Unit 9 Dowren House
Foundry Lane
Hayle
Cornwall
Tr27 4HD
Tel : 01736 448263
Email: careteam@phcs.me.uk
Premier Healthcare Solutions are committed to treating job applicants and employees fairly and
consistently. We will act to ensure equality of opportunity during the recruitment and selection
process, both for reasons of natural justice and fair treatment and to ensure that the most
suitable employees are appointed in order to maximise the Companies efficiency. We aim to
embrace diversity in all that we do and we recognise the worth of each individual’s experience,
expertise and opinion, and we hold respect for one another at the heart of our organisation.
Which post are you applying?
How did you learn of this vacancy?
Are you related to an employee of Premier Healthcare Solutions:
(Please give details)
Post reference number:
Personal Details:
Surname:
Forenames:
Address:
Home Number:
Mobile Number:
Email Address:
Work Number:
Current Employment Details:
Name of current/most recent Employer:
Address:
Telephone no:
Current post:
Brief Description of Duties:
Current Pay:
Period of Notice required by current employer:
£
Education:
General Education
Further
Education/Professional Qualifications
Level
Grade
Qualification
Grade/Class
Employment History
Name and address of
employer
(Most recent first)
Positions
Key Achievements
Reason for leaving
Disability
We are using the word “disability” to include people with obvious disabilities and those with
invisible disabilities or persistent health problems. The Disability Discrimination Act 1995 defines
a disability as:
“A physical or mental impairment which has substantial and long-term (lasting more than 12
months) adverse effect on your day to day living”
Have you a disability which requires the provision of specific facilities at interview or for work?
If so, is there anything we could do to assist you? Please give details:
Personal Development
Please state any courses, membership, voluntary work or public service/duties you consider
relevant, with outcomes where applicable:
Rehabilitations of Offenders Act 1974
Have you ever been cautioned or convicted of a criminal offence?
NO
YES
If yes, please give details in a separate envelope. You are required to give details of all “spent
convictions” if you are applying for a post that involves direct contact with vulnerable adults.
Criminal Records Bureau
If this post is subject to a satisfactory criminal record bureau check, which will disclose all
cautions, reprimands and warnings as well as convictions, in addition to completing this
application form you are required to provide us with details of all spent and unspent convictions.
Please send this information to us under separate, confidential cover to either the service
provider or manager of premier healthcare solutions. Remember to include your name, address
and the position for which you are applying. We guarantee that the information you provide will
be used fairly and will only be seen by those who need to see it as part of the recruitment
process.
Asylum and Immigration Act 1996
To enable us to comply with our obligations under the Asylum and immigration Act, you will be
asked to provide written proof of your right to work in the UK before any job offer is made to
you.
Do you require permission to work in the UK?
NO
YES
Supporting Statement
This is an opportunity to draw attention to aspects of your career, training courses attended,
interests,
Ambitions, etc., which make you suitable for the post. Also state why you are interested in
applying for this post and make particular reference to the Role Description. Use additional
sheets if necessary.
References
Please give names and address of two referees, one of whom should be your current or most
recent employer.
Reference 1
Reference 2
Employer:
Employer/Personal
Name:
Name:
Job Title:
Relationship:
Company:
Company:
Address:
Address:
Telephone No:
Telephone No:
E-mail:
E-Mail:
Should referees be approached prior to interview?

Yes 
No
Sickness and Absence:
Please state the number of absences, due to sickness, over the past 12 months
Signature
The information given in this application is, to the best of my knowledge, true and accurate. I
understand
that any false declarations may lead to the withdrawal of a job offer or termination of
employment.
Canvassing will disqualify your application.
Signature of applicant:
Date:
Equalities & Diversity Monitoring
Questionnaire
Strictly Confidential
Monitoring the diversity of our applicants and staff is an essential part of Premier
Solution’s commitment to Equalities and Diversity. Please complete this form and
your application form. It is entirely confidential and will not be made available to
in short listing or the selection process, or for any purpose other than monitoring
reporting.
Healthcare
return it with
those involved
and statistical
Date of birth:
Gender:
Ethnicity - please tick the most appropriate box below to describe your ethnic group or origin.
(This question helps us to identify the ethnic diversity of those applying for vacancies within the
organisation. The classifications are those used in the 2001 census, and are recommended by
the Commission for Racial Equality).
White:
British
Irish
Other White
Mixed:
White
White
White
Other



Asian or Asian British:
Indian
Pakistani
Bangladeshi
Other Asian




Black or Black British
Black Caribbean
Black African
Other Black




Chinese or Other Ethnic Group:
Chinese
Other Ethnic Group 
and Black Caribbean
and Black African
and Asian
Mixed




Do you consider yourself to have a disability? (Premier Healthcare Solutions are committed to
ensuring that people with disabilities are supported and encouraged to apply for employment with
us and to achieve progress in that employment. This question helps us to assess our success
in achieving this aim).
Yes
NB.
No


The Disability Discrimination Act 1995 defines a disability as:
“A physical or mental impairment which has substantial and long-term (lasting more than 12
months) adverse effect on your day to day living”
If you wish to provide any additional details please do so below:
If you wish you may disclose information about yourself in this section:
Religion:
Sexual Orientation:
Is there anyone who relies on you for day to day care and attention?
(This question is
recommended by the Equal Opportunities Commission and will help us review our flexible working
policies.)
Yes
No


If yes, are they:
a) Children:
aged
0-5
Date(s) of Birth:
6-11
Date(s) of Birth
12-18 Date(s) of Birth:
and/or
A family member / partner (please specify):
This information will be used solely by the People and Performance Department for monitoring
purposes and will be treated as confidential.
Thank you for your Co-operation
JOB DESCRIPTION
Title of Post: Community Care Assistant
Part and Full Time:
Purpose of Post: Responsible for the care, treatment and well being of the
allocated Client. Working within the legislative requirements
and health and safety requirements, to comply with the procedures set out in
Premier Healthcare Solutions policy documents.
Duties and Responsibilities:
1. To help as a team member create a caring, safe and secure environment
or elderly people connected to Premier Healthcare Solutions.
2 .Involvement in and supervision of daily routine living i.e. getting up, meal
times, chores, community group meeting, socialising, leisure time, and going to
bed.
3 .To ensure that all clients receive an acceptable level of material, physical
and emotional care.
4 .Supervise elderly people on social outings.
5. Accept the role of Community carer and support them in their everyday life
styles individually with elderly people.
6. Identify difficulties experienced by elderly people and areas of progress and
good functioning for the purpose of the client to gain self-development.
7. Aware of Premier Healthcare Solutions policies: No Lifting, No Smoking, Equal
Opportunities and Confidentiality.
8. Seek professional development through attendance at staff meetings
months), in house training initiatives and external training opportunities.
(every 6
9. To work as a committed, co-operative, supportive and flexible colleague within
a staff team.
10 .To communicate with colleagues effectively
11. To support the care plan for each elderly person in a professional manner.
12. To understand and comply with Premier Healthcare Solutions policies and
procedures documents.
13. Carry out other duties within the post-holders competence or may be
required from time to time.
14 .Appraisals to be carried out according to our policy.
15. Hours are variable over a 7-day rota, are not guaranteed, and may involve
working over 48 hours, for which a separate agreement will be signed, this is
contained within the contract.
16. To work in the community, based in clients homes to provide a service for
the client.
17. To promote independence and retain a high standard of living in their
everyday life.
18. To report any problems that may occur during working hours at the earliest
opportunity.
19. To use all safety equipment in an appropriate manner i.e. wearing gloves in
all clients’ homes of which receive personal care.
20. To use hoists and/or sliding sheets when required and within our
policy
documents.
21. To dispose of waste i.e. pads.
22. To ensure that each working environment is left clean, tidy and safe for the
client and colleague’s.
23. To have a good health record and be fit enough to take part in a range
of physical activities involving elderly people.
24. To ensure that personal information such as telephone numbers and
addresses is not exchanged either way with service users.
25. Not to discuss with a client any information regarding another client or
colleague.
26. To maintain a level of patience, integrity, Sensitivity, Self confidence, good
personal boundaries and a degree of personal maturity.
27. Staff are required to notify Premier Healthcare Solutions of any new criminal
offence they may have committed, including motoring offences.