JOB DESCRIPTION

Age UKIndependent Living Coordinator

attached to GP Practice

Stoke-on-Trent and North Staffordshire

1. / JOB DETAILS:
Job Title: / Age UKIndependent Living Coordinator
Reporting to: / GP Practice Manager
Services Manager, Age UK North Staffordshire
Line Management: / To be arranged
Working Hours / Half-time and part-time, subject to agreement
Location: / Based in one or more GP Practices in the City and/or North Staffordshire; and inAge UK North Staffordshire,Hanley.
Remuneration:
Mileage allowance:
Duration: / £10.44 per hour
45p per mile for travel between work base(s)
Initially to end June, 2016.
2. / JOB PURPOSE:
Working within anintegrated model of care supporting older people, carers and families, working closely with GPs, Practice staff and other agencies to provideactive support to a cohort of older patients of the Practice. To reduce demand on statutory services and to combat unnecessary hospital admissions, residential care placements and GP appointments.
The nature of the service to the patient is non-medical support and includes:
  • Holistic care planning and co-ordination, including assessments carried out in clients’ homes;
  • Information and advice about a range of services to promote health and wellbeing, and maintain independence within communities;
  • Advice on relevant benefits, personal budgets, etc, and referral on to our Information Advice service as required;
  • Health and wellbeing activity;
  • Support services at home.

3. / MAIN DUTIES AND RESPONSIBILITIES:
1) / Enabling patient access to local services, including personalisation support:
  • Take referrals from GPs and other members of the Practice multi-disciplinary team for individual older people, families and their carers;
  • Lead a guided and positive conversationwith the older person about their needs, leading to a holistic care plan of support. The plan is to be copied to the GP and any other professionals involved in the person’s care;
  • Help the person access community care assessments as well as carers assessments, where potentially eligible; following up to ensure the process is going smoothly and have knowledge of outcomes;
  • Where a personal budget is allocated, advise on the main choices the person will need to make (e.g. whether to accept a Direct Payment and how this could potentially be spent);
  • Develop knowledge of local services to enable the person to access a range of services to meet their needs. Services may be open access (free) or require payment, either through a personal budget or own funds;
  • Where affordability is a barrier to engagement, supply basic information on relevant benefits to the person,and/or refer on for more in-depth advice where required;
  • Ensure people are engaged and connected with their local community and other organisations to make best use of resources;
  • Identify unpaid carers and enable access to services for their support;
  • Inform and advise GPs and Primary Care staff about what is available to support older people in the community.
2) Co-ordination and integration:
  • Liaise with a range of multi-disciplinary professionals who are involved in a person’s care, ensuring a smooth and coordinated approach, especially where multiple agencies are involved;
  • Support the management of care and support; and avoid unnecessary hospital admissions, residential care placements and unnecessary GP appointments;
  • Actively participate in Practice level multi-disciplinary team meetings;
  • Identify when there is a need for urgent action or for a step-up in care and alert the relevant professional(s) appropriately.
3) Record keeping and service evaluation:
  • Keep accurate and up-to-date records of client contact, including the use of Age UK and GP databases as required (relevant training will be provided);
  • Record and collate information, including case studies, to demonstrate the impact of the service. Write quarterly activity and outcome reports;
  • Demonstrate an understanding of the impact of the service on wider health, social and voluntary sector services;
  • Contribute towards the development of the service, attending meetings and assisting with presentations as requested;
  • Identify opportunities and gaps in services; feeding back information on this as well as service quality and accessibility.
4) General responsibilities:
  • Consider how to introduce best practice already being developed through other local Age UKs;
  • Establish strong links with other Age UK North Staffordshire staff and contribute to the wider aims and objectives of the organisation;
  • Work in accordance with the organisation’s values, policies and procedures;
  • Attend training courses as required;
  • Be prepared to carry out occasional weekend or evening work;
  • Carry out any other duties as may be reasonably required by the Chief Officer from time to time.

Person specification:
Essential / Desirable
Qualifications / Health, social care or information & advice / X
Experience / At least 2 years’ experience of working in health, social care or information and advice, in direct contact with people, families and carers in a paid or voluntary capacity / x
Experience of working with multi- professional people across health, social care, the voluntary sector, primary care and GP’s / X
Experience of person-centred planning / X
Experience of working with older people; and with volunteers / X
Skills and Knowledge / Computer literate, able to use email, the internet and web searches as standard applications, and databases / x
Excellent communication skills, both verbal and written; able to provide reports as required / x
Ability to collect data efficiently in order to provide statistical evidence for analysis / x
Ability to demonstrate an effective approach to gaining knowledge of local services / x
Thorough and up-to-date knowledge and understanding of policy and practice in Adult Social Care and Health. / x
Excellent interpersonal skills,tactful and diplomatic, able to build relationships with people from a wide range of backgrounds / x
Personal attributes / A professional and compassionate outlook, able to be supportive while being clear on boundaries. / x
Enthusiasm for and physical ability to make unaccompanied home visits to clients / x
Flexibility, stamina and a willingness to work across organisational boundaries and agencies including GP surgeries, voluntary and statutory organisations / x
A methodical and organised approach / x

JL/PB July 2015