Care Navigator

Job description

Job responsibilities

The care navigator role is developmental in nature and continues to evolve over the duration of the operational period based in the GP Practices. As post holders will be visiting patients in their own homes (primarily over the age of 65), they will need to demonstrate flexibility and adaptability to working in a dynamic environment.

The care navigator will work as part of the model of delivering co-ordinated care, through the integrated care teams to ensure that patients receive the most appropriate care. The post is a supportive role to the health and social care professionals who will take the lead and responsibility for the clinical and social care provided to the patient.

The care navigator will work with other professionals to ensure wellbeing plans are delivered from all parties to fulfil the patients requirements and to navigate the health and social care system with the patients/carer. Providing a point of regular contact for the patient and their carer, acting as a bridge between social care, health care and voluntary sectors.

The role of the care navigator is pivotal in supporting a self-management approach to care ensuring the patient and carer is at the centre and an active part of the holistic care approach. As part of the GP surgery team and wider primary care network team, a care navigator will work with the voluntary services in the local community and signpost patients to services depending on their needs, liaising with adult services if necessary.

Core Responsibilities:

To perform specific day to day tasks associated with care navigation including:

To meet with (or telephone) the patient/carer in a mutually convenient location including but not restricted to the patients/carers home, hospital, or GP surgery.

To support patients in completing a wellbeing plan to ensure appropriate referrals are made, identifying clear needs and goals.

Co-ordinate the delivery of the wellbeing plan and ensure that the agreed interventions are actioned through onward signposting to the appropriate service. Examples of services and support patients/carers could be signposted to include, lunch clubs, social groups, befriending services, GP, volunteering schemes, social care, and urgent community responses, including other healthcare professionals within the primary care networks.

Explain and help the patient and their carer understand the processes and systems within the NHS and statutory sector. For example, how to refer to the occupational therapy team or adult services for a care needs assessment.

Keep up to date with NHS and community services through pro-active networking to ensure individuals are aware.

Devise a strategy with the patient and their carer to enable patients to lead more independent lives, reducing their need to engage health and social services.

Act as the coordinator between different agencies involved with the patients/carers to ensure joined up and seamless care.

Enable the patient and their carer to liaise with professionals from secondary and primary care and the wider integrated care team.

Keep up to date well documented notes on the patients medical record ensuring all components reflected on the patient referral are covered.

Maintain the patient at the centre of their care and decision making.

Attend practice ward, ICT, Primary Care Network (PCN), and other relevant meetings such as hospital discharge meetings as required.

Complete all mandatory training and attend any other training opportunities as required.

Participate in staff appraisal and lone worker practices on an annual basis.

This is a non-clinical role.

Person Specification

Skills and Knowledge

Essential

• Knowledge of the personalised care approach.
• Understanding of the wider determinants of health, including social, economic and environmental factors and their impact on communities.
• Knowledge of IT systems, including ability to use word processing skills, emails and the internet to create simple plans and reports.

Desirable

• Knowledge of VCSE and community services in the locality.

Other

Essential

• Meets DBS reference standards and has a clear criminal record, in line with the law on spent convictions.
• Access to own transport and ability to travel across the locality on a regular basis, including to visit people in their own homes.
• The post holder will be required to travel between practices in the locality.

Qualifications

Essential

• Demonstrable commitment to professional and personal development.

Desirable

• NVQ Level 3, Advanced level or equivalent qualifications or working towards.
• Training in motivational coaching and interviewing or equivalent experience.

Personal Qualities and Attributes

Essential

• Ability to listen, empathise with people and provide person-centred support in a non-judgemental way.
• Able to get along with people from all backgrounds and communities, respecting lifestyles and diversity.
• Commitment to reducing health inequalities and proactively working to reach people from all communities.
• Able to support people in a way that inspires trust and confidence, motivating others to reach their potential.
• Ability to communicate effectively, both verbally and in writing, with people, their families, carers, community groups, partner agencies and stakeholders.
• Ability to identify risk and assess/manage risk when working with individuals.
• Have a strong awareness and understanding of when it is appropriate or necessary to refer people back to other health professionals/agencies, when what the person needs is beyond the scope of the Care Navigator role e.g., when there is a mental health need requiring a qualified practitioner.
• Ability to maintain effective working relationships and to promote collaborative practice with all colleagues.
• Commitment to collaborative working with all local agencies (including VCSE organisations and community groups).
• Able to work with others to reduce hierarchies and find creative solutions to community issues.
• Ability to organise, plan and prioritise on own initiative, including when under pressure and meeting deadlines.
• High level of written and oral communication skills.
• Knowledge of and ability to work to policies and procedures, including confidentiality, safeguarding, lone working, information governance, and health and safety.

Experience

Desirable

• Experience of working directly in a community development context, adult health and social care, learning support or public health/health improvement (including unpaid work).
• Experience of supporting people, their families and carers in a related role (including unpaid work).
• Experience of supporting people with their mental health, either in a paid, unpaid or informal capacity.
• Experience of data collection and providing monitoring information to assess the impact of services.
• Experience of partnership/collaborative working and of building relationships across a variety of organisations.

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

Eastleigh Southern Parishes Network Ltd

Address

ESP Primary Care Hub

Lowford Centre

Southampton

Hampshire

SO31 8ES

Employer's website

https://www.espnetwork.co.uk/ (Opens in a new tab)