Care Assistant Home
Resume:
The information supplied on this application form will be treated as strictly confidential and will be used only for the purpose of personnel administration.
If you are successful in your application you will be required to provide relevant evidence of all of the details you provide in this application prior to your appointment.
Job Title:
Care assistant
Last Name:
Saleem
First Name(s):
Riffat
Previous Name:
From / To:
-
Home Address:
34 Bridgewater Crescent dudley
Home Post Code:
Dy2 7lu
Home Telephone No:
Please tick the best way we can contact you:
Home Telephone
Work Telephone No:
Work Telephone:
Mobile Telephone No:
Mobile Telephone:
Email address:
******.********@*****.***
Email:
As part of of the Asylum and Imigration Act 1996, we are required to establish your eligability to work in the UK. Please provide your N.I. number here for that purpose
National Insurance No:
Ss-46-85-06c
Are you free to remain and take up employment in the UK with no current immigration restrictions?
YES
NO
Protection of Vulnerable Adults
The following information is required for the post you are applying for. We will request Disclosure & Barring Service (DBS) clearance before offering this post.
Are you aware of any police enquires undertaken following allegations Yes No
made against you, which may have a bearing on your suitability for this post?
Rehabilitation of Offenders Act (1974)
The post for which you are applying is exempt from the provisions of the above Act. You are therefore not entitled to withhold any information about convictions you may have had including any “spent” convictions. Any information you do disclose will be kept in strict confidence and will be used only in consideration for your suitability for the post for which you are applying. In the event of employment, any failure to disclose convictions may result in disciplinary action or dismissal. You must also disclose if you are currently subject to any kind of probation or supervision order.
Do you have anything to disclose? Yes No
If you have ticked yes, please place full details of the offence and outcome in a sealed envelope and attach the envelope to the Employment Equal Opportunities Diversity Monitoring Form.
Do you have a valid UK driving licence?
Yes No
Do you have access to a vehicle to use during the course of your working duties and are you prepared to use your vehicle to undertake work duties?
Yes No
If you have any endorsements, please give details:
Notice period required by current employer:
Bridgewater home care sandwell
If the Company has interviewed you previously, please state for which post and when:
Care assistant 16th may 2025
If offered this position, will you continue to work in any other capacity (including Voluntary commitments) for any other organisation?
Yes No
If YES please give details:
How many hours do you want to work?
8-15 16-30 30+ Full-time
EMPLOYMENT RECORD
In accordance with the Care Quality Commission you must provide full details of present and past employment. Please begin with your current or most recent employer, include all jobs since leaving full time education. To enable us to establish full employment history please don’t leave any gaps without explanation.
Present Employment (If now unemployed give details of last employer)
Name of present / most recent Employer:
Nationwide care service
Position held: care assistant
Address of present / most recent Employer:
Trafalgar house 47-49 king street dudley
DY2 8PE
Month
Year
From
09
2021
To
12
2021
Final wage:
Telephone Number:
Web site address:
Summary of main duties:
Workingwith clients and professional to gain an understanding of practical, physical,mental health and social need
Assistant clients with daily personal care
Carrying out everyday tasks including domestic duties such a cleaning general comfort and well-being
Providing breakfas and,making tea and toast and serving cereal
And medication
Reason for leaving:
I was pregnant
Required notice period:
Previous Employment
Name of Employer:
Position held: care assistant
Address of Employer:
Month
Year
From
09
2021
To
12
2021
Final wage:
Summary of main duties:
Reason for leaving:
Previous Employment
Name of Employer:
Position held:
Address of Employer:
Month
Year
From
To
Final wage:
Summary of main duties:
Reason for leaving:
Previous Employment
Name of Employer:
Position held:
Address of Employer:
Month
Year
From
To
Final wage:
Summary of main duties:
Reason for leaving:
Previous Employment
Name of Employer:
Position held:
Address of Employer:
Month
Year
From
To
Final wage:
Summary of main duties:
Reason for leaving:
Previous Employment
Name of Employer:
Position held:
Address of Employer:
Month
Year
From
To
Final wage:
Summary of main duties:
Reason for leaving:
Education & Training
School & Qualifications Gained
Name of School
Subjects studied
Qualification & grade
Date achieved
Government girls college chechiyan
Pakistan
Mirpur
Sonic English maths home economics and urdu
Level 9
2006
Further/Higher Education Summary
(please start with most recent qualification first and then add in descending date order)
Name of College/Polytechnic/ University or Professional Body
Subject Area
Qualifications e.g. GCSE, O, A, BA, BSc, etc., & Membership Grade
(Please state if membership gained by examination)
Grade
Date
Roseland house Dudley
Jessons Primary School Dudley
English and maths
ESOL
Functional skills in English and maths
Entry 1 level 1
2014-2015
Same
DATE
Membership of Professional / Educational Bodies
Name of Organisation
Specialism
Registration No.
Date Registered
Training & Development
(please include all mandatory training you have completed & the date the certificate was awarded – this section is where you would include any training for First Aid, Fire Safety, Health & Safety, Infection Control, etc.)
Title of Training Programme or Course
Duration of Course
Date Achieved
How would you rate your computer literacy at this current time?
Non-existent
Very basic
Average
Good
Excellent
Personal Statement
As a candidate to become a part of the Bridgewater family we really want to get to know more about you!
It would be great if you could tell us about your hobbies, what you enjoy, what motivates you and anything else you might think would support your application.
You can split your personal statement submission into the below areas:
a.Previous knowledge and experience
b.Skills and abilities
c.Attitude & motivation
d.How you have promoted dignity for service users
e.Your knowledge of the Care Quality Commission’s Key Performance Indicators
f.Other information in support of your application
Please use the space below.
I’m a loving, respectful, and naturally kind person who truly enjoys helping others. Being a mother has shaped me in so many positive ways — it’s taught me to listen deeply, understand people’s needs, and approach every situation with patience and care. These are qualities I carry with me in my work, especially in care, where empathy and trust really matter.
I’ve had experience working in the care sector and feel confident supporting others with dignity and compassion. I’m not afraid to make decisions when needed and always try to do what’s right for the people I’m looking after. I have some knowledge of Care Quality Commission (CQC) standards and key performance indicators, and I’m keen to keep learning and growing in this area.
For me, caring isn’t just something I do — it’s part of who I am. I’m motivated to work in a role where I can make a positive difference and be part of a team that shares the same values.
PROFESSIONAL REFERENCES
Please provide details of two referees who can provide information relating to your competency in a caring role, one of whom must be your present or most recent employer (referees for qualified Nurses must be professionals). If you are a student, please give an academic referee. If you are applying for a post which requires unsupervised access to children/vulnerable adults, the company reserves the right to approach any past employer for a reference.
1.
Name: Ayesha Iqbal
Email address
****@********************.**.**
Friend
2.
Name: Sahna Iqbal
Email address
*****.*****@***.***
Position: Nursing Director
Position: register Nurse
Organisation: Harley Skin Aesthetics
Organisation: NHS
Address:
467 Brook Ln, Birmingham,
Postcode: B13 0BT
Address:
15 Harlow Grove
Postcode: b28 9qa
Tel No: 074**-******
Tel No: 078********
May the company approach the above prior to interview? Yes No
May the company approach the above prior to interview?
Yes No
PERSONAL REFERENCES
Please provide details of three referees who can provide information relating to your character. This can include friends, neighbours, work associates, or a trusted professional (i.e. teacher, doctor, religious leader etc)
1.
Name: Ahmed Majid
2.
Name: Rukhsana mubarik
Email: ***********@*******.***
Email: *********@******.***.**
Relationship: Friend
Relationship: friend
Address:
39 hazelville road
Postcode: b28 9py
Address:
259 sarehole road hall green
Postcode: B28 0AH
Tel No: 075********
Tel No: 077********
May the company approach the above prior to interview? Yes No
May the company approach the above prior to interview?
Yes No
3.
Name: samina kousar
4.
Name:Rekha rani
Email: *****************@*******.***
Email:*********@*****.***
Relationship: friend
Relationship:friends
Address:
463 stourbridge road brierley hill
Postcode: DY5 1LB
Address:
68 maple road dudley
Postcode: DY1 4HH
Tel No: 079********
Tel No: 073********
May the company approach the above prior to interview? Yes No
May the company approach the above prior to interview?
Yes No
DECLARATION
I confirm that the information I have given on this form is correct and complete, and I understand that misleading statements may be sufficient grounds for cancelling any agreement made.
I give my consent to the processing of data contained or referred to on this form in accordance with GDPR.
Name: Riffat Saleem
Signature: R.saleem
Date: 20.05.2025
Do you have a spouse, partner, relatives or friends employed by our company? If so, please state name and relationship:
Contact this candidate