HCA Application Form
HCA Application Form
HCA Application Form
What is the postal address of the place where you live? 6000
What is your proof that you live and work legally in the Passport
country you are in now (if different from your own)?
IELTS Score/ECCTIS (if applicable) 5.5 overall band score
Please list your care qualifications - Experience in Care home for 2 years
- NC II care giving Certificate
- English proficiency exam
EMPLOYMENT HISTORY (No unexplained employment gaps)
Please start with your current employment and go back in time
**PLEASE INCLUDE ALL PREVIOUS EMPLOYMENT FROM THE AGE 0F 18 **
Dates - including months Employer (name and Position held Reasons for leaving
From (MM / To (MM / address)
YY) YY)
September 2021 Present D & B Vergara Store Care giver Still working at present
January 2021 September Fehan TLC Home Healthcare Assistant Found work in another
2021 (assisted living) company
January 2021 –
September 2021
March 2014 January 2021 D & B Vergara Store Store care taker Helped my family in our
family owned store, I left to
be a care giver
TM
Describe the type of patients you are looking after Elderly with dementia and/or with long term medical
illnesses.
Are you a full-time employee working shifts or a Full time employee – 40 hours
volunteer? How many hours/week?
What experience do you have working with elderly Assisted elderly with their personal care, toileting,
patients? assisting them with their oral intake, giving activities such
exercise, walking and shopping. I have also assisted in
taking their vitals signs/vital observations while they are
in the facility. Assisted/encourage them to take their
medication. Report to the nurse on duty for any
remarkable changes with my patients.
What experience do you have working with people I have learned that dealing with dementia needs to have a
suffering from dementia or mental health illnesses? lot of patience and understanding. Because they can be
very confused, agitated and sometimes become very
resistive towards care. For you to support them with their
needs you must understand what dementia can bring to a
person. This will not affect them mentally but also
physically. Therefore, it is very important to be patient
and understanding with them.
Do you have any experience in leading a small team, or in No, but a care giver working in a care home facility, you
training more junior members of staff? will be working in a team, even if you are not a team
leader or are just part of the team, you still must
communicate with your team to bring continuity to the
care you provided with the residents. Like for example,
giving my co workers some strategies on what work bests
to a certain resident.
Family/Friends in the UK? Where are they located? Sister in Crosshill, Keighley
Cousin in London
Do you prefer a certain area to relocate to the UK? I have no preferences as of the moment but If there is
opportunity I would like to be nearer my sister in
Keighley
Please tell us about your family: Married? I have civil partner. I don’t have children.
Children(ages)?
Scenario Questions
QUESTION ANSWER
1. What would you do if you were checking the At first, I will ask my colleagues if they had assisted that
resident’s charts at lunch time and one of the resident with any fluid during lunch. This is why proper
fluid balance charts was blank? communication among the team is very important. If they
can’t answer me, then I will offer the resident a drink of
his/her preference. I have learned that if it is not recorded
that means it is not done. If his/her fluid is very low at this
time I will inform the nurse and tell her that we will keep
an eye on her fluid and keep offering fluid if applicable.
2. If you discovered your resident had a red and sore At first, I will do an initial assessment whether the area is
area on their heel, what initial actions would you blanching or non-blanching. Then I will off load the feet
take? and tell the nurse that the resident is having a sore on
his/her heel and tell her that I have offloaded it. So, that
the nurse is aware of this situation.
3. If you had a resident that was losing weight, what At first, I would encourage the resident to eat, make sure
simple steps could you take to improve their that he is given extra serving to his/her meal should be
nutritional status. fortified and offer the resident milky drinks for extra
calories. Report to the nurse about the weight loss of the
resident. And more importantly, follow the nutritional
care plan of the resident.
4. What do you understand by the term Abuse? In my own understanding abuse is when you take
advantage of someone who is vulnerable and unable to
defend themselves. This can be in any form. For me the
most common that I see is the physical abuse.
5. How would you ensure a Resident’s privacy and I would ensure that resident’s privacy and dignity is
dignity is maintained? maintained during personal cares by closing the windows
and doors. Asking them if they want me to go out while
they are doing their personal cares.
6. What would you do if you were alone in a room I would make sure that I shout for help. Especially, call
with a resident and they slipped to the floor? the nurse. I will not leave the patient and don’t move
him/her until help comes. I know that in the UK they have
to press the emergency buzzer in this situation.
DECLARATION
I declare that the information given in this document is true and complete and I confirm the answers are my own.
TM
Signature Date: