Lead Family Link Worker - Neurodivergence and Learning Disabilities
This is an excitingexpansion to our PCN Children and Young Persons Wellbeing Service, and as suchthe successful post holder will have the opportunity to be involved in thedevelopment of the service, research opportunities, as well as having theresponsibility for collecting user feedback and adapting the role to suit theneeds of users in line with the THRIVE model.
Therole is primarily to work with children, young people and parents/carers,specialising in Neurodiversity and Learning Disability. You will work closelywith the Mindworks Surrey service to provide a range of services for children,young people and their families and deliver the appropriate level of support atthe right time. The role will also provide leadership to the PCN PersonalisedCare roles, whilst acting as the liaison between social prescribing and PCNpractice staff.
Main duties of the job
Social prescribing empowers people to take control of their health and wellbeing through referral to a non-medical link worker who gives time, focuses on what matters to me and takes a holistic approach, connecting people to community groups and statutory services for practical and emotional support. Link workers support existing groups to be accessible and sustainable and help people to start new community groups, working collaboratively with all local partners. Social prescribing can help to strengthen personal and community resilience and reduces health inequalities. It addresses the wider determinants of health, such as debt, poor housing, and physical inactivity, by increasing peoples active involvement with their local communities.
The successful postholder will engage with and offer advice and support to children, young people and their families using a combination of 1:1, group, online and telephone interventions. You will work as part of a small team, undertaking initial assessments and delivering a range of evidence-based interventions, which will include holding a caseload.
You will receive ongoing support and supervision of your caseload from the PCN GPs, and have the opportunity to access group supervision with other Social Prescribing colleagues via the National Centre for Behavioural Change (NCBC). You will join the ABC East Surrey CYP wellbeing team peer support network including those from neighbouring PCNs and access monthly reflective practice sessions.
About us
Alliance for Better Care CIC
Alliance for Better Care (ABC) is aGP Federation uniting 77 NHS GP member practices across 98 sites within 24Primary Care Networks in Sussex and Surrey. We support our Primary Carecolleagues - and their patients - to transform how healthcare is delivered intheir communities.
We work closely with GP Practices,PCNs, Hospitals, Community Organisations, and the Third Sector. These vitalpartnerships enable us to deliver a truly integrated approach that offers thesupport and expertise needed to effectively serve our populations.
Healthy Horley PCN
Our Primary CareNetwork (PCN) is an NHS collaboration between 2 GP practices East SurreyModality Medical Practice and Wayside Surgery covering Horley and surroundingareas (Outwood, Salfords and Smallfield) and has one site in Caterham. Thepractices have a combined population of 45,000, with approximately 30% ofpatients being aged between 0-25 years. There is a wide socio-economic anddemographic served within this area which will provide an interesting andvaried case mix.
Our surgery teams work closely, sharing expertise andresources to develop new services. Our vision is to continue to improve thequality of care that we provide in alignment with the needs of our patientpopulation and find innovative solutions in general practice to deliver thebest care we can for our patients.
Job responsibilities
Personalised care and support:
Assessthe needs and strengths of individuals referred to the service and help themidentify individual goals to achieve desired change.
Providespecialist support to children, young people and parents with LearningDisabilities and Neurodiversity (diagnosed and suspected).
Design,deliver and evaluate interventions for young people and families which aim toimprove mental health and wellbeing, build on existing strengths and increaselevels of resilience.
Providepersonalised support to children, young people and their families, to enablethem to take control of their wellbeing, live independently and improve theirhealth outcomes.
Offerevidence-based interventions to families to increase social support andparenting skills for parents with learning disabilities.
Manageand prioritise your own caseload, in accordance with the needs, priorities andsupport required by individuals, some with complex and multiple needs.
Co-producea personalised support plan to improve health and wellbeing, introducing,connecting, and supporting young people and parents to community groups andstatutory services.
Have agood understanding of and utilise the THRIVE delivery model in sessions,which conceptualises the mental health and wellbeing needs of children, youngpeople and families in terms of five different needs-based groupings: gettingadvice, getting help, getting more help, getting risk support, and thriving.
Offertime-limited sessions with children, young people and families for up to anhour, face-to-face or virtual and offer follow up where needed.
Meetyoung people on a one-to-one basis and give them time to tell their stories andfocus on what matters to me. Build trust with the person, providingnon-judgemental support, respecting diversity, and lifestyle choices. Work froma strength-based approach focusing on a persons assets.
Provideearlier intervention whilst waiting or avoiding the need to wait for triagethrough the Mindworks Access and Advice line.
Leadership:
Act asa PCN lead point of contact for young people with additional needs requiringsupport.
Takeresponsibility for more complex cases / situations presenting within the service,under the supervision of a clinical lead / GP.
Providepoint of contact support to the PCN Personalised Care team to include 1:1s,appraisals, assessing training needs, and service development.
Ensurethe service operates to national best practice, that processes are safe,effective and working guidelines are kept up to date.
Play aleadership role in PCN projects providing a social prescribing perspective andinterventions, as appropriate i.e. tackling neighbourhood inequalitiesspecification
Promote,monitor and maintain health, safety and security in the working environment.
Beflexible to work in-hours and out of hours.
Integrated partnership working:
Acceptreferrals from a wide range of agencies including GP practices within primarycare networks.
Workclosely with Mindworks Alliance Partners such as YMCA and the school-basedmental health support teams, as well as the Children's community healthprovider, in order to ease cross referral processes and provide effectiveservice for children, young people and their families.
Workclosely and communicate with other agency partners such as schools, CommunityDevelopment Workers, Local Area Coordinators, Targeted Youth Service and FamilySupport Teams when necessary to ensure the local system is working in ajoined-up way to provide the young person(s) with holistic care.
Buildrelationships with key staff in GP practices within the local Primary CareNetwork, becoming part of the wider network team and giving information andfeedback on social prescribing, work as part of a team and attend teammeetings, practice huddles, training events and participate fully in one toone, peer and group supervision.
Formeffective links with local schools and other community enterprises.
Referyoung people and families back to other health professionals/agencies, whentheir needs are beyond the scope of the link worker role.
Proactive care and early intervention:
Supportthe Primary Care Network in reducing inequalities by proactively seekingengagement from Children and Young People and their families, who may requireearly intervention and support.
Usepopulation health management tools to identify patients who may benefit fromearly intervention.
Deliverproactive group consultation workshops and peer-support workshops for patientswith Learning Disabilities and/or Neurodiversity.
Keepaccurate records of individual engagement, evidence of change and celebrateprogress with children, young people and families.
Provide,record and report the appropriate data to ensure the service and support offerscan be accurately monitored and evaluated.
Worksensitively with young people and families to capture key information, enablingtracking of the impact of social prescribing on their health and wellbeing.This will include written case studies as evidence of the effectiveness ofindividual interventions.
Encourageyoung people and families to provide feedback and to share their stories aboutthe impact of social prescribing on their lives.
Providequarterly reports to the PCN board and an annual evaluation report for theservice.
Clinical supervision:
Activelyparticipate in regular clinical supervision with a GP.
Workcooperatively and under the management of the PCN board to ensure the highestquality of delivery and support.
Applysafeguarding and child protection procedures and work closely with thesafeguarding lead to ensure any issues and concerns are escalated and dealtwith quickly and effectively.
Please see the full job description for further information.
Person Specification
Other Requirements
* Meets DBS reference standards and has a clear criminal record, in line with the law on spent convictions
* Willingness to work flexible hours when required to meet work demands
* Ability to address sensitive issues with cultural awareness and respect for individual beliefs and identities e.g. sudden death/bereavement, child abuse, domestic violence
* Access to own transport and ability to travel across the locality when required
* Champion of equality and valuing diversity
* Operates at all times in line with Confidentiality and Data Protection Act
Experience
* Experience of working with a range of professionals including senior clinicians
* Minimum of 2 years experience of working within a primary care setting
* Experience of working with children and young people or directly in a community development context, childrens health and social care, learning support or public health/health improvement (including unpaid work)
* Experience of working with children, young people and families with Learning Disabilities and/or Neurodiversity.
* Experience of supporting people, their families and carers in a related role (including unpaid work)
* Experience of supporting people with their mental health, either in a paid, unpaid or informal capacity
* Experience of working with the VCSE (Voluntary, Community and Social Enterprise) sector (in a paid or unpaid capacity), including with volunteers and small community groups
* Experience of data collection and providing monitoring information to assess the impact of services
* Experience in using IT based patient documentation systems
* Experience of partnership/collaborative working and of building relationships across a variety of organisations
Qualifications
* NVQ Level 3 Health and Social Care, or equivalent qualifications, or working towards
* Demonstrable commitment to professional and personal development
* Training in motivational coaching and interviewing, or equivalent experience
* Introductory training to CBT, or equivalent experience
* Zones of regulation training, or equivalent experience
Personal Qualities & Attributes
* Ability to listen, empathise with, and provide person-centred support to children, young people and families
* Ability to form and maintain connections with people from all backgrounds and communities, respecting lifestyles and diversity
* Commitment to reducing health inequalities and proactively working to reach people from all communities
* Ability to demonstrate leadership skills, with or without formal designation, including problem-solving, decision-making, and collaboration
* Able to support people in a way that inspires trust and confidence, motivating others to reach their potential
* Ability to communicate effectively with people, their families, carers, community groups, partner agencies and stakeholders, using various methods (written, verbal, assistive technology etc.)
* Ability to identify risk and assess/manage risk when working with children and young people
* Understanding of and commitment to cultural competency, with the ability to work effectively with patients and colleagues from diverse backgrounds
* Have a strong awareness and understanding of when it is appropriate or necessary to refer people back to other health professionals/agencies, when what the person needs is beyond the scope of the link worker role e.g. when there is a mental health need requiring a qualified practitioner
* Able to work from an asset-based approach, building on existing community and personal assets
* Able to provide leadership and to finish work tasks
* Ability to maintain effective working relationships and to promote collaborative practice with all colleagues
* Commitment to collaborative working with all local agencies (including VCSE organisations and community groups). Able to work with others to reduce hierarchies and find creative solutions to community issues
* Demonstrated ability to foster an inclusive and supportive environment for colleagues and patients of all backgrounds
* Committed to bringing diverse perspectives to the team and fostering a culture of equity and inclusion
* Ability to motivate other team members
* Ability to promote a learning environment
* Ability to organise, plan and prioritise using your own initiative, including when under pressure and meeting deadlines
* Ability to demonstrate professionalism and commitment to high standards of care, including equity and inclusion
* Ability to work flexibly and enthusiastically within a team or using your own initiative
* Ability to professionally and appropriately challenge differing opinions as a patient advocate
* Understanding of the needs of small volunteer-led community groups and ability to support their development
* Knowledge of and ability to work to policies and procedures, including confidentiality, safeguarding, lone working, information governance, and health and safety
Skills & Knowledge
* Knowledge of the personalised care approach
* Ability to demonstrate good organisational skills including effective time management
* Understanding of the wider determinants of health, including social, economic and environmental factors and their impact on communities
* Knowledge of community development approaches
* Knowledge of safeguarding and child protection issues
* Knowledge of IT systems, including ability to or ability to learn to use word processing skills, emails and the internet to create simple plans and reports, with appropriate adjustments or support as needed
* Knowledge of motivational coaching and interview skills
* Knowledge of VCSE and community services in the locality
Experience
* Experience of working with a range of professionals including senior clinicians
* Minimum of 2 years experience of working within a primary care setting
* Experience of working with children and young people or directly in a community development context, childrens health and social care, learning support or public health/health improvement (including unpaid work)
* Experience of working with children, young people and families with Learning Disabilities and/or Neurodiversity.
* Experience of supporting people, their families and carers in a related role (including unpaid work)
* Experience of supporting people with their mental health, either in a paid, unpaid or informal capacity
* Experience of working with the VCSE (Voluntary, Community and Social Enterprise) sector (in a paid or unpaid capacity), including with volunteers and small community groups
* Experience of data collection and providing monitoring information to assess the impact of services
* Experience in using IT based patient documentation systems
* Experience of partnership/collaborative working and of building relationships across a variety of organisations
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.
Primary Care Business and Transformation Manager
£34,872.71 to £41,676.11 a yeardependent on experience (pro rata)
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