Candidate

Ref. No

HALTON CARERS CENTRE

Employment Application Form
General notes and guidance

Please complete in black ink or type. We cannot consider any applications where
this form has not been fully completed. CVs will not be considered.

When completing your application form please ensure that you address each
point of the Person Specification requirements. Please detail them as they are in
our document, point by point.

It may be useful to photocopy your application prior to sending it to us. You may
need to refer back to it.

This sheet will be removed from the rest of your application form when we shortlist
to ensure all candidates are treated equally.

Post applied
for:

1. Personal details

Full Name : Nokulunga Lebo Mahlangu

Address : 6837 Bushrike and Buttonquail street ,Benoni ,Gauteng ,South Africa
Postcode
Telephone Number: +2771 671 5509 Day : Available 8 a.m-5
p.m
Evening: 6 p.m - 10p.m
 Candidate
Ref. No

2. Current Employment
(Please provide details of your current employment)

Employers name & address Job title and brief description of duties

Mrs Z.Simelane Disability Support Au Pair -Providing

emotional support and companionship to the
66 High Road ,Norton Estate child.
Home
● Assisting with his daily routines and
activities of daily living, such as
mealtime, hygiene, and bedtime
routines.
 Candidate
Ref. No

Dates of employment ● Engaging in play-based activities and

recreational outings tailored to the
02/2023 - Current child's interests and needs.
● Implementing behavior management
strategies and techniques
recommended by therapists or
professionals working with the child.
● Supporting the child's communication
and social skills development through
interaction and engagement.
● Creating and maintaining a structured
and predictable routine to help the
child feel secure and comfortable.
● Accompanying the child to therapy
sessions, medical appointments, and
other specialized interventions.
● Collaborating with the child's parents,
therapists, and educators to ensure
consistency and continuity of support
across different environments.
● Offering emotional support and
encouragement to the child during
challenging or overwhelming
situations.
● Participating in ongoing training and
professional development to enhance
skills and knowledge in autism
support and caregiving.

Notice required by present employer: Immediate

_______________________________

3. Previous Employment
(Please provide details of your previous employment. Please start with your
most recent)
 Candidate
Ref. No

Employers name & Dates of Job title and brief description of

address employment duties

Mrs Z.Simelane 02/2023- Current Disability Support Au Pair -

Providing emotional support and
66 High Road ,Norton companionship to the child.
Estate Home
● Assisting with his daily
routines and activities of
daily living, such as
mealtime, hygiene, and
bedtime routines.
● Engaging in play-based
activities and recreational
outings tailored to the
child's interests and
needs.
● Implementing behavior
management strategies
and techniques
recommended by
therapists or
professionals working
with the child.
● Supporting the child's
communication and
social skills development
through interaction and
engagement.
● Creating and maintaining
a structured and
predictable routine to
help the child feel secure
and comfortable.
● Accompanying the child
to therapy sessions,
medical appointments,
and other specialized
interventions.
● Collaborating with the
child's parents,
therapists, and educators
to ensure consistency
 Candidate
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and continuity of support

across different
environments.
● Offering emotional
support and
encouragement to the
child during challenging
or overwhelming
situations.
● Participating in ongoing
training and professional
development to enhance
skills and knowledge in
autism support and
caregiving.

01/2020-06/2021 School counsellor for young

adults and children suffering
from mental health challenges-
• Emotional Support: provided
emotional support to students
dealing with anxiety and
depression, listening to their
concerns, validating their
Midrand High School feelings, and offering guidance.
Ms Kambula
● Crisis Intervention: I was
Third Rd,Halfway trained to handle crisis
Garden,Johannesburg, situations, including
2000 mental health crises such
as suicidal ideation or
severe anxiety attacks
including panic attacks.
● Psychoeducation:
Educated students,
parents, and staff about
mental health issues,
including symptoms,
treatment options, and
available resources.
● Advocacy and
Collaboration:Collaborate
d with teachers, parents,
 Candidate
Ref. No

and external agencies to

advocate for students'
needs and coordinate
support services.
● Developing Coping
Strategies: Helped
students develop coping
strategies to manage
their anxiety and
depression, such as
relaxation techniques,
mindfulness exercises,
and cognitive-behavioral
strategies.

4. Qualifications
(Please list qualifications relevant to this post and schools/ colleges attended)
Schools/Colleges attended Dates Qualifications gained

1)Basic Life Support Theory 23/07/2 Florence Academy

2)Mental Capacity 3
3)Understanding learning disabilities 24/07/2
and autistic spectrum disorder 3
4)Pathway to Care 24/07/2
Programme:Module A-Adult Social 3
Care
5)Pathway to Care 23/07/2
Programme:Module B-The 6 C’s of 3
Care
6)Pathway to Care Module C-
Communication 23/07/2
7)Dementia Level 1 3
8)Pathway to Care Programme
Module E - Nutrition/Hydration
 Candidate
Ref. No

9)Pathway to Care Progamme- 23/07/2

Module K- Personal Development 3
10)Pathway to Care Program-
Module I- End of life care 24/07/2
11)Pathway-Module G-Mobility and 3
falls
12)Pathway-Module H-Supporting 27/09/2
and sleep bed 023
13) Continence Care-Module F
27/09/2
023
27/09/2
Advanced diploma in cognitive 3
behavioural therapy 27/09/2 Alison Academy
023
Mental health care child and youths
27/09/2 Alison Academy
023
27/09/2
023

03/2024

03/2024

5. Training
(Please list any training courses attended relevant to this post e.g. work based
training or in house training etc.)

Establishment Dates Course/Training attended

DPSA 9/2020 School counsellor training program

A;SA 3/2021 Understanding Autism Spectrum

Disorders

Positive Behaviour support for children

and Young adults with disabilities.
Candidate
Ref. No
 Candidate
Ref. No

6. Experience relevant to this post

Please state how your skills and experience are relevant to this post.

Please look carefully at the PERSON SPECIFICATION enclosed and use this space to
tell us how you think you meet the requirements of the post. It may be helpful if you
number your reply according to the number of each point on the person specification.
Use additional sheets if necessary.

In response to the Person Specification provided, I believe my skills and

experience closely align with the requirements of the post:

● Experience of being an unpaid Carer of an elderly/frail, sick, or disabled

person or of working with people with disabilities and/or Young Carers
(Desirable)
○ While I may not have direct experience as an unpaid carer, I have
extensive experience working with individuals with disabilities and
young carers in various capacities , my experience as a counselor
has provided me with valuable insights into the challenges faced
by individuals caring for others. I have worked closely with
individuals with disabilities and young carers in my previous roles,
providing them with support and guidance. Additionally, I hold
certifications as a mental health support worker and have provided
support to individuals facing mental health challenges.
● Experience of working in a Health or Social Care environment (Essential)
○ I have experience working in health and social care settings,
where I have provided support and assistance to individuals in
need, including those with disabilities and young carers.
● Ability to deliver training using a variety of methods (Essential)
○ With my advanced diploma in cognitive behavioral therapy (CBT)
and experience as a mental health support worker, I am adept at
delivering training sessions using a variety of methods tailored to
the needs of diverse audiences.
● Organisational and office management skills including knowledge of
Microsoft office, Word, Excel, PowerPoint, and the ability to learn new
systems (Essential)
○ I possess strong organizational and office management skills,
including proficiency in Microsoft Office Suite. I am quick to learn
new systems and technologies to enhance efficiency and
productivity.
 Candidate
Ref. No

● Understanding of the needs of Carers (Essential)

○ Through my experience working with individuals in various support
roles, including mental health care for children and youths, I have
gained a deep understanding of the needs and challenges faced
by carers. I am committed to providing tailored support to meet
their unique requirements.
● Experience of providing information and advice (Essential)
○ As a mental health support worker, I have provided individuals
with information and advice on mental health care, coping
strategies, and accessing support services.
● An understanding of confidential issues (Essential)
○ Confidentiality is paramount in my work, and I adhere to strict
ethical guidelines to ensure the privacy and confidentiality of
individuals I work with.
● Excellent communication skills both verbal and written (Essential)
○ I possess excellent communication skills, both verbal and written,
which enable me to effectively convey information and engage
with individuals and groups.
● Ability to undertake advocacy work on behalf of Carers (Essential)
○ With my background in mental health support and advocacy, I am
well-equipped to represent the interests of carers and ensure their
needs are addressed effectively.
● Ability to communicate sensitively with both individuals and groups
(Essential)
○ I have demonstrated sensitivity and empathy in my interactions
with individuals and groups, recognizing and respecting their
diverse backgrounds and experiences.
● Ability to facilitate groups and meetings (Desirable)
○ While I may not have extensive experience in facilitating groups
and meetings, I am eager to develop this skill further and
contribute to the collaborative efforts of the team.
● Ability to work in a multi-disciplinary environment (Desirable)
○ I have collaborated with professionals from diverse backgrounds
in previous roles, and I am comfortable working in a multi-
disciplinary environment to provide comprehensive support to
individuals.
● Ability to manage own workload and work independently (Essential)
○ I am self-motivated and capable of managing my workload
efficiently, prioritizing tasks effectively to meet deadlines and
deliver high-quality support services.
● Willingness to work out of hours (Essential)
 Candidate
Ref. No

○ I am flexible and willing to work out of hours when required to

ensure the needs of carers are met and support services are
accessible to them.
● Car owner and ability to use for work (Essential)
○ I do not own a car currently as I am outside the UK but I have a
valid driver's license and I don’t have a problem purchasing a
vehicle on arrival to enable me to travel to different locations as
needed for work purposes.
● Ability to maintain and produce accurate statistical returns of work
undertaken (Essential)
○ I have experience in maintaining accurate records of my work and
producing statistical reports to track progress and outcomes.
● An understanding of the value of supervision to aide development
(Desirable)
○ I recognize the importance of supervision in professional
development and am open to receiving constructive feedback and
guidance to enhance my skills and practice.
● Ability to work as part of a team (Essential)
○ I am a collaborative team player who values teamwork and
actively contributes to achieving common goals and objectives.
● Understanding of and commitment to Equal Opportunity practices
(Essential)
○ I am committed to promoting equality and diversity and ensuring
that support services are accessible and inclusive to all
individuals, regardless of their background or circumstances.
● Understanding of and commitment to Halton Borough Council's
Interagency safeguarding policies and procedures (Essential)
○ I am familiar with safeguarding policies and procedures and am
committed to upholding the highest standards of safeguarding
practice to ensure the well-being and safety of individuals.

I am confident that my skills, experience, and commitment make me a strong

candidate for the Young Carers Support Worker position at Halton Carers
Centre.
 Candidate
Ref. No

7. Referees
Please provide two names and addresses of referees (one must be of your
current or most recent employer). Please indicate if your references may be
contacted prior to interview.

Name: Mrs Z Simelane Name: Ms Kambula

Position:Disability Support Au Pair Position :HR

Organisation:Private Organisation : School

Address : 66 High Road,Norton Estate,Benoni Address :Third Road ,Halfway Gardens,Midrand

Postcode :1501 Postcode :1685

Telephone no:072 651 6445 Telephone no. :+27 670776139

Contact prior to interview: Yes Contact prior to interview Yes

8. Rehabilitation of Offenders Act

(Please read Guidance notes before completion)

Do you have a criminal record Yes / No

Have you ever been convicted by the courts or cautioned, reprimanded No
or given a final warning by the police?
(Note: the post you have applied for is excepted from the Rehabilitation of
Offenders Act 1974, which means that all convictions, cautions, reprimands
and final warnings on your criminal record need to be disclosed.)

No I don’t have any offences ,penalties or convictions,I have a valid

police clearance / criminal record check that states that I don’t have any
criminal convictions or any pending criminal charges.

No

Are you aware of any police enquiries undertaken following allegations

made against you, which may have a bearing on your suitability for this
post?

No I don’t have any allegations made against me.

 Candidate
Ref. No

9. Sickness

Please state how many days sickness you have had in the last two years:

3__________
10. Declaration

I confirm that the information given in this application form is correct and
complete, and that misleading statements may be sufficient for cancelling
any agreements made.
I understand that, in the event of being short listed for interview I will be
required to complete a declaration that will include details of any criminal
convictions, cautions, reprimands and final warnings and any other
information that may have a bearing on my suitability for the post. I
understand too that an Enhanced disclosure will be sought in the event
of a successful application.

Signed L. N. Mahlangu

Date 5/03/2024