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Page 1 of 15 Recruitment Pack Chief Executive Officer Please find enclosed the following documents. 1. Message from the Chair 2. About Age UK Staffordshire 3. How we are funded and expense funds 4. Strategic Objectives 5. Governance 6. CEO Brief + Job description + Person specification 7. How to Apply 8. Privacy Notice Appendix 1 – Boundary Map of Staffordshire Appendix 2 – AUKS Annual report & accounts YE 31 st March 2020 Appendix 3 – AUKS Application form Appendix 4 – Equality & Diversity monitoring form Closing date: 11th June 2021 Interviews: w/c 14 th June 2021 Return completed applications to David Hole – Interim CEO at [email protected]

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Page 1 of 15 

 

Recruitment Pack

Chief Executive Officer

Please find enclosed the following documents.

1. Message from the Chair

2. About Age UK Staffordshire

3. How we are funded and expense funds

4. Strategic Objectives

5. Governance

6. CEO Brief + Job description + Person specification

7. How to Apply

8. Privacy Notice

Appendix 1 – Boundary Map of Staffordshire

Appendix 2 – AUKS Annual report & accounts YE 31st March 2020

Appendix 3 – AUKS Application form

Appendix 4 – Equality & Diversity monitoring form

Closing date: 11th June 2021

Interviews: w/c 14th June 2021

Return completed applications to David Hole – Interim CEO at

[email protected]

Page 2 of 15 

1. Message from the Chair We are looking to appoint a new CEO from either within or outside the Age UK commu-nity to work with the Trustees on the next stage of the development of the Charity. As part of the brief for the incoming CEO, we want someone who can work with the Trus-tee Board, Senior Management Team, staff and volunteer team, our partners, service us-ers and the community so the charity has the maximum impact on improving the lives of elderly people in the community. A charity background is desirable but not essential, we are open to high quality leaders who are looking for a new direction, especially reflecting on the experiences of the pandemic. Over the next 6 months, the priority for the Trustees and CEO will be to determine the future strategy as we emerge from the covid crisis. Despite the challenges ahead the charity’s mantra is to ‘Build Back Better, so we can support elderly people in the commu-nity. The CEO will help shape that strategy and be responsible for its implementation. As a local Age UK covering the county of Staffordshire (at Appendix 1 is a boundary map of Staffordshire), we want to be champions for:

Being the first point of contact for older people. Delivering services that both meet needs and are person centred. Tackling loneliness and isolation

We are recognised as successfully achieving the national Age UK Charity Quality Stand-ards. You will be working with the Senior Management and Leadership team ensuring our day-to-day quality and financial management is sustained while reviewing what is next for the Charity. Stuart Clapham Chair of Trustees 2. About Age UK Staffordshire Age UK Staffordshire was formed in 2018 from the merger of three Age UK Brand Part-ners: South Staffordshire, North Staffordshire, and Burton on Trent. Together it has served Staffordshire for over 40 years delivering a wide range of trusted, high quality services to people aged 50+ as they enter later life, and we are committed to making sure that we can make later life a fulfilling and enjoyable experience for everyone. In addition, there is a dormant trading company – Age UK South Staffordshire Trading Limited

Page 3 of 15 

The charity’s services are diverse and include. Information and Advice – This vital service is in the process of being brought back.

The service is currently provided by Age UK National Advice Line. Age UK’s advice line is a free, confidential national phone service for older people, their families, friends, carers, and professionals. Their team of expert advisers provide infor-mation and advice that covers every facet of later life, from helping people find out the benefits they are entitled to claim, to discussing options that help make later life at home more manageable. You can also visit the national Age UK website here: https://www.ageuk.org.uk/

Contracts with statutory authorities to deliver Day Care support for older people, both at home and at our centers.

An individual can receive person-centered care from Age UK Staffordshire's trusted and experienced Day Opportunities team. Individuals with dementia, physical disabilities or other complex needs can continue getting support when other healthcare services are not operating due to Covid-19. No need to travel - our Day Opportunities team will travel to the individual's home, rather than the individual being collected by our transport team. This keeps contact and Covid risk to a minimum. See at - https://www.ageuk.org.uk/staffordshire/our-services/day-opportunities/

Help at Home - across Staffordshire

What do we offer across Staffordshire? - Home help for shopping, cleaning, washing & ironing, meal preparation, making tea or coffee, arrange appointments, general monitoring to prevent social isolation, companionship, help with reading or other hobbies and crafts, monitoring of diet and fluid intake, prevention of so-cial isolation, reminiscence & conversation.

Who is the service for? - Individuals or couples living independently, living in our catchment area

See at - https://www.ageuk.org.uk/staffordshire/our-services/helpathome/ Care Navigation – The right care at the right place, at the right time.

This service helps older people to stay healthy, safe, and independent in their own home. By working alongside local health care, social care, and third sector teams, our Care Navigation team can provide 'supported signposting' to enable older peo-ple to live more independent, healthier lives.

Care Navigation brings all the professionals together in one place. This enables access to the right information so we can help older people to get the right care, at the right place, at the right time.

See at - https://www.ageuk.org.uk/staffordshire/our-services/care-navigation/

Page 4 of 15 

Social Prescribing / Independent living coordination

An Independent Living Coordinator from Age UK Staffordshire works with GPs and practice staff in North Staffordshire to support older people with non-medical is-sues. The support we give helps to minimise hospital admissions, maximise older people's income and independence, and reduce social isolation.

We make a home visit to meet with the client and initiate a ‘guided conversation’ to help identify the things they need help with and agree a support plan. This could include social opportunities, practical arrangements - such as assisted bin collec-tions or Blue Badge applications, benefits’ applications, supported signposting to other agencies.

See at - https://www.ageuk.org.uk/staffordshire/our-services/working-with-local-gps-in-north-staffordshire/

Veterans support in Staffordshire

What support is available? - Home deliveries of essential items, home deliveries of books, magazines, newspapers, activity packs, Wellbeing telephone calls – check-ing in on how you are, 1 to 2 hours support at home by experienced trained staff to support you with activities of your choice, collect/deliver prescriptions, Meal deliv-ery, signposting to other organisations, Help find professionals to undertake emer-gency home repairs. See at - https://www.ageuk.org.uk/staffordshire/our-services/veterans/

Charity shops located at Longton in Stoke on Trent and in Stone

Whether you are having a clear out or after a bargain, every penny we raise at our Longton & Stone charity shops helps us to continue supporting local older people. Through every penny of the proceeds from our charity shop, we can help older people make more of life and contribute towards a thriving local community.

59 The Strand, Longton, Stoke-on-Trent. ST3 2NS

53 High Street, Stone, Staffordshire. ST15 8AD See at - https://www.ageuk.org.uk/staffordshire/about-us/

Community Engagement Forums and workshops.  

Campaigning and championing the voice of older people. Further detail regarding our work and impact can be found in the attached annual report 2019-20 – Appendix 2. For further information about our work visit: https://www.ageuk.org.uk/staffordshire/  

Page 5 of 15 

2.1 Working with and on behalf of local older people. Involvement and seeking and listening to the views of local older people, including:

Participating in National Campaigns Influencing our MPs and local government Managing relationships with CCG’s and NHS Managing collaborative relationships with neighboring Age UK brand partners Informing local media and working with Age UK on National media Linking with District Older Peoples Forum’s and using every opportunity to work

with the many local organisations and decision-making groups, to ensure that our people and communities are equipped to make the most of later life.

3. How we are Funded and Expense funds In 2019/20… Our total income resources were £2,308k and total expenditure £2,448k.

Draft accounts for the year ended 31st March 2021 indicate a modest surplus, despite being during the pandemic. This is an exciting time and an opportunity for the successful applicant to join Age UK Staffordshire. Priority areas for the new CEO include.

To guide the Charity to build back better, following the pandemic. To work with the new board of trustees on strategic planning. To identify new AgeUK services & diversify income sources. To collaborate with neighboring brand partners &/or complimentary organisations

to share core costs, service delivery and funding bids. To balance IMPACT with financial sustainability.

4. Strategic Objectives The Charity is working with an Interim CEO who is providing executive leadership and financial modelling of the charity in the short term. A new CEO upon appointment will vision and co-produce a new medium – long term strategic plan.

2020 Total £ 

Income from:   Donations and legacies  83,473 

Charitable activities  2,127,324 

Other trading activities  97,288 

Investments  572 

Total income  2,308,657  

Expenditure on:   

Raising funds  68,920 

Charitable activities  2,379,154 

Total expenditure  2,448,074  

Net (expenditure)/ Income  (139,417) 

Page 6 of 15 

The current Core Strategic Objectives are:

1. Deliver high quality services 2. Work with our local communities 3. Influence & Campaign 4. Raise our profile 5. To be sustainable

The new CEO will have to work with the trustees to develop new objectives for the next 3 years. 5. Governance Age UK Staffordshire is registered with the Charity Commission. It was established under a Memorandum of Association and is governed by its Articles of Association. The directors of the company are also the charity trustees, and the Board is diverse and represents people from across the Staffordshire Region. New employees joining AUKS undergo a comprehensive induction and training is available via Age UK, nationally and locally. The charity has very passionate and hugely committed staff, volunteers and trustees who make a difference every day to the lives of older people in the Staffordshire region. We currently employ 188 members of staff (87 FTE) and 25 volunteers to deliver our work. The Charity’s operation is delegated to the Chief Executive Officer. 6. CEO Brief + Job Description + Person Specification

We are looking for a CEO that has a suite of skills which enables them to sustain the positive culture of the organisation whilst leading a strategy refresh and developing struc-tures to support that strategy. We are looking for somebody who understands the leadership traits of being a CEO and will be:

A good listener – who can walk the floor and quickly identify what the key issues are, whilst building relationships internally and externally.

A good people manager with high levels of emotional intelligence. An excellent stakeholder relationship builder with commissioners, local partners,

and our local Age UK neighbours’. A highly visible, present, and inclusive leader A strategic thinker who can look at where we are, where we need to get to and how

we are going to get there. To achieve balance between IMPACT and financial sustainability

The successful candidate needs to demonstrate:

strong analytical skills - especially the ability to interpret and manage using financial data, KPIs, and driving operational improvement efficiencies across all aspects of the organisation.

effective motivational and supportive leadership through engagement initiatives excellent relationship building skills. empathy for Age UK Staffordshire’s mission combined with sound commercial judg-

ment.

Page 7 of 15 

 

 

Job Description

Job Title:  CEO  

Accountable to:    Board of Trustees 

Hours:    37 Mon ‐ Fri 

Salary:  Circa £50k+ depending on experience + other benefits 

Direct Reports:  Senior Management Team  

Location:  Blended working including Home, Remote and at Age UK 

Staffordshire premises subject to business priorities.  

JOB PURPOSE: To manage, develop, and promote the work of Age UK Staffordshire. To provide products and services which improve quality of life for older people and their

carers. To provide inspirational leadership and management to the Senior team and to support

all staff in their work to provide excellent services for older people in the Staffordshire Region.

To ensure the financial sustainability of the organisation through sound financial plan-ning, risk and business management and income generation.

To develop and implement business and service plans to ensure financial sustainability. To develop the business agenda to meet changing market needs, utilising its people

and resources optimally for this purpose in line with policies and guidelines agreed by the Board.

Key duties and responsibilities 1. STRATEGIC DIRECTION

a. Ensuring that the Board of Trustees is kept aware of the changing external envi-

ronment and the needs of older people and their carers including policy initiatives, research, publications, and other initiatives both locally and nationally.

b. Identifying opportunities for providing innovative services for older people and their carers via a broad range of funding and income generation mechanisms.

c. Informing and advising the Board of Trustees in the formulation of policies and strategies for Age UK Staffordshire and for implementation of the Boards Deci-sions.

Page 8 of 15 

d. Working with the Senior Management Team in preparing, monitoring, and updat-ing the Strategic Plan and, subject to approval from the Board of Trustees, deter-mining and implementing strategies to achieve the goals of the plan.

2. LEADERSHIP AND MANAGEMENT

a. Providing leadership to encourage, motivate and inspire staff and volunteers

working for Age UK Staffordshire b. Providing support, leadership, and line management to the Senior Management

Team and other directly reporting staff c. Providing leadership in the management of change and fostering innovation to

ensure that Age UK Staffordshire develops appropriately to meet the future needs and challenges.

d. Demonstrating an inclusive management style leading to consultative decision making, good communication and sharing of good practice within the organisation maintaining an environment that continues to attract and motivate high quality staff and volunteers.

e. Facilitate a learning environment where all staff and volunteers can maintain and develop their skills to enhance the quality of services provided for older people in the Staffordshire region.

f. Ensuring that Age UK Staffordshire’s staff and volunteers are effectively led, su-pervised, and motivated.

g. Ensuring that all other resources are managed and effectively focused on achiev-ing the mission and objects of the organisation.

3. FINANCE AND INCOME GENERATION In accordance with the policy of the Board of Trustees and charity legislation, working with the Finance Sub Committee and Senior Management Team, to develop a financial strat-egy for the organisation. This will include:

An effective income generation policy Management of financial resources (including budget setting, financial reporting,

and monitoring) Appropriate use of reserves Financial risk management

4. PUBLIC RELATIONS AND COMMUNICATIONS

a. Working to identify, represent and campaign for the rights and aspirations of older people in the Staffordshire region.

b. Working to represent the positive contribution of older people to society. c. Working with the Senior Management Team to identify and implement an effective

and appropriate external communication strategy. d. Working with the Senior Management Team to identify and implement an effective

internal communication strategy.

Page 9 of 15 

5. GOVERNANCE

a. Acting as Company Secretary ensuring that all requirements of Companies Act and other appropriate legislation is met.

b. Advising the Board of Trustees and its sub-committees on their legal responsibil-ities, policy issues related to the work of the organisation and its management (including Health and Safety and Diversity)

c. Arranging for the publication of the Annual Report and Review d. Working with the Chairman of the Board of Trustees to recruit new members onto

the Board, inform and train the Board of Trustees/Directors as appropriate 6. PARTNERSHIPS AND COLLABORATION

a. Ensuring that Age UK Staffordshire remains an active and influential member of Age UK and works with other Age UKs at a local, regional, and national level.

b. Maintaining positive links with statutory (including NHS and local government) partners and identifying new opportunities to work for the benefit of older people and their carers.

c. Maintaining positive working partnerships with current voluntary sector partner or-ganisations

d. Identifying and building relationships with potential voluntary sector working part-ners

e. Maintaining current links and identifying new opportunities for working with com-mercial partners.

7. SERVICES

a. Ensuring systems are in place to support, monitor and assess the current and potential services and activities of Age UK Staffordshire to ensure their continued high quality.

b. Working with older people to identify what services they need and want. c. Working with the SMT and staff team to develop new and sustainable services for

the organisation. b. Ensuring that quality marks appropriate to the works of Age UK Staffordshire are

achieved and maintained

Organisation-wide Responsibilities  

To ensure that all relevant Age UK Staffordshire policies, procedures and legislative requirements are observed.

To participate in Age UK Staffordshire promotional fundraising, social events and other activities as requested

To always work in accordance with the philosophy, ethos and values and principles of the organisation.

To comply with individual responsibilities in relation to health and safety in accordance with AUK Staffordshire’s Health and Safety Policy and Procedure and to ensure all health and safety requirements are effectively implemented.

Any other duties as required by the Board of Trustees which are commensurate with the duties and responsibilities of the post.

Page 10 of 15 

Knowledge, Skills & Experience

Refer to the person specification. This post is subject to a disclosure check with the Disclosure and Barring Service at an Enhanced Level. Probationary Periods All appointments are subject to a six-month probationary period.  

Page 11 of 15 

PERSON SPECIFICATION

CHIEF EXECUTIVE OFFICER

If candidates do not meet the person specification, they may be required to undertake training as specified by the organisation.

You must be able to demonstrate in your application that you have:  Essential  Desirable 

QUALIFICATIONS, SKILLS AND ABILITIES 

Proven management, team building, and leadership skills, including people development, volunteer management  

✓ 

Strategic management and development skills and ability to think stra-tegically, develop and implement long and mid-term plans 

✓ 

Excellent communication and interpersonal skills and proven ability to develop effective working relationships with a range of organisations, partners, funders, and users of the services 

✓ 

Excellent communication skills, written and verbal, including drafting policies and procedures, writing reports, and undertaking presenta-tions and public speaking 

✓ 

Commitment to equality and diversity and ability to translate this into development of provision, sensitivity to differing needs and circum-stances, and approaches to funders and service providers 

  ✓

Ability to drive and have access to a vehicle for business travel  ✓  

Qualifications in the areas of social care and/or management or rele-vant degree, evidence of training and development in management and/or social care 

✓ 

KNOWLEDGE AND EXPERIENCE 

Proven track record of management at a senior level  ✓ 

Strong business acumen  ✓ 

Experience of leadership and management of projects/activities fi-nances and people 

✓ 

Previous experience of working with boards  ✓  

Demonstrable experience in developing and implementing new work and evidence of income generation 

✓ 

Experience of quality systems and development of standards  ✓ 

Understanding of entrepreneurial approach to service delivery  ✓  

Page 12 of 15 

Knowledge of Social Care and Health Sectors, with particular empha-sis on services for older people and their carers 

  ✓

Knowledge of the voluntary sector, charity law and regulations    ✓

Knowledge and understanding of the challenges facing older people and their carers, their needs, and aspirations 

  ✓

Understanding of the legal and regulatory requirements relating to fi-nance, employment, health, and safety plus knowledge of sources of information and support in these areas 

✓ 

Understanding of good governance and the key role of voluntary boards 

✓ 

PERSONAL QUALITIES 

Honesty and integrity and a commitment to the values and aims of our Char-ity, Age UK Staffordshire including its equal opportunities policies.

✓ 

Team and inclusive management style  ✓ 

Energetic & self-motivated  ✓ 

Flexible  ✓ 

Committed to continuously improving service delivery  ✓ 

Customer / client / beneficiary focus  ✓ 

Persistent & able to persuade others to meet your deadlines  ✓ 

Attention to detail and able to see the bigger picture  ✓ 

Excellent communication skills at a strategic level within and outside the or-ganisation 

✓ 

 

Page 13 of 15 

7. How to Apply

Applications need to include:

A covering letter explaining:

➢ Why you wish to be considered for this role.

➢ How will your skills and Age UK experience make a difference and add value?

The completed AUKS application form – see Appendix 3 (Please kindly note that we do not accept CVs)

Completed Equality & Diversity Form (Appendix 4)

Please email your completed application to the interim CEO - [email protected]

Or post to:

Private & Confidential, David Hole - CEO; The Roller Mill, Teddesley Rd, Penkridge, Stafford, Staffordshire. ST19 5BD

 

Page 14 of 15 

DATA PROTECTION ACT 

Privacy Notice – Job Applicants 

 

At Age UK Staffordshire (“the Organisation”), we are committed to protecting and respecting your privacy. As part of any recruitment process, The Organisation collects and processes personal data relating to job applicants. The organisation is committed to being transparent about how it collects and uses that data and to meeting its data protection obligations. What information do we collect? The Organisation collects a range of information about you. This includes:

your name, address and contact details, including email address and telephone num-ber.

details of your qualifications, skills, experience, and employment history. information about your current level of remuneration, including benefit entitlements. whether or not you have a disability for which the organisation needs to make reason-

able adjustments during the recruitment process; and information about your entitlement to work in the UK.

The Organisation may collect this information in a variety of ways. For example, data might be contained in application forms, CVs, or resumes, obtained from your passport or other identity documents, or collected through interviews or other forms of assessment. We may also collect personal data about you from third parties, such as references supplied by former employers. We will seek information from third parties only once a job offer to you has been made and will inform you that we are doing so. Data will be stored in a range of different places, including on your application record, in HR management systems and on other IT systems (including email). For what purpose will your data be used? The personal data you provide in your application and as part of the recruitment process will only be held and processed to facilitate the selection process and in connection with any subsequent employment. Your personal data may be used to assess your application for employment with the Organi-sation, to verify your information, to conduct reference checks, to communicate with you and to inform you of further career opportunities. In some cases, we need to process data to ensure that we are complying with its legal obligations. For example, it is mandatory to check a successful applicant's eligibility to work in the UK before employment starts. The Organisation may process special categories of data, such as information about ethnic origin, sexual orientation or religion or belief, to monitor recruitment statistics. We may also collect information about whether applicants are disabled to make reasonable adjustments for candidates who have a disability.

Page 15 of 15 

In the event of your application resulting in an offer of employment and your acceptance of a position with the Organisation, the data collected will become part of your employment record and will be used for employment purposes. Who has access to data? Only selected employees of the Organisation - such as senior management team members, potential future line managers or HR and Payroll staff - have access to your personal data. We will not share your data with third parties unless your application for employment is suc-cessful and we make you an offer of employment. We will then share your data with former employers to obtain references for you. How does The Organisation protect data? We take the security of your data seriously. We have internal policies and controls in place to ensure that your data is not lost, accidentally destroyed, misused, or disclosed, and is not accessed except by our employees in the proper performance of their duties. For how long does The Organisation keep data? Your personal data shall not be kept for longer than is necessary for the recruitment process. Therefore, unsuccessful application data will be deleted one month after the completion of the hiring process. In addition to using your data for the position for which you have applied, the Organisation may wish to retain and use your application data to consider you for other positions future employment opportunities for which you may be suited. We will ask for your consent before it keeps your data for this purpose and you are free to withdraw your consent at any time. Your Rights You may exercise the following rights in relation to your candidate data:

access and obtain a copy of your data on request. require the organisation to change incorrect or incomplete data. require the organisation to delete or stop processing your data, for example where the

data is no longer necessary for the purposes of processing; and object to the processing of your data where The Organisation is relying on its legitimate

interests as the legal ground for processing. If you would like to exercise any of these rights, please contact [email protected]. If you believe that the organisation has not complied with your data protection rights, you can complain to the Information Commissioner, using any of the below contact methods:

Telephone: 0303 123 11113 Website: https://ico.org.uk/make-a-complaint/

What if you do not provide personal data? You are under no statutory or contractual obligation to provide data to The Organisation during the recruitment process. However, if you do not provide the information, we may not be able to process your application properly. 

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;< Appendix 1

Appendix 2

1

 Appendix 3 ‐ Application for Employment  General Notes and Guidance  

This application form has three parts:   

You must complete Part 1 & 2 to provide the information we need to consider your application. 

Part 3 – Equality & Diversity Monitoring form. We will separate this part from the rest of the form, 

and it will not be used as part of the selection process.  

Please complete in black ink or type. We will only consider information provided on this application form. Please do not send in a CV as is will not be considered.  

This front sheet will be removed from the remainder of your application form when we shortlist to en‐sure all candidates are treated equally.  

Part 1  

Position applied for:   

Role Title  Chief Executive Officer 

Closing date  7th June 2021 

Applicant Reference (office use only)   

Personal Details:   

Title (Mr / Mrs / Ms etc)    

Address & Postcode   

 

 

2

 

Email   

Mobile / Landline (Day & Evening)   

 

 

Immigration Status:  

Are you a settled worker (i.e., do you have a permanent right to work in the UK – for example as a British or EEA citizen)?    Yes / No 

If no, do you already have temporary permission to work in the UK?    Yes / No  

If yes, please specify your visa type and visa end date: _______________________________________ 

 INTENTIONALLY BLANK 

 Applicant Reference (office use only)

 

3

IF YOU NEED MORE SPACE THEN PLEASE ADD ADDITIONAL SHEETS Career History:  Starting with current, please give details of your full career history. As well as employment, please include any periods of voluntary work, travel, career breaks and unemployment. If you have worked for Age UK Staffordshire before, we may ask the relevant line manager about your employment record. 

 

From ‐ To 

Employer  Job Title and Key responsibilities  Reason for leaving or notice period (where 

Applicable) 

                                      

     

4

 

Education, Qualifications & Training:  

Please list qualifications relevant to this post and the place of learning. We may ask you to produce qualification certificates if we ask you to come to an interview.  

 

Subject  Qualification Level  Place of learning  Date obtained

 

Training:  

Please give details of any training which is relevant to your application.   

 

Subject  Training Provider / Establishment  Date obtained

5

 

Professional Body Membership  Please give details of any professional membership which you hold. 

 

Professional body ‐ 1

Membership Level

Start date

Professional body ‐ 2 

Membership Level 

Start date 

Professional body ‐ 3 

Menerbship Level 

Start date 

 Suitability for the Role  Please review the requirements of the role (Job Description and Person Specification) and provide evidence of how you meet these, using specific examples. It is often helpful to deal with each re‐quirement under a separate heading. Please you use extra pages if required, but do not exceed more than three sides. 

 

6

 References:  

Please provide details of two people (not relatives) who will each provide an employer’s reference. One of these referees must be your current or most recent employer. Please confirm whether we may contact your chosen referee before any offer of employment has been made to you?  

Reference – 1    Reference – 2 

Name    Name   

Position    Position   

Address  & Postcode 

 

 

 

 

Address  & Postcode 

 

Tele No    Tele No   

Email    Email   

Contact prior to any offer 

YES / NO Contact prior to any offer 

YES / NO 

7

Request for reasonable adjustments to the selection process:  

If you require any reasonable adjustments to the recruitment process, please provide details below. If, however, you would prefer to discuss any special arrangements with us, please contact the person speci‐fied in the job advert or applicant covering letter as the point of contact for this vacancy, or  

email ‐ [email protected]  

 

 

Declaration:  

The information you have provided will be used to process your application and will be used in accordance with our legal obligations under the Data Protection Act 2018 (the “2018 Act‟) and the EU General Data Protection Regulation (“GDPR‟). Please read the enclosed Employment Application Privacy Notice for fur‐ther details.   

Please sign to confirm your acceptance of the statements outlined below:  

∙ I confirm the information I have given in this application for employment form and any supporting documents is correct and complete. 

  

∙ I understand that failure to disclose any relevant information or the provision of false information may lead to dismissal / withdrawal of any offer of employment made to me.  

 

Signature:                                                                                           Date:                                                  _ 

 

 

8

Part 2

Information for additional screening purposes  

For some jobs, we must make extra checks to ensure that applicants are suitable and/or that it is legal for us to employ them.  

Because the nature of the role  for which you are applying  involves direct contact with older people, some of whom may be classed as vulnerable adults, this post is exempt from the provisions of the Re‐habilitation of Offenders Act 1974, by virtue of the Exceptions Order 1975. This means that we will con‐duct a criminal record check on the successful applicant through the Disclosure and Barring Service (DBS – https://gov.uk/government/organisations/disclosure‐and‐barring‐service).  

You must now disclose any pending criminal proceedings, cautions or convictions against you (spent and unspent) which are not “protected”. Protected matters – usually old, minor cautions and convictions – will be filtered out when the DBS responds to our request for a check, and you need not disclose them. The DBS has guidance on which cautions/convictions are subject to filtering:  

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/240164/Filter‐ing_gu idance_v1_5.pdf.  

If the role you are applying for involves working with children or adults in regulated activity, the law requires that you must also inform us if you have been barred from such employment.  

If you do not disclose something new that is revealed by the DBS check then we may withdraw any con‐ditional offer, we have made (or dismiss you if you have begun employment) and we may report you to the DBS.  

A conviction would not automatically bar you from working with Age UK Mid Mersey. We actively pro‐mote equality of opportunity  for all and welcome applications  from a wide range of candidates.   We acknowledge that not all convictions will automatically bar people from working with us and it is there‐fore important that people who have been convicted are treated fairly.  

The information you provide is completely confidential and the only people who will have access to it is the HR Lead and the Chief Executive of Age UK Staffordshire who will make a final decision based on any information you have provided.   

Age UK Staffordshire adheres to the Disclosure and Baring Service Code of Practice on disclosures. A copy of this is available if you wish to read it.  

 

 

 

9

Do you have any spent or unspent cautions or   criminal convic‐tions that are not protected by law? 

Yes   / No  If ‘yes’, please provide further information. 

Do you have any criminal proceed‐ings pending?   

Yes   /   No  

If ‘yes’, please provide further information.

Have you been barred?   

from working with adults in regulated ac‐tivity.  

Yes   /   No  

If ‘yes’, please provide further information.

 Appendix 4 ‐ Equality and diversity monitoring form   Age UK Staffordshire is committed to eliminating discrimination and encouraging diversity amongst the workforce. Our aim is that our workforce will be truly representative of all sections of society.   

As part of our monitoring processes, we ask for your co‐operation in completing the questions on this form. The Organisation is committed to the principles of fairness, consistency, meritocracy, and equality of opportunity. No applicant will be discriminated against regardless of their age, colour, disability, eth‐nicity, gender or gender  identity, race, religion, or belief and / or sexual orientation or  if you do not wish to complete this form.  

The information you enter on this form will be used for monitoring purposes only.  Please indicate your answers with a Y 

Gender Male   _____   Female  _______

Age Group 16‐25  __ 26‐35 __ 36‐45 __ 46‐55 __ 56‐

65 __ 65 and over  

Do you live and work in a gender other than that assigned at birth?

Yes __ No __ Prefer not to disclose __

Please select the option which best describes your sexuality

Lesbian / Gay __ Heterosexual __ Bi‐sexual __ Prefer not to disclose __  

The Equality Act 2010 protects disabled people – do you consider yourself disabled

Yes __ No __ Prefer not to disclose __

If you ticked yes, please state the impairment (s) which apply to you

Physical Impairment __ 

Sensory Impairment __ 

Mental Health Condition __  

Learning Disability/Difficulty __  

Long‐Standing illness __ 

Other ______________________   

Belief Atheism__ Islam __ Buddhism __ Jainism __

Christianity__   Judaism__  Hinduism__ 

Sikhism __ Other __Prefer not to disclose __ 

I would describe my ethic origin as: Asian - Bangladeshi __ Indian __ Pakistani__ Black - African__Caribbean__Other__ White – British__Irish__Other__ Mixed - Asian/White__African/White__

Caribbean/White__ Other ethnic groups – Chinese__ Undisclosed__

Thank you for taking the time to complete this form   

 Date completed__________________________