Personal Assistant Application Form Submission 

Title *: Mrs. 
First Name *: 
Address 1 *: 
Address 2: 
Town *: Pontyclun 
County *: RCT 
Postcode *:  
Phone number *:  
Please enter your email address for submission confirmation. * 
Reference number of job being applied for *:
I confirm that I have the right to work in the UK and am able to prove my eligibility status when required to do so. *: Yes 
Please read the Job Description carefully before providing information in this Section of the Application Form. Give details of your previous employment or experience which you think would help you to do this job. *: I am qualified to Masters level Have Registered General Nurse qualifications. I have specialised in medical and palliative care nursing in hospitals and on community. I have retired but my last post was at Maesteg General Hospital which involved caring for mainly elderly patients to rehabilitate where possible in preparation for home. Previously I worked for the Early response Team which involved responding to requests from GP,a and other health professionals to assess people for health and social care at home and arrange care and/ or other services. This involves a full medical assessment and examination and personal care at times when required. 
What qualities do you think are important when working as a personal assistant with a disabled person? *: I have been a registered nurse for over 40 years and have enjoyed all my nursing posts. I particularly enjoy using an enabling approach to facilitate independence and rehabilitation and for the client to reach their full potential. I am very patient and work with clients to establish their needs and involve them in a care plan which will best suit them. I have assisted clients with communication using various sign charts which have been personalised for their specific needs, and with Motor Nuerone clients have learnt to be particularly observant to whatever signals they can manage in order to communicate effectively. Documentation and attention to detail are very important to maintain safety and accurate records of care and requirements. Establishing a rapport with clients enables a trusting relationship to be built up so that the client can be safe, cared for, but maintain their character and independence as much as they are able. 
How do you think you can contribute towards the needs and the independence of a disabled person? *: My aim is to listen to the client and establish their needs and requirements and to evolve a plan of care that enables the client to reach their desired potential. I am an effective listener and communicator and an used to speaking to many disciplines by telephone,face to face and by e mail or in writting. 
What is it about PA work which appeals to you? *: I would look forward to working closely with a client and being involved in assisting them to continue an independent life style. 
What are your hobbies/interests?:I enjoy walking especially in forestry or sea side kications. I enjoy swimming though lately I have not kept this up due to the covid restrictions. I like all forms of art, and have commenced watercolour and drawing classes. I also enjoy photography, music, and cinema or stage plays and musicals. 
Would you consider a casual position if you are unsuccessful with this job? *: Yes 
Do you drive? *: Yes 
Are you a vehicle owner? *: Yes 
Do you smoke? *: No 
Are you able to undertake training? *: Yes 
What days/nights are you able to work, or prefer to work? *: Any days but would like part time hours please . 
Are there any circumstances which would prevent you from providing cover or swapping a shift? *: No 
If you would like to expand on the answers given above? Please use the box below.:With the exception of illness. 
Name *: 
In what capacity do you know this person (should not be a family member)? *: Li
Is there is any such information you wish to disclose, relating to any cautions or convictions which will appear on your mandatory DBS check? *: No/ 
Please provide details if necessary: 
I agree that there is nothing which would prevent me from doing this job. *: Yes 
I consent to the above *: Yes 
I agree that the information I provide will be posted to the Dewis CIL PA noticeboard (all personal information will be withheld).: Yes 
What geographical area’s are you able to cover?: I am based in Llanharran. I would be able to cover this area and BeddauLlanharranLlanharryPontyclunBrynnaLlantrisant andPencoed areas 
How many hours of work can you offer per week?: 16 
Please indicate the approximate times that you are available for work throughout the week.: Monday AM/Monday PM/Tuesday AM/Tuesday PM/Wednesday AM/Wednesday PM/Thursday AM/Thursday PM/Friday AM/Friday PM/Saturday AM/Sunday AM/ 
Further Information: