Referral Line:
0800 7833 779
info@thedrivecarehomesltd.org.uk
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Dear Referee, Your name has been given to us as a referee for an applicant who has applied for a position with
The Drive Care Homes Limited.
We would appreciate it if you would complete the form below regarding the applicant’s suitability for the post they have applied for, including abilities, relationships with colleagues and personal qualities. If relevant, please provide information regarding their sickness record and please indicate whether you would re-employ this applicant. The position applied for is exempt from the provisions of the Rehabilitation of Offenders Act 1974 by virtue of the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975. Consequently, it will not contravene the Act if you disclose any information that you may have in connection with the applicant regarding any convictions that would otherwise be considered as “spent”. The Drive Care Homes Limited complies fully with the Data Protection Act 1998, and therefore any information provided will be treated in the strictest confidence. It would be appreciated if you would give this request your urgent attention. Please upload a compliment slip with your Company’s logo or alternatively letter headed paper. Thank you for your assistance in this matter.
HR & Training Department
Click Next below to continue with reference.
Employment Reference
Applicants Name
*
First
Last
Position applied for:
*
Support Worker
Deputy Home Manager – Children’s residential Home
Thank you for providing this reference to
The Drive Care Homes LTD.
Please answer all questions, ensuring that the reference is accurate, and does not contain any material misstatement or omission.
Please note: Failure to provide accurate information may result in an unsuitable candidate being appointed to this post and/or loss of continuous service benefits.
How long have you known the candidate (Years) ?
*
Please enter a number from
1
to
99
.
In what capacity?
*
Date Employed from
*
MM slash DD slash YYYY
Date Employed to
*
MM slash DD slash YYYY
Candidate’s current / previous post title
*
Candidate’s current / final salary
*
Applicants Suitability
Timekeeping
*
Excellent
Good
Average
Below Average
Not applicable
Team Work
*
Excellent
Good
Average
Below Average
Not applicable
Working Unsupervised
*
Excellent
Good
Average
Below Average
Not applicable
Ability to prioritise workload
*
Excellent
Good
Average
Below Average
Not applicable
Ability to meet deadlines
*
Excellent
Good
Average
Below Average
Not applicable
Communication skills
*
Excellent
Good
Average
Below Average
Not applicable
Customer service
*
Excellent
Good
Average
Below Average
Not applicable
Budget responsibility
*
Excellent
Good
Average
Below Average
Not applicable
Disciplinary record
*
Excellent
Good
Average
Below Average
Not applicable
Absence Record
*
Excellent
Good
Average
Below Average
Not applicable
Please comment
Absenteeism
How many periods of absence have they had over the last three years?
*
Absence Period 1
Date from
*
MM slash DD slash YYYY
Date to
*
MM slash DD slash YYYY
Reason for Absence 1?
*
Absence Period 2
Date from
*
MM slash DD slash YYYY
Date to
*
MM slash DD slash YYYY
Reason for Absence 2?
*
Absence Period 3
Date from
*
MM slash DD slash YYYY
Date to
*
MM slash DD slash YYYY
Reason for Absence 3?
*
Absence Period 4
Date from
*
MM slash DD slash YYYY
Date to
*
MM slash DD slash YYYY
Reason for Absence 4?
*
Absence Period 5
Date from
*
MM slash DD slash YYYY
Date to
*
MM slash DD slash YYYY
Reason for Absence 5?
*
Disciplinary and other matters
Please provide details of any disciplinary procedures that the candidate has been subject to in which the disciplinary sanction is current?
Please provide details of any disciplinary procedures that the candidate has been subject to involving issues related to the safety and welfare of children/young people/vulnerable adults, including any in which the disciplinary sanction has expired?
Please provide details of any allegations or concerns that have been raised about the candidate that relate to the safety and welfare of children/young people/vulnerable adults or behaviour towards children/young people/vulnerable adults, and the outcome of those concerns e.g. whether the allegation or concern was investigated, the conclusion reached, and how the matter was resolved?
Why did the candidate leave your employment?
Candidate Suitability
Would you re-employ this candidate?
*
Yes
No
As you stated NO, please provide details of your reason. This may or may not be applicable to this post:
*
Do you consider that the candidate has the ability and is suitable to undertake the job for which s/he has applied??
*
Yes
No
Please provide further details:
Are you satisfied that this candidate is suitable to work with children?
*
Yes
No
Please provide further details:
Do you approve / authorise the candidate to see this reference should they request Subject Access under the Data Protection Act 1998?
*
Yes
No
Please note: It may be necessary to discuss relevant factual content of this reference with the applicant or to contact you again for clarification on any information you have provided in this reference. It may also be necessary to disclose the reference if a Subject Access request is made under the Data Protection Act 1998
Confirmation of Identity
Please upload Company Compliments Slip or Letterhead
Accepted file types: jpg, gif, png, pdf, Max. file size: 2 MB.
Reference completed by
*
Mr.
Mrs.
Miss
Ms.
Dr.
Prof.
Rev.
Prefix
First
Last
Position
*
Date
*
MM slash DD slash YYYY
Email
*
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