Application Form  Logo
  • Application Form

  • A. PERSONAL DETAILS

  •  - -
  •  -
  • B. NEXT OF KIN

  •  -
  •  -
  • C. DRIVING LICENCE

  •  
  • E. TRAININGS (e.g. Moving Handling, BLS)

    Details of training courses attended, and awards achieved, including dates, if appropriate
  •  
  • F. EMPLOYMENT RECORD

    (Please list chronologically, starting with current or last employer) (Please provide us with 10-year work history/education)
  •  
  • G. CRIMINAL CONVICTIONS

  • H. VALID WORK PERMIT

  • I. EQUAL OPPURTUNITIES AND DIVERSITYMONITORING FORM

  •  - -
  • J. IDENTIFICATION DOCUMENTS FOR A NEW DBS APPLICATION ONLINE*Please follow these instructions toapply online.

    1) Go to www.dbsassist.co.uk/ucheck/applicant/ 2) Username: RAIN24 Password:raintwentyfour (This is case – sensitive)
  • Please bring with you the documents listed below when attending the interview.

    a)      One (1) identification document showing your date of birth (Appendix I, Group 1) and

    b)      Two (2) identification documents showing your current address (Appendix I, Group 2) Two passport size photographs

    c)      Proof of N.I. number

    d)      An affidavit from a solicitor (if necessary) for any employment we are unable to

    reference you for within your 1O year work history up to and including 1996.

    All documents must be originals. They will be photocopied and returned to you. Failure to supply these documents could result in a job offer being refused or dismissal if already employed.

    Group 1

    Valid passport (any nationality)

    UK Driving License (either photo card or paper)

    Original UK Birth Certificate (issued within 12 months of date of birth) (full or short form acceptable)
    Valid Photo identity card (EU countries only)

    Documents showing leave to remain in the UK

    Group 2

    Non-original UK birth certificate (issued 12 months of date of birth) (full or short form acceptable)
    P45/P60 statement

    Bank or Building Society Statement*

    Utility Bill (electricity, gas, water, telephone (NOT mobile phone contract bill) *
    Valid lD License

    Credit card statement*

    Store card statement*

    Mortgage statement**

    Valid insurance certificate**Correspondence or a document from: The Benefits Agency; the Employment Services; The Inland Revenue; or a
    Local Authority*

    Financial statement (Pension, endowment, ISA) **
    Valid Vehicle registration document

    Mail order, catalogue statement*

    Court Summons

    Valid NHS Card

    National Insurance Number card
    Exam Certificates (e.g. GCSE, NVQ)
    Child Benefit Book**

    Connections Card

    Certificate of British nationality
    Work permit/visa**

     

    *Documentation should be less than three months old
    **issued within 12 months

     

  • K. REFERENCES

    Please give the details of two work related referees, including your current or most recent post. Referees will not be contacted without your prior approval.
  •  
  • L. VERIFICATION OF INFORMATION

  • Clear
  •  - -
  • PRE-EMPLOYMENT HEALTH QUESTIONNAIRE

  • Clear
  •  - -
  • Handbook Acknowledgment

    I hereby acknowledge that I have read and understood the requirements provided by RAINBOW STAFFING SERVICES LTD. in this staff handbook. To be sent via Email.
  • Clear
  •  - -
  • ID Badge Acknowledgment

    My signature below confirms that I have received my ID Badge fromRainbow Staffing Services Ltd.
  • Clear
  •  - -
  • TERMS AND CONDITIONS

  • "Health Care Professionals" are introduced by RAINBOW STAFFING SERVICES Ltd. to Hospitals/Clients for each assignment on the following Terms and Conditions, which may vary from time to time.

    Health Care Professionals must have an up-to-date registration with the Relevant Regulatory Authority.
    Health Care Professionals must provide an original Registered Body certificate at the commencement of registration with Rainbow Staffing Services Ltd.
    Health Care Professionals must provide a copy of a valid work permit (where applicable) and Passport at the commencement of registration with Rainbow Staffing Services Ltd.
    Health Care Professionals must always clearly display their Identification Badge whilst on Duty
    Health Care Professionals where applicable, must provide a copy of their letter confirming entry to the Specialist Register.
    Health Care Professionals are obliged to inform Rainbow Staffing Services of any former or pending disciplinary action against them with the Registration Body.
    Health Care Professionals are required to maintain their membership of the
    NMC/GMC/or Indemnity Insurance as applicable.

    Rainbow Staffing Services Ltd. will obtain references for Health Care Professionals on behalf of its clients and reserves the right to submit information contained within this to its clients, in the strictest of confidence.
    Rainbow Staffing Services Ltd. will not be held responsible for any telephone calls, meals, car parking charges, and Travel expense or accommodation arrangements made by the Health Care Professional.
    If Rainbow Staffing Services is your main place of work, you are required to supply our accounts department with a P45.
    Health Care Professionals will be Self-Employed individuals offered temporary work placements from Rainbow Staffing Services Ltd or Health Care Professionals are employed on a variable hour’s contract
    While Staff are Self-employed, National Insurance and PAYE will be deducted according to IR35 and any prevailing legislation or any other relevant information supplied by HMRC.
    Rainbow Staffing Services Ltd. introduces Health Care Professionals to its Clients and is not responsible for any payments made to the Staff in respect to absence due to illness (except those grades covered by the Work Time Directive).
    Health Care Professionals Annual Leave/Holiday Pay is paid as a percentage of your hourly rate, which is inclusive within that rate and is paid on a weekly basis.
    The Health Care Professional is not an employee of RAINBOW STAFFING SERVICES LTD. They will work under the direct control, direction and supervision of the Client throughout their assignment. RAINBOW STAFFING SERVICES Ltd. acts as an Agent to the Client.
    The Health Care Professional agrees whilst on an assignment to any Client to the following:
    a)       To avoid any conduct that may be considered detrimental to the Client or Rainbow Staffing Services Ltd.

    b)       To be present at the place of work according to the duties given by the client.

    c)       To take all required steps to safeguard their own actions and ensure that safety of any other persons who may be affected by their actions.

    Once the Health Care Professional has accepted and has been confirmed for a booking, they are committed to Rainbow Staffing Services Ltd. and its Clients. Therefore, no other bookings should be taken by the Health Care Professional that would prevent them honouring this commitment. Should any other situation arise which prevents the undertaking of the Health Care Profession, a "Reasonable Notice Period" must be given to enable Rainbow Staffing Services Ltd. to find a replacement (Only applicable to Agency Worker).
    a)       If for any reason the Health Care Professional is delayed and will be late for an assignment, they must call Rainbow Staffing Services and Client to inform of the delay. They must phone Rainbow Staffing Services Ltd. directly on 0121 266 1516 and the client to inform them of the delay.

    b)       Should the hours be altered in any way from those notified when the booking was first made, Rainbow Staffing Services Ltd. must be informed immediately. Whilst every effort is made on behalf of the Health Care Professional to ensure no reduction of the working hours is made, Rainbow Staffing Services Ltd. can accept no responsibility should this occur.

    c)       In the event of a last minute or on the day cancellation of bookings or double bookings, Rainbow Staffing Services Ltd. cannot be held responsible for any loss incurred. However, if this is very short notice (less than four hours), representation will be made on the Health Care Professional's behalf for compensation.

    d)       Should a client request the removal of a Health Care Professional due to unsatisfactory conduct, clinical or otherwise, Rainbow Staffing Services Ltd. will not be liable for payment. A full investigation of any complaint will be carried out. The Health Care Professional will receive in writing details of the complaint / allegation within 96 hours.

    e)       In case of a cancellation upon arrival we will compensate you with 4 hours wage.

    The Health Care Professional must inform Rainbow Staffing Services Ltd. forthwith should they accept an assignment at any establishment to which the Health Care Professional was first introduced by Rainbow Staffing Services Ltd Only applicable to Agency Worker). 
    All such arrangements as stated in clause 18 should be informed to Rainbow Staffing Services by the Health Care Professional regardless of whether the client states that they will inform/have informed Rainbow Staffing Services Ltd.
    Payment to the Health Care Professionals will only be made on the hours worked on authorised timesheets submitted (Only applicable to Agency Worker).
    Rainbow will issue Healthcare professionals with company issue timesheets. It is the Candidates responsibility to have their timesheets signed off from the clients to ensure evidence of work done (Only applicable to Agency Worker).
    Timesheets are to be signed for work between Monday to Sunday and are required to be sent via email by the following Monday to be in time for Payroll. Failure to do this will result in the timesheet being processed the following week (Only applicable to Agency Worker).
    The Health Care Professional will be paid in arrears directly into their bank account at the agreed rate of pay made prior to the commencement of the Assignment.
    All payslips will be sent to the most recent email address supplied by the Health Care Professional on the payroll form (an admin fee will be applied to those requesting payslip by post).
    Any extra hours undertaken will only be paid on agreement with the Client.
    The Health Care Professional can opt to be a contractor (limited company) when working on non-NHS contracts, Rainbow Staffing Services Ltd. will not be responsible for the payment of PAYE or National Insurance for all contractors.
    Information will be shared with commissioners and other Government Bodies in line with NHS Framework Terms & Conditions.
    The Health Care Professional is prohibited to working privately with a client introduced to them by Rainbow Staffing Services Ltd. until either a period of 14 weeks has passed since the last assignment from Rainbow Staffing Services with the client, or the client opts to pay a transfer fee according to Rainbow Staffing Services Ltd. Contractual Terms and Regulations (Only applicable to Agency Worker).
    Appraisals are conducted annually for all the staff by Manager.
    Staff Supervisions are supervised by Manager every 3 months.
    Staff Induction will take place before their work start date (vary on each department).
    Spot check can take place by the manager at any time during employees working hours.  
    All staff will undergo probation period from 3 to 6 months depending on their job role and contract of employment.
    All Staff DBS updated service will be checked monthly.
     All staff trainings will be updated annually on HB Compliance (Online) and Practical (Manual Handling & BLS).
    Staff must attend Staff Meetings (Face to face or online).
    Staff must be compliant with TrustID to prove their Right to work in the United Kingdom. 
     

     

     

    I declare that I have read and understood the above Terms & Conditions.

  • Clear
  •  - -
  • DBS Online Update Service (PLEASE FILL IN BLOCK CAPITALS)

  • The DBS now offer an Update Service which you can subscribe to as part of your application. This means that you may need not apply for another DBS. For more information, please visit www.gov.uk/dbs-update-service where you will find the Applicant Guide. If you do subscribe, please advise us as we may be able to undertake future checks using this service.

    Please be aware that you only have 19 days after applying for original DBS to subscribe to the update service.

     Below is a consent form for you to sign giving your permission for us to check your DBS annually via the Update service in the future.         

    Please return this consent form to us.

     

                    Once the DBS has processed your application, only you will be sent a Disclosure Certificate. When you receive this, please bring your original DBS Certificate into the office, and we will make a copy for our records.                                                  It is essential that we receive your Disclosure before the existing Disclosure expires.

    We are unable to offer shifts after the expiry date and any pre-booked shifts will be cancelled until such time as a new Disclosure is received.

     

    If you have chosen to join the update service, please include this completed consent form.

    Please provide us with the following information.

  • DBS Update Service Consent Form

  • I   *      , D.O.B   Pick a Date*   give my consent for Rainbow Staffing Services to use the DBS Update service to carry out status checks for the duration of my registration with the agency.

  • Clear
  •  - -
  • 48 HOUR OPT OUT AGREEMENT

  • I,   *      agree that I may work for more than an average of 48 hours a week.
    If I change my mind, I will give my employer one months’ notice in writing to end this agreement.
    For further advice on the *WTR please see our online legal guide at www.rec.uk.com/legal or contact the Health and Safety Executive.
    *WORKING TIME REGULATIONS

  • Clear
  •  - -
  • Pension Contributions Opt Out Agreement

  • I,   *   [Worker’s name] would like to opt out of making Pension payments through my payroll.
     
    If I change my mind, I will give my employer one months’ notice in writing to end this agreement. Please be aware that you will need to Opt Out of NEST Pensions directly.
     
    For further advice on opting out of your Workplace Pension agreement, please see the following website:
    https://www.gov.uk/workplace-pensions/if-you-want-to-leave-your-workplace-pension-scheme

  • Clear
  •  - -
  • RAINBOW STAFFING SERVICES OFFICIAL UNIFORM SIGN OFF

    My signature below confirms that I have received my Officialuniform from Rainbow Staffing Services Ltd.
  • Clear
  •  - -
  • Consent Form for Blood Test  (For Hospital work only)

  • I,      [Worker’s name] give my consent to Rainbow Staffing Services Ltd for a Health Professional to take my Blood Test for me to work in NHS Hospitals and NHS Community Hospitals.
       

  • Clear
  •  - -
  • Night Shift Health Assessment Opt OutAgreement

  • I,   *   [Worker’s name] would like to opt out of having a Health Assessment by a qualified Health Professional.
    If I change my mind, I will give my employer notice in writing to end this agreement.
    For further advice on Night Shift Worker Health Assessments, please see the following website:
    https://www.gov.uk/night-working-hours/health-assessments   

  • Clear
  •  - -
  • PAYROLL FORM (PLEASE FILL IN BLOCK CAPITALS)

    PERSONAL DETAILS
  • Full Name :         D.O.B.   Pick a Date   
    Email      Mobile         
    Is this your first source of income?         
    Have you worked Since April?         
    Student Loan?     
    Are you registered with an umbrella body?          (If Yes complete section below)
    New Staff    or  I am a current member of staff changing my bank details      
    P.A.Y.E.              or          Private Limited Company*/Self Employed               or      Umbrella Company      
    N.I. Number      
    Employee Number (office use only) _____________________________________________
    Umbrella Company: _________________________________________________________
    Sort Code:      Account Number:   
    Home Address/Umbrella: __    
    ______________________________________________ Post Code: _    
    BANK / BUILDING SOCIETY ACCOUNT
    Name of Bank:      
    Branch:      
    Account Name:      
    Sort Code:      Account Number:      
    (If Personal Account Number includes symbols or spaces, please show clearly)

  • Clear
  •  - -
  • CONSENT FORM

  • I   *   *   D.O.B.   Pick a Date*   with full of my knowledge and understanding, I give my consent to Rainbow Staffing Services Ltd for the following list below for all checks and updates.

  •  
  • I understand that all the information I provide will be treated strict confidence and will be kept confidential to Rainbow staffing services Ltd under the GDPR regulations.

  • Clear
  •  - -
  • GDPR Data Protection Regulations Privacy Notice and Consent form for Employees

    In May 2018, the law changed about how employers record, store and use individual’s personal data.
  • Your consent is requested:
     

    Rainbow Staffing Services would like your consent to hold personal and epical data about you in order to complete your employment contract. You are entirely in control of your decision to give consent to Rainbow Staffing Services to use your data as requested in this form. There will be no repercussions if you choose to withhold consent however, without some data Rainbow Staffing Services may not be able to make a decision on your suitability for employment or comply with the law and therefore Rainbow Staffing Services may not be able to make an offer of employment.

     

     

  •  
    Type of Data 

    How Long it will be kept for

    1)Recruitment data:

    Previous experience, skills and qualifications

    This will allow Rainbow to decide on your suitability for employment
    Data will be kept for the duration of your employment with Rainbow. When your employment is completed, it will be destroyed after 6 months.

    2)Recruitment Data:

    Convictions. This is classed as ‘special’ data under GDPR and is more strictly controlled.

    This will allow Rainbow to decide on your suitability for employment.
    Data will be kept for the duration of your employment with Rainbow. When your employment is completed, it will be destroyed after 6 months.

    3)Your personal details:

    Name, address, etc.

    This enable Rainbow to comply with the law and maintain correct employment records.
    Data will be kept for the duration of your employment with Rainbow. When your employment is completed, it will be destroyed after 6 months.

     
     
    Type of Data

    How Long it will be kept for

    4)Next of kin and their contact details

    If there is an accident, then Rainbow can contact your emergency contacts.
    Data will be kept for the duration of your employment with Rainbow. When your employment is completed, it will be destroyed after 6 months.

    5)Health/ Disability information and details of your GP.

    This is classed as ‘special’ data under GDPR and is more strictly controlled
    So that Rainbow is aware of any medical issues you may have, can make provision for these in your work and know who to contact if you have a medical episode.
    Data will be kept for the duration of your employment with Rainbow. When your employment is completed, it will be destroyed after 6 months.

    6)Financial Information:

    Bank details, Tax Codes, NI number etc.
    This will allow Rainbow to comply with the law and register you as an employee with HMRC and share with HMRC how much Rainbow pay you.
    Data will be kept for the duration of your employment with Rainbow. When your employment is completed, it will be destroyed after 7 years+. (HMRC may keep the data for up to 7 years).

    7)Financial Information:

    Tax Codes, NI number etc.
    Rainbow will need to share this information with Rainbow’s payroll service in order to calculate what Rainbow needs to pay you.
    Data will be kept by the payroll service for 7 years.

    8)Financial information:

    Bank Details and Salary payments
    Rainbow will need to share this information with the Holding account provider so that they can pay your salary to you on Rainbow’s behalf. (n/a if you don’t use a holding account.)
    Data will be kept by the Holding account provider for 7 years.

  •  
  • Sharing your data:

    Rainbow Staffing Services need to share your data with third party outside agencies such as various health services which can support you.
  •  
  • Agreement to use my data

    I hereby freely give my employer ‘Rainbow Staffing Services’ consent to use and process my personal data relating to my employment.

    In giving my consent:

    I understand that I can ask to see this data to check its accuracy at any time via a request.

    I understand that I can ask for a copy of the personal data held about me at any time, and that this request is free of charge.

    I understand that I can request that data is no longer required to be held can be removed from my file and destroyed.

    I understand that if I leave my employment, my data will be destroyed after 6 months, or if longer this is stated above.

    I understand that you are the Data Controller for my employment, and I can contact you directly if I have any questions or concerns about my data.

    I understand that if I am dissatisfied with how you use my data, I can make a complaint to the government body in charge (Information Commissioner’s Office, Wycliffe House, Water Lane, Wilmslow, Cheshire SK9 5AF or online at www.ICO.org.uk)

  •  
  • Clear
  •  - -
  • Should be Empty: