Care Home Health & Wellbeing Coordinator

Job description

Job responsibilities

Basic Purpose of the Role

To collaborate with GP surgeries, care homes, paramedics, and attached teams to deliver high-quality care for care home residents.

Key Duties

Enable access to personalised care and support

a. Take referrals for individuals or proactively identify people who could benefit from support through care coordination.

b. Have a positive, empathic, and responsive conversation with the person and their family and carer(s) about their needs.

c. Support people to develop and implement personalised care and support plans.

d. Review and update personalised care and support plans at regular intervals.

e. Ensure personalised care and support plans are communicated to the GP and any other professionals involved in the persons care and upload the relevant online care records, with activity recorded using the relevant SNOMED codes.

f. Where a personal health budget is open, to work with the person and the local ICB team to provide advice and support as appropriate.

Coordinate and integrate care

a. Help people transition seamlessly between services and support them to navigate through the health and care system.

b. Refer onwards to other healthcare agencies where required.

c. Regularly liaise with the range of multidisciplinary professionals and colleagues involved in the persons care, facilitating a coordinated approach and ensuring everyone is kept up to date so that any issues or concerns can be appropriately addressed and supported.

d. Actively participate in multidisciplinary team meetings in the PCN as and when required.

e. Identify when action or additional support is needed, alerting a named clinician contact in addition to relevant professionals, and highlighting any safety concerns.

Professional development

a. Work with a named clinical point of contact for advice and support.

b. Undertake continual personal and professional development, taking an active part in reviewing and developing the role and responsibilities, and provide evidence of learning activity as required.

c. Attend any training courses and supervision sessions as required.

d. Adhere to organisational policies and procedures, including confidentiality, safeguarding, lone working, information governance, equality, diversity and inclusion training and health and safety.

Miscellaneous

a. Establish strong working relationships with GPs and practice teams and work collaboratively with other care coordinators, social prescribing link workers and other agencies, supporting each other, respecting each others views, and meeting regularly as a team.

b. Report any Safeguarding concerns to the appropriate person

c. Act as a champion for personalised care and shared decisional making within the PCN.

d. Demonstrate a flexible attitude and be prepared to carry out other duties as may be reasonably required from time to time within the general character of the post or the level or responsibility of the role, ensuring that the work is delivered in a timely and effective manner.

e. Identify opportunities and gaps in the service and provide feedback to continually improve the service and contribute to business planning.

f. Contribute to the development of policies and plans relating to equality, diversity, and reduction of health inequalities.

g. Work in accordance with the Practices and PCNs policies and procedures.

h. Contribute to the wider aims and objectives of the PCN to improve and support primary care.

i. Undertake any other duties as may reasonably be required from time to time.

j. Ensure that all activities are monitored and evaluated.

Person Specification

Qualifications

Essential

• GCSE grade A to C in English and Maths

Desirable

• Qualified in Phlebotomy

Skills/Abilities

Essential

• Highly organised, able to complete administrative tasks with a high degree of accuracy.
• Ability to collect data for monitoring and evaluation.
• Strong organisational skills, and ability to coordinate information and data from a range of sources.
• Ability to develop strong working relationships with project partners.
• Excellent verbal and written communication skills ability to adapt to meet the communication styles and needs of individuals.
• Planning/organising skills/coordinating.
• First class interpersonal skills.
• Excellent team worker strong ability to motivate others in the development and delivery of meaningful occupation and activities for older people.
• Good IT skills in Word, Excel, Outlook and Powerpoint.
• Creative thinking.

Desirable

• Good system IT knowledge of EMIS.
• Experience taking patient observations including height, weight, BP, pulse.
• Knowledge of basic wound care.

Experience

Essential

• Good knowledge of the social aspect/model of care, holistic approach.
• Experience of working in a health or care environment.
• Experience of managing a caseload of clients/patients.
• Proven ability to provide advice and support to clients
• Experience of working with individuals on a 1:1 basis.
• Experience of project administration, and of coordinating and developing projects.
• Experience of working in partnership with other groups and agencies.
• Experience of researching and producing written reports.

Desirable

• Experience in and/or knowledge of the care of older people and people living with dementia.
• Experience in arranging social activities in a care setting.
• Previous experience of setting and/or participating in groups and committees.
• Experience of providing health and wellbeing advice.
• Previous experience of working with GPs.
• Experience of dealing with safeguarding issues.

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.

Employer details

Employer name

Fleetwood Community Care Ltd

Address

Fleetwood Health & Wellbeing Centre

Dock Street

Fleetwood

Lancashire

FY7 6HP

Employer's website

https://www.fleetwoodpcn.nhs.uk/ (Opens in a new tab)