Please answer all the questions in full to the best of your ability — any difficulties should be discussed with a member of the ProCare Management Staff. Your application form may be subject to scrutiny by Local Authority Accreditation Bodies and Care Inspectorate Wales.

Desirable: • NVQ Level 2 Health & Social Care • An understanding of the relevant Health & Safety Legislation for Movement and Handling Essential: • Complete NVQ within 2 years of course commencement, if not qualified. • Understand the effects of ageing, disability, incapacity and illness and the effects these can have on a Service User's well-being. DBS Criminal Record Checks: This post will result in you having substantial contact with the elderly, sick or disabled. ProCare therefore requires that, by virtue of the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 and the Police Act 1997, you reveal any criminal convictions, bind-over orders or cautions, including those which would normally be regarded as spent. You must complete the relevant section on the application form — your application will be returned if this section is incomplete. If successful in your application you will be subject to a DBS Criminal Record Check.

A) DRIVING LICENCE AND AUTHORITY TO DRIVE VEHICLES 1) You must be in possession of a current driving licence to drive on our business. 2) Your driving licence must be produced for scrutiny by a director when required, or you may be required to provide access to your driving licence details online. 3) If at any time your licence is endorsed, or you are disqualified from driving, we must be informed immediately. Should your licence be removed or become invalid for any reason, your employment may be terminated. B) CAR INSURANCE If you are using your own car for business purposes, you must ensure that your car insurance provides adequate cover. Proof of adequate (business) insurance, Driving Licence, Tax and an MOT Certificate must be produced for scrutiny upon renewal and at any time when requested. C) USE OF MOBILE PHONE WHILST DRIVING It is illegal to use a mobile phone whilst driving (without a hands-free set). It is company policy that you should not use any mobile phone whilst driving. You should pull over in an appropriate place before making or receiving calls, and return any missed call as soon as it is safe to do so. D) SMOKING POLICY All workplaces including vehicles are smoke free, which includes e-cigarettes. This applies to all employees, contractors, clients or members of the public, including when using their own vehicle for Company business. You may only smoke during authorised breaks and in designated areas. Company disciplinary procedures will be followed for non-compliance; those who do not comply with the smoke-free law may also be liable for a fixed penalty fine and possible criminal prosecution. E) FUEL ETC. 1) In addition to keeping the vehicle regularly serviced, it is your responsibility to maintain oil and water levels, battery, brake fluid and tyre pressures, and to ensure tyre tread conforms to the minimum legal requirements. 2) Unless agreed otherwise in writing, we will only reimburse fuel and oil used on our business. Claims must be submitted on a weekly report sheet, signed by yourself and accompanied by receipted bills, with a deduction shown for private mileage. F) FINES We will not be held responsible for any fines (e.g. parking, speeding) incurred by you whilst working for us.

G) DAMAGE OR INJURY 1) If you are involved in an accident causing damage to property or another vehicle, or injury to any person or animal, you must give your name and address, the vehicle registration number and the name of the insurance company to any person with reasonable grounds for requiring it. Give no further information. If this is not possible at the time, report the matter to the office and, where necessary, the police as soon as possible and within twenty-four hours. 2) Where injury to another person or to a notifiable animal (e.g. a dog) is involved, you must notify the police and produce your insurance certificate to an attending officer, or produce it in person within five days at a police station. H) ACCIDENT PROCEDURE 1) Insurers must be notified of all accidents, even minor ones. Obtain an accident report form from us, complete it and return a copy within twenty-four hours. Wherever possible record: a) name, address and insurer of the other driver; b) names and addresses of all passengers in both vehicles; c) names and addresses of all witnesses (statements at the time are helpful); d) details of attending police (name, number, division). 2) Provide a detailed sketch showing the relative positions of the vehicles before and after the accident, with road details and measurements. 3) If your vehicle is undriveable, you are responsible for arranging towing and subsequent repairs. 4) Do not express any opinion on responsibility for the accident — only exchange the particulars above.

I) OTHER GUIDELINES 1) You must never drive under the influence of alcohol or drugs, including medicines which may affect your driving. 2) Use seat belts at all times and comply with local traffic conditions. 3) Always drive within the speed limit and reduce speed where weather requires. 4) DO NOT DRIVE if tired. 5) Always take regular breaks from the vehicle.

Please supply the names and addresses of ALL employers since leaving full-time education, stating the reason for leaving each position. Start with your current/latest employer and work back to the earliest. Account for any gaps in your employment history. You may submit a CV with the same information.

We require a minimum of 2 references. Your first two references must be from your latest two employers (unless there are extenuating reasons). All references must be obtained before you start work, including from previous care companies. If you have no previous employers, please provide three character references (someone you have known 5+ years). You may not use a relative as a referee.

Please list all schools and colleges attended from age 11 to present, covering all gaps, in MM/YYYY – MM/YYYY format, including grades obtained. You may also submit a CV with the same information.

Please read the job description and use this space to convince us that you are qualified for the vacant position. Draw on your experience (voluntary, paid or temporary). The information you provide here will be used to determine whether you are short-listed for an interview.

Under the Asylum & Immigration Act 1996 we must establish that all personnel satisfy the requirements of the Act. If your application is successful you will be invited to an interview and MUST provide: • Right to work check: UK or EU Passport, share code, or birth certificate. • Proof of ID: passport, BRP, or driving licence. • Two proofs of address (dated within the last 3 months, showing name and address): utility bill, bank statement, HMRC letter, DWP letter, driving licence, etc. • NI number: payslip, P46, P60, letter from DWP or HMRC. • Birth certificate. • Photo of yourself for your ID badge. • Training certificates.

Having a medical condition does not automatically preclude you from employment, but we need to take account of any known medical history to ensure your own health and safety and that of the vulnerable people for whom we care. It is very important for all Care Support Workers to be aware of the importance of immunisation, to safeguard the Service User, the worker and their families. Vaccination against the following is advisable and should be maintained — this is advisory, not an employment requirement.

Please complete this section if applying for posts exempt under the Rehabilitation of Offenders Act 1974. Any information given is completely confidential and considered only in relation to your application. Many of our posts are exempt from Section 4 of the Act (Exceptions Order 1975); applicants are not entitled to withhold information about convictions which are otherwise 'spent'. In the event of employment, any failure to disclose such convictions could result in dismissal from Pro Care Nursing Agency Ltd. If unsuccessful, this statement and application form will be destroyed.

Due to regulations made by Care Inspectorate Wales (CIW), it is mandatory for all employees within the care sector to have criminal record checks done by the Disclosure & Barring Service (DBS). Applications from ex-offenders are welcomed and considered on their merit. This post is exempt from section 4(2) of the Rehabilitation of Offenders Act (Exceptions) Order 1975. You are required to disclose all criminal convictions, prosecutions or cautions (including 'spent' convictions). Information will be completely confidential. Successful applicants will be required to undergo an Enhanced DBS check.

DBS: The agency will pay £62.50 on behalf of a new care worker for the cost of a DBS, repayable in instalments per the DBS agreement. Training Costs: This agreement allows you to undertake training of direct benefit to you and the Agency, which the Agency will fund subject to your agreement to refund the Agency if your employment terminates within a given period. If you do not complete the course, or your employment ceases during the course, you will be expected to refund the full amount (the Agency may waive this at its discretion). After completion, repayment is by deduction from pay per this schedule: • Up to 6 months after completion — 100% of course fees repayable • 6 to 12 months after completion — 50% repayable • After 12 months' employment — 0% repayable Shadowing Hours (on termination, deducted from monies due): • Up to 6 months after completion — 100% • 6 to 12 months after completion — 50% • After 12 months' employment — 0% Uniforms: On termination you must return all our property in your possession. Failure to return such items will result in the cost being deducted from any monies outstanding.

Pro Care Nursing Agency follows the regulations set by the GDPR Act 2018, including personal data relating to those who apply for vacancies. We will not share identifiable information about you with third parties without your consent unless required by law. Personal data provided during an application is retained for at least six months, or longer if required by law. This privacy notice does not form part of an employment offer or contract. By signing below you agree to follow company policy under the GDPR Act 2018. All information, including the names of the people we support and your colleagues, is given in strictest confidence and must NOT be shared with any party not associated with Pro Care. All service users and employees have the right to confidentiality. Personal information will not normally be passed to a third party without agreement, and only where beneficial to the service user/employee or at the legal request of another party. All service users and employees have a right to see the personal information held about them by making a request in writing with at least 48 hours' notice.

1. Personal information held by the Company is confidential and must not be disclosed to anyone without the consent of the person to whom it relates, except in accordance with these procedures. 2. Personal information from a health professional may be used only for the purpose for which it was disclosed; otherwise the consent of the health professional must be obtained unless the law requires disclosure. 3. Personal information not obtained by a health professional may be disclosed with the consent of the service user, or when required by law, a Court or Tribunal. 4. In exceptional circumstances, where protecting the welfare of the service user, employee or another person (or the public interest) overrides the right to confidentiality (e.g. to prevent or detect serious crime, child protection, protection of vulnerable adults). Wherever possible the service user should be informed. 5. All staff must agree to abide by the Company's Confidentiality Policy. 6. Personal information must be kept securely and under lock and key; computer records must be password protected. 7. Staff should not normally take files out of the office; if necessary they must be kept secure and signed out/in. Files must not be left in cars. 8. Files containing personal information must not be left on view. 9. Information that could identify an individual should be kept secure at all times and encrypted wherever possible. This policy should be read in conjunction with the Staff Handbook. Any suspected or confirmed breaches of confidentiality will be dealt with under the organisation's disciplinary procedure.

The EEC Working Time Regulations (WTR) recommend that an employee should not exceed a 48-hour working week (without sufficient periods of rest). All employees are required to sign an agreement stating whether or not they wish to exceed these recommendations.

Pro Care Nursing Agency Ltd has invested considerable time, effort and expense in developing its business. You acknowledge that competing with Pro Care immediately after termination would do damage, and that these restrictions are fair and reasonable to protect Pro Care's legitimate business interests. Definitions: • Customer: any person/firm/company/organisation who was, during the Relevant Period, a customer of Pro Care and for whose business you (or anyone reporting to you) had responsibility. • Prospective Customer: any party with whom, during the Relevant Period, you were involved on behalf of Pro Care in a formal tender or proposal. • Relevant Period: the 12 months before the termination date. • Restricted Area: the Cardiff area in which Pro Care has conducted Restricted Business. • Restricted Business: any business of Pro Care with which you were involved during the Relevant Period. • Termination Date: the date your employment with Pro Care terminates. Non-Competition: For 6 months after your Termination Date you will not engage in or be interested in any party that conducts Restricted Business within the Restricted Area. Non-Solicitation: For 6 months after your Termination Date you will not canvass, solicit or attempt to solicit business from Pro Care's Customers or Prospective Customers in competition with Pro Care. Non-Dealing: For 6 months after your Termination Date you will not deal, negotiate or contract with any Customer or Prospective Customer with whom you personally dealt in the six months before termination, in competition with Pro Care. Non-Poaching: For 6 months after your Termination Date you will not employ or engage any person who was, during the Relevant Period, a director, senior or key employee of Pro Care. General Terms: Each restriction is reduced by any garden-leave period before termination. If any restriction is judged invalid or unenforceable, it shall be severed without affecting the remaining restrictions. Further terms include short-time working/lay-off, key-holder responsibilities, liability for damage/loss, fitness to work, Company mobile phone use, notice periods, and return of Company property on termination.

1) Overpayments will normally be deducted from your next payment (or over a longer period if this would cause hardship). 2) If you arrive more than one hour late without prior notice, other cover may have been arranged and you may be sent off the premises for the day without pay. 3) Lateness or absence may result in disciplinary action and/or loss of payment. 4) You must complete and submit timesheets as directed. Incorrect or late timesheets may result in incorrect or delayed pay; deliberate falsification is a disciplinary offence and may lead to summary dismissal. 5) In a temporary shortage of work we will try to maintain continuity of employment, which may mean short-time working (reduced pay for time worked) or lay-off (no pay other than statutory guarantee pay). 6) Allocated key holders must follow all security procedures; loss or damage from failure to do so may result in disciplinary action and the cost being deducted from monies owed. 7) Damage to stock or property through carelessness, negligence or vandalism may render you liable for the full or part cost of repair/replacement. 8) Any loss resulting from your failure to observe rules, negligence or unsatisfactory work may render you liable to reimburse the full or part cost; in default this will be deducted from your pay. 9) If, in our opinion, you are not fit to work, we may send you away for the day with or without pay and you may be liable to disciplinary action. 10) Company mobile phones are for business use only except in emergencies; unauthorised personal use may be repayable and may result in disciplinary action. Communications may be monitored. 11) If you leave without giving or working the required notice, an amount equal to the additional cost of covering your duties may be deducted from termination pay, and you may forfeit contractual holiday pay above statutory entitlement. 12) On termination you must return all Company property; failure to do so will result in the cost being deducted from any monies outstanding.

Pro Care Nursing Agency Ltd has an Equal Opportunities Policy. To ensure the policy is effective, ProCare uses this monitoring system. This information is confidential and used solely to monitor and plan our services and procedures.

All information will be treated in the strictest confidence. I understand that appointment, if offered, is subject to the information given on this form being correct. I declare that all the preceding information and statements are true to the best of my knowledge. I authorise Pro Care to make any inquiries necessary to verify the information given and I agree to inform them of any convictions and/or cautions received prior to taking up employment. We process personal data of those who apply for vacancies for employment purposes — to assist in the selection of candidates and the running of the business. This may include name, date of birth, gender, qualifications and previous employment history. We will not share identifiable information with third parties without your consent unless required by law. Personal data is retained for at least six months, or longer if required by law. This notice does not form part of an employment offer or contract.