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Do you have the right to work in the UK? *
Work Permit Number (If Applicable)
National Insurance Number *
Do you hold a current UK driving licence? *
Do you have use of a car? *
Next of Kin
Telephone Number (Home)
Telephone Number (Work)
Are you registered with any other agencies?
How did you hear about Next Generation Staffing Group?
Next Generation Staffing Group is an equal opportunities employer, and these questions are asked solely for the purpose of ensuring that all applicants can be considered on an equal footing.
How many sick days have you had in the past 2 years?
Are you currently suffering from any illness or taking any prescribed medication?
If Yes, please give details
Have you been in recent contact with MRSA?
Have you ever suffered from back problems?
Have you ever undergone any majos surgery?
Date of last chest X-Ray
Have you travelled outside the UK?
Do you consider that you have a disability?
Full employment history back at least 10 years should be given, with any gaps fully explained.
Feeding a Helpless Patient
Use of Bath Aids
Ensuring Pressure Areas are Healthy
Mouth Care (including dentures)
Ensuring Medication has been taken
Care of Feet (including toenails)
Washing of Personal Laundry
Dressing/Undressing of Patients
Changing a Bed/Drawsheet with patient in/on it
Sitting With a Terminal patient
Care of Hair
Dealt with Relatives of ill and terminally ill patients
Care of Fingernails
Observing Client Confidentiality
Care of Eyes
Care of Bladder and Bowels
Record Instructions from GP/District Nurse
Use of Bedpans/Commodes
Observe Changes in Patients/Clients condition and Report to person in charge of care
Emptying a Catheter Bag
Simple Dressing Procedure
Changing a Colostomy Bag
Recording Fluid Balance
Moving and Handling Patients
Experience in Hospice
Use of Walking Aids
Experience with Dementia
Use of Hoist
Experience in First Aid
Moving and Handling Course
Assisted with Last Offices
Assisted with return of a patient from the operating theatre
Assisted with Care of a Patient after return from an Operating Theatre
Assisted with Occupational Therapy, including Recreation, Sports and Play
Answered the Telephone, Taking, Recordingand Conveying Messages
Obtain Simple Specimens
Preparation of Meals
Enhanced Auxiliary Skills Course (Derriford)
Administering Epilepsy Medication
Administering Insulin Injections
Control and Restraint
NVQ in Care
Abuse of Elderly Awareness
Deputy Manager Experience
Other (please give details)