Scarborough Medical Group

Care Coordinator (Dementia and Long term Conditions)

Information:

This job is now closed

Job summary

An exciting opportunity has arisen for a care coordinator to join our growing team within Filey and Scarborough Healthier Communities Primary Care Network (PCN).

These roles will be crucial in supporting the quality improvements of healthcare provision that we provide to our registered patient populations who have dementia / learning disabilities.

The successful candidate will be employed by a lead practice, for and on behalf of the PCN. However, the candidate will be required to work across practice sites within our PCN, working in collaboration with other health care professionals across the PCN to provide improved and integrated services for our patients in Filey and Scarborough.

This role within our PCN and will evolve over time. However, we recognise the value this role can bring to our practices and patients alike. We are looking for candidates who are highly motivated, forward thinking, experienced and personable who are interested in developing their careers and supporting Primary Care.

Main duties of the job

The successful candidate will play a key role in proactively identifying and working with people, including the frail, elderly and those with long-term conditions specifically dementia, to provide coordination and navigation of care and support across health and care services. This role will have a particular focus on vulnerable housebound patients and supporting delivery of the enhanced health in care homes.

They will work closely with both clinical and non-clinical practice teams, making sure that appropriate support is made available to people; supporting them to understand and manage their condition and ensuring their changing needs are addressed. They will enable people to access the services and support they require to meet their health and wellbeing needs, helping to improve peoples quality of life.

They will work alongside social prescribing link workers to provide an all-encompassing approach to personalised care and enable people to navigate through the health and care system. They will work with a diverse range of people from different cultural and social backgrounds. The ability to work confidently and effectively in a varied and sometimes challenging environment is essential.

The successful candidate will have excellent interpersonal and communication skills, and be organised, patient and empathetic. They will have experience of working in health, social care or other support roles including direct contact with people, families or carers.

About us

Filey and Scarborough Healthier Communities Network is located in the beautiful coastal town of Scarborough, in the County of North Yorkshire. Scarborough is the largest holiday resort on the Yorkshire Coast, and has both service and fishing industries.

The PCN is a collaboration of 4 GP Practices serving residents in the Scarborough and Filey locality. Collectively, we have 32,939 registered patients, and work together to improve services for our populations.

Details

Date posted

29 May 2024

Pay scheme

Other

Salary

£23,092 a year

Contract

Permanent

Working pattern

Full-time, Part-time

Reference number

A3880-24-0010

Job locations

York House

King Street

Scarborough

North Yorkshire

YO11 1ND


Job description

Job responsibilities

KEY RESPONSIBILITIES

Please see the attached job description and person specification for further details.

Work with people, their families and carers to improve their understanding of the patients condition and support them to develop and review personalised care and support plans to manage their needs and achieve better healthcare outcomes.

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.

Support people to understand their level of knowledge, skills and confidence (their Activation level) when engaging with their health and wellbeing, including through the use of the ONS 4 personal wellbeing score, where this is relevant.

Assist people to access self-management education courses, peer support or interventions that support them in their health and wellbeing and increase their Activation level.

Support people to take up training and employment, and to access appropriate benefits where eligible.

Provide coordination and navigation for people and their carers across health and care services, working closely with social prescribing link workers, other primary care professionals and health and social care colleagues; helping to ensure patients receive a joined-up service and the most appropriate support.

Work collaboratively with GPs and other primary care professionals within the PCN to proactively identify and manage a caseload, which may include patients with long-term health conditions, and where appropriate, refer back to other health professionals within the PCN.

Support the coordination and delivery of multidisciplinary teams with the PCN.

Raise awareness of how to identify dementia patients who may benefit from shared decision making and support PCN staff and patients to be more prepared to have shared decision-making conversations.

Explore and assist people to access a personal health budget where appropriate.

Work with people, their families, carers and healthcare team members to encourage effective help seeking behaviours;

Support the PCN in developing communication channels between GPs, people and their families and carers and other agencies;

Identify unpaid carers and help them access services to support them;

Conduct follow-ups on communications from out of hospital and in-patient services;

Maintain records of referrals and interventions to enable monitoring and evaluation of the service;

Support practices to keep care records up-to-date by identifying and updating missing or out-of-date information about the individuals circumstances;

Contribute to risk and impact assessments, monitoring and evaluations of the service;

Work with commissioners, integrated locality teams and other agencies to support and further develop the role.

Closing date for applications is the 7th June 2024. Please note the advert may close sooner if we have received enough applications for the role. For further details about the role please contact James Bowman on 07444 040201

Job description

Job responsibilities

KEY RESPONSIBILITIES

Please see the attached job description and person specification for further details.

Work with people, their families and carers to improve their understanding of the patients condition and support them to develop and review personalised care and support plans to manage their needs and achieve better healthcare outcomes.

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.

Support people to understand their level of knowledge, skills and confidence (their Activation level) when engaging with their health and wellbeing, including through the use of the ONS 4 personal wellbeing score, where this is relevant.

Assist people to access self-management education courses, peer support or interventions that support them in their health and wellbeing and increase their Activation level.

Support people to take up training and employment, and to access appropriate benefits where eligible.

Provide coordination and navigation for people and their carers across health and care services, working closely with social prescribing link workers, other primary care professionals and health and social care colleagues; helping to ensure patients receive a joined-up service and the most appropriate support.

Work collaboratively with GPs and other primary care professionals within the PCN to proactively identify and manage a caseload, which may include patients with long-term health conditions, and where appropriate, refer back to other health professionals within the PCN.

Support the coordination and delivery of multidisciplinary teams with the PCN.

Raise awareness of how to identify dementia patients who may benefit from shared decision making and support PCN staff and patients to be more prepared to have shared decision-making conversations.

Explore and assist people to access a personal health budget where appropriate.

Work with people, their families, carers and healthcare team members to encourage effective help seeking behaviours;

Support the PCN in developing communication channels between GPs, people and their families and carers and other agencies;

Identify unpaid carers and help them access services to support them;

Conduct follow-ups on communications from out of hospital and in-patient services;

Maintain records of referrals and interventions to enable monitoring and evaluation of the service;

Support practices to keep care records up-to-date by identifying and updating missing or out-of-date information about the individuals circumstances;

Contribute to risk and impact assessments, monitoring and evaluations of the service;

Work with commissioners, integrated locality teams and other agencies to support and further develop the role.

Closing date for applications is the 7th June 2024. Please note the advert may close sooner if we have received enough applications for the role. For further details about the role please contact James Bowman on 07444 040201

Person Specification

Qualifications

Essential

  • NVQ Level 3 in Adult Care or NVQ Level 3 in Business Administration (or relevant experience)
  • Demonstrable commitment to professional and personal development
  • Ability to use Microsoft Office applications Word, Excel, PowerPoint, Outlook

Desirable

  • Minimum of 2 years experience of working with healthcare professionals and/or previous experience in the NHS or social care or relevant field
  • Qualification in health or social care allied profession
  • Long term conditions and Welfare Rights basic training

Experience

Essential

  • Experience of working in health, social care and other support roles in direct contact with people, families or carers (in a paid or voluntary capacity)
  • Experience of working within multi-professional team environments
  • Experience of supporting people, their families and carers in a related role
  • Experience of data collection and using tools to measure the impact of services

Desirable

  • Experience of working directly in a care coordinator role, adult health and social care, learning support or public health / health improvement
  • Experience or training in personalised care and support planning
  • Experience of working with elderly or vulnerable people, complying with best practice and relevant legislation

Personal Qualities and Attributes

Essential

  • Ability to actively listen, empathise with people and provide personalised support in a non-judgemental way
  • Ability to provide a culturally sensitive service supporting people from all backgrounds and communities, respecting lifestyles and diversity
  • Commitment to reducing health inequalities and proactively working to reach people from diverse communities
  • Ability 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 the person needs are beyond the scope of the care coordinator role e.g. when there is a mental health need requiring a qualified practitioner
  • Ability to work from an asset-based approach, building on existing community and personal assets
  • Ability to maintain effective working relationships and to promote collaborative practice with all colleagues
  • Ability to demonstrate personal accountability, emotional resilience and work well under pressure
  • Ability to organise, plan and prioritise on own initiative, including when under pressure and meeting deadlines
  • High level of written and verbal communication skills
  • Ability to work flexibly and enthusiastically within a team or on own initiative
  • Knowledge of, and ability to work to policies and procedures, including confidentiality, safeguarding, lone working, information governance, and health and safety

Desirable

  • Ability to provide motivational coaching to support peoples behaviour change

Knowledge and Skills

Essential

  • Understanding of the wider determinants of health, including social, economic and environmental factors and their impact on communities, individuals, their families and carers
  • Understanding of, and commitment to, equality, diversity and inclusion
  • Strong organisational skills, including planning, prioritising, time management and record keeping
  • Effective written, verbal and non-verbal communication skills
  • Ability to convey sensitive information in an empathetic manner to patients, carers and staff
  • Ability to recognise and work within limits of competence and seek advice when needed
  • Understanding of the needs of older people / adults with disabilities / long term conditions particularly in relation to promoting their independence
  • Basic knowledge of long term conditions and the complexities involved: medical, physical, emotional and social
  • Understanding of the needs of older people / adults with disabilities / long term conditions particularly in relation to promoting their independence

Desirable

  • Knowledge of the personalised care approach
  • Knowledge of how the NHS works, including primary care and PCNs
  • Knowledge of Safeguarding Children and Vulnerable Adults policies and processes

Other Requirements

Essential

  • Meets DBS reference standards and criminal record checks
  • Access to own transport, with full clean UK driving license
  • Ability to travel across the locality on a regular basis

Desirable

  • Willingness to work flexible hours when required to meet work demands
Person Specification

Qualifications

Essential

  • NVQ Level 3 in Adult Care or NVQ Level 3 in Business Administration (or relevant experience)
  • Demonstrable commitment to professional and personal development
  • Ability to use Microsoft Office applications Word, Excel, PowerPoint, Outlook

Desirable

  • Minimum of 2 years experience of working with healthcare professionals and/or previous experience in the NHS or social care or relevant field
  • Qualification in health or social care allied profession
  • Long term conditions and Welfare Rights basic training

Experience

Essential

  • Experience of working in health, social care and other support roles in direct contact with people, families or carers (in a paid or voluntary capacity)
  • Experience of working within multi-professional team environments
  • Experience of supporting people, their families and carers in a related role
  • Experience of data collection and using tools to measure the impact of services

Desirable

  • Experience of working directly in a care coordinator role, adult health and social care, learning support or public health / health improvement
  • Experience or training in personalised care and support planning
  • Experience of working with elderly or vulnerable people, complying with best practice and relevant legislation

Personal Qualities and Attributes

Essential

  • Ability to actively listen, empathise with people and provide personalised support in a non-judgemental way
  • Ability to provide a culturally sensitive service supporting people from all backgrounds and communities, respecting lifestyles and diversity
  • Commitment to reducing health inequalities and proactively working to reach people from diverse communities
  • Ability 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 the person needs are beyond the scope of the care coordinator role e.g. when there is a mental health need requiring a qualified practitioner
  • Ability to work from an asset-based approach, building on existing community and personal assets
  • Ability to maintain effective working relationships and to promote collaborative practice with all colleagues
  • Ability to demonstrate personal accountability, emotional resilience and work well under pressure
  • Ability to organise, plan and prioritise on own initiative, including when under pressure and meeting deadlines
  • High level of written and verbal communication skills
  • Ability to work flexibly and enthusiastically within a team or on own initiative
  • Knowledge of, and ability to work to policies and procedures, including confidentiality, safeguarding, lone working, information governance, and health and safety

Desirable

  • Ability to provide motivational coaching to support peoples behaviour change

Knowledge and Skills

Essential

  • Understanding of the wider determinants of health, including social, economic and environmental factors and their impact on communities, individuals, their families and carers
  • Understanding of, and commitment to, equality, diversity and inclusion
  • Strong organisational skills, including planning, prioritising, time management and record keeping
  • Effective written, verbal and non-verbal communication skills
  • Ability to convey sensitive information in an empathetic manner to patients, carers and staff
  • Ability to recognise and work within limits of competence and seek advice when needed
  • Understanding of the needs of older people / adults with disabilities / long term conditions particularly in relation to promoting their independence
  • Basic knowledge of long term conditions and the complexities involved: medical, physical, emotional and social
  • Understanding of the needs of older people / adults with disabilities / long term conditions particularly in relation to promoting their independence

Desirable

  • Knowledge of the personalised care approach
  • Knowledge of how the NHS works, including primary care and PCNs
  • Knowledge of Safeguarding Children and Vulnerable Adults policies and processes

Other Requirements

Essential

  • Meets DBS reference standards and criminal record checks
  • Access to own transport, with full clean UK driving license
  • Ability to travel across the locality on a regular basis

Desirable

  • Willingness to work flexible hours when required to meet work demands

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

Scarborough Medical Group

Address

York House

King Street

Scarborough

North Yorkshire

YO11 1ND


Employer's website

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

Employer details

Employer name

Scarborough Medical Group

Address

York House

King Street

Scarborough

North Yorkshire

YO11 1ND


Employer's website

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

Employer contact details

For questions about the job, contact:

PCN Development and Transformation Manager

James Bowman

james.bowman@nhs.net

07444040201

Details

Date posted

29 May 2024

Pay scheme

Other

Salary

£23,092 a year

Contract

Permanent

Working pattern

Full-time, Part-time

Reference number

A3880-24-0010

Job locations

York House

King Street

Scarborough

North Yorkshire

YO11 1ND


Supporting documents

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