• Application Form

  • Format: (00000000000).
  • Date of Birth
     - -
  • Do you have a full driving licence?
  • Do you have access to a car for work
  • Do you have any driving endorsements ?

  • Employment History 

  • Employed from to

  • Employed from to

  • Employed from to

  • Employed from Employed to .

  • If we require further employment history would you be able to provide it?

  • References

    Please insert your current/most recent employment referee first
  • How many hours approximately are you looking for each week?
  • If you are successful at interview, would you be able to provide suitable references including your last employer?

  • Rehabilitation of Offenders Act Due to the nature of this post, you must reply to this question by virtue of the Rehabilitation o Offenders Act 1974, Section 2.4 (exemption order 1975) meaning you must declare any convictions, cautions, reprimands or warnings you have ever received, even those which would normally be considered spent, under the provision of the act and event of employment. Any failure to disclose such convictions could result in dismissal or disciplinary action. All information given will be completely confidential. A criminal record is not necessarily a bar to employment.

  • Have you ever been cautioned or convicted of any offence?
  • Have you ever been dismissed or suspended from any post because of a safeguarding issue?
  • Are you currently under any investigation because of your conduct or performance?
  • Is there any charge against you that remains to be dealt with by any court?

  • If you are successful at interview and you have answered yes to any of the above, you will be required to complete additional information

  • Are you registered with the NMC?
  • Are you subject to any sanctions under a regulatory body? i.e.(NMC)
  • Are you a member of the PVG Scheme?

  • I can confirm that all the information provided here is correct and iI am unaware of any incidents that have occurred that may give rise to or have caused my inability to pass a PVG check. I agree to have a PVG membership or update Scheme record check and understand that any payment made for processing of my PVG is not refundable

  • All businesses are required to be GDPR (General Data Protection Regulations) compliant.
    Gold Healthcare fulfills our obligations under these terms to our staff and clients and reassure you that we only share your information when it is necessary to do so to meet our legal, contractual and employer requirements.
    These include:
    ** Regulators and statutory bodies (e.g. HMRC, Care Inspectorate, Scottish Social Services Council, Nursing and Midwifery Council).
    ** Software providers which allow us to operate efficient digital processes, including:
    ** Logezy
    ** Microsoft
    ** Care Skills Academy
    ** Disclosure Scotland
    **Our external IT support provider - James Hayward
    **Highland Accountancy Practice
    For practical reasons, this is an indicative, but not exhaustive list. Please also note that the list may be updated from time to time.
    The Data Protection Policy is kept at

    Gold Healthcare Head Office
    Stirling Suite, Castle House 
    Fairways Business Park
    Inverness
    IV2 6AA

    Additional copies are available on request.

  • Skills and Experience - Please indicate your level of proficiency according to the scale below
    Rows

  • TRAINED STAFF SKILLS CHECKLIST 

  • Have you had recent experience as a Clinical Nurse in a care home setting, including undertaking regular medication administration?
  • Have you had recent experience in NHS/Private Hospital?
  • Are you familiar with the responsibilities you have to deliver care under the NMC Code of Practice and appropriate care standards that apply to your area of work? (I.e. Care inspectorate)
  • Are you willing to abide by these standards and maintain your Revalidation requirements?
  • Self assessed skills: Please indicate the level of proficiency you believe to be competent to according to the scale below.
    Rows
  • Do you feel competent to deliver basic life support?
  • Applicant's Declaration:I agree that this is a true self-assessment of my level of competency in the areas scored above. I can confirm that i will undertake to uphold my revalidation requirements and that i have appropriate (recent) experience and competency to work in the following  areas:
  • Are you a non-medical nurse prescriber?
  • Are you able to verify expected death?

  • Equal Opportunities


  • Gold Healthcare operates an equal opportunity policy.

    As part of this policy we welcome applicants from all parts of the community.

    It would help us if you would answer these questions which help us monitor how effective our policy is.

    We treat this information you give us in confidence and we will not use it as part of the recruitment process.

  • Please choose which best describes the ethnic category you belong to
  • I am
  • Date
     - -
  • Should be Empty: