for our specific purpose. The information collected in this application form is specific to our recruitment exercise and necessary for the performance of the role that you have applied for. If you are recruited for the role you have applied for, or any other role you are offered by us, the information provided will then be used for the purposes of your employment with us, together with further information collected upon recruitment for those purposes.

    2. We will treat all personal information about you with utmost integrity and confidentiality. Our data protection policy sets out our approach to ensuring that your data is processed in line with the data protection principles within current data protection legislation.
  • By selecting the checkbox you give consent to the Family Care Agency to use your data in accordance with GDPR regulations as per our privacy policy.
  • Date Format: MM slash DD slash YYYY

 

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