Care Home Care Co-Ordinator (GP Practice)

Integrated Care System; Burton-on-Trent; On-site; GBP 25,000 - 30,000; Part time

Job summary

A local healthcare provider is seeking a caring individual for maternity cover, coordinating care for care home residents. The role involves working 15 hours a week across two practices in Burton-on-Trent. Key responsibilities include liaising with care homes and clinicians, ensuring optimal patient care, and maintaining comprehensive care plans. Candidates should possess strong interpersonal skills and experience with systems such as EMIS Web.

Qualifications

• Experience working in an office environment.
• Practical experience of computerised recording systems.
• Experience in General Practice or other Primary/Secondary care environment.

Responsibilities

• Ensure care-home patients have the best health care journey possible.
• Liaise proactively with care homes and clinicians.
• Act as a central point of access for care home support.

Skills

Excellent interpersonal skills

Good personal organization

Proficient in Microsoft Word and Excel

Ability to follow procedures

Ability to work unsupervised

Education

Good standard of literacy and numeracy (Maths and English Grade C)

Tools

EMIS Web

DOCMAN

Job description

We are looking for a driven and caring person to join our team as maternity cover, to work across both the Dove River Practice and the Tutbury Practice, in a role co-ordinating care for our care home residents. You will work within our friendly team to support our Clinicians and provide excellent care to our patient population. You need to be motivated and compassionate, someone who can forward think and problem solve.

The role is for 15 hours a week, over 3 days.

Interviews will take place w/c 08/09/2025 - times TBC based on applicants. These will be with a representative from both the Dove River and Tutbury Practices.

Main duties of the job

You will work to ensure that our care-home patients have the best health care journey possible. Liaising with the care homes and clinicians across both Practices in a pro-active model of care.

You will use various IT systems including our GP IT system EMIS Web and will be confident in engaging with all other providers.

About us

The two Practices in Tutbury have a welcoming and supportive environment, we work closely together and always strive to provide the best care possible to our patients.

Job responsibilities

Hours: 15 hours per week. Your normal working hours will be Monday,Tuesday and Wednesday at the Tutbury Health Centre; 5 hours per day during core workinghours.

Responsibleto: TheIM&T Manager

Accountable to: Practice Manager and Partners

Generaldescription of the post:

The Enhanced Health in Care Homes model moves us away from reactive care to aproactive model of care, this role is pivotal in making this happen.

To act as the central point of access for all care homes to support thedelivery of the Enhanced Health in Care Homes element of the Primary CareNetwork (PCN) Direct Enhanced Service.

Duties:

To develop and refresh as required a personalised care and support plan forevery resident a standard template will be developed. Within 7 working daysof admission to the home and within 7 working days of readmission following ahospital episode. This is to be done in conjunction with the patient, familyand or carer and MDT members. Work with the Practices to ensure that allrelevant information is held within the patients medical record whentransferring to a new practice. List of up to date medication, ESCAs, summaryprint out is requested from their previous practice if required

Draw on any existing assessments that have been made.

Use a directory of services(this will be complied for you but it is expected that in time you will forgelinks with other external provision to help enhance the care and supportavailable to care homes) to navigate the right care to the right home as andwhen this is required. This

active engagement with external providers will include thevoluntary sector and Social Prescribing link workers.

To be the central point of contact for all care homes andensure that each care home has access to a weekly check in home roundfacility and prioritise residents for review according to identified need basedon MDT clinical judgement and care home advice.

To identify and or engage in locally organised sharedlearning opportunities as appropriate and as capacity allows.

Actively encourage an excellent working relationship withthe care home and support them to self-manage by disseminating educationalmaterial, advice and guidance as prepared by MDT members when and whereappropriate.

To ensure that action points arising from MDT meetings arefollowed up

To support the patients discharge from hospital andtransfers of care between settings giving due regard to NICE Guideline 27 Relatesto referrals only

Assist with the collection of data required for the PCNEHCH DES

Implement and co-ordinate advanced care plans on annualbases and when notified of a new patient.

Work with the home (and MDT) in coordinating their fluimmunisation campaign.

Where someone is identified as likely to die in next fewdays or hours, to ensure everyone who needs to be aware is. Liaise withdispensary and GPs to ensure anticipatory drugs, DNAR etc all arranged. Liaisewith St Giles as appropriate. The patients care plan is reviewed andtreatment escalation plan in place. Family have been informed and DNAR etcdiscussed. If a treatment plan surrounding their death is in place it isfollowed where possible, through collaboration with the home and other in the MDTwhere necessary. Following a death, ensure that the relevant parties have beeninformed. Bereavement support is available for the families (and care workers)Ensure ADASTRA form is uploaded in a timely manner.

Aware of when SMRs need doing, add them to the MDT meetingsto ensure all relevant parties review medications of the patient.

If a falls prevention plan is in place, ensure it isreviewed as required, at least annually. Ensure it is on the agenda for the MDTmeetings.

Identify who needs a review, of what, when. Make sure thatthe relevant parties are aware, follow it up to make sure it has been actioned.

Co-ordinate hospital discharges i.e. onward referrals,(where a patient has had a fall, referral to falls team) medication changes,DNARs etc

Confidentiality:

Allpatient information that you come into contact with must be dealt with in thestrictest of confidence. Any breach inconfidence can lead to instant dismissal:-

In thecourse of 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 rightto expect that staff will respect their privacy and act appropriately

In the performance of the duties outlined in this JobDescription, the post-holder may have access to confidential informationrelating to patients and their carers, Practice staff and other healthcareworkers. They may also have access toinformation relating to the Practice as a business organisation. All suchinformation from any source is to be regarded as strictly confidential

Information relating to patients, carers, colleagues, otherhealthcare workers or the business of the Practice may only be divulged toauthorised persons in accordance with the Practice policies and proceduresrelating to confidentiality and the protection of personal and sensitive data.

Health & Safety:

The post-holder will assist in promoting and maintaining theirown and others health, safety andsecurity as defined in the Practice Health & Safety Policy, to include:

Using personal security systems within the workplace accordingto Practice guidelines

Identifying the risks involved in work activities andundertaking such activities in a way that manages those risks

Making effective use of training to update knowledge and skill

Safeguarding:

Allemployees are required to act in such a way that at all times safeguards thehealth and wellbeing of children and vulnerable adults. Familiarisation withand adherence to Safeguarding policies is an essential requirement of allemployees as is participation in related mandatory/statutory training. Forfurther information regarding these policies please look at the T:Drive folderunder Safeguarding, or the Staffordshire Safeguarding Childrens Boards website.

Weoperate a No Smoking Policy.

Person Specification

Skills and Abilities

• Excellent interpersonal skills.
• Good personal organisation.
• Proficient in computer skills, including knowledge of Microsoft Word and Excel.
• Ability to follow procedures.
• Ability to work unsupervised.

Qualifications

• Evidence of a good standard of literacy and numeracy (Maths and English Grade C).

Personal Qualities and Attributes

• Understanding and acceptance of the need for strict confidentiality in the workplace and be able to follow data protection policies and guidelines.
• Ability to use own judgement, initiative and common sense.
• Ability to work as part of a multi-skilled team.
• Pleasant and articulate.
• Able to work under pressure.
• Able to adapt to change.

Experience

• Experience working in an office environment.
• Practical experience of computerised recording systems.
• Experience of EMIS clinical system including search and reporting.
• Experience working with DOCMAN and workflow of clinical correspondence following procedures and policies.
• Experience of working in General Practice or other Primary/Secondary care environment.

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.