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Statement of Main Terms and Conditions of Employment

(Service User as Employer version) 

In compliance with the Employment Rights (Northern Ireland) Order 1996, this statement sets out certain terms and conditions of your employment contract which are relevant as on the………………….(date of issue of contract). 

Name of Employer:     ...................................................

Address:                   ...................................................


Name of Employee:   ...................................................

Address:                  ...................................................


Date of Commencement of Employment

Your employment starts/started on.......................... and no previous period of employment counts towards this period of employment for the purposes of calculating your continuous service.

Period of Employment

Your employment is permanent, subject to the satisfactory completion of a probationary period of  .......... month(s). (minimum one month.) Provided a satisfactory standard is achieved and maintained during this period, your employment will be confirmed. In the event of unsatisfactory progress, your employment will not be regarded as confirmed and will be terminated either during or at the end of the probation period.


Your employment is temporary and is expected to continue for..................... (insert period of likely duration in weeks or months or specify an event  which will terminate the period of employment). However, circumstances may dictate an earlier termination or, by mutual agreement, an extension to the period.

Job title

You are employed as a Personal Assistant.

Your duties are as  

outlined in the job description which is attached to this document


verbally agreed with me, as your employer.

Special Term of Employment

With regard to both the Period of Employment and Job title provisions outlined above, your employment is subject to my assessed care needs and the related funding for it. In the event of a further or revised assessment of my needs, I will notify you within seven days of the revised assessment if your job description or period of employment is to change. If the funding is reduced or withdrawn, this may result in the reduction or termination of employment.

Place of Work

You will be required to work mainly at........................... (insert venue, normally the Employer's residence). The requirement however to provide support duties to me will involve accompanying me to various places and/or travelling to other venues to collect items such as medication/shopping etc.


Rate of Pay

Your rate of pay is currently £.................. gross per hour as itemised on the payslip, which you will receive with your pay.

Pay Arrangements

The pay week ends on..................... (normally Friday?) and you will be paid     weekly, in arrears, on.......................... by cash/cheque/credit transfer.


You will be paid monthly, in arrears, on................/every 4th week by cash/cheque/credit transfer.

Hours of Work

Your normal hours of work are........... hours per week. You will usually work from .................. to ........................ on................ (insert "each day" or the specific days of the week on which the employee is normally to work).


Depending on my needs, I will let you know in advance what hours I need you to work.

You are entitled to a break of 20 minutes on any day on which you work for more than 6 hours. The timing of breaks will be dictated by the events of the day but I will endeavour to be as flexible as possible. The break will be unpaid/paid.

Punctuality and Reliability

You must arrive at your agreed starting time. If you are delayed for more than 10 minutes, please inform me by telephone. Please do not arrive more than 10 minutes earlier than the agreed starting time. It is very important that you are reliable and attend work regularly.

Additional Hours of Work

You may be asked from time to time to work additional hours to assist with my care including, for example, to cover for other staff on sick leave or holiday. I will provide as much notice as possible if this is required. You will be paid at your normal rate of pay for any additional hours worked


Holiday Entitlement

The holiday year runs from................... to........................... (You can choose any yearly period but it will normally run from 1 April to 31 March.)

You will accrue 5.6 weeks pro rata equivalent to your average working week for each complete year of service. Part years will be calculated on this basis e.g. if you commenced this employment after the beginning of a holiday year or leave partway through the holiday year, you shall be entitled in that holiday year to annual holiday (with pay) proportional to your length of service.

(Optional) I will specify when I need you to take.................. weeks out of your holiday entitlement and will give you.................... weeks’ notice.

On Termination of Employment

You shall be entitled to annual holiday with pay, or pay instead of, proportional to your length of service in that holiday year, less any annual holidays you have already taken. If you are leaving my employment and have taken more leave and you have earned, I will recover from your final pay the money equivalent to the excess leave you have taken.

Annual Holiday Arrangements

You shall be required to give............... days/weeks notice of any holidays which you wish to take and you should check with me to ensure that it suits before you book any holidays.

There may also be occasions when I may require you to take some of your holidays e.g. at times when I will be in hospital or in respite care. I will endeavour to give at least a day's notice of any requirement to take such holidays but there may be occasions when I will be unable to give advance notice.

During the first year of employment, holiday leave should be accrued in advance unless exceptionally agreed between us.

You must take all of your holiday entitlement within the holiday year and no carryover of holiday leave is permitted


You may carryover up to...................... into the next holiday year. (Maximum 1.6 weeks.)

Holiday Pay

During holidays, an employee will be entitled to holiday pay at their current hourly gross rate of pay, subject to deductions for income tax and NICs.

Pension Scheme

(Under the UK Pensions Act 2008, the employer has a legal requirement to help an employee save for his/her retirement by automatically enrolling him/her, if eligible, into a workplace pension scheme and contributing towards it. The employer should consult his/her Independent Living Adviser at CILNI to find out the wording which to include here, depending on the circumstances in each case.)

Notice of Termination

If you have one month’s continuous service or more and you wish to terminate your employment, you are required to give the employer one week’s notice of your intention.

If you have one month’s continuous service you are entitled to receive one week’s notice in the event of termination.  This increases to 2 weeks after 2 year’s continuous service and then by a further week for each completed year of continuous service, up to a maximum of 12 weeks.

In the case of gross misconduct, you will be dismissed summarily i.e. without notice and without payment in lieu of notice.

Collective Agreements

There are no collective agreements which directly affect the terms and conditions of your employment.

Requirement to work outside the UK

You are not required to work outside the UK. There may be occasions when you may be asked to accompany me outside the UK e.g. to the Republic of Ireland. You are not under any obligation to accompany me if you do not wish to do so.

Sickness Absence

If you are unable to work due to illness, please inform me as soon as possible to allow the time to make alternative arrangements. Please contact me by telephone as soon as you realise that you will be unable to work owing to ill-health. If I am unavailable, please leave a message. Full details of notification and certification requirements are set out in the attached Appendix 1 to this document. You are required to make yourself fully aware of the contents of this appendix. If you meet the qualifying conditions, you will be entitled to Statutory Sick Pay.


It is very important that you respect my privacy and that of my family, friends and neighbours. It is your responsibility to keep any information gained about me, or anyone else associated with me, in the course of working for me strictly confidential. You must not discuss or refer to my personal business with any other person.


A reasonable attitude toward your responsibilities during working hours is expected, especially as the place of work is likely to be my home.

In particular, you are asked to:

  • Respect confidentiality and privacy as indicated above.
  • Perform the tasks outlined in your job description to a competent standard.
  • Except with my express permission, switch off your mobile phone whilst you are on duty.
  • Notifying me as early as possible if you are unable to attend work.
  • Respect my home and personal property. If you move any item in my home from where you found it, please return it before you leave.
  • Use any equipment in a safe manner. If you are not sure how to use any particular item of equipment, please ask me for guidance and instructions.
  • Make me aware of any issue related to working for me that may compromise the health and safety of you or anyone else.
  • Be aware that there may be times when you are on duty, that you will be required to wait for me if I am busy.
  • Be able to make your own way to work.
  • Be prepared to work additional hours as and when required.
  • Report any accidental damage to my home or personal property to me immediately.
  • Provide a telephone number (or numbers) on which you can be contacted

You must not:

  • Use my property without my consent.
  • Arrive for work under the influence of alcohol or illegal substance.
  • Bring anyone, including children, to my home without my prior agreement.
  • Bring pets or other animals to my home.
  • Give my telephone number or contact details to anyone without permission.
  • Smoke inside my home.
  • Bring in or consume any intoxicating beverages or illegal drugs whilst in my home.

Disciplinary and Dismissal Procedures

The disciplinary and dismissal procedures are non-contractual and are set out in the attached Appendix 2 to this document. You are required to make yourself fully aware of the contents of this appendix. I reserve the right to vary these procedures in line with revisions to the minimum Statutory Procedures. If you are of relatively short service, the procedure may be shortened and you may be dismissed with due notice for a first breach of discipline.

Grievance Procedure

The procedure for raising any grievance is set out in the attached Appendix 3 to this document. You are required to make yourself fully aware of the contents of this appendix.

Changes in Terms and Conditions

From time to time your main terms and conditions of employment may be subject to change (e.g. by mutual consent or changes to the statutory employment law). Should any change be agreed between us, this will be confirmed within one month from the change taking effect, by written notification.

Employee's Signature

By signing this document I, as the Employee, acknowledge receipt of this Statement together with copies of Appendices 1, 2 and 3.

Relevant Agreement

For the purposes of the Working Time Regulations (NI) 1998 (as amended), it is agreed that the sections on holidays, including holiday entitlement, annual holiday arrangements and holiday pay of this Statement constitute a relevant agreement and be treated as agreed in writing: –

Signature....................................................................................... (Employer)


Signature...................................................................................... (Employee)


Doc/WTAR/21 February 2011


Appendix 1 (Service User as Employer version)

Sickness Absence

As the Employer, I recognise that a certain level of absence may occur due to sickness and ill-health.

Absence Notification and Certification Procedures:

Statutory Sick Pay

Evidence of Incapacity 

  1. If you, as an Employee, qualify, Statutory Sick Pay (SSP) is payable for up to 28 weeks of sickness absence.
  2. For SSP purposes, Qualifying Days in this employment are Sunday to Saturday.
  3. An Employee, absent from work due to illness or injury, will be paid SSP provided the qualifying conditions for receipt of SSP are satisfied; and provided that the requirements in respect of notification and supply of evidence of incapacity as set out below are fully met.
  4.     Notification:
    • If you are ill and your absence extends beyond three working days, you must present to me, as your Employer, a completed HMRC self certification form SC2. This form is available from Doctors' surgeries and should arrive as soon as possible but not later than the eighth day of absence.
    • If your absence extends beyond seven calendar days, you must submit to me, as your Employer, a Statement of Fitness for Work covering absence from the eighth calendar day. This Statement is available from Doctors' surgeries and should be forwarded to me, as your Employer, as soon as possible after the eighth day of your absence.

A Statement of Fitness for Workwill advise on one of two options i.e. you will be either "not fit for work " or you "may be fit for work".

"Not fit for work"

Your doctor will choose this option when they believe that your health condition will prevent you from working for a stated period of time.

"Maybe fit for work"

Your doctor will choose this option when they believe that you may be able to return to work while you recover with some help from me, as your Employer. Your doctor may include some comments which will help me understand how you are affected by your condition. If appropriate, they may also suggest one or more, ways to help you return to work. These could include:

  • A phased return to work – where you may benefit from a gradual increase in your work duties on working hours e.g. after an operation on injury.
  • Altered hours – allowing you the flexibility to start or leave later e.g. if you are fatigued and may struggle to work later shifts. This we would need to negotiate to ensure that your absence outside your working hours can be covered in some other way.
  • Amended duties – to take into account your condition e.g. avoiding heavy lifting if you have a back injury.
  • Reasonable changes to your working conditions, taking into account your condition.
  •  Continued absence must be covered by further statements from your doctor on a regular basis.

Unacceptable delays in notifying me or failure to provide evidence of incapacity may result in the withholding of any SSP due.

5)  A person who knowingly makes a false statement on HMRC self certification form will be dealt with in accordance with the Disciplinary   Procedures.

Doc/WTAR/21 February 2011


Appendix 2  (Service User as Employer version)

Disciplinary and Dismissal Procedures

If I am considering taking disciplinary action against you or dismissing you, I will inform you in writing of the allegations. I will arrange a meeting with you to give us both the opportunity to discuss the allegations before I make any decision. I will provide all relevant information to you in advance of the meeting. You will have the right to be accompanied by a work colleague or a (paid or lay) trade union official. After the hearing, I will inform you in writing of my decision and will invite you to appeal if you are dissatisfied with the decision.

If you decide to appeal, you should do so to me in writing within five days of receipt of my decision. I will arrange to hold the appeal meeting as soon as possible following receipt of the written request. You again have a right to be accompanied by a work colleague or (paid or lay) trade union official at the appeal meeting.

I reserve the right to suspend you on full pay pending an investigation into an alleged incident. Suspension is not a sanction in itself, it is merely a holding measure pending further investigations.

I will inform you in writing of my decision regarding the appeal and will endeavour to do this as promptly as possible.

This above procedure will be followed when I am taking disciplinary action for both minor and more serious issues.

If you are found guilty of misconduct which I consider to be minor in nature, you will receive a:

  • Recorded oral warning (expiring after six months) on the first occasion.
  • Written warning (expiring after nine months) on the second occasion.
  • Final written warning (expiring after 12 months) on the third occasion.
  •  Termination of contract of employment – final stage.

If however you are found guilty of a more serious issue, you will receive a final warning for the first offence and dismissed on the second occasion.

If you are found guilty of an offence which I consider to be gross misconduct, you will be dismissed on the first occasion.

The following are examples of issues which I will consider to be gross misconduct:

  • Threatening behaviour towards me or anyone else.
  • Verbal abuse towards me or anyone else.
  • Wilful damage to, or destruction of, my personal property or home.
  • Serious breach of confidentiality.
  • Fraud or theft from me or my family, friends and neighbours.
  • Arriving for work under the influence of alcohol or illegal drugs.
  • Obscene or totally inappropriate behaviour.
  • Serious disobedience of my instructions (including conduct which undermines my self autonomy and independence).
  •   Deliberately or knowingly compromising my safety or that of anyone else.

Breakdown of working relationship

Due to the nature of this employment relationship it may be untenable to continue employment in circumstances whereby our personal working relationship is no longer sustainable. If such circumstances arise, I will take appropriate measures to ensure you are treated fairly and a fair and thorough procedure is undertaken prior to making any decision to terminate your employment on this basis.

Doc/WTAR/21 February 2011


Appendix 3  (Service User as Employer version)

Grievance Procedure

I will endeavour to address any grievance brought by you to my attention, by means of negotiation. If this informal approach fails, it is your responsibility to give me a written explanation of the grievance you have in relation to working for me.

On receipt of your grievance in writing, I will arrange to meet you to discuss the issue or issues that you have raised. After the meeting, I will advise you of my decision in relation to your grievance.

If you're not satisfied with my decision, you may request an appeal within five working days. I will arrange to hear your appeal at a mutually suitable time and venue. After the appeal, I will let you know my final decision.

If you have a grievance, I would encourage you to discuss it with me as soon as possible so that we may attempt to resolve it at the earliest possible opportunity.

If this informal approach does not work or if you prefer to raise a grievance formally in the first instance, you should write to me detailing your grievance. You should also provide me with any information I would need to allow me to deal with the issue appropriately. When I have received this, I will arrange to meet with you to discuss the issue. You have a right to be accompanied at this meeting by a work colleague or a (paid or lay) trade union official.

After the meeting, I will inform you in writing of my decision and, if you are dissatisfied with the decision, will invite you to appeal.

You should appeal in writing to me within five days of receipt of my decision. I will arrange to hold the appeal meeting as soon as possible at a mutually suitable time and venue following receipt of your written request. You again have a right to be accompanied by a work colleague or (paid or lay) trade union official at this meeting. I will take notes on this meeting.

I will inform you in writing of my decision and will endeavour to do this as promptly as possible.

If the grievance is about me or a decision I have made and I feel it may be appropriate that the matter is heard by a 3rdparty, I will inform you of this and request the grievance procedure be chaired by that party.

Doc/WTAR/21 February 2011