Pcn South Care Home Care Coordinator

7 months ago

South Shields, United Kingdom South Tyneside Health Collaboration Full time

Key Responsibilities Support the coordination and delivery of Multidisciplinary Team Meetings (MDT) within PCN, this includes but is not limited to making a weekly call to each home, attending MDT, supporting documentation and ongoing referrals, and supporting the NPs in the home rounds where the care coordinator is most appropriate team member for the task. Utilise population health intelligence to proactively identify and work with a cohort of patients to support their personalised care. Bring together all a persons identified care and support needs and explore their options to meet these into a single personalised care and support plan, in line with Personalised Care and Support Planning (PCSP) best practice. Help patients to manage their needs, answering their queries and supporting them to make appointments.

Supporting Practices and Care Homes with provision of information. Supporting the Nurse Practitioners with annual reviews where appropriate including uploading of information to patient records as appropriate. Collecting data to support the EHCH team as required. Raise awareness of shared decision-making and decision-support tools and assist individuals to be more prepared to have a shared decision-making conversation.

Ensure that individuals have good quality information to help them make choices about their care. Provide coordination and navigation for patients and their carers across health and care services, alongside working closely with GPs, Social Prescribing Link Workers, and other primary care professionals within the PCN. This would include supporting residents to re-register with linked or PCN appropriate GP Practices. Support the aims of the DES, IIF and other targets as requested.

As a Care Coordinator you will have linked care homes for which you are responsible, however it is expected that cross cover will be provided so that all homes have cover in times of sickness or holiday. Care Coordinators would be expected to work within the structure of the EHCH Team. Confidentiality While seeking treatment, patients entrust us with, or allow us to gather, sensitive information in relation to their health and other matters. They do so in confidence and have the right to expect that staff will respect their privacy and act appropriately.

In the performance of the duties outlined in this Job Description, the post-holder may have access to confidential information relating to patients and their carers, practice staff and other healthcare workers. They may also have access to information relating to the practice as a business organisation. All such information from any source is to be regarded as strictly confidential. Health & Safety The post-holder will assist in promoting and maintaining their own and others health, safety and security as defined in the practice Health & Safety Policy, to include: Using personal security systems within the workplace according to practice guidelines.

Identifying the risks involved in work activities and undertaking such activities in a way that manages those risks. Making effective use of training to update knowledge and skills. Using appropriate infection control procedures, maintaining work areas in a tidy and safe way and free from hazards. Reporting potential risks identified.

Equality and Diversity The post-holder will support the equality, diversity and rights of patients, carers, and colleagues, to include: Acting in a way that recognises the importance of peoples rights, interpreting them in a way that is consistent with practice procedures and policies, and current legislation. Respecting the privacy, dignity, needs and beliefs of patients, carers, and colleagues. This Job Description provides a guide to the duties and responsibilities of the post and is not an exhaustive list. The post holder may be asked to undertake any other relevant duties appropriate to the post.

The Job Description may be amended over time, in consultation with the post holder to meet the needs of the service.

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