Hazelhead Homecare Ltd providers of Care at Home and Housing Support Services across Central Scotland Providing Care at Home and Housing Support Services since 1995

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What vacancy are you applying for?

Where would you like to work?

How did you hear about this vacancy?

Your Details

Do you hold a full UK Driving License?:


Do you own and have a car available to use for work?


Qualifications and Experience

Do you have any qualifications relevant to the vacancy?


Do you have any previous experience in providing care for someone?


Have you previously worked for a care company?


If Yes, please give brief details including dates and the name(s) and address(s) of the care company(s)


Are you working at present?


If your application is successful, when are you available to start?

Do you have any holidays booked?


Employer Details

Please list your previous employment. Please start from your current or most recent employer? Please provide a full employment history and provide details for any periods of unemployment (do not leave any gaps between employment dates). You may add rows if required

Employer Details 1

Add another employer?


Employer Details 2

Add another employer?


Employer Details 3


Please provide the names and addresses of TWO suitable referees. PLEASE NOTE- No references will be accepted from any family members or relatives or family/personal friends. Suitable personal/character referees must be from professional persons only.


Referee 1 : Current or Most Recent Employer

Referee 2

Please note as a prospective employer, as part of your application, additional references may be sought from any of your previous employers in addition to the referees listed above. Please advise of any employer you do not wish us to contact stating your reason for not contacting:

Registrations and Memberships

Have you been previously registered with the Scottish Social Services Council (SSSC) or other Professional Body?


If Yes, please provide your Registration/Membership Number:

Applicable part of Register:

Are you currently registered with the Scottish Social Services Council (SSSC) or other Professional Body?


If Yes, please provide your Registration/Membership Number:

Applicable part of Register:


Do you have any family or close relationship to an existing employee and/or to any individuals or relatives of people who use our services?

PVG Scheme Membership

Due to the nature of our industry, all applicants must also be willing to become members of the PVG scheme.

Are you currently a member of the PVG scheme?


If yes, please provide your PVG number and membership type e.g. Adults, Adults & Children etc.


Do you have a disability?


If offered a post, would you require any special adjustments to be made in order for you to carry out the job as described in the job description and/or person specification.



How many hours a week would you like to work?

Our support services are provided 7 days per week throughout the day between 07.00am and 11.00pm and include evening and weekend working. Standard working requirements for homecarers, are five days each week for 30 plus hours and 4 days per week for hours less than 30 hours. For 30 plus hours, you will require to have suitable availability to be allocated sufficient shift patterns to achieve 30 plus hours.

Criminal Convictions

Have you ever been convicted of any Criminal Offence?


Please Note

Due to the nature of the work that you are applying for, this post is exempt from the provisions of section 4(2) of the Rehabilitation of Offenders Act, 1974 by virtue of the Rehabilitation of Offenders Act 1974 (exemptions) order, 1975. applicants are therefore not entitled to withhold information re convictions which for other purposes are ‘spent’ under the provisions of the act, and in the event of employment, any failure to disclose such convictions could result in dismissal or disciplinary action by the company. Any information given will be completely confidential and will be considered only in relation to an application for positions, which the order applies.

Personal Statement

Please provide below, a personal statement which details your personal qualities and experience that you feel are relevant and support your suitability for the post to which you are applying. Your statement should also include how you feel you meet the person specification for this post.

Please use the space below to tell us your hobbies and interests

By Submitting this form, I confirm that all information contained within this application form is true and correct. I understand that any misrepresentation or false information provided by me or not disclosed by me will invalidate my application and, if found to contain invalid or undisclosed information following employment, could lead to the termination of my employment. I am prepared to undergo a medical examination if required, and confirm that to the best of my knowledge there are no medical reasons that would prevent me from undertaking the duties of the post as listed in the job description and person specification related to this post.

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Our office locations across Central Scotland

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South Lanarkshire Office

21 Braidwood Road,
Braidwood, Carluke,
ML8 5PD ( Head Office ) SouthLanarkshire@hazelhead.com

01555 771185 fax 01555 771459
North Lanarkshire Office

2C Napier Place,
Wardpark North,
Cumbernauld, G68 0LL NorthLanarkshire@hazelhead.com

01236 739947 fax 01236 738728
Ayrshire Office

22 Mill of Shield Road,
Drongan, East Ayrshire,

01292 269100 fax 01292 267452

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