Location: Bedfordshire, Luton and Milton Keynes, administrative base at Head Office, Bedford
Salary: £34,540 - £41,189 Full Time Annual Equivalent
Hours: 30-37.5 hours per week
Line Manager: Keyworker Operational Lead
Contract: 23 months fixed term (potential to renew)
Closing Date: Wednesday 17th June 12pm
The Keyworker Programme is a national initiative under the NHS Long Term Plan, aimed at ensuring that all children and young people (CYP) with a learning disability, autism, or both who are inpatients or at risk of admission, have access to a named Keyworker. This support is designed to provide personalised, coordinated care that places the voices of young people and their families at the centre.
Job Summary:
To support children, young people who are autistic and/or have a learning disability (and families) in their journey through the system, and wherever possible prevent admissions to mental health hospitals or ensure that if children and young people are admitted to hospital, this is for the shortest time possible, and discharge is not delayed.
Keyworkers are making sure that these children, young people and families get the right support at the right time. They are making sure that local systems effectively meet the young people’s needs in a joined-up way and that whenever it is possible to provide care and treatment in the community with the right support, this becomes the norm.
Keyworkers work with children and young people with the most complex needs and their families and carers to make sure families are fully involved in their plans, feel listened to and informed, plans are personalised, and they have the support they need at the right time, in a co-ordinated way.
1. Keyworker functions:
- Working with children, young people (0-25) and families identified as medium or high risk on the Dynamic Support Register including those who have complex needs, at risk of harm and those with adverse childhood experiences
- Provide intensive, tailored post-discharge support to 18–25-year-olds identified as high risk of Tier 4 readmission
- Work proactively with inpatient teams, transition coordinators, and community services to create and implement robust discharge and aftercare plans
- Maintain involvement pre, during, and post-discharge, ensuring continuity of care and avoiding breakdowns that lead to readmission
- Monitor progress closely, with regular reviews and crisis planning with the Multi-Disciplinary Teams
- Implementing Care, Education and Treatment Review (CETR) recommendations
- Coordinating support at pace to avoid admission. Where admission is deemed necessary following a community CETR, the keyworker should continue their involvement throughout inpatient treatment, to facilitate timely discharge, well managed transition and full implementation of CETR recommendations for community support
- Undertake assessment of individual cases to ascertain what support is already in place and identify what additional support might improve outcomes
- Identifying if the children or young person may be eligible for Children’s Continuing Care funding and support the implementation of Personal Health Budgets (PHB)
- Be responsible for improving outcomes for children and young people by providing advice and support to ensure the use effective assessments, reviews and ongoing case management across the local children’s system
- Providing cross system knowledge and experience to help families navigate services and has a degree of independence from those services to facilitate providing family focussed support and challenging system partners when necessary
2. Caseload focus:
- Hold a reduced caseload for 18-25 adults to enable more frequent contact, higher intensity engagement, and proactive support planning
- Provide assertive outreach and support to pull the system together
- The Keyworker will use trauma-informed approaches to build trust and sustain long-term engagement
3. Keyworking relationships
- The post holder will be required to proactively engage with young people and their families, Local Authority and CCG, Acute Trusts and Community Services, Education providers, in-patient units as well as a range of other internal and external stakeholders:
- Service Users young people / young adults and Parents/Carers
- CAMHS staffing and leadership team
- Clinical leads and practitioners within hospital and in-patient settings
- Professional Leads
- Supported living providers
- Social Care
- Transition Teams
- Other professionals working with children and young people in social care, health, education and the third sector Trust corporate departments including Human Resources, Training and Development etc
4. Family Support:
- Navigate the System to ensure families receive the required support at the right time
- Ensure professionals listen to parents/carers and C&YP and understand what they need
- Support families to understand which professionals they go to when as there are often so many involved
- Support parents and carers of 18–25-year-olds to understand adult service pathways and entitlements
- Advocate across child and adult services to ensure a smooth handover of care responsibilities
- Ensure transition assessments and planning are embedded in the discharge process
- Identify what current services and support the young people are accessing
- Identify what services and support they feel would benefit them and their family
- Begin to co-produce and tailor a appropriate family support plan where required
5. Operational
- To provide and receive highly complex clinical and social information relating to young people and explain this to Multi-disciplinary (MDT) meetings, team meetings, other agencies, young people and family members carers
- Work flexibly within a team and communicate well with colleagues, ensuring all records are
comprehensive and those colleagues are briefed on potential issues, which may arise during any planned absence
- Manage difficult relationships from other parties which arise out of case management, reporting difficulties
and seeking support to manage as required
- Follow the processes set out by the Department of Health, Clinical Commissioning Group and Local Authority and other relevant bodies, to ensure comprehensive clinical advice, assessment, case management, review and follow up
- To ensure effective care management within the local system
- To assist the CCG and Local Authority with jointly funded packages
- To ensure any safeguarding or examples of poor-quality care are appropriately reported and followed through
- To participate in arranging emergency placements should the need arise
6. Service Management
- Ensuring effective caseload management in place
- Be able to support the MDT approach for complex CYP in line with national frameworks i.e., Transforming Care and Children’s Continuing Care.
- Attend and contribute to Care Education and Treatment Reviews and Local Emergency Area Protocols meetings
- Ensure CETR recommendations are monitored and achieved
- Challenge the systems and escalate concerns when appropriate support is delayed or refused
- Provide professional oversight for the Keyworker Support Staff within the team
- To provide specialist advice to teach, train, supervise, support and consult to members of other staff groups on psychological therapies theory and practice as appropriate
- To receive regular supervision (clinical / professional) in accordance with good practice guidelines and NHS Trust/Autism Beds policy and participate in CPD and other training activities keeping abreast with relevant research and national guidance
- To be accountable for own professional actions and work within professional boundaries
- Identify training needs and recommending appropriate training courses in accordance with core competency requirements and service development
7. Policy and Service Development
- To follow local policies, procedures and guidance at all times
- To have up-to-date knowledge and the ability to research and and stay up to date on a wide range of medical conditions
- Understand policies that affect delivery of care, such as Children Act 1989/2004; Children and Family Act 2014; Care Act 2014; Working Together to Safeguard Children, Mental Health Act 1983.
8. Planning and Organisation
- Contribute to the strategic planning of services, identifying interdependencies across services, potential impacts on wider organisation, and resource requirements.
- Support building in contingency and adjustments as necessary
- Contribute to evaluation of the keyworker scheme, evidencing and achieving quality
DATA PROTECTION & CONFIDENTIALITY:
- All staff are required to respect the confidentiality of all matters that they may learn relating to their employment, other members of staff and to the public
- All staff are expected to adhere to the regulations regarding the Data Protection Act 2018 and ensure that information is stored correctly
SAFEGUARDING:
- Autism Bedfordshire is committed to safeguarding and promoting the welfare of children, young people and vulnerable adults in its care. The post holder is required to be the named officer for caseload they are overseeing and attend relevant training
- Report and share any safeguarding concerns immediately to the Autism Bedfordshire Designated Safeguarding Officer
- To ensure that this is achieved we expect all employees to share this commitment and staff working with these vulnerable groups will be recruited and selected in line with safer recruitment policies and practises including the completion of an Enhanced DBS check
HEALTH & SAFTEY:
- Employees have a legal responsibility not to endanger themselves, fellow employees or the families they are supporting and should adhere to relevant policies at all times
- Risk Assessment should be carried out, signed off and shared with other in advance of any visits or community support taking place with C&YP and their families
EQUAL OPPORTUNITIES AND DIVERSITY;
- Autism Bedfordshire is an equal opportunities employer. The aims of the equal opportunities policy are to ensure that no job applicant or employee receives less favourable treatment on the grounds of race, colour, nationality, gender, sexual orientation, marital status, age, religion or any disability nor disadvantaged by conditions or requirements which cannot be shown to be justifiable
Job Types: Full-time, Part-time
Pay: £34,540.00-£41,189.00 per year
Benefits:
Willingness to travel:
Work Location: In person
