Job summary
This is an exciting opportunity to provide a
new model of care across Plymouth, through the establishment of the Inclusion
Health Service.
In line with current
best practice this service is being developed using the “Pathway” approach,
providing ‘end to end’ support for individuals who are homeless. It involves
not only medical staff, but a range of multidisciplinary professionals with
expertise in social care, housing law and benefits issues, ensuring that a
person’s full range of needs are supported. More information about the "Pathway" approach can be found here www.pathway.org.uk
The aim of the
Inclusion Health service is:
- To create a
comprehensive service, for adults with complex needs related to
homelessness, health, contact with the criminal justice system and
substance misuse issues.
The
Service will:
- Prevent more
entrenched and longer-term homelessness.
- Contribute towards improving outcomes and addressing
health inequalities for
some of the most disadvantaged individuals in Plymouth.
- Achieve truly
joined up and effective care for this most vulnerable group of individuals
and ensure engagement and completion of treatment wherever possible.
Main duties of the job
- To provide a professional social work service to adults, their families
and carers in line within the requirements of the Care Act 2014.
- The role will involve working within a
Multi-disciplinary Integrated Health care team which will enable close
working partnerships with healthcare and professionals leading to positive
outcomes for people supported in the community.
- Due to the nature of those accessing the service,
the role holder is expected to work face to face, both on clinical sites and
in the community.
- To undertake safeguarding enquiries in line with legislation, statutory
guidance and good practice approaches with a focus on making safeguarding
personal to ensure that the adult is at the centre of the process.
To identify, respond to, manage and evaluate risk as appropriate
considering and applying the Mental Capacity Act 2005 as appropriate.
All team members are expected to work collaboratively and supportively
with each other across Primary, Secondary Care and Community care boundaries
to improve outcomes for people who are homeless.
- They should also work to the Pathway model (with flexibility as
required), to attend team handover and MDT meetings, and to be present to
take referrals, and undertake assessments and ward rounds where needed.
About us
This service will be delivered through an exciting and innovative partnership approach with collaboration from organisations such as Livewell Southwest CIC, Adelaide and St Levan Surgery, University Hospitals Plymouth NHS Trust and the Plymouth Alliance.
Livewell Southwest is a recognised provider of integrated health and social care services operating across South Hams, West Devon and Plymouth www.livewellsouthwest.co.uk
Adelaide and St Levan Surgery is a GP practice in the most deprived area of Plymouth, supporting many adults with complex needs. www.stlevansurgery.nhs.uk
The Plymouth Alliance was formed with a group of local charities / community organisations with leadership from Plymouth City Council to provide services to people with complex needs (homelessness, drug or alcohol misuse, mental illness and offending).
Our Plymouth health and care system requires and features strong and effective collaboration.
This role will be employed by one of these partner organisations.
Job description
Job responsibilities
Promotes independence and autonomy
- Uses a strength based, person centred approach, developing creative and personalised solutions to assist people to manage their lives independently for as long as possible, ensuring agreed outcomes are met. Encourage the use of direct payments as an option wherever possible.
- Promotes independence by taking a preventative approach to interventions, maximising use of appropriate resources including Reablement, equipment, adaptations, assistive technology and advice and information.
- Ensure those accessing the service, including families and carers, are at the centre of decision making over their support arrangements and that opportunities and capacity for choice and control are optimised and reflected in their assessments and reviews.
- Actively engage with, assist and provide advice to carers, conducting carers assessments when appropriate, to enable them to sustain their caring role.
- Initiate and develop joint working with health-related agencies (including GPs and Intermediate care), the third sector, local housing providers and other agencies, in order to facilitate co-ordinated, high quality outcomes for people needing support.
- Develop joint working with all related agencies (including GPs, Community Nursing, and specialist mental health service), the third sector, local housing providers and other agencies, in order to facilitate co-ordinated high quality outcomes for people needing support.
- Ensure that people have access to information, advice, and signposting to universal and preventative services which promote their health and wellbeing.
- To suggest and critically explore new concepts without prejudice or assumption.
- All team members are expected to work collaboratively and supportively with each other across Primary, Secondary Care and Community care boundaries to improve outcomes for people who are homeless.
- They should also work to the Pathway model (with flexibility as required), to attend team handover and MDT meetings, and to be present to take referrals, and undertake assessments and ward rounds where needed.
Ensures effective safeguarding and risk management
- To make ongoing assessments of need of service users allocated, including assessment of risk. Identify and process any safeguarding and quality of care issues and refer on to the appropriate staff/agency to ensure that clients’ welfare is protected and that the quality and standard of support provided is optimised.
- Undertake safeguarding enquiries, providing expert knowledge of safeguarding processes, practice, policy and case law where appropriate. Seeks the direction of a manager dependent on experience. Lead on cases where a safeguarding concern has been identified and utilise the council’s policies and procedures.
- To ensure statements for court and reports for case conferences, panels and reviews are prepared and presented to a high standard, within allocated timescales and evidence the involvement of adults, families and carers.
Casework Management
- Manage a complex and diverse caseload including safeguarding. Maintain records by recording assessments and other data accordingly, ensuring that all data entered meets the relevant and stated levels of accuracy, quality and timeliness as defined within the Service Standards and Practice Recording Standards. Adhere to the Standards of Proficiency as defined by Social Work England.
Values
- Empathy and compassion – providing care for patients that is rooted in the patient’s
priorities.
- Collective responsibility – all team members take responsibility for patients and the team’s
success, work collaboratively, and support each other.
- Creative persistence – team members tackle complicated problems together, seek practical
solutions, and ‘never give up’.
- Challenging discrimination and poor practice – teams support the delivery of equitable health care, challenging
poor attitudes, behaviours and practices.
- Inclusive approach to healthcare – teams subscribe to Pathway’s belief that everything about a
person’s situation affects their health – not just their medical conditions.
- Promoting autonomy – patient empowerment and individual agency.
- Relationship builders and influencers – form strong networks within and outside of the hospital and
influence the behaviour of different stakeholders across those networks
including by teaching, training and inspiring others.
- Constantly improving – seeking new opportunities and ways to improve their service, its
resilience, and the support it gives to, and receives from, others.
- Trauma-informed
– the culture of the whole system,
including all work practices and settings reflects a trauma-informed approach.
Additional Information
As a new service we are keen for the
successful applicant to bring their expertise and experience to help shape and
define the job role and the Health Inclusion Service. Equally, as this new service launches and
evolves it may be necessary to review job responsibilities. Therefore, at this
stage this is a draft job description.
Job description
Job responsibilities
Promotes independence and autonomy
- Uses a strength based, person centred approach, developing creative and personalised solutions to assist people to manage their lives independently for as long as possible, ensuring agreed outcomes are met. Encourage the use of direct payments as an option wherever possible.
- Promotes independence by taking a preventative approach to interventions, maximising use of appropriate resources including Reablement, equipment, adaptations, assistive technology and advice and information.
- Ensure those accessing the service, including families and carers, are at the centre of decision making over their support arrangements and that opportunities and capacity for choice and control are optimised and reflected in their assessments and reviews.
- Actively engage with, assist and provide advice to carers, conducting carers assessments when appropriate, to enable them to sustain their caring role.
- Initiate and develop joint working with health-related agencies (including GPs and Intermediate care), the third sector, local housing providers and other agencies, in order to facilitate co-ordinated, high quality outcomes for people needing support.
- Develop joint working with all related agencies (including GPs, Community Nursing, and specialist mental health service), the third sector, local housing providers and other agencies, in order to facilitate co-ordinated high quality outcomes for people needing support.
- Ensure that people have access to information, advice, and signposting to universal and preventative services which promote their health and wellbeing.
- To suggest and critically explore new concepts without prejudice or assumption.
- All team members are expected to work collaboratively and supportively with each other across Primary, Secondary Care and Community care boundaries to improve outcomes for people who are homeless.
- They should also work to the Pathway model (with flexibility as required), to attend team handover and MDT meetings, and to be present to take referrals, and undertake assessments and ward rounds where needed.
Ensures effective safeguarding and risk management
- To make ongoing assessments of need of service users allocated, including assessment of risk. Identify and process any safeguarding and quality of care issues and refer on to the appropriate staff/agency to ensure that clients’ welfare is protected and that the quality and standard of support provided is optimised.
- Undertake safeguarding enquiries, providing expert knowledge of safeguarding processes, practice, policy and case law where appropriate. Seeks the direction of a manager dependent on experience. Lead on cases where a safeguarding concern has been identified and utilise the council’s policies and procedures.
- To ensure statements for court and reports for case conferences, panels and reviews are prepared and presented to a high standard, within allocated timescales and evidence the involvement of adults, families and carers.
Casework Management
- Manage a complex and diverse caseload including safeguarding. Maintain records by recording assessments and other data accordingly, ensuring that all data entered meets the relevant and stated levels of accuracy, quality and timeliness as defined within the Service Standards and Practice Recording Standards. Adhere to the Standards of Proficiency as defined by Social Work England.
Values
- Empathy and compassion – providing care for patients that is rooted in the patient’s
priorities.
- Collective responsibility – all team members take responsibility for patients and the team’s
success, work collaboratively, and support each other.
- Creative persistence – team members tackle complicated problems together, seek practical
solutions, and ‘never give up’.
- Challenging discrimination and poor practice – teams support the delivery of equitable health care, challenging
poor attitudes, behaviours and practices.
- Inclusive approach to healthcare – teams subscribe to Pathway’s belief that everything about a
person’s situation affects their health – not just their medical conditions.
- Promoting autonomy – patient empowerment and individual agency.
- Relationship builders and influencers – form strong networks within and outside of the hospital and
influence the behaviour of different stakeholders across those networks
including by teaching, training and inspiring others.
- Constantly improving – seeking new opportunities and ways to improve their service, its
resilience, and the support it gives to, and receives from, others.
- Trauma-informed
– the culture of the whole system,
including all work practices and settings reflects a trauma-informed approach.
Additional Information
As a new service we are keen for the
successful applicant to bring their expertise and experience to help shape and
define the job role and the Health Inclusion Service. Equally, as this new service launches and
evolves it may be necessary to review job responsibilities. Therefore, at this
stage this is a draft job description.
Person Specification
Experience
Essential
- Working knowledge of national policies and the relevant legislation, including Care Act 2014, Mental Health Acts, Mental Capacity Act, equalities and diversity and theories underpinning the provision of services to the relevant client group.
- Good general knowledge base of the health issues surrounding people with complex needs. Including mental health conditions that effect homeless people, including dual diagnosis presentations i.e., drug and alcohol /substance misuse.
- Knowledge of support available to improve the general health needs of those with complex needs, and motivated to promote and expand this further.
- Knowledge of the needs of homeless and /or refugee and asylum seekers and working to No Recourse to Public Funds guidance.
- Knowledge and understanding of homelessness strategies international, national and local e.g., Homelessness code of guidance for Local Authorities 2018.
- Demonstrable ability to work in a person-centred outcome focused way.
- Demonstrable experience of ensuring the full and active participation of users and carers in their own care arrangements.
- Demonstrable experience of working in conjunction with other health and social care agencies and professionals.
- Demonstrable experience of using community resources, family and natural networks of support to create sustainable packages of care for individuals and help prevent, reduce or delay the need for statutory services.
Qualifications
Essential
- CQSW, Dip SW or other GSCC/HCPC recognised social work qualification, and current Social Work England registration.
Person Specification
Experience
Essential
- Working knowledge of national policies and the relevant legislation, including Care Act 2014, Mental Health Acts, Mental Capacity Act, equalities and diversity and theories underpinning the provision of services to the relevant client group.
- Good general knowledge base of the health issues surrounding people with complex needs. Including mental health conditions that effect homeless people, including dual diagnosis presentations i.e., drug and alcohol /substance misuse.
- Knowledge of support available to improve the general health needs of those with complex needs, and motivated to promote and expand this further.
- Knowledge of the needs of homeless and /or refugee and asylum seekers and working to No Recourse to Public Funds guidance.
- Knowledge and understanding of homelessness strategies international, national and local e.g., Homelessness code of guidance for Local Authorities 2018.
- Demonstrable ability to work in a person-centred outcome focused way.
- Demonstrable experience of ensuring the full and active participation of users and carers in their own care arrangements.
- Demonstrable experience of working in conjunction with other health and social care agencies and professionals.
- Demonstrable experience of using community resources, family and natural networks of support to create sustainable packages of care for individuals and help prevent, reduce or delay the need for statutory services.
Qualifications
Essential
- CQSW, Dip SW or other GSCC/HCPC recognised social work qualification, and current Social Work England registration.
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.
Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab).
From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab).
UK Registration
Applicants must have current UK professional registration. For further information please see
NHS Careers website (opens in a new window).
Additional information
Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab).
From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab).
UK Registration
Applicants must have current UK professional registration. For further information please see
NHS Careers website (opens in a new window).