Reference form

We always ensure that our candidates undergo our rigorous recruitment process prior to any work being offered to them. Therefore, the more rapid the response is – the faster we can assess the candidate and allow them to start working.

    Referee Details

    Name

    Job Title

    Company

    Contact Number

    In what capacity did you know the applicant?

    Applicant Details

    Name

    Job Title

    Company

    Date employed from?

    Date employed until?

    Reason for leaving?

    Would you employ this person again?
    YesNo

    If no please explain why below:

    Section One: How would you asses the following?:

    Please tick the relevant boxes.

    Ability to follow care plans

    ExcellentGoodAveragePoor

    Reliability / Time-Keeping / Attendance

    ExcellentGoodAveragePoor

    Character

    ExcellentGoodAveragePoor

    Attitude

    ExcellentGoodAveragePoor

    Ability to ensure dignity is upheld

    ExcellentGoodAveragePoor

    Communication

    ExcellentGoodAveragePoor

    Relationship with colleagues

    ExcellentGoodAveragePoor

    Ability to work under own initiative

    ExcellentGoodAveragePoor

    Section Two

    Please answer the following questions:

    Has the applicant been subject to any disciplinary action?
    YesNo

    If yes please provide details below:

    Are you aware of the applicant's involvement in any safeguarding investigations (previous or current)?
    YesNo

    If yes please provide details below:

    Are you aware of any reasons why the applicant should not be employed to work with children or vulnerable people?
    YesNo

    If yes please provide details below:

    To the best of your knowledge has the applicant been convicted or cautioned of a criminal offence*?
    YesNo

    If yes please provide details below:

    *Due to the nature of care work, all spent convictions must be disclosed (Rehabilitation of offenders act 1974)

    Additional Comments:

    I can confirm that all the details provided are accurate at the time that this reference was completed. I can confirm that I am authorised to provide a reference on behalf of my organisation. I understand this reference may be shown to a third party for auditing purposes and I can confirm that Local Care Force has this organisation’s consent and authorisation to disclose the contents of this reference to its end user, hirer clients. I understand that the applicant has the legal right to request a copy of their reference.

    Name

    Position

    Date

    By clicking the below button you confirm the above information is accurate to the best of your knowledge

    We always ensure that our candidates undergo our rigorous recruitment process prior to any work being offered to them. Therefore, the more rapid the response is - the faster we can assess the candidate and allow them to start working.