Shared Lives carers: before you apply

You will be asked to provide information on the following areas while you are completing the application form. Please be aware that you will be unable to save your application part completed and return to it later so ensure you are prepared and have the time to complete the form.

Personal details

This includes your last 5 years’ address history.

Other household members

Name, age, employment status of any other adults that live at the same address as you and their relationship type with you.

Name, age and relationship of anyone aged under 18 living with you

Accommodation

We will ask you information about your home such as how many rooms the property has, whether you have any outdoor space, if you have any pets at home and information about the locality of where you live, for example local amenities that are nearby.

Employment history

You will be asked to provide information about your current employment status, what type of work you undertake and your working hours.

References

As part of the application and assessment process we need to gain a professional reference from your current/previous employer and also two personal character references. Please ensure you have their permission for our team to contact them should we progress your application.

We also require a medical reference from your GP. You are required to obtain this information yourself and if required pay any fee your G.P may charge.

More about you

You will need to let us know if you have applied to be a Shared Lives Carer before with us or another local authority.

We will also ask you if you can drive and whether you have access to a vehicle you can use as part of the Shared Lives Carer role

A day in the life

We will ask you to outline details of an average or typical day in the life of your household. This can be as informal or formal as you like. Let us know what happened in that day, people you saw, places you went, things you did and problems you solved.

This exercise is designed to give a picture to the Shared Lives assessor and independent panel of the sort of person you are and how you live your life.

This is important if you are to share your life and/or household with a disabled or vulnerable person as a Shared Lives Carer.

Write as much or as little information as you would like.

Person profile

We would like you to outline a profile of you as a person. Think about your strengths and weaknesses, your likes and dislikes, your dreams and fears and what motivates you. If you find it difficult to write about yourself, maybe outline how you think your friends and family would describe you.

This exercise is designed to give a picture to the Shared Lives assessor and independent panel of the sort of person you are and what makes you tick.

This is important if you are to share your life and/or household with a disabled or vulnerable person as a Shared Lives Carer.

Consent and agreements

On submitting your application, you will be consenting to the following declaration:

Consent and agreement

  • I declare that I have no criminal convictions
  • I have criminal convictions (even those that are deemed to be spent) that I am willing to discuss
  • I declare that I know of no conflict of interest that may affect my application as a Shared Lives carer
  • I am aware of a potential conflict of interest that may affect my application as a Shared Lives carer that I am willing to discuss
  • I consent for detailed checks and references to be taken up to support my application to become a Shared Lives carer. I understand that these checks could involve information about myself of a confidential medical and personal nature
  • I consent to information being passed by the council Shared Lives service to the regulatory body as required
  • I hereby give consent for my photograph / image and name to be used in the Council's Shared Lives service to be used to raise awareness and promote Shared Lives to others via local media, brochures, posters, DVD and council websites
  • I consent for information about me to be kept by the council Shared Lives service both in paper and on a computer database
  • I confirm that I am eligible to work in the UK
  • I confirm that the information supplied by me in this application is complete and correct to the best of my knowledge

You can withdraw your consent at any time by contacting the Council's Shared Lives service