Job summary We are seeking to recruit an individual with a passion for helping children and young adults to age 25, along with their families / carers to get the right support from services across the whole system by coordinating multi agency working. The Keyworker will be employed by NHS Cheshire and Merseyside ICB, Knowsley Place and work across Health, Social Care, Education and other partners / providers to coordinate and provide challenge to the system, thereby ensuring that children/young people and their families can access the right support to enable them to achieve better outcomes. The role involves, coordinating professionals to : Reduce the number of young people (up to 25) from Knowsley with mental health, learning disability and/or Autism being admitted to Tier 4 CAMHS / Adult Mental Health Wards and/or accommodation placements. Reduce the length of stay in Tier 4 CAMHS/ Adult Mental Health Wards, where admission is clinically appropriate. Reduce the length of stay for young people in Acute Paediatric/Adult Wards where there are unmet mental health and/or social care needs. Reduce the need for out-of-borough placements and specialist mental health placements for our Looked After Children. For informal enquiries please contact: Rebecca.Westwoodcheshireandmerseyside.nhs.uk Telephone 07900405736 Main duties of the job We are looking for these Core Competencies: Person centred | Facilitating the involvement of services | Effective communication | Challenging and influencing | Understanding collaborative working | Problem-solving at individual/family level and at systems level | Building strong relationships | Networking and Coordinating | We are keen to recruit a diverse team from a wide variety of backgrounds. We would love to hear from you if: you are keen to make sure that young people are at the heart of any process and that their voice is heard. you have a good understanding of working in partnership and developing positive relationships that make things happen for young people. you have a relevant professional background such as Social Care, Nursing, Youth Work, Allied Health Professional, Teaching or other relevant experience. you have experience and/or training specific to LD, Autism. Mental Health. you are organised and a good communicator with a passion for working to meet individual personalised needs you have a sound knowledge of safeguarding you understand risk and risk management About us Since July 1st 2022 NHS Cheshire and Merseyside - an Integrated Care Board - has held responsibility for planning NHS services, including Primary Care, community pharmacy and those previously planned by clinical commissioning groups (CCGs). As well as our chair and chief executive, membership of the board includes partner members drawn from local authorities, NHS trusts / foundation trusts and Primary Care. Date posted 10 February 2025 Pay scheme Agenda for change Band Band 6 Salary £35,392 to £42,618 a year pa Contract Permanent Working pattern Full-time, Flexible working Reference number 493-ICB-6988986 Job locations Nutgrove Villa Westmorland Road Huyton L36 6GA Job description Job responsibilities This role will cover the cohort of all those children and young people at risk of admission to Tier 4 CAMHS awaiting discharge from Tier 4 CAMHS delayed discharge from Paediatric wards at risk of care placement breakdown at risk of custody children discussed within DSD tracker meetings who are at risk of the above. For all children and young people with a learning disability, autism or both, the NHS Long Term Plan outlines the commitment that those with the most complex needs should have a designated Keyworker. The role of the keyworker is to co-ordinate the input of other professionals, the keyworker is not a case manager or frontline service. The ICB at Knowsley is responsible for this cohort, arranging multi-disciplinary team around the child meetings (MDTs), Care, Education and Treatment Reviews (CETRs) and overseeing action plans based on recommendations developed through the MDT and CETR. The Gateway process accepts referrals where it becomes evident that children and young people who fall outside this LD/autism classification are at similar risk. The risks are as above with the additional instance of placement breakdown that has resulted in inappropriate hospital admission, or this is imminent. These referrals are discussed at the local Gateway meetings. Initially, Keyworker support will be provided to children and young people up to age 25 years (LD/autism) or 18 for Gateway, who are inpatients or at risk of being admitted to hospital, becoming known to the Youth Justice Service, or at risk of placement breakdown through escalating behaviour that challenges. Keyworker support will also be extended to the most vulnerable children with a learning disability and/or autism, including those who face multiple vulnerabilities such as children looked after and adopted children, and children and young people in transition between services. The clinical manager of the Team determines who is allocated a keyworker and the need for key working is kept under review. The purpose of the Keyworker role is: - To ensure that the MDT improve outcomes for children and young people with learning disabilities, autism or both by being the key point of contact and co-ordinator for service users and partner services as determined at MDT meetings and CETRs To ensure that the needs of the child/young person and their family are understood and promoted within and amongst the MDT To ensure that local systems and services are responsive to meeting needs in a holistic and joined up way, supporting implementation of the joint plan for the child/young person Develop and maintain a strong, positive relationship with children and young people with a learning disability, autism, or both in order to understand needs and ensure that they and their families get the right support at the right time. Actively build and maintain strong relationships with a range of professionals across teams and settings to act as a link between Health, Education and Social Care teams, including the third sector and facilitate collaborative working amongst this MDT. Ensure the child/young person and family can express their needs and preferences in multi-disciplinary and multi-agency discussions as and when appropriate; acting as intermediary if needed. Ensure service users access the right help at the right time across complex systems, particularly in the transition between children and adults services by working with the appropriate services. Co-ordinate and prompt MDT actions against timescales within the person-centred plan. Ensure services communicate clearly with the child, young person and their family to help them understand and navigate the system, for example conveying complex legal and medical information around Tier 4 admissions in a clear accessible way. Maintain regular communications with Lead Professionals regarding the child/young persons care, including where they are fulfilling the keyworker role. Represent the team manager in their absence, at meetings, reviews etc as directed. Keyworkers will have a co-ordinating role: Be trained to apply the DSD Risk Rating Tool and SBAR and will work with other professionals across the system to identify children and young people at risk. Explain the DSD, Gateway and Keyworker functions to children/young people and their families and gain consent for inclusion on the database. Update information on the database whenever changes occur and within 24 hours. Provide updates to DSD and Gateway meetings and as otherwise required. This may involve gathering information from other professionals across the system. Support the arranging of CETR meetings, gaining consent, ensuring all relevant services are represented, and collating documentation in advance for sharing with the meeting members. Participate in CETRs, providing information and supporting the child/young person and their family. Follow up on any actions from CETRs and subsequent meetings to remind and to support services implementation of the agreed plan. Support the child/young person and their family to identify and access services to that provide support in the community. Advise services on appropriate adjustments for the young person based on their autism and/or learning disability profile. Facilitate the provision of identified interventions to prevent admission to inpatient settings where appropriate. Support discharge from specialist services by facilitating communication and collaboration between inpatient and community settings/services and ensuring agreed actions are completed. Facilitate step down from specialist services at the appropriate time. Track childs /young persons progress, identifying triggers which may lead to crisis. Identify themes for individuals and across cases to inform service development and commissioning. Support parents to access and implement support and strategies for preventing, de-escalating and for managing behaviour that challenges. Produce reports on completed work including suggestions for future service provision and identification of gaps in services. Evidence how the Keyworker role facilitates improved outcomes for individuals. (State what is different about the CYP and how this links to your work). Keep up to date records and support the evaluation of the role, providing relevant data and anonymised case studies. Keep contemporaneous notes on the system, in a timely manner in line with policy. Collect and collate feedback from children, young people, and their families regarding their experiences of services. Identify changes that would increase flexibility, integration, joined up working, improve communication and lead to better outcomes for children and young people, including the cohort with autism and/or learning disability. Take part in and contribute to national and regional Keyworker Community of Practice events. Undertake training that will increase your skills and knowledge of the role and of the service users/service providers that you work with. The NHS, ICB is committed to equality and diversity and works hard to make sure all staff and service users have access to an environment that is open and a free from discrimination. We value the diversity of our staff and service users, and therefore recognise and appreciate that everyone associated with the organisation is different and so should be treated in ways that are consistent with their needs and preferences. All employees are required to act in such a way that, at all times, safeguards and promotes the health and well-being of children, young people and vulnerable adults. Familiarisation with and adherence to the policies and procedures of the Local Safeguarding Boards (Children and Adults) and those of the organisation is an essential requirement of all employees, as is participation in mandatory safeguarding training in accordance with the employees role and responsibilities. In accordance with the Health and Safety at Work Act 1974 and other supplementary legislation, you are required to take reasonable care to avoid injury during the course of work and to co-operate with the Cheshire and Merseyside ICB and others in meeting statutory regulations. All staff are expected to: - ensure the confidentiality and security of all information that is dealt with in the course of performing your duties in accordance with the requirements of the Data Protection Act 1998 and adhere to the principles of Caldicott. be aware that the ICB has an Information Governance Handbook which provides the framework and procedures in which information should be managed. They should become familiar with the handbook and keep up to date with any changes that are made, including the completion of mandatory IG Training on an annual basis. Breaches of the procedures within the handbook could be regarded as gross misconduct and may result in serious disciplinary action being taken, up to and including dismissal. comply with and keep up to date with the requirements of legislation such as the Freedom of Information Act 2000 and Computer Misuse Act 1990 and remain updated about any changes or additions to relevant legislation. Maintain an overview of relevant legislation and rights frameworks. including the Children and Families Act; Mental Health Act; the Mental Capacity Act and Deprivation of Liberty Safeguards (DOLS); 117 After Care Procedures; the Care Act; and the Human Rights Act Each member of the ICB is responsible for ensuring that any external interest they have does not conflict with the duties of their post and they must disclose the external interest if this is likely to occur, or if they are in doubt about a possible conflict of interest. Job description Job responsibilities This role will cover the cohort of all those children and young people at risk of admission to Tier 4 CAMHS awaiting discharge from Tier 4 CAMHS delayed discharge from Paediatric wards at risk of care placement breakdown at risk of custody children discussed within DSD tracker meetings who are at risk of the above. For all children and young people with a learning disability, autism or both, the NHS Long Term Plan outlines the commitment that those with the most complex needs should have a designated Keyworker. The role of the keyworker is to co-ordinate the input of other professionals, the keyworker is not a case manager or frontline service. The ICB at Knowsley is responsible for this cohort, arranging multi-disciplinary team around the child meetings (MDTs), Care, Education and Treatment Reviews (CETRs) and overseeing action plans based on recommendations developed through the MDT and CETR. The Gateway process accepts referrals where it becomes evident that children and young people who fall outside this LD/autism classification are at similar risk. The risks are as above with the additional instance of placement breakdown that has resulted in inappropriate hospital admission, or this is imminent. These referrals are discussed at the local Gateway meetings. Initially, Keyworker support will be provided to children and young people up to age 25 years (LD/autism) or 18 for Gateway, who are inpatients or at risk of being admitted to hospital, becoming known to the Youth Justice Service, or at risk of placement breakdown through escalating behaviour that challenges. Keyworker support will also be extended to the most vulnerable children with a learning disability and/or autism, including those who face multiple vulnerabilities such as children looked after and adopted children, and children and young people in transition between services. The clinical manager of the Team determines who is allocated a keyworker and the need for key working is kept under review. The purpose of the Keyworker role is: - To ensure that the MDT improve outcomes for children and young people with learning disabilities, autism or both by being the key point of contact and co-ordinator for service users and partner services as determined at MDT meetings and CETRs To ensure that the needs of the child/young person and their family are understood and promoted within and amongst the MDT To ensure that local systems and services are responsive to meeting needs in a holistic and joined up way, supporting implementation of the joint plan for the child/young person Develop and maintain a strong, positive relationship with children and young people with a learning disability, autism, or both in order to understand needs and ensure that they and their families get the right support at the right time. Actively build and maintain strong relationships with a range of professionals across teams and settings to act as a link between Health, Education and Social Care teams, including the third sector and facilitate collaborative working amongst this MDT. Ensure the child/young person and family can express their needs and preferences in multi-disciplinary and multi-agency discussions as and when appropriate; acting as intermediary if needed. Ensure service users access the right help at the right time across complex systems, particularly in the transition between children and adults services by working with the appropriate services. Co-ordinate and prompt MDT actions against timescales within the person-centred plan. Ensure services communicate clearly with the child, young person and their family to help them understand and navigate the system, for example conveying complex legal and medical information around Tier 4 admissions in a clear accessible way. Maintain regular communications with Lead Professionals regarding the child/young persons care, including where they are fulfilling the keyworker role. Represent the team manager in their absence, at meetings, reviews etc as directed. Keyworkers will have a co-ordinating role: Be trained to apply the DSD Risk Rating Tool and SBAR and will work with other professionals across the system to identify children and young people at risk. Explain the DSD, Gateway and Keyworker functions to children/young people and their families and gain consent for inclusion on the database. Update information on the database whenever changes occur and within 24 hours. Provide updates to DSD and Gateway meetings and as otherwise required. This may involve gathering information from other professionals across the system. Support the arranging of CETR meetings, gaining consent, ensuring all relevant services are represented, and collating documentation in advance for sharing with the meeting members. Participate in CETRs, providing information and supporting the child/young person and their family. Follow up on any actions from CETRs and subsequent meetings to remind and to support services implementation of the agreed plan. Support the child/young person and their family to identify and access services to that provide support in the community. Advise services on appropriate adjustments for the young person based on their autism and/or learning disability profile. Facilitate the provision of identified interventions to prevent admission to inpatient settings where appropriate. Support discharge from specialist services by facilitating communication and collaboration between inpatient and community settings/services and ensuring agreed actions are completed. Facilitate step down from specialist services at the appropriate time. Track childs /young persons progress, identifying triggers which may lead to crisis. Identify themes for individuals and across cases to inform service development and commissioning. Support parents to access and implement support and strategies for preventing, de-escalating and for managing behaviour that challenges. Produce reports on completed work including suggestions for future service provision and identification of gaps in services. Evidence how the Keyworker role facilitates improved outcomes for individuals. (State what is different about the CYP and how this links to your work). Keep up to date records and support the evaluation of the role, providing relevant data and anonymised case studies. Keep contemporaneous notes on the system, in a timely manner in line with policy. Collect and collate feedback from children, young people, and their families regarding their experiences of services. Identify changes that would increase flexibility, integration, joined up working, improve communication and lead to better outcomes for children and young people, including the cohort with autism and/or learning disability. Take part in and contribute to national and regional Keyworker Community of Practice events. Undertake training that will increase your skills and knowledge of the role and of the service users/service providers that you work with. The NHS, ICB is committed to equality and diversity and works hard to make sure all staff and service users have access to an environment that is open and a free from discrimination. We value the diversity of our staff and service users, and therefore recognise and appreciate that everyone associated with the organisation is different and so should be treated in ways that are consistent with their needs and preferences. All employees are required to act in such a way that, at all times, safeguards and promotes the health and well-being of children, young people and vulnerable adults. Familiarisation with and adherence to the policies and procedures of the Local Safeguarding Boards (Children and Adults) and those of the organisation is an essential requirement of all employees, as is participation in mandatory safeguarding training in accordance with the employees role and responsibilities. In accordance with the Health and Safety at Work Act 1974 and other supplementary legislation, you are required to take reasonable care to avoid injury during the course of work and to co-operate with the Cheshire and Merseyside ICB and others in meeting statutory regulations. All staff are expected to: - ensure the confidentiality and security of all information that is dealt with in the course of performing your duties in accordance with the requirements of the Data Protection Act 1998 and adhere to the principles of Caldicott. be aware that the ICB has an Information Governance Handbook which provides the framework and procedures in which information should be managed. They should become familiar with the handbook and keep up to date with any changes that are made, including the completion of mandatory IG Training on an annual basis. Breaches of the procedures within the handbook could be regarded as gross misconduct and may result in serious disciplinary action being taken, up to and including dismissal. comply with and keep up to date with the requirements of legislation such as the Freedom of Information Act 2000 and Computer Misuse Act 1990 and remain updated about any changes or additions to relevant legislation. Maintain an overview of relevant legislation and rights frameworks. including the Children and Families Act; Mental Health Act; the Mental Capacity Act and Deprivation of Liberty Safeguards (DOLS); 117 After Care Procedures; the Care Act; and the Human Rights Act Each member of the ICB is responsible for ensuring that any external interest they have does not conflict with the duties of their post and they must disclose the external interest if this is likely to occur, or if they are in doubt about a possible conflict of interest. Person Specification Knowledge Essential Understanding of the needs and characteristics of children and young people with a diagnosis of autism and/or complex communication difficulties Knowledge Essential Understanding of strategies and resources that will support children and young people with autism and/or communication difficulties Experience Essential Experience of working with children/young people with autism and/or learning disabilities with communication, behavioural or who have suffered trauma and isolation issues. Experience Essential Experience of liaising with multi-disciplinary professionals and working across agencies Skills Essential Able to build and maintain positive trusting and strong working relationships with health and social care services Skills Essential Ability to maintain appropriate professional boundaries Person Specification Knowledge Essential Understanding of the needs and characteristics of children and young people with a diagnosis of autism and/or complex communication difficulties Knowledge Essential Understanding of strategies and resources that will support children and young people with autism and/or communication difficulties Experience Essential Experience of working with children/young people with autism and/or learning disabilities with communication, behavioural or who have suffered trauma and isolation issues. Experience Essential Experience of liaising with multi-disciplinary professionals and working across agencies Skills Essential Able to build and maintain positive trusting and strong working relationships with health and social care services Skills Essential Ability to maintain appropriate professional boundaries 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 NHS Cheshire and Merseyside Integrated Care Board Address Nutgrove Villa Westmorland Road Huyton L36 6GA Employer's website https://www.cheshireandmerseysidepartnership.co.uk/ (Opens in a new tab)