Job pack

Care Navigator

December 2020

Dear Applicant

Re: Care Navigator

Thank you for your enquiry in response to our advertisement for the above position. I have pleasure in enclosing the following:

· Job description and Person Specification

· Background information about Age UK Bromley & Greenwich

· Application form

· Equal opportunities monitoring form

We regret that we only contact applicants who are shortlisted for an interview. Therefore, if you have not heard from us by Monday 11th January 2021 you should presume that unfortunately on this occasion your application has not been successful.I look forward to receiving your completed application form no later than Monday 4th January 2021. Interviews will be held week commencing 11 January 2021. Candidates shortlisted for an interview will be contacted by email and or telephone so please include an email address and mobile telephone number or any other telephone number where you can be reached. Please note that we do not accept CV’s. Thank you for your interest in this role.

Yours sincerely

Mark Ellison

Mark EllisonChief Executive

BACKGROUND TO THE POST

In 2014, St Christopher’s Hospice was commissioned to provide a 24/7 Bromley Care Co-ordination (BCC) service to:-

· Enable people over the age of 75, with advanced illness or frailty thought to be in their last year of life, to receive timely and co-ordinated care

· Help people die with dignity in the place of their choice

· Provide support to their families and carers

· Reduce unnecessary hospital admissions

Over the last four years nearly 3000 people have been referred. The service enabled over 70% of those who died to be cared for their own home or care home at the end of their life. The service received 700 referrals in 2017-18 and the average age was 86. The service manages a daily caseload of around 300 people

Bromley CCG have commissioned a number of services to meet the needs of the frail older population that reside in the borough. Bromley has the oldest population in London residing in its borough and the highest age related incidence of dementia. 73% of all deaths were in the over 75 age group and 31% of the over 65 population live in single person households.

Amongst the newly commissioned services are the three Integrated Care Networks (ICN’s) where services are brought together in clusters. This model is centred around three weekly multi-disciplinary team meetings where GP’s and community matrons present challenging patients and together the team form a plan of care. The voluntary sector is embedded into these teams through the role of a care navigator.

The CCG have now commissioned two care navigators to join this service in a partnership role between Age UK Bromley and Greenwich and St Christopher’s to enable BCC patients to gain more comprehensive support to the third sector services. The post holders will be employed by Age UK Bromley and Greenwich as part of their care navigator roles described below, but will be physically located with BCC at Caritas House in Orpington.

Also commissioned is a frailty pathway which includes step down/step up beds in Orpington Hospital. The care navigator role is also embedded into this service. Both care navigator roles represent an important link into a large number of 3rd sector services commissioned through the newly formed ‘Bromley Well’ organisation. These services are delivered by a partnership of local voluntary sector organisations called Bromley Third Sector Enterprise CIC (BTSE) which is made up of Age UK Bromley & Greenwich, Bromley & Lewisham Mind, Bromley Mencap, Citizens Advice Bromley, Community Links Bromley and a growing number of Associate Member organisations.

KEY RELATIONSHIPS

· Patients/service users for BCC

· Nursing, Medical and Social work and administration staff working with BCC

· Third sector organisations/services as required

· Other Care Navigator posts within Bromley

· Head of Volunteers at St Christopher’s

· Nursing Care Home Managers in Bromley

· Head of Bromley Bereavement service

· Lead trainer for volunteers for St Christopher’s

· Social Care agencies

· ICN and frailty unit personnel

JOB DESCRIPTION

Care Navigator

Job Title:

Care Navigator

Accountable to:

Care Navigation Coordinator

Reporting to:

Day to day operational relationship with Consultant Nurse for BCC

JOB PURPOSE:

This role includes supporting people with advanced illness and frailty who have been referred to BCC pathways by signposting them to the most relevant services (non-clinical/medical, social care third sector support) to enable those individuals to achieve improved quality of life.

The post holder will have responsibility for non-medical assessment; development and co-ordination of plans for individuals in association with BCC nursing staff, monitoring those services and their impact on people’s care. They will work with colleagues from across a number of services in developing a multi-disciplinary approach to patient care, ensuring a holistic approach is taken. Fundamental to this approach will be ensuring that services work together to provide a seamless service, reducing unnecessary duplication and building relationships between services. The post holder will co-ordinate a group of volunteers on a day to day basis who are befriending and monitoring a segment of the BCC population.

MAIN DUTIES AND RESPONSIBILITIES:

· Enabling access to third sector, local health and social care services.

· To provide person-centred support to people who have been assessed as benefiting from coordinated care and who require access to third sector services in Bromley and help them to navigate the system.

· To conduct a basic welfare rights screening to ensure BCC patients are claiming their entitled benefits and refer to external agencies for further help.

· To improve people’s experience and quality of care by providing a point of contact for non-medical queries and for signposting to medical services (with support from the BCC nursing staff).

· To support the BCC nursing staff in carrying out guided conversations with people about their needs, leading to a holistic care plan of support.

· To be part of the MDT review and planning meetings for patients on the BCC caseload.

· To inform health and social care colleagues of the potential third sector services which can support people at the end of life.

· To assist in documenting patient history in sufficient detail to enable health and care professionals to plan and deliver effective and timely intervention.

· To support BCC nursing staff with communication about changes in the patient’s condition with social care agency staff and newly formed changed care plans.

· To assist people who may be eligible to access community care and carers assessments.

· To offer families known to the care navigator initial support, assessing risk and referring into the Bromley bereavement service if further support is needed.

Supporting and supervising volunteers:

To co-ordinate on a day to day basis a group of Age UK volunteers who will

· Provide company and social support for BCC patients

· Monitor the patient’s condition and notify the care navigator or BCC nurse of any changes

· Keep the patient company while family members take a break or get on with their own tasks

· Provide gentle massage for patients who would welcome this as a source of support

· Help with small tasks such as sorting paperwork, or preparing drinks and snacks

· Accompany the patient on outings, such as to a local café or to the hospital for an appointment

· Promote access to the Silver Line for frail older people

Record keeping and reports:

· To input data on the SystmOne database and keep all online records up-to-date (training will be provided)

· To collate, input and produce relevant data for analysis using IT packages

· To ensure all recorded information is accurate, up to date and factual

· To carry out written reports e.g. case studies requested by the Care Navigation Manager and Consultant Nurse for BCC

Communication:

· To establish good relationships with the health and social care professionals across organisations

· To establish good communication with people receiving co-ordinated care and their carers / families.

· To deal effectively and diplomatically with telephone and face to face enquiries, taking messages or appropriate action as required.

· To ensure any complaints and serious incidents are managed and dealt with in line with the latest governance and policy guidance.

Learning and Development:

· To attend and participate in an induction programme and all relevant training.

· To attend regular monthly supervision sessions and annual appraisals with the Care Navigation Manager taking responsibility to comply with agreed personal development.

· To attend regular monthly Care Navigation team meetings with the Care Navigation Manager plus any other appropriate meetings to ensure good team working

To take part in Age UK Bromley & Greenwich/St Christopher’s events and activities as appropriate to the role

Quality and General responsibilities:

· To establish strong links with other Age UK Bromley & Greenwich staff and contribute to the wider aims and objectives of the organisation

· At all times to maintain the professional integrity and reputation of the Charity and represent their main interests in any dealings with other bodies, groups and individuals.

· To use and maintain resources efficiently and effectively and encourage others to do so

· To evaluate the quality of own work and raise quality issues and related risks with the relevant people through the relevant channels

· To support the introduction and maintenance of quality systems/processes in own work area

· To ensure documentation is accurate and up to date, and monitor and promote high standards of documentation within the team

· To support the collation of information and data for any relevant audit requirements

Service Improvement

· To contribute to the identification and development of service improvements initiatives sharing the suggestions with other BCC staff

Equality and Diversity

· To comply with St Christopher’s policies with particular regard to Diversity, Health and Safety and Confidentiality and policies adopted by the Bromley ICNs that apply to the Proactive Care and Frailty pathways

Health, Safety and Security

· To be aware of Safeguarding at all times, keeping adults safe from abuse and ensuring that all alleged abuse is reported as per St Christopher’s policy and guidance

· To familiarize themselves and fully comply with Age UK Bromley & Greenwich policies and procedures

· At all times to respect patient confidentiality and in particular the confidentiality of electronically stored personal data in line with the requirements of the Data Protection Act

· To be aware of individual responsibilities under the Health & Safety at Work Act and identify and report as necessary any untoward accident, incident or potentially hazardous environment

· To initiate and undertake routine risk assessments, both of environmental and individual case management, and to advise others in determining appropriate management - specifically relating to moving & handling and safe use of medical devices

· To be aware of, and adhere to. health and safety legislation in all aspects of their own and their teams work

· To monitor work areas and practices to ensure that they are safe and free from hazards and conform to health safety and security legislation, policies, procedures and guidelines

· To take the necessary action in relation to risk with support from their Line Manager

This job description reflects the immediate requirements and objectives of the post and is intended as a summary of the main elements of the job described. This is not an exhaustive list of duties and responsibilities and the post holder may be required to undertake other duties which fall within the grade of the job, as directed by their line manager. This job description will be reviewed regularly and may be varied from time to time in consultation with the job holder without changing the general character of the duties or the level of responsibility entailed. Such variations are a common occurrence and cannot of themselves justify a reconsideration of the grading of the post.

Infection Prevention and Control Responsibilities

Employees must adhere to relevant infection control policies placed on them by The Health Act 2006: Code of Practice for the Prevention and Control of Health Care Associated Infections. The prevention and control of healthcare associated infections must be embedded into everyday clinical practice and applied consistently to ensure prevention or containment of infections.

It is the responsibility of all patient-facing staff to ensure that they have sound working knowledge of standard infection control precautions. They must ensure that no act or omission on their part or within their sphere of responsibility is detrimental to the interests or safety of patients or clients.

They must also keep their infection control knowledge and skills up to date by attending mandatory infection control training as required to enhance infection control practice and to maintain a safe environment for patients, visitors and colleagues.

CARE NAVIGATOR PERSON SPECIFICATION

Method of Assessment: A=application, I=interview, E= exercise

Qualifications

Essential

Desirable

Two (2) or more and GCSEs including English and Mathematics (A)

X

A - Levels (A)

X

A relevant qualification, degree (or equivalent experience in health, social care or information and advice) (A / I)

X

Evidence of continued learning and development (A / I)

X

Adult safeguarding – level 2 training (A / I)

X

Basic life support training (A / I)

X

Experience

Minimum three years’ experience of working in health, social care, or third sector or information and advice, in direct contact with people (A / I)

X

Experience of building relationships in health, social care or third sector environment (A / I)

X

Experience of delivering services to people with complex needs (A /I)

X

Experience of person – centered planning (A / I)

X

Experience of collating data and producing reports (A / I)

X

Experience of working with volunteers (A / I)

X

Experience of being an advocate (paid/unpaid role) and negotiating with providers to achieve the best outcomes for people (A / I)

X

A basic knowledge / understanding of (or a willingness to learn) health and social care terminology (A / I)

X

Skills and Knowledge

Knowledge of health and social care policy (A / I)

X

Strong motivational skills to support people to self – care (A / I)

X

Ability to gain knowledge and understand local services (A / I)

X

Innovative with good problem solving skills (A / I)

X

Good listener and clear communicator (A / I)

X

To be comfortable staying with people who are facing loss (A / I)

X

Approachable and friendly person who is able to get on well with people of different backgrounds (A / I)

X

Emotional resilience in the face of the difficult circumstances that can affect people at the end of life (A / I)

X

Be reliable and flexible (A / I)

X

Ability to respect others differences and choices (A / I)

X

Team Working

Able to build effective relationships (A / I)

X

Ability to work on own initiative and with minimum supervision (A /I )

X

Ability to work as part of a team (A / I)

X

Communication Skills

Excellent communication skills, both verbal and written (A / I / E)

X

Diplomatic with sensitive information / managing potential conflict

(A / I)

X

Understands the importance and limits of confidentiality (A / I / E)

X

Personal Attributes

Demonstrate compassion and empathy for people in a professional manner (A / I)

X

Ability to recognize limitations (A / I)

X

Able to deal with conflict, complaints and distress (A / I)

X

Ability to recognise and manage risk (A / I)

X

Organised, adaptable and flexible (A / I)

X

Able to promote equality and diversity principles (A / I)

X

Information Management and Technology

Good literacy and IT skills, confident in use of a range of software, including Microsoft Office (Word, Excel and PowerPoint) (A / I)

X

Able to use electronic records, databases, spreadsheets relevant software packages and associated electronic equipment (A / I / E)

X

Travel

Ability to travel across assigned ICN and wider borough (A / I)

X

Full UK driving license (A / I)

X

Access to a vehicle (A / I)

X

TERMS & CONDITIONS OF EMPLOYMENT

Salary

£24,500pa

Pension

All eligible employees are automatically enrolled into our scheme with The Pensions Trust, contributions are in line with the government’s minimum standards (currently 3% employees, 2% employers)”

Hours

37.5 hours per week

Annual leave

27 days p.a. + 8 public holidays

Based at:

A specified location based in the assigned ICN (likely to be Beckenham Beacon, Princess Plain Clinic in Bromley, and St Paul’s Cray Clinic in Orpington). The Care Navigator will be co-located with the MDT Liaison Coordinator and Community Matrons. In addition, hot desking at Age UK Bromley & Greenwich, Community House, South Street, and Bromley.

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.

ABOUT AGE UK BROMLEY & GREENWICH

Age UK Bromley & Greenwich is the trading name of Age Concern Bromley a registered charity and company limited by guarantee. Age Concern Bromley was established in 1965 and Age Concern Greenwich merged with it on 30th November 2011.

Age UK Bromley & Greenwich has its main office in Bromley with two offices located in Greenwich. It is a partner of the national network of independent Age UK charities each is responsible for their own governance and own income generation. Age UK is the national charity and partner and all partners share common aims and values and work together for the benefit of all older people.

Age UK Bromley & Greenwich provides a wide variety of services to older people who are 50+ and resident in the London Boroughs of Bromley and Greenwich (direct service users are usually 60+). We provide practical help and advice to older people many of whom are frail or housebound, provide information on issues relating to older people their relatives and or carers such as money matters, housing, health and community care. Age UK Bromley & Greenwich campaigns locally on Age Discrimination and many other issues that impact the lives of older people.

Mission and Values

Age UK Bromley & Greenwich aims to promote the wellbeing of all older people in the community. We value older people and believe that later life should be a fulfilling and enjoyable experience.

Our core values are:

CaringWe are passionate about what we do and care about each individual.

DynamicWe are innovative and deliver quality services for older people.

EnablingWe enable older people to live independently and exercise choice.

ExpertWe are authoritative, trusted and quality-orientated.

InfluentialWe draw strength from the voices of older people and ensure those voices are heard.

Our specific aims are to:

Provide Borough-wide services and support for older people.

Raise awareness of the needs of older people and influence decision-makers, and to provide a voice for older people in the Borough.

Contribute to research which identifies the changing needs of older people locally and find innovative ways of meeting them.

Challenge discrimination of older people on the basis of their age.

Work in partnership and cooperation with other organisations across the sectors to effectively meet the needs of older people throughout the Boroughs.

Some of the services we provide are commissioned by local authorities and NHS

Trust, others by charitable Trusts and we also have paid services for self

funders, and people with personal budgets.

Our present and any future services will comply fully to our approach of how we work with and for older people:

· have a zero tolerance of all forms of abuse

· support people with the same respect and dignity you would want for yourself or a member of your family

· treat each person as an individual by offering personalised service

· enable people to maintain the maximum possible level of independence, choice and control

· listen and support people to express their needs and wants

· respect people’s right to privacy

· ensure people feel able to complain without fear of retribution

· engage with family members and carers as care partners

· assist people to maintain confidence and a positive self-esteem

· act to alleviate peoples’ loneliness and isolation

Age UK Bromley & Greenwich services include:

· Advocacy and Representation – both boroughs

· Specialist Dementia Care /choir - Bromley

· Support Planning – both boroughs

· Charity Shops – Orpington, West Wickham and Woolwich

· Care Navigation - Bromley

· Community helpers befriending and support service – both boroughs

· Community Services:

· Clip It - Toe Nail Cutting – both boroughs

· Exercise classes – both boroughs

· Help at Home - Bromley

· Hospital Aftercare - Bromley

· Community Volunteers Time Bank - both boroughs

· Day Opportunities – both boroughs

· Dementia Support Hub – Bromley

· Men in Sheds – both boroughs

· Computer & art classes – both boroughs

· Information and Advice – both boroughs: a single telephone number for all information and advice enquiries from people resident in both boroughs, letter and to personal callers, casework and welfare benefit checks. Home visits are made to older people who are frail and unable to visit our office. In Greenwich we deliver Information and Advice at a variety of outreach locations throughout the borough including welfare benefits.

· Walking Football

For further information about Age UK Bromley & Greenwich visit our website: www. ageukbromleyandgreenwich.org.uk

Job Pack: Care NavigationDecember 2020Page 9 of 12