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Home From Hospital In-reach Co-ordinator

2 months ago

Worcester, United Kingdom Age UK Herefordshire and Worcestershire Full time

Working at Age UK Herefordshire and Worcestershire is more than just a job to us. We are united in making Herefordshire and Worcestershire a great place to grow older, through supporting our clients, their families, and their careers.

We are proud of our commitment to our 300 staff and volunteers as well as our approach to making Age UK Herefordshire and Worcestershire a great place to work. We are committed to meeting the needs of our clients, staff, and volunteers, and this includes offering flexible ways of working opportunities and supporting wellbeing. By encouraging a better work-life balance, we gain a happy, engaged and committed workforce, who then deliver meaningful outcomes for older people throughout the two counties.

**JOB DESCRIPTION**

**JOB TITLE**:Home from Hospital In-Reach Coordinator

**DEPARTMENT**:Home from Hospital Team
- Home Support

**RESPONSIBLE TO**:Home from Hospital Service Manager

**RESPONSIBLE FOR**:N/A

**LOCATION**:Predominantly based in Worcestershire Hospitals - with some travel throughout the county

**JOB PURPOSE AND ROLE**:
The Home from Hospital service is to provide a short-term practical support for people being discharged from hospital. This involves triaging and facilitating a smooth discharge home from hospital and follow up visits for tasks such as shopping, light housework to ensure their house is safe to live in, transport to appointments, meals preps etc.

The service also aims to reduce hospital readmissions through working with a client to assess their needs holistically which includes the use of assisted technology.

This service can be provided for those who have not been in hospital but are at risk of requiring hospital support.

As the Hospital In Reach Co-Ordinator you will work closely with the discharge teams at the acute hospitals (Worcestershire Royal and Alexandra Hospital Redditch), liaising with referrers and patients directly to facilitate a smooth discharge of patients to their own homes.

The Hospital In-Reach Co-Ordinator will also work closely with NHS colleagues across the system to ensure that the most appropriate level of support is provided for each patient, with the aim of reducing pressure on health and social care systems, to improve patient flow within hospitals and to provide an improved patient experience.

Although this role will be mostly hospital based, support will also be required in the community. This could include visiting patients who have been discharged from hospital to determine the level of support needed to enable them to regain their independence and avoid being readmitted into hospital.

As a Hospital In-Reach Co-ordinator, you will work closely with the Home Support

Service Manager, Home from Hospital Co-ordinators and volunteers to ensure the service is meeting patients’ and commissioners’ requirements.

** An Enhanced DBS Check will be required**

** A full driving license and access to a vehicle for work purposes including transportation of patients is required (with appropriate business insurance)**

**PRINCIPLE RESPONSIBILITIES AND DUTUES**

1. To work within our local Acute Hospitals, developing relationships with professionals, liaising with referrers to assist in timely and safe discharges.

2. To liaise directly with patients whilst in hospital if pre discharge support is required, including working with external contractors to ensure a house is safe for a patient to return to.

3. To deliver a person-centred approach by assessing the requirements of patients in their own home following their discharge from hospital, using health and wellbeing score frameworks to co-produce a tailored support plan to meet the patients’ needs and wishes.

4. To motivate and support individuals to identify their own goals aspirations as well as developing self-management strategies to improve their health and wellbeing and maintain their independence. Ensuring that guided conversations are led by the individual and that they are at the centre of everything we do.

5. To work collaboratively with volunteers to ensure support is provided for patients to meet their needs.

6. To support patients where possible to use assistive technology and/or support patients to move towards online e.g prescription service, online food shopping etc.

7. To refer patients who consent into other relevant services to further support them to stay independent at home and reframe from being admitted back to hospital.

8. To promote the Help at Home service as an exit route from the independence at Home Service.

9. To maintain accurate and contemporaneous patient records using designated electronic/other organisational databases and provide written and verbal reports as required.

10. To maintain accurate and contemporaneous patient records using designated electronic/other organisational databases.

11. To form an active part of the team, participating in team meetings

12. To think and act in a supportive and non - judgmental way

13.

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