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[For OACP use only] Approval Number APP/SWC/PA/034/0411

Title Mr Mrs x Miss Ms Dr Prof

Full Name

First Name Andrea

Family Name Thomas-Barnaby

Gender Male Female x

Daytime Telephone Number

Mobile 07554 474559

Email [email protected]

Date of last DBS check, or state never September 2013

Course type Completed ddmmyyyy

1. Catheterization and incontinence care management

2. Infection Control

3. Food Hygiene

4. Adult resuscitation

5. Medication Administration

6. Manual Handling

7. Falls Awareness

8. Equality and Diversity

9. Health and Safety

1 | P a g e 10. Fire Awareness

11. Safeguarding Adults 1 & 2

12. Safeguarding Children 1

13. Blood glucose monitoring

14. Vital signs observation

15. Conflict resolution

16. Principles of care

17. Diet and Nutrition

18. Prevention and Management of Pressure Damage and

Ulcers 19. Record and Documentation

20. Dementia care and management

21. Communication

Car Driver Yes x No

Approximate charges:

Per hour 8am – 8pm Monday to Friday £ 18 Per hour 8am – 8pm Weekends and Bank Holidays £ 20 Per hour 8pm – 8am Overnight care £ 20 Sleep-overs £ 60 Mileage £ negotiable

Short description

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Which tasks are provided as a Personal Assistant? Personal care x Social & Leisure activities x Domestic Assistance x Work or study support Other, please state

3 | P a g e Which area the Personal Assistant works in

Tick Postcode Including Broadwell, Claydon, Claydon Pike, Downington, , Fyfield, , , Langford, Little , Little London, x GL7 , Thornhill, Warrens Cross x Adlestrop, Aston Magna, Barton-on-the-Heath, Batsford, Blockley, Bourton on the Hill, Broadwell, , Daylesford, GL56 Donnington, Dorn, Draycott, Evenlode, Little Compton, Longborough, Lower Lemington, Oddington, Old Town, Sezincote, Snowshill Hill, Springhill, Stretton on Fosse, Todenham, Upper Oddington x NN13 Brackley, Croughton, Farthinghoe, Hinton-in-the-Hedges, Westbury, Turweston, Mixbury x OX1 , Oxford (Central and South), Kennington, New Hinksey, Osney, x OX2 Botley, Jericho, Oxford (North and West), , Summertown, , Wolvercote x OX3 Beckley, Elsfield, Headington, Marston, Noke, Oxford (North East), Woodeaton, Woodperry x OX4 Blackbird Leys, Cowley, Oxford (East), Iffley, Littlemore, Rose Hill, Sandford-on-Thames x OX5 Begbroke, Charlton-on-Otmoor, Fencott, Islip, Kidlington, Murcott, , Yarnton, x OX7 Bledington, , , x OX9 North Weston, Postcombe, Thame, Towersey x OX10 Berinsfield, Cholsey, Dorchester, Wallingford x OX11 Aston Tirrold, Aston Upthorpe, , Chilton, Didcot, Harwell, South Moreton, Upton x , , , Challow (East & West), , Farnborough (Berks), Fawley, Ginge (East & OX12 West), Grove, (East & West), Hendred (East & West), , , , Lockinge (East &West), Lyford, Sparsholt, Appleton, , , Cothill, , , , , , , Steventon, x OX13 ,

4 | P a g e Tick Postcode Including x Abingdon, Appleford-on-Thames, Burcot, Clifton Hampden, Culham, Drayton, Little Wittenham, Long Wittenham, Milton, OX14 , x Alkerton, Balscote, Barford St Michael, Barford St John, Bloxham, Bodicote, Brailes, Broughton, Deddington, Hempton, OX15 Drayton, Edge Hill, Epwell, Hook Norton, Horley, Hornton, Milcombe, Milton, North Newington, Ratley, Shenington, Sibford Ferris, Sibford Gower, Shutford, South Newington, Swalcliffe, , Tadmarton, Upton, Wigginton, Wroxton, x OX16 Banbury x Adderbury, Appletree, Aynho, Arlescote, , Charlton, Cheney, Chipping Warden, Claydon, Cropredy, Culworth, Edgcote, Farnborough (Warks), Greatworth, Great Bourton, Hanwell, King's Sutton, Little Bourton, Lower Thorpe, Marston OX17 St Lawrence, Middleton Mollington, Nethercote, Newbottle, Overthorpe, Prescote, Shotteswell, Stuchbury, Sulgrave, Thenford, Thorpe Mandeville, Twyford, Upper Astrop, Wardington, Warkworth, Warmington, Williamscott x , , Aston, Bampton, Barrington, , Bradwell, , , Carterton, Chimney, OX18 Clanfield, Cote, Fulbrook, Grafton, Holwell, Lew, Little Clanfield, Radcot, Shilton, Signet, , Taynton, Upper Windrush, Upton, Weald, Westwell, Widford, Windrush x OX20 , , , Woodleys, Woodstock, Wootton x Ambrosden, Arncott, Blackthorn, Caulcott, Duns Tew, Little Chesterton, Lower Heyford, Merton, Middle Aston, Middleton OX25 Stoney, North Aston, Piddington, , Somerton, Steeple Aston, , Upper Heyford, Wendlebury, Weston-on-the-Green x OX26 Bicester, Chesterton, Launton x Ardley, Bainton, Baynards Green, Bucknell, Caversfield, Charndon, Fewcott, Fringford, Fritwell, Godington, Hardwick, OX27 Hethe, Marsh Gibbon, Newton Morrell, Poundon, Souldern, Stoke Lyne, Stratton Audley, Tusmore x OX28 x , , Church , Combe, Crawley, Curbridge, , , Freeland, Hailey, OX29 Hardwick, High , , New Yatt, Newbridge, , East End (North Leigh), Old , Shifford, , , , Sutton,

5 | P a g e Tick Postcode Including Forest Hill, Holton, Horspath, Horton-cum-Studley, Littleworth, Milton Common, Stanton St. John, Waterperry, Waterstock, x OX33 Wheatley, Woodperry x OX39 Chinnor, Crowell, Emmington, Henton, Kingston Blount, Sydenham Ascott, Chalgrove, Chippinghurst, Chiselhampton, Cuddesdon, Denton, Garsington, Great Haseley, Great Milton, Little x OX44 Baldon, Little Haseley, Little Milton, Marsh Baldon, Nuneham Courtenay, Stadhampton, Toot Baldon Aston Rowant, Brightwell Baldwin, Britwell Salome, Christmas Common, Cuxham, Easington, Lewknor, Pyrton, Shirburn, x OX49 Watlington x RG4 Sonning, Sonning Common, Kidmore End x RG8 Goring, Streatley, Pangbourne, Whitchurch-on-Thames Hambleden, Rotherfield Peppard, Turville, Turville Heath, Skirmett, Rockwell End, Mill End, Fawley, Fingest, Frieth, x RG9 Greenlands, Nettlebed, Shiplake, Henley-on-Thames x RG10 Charvil, Hurst, Ruscombe, Twyford, Wargrave, Waltham St Lawrence Highworth, Cricklade, , , Ashton Keynes, Ashbury, Bishopstone, Castle Eaton, Hannington, , x SN6 Marston Meysey, Leigh Faringdon, , Uffington, , , Buckland, , , Littleworth, x SN7 ,

6 | P a g e Days and times the Personal Assistant is available, or specific hours.

Day Morning Afternoon Evening Night

Monday x x x x

Tuesday x x x x

Wednesday x x x x

Thursday x x x x

Friday x x x x

Saturday x x x x

Sunday x x x x

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