Home Visiting Care Co-ordinator

Integrated Care System; Plymouth; On-site; GBP 20,000 - 30,000; Full time

Job summary

A local health care provider in Plymouth is seeking a Home Visiting Care Co-ordinator. This role involves supporting housebound patients through home visits and offering assistance with managing health conditions. Ideal candidates should have experience in care settings and possess clinical IT skills. This full-time position comes with flexible hours and no weekend work, providing a supportive environment within a dedicated team.

Qualifications

• Experience of working within a care setting or customer service setting.
• Experience of dealing with vulnerable patients.
• Experience of working in a GP practice.

Responsibilities

• Visiting housebound and care home residents for basic observations.
• Using TPP SystmOne to identify actions for patients.
• Supporting patients and their families with referrals to services.

Skills

Empathy

Client management

Attention to detail

Education

GCSE level in English and Maths

NVQ Level 2 or 3 in Health and Social Care

Tools

TPP SystmOne

AccuRx

Job description

Go back Drake Medical Alliance Primary Care Network

Home Visiting Care Co-ordinator

The closing date is 18 August 2025

Care Coordinators play an importantrole in the PCN by identifying and supporting patients manage their long-termhealth conditions. Care Coordinators work closely with GPs and practice teamsto manage a caseload of patients, ensuring that appropriate support is madeavailable to them and their carers; supporting them to understand and managetheir condition and ensuring their changing needs are addressed.

The role of Care Coordinator withHome Visiting speciality is to provide support to the practice by being asupportive link between the practice and housebound/care home patients, their family andcarer(s) to provide the best outcome for the patient.

This role is within our Community Care Team, which consists of a frailty nurse practitioner (team manager), an occupational therapist ACP, a nurse practitioner ACP and a home visiting care coordinator.

We are looking to recruit a further home visiting care coordinator to support the recent expansion of this team.

We are looking to recruit on a permanent contract for 37.5 hours per week. We can offer some flexibility for how these hours are organised across the working week.There is no evening or weekend working with this role.

Main duties of the job

• Visiting housebound and care home residents onscheduled domiciliary visits for basic observations, blood tests, diabetic footchecks, collect of urine samples, QFit tests and wellbeing assessments. (We are willing to train the successful applicant in phlebotomy and diabetic foot checks.)
• Using TPP SystmOne to identify actions for Housebound and Care Home Patients. Liaising with the patient, next of kin or lasting power of attorney where appropriate.
• Supporting housebound patients, carers and care homes with referral to external services such as Social Prescribing, social care and befriending services.
• Raising awareness with the appropriateprofessional in the event of concerns over patient health or wellbeing.
• Support triage of information received via email,letter or via other platforms.
• Use internal and external email and the internetto keep up to date and send and receive messages.
• Respond, using a helpful and problem-solvingapproach, to all queries and requests for assistance from practice staff,patients and care home staff.

About us

Drake Medical Alliance Ltd is a Primary Care Network of 5 GP surgeries within the city of Plymouth.

These are Knowle House Surgery, Lisson Grove & Woolwell Medical Centres, North Road West Medical Centre, Roborough surgery and Wycliffe Surgery.

We centrally employ our ARRS staff under a Limited Company which has access to the NHS Pension Scheme.

Job responsibilities

• Use SystmOne to access patient records, running reports to identify patients requiring Long Term Condition reviews that require a home visit due to housebound or care home status.
• Add bloodrequests to ICE or equivalent pathology system with the appropriate clinician.
• Help people to manage their needs throughanswering queries, making and managing appointments, and ensuring that peoplehave good quality written or verbal information to help them make choices abouttheir care.
• Provide expertise to address both the publichealth and social care needs of patients, including lifestyle advice, serviceinformation, and help in tackling local health inequalities.
• Ensure appropriate onward referral of urgentissues to an appropriate clinician.
• Support the coordination and delivery ofmultidisciplinary teams.
• Raise awareness of how to identify patients whomay benefit from shared decision making and support PCN staff and patients inhaving these conversations.
• Maintain records of referrals and interventionsto enable monitoring and evaluation of service.
• Ensure appropriate SNOMED codes are used torecord activity.
• Have a positive, empathetic, and responsiveconversation with the person, and their family and carer(s) about their needs.
• Work towards increasing patients understandingof how to manage and develop health and wellbeing through offering advice andguidance.
• Work with the wider PCN, MDTs and the socialprescribing service to look at how to support patients requiring personalisedcare and support.
• Support patients as guided by the practice tomanage health inequalities.
• Making and managing appointments for patients,related to primary, secondary, community, local authority, statutory, andvoluntary organisations.
• Help people transition seamlessly betweensecondary and community care services, conducting follow-up appointments, andsupporting people to navigate through wider the health and care system.
• Refer onwards to social prescribing link workers,occupational therapist and health and wellbeing coaches where required.
• Regularly liaise with the range ofmultidisciplinary professionals and colleagues involved in the persons care,facilitating a coordinated approach and ensuring everyone is kept up to date sothat any issues or concerns can be appropriately addressed and supported.
• Actively participate in multidisciplinary teammeetings in the PCN as and when appropriate.
• Identify when action or additional support isneeded, alerting a named clinical contact in addition to relevantprofessionals, and highlighting any safety concerns.
• Record what interventions are used to supportpeople, and how people are developing on their health and care journey.
• Demonstrate a flexible attitude and be preparedto carry out other duties as may be reasonable required from time to timewithin the general character of the post or the level of responsibility of therole, ensuring that work is delivered in a timely and effective manner.
• Identify opportunities and gaps in the serviceand provide feedback to continually improve the service and contribute tobusiness planning.
• Work in accordance with the practices and PCNspolicies and procedures.
• Contribute to the wider aims and objectives ofthe PCN to improve and support primary care.
• Develop a culture that promotes equality andvalues diversity. The postholder must be aware of and committed to the Equalityand Diversity policies of the appointing company and comply with all therequirements of these policies and actively promote Equality and Diversityissues relevant to the post.
• Ensure the principles of openness, transparencyand candour are observed and upheld in all working practices.
• The post holder will have, or acquire throughtraining provided by the organisation, the appropriate level of safeguardingand knowledge, skills and practice required for the post and be aware of andcomply with the organisations safeguarding protection policies and procedures.
• Ensure that any infection prevention and controlissues are reported to the line manager/Infection Prevention and Control.

Person Specification

Experience

• Experience of working within a care setting or customer service setting.
• Experience of dealing with vulnerable patients
• Experience of working in a GP practice
• Knowledge of Clinical IT systems (TPP Systm1, AccuRx etc)

Qualifications

• Educated to GCSE level in English and Maths
• Full Driving Licence and use of own car with business insurance.
• Experience of working in a GP practice Knowledge of Clinical IT systems (TPP Systm1, AccuRx etc)
• NVQ Level 2 or 3 Health and Social Care
• Diabetic foot checks
• We are willing to train in these areas.

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.

Employer name

Drake Medical Alliance Primary Care Network