Care Co-ordinator in Waterlooville

We are seeking a compassionate, proactive and organised CareCo-ordinator (Care Homes) to join our Enhanced Care Team on apart-time basis.

Care Co-ordinators play a vital role in supporting patients with complex and long-term care needs. Working within a dedicated Enhanced Care Team, they specialise in one or more key service areas including frailty, care homes, learning disabilities, cancer/palliative care and serious mental illness.

We are looking for someone who:

• Has excellent interpersonal and communication skills, with the ability to build rapport and trust with a wide range of people
• Is highly organised and able to manage a varied workload effectively
• Demonstrates empathy, compassion, and a person-centred approach to care
• Can work confidently and professionally within a busy and sometimes challenging environment
• Has the ability to establish and maintain effective working relationships with external partners and healthcare professionals
• Is committed to delivering high-quality support that improves patient experience and outcomes

This is a part-time position, and we welcome applications from candidates seeking 28 to 30 hours per week, working Monday to Friday with a working pattern to be agreed.

Please note: We reserve the right to close this vacancy early should we receive a high volume of applications.

Vine Medical Group is committed to equality, diversity, and inclusion. We actively encourage applications from veterans, service leavers.

Main duties of the job

The Care Co-ordinator (Care Homes) will work closely with the Clinical Team to support patient care and the delivery of timely, appropriate and well-co-ordinated enhanced care services to care home residents. You will also maintain an awareness of the wider patient cohorts supported by the Enhanced Care Team, contributing to effective multidisciplinary working, service continuity, and the sharing of best practice across the team.

You will proactively manage a caseload of patients with complex care needs, ensuring coordinated, person-centred support and timely review of changing health and wellbeing needs.

You will act as a key link between the Practice and our local care homes, coordinating care plans, medication and health reviews, supporting weekly care home ward rounds, registration of new residents and supporting clinicians. You will build relationships and work closely with patients, carers, care home staff, GPs, community services, and partner organisations. Ultimately helping us to deliver high-quality, integrated care that improves patient outcomes and experience.

You will support the development and review of personalised care plans, facilitating access to health and care services, promoting effective communication across healthcare providers.

About us

Vine Medical Group is one of the largest practices in thelocality. We care for around 25,500patients across the whole of the Waterlooville area and its surroundingvillages. We are one of two practices in Strawberry Health Primary Care Network with shared responsibilities for approximately 41,000 patients.This larger size means morediverse learning and development opportunities are possible to aid with longerterm career development goals. We are a family-friendly practice and try toaccommodate working patterns to suit as far as we can.

We operate across four locations; the Forest End, Waterlooville HealthCentre, Aintree Drive and Stakes Lodge sites.We employ a multi-skilled team including GPs, Practice Nurses, Advanced NursePractitioners, Healthcare Assistants, Paramedics, Pharmacists and skilledadministrative teams who support the smooth running of the Practice.

Our Enhanced Care Team includes Social Prescribers, CareCo-ordinators, Wellbeing Advisors and Mental Health Practitioners. The teamproactively supports our patients health and wellbeing providing apersonalised care approach.

We are rated Good by the CQC.

Job responsibilities

• Support the Clinical team to deliver enhanced care services to the key service area of Care Homes and other differing patient cohorts as required. Maintaining an awareness of other cohorts supported by the Enhanced Care Team to enable effective team work and sharing of good practice.
• Identifyand manage a caseload of identified patients, making sure that appropriatesupport is made available to them, and ensuring that their changing needs areaddressed
• Bringtogether all the information about a persons identified care and support needsand explore options to meet these within a single personalised care and supportplan
• Helpcreate single personalised care and support plans, in line with best practice
• Assistand direct patients in accessing the appropriate service or healthcareprofessional in a courteous, efficient and effective way
• Facilitateeffective communication between patients, members of the primary health careteam, secondary care and other associated healthcare agencies
• Supporta formalised process of delivering healthcare reviews to patients
• Supportthe Clinical Directors and team to deliver the Directed Enhanced Servicesspecifications for individual services
• Co-ordinatethe work of healthcare professional and non-clinical staff including volunteersand keep an up-to-date database of contacts
• Buildand develop relationships with partner organisations, such as communityservices, volunteer groups, community learning disability teams, care homes andkeep a comprehensive and up to date database of contacts
• Providea link between Vine Medical Group and Homewell Practice
• Provideadvice and information ensuring health and care planning is timely, efficientand patient-centred
• Ensurethat all relevant and useful information is available to patients/cliniciansand is up to date
• Supportteams with quality improvement projects and achieving KPIs (QOF and IIF)
• Monitorand cleanse existing data. Ensure datais recorded and coded accurately and aligned with the PCN
• Understandand provide support for digital initiatives
• Attendregular / monthly meetings to discuss good practice and share information
• Keeprecords of your work and adhere to confidentiality, information sharingprotocols and provide monitoring information as required
• Undertakeregular training to extend and update own knowledge of health and wellbeingissues
• AlertTeam Lead or Senior Management of any issues that may impact patient safety orservice quality
• Befamiliar with patient safety policy and reporting (e.g. LFPSE and/or otherappropriate systems) and awareness of the process and key stakeholders forsafeguarding referrals
• Maintainaccurate patient / clinical records in conjunction with Practice policies andcurrent legislation
• Ensureadherence to confidentiality, data protection, and information governancerequirements
• Worksafely at all times in accordance with legislative requirements and PracticePolicy and Procedures

Care Home Support:

• Undertake weekly calls and scheduled visits tolocal care homes to support GP-led ward rounds to ensure support and access andcoordinate clinical unput where required. Regular travel across the locality isan essential requirement of the role
• Registernew care home patients and manage proxy access, liaising with the Admin teamand care home managers as required
• Co-ordinateregular Multi-disciplinary Team meetings. Take notes and record actions at thesemeetings
• Managethe Practices care home email inboxes and ensure that all emails and documentsare dealt with or distributed to the appropriate clinician
• Keepup to date contact information and processes for all care homes
• Ensurethat all relevant and useful information is available to the care homes and isup to date
• Developrelationships with external third parties that help support care homes andtheir residents
• Ensurethat all relevant information or changes from external stakeholders, such asCare Home Managers, CCG, NHS England is shared with the Care Home Team
• Maintainpatient appointment lists for ward rounds

Person Specification

Qualifications

• GCSE in English and Maths at Grade C/4 or equivalent
• NVQ in Health & Social Care or Community Health and Wellbeing Worker
• PCI Personalised Care and Support Planning / Shared Decision Making Training

Knowledge & Skills

• Excellent communication skills (written and verbal), able to effectively engage with a diverse range of people recognising the need for alternative methods of communication to overcome different levels of understanding, cultural background, and preferred ways of communicating
• Good IT skills with a working knowledge of Microsoft 365
• Excellent organisational and time management skills, able to manage and prioritise workload
• High level of attention to detail and accuracy
• Understanding of confidentiality
• Able to assess problems and identify solutions
• Ability to work as an effective part of team
• Working knowledge of EMIS / medical systems
• Knowledge of local health services and providers
• Knowledge of and ability to work to policies and procedures, including confidentiality, safeguarding, information governance, and health and safety

Experience

• Previous experience within an administrative role
• Experience of working in health, social care and other support roles in direct contact with people, families or carers
• Experience of working in a GP Practice or NHS setting
• Experience working as a Care Co-ordinator within Primary Care
• Experience working with people with complex needs, including those living with learning disabilities, dementia, severe mental illness, frailty, and multiple long-term conditions

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.