Purple : Vacancy Form

Personal Details

First Name *

Last Name *

Email Address *

Phone Number *

Are you the person who will be receiving support from a PA? * Yes No

Please advise your relationship to the person who requires a PA? *

What is the First Name of the person requiring a PA? *

What is the Last Name of the person requiring a PA? *

What is the Date of Birth of the person requiring a PA? DD/MM/YYYY

What type of Direct Payment do they have? * Service User Direct Payment Carers Direct Payment I do not know

Has the Direct Payment been agreed? Yes No

What is the Direct Payment budget agreed for this role?

What is the Direct Payment Holder's home postcode? * This is to check the Direct Payment Holder status with Hertfordshire County Council.

Main location for this Vacancy * e.g. Home, School, Office.

Vacancy Address Line 1

Vacancy Address Line 2

Vacancy Address City

Vacancy Address Postcode

What is the gender of the person requiring a PA? * Male Female Non-binary Prefer not to say

Has the Direct Payment Holder (or their representative) received Employment Advice & Guidance with regards to this vacancy? * Yes No

Vacancy Details

The following details will be shared with those PA's registered with Purple Match, to see if they are interested in your vacancy. Unless required, we will not adapt this too much, so they can get a real feel for who you/the person who requiring a PA is and what you/they need.

Why are they looking for a PA? What will this PA role enable the Direct Payment Holder to do? What benefit will this role have? What value will this role add? *

Please provide more detail about their specific conditions: * This information helps us to find the right PA.

Is this a permanent or temporary role * Permanent - Full or part time ongoing role Temporary - Until a certain time Temporary - Available for some ad hoc cover of annual leave/sickness/respite

Details, if you wish to expand on the previous question:

How many hours per week is support required for? *

What is the hourly rate of pay for the vacancy? £11-£12 per hour £12-£13 per hour £13-£14 per hour £14-£15 per hour £15-£16 per hour Other

If Other, please specify the hourly rate:

What days of the week and hours in each day is support required for? * Please specify if this is year round or if there are any times a PA will not be required to support on your specified days and hours.

What are the care and support needs of the person requiring a PA? What would they like to happen on these days in terms of activities or tasks? * Please also include any regular activities or tasks assistance is required with.

Please provide any additional information or clarification on these requirements: *

Tell us a bit about the Direct Payment Holders hobbies or interests: *

What are the most important qualities and skills being looked for in a PA? *

What is the environment like? * e.g. Are there other people, pets, other PA's and any other information you wish to provide.

Safeguarding, First Aid and Health and Safety are mandatory training for a PA. Do you have any additional training requirements for the PA? *

Please use this space to advise of anything else you want potential PA's to know, not already covered in your previous answers.

Where did you hear about Purple Match? *

Please confirm you have read the Purple Match terms and conditions (read)

PA Vacancy Form

Personal Details

Vacancy Details