Work Placement (in person) Provider and Placement Details

The Work Experience Programme is a very valuable exercise for all our pupils and is very beneficial to them in their preparation for the world of work.

Thank you for completing this form. Your participation in the Work Experience Programme is very much appreciated.

1.Provider Details

Name of Provider (company/organisation/agency): Provider: The name, address, postcode, telephone Nature of Business: No. of Employees: number and email address of the organisation. Placement Organiser/Supervisor: Your Position: Placement Organiser and Position: The person with the responsibility for work Address: Postcode: experience within the organisation. Normally this person will be the contact Tel: Email: individual that the pupil reports to on the first Website: morning or when placements are being confirmed.

The pupil will not be allowed to work outside the hours stipulated in the job description, in addition, the pupil will not receive any payment for the work.

2.PLACEMENT DETAILS

Title of placement: Placement Title: E.g. clerical assistant, sales assistant etc.

Which section/department will the pupil be working in? Description of duties: Details of the types of Description of duties: activities in which the pupil will be involved.

Work times: E.g. Monday to Friday 9 am – 5 pm Work Times: Start: Finish: Lunch arrangements: Indicate if you will provide Lunchtime Duration/Arrangements: lunch, if canteen facilities are available or if the pupil has to bring his/her own Canteen Facilities: Yes No lunch.

3.PLACEMENT requirements

Additional Requirements e.g. Dress Code etc.: Placement requirements: Please indicate any extra details e.g. special clothing requirements, dress code, pre-placement interview, school subject requirements e.g. English, Health and Safety Details

To comply with the Management of Health & Safety at Work 1999 regulations, firms or organisations providing work placements are required to assess the risks associated with the activities carried out by the pupil.

The pupils will be carrying out meaningful work during their period of work placement. The work will be carried out by a responsible person and th e pupils will be given appropriate instruction before and supervision whilst, participating in any activity. Under no circumstances should pupils operate prescribed and/or any prescribed machinery as defined by statute. The firm or organisation providing work placement will therefore ensure that the pupil is not required to operate any hazardous machine, to work in any hazardous environment, or to carry out work of an unsuitable or objectionable nature. The firm or organisation will take responsibility for ensuring th e pupils welfare. The firm or organisation will supply any special or protective clothing required by the pupil whilst performing the task.

4. Provider’s Risk Assessment

Risk Assessment: Has a Risk Assessment been carried out of the activities in which the pupil will Yes No By law a company with 5 be involved and any other process, procedure or environmental factor by which employees or more should have a Health and Safety they may be affected (click here for guidelines) Policy which contains a statement of general policy on health and safety at work and the Has a Risk Assessment been carried out specific to COVID 19 specifications? Yes No organisation and arrangements for putting that policy into practice

5. Provider’s HAZARDS IDENTIFICATION

Yes No Yes No Hazards: Please use this checklist Slips/Trips/Falls Hazardous substances to help you identify any (Spillages, trailing cables/flooring) (Cleaning products/oils, etc) significant hazards. Once you have done this it is important to have control Falls from h eight Pressure Systems measures in place to (Platforms/ladders/fragile surfaces) (Gas/air/ receivers/steam boilers) minimise any associated risk. As well as induction and supervision, control Display screen equipment Equipment/Machinery measures may include (Computers/cash register) (mechanical/electricay training, protective equipment or clothing etc. Electricity Transport (Mains operated & portable appliance) (Fork lift trucks/Cars/HGV etc) Noise Radiation (Machinery/tools/equipment/environment) (X-Ray/UV/lasers/radioactive materials) Vibration Asbestos (Machinery/transport/powered hand tools) (Building maintenance/vehicle repairs) Working with animals Manual Handling (Farm/domestic/wild) (Lifting/carrying/pushing/pulling etc)

5a. Provider’s control measures (Highlight Hazaedous Equipment)

Control Measures: Identify what pupils can and can’t use: The majority of placements will be visited by a member of our Business Liaison Team to carry out a Health & Safety Check. A member of the team will call on you to arrange a visit. The team will work with you to help you meet your duty of care.

5b. personal protective equipment

PPE: Please list all that may be required: If an identified control measure is to wear or use protective clothing or equipment, please specify what is required e.g. a hard hat, safety boots or special Will this PPE be provided by you? Yes No eyewear and whether you will provide this?

The firm or organisation providing work placements will ensure that the firm’s or organisation’s Public and Employers’ Liability Insurances will provide cover for pupils for the period(s) of work placements. Firms or organisations providing work placements must be prepared to accept pupils on this basis and should advise their insurers accordingly. This must take place prior to pupils taking part.

6. insurance details (please enclose a copy of current policy) Insurance: Does the com pany have Public & Employers Liability Insurance? All placement providers Yes No must have valid Public A certificate should be clearly displayed where it can be seen by employees. and Employers Liability Insurance in place to Name of Insurance Company: cover the period of the placement. This is regardless of employee Insurance Policy Number: numbers or sole trader status. Date of Expiry : Indemnity Limit:

Is your policy renewed automatically annually? Yes No

7. school calendar 2021/22

Please comp lete the school calendar marking clearly which school(s) and week(s) and how many pupils you are able to accommodate.

Please take into consideration when selecting dates and schools:-

• is an East school; however, pupils can travel to placements with more ease.

• Extended Outreach works with S1-S4 pupils who have personalised education provision working in partner-ship with mainstream schools.

• (South Ayrshire), St Joseph’s Academy () and St Matthews Academy (North Ayr-shir e) will have pupils travelling from all over the local authority and might have students who live close to your place of work.

• Add itional Support schools: - Hillside, Park, QMA SL, James Reid, James McFarlane, Stanecastle, Haysholm and South Crai g Campus. Max. Max. Max. no. of no. of no. of WEEK DATE EAST AYRSHIRE pupils NORTH AYRSHIRE pupils SOUTH AYRSHIRE pupils NO SCHOOLS SCHOOLS SCHOOLS 4 06/09/2021 Academy 5 13/09/2021 Auchenharvie Academy Girvan Academy 6 20/09/2021 Greenwood Academy Girvan Academy 7 27/09/2021 Academy Garnock Comm Campus Robert Burns Academy Greenwood Academy Belmont Academy *Queen Margaret 8 04/10/2021 Robert Burns Academy Acad 11 18/10/2021 St Joseph's Academy Academy Queen Margaret SL 12 25/10/2021 Grange Academy Robert Burns Academy Girvan Academy Academy 13 01/11/2021 Robert Burns Academy St Joseph's Academy Ayr Academy 15 15/11/2021 *Doon Academy *Doon Academy 16 22/11/2021 *Doon Academy *Doon Academy 22 24/01/2022 Hillside School Prestwick Academy Robert Burns Academy 26 31/01/2022 Grange Academy Supp Learning 30 28/02/2022 Park School *Extended Outreach South Craig Campus 31 07/03/2022 Park School *Extended Outreach James Reid School Haysholm School 32 14/03/2022 Stanecastle School Prestwick Academy James McFarlane School 33 21/03/2022 Arran High School 38 25/04/2022 Ardrossan Academy Garnock Community 39 02/05/2022 Robert Burns Academy Campus St Joseph's Academy Greenwood Academy Cumnock Supp Garnock Community Carrick Academy 40 09/05/2022 Learning Campus Robert Burns Academy Belmont Academy 41 16/05/2022 St Joseph's Academy *St Matthew's Academy Irvine Royal Academy Kilwinning Academy 42 23/05/2022 *St Matthew's Academy 43 30/05/2022 Loudoun Academy 44 06/06/2022 Loudoun Academy Kyle Academy 45 13/06/2022 Kilmarnock Academy Would you consider having an additional support needs pupil? Yes No

Would you offer a more FLEXIBLE placement? e.g. 1 day a week, 2hrs a day: Yes No

Please note which school/s:

FLEXIBLE PATHWAY INITIATIVE is a targeted programme in East Ayrshire to engage our most vulnerable young people, ensuring they move into a positive destination. It consists of a 10 week work placement, 3 days per week.

Interested in finding out more? Yes No

8. provider/employer checklist (Please tick box if Yes) You are clear about the purpose of Work Experience Placements You are able to offer an induction programme for pupils taking up your offer of a placement. You know who to contact should you require support or advice about any issue relating to the placement. You have identified a range of appropriate activities for the pupils to do during their time with you. You aim to have a feedback session with the pupil before the end of the placement.

We would welcome your comments on the elements of work experience that you believe make it most meaningful for young people:

Please note: Schools endeavour to send a confirmation letter 2 weeks prior to your offered date.

9. Acceptance and agreement

I confirm that -

. I have read the application form and agree that all points are acceptable to me and I have taken all appropriate action.

. This company’s Public and Employers Liability Insurance have confirmed they will cover a pupil for the duration of his/her Work Experience Placement and a copy of this policy is enclosed.

. The pupil will receive induction and instruction, which includes Health & Safety issues covering identified hazards and control measures, by a competent person.

• The pupil will be supervised at all times.

• The details provided are held on a database to support Work Experience and other similar activities.

• The pupil may be required to sign an agreement, copies of which will be available for inspection on request, stating that he or she will: o Not disclose any information confidential to the firm or organisation without the firm’s or organisation’s approval. o Obey all safety, security and other instructions given by the firm or organisation providing work experience.

• In case of an accident, sickness or absence, the firm or organisation providing work experience will notify by telephone, and with- out, delay, the head teacher of the pupil’s school, and the pupil’s home if a telephone number is given. The pupil will be allowed to use whatever facilities the firm or organisation provides in these circumstances.

• The identified occupation is based on due consideration of the nature of the anticipated work activities involved in this placement. You are asked to bring to our attention any other factors related to the actual activities to be carried out or the layout and/or the use made of your premises e.g. the presence of machinery or high volumes of traffic in or around the premises, which may require a re-assessment of this rating. If you do not agree with this assessment you are asked to provide details for information regarding the assessment.

• The firm or organisation will comply with its legal obligations under the Data Protection Act at all times.

Name of organisation:

Signed: Position: Date: