Live-in Carer Jobs with Able Community Care

Carer Application Form

Email required documents to recruitment@ablecommunitycare.com within 10 days.

Your Details

Surname Forenames*

Address*

Post Code*

Main Tel Number*

Mobile Number

Email Address*

If you prefer not to receive our correspondence by email, tick here Yes

Emergency Contact

Name*

Address*

Tel. No.*

Relationship*

Driving and Lifestyle

Do you smoke?* —Please choose an option—Select optionYesNo

If yes, how many per day?

Can you manage without smoking during work?* —Please choose an option—Select optionYesNo

Do you hold a FULL UK manual driving licence?* —Please choose an option—Select optionYesNo

If yes, is it Manual, Auto, or Both? —Please choose an option—Select optionManualAutoBoth

Do you have a car available?* (THIS MUST BE INSURED FOR BUSINESS USE) —Please choose an option—Select optionYesNo

Are you prepared to drive a client’s car?* —Please choose an option—Select optionYesNo

Are you prepared to work OUTSIDE the county in which you live?* —Please choose an option—Select optionYesNo

Please note you will be required to provide a copy of your own Public Liability Insurance Certificate.

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Carer Application Form

Step 2 of 5

Please complete all fields with a *. Email required documents to recruitment@ablecommunitycare.com within 10 days.

Skills & Experience

To enable us to match your previous experience and skills to a client’s care needs, please indicate which of the following areas of care work you have experience of, please tick as appropriate:

Peg Feeding* —Please choose an option—Select optionYesNo

Colostomy care (changing bag only)* —Please choose an option—Select optionYesNo

Learning difficulties* —Please choose an option—Select optionYesNo

Spinal Injury care* —Please choose an option—Select optionYesNo

Acquired Head Injury care* —Please choose an option—Select optionYesNo

Client senile dementia* —Please choose an option—Select optionYesNo

Parkinsons* —Please choose an option—Select optionYesNo

Cerebral Palsy* —Please choose an option—Select optionYesNo

Muscular Dystrophy* —Please choose an option—Select optionYesNo

MS* —Please choose an option—Select optionYesNo

Terminal Illness* —Please choose an option—Select optionYesNo

HIV/AIDS* —Please choose an option—Select optionYesNo

Urinary incontinence* —Please choose an option—Select optionYesNo

Fecal incontinence* —Please choose an option—Select optionYesNo

Personal hygiene (washing etc.)* —Please choose an option—Select optionYesNo

Mental illness care* —Please choose an option—Select optionYesNo

Client confusion* —Please choose an option—Select optionYesNo

Stroke* —Please choose an option—Select optionYesNo

Client aggression (verbal & physical)* —Please choose an option—Select optionYesNo

Epilepsy* —Please choose an option—Select optionYesNo

Have you been taught M&H Techniques?* —Please choose an option—Select optionYesNo

Do you have certificates?* —Please choose an option—Select optionYesNo

Have you been taught to use a hoist?* —Please choose an option—Select optionYesNo

Do you have certificates?* —Please choose an option—Select optionYesNo

Any other relevant experience

Do you have certificates? —Please choose an option—Select optionYesNo

Additional Information

It is a requirement that you cook meals according to your client’s wishes and in the interests of providing them with a fresh, nutritious and varied diet, learning new recipes as needed. How would you rate your cooking skills?*

—Please choose an option—Select optionExcellentGoodFairPoor

Housekeeping is another essential part of being a live-in carer. How would you rate your domestic skills?*

—Please choose an option—Select optionExcellentGoodFairPoor

Please give details of any hobbies you enjoy

Any other relevant information

Have you applied to or worked for Able Community Care before?* —Please choose an option—Select optionYesNo

If yes, please give details (dates etc.)

Please state in your own words why you feel you are suited to being a live-in carer.* THIS MUST BE COMPLETED

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Carer Application Form

Step 3 of 5

Please complete all fields marked with a *. Email required documents to recruitment@ablecommunitycare.com within 10 days.

Employment History

Please provide details of your work history. Include all relevant jobs, even if they were short-term or in a different field. If you have more than 3 positions, please list additional ones on a separate sheet and email it with your documents.

Position 1

Employer / Company Name*

Job Title / Position Held*

Timeframe (From – To)*

Main Duties & Responsibilities Describe your main responsibilities and tasks in this role

Position 2 (if applicable)

Employer / Company Name

Job Title / Position Held

Timeframe (From – To)

Main Duties & Responsibilities Describe your main responsibilities and tasks in this role

Position 3 (if applicable)

Employer / Company Name

Job Title / Position Held

Timeframe (From – To)

Main Duties & Responsibilities Describe your main responsibilities and tasks in this role

Employment gaps
If there are any periods when you were not in paid employment (e.g. studying, caring responsibilities, travel, unemployment), please explain them briefly here: e.g. 2018–2019: Full-time parent / carer for family member

References

We require **two** references: one **Employment Reference** (professional, from a recent employer) and one **Character Reference** (personal, from someone who has known you for at least 12 months and is not related to you).

Employment Reference – This must be from your most recent employer (or a previous one if your current/recent role was less than 12 months). They should be able to comment on your work performance, reliability, and suitability for care roles. Minimum 12 months duration preferred.

PLEASE NOTE: We cannot accept private/personal emails or addresses unless they are from private clients or for character purposes only.

Contact Name* (Employment Reference)

Company/Organisation Name*

Job Title/Position of Referee

Address* Full work address of referee

Landline / Work Phone*

Email* (Work/Professional email preferred)

Character Reference – This should be a personal reference from someone who has known you for at least 12 months (e.g., friend, colleague from non-work context, community leader, tutor, etc.). They should be able to comment on your character, honesty, reliability, and suitability to work with vulnerable people. Must not be a relative.

Contact Name* (Character Reference)

Relationship to You*

Address* Full address of referee

Phone Number*

Email*

If you have any concerns about providing these details or need to explain anything (e.g., recent job change), please add notes here: Optional: Any additional information about your references

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Carer Application Form

Step 4 of 5

Please complete all fields marked with a *. Email required documents (Enhanced DBS, Public Liability Insurance, CV, etc.) to recruitment@ablecommunitycare.com within 10 days.

Rehabilitation of Offenders Act (1974)

This position is exempt from the Rehabilitation of Offenders Act 1974. You must disclose all criminal convictions (spent or unspent) and pending proceedings. All carers must hold a valid Enhanced DBS certificate.

Do you have any criminal convictions (spent or unspent)?* YesNo

If Yes to convictions: Please enter the date of the most recent conviction (or approximate date if multiple/ongoing). Leave blank if not applicable.

Do you have any criminal proceedings pending?* YesNo

If Yes to proceedings: Please provide details or the relevant date. Leave blank if not applicable. Details of pending proceedings (optional)

Date of answering these questions* (this records when you completed this section)

How You Heard About the Agency

How did you hear about Able Community Care?* —Please choose an option—Select an optionWebsiteSearch Engine AdvertisementPrinted PublicationRecommendation by Existing/Former CarerOther

Please provide details (e.g., publication name, carer’s name, or other source)* e.g., The Guardian, Jane Doe (carer), Google Ads

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Carer Application Form

Step 5 of 5

Please complete all fields with a *. Email required documents to recruitment@ablecommunitycare.com within 10 days.

Final Declaration

I confirm that the information I have given on this form is true and correct. I am fit and able to carry out the tasks of a self-employed carer, including pushing a manual wheelchair and hoisting as needed.

I agree to the above declaration* Yes

Document Submission

You must email the following documents to recruitment@ablecommunitycare.com within 10 days: Enhanced DBS, Public Liability Insurance, CV, training certificates, proof of address, passport, etc. See the full list in the application instructions.

Reminder: Please email all required documents within 10 days

Your Data

Data Permission
To process your application, we need to record and store your details on our secure database. By submitting this application to Able Community Care Ltd. you agree to your data being held for this purpose. Able Community Care Ltd promises never to share or sell your information to other organisations or businesses and you can opt out of our communications at any time by emailing info@ablecommunitycare.com, phoning 01603 764567 or writing to Able Community Care Ltd., The Old Parish Rooms, Whitlingham Lane, Trowse, Norwich, NR14 8TZ. Your information will be kept on file in line with GDPR requirements, after this time, all details will be disposed of securely. If you would like to read our full Privacy Statement, please request a copy by contacting us as above. Thank you very much for contacting Able Community Care, we look forward to hearing from you.

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