Job summary
To work closely with the PCN focused Care Home Team
in coordinating all key activities to enhance patient care in Care Homes.
This will include access to services, advice,
information, and ensuring health and care planning is timely, efficient, and
patient-centred.
The post holder will support Care homes to help patients
interact and engage with everyday life through activities designed to develop, maintain,
or retrain skills for people with a cognitive, physical, or mental disorder, condition,
or illness. You will support the provision of continuity of care and act as a
point of contact for families, residents, and professionals for identified
patients in your caseload.
Main duties of the job
As Care Home Support Coordinator you will help to improve the continuity of care by acting as a point of contact for residents, families and professionals who visit, or work in the care home. You will sometimes be required to lead the coordination of the Care Home MDT and the weekly care home round, through identification of people in need of review and/or discussion.
Care coordinators provide time, capacity and expertise to support individuals preparing for, or following-up clinical conversations with primary care professionals.
You will work closely with the Care Home Leads and other primary care professionals within the PCN to identify and manage a caseload of care homes looked after by our practices.
This role is designed to improve communication between Primary Care and Care Home staff.
The Enhanced Health in Care Homes Framework is a new initiative and as such this role will adapt and evolve, the post holder must have a positive and adaptable approach towards change and service development.
About us
You will be supported by a friendly yet focused team comprising of an experienced Clinical Pharmacist, Pharmacy Technician, GP and Nursing team, who are dedicated to continued high level of care and safety for our patients.
You will receive and undertake mandatory training as and when required. You will be receive both clinical an non-clinical support to create and maintain your own personal development plan.
Job description
Job responsibilities
Provide
coordination and navigation for people and their carers across health and care
services, working closely with the Care Home Lead Clinician, social
prescribers, health and wellbeing coaches and other primary care professionals.
Utilise
population health intelligence to proactively identify and work with a cohort
of patients to deliver personalised care
Support
the Care Home staff and patients to be prepared to have shared-decision making conversations
including utilising decision aids and tools.
Help
people to manage their needs through answering queries, making and managing appointments
and ensuring that people have good quality written or verbal information to
help them make choices about their care
Holistically
bring together all of a persons identified care and support plan, in line with
best practice, based on what matters to the person
Support
people to take up training and education courses, peer support, and/or personal health budgets where
applicable.
Raise
awareness within the PCN of shared-decision making and decision support tools,
including how to identify patients who may benefit from this
As
part of the multidisciplinary team, build relationships with staff in GP
practices within the PCN, attending relevant meetings, providing information
and feedback on care coordination priorities
Be
proactive in developing strong link with local agencies, and in encouraging
equality and inclusions
Liaise
directly with care homes and other key providers, and compile and circulate
relevant information across stakeholder groups
Understand,
our in place and adhere to safeguarding protocols for vulnerable individuals
Capture
key information to enable comprehensive and accurate records of support,
inputting these into clinical systems as required and adhering to data
protection legislation
Job description
Job responsibilities
Provide
coordination and navigation for people and their carers across health and care
services, working closely with the Care Home Lead Clinician, social
prescribers, health and wellbeing coaches and other primary care professionals.
Utilise
population health intelligence to proactively identify and work with a cohort
of patients to deliver personalised care
Support
the Care Home staff and patients to be prepared to have shared-decision making conversations
including utilising decision aids and tools.
Help
people to manage their needs through answering queries, making and managing appointments
and ensuring that people have good quality written or verbal information to
help them make choices about their care
Holistically
bring together all of a persons identified care and support plan, in line with
best practice, based on what matters to the person
Support
people to take up training and education courses, peer support, and/or personal health budgets where
applicable.
Raise
awareness within the PCN of shared-decision making and decision support tools,
including how to identify patients who may benefit from this
As
part of the multidisciplinary team, build relationships with staff in GP
practices within the PCN, attending relevant meetings, providing information
and feedback on care coordination priorities
Be
proactive in developing strong link with local agencies, and in encouraging
equality and inclusions
Liaise
directly with care homes and other key providers, and compile and circulate
relevant information across stakeholder groups
Understand,
our in place and adhere to safeguarding protocols for vulnerable individuals
Capture
key information to enable comprehensive and accurate records of support,
inputting these into clinical systems as required and adhering to data
protection legislation
Person Specification
Qualifications
Essential
- Experience of working in a care home or similar care co-ordination role
- Must be a confident administrator
- IT Literate
- Understanding of primary care an advantage
- Qualifications - GCSE grade A* to C (9-4) in English and Maths or equivalent
Desirable
- Evidence of Working in/with Care Homes - Willingness to work towards further educational qualifications required for the role.
- Experience with Primary Care digital systems such as EMIS Web and Docman.
Person Specification
Qualifications
Essential
- Experience of working in a care home or similar care co-ordination role
- Must be a confident administrator
- IT Literate
- Understanding of primary care an advantage
- Qualifications - GCSE grade A* to C (9-4) in English and Maths or equivalent
Desirable
- Evidence of Working in/with Care Homes - Willingness to work towards further educational qualifications required for the role.
- Experience with Primary Care digital systems such as EMIS Web and Docman.
Disclosure and Barring Service Check
This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.