Job summary To undertake holistic needs-led assessments in partnership with service users, patients and carers, prepare care plans, commission services and manage a caseload to ensure the most effective and beneficial care packages are established, delivered, monitored and reviewed, and comply with all statutory requirements, Torbay and South Devon NHS Foundation Trust policies, standards and guidelines. Main duties of the job To be a core member of a multi-disciplinary Baywide Health and Wellbeing Team and contribute to the effective assessment and discharge planning with working age adults in the area of Torbay and for Torbay residents in out of area hospitals in the region To undertake holistic social care assessments, in partnership with service users, families and carers, prepare care plans, commission services to ensure the most beneficial and cost-effective care packages are established, delivered, monitored and reviewed, and comply with all statutory requirements for Torbay and South Devon NHS Foundation Trust policies and guidelines To have clear responsibilities for the safeguarding of adults and children and for operating in a manner consistent with Human Rights legislation To be compliant with and practice utilising social care legislation including Care Act 2014 and Mental Capacity Act 2005 Areas of Specialism To initiate investigations where the abuse of vulnerable adults may have occurred, and participate in Strategy meetings Specialist roles may include Hospital Discharge, Learning Disability, Mental Health or Drugs and Alcohol To develop specialist skills and knowledge to facilitate the development of evidence-based practice within the Team About us Why Work With Us Please click on above link for more information Our people are caring, committed, inclusive and focussed on quality. We focus on solutions and people's strengths. We encourage outside the box thinking and embrace innovation and change wherever it can drive improvement. If you share our values and vision and are passionate about working with people on what matters to them, you could be a real asset to Team Torbay and South Devon. And if you do join us, you'll be working in one of the most beautiful parts of the UK, with a fantastic quality of life. We actively encourage our people to enjoy a good work/life balance and Devon offers everything from city living to a host of outdoor activities. Whether it's the coast that floats your boat, the adrenaline of white-water rafting, trekking across the moors or being mindful in nature, you'll find it all right on your doorstep. Date posted 14 February 2025 Pay scheme Agenda for change Band Band 5 Salary Depending on experience Per Annum Contract Permanent Working pattern Full-time Reference number 388-6839186-ACS Job locations Kings Ash House Kings Ash Road Paignton TQ3 3XZ Job description Job responsibilities Detailed job description and responsibilities Communication and working relationships Communication with service users, patients and carers Informed verbal and written consent should be obtained from service users and patients for all assessments care plans and interventions Communications may include dealing with those people who have difficulties relating to highly complex, contentious emotional, psychological as well as physical conditions associated with their presenting conditions. People may have difficulties in communicating or understanding, and may be dysphasic, depressed, deaf, blind, or unable to accept their diagnosis or situation. Communication may involve skills in diffusing anger, motivating, negotiating, counselling, training, empathising and reassuring Communicating with Colleagues To forge strong links with colleagues in the multi-disciplinary team, and across the Hospital Teams and Health and Social Care Teams, and provide specialist advice to medical staff, GPs, Nurses, health and social care professionals, other agencies and managers Information to be provided in several formats including verbal, e.g. multi-disciplinary case conferences, written reports and Email. To work constructively and maintain professional working relationships with people from different occupational backgrounds and cultures within the ethos of an integrated service Communication External To represent the Hospital Discharge at inter-agency meetings Key Working Relationships External Key external working relationships will be with health professionals, private domiciliary and residential care providers, voluntary sector organisations, Torbay Council Legal Department, Housing and Supporting People teams, Childrens Services, and other Local Authorities and Health Trusts in individual and group settings Internal Key internal working relationships would be multi-disciplinary colleagues in the Zone team, domiciliary and residential Care providers, the Hospital Team, other specialist teams (e.g., Mental Health, Sensory Loss), the Emergency Duty Service Financial Assessment and Benefits Team, Disability Information Service and Receiverships Areas of Specialism To initiate investigations where the abuse of vulnerable adults may have occurred, and participate in Strategy meetings Specialist roles may include Hospital Discharge, Learning Disability, Mental Health or Drugs and Alcohol To develop specialist skills and knowledge to facilitate the development of evidence-based practice within the Team Analytical and judgement To be responsible for managing and prioritising a high-volume personal caseload of varying complexity Planning and organisation To plan and prioritise own work and caseload supported through regular supervision and consultation To draw up detailed care plans in partnership with service users, patients and carers which can be used by brokers and service providers to set up appropriate services Physical skills The job involves a combination of sitting, standing and walking on a daily basis General manual handling Patient and client care To ensure that service users are placed at the heart of the Service, treated courteously and fairly, and consulted on all aspects of their service provision Monitor the standards and quality of care provided to clients through service contracts to ensure that they meet the standards specified within these contracts and conform to Directorate policies and guidelines To protect the rights and advocate on behalf of vulnerable people in accordance with legislation Policy and service development To undertake complex assessments including involvement with vulnerable adults cases, and to undertake intensive care management, in accordance with Directorate policies, standards and guidelines, identifying where specialist assessment is required Manage a caseload to ensure that individuals receive care to meet their assessed needs, within budget To undertake home visits in the community as a lone worker unless a risk assessment stipulates that workers should not visit on their own Contribute to the collation of information needs within the community to assist the development of appropriate resources Contribute to the decision-making on client priority needs To participate in shared team responsibilities, and provide cover for absent colleagues according to the teams requirements Where appropriate and having applied Care Act 2014 eligibility criteria, arrange services to meet the individuals assessed needs, within the framework of the social care contracting process In accordance with Torbay and South Devon NHS Foundation Trust policies, provide information and advice on alternative services which may be available To demonstrate an ability to undertake duties with greater autonomy and accountability, and require less direction and direct supervision To act as a Duty Officer dealing with emergencies and same day urgent assessments as required Job description Job responsibilities Detailed job description and responsibilities Communication and working relationships Communication with service users, patients and carers Informed verbal and written consent should be obtained from service users and patients for all assessments care plans and interventions Communications may include dealing with those people who have difficulties relating to highly complex, contentious emotional, psychological as well as physical conditions associated with their presenting conditions. People may have difficulties in communicating or understanding, and may be dysphasic, depressed, deaf, blind, or unable to accept their diagnosis or situation. Communication may involve skills in diffusing anger, motivating, negotiating, counselling, training, empathising and reassuring Communicating with Colleagues To forge strong links with colleagues in the multi-disciplinary team, and across the Hospital Teams and Health and Social Care Teams, and provide specialist advice to medical staff, GPs, Nurses, health and social care professionals, other agencies and managers Information to be provided in several formats including verbal, e.g. multi-disciplinary case conferences, written reports and Email. To work constructively and maintain professional working relationships with people from different occupational backgrounds and cultures within the ethos of an integrated service Communication External To represent the Hospital Discharge at inter-agency meetings Key Working Relationships External Key external working relationships will be with health professionals, private domiciliary and residential care providers, voluntary sector organisations, Torbay Council Legal Department, Housing and Supporting People teams, Childrens Services, and other Local Authorities and Health Trusts in individual and group settings Internal Key internal working relationships would be multi-disciplinary colleagues in the Zone team, domiciliary and residential Care providers, the Hospital Team, other specialist teams (e.g., Mental Health, Sensory Loss), the Emergency Duty Service Financial Assessment and Benefits Team, Disability Information Service and Receiverships Areas of Specialism To initiate investigations where the abuse of vulnerable adults may have occurred, and participate in Strategy meetings Specialist roles may include Hospital Discharge, Learning Disability, Mental Health or Drugs and Alcohol To develop specialist skills and knowledge to facilitate the development of evidence-based practice within the Team Analytical and judgement To be responsible for managing and prioritising a high-volume personal caseload of varying complexity Planning and organisation To plan and prioritise own work and caseload supported through regular supervision and consultation To draw up detailed care plans in partnership with service users, patients and carers which can be used by brokers and service providers to set up appropriate services Physical skills The job involves a combination of sitting, standing and walking on a daily basis General manual handling Patient and client care To ensure that service users are placed at the heart of the Service, treated courteously and fairly, and consulted on all aspects of their service provision Monitor the standards and quality of care provided to clients through service contracts to ensure that they meet the standards specified within these contracts and conform to Directorate policies and guidelines To protect the rights and advocate on behalf of vulnerable people in accordance with legislation Policy and service development To undertake complex assessments including involvement with vulnerable adults cases, and to undertake intensive care management, in accordance with Directorate policies, standards and guidelines, identifying where specialist assessment is required Manage a caseload to ensure that individuals receive care to meet their assessed needs, within budget To undertake home visits in the community as a lone worker unless a risk assessment stipulates that workers should not visit on their own Contribute to the collation of information needs within the community to assist the development of appropriate resources Contribute to the decision-making on client priority needs To participate in shared team responsibilities, and provide cover for absent colleagues according to the teams requirements Where appropriate and having applied Care Act 2014 eligibility criteria, arrange services to meet the individuals assessed needs, within the framework of the social care contracting process In accordance with Torbay and South Devon NHS Foundation Trust policies, provide information and advice on alternative services which may be available To demonstrate an ability to undertake duties with greater autonomy and accountability, and require less direction and direct supervision To act as a Duty Officer dealing with emergencies and same day urgent assessments as required Person Specification Qualifications and training Essential GCSE grade C or above To have an NVQ level 4 in health & Social Care/or equivalent Evidence of consistent pattern of learning from education, training and experience Understanding of basic human needs - physical, emotional, health and social Knowledge and experience Essential Understanding of basic human needs, physical, emotional and social needs Ability to communicate effectively with clients, carers, specialist Proven interpersonal skills Effective working as an individual but also as part of a wider multi-disciplinary team Ability to use time effectively Effective recording skills Willingness to undertake training to develop within the role Ability to use IT based care management systems Ability to work on own initiative whilst making positive use of supervision and training Awareness of Care Act 2014 legislation Assessment & Care Management Process, policies and standards Effective in using multiple data base computer systems Ability to undertake holistic assessments of persons need, arranging and reviewing services Desirable Care Management process, policies and standards Community Care and other relevant legislation Knowledge of long-term conditions Customer care/reception training Evidence of risk assessment training/awareness Use of recognised IT packages Person Specification Qualifications and training Essential GCSE grade C or above To have an NVQ level 4 in health & Social Care/or equivalent Evidence of consistent pattern of learning from education, training and experience Understanding of basic human needs - physical, emotional, health and social Knowledge and experience Essential Understanding of basic human needs, physical, emotional and social needs Ability to communicate effectively with clients, carers, specialist Proven interpersonal skills Effective working as an individual but also as part of a wider multi-disciplinary team Ability to use time effectively Effective recording skills Willingness to undertake training to develop within the role Ability to use IT based care management systems Ability to work on own initiative whilst making positive use of supervision and training Awareness of Care Act 2014 legislation Assessment & Care Management Process, policies and standards Effective in using multiple data base computer systems Ability to undertake holistic assessments of persons need, arranging and reviewing services Desirable Care Management process, policies and standards Community Care and other relevant legislation Knowledge of long-term conditions Customer care/reception training Evidence of risk assessment training/awareness Use of recognised IT packages 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 details Employer name Torbay and South Devon NHS Foundation Trust Address Kings Ash House Kings Ash Road Paignton TQ3 3XZ Employer's website https://www.torbayandsouthdevon.nhs.uk (Opens in a new tab)