Apply Now | Careers | Cecilia Comfort Care

Personal Details

Please provide your personal information exactly as it appears on your official identification.

Role Applied For *

Title *

Date of Birth *

First Name *

Middle Name(s)

Surname *

Previous Names (if applicable)

National Insurance Number *

Do you hold a valid UK driving licence? *

Yes No

Do you have access to a vehicle for work? *

Yes No

Driving Licence — Front — JPG, PNG or PDF, max 5MB

Driving Licence — Back — JPG, PNG or PDF, max 5MB

Contact Details

Please upload a recent passport-style photograph and provide your current contact information.

Upload Your Photo * — JPG or PNG, max 5MB

Passport-style photo, clear face, plain background

Current Address *

How long at this address? *

Home Telephone

Mobile Number *

Email Address *

Identity Verification

We are required to verify your right to work in the UK and your registration with relevant professional bodies.

Nationality *

Do you require a work permit? *

Yes No

Are you a British or European citizen? *

Yes No

Visa / Permit Expiry Date (if applicable)

PVG & SSSC Registration

PVG Number

Date PVG Issued

Are you registered with the SSSC? *

Yes No Applied

SSSC Registration Number

Consent for PVG & SSSC check * I consent to Cecilia Comfort Care carrying out a check of my PVG disclosure and SSSC registration as part of the recruitment process.

Document Uploads

Please upload clear scans or photos of your documents. All uploads accept JPG, PNG or PDF (max 5MB each). You can add multiple files per category.

Passport — cover page, bio data page, and signature page *

Photo ID (if different from passport — e.g. national ID card)

Right to Work Document (e.g. visa, BRP, share code, settled status letter)

PVG Certificate (if you hold one)

SSSC Registration Proof (if registered)

Education & Qualifications

Please list your relevant education and any care-related training you have completed.

University / College Education

University or College Name

Dates Attended

Qualification Obtained

Relevant Training Certificates

Training Course

Date Attended

Certificate Obtained?

Yes No

Training Course

Date Attended

Certificate Obtained?

Yes No

Upload Certificates

Upload any qualification or training certificates you hold (e.g. SVQ, HNC, Moving & Handling, Basic Life Support, Medication Administration). This helps us assess what training you already have in place.

Qualification Certificates — JPG, PNG or PDF, max 5MB

Training Certificates — JPG, PNG or PDF, max 5MB

Employment History

Please provide full details of your employment history for the last 5 years. All gaps must be explained — this is a requirement of the Care Inspectorate.

Current / Most Recent Employer

Employer Name & Address *

From (Month/Year) *

To (Month/Year) *

Job Title *

Reason for Leaving *

Main Duties & Responsibilities *

Previous Employer

Employer Name & Address

From (Month/Year)

To (Month/Year)

Job Title

Reason for Leaving

Main Duties & Responsibilities

Gaps in Employment

Please explain any gaps in your employment history

Skills & Experience

Please tick all areas where you have relevant experience. This helps us match you with the right care packages.

Care Settings

Conditions & Client Groups

Clinical Skills

Administration of Medicines Catheter Care Stoma Care Moving & Handling Challenging Behaviour Person Centred Planning Record Keeping Eating Disorder Support

Fitness to Work Assessment

As a registered home care provider, Cecilia Comfort Care has a legal and professional duty to assess fitness to work for all care roles. Our staff work in vulnerable clients' homes, administering medication, providing personal care, and handling confidential information.

🔒 This assessment ensures: client safety — that the people in our care are not put at risk; staff safety — that you are supported and safe in your role; infection control — that vaccination and health status are appropriate for close-contact care; and legal compliance with the Health and Safety at Work Act 1974, Management of Health and Safety at Work Regulations 1999, and Care Inspectorate requirements. Answering ‘Yes’ does not automatically disqualify your application — where appropriate, we will arrange an occupational health referral to discuss support or reasonable adjustments.

Section A — Fitness for Care Duties

#	Question	Response
1	Do you have any condition affecting your mobility, joints or back that may impact moving and handling duties?	Yes No
2	Do you have any heart or circulatory condition that may affect your ability to carry out physical care tasks?	Yes No
3	Do you have any respiratory condition (e.g. asthma) that may affect your ability to work in varied environments?	Yes No
4	Do you experience fainting, blackouts, seizures or episodes of dizziness?	Yes No
5	Do you have any condition affecting your vision that is not corrected by glasses or lenses?	Yes No
6	Do you have any condition affecting your hearing?	Yes No
7	Do you have any skin condition that may be affected by personal care duties or the use of PPE?	Yes No
8	Do you have diabetes or any condition requiring regular monitoring during working hours?	Yes No
9	Do you have any condition affecting your mental health or wellbeing that we should be aware of to support you in your role?	Yes No
10	Are you currently taking any medication that may affect your ability to work safely (e.g. drowsiness, impaired coordination)?	Yes No
11	Do you have any other condition or disability that may require reasonable adjustments in the workplace?	Yes No
12	Have you ever been advised by a medical professional that you are unfit for a particular type of work?	Yes No

If you answered ‘Yes’ to any question above, please provide details so we can assess whether an occupational health referral or reasonable adjustments may be needed:

Section B — Vaccination Status (Required for Care Roles)

Working in care settings requires up-to-date vaccination status to protect both you and the people in your care. All applicants must meet vaccination requirements.

Hepatitis B — Course Date *

Hepatitis B — Booster Due Date

Chickenpox (Varicella) — Have you had this? *

Yes No

MMR / Rubella — Immunisation Date(s) *

Tuberculosis — Have you had TB or a BCG vaccination? *

Yes No

Covid-19 — Vaccinated? *

Yes No

Flu (Influenza) — Most Recent Vaccination Date

Are you willing to receive any additional vaccinations required for the role? *

Yes No

Upload Vaccination Record / Card — JPG, PNG or PDF, max 5MB

Section C — GP Details

Required for occupational health referrals where needed.

GP Name *

GP Surgery Name & Address *

References & Next of Kin

Please provide two employment references and one character reference. References will only be contacted after a successful interview.

Employment Reference 1

Company Name *

Contact Name *

Address & Postcode *

Telephone *

Email *

Employment Reference 2

Company Name *

Contact Name *

Address & Postcode *

Telephone *

Email *

Character Reference (not a family member)

Full Name *

Relationship to You

Address & Postcode *

Telephone

Email *

Next of Kin

Full Name *

Relationship *

Contact Address

Home Telephone

Mobile *

Email Address

Declarations & Agreements

Please read each declaration carefully and confirm your agreement before submitting your application.

Equality & Diversity Monitoring

ℹ️ This information is optional and for monitoring purposes only. It will be kept strictly confidential and will not affect your application.

Gender

Marital Status

Ethnic Background

Criminal Convictions

⚠️ Due to the nature of care work with vulnerable adults, you are required to disclose all convictions including spent convictions under the Rehabilitation of Offenders Act 1974. This is a requirement of the Protection of Vulnerable Groups (Scotland) Act 2007.

Do you have any criminal convictions (including spent)? *

Yes — please give details below No

Details (if Yes)

Declarations

I declare that the information provided in this application is true and correct to the best of my knowledge. I understand that providing false information may result in my application being withdrawn or, if employed, summary dismissal. (Required) I consent to Cecilia Comfort Care holding my personal data for recruitment purposes in accordance with UK GDPR and the Data Protection Act 2018. I understand my data may be held for up to 12 months following an unsuccessful application. (Required) I agree to the Confidentiality Agreement — I understand that information about service users must be held in strictest confidence and never shared on social media or with unauthorised third parties. (Required) 48-Hour Opt-Out — I agree to opt out of the Working Time Regulations 1998 restriction on working more than 48 hours per week. I understand I may cancel this agreement with 4 weeks' written notice. (Optional) Uniform Policy — I accept that I must wear the Cecilia Comfort Care uniform (maroon polo shirt) when on assignment and understand the cost deduction arrangement. (Required)

Applicant Signature

✍️ Please sign in the box below using your mouse or finger. This electronic signature carries the same legal weight as a handwritten signature under the Electronic Communications Act 2000.

Draw Your Signature *

Draw your signature above

Full Name (print) *

Date Signed

✅ Once submitted, you will receive a confirmation email. We aim to respond to all applications within 5 working days.

Application Form