Adolescent Outreach Case Worker & Discharge Coordinator

Job overview

We are looking to recruit an experienced band 6 Occupational Therapist, Nurse or Social Worker to work as a member of our established Adolescent Outreach Team. The team are really fortunate that we have an experienced full multi disciplinary representation, and high levels of retention of staff. The MDT are skilled and highly committed to supporting the wider network, parents and carers to support young people to remain at home, and if required to come to hospital facilitate a safe discharge and reduce length of stay.

Applicants must hold a professional registration in a relevant field of mental heath care and have demonstrable experience of working with young people with complex mental health needs. The postholder will work within AOT as a Case Worker and Discharge Coordinator providing Care Coordination and Assessment of an agreed caseload of AOT clients, and offering consultation to the network and referrers, and will have a primary practitioner role servicing the Discharge Coordinator function in  AOT, by being the designated point of contact for all CAMHS inpatient services regarding potential referrals and intervening early to remove barriers to prevent patients becoming delayed transfers of  care.

The post-holder must be committed to effective team working and to the coherent delivery of the care this will include individual, family, group work and telephone support.

Main duties of the job

This is a fantastic and exciting opportunity has arisen for a new Case Worker/Discharge Coordinator to join AOT.

The post-holder will work within AOT as a Case Worker/Discharge Coordinator (OT/Nurse/Social Worker) providing Care Coordination and Assessment of an agreed caseload of AOT clients, and offering expert consultation to the network and referrers, and Intervening early to remove barriers to prevent patients becoming delayed transfers of care.

Agile and flexible working: In this role you will be able to work 7 days of the week. The shifts will include 8am-4pm, 9-5pm and 12pm-8pm on weekdays and 11am-7pm on weekends and bank holidays, giving you the very best of good work life balance.

Detailed job description and main responsibilities

Clinical – Core AOT work

• To act as care coordinator within AOT and, where appropriate, to take responsibility for initiating reviews of care plans under enhanced CPA
• When care planning, to include young people, their carers, referring agents, and others involved the network of care
• To be responsible for the flexible management of a defined caseload designed to meet the individual needs of the young person and their carers
• To prepare reports for and to attend CPA meetings
• To communicate in a skilled and sensitive manner information concerning the assessment, formulation and treatment components of young people’s care plans
• In collaboration, to make crisis plans appropriate to presenting risk
• To adhere to the Lone Working Policy.
• To share the task of chairing meetings and taking minutes
• To contribute to the effective working of the multidisciplinary team and to participate in team and service development
• To promote effective communication within the team and share relevant information as required
• To work within the policies and procedures of the Trust and within relevant legal frameworks
• In particular, to have a clear understanding of risk assessment and child protection protocols, Mental Health Act, and CPA
• To keep up-to-date with developments within the field of adolescent mental health.

Clinical – Discharge Coordinator

• To be a designated point of contact for all CAMHS inpatient services regarding potential AOT referrals.
• Intervening early to remove barriers to prevent patients becoming delayed transfers of care.
• To ensure updates from bed management re admissions are shared with  AOT and documented.
• Verification of purpose of admission and expected length of stay
• Pre-empt and resolve arising barriers to discharge i.e. keys, other agency support to discharge
• Ensuring that patient EDDs is reviewed regularly in conjunction with the MDT particularly for patient who for clinical reason are not able to be discharge on the set EDD date
• To contribute to the formulation of clients’ difficulties and attend ward round on Aquarius to provide updates, share in the care planning and feed into ward and AOT care plan.
• To participate in risk assessment and risk management plans and contingency plans are shared from the ward to AOT
• To attend Care Plan Review meetings and ensure staff are allocated from AOT and coordinate inreach response to the young person their carers in order to ensure the safe running of services and adherence to complex Care Plans.
• At times when there are complexities in admission planning join the SLP bed management meeting alongside the team manager

Professional

• To record all clinical work in accordance with Trust clinical record-keeping standards.
• To maintain and improve own professional, clinical, managerial, knowledge and skills by promoting self-growth and development through the in-service training program and other educational program and materials as agreed by the Team Manager and Modern Matron for Specialist CAMHS.
• To maintain professional standards of ethical practice and professional behaviour as set out by the relevant professional body responsible for registration.
• To conform to Trust professional standards.
• To maintain a record of Continuous Professional Development and supervision attendance so as to meet requirements for renewal of registration.
• To identify needs and goals through supervision, appraisal and development reviews.
• To contribute to local Quality Improvement initiatives.

Teaching, Training, and Supervision

• To participate in individual and team-based supervision as required by Trust policies.
• To receive clinical and professional supervision as determined by the relevant Professional Lead.
• To undertake mandatory and statutory training as required.
• To undertake a Professional and Development Review each year.
• To request appraisal and agree a Personal Development Plan (PDP) that enhances knowledge and skills and opportunities for career development.
• To undertake personal development and training as identified in the PDP.
• To contribute to pre- and post-qualification teaching as appropriate.

Management, Recruitment, Policy and Service Development

• To contribute to the development of the team’s operational policies and services using service evaluation and audit tools.
• To advise service and professional management on those particular aspects of the service that the post-holder is involved with.
• Research and Service Evaluation
• To utilise theory, evidence-based literature and research to support evidence based practice.
• To contribute to appropriate audit, research and evaluation of AOT services.