Hospital Discharge Social Worker – AR

Job Details

Hospital Discharge Social Worker x2

A Discharge Social Worker within a community mental health social work team plays a key role in facilitating safe, timely, and legally compliant hospital discharges. Working closely with inpatient wards, community mental health teams, health colleagues, housing services, and external agencies, they coordinate discharge planning from admission through to transition back into the community.

The role includes undertaking Care Act assessments, contributing to Section 117 aftercare planning where applicable under the Mental Health Act 1983, arranging appropriate care and support packages, addressing safeguarding and risk management concerns, and ensuring that housing and social care needs are appropriately met prior to discharge.

Discharge Social Workers act as a bridge between inpatient and community services, promoting continuity of care, reducing delayed transfers of care, and supporting individuals to achieve safe and sustainable community living outcomes.

 

LONDON BOROUGH OF HACKNEY

JOB DESCRIPTION

POST TITLE: SOCIAL WORKER – Adult Services

DIRECTORATE: Adult Health and Integration

SERVICE: Adult Social Services

GRADE: PO1 – PO3

LOCATION: London Borough of Hackney

RESPONSIBLE TO: Senior Practitioner

RESPONSIBLE FOR: –

PURPOSE OF THE JOB:

To provide a high quality and effective social work service to respond to the needs of local residents with care and support needs, their carers and their families in a timely manner and within statutory guidelines. All assessments and support plans will be completed in accordance with the wellbeing principles of the Care Act and in a strengths based approach. Guidance, support and supervision will be provided in line with the individual’s experience and capabilities and in line with our Supervision

Policy.

Newly qualified staff at grade P01 will undertake all work with support, close supervision and guidance and will have a reduced caseload.

Upon successful completion of the ASYE, Social Workers will automatically move to P02.

MAIN AREAS OF RESPONSIBILITY:

The post holder will have lead responsibility and accountability for the following. However, these will be with close supervision to ensure that the post holder is supported in completing the below effectively:-

Assessment and Signposting

  1. Understanding of the context of the provision of statutory social care for children and families, adults and older people and awareness of relevant legislation underpinning care and support – for instance the Children Act 1989 or the Care Act 2014.
  2. To provide strengths based assessments, signposting and assistance in a way that is consistent with customer service standards and which promotes independence.
  3. Have awareness and understanding of safeguarding issues and local authority statutory duties pertaining to them with appropriate and timely support and interventions showing an understanding of capacity assessment, risk enablement, working with an understanding of unwise decision making and Making Safeguarding Personal.
  4. To ensure customers get the right help at the right time, addressing their needs for choice, early intervention, prevention, information and advice, helping them take advantage of opportunities and make decisions regarding their support. This will include devising appropriate well-being and support plans. The use and understanding of Advocacy will be key to this role.
  5. To proactively promote activities and services that improves health and wellbeing and helps people to continue to live independently through access to a range of resources and universal services that do not require a social care assessment.

Assessment and Support Planning

  1. To participate in the assessment of needs of residents in line with the legislative framework and Care Act wellbeing principle and thresholds, and in partnership with multi-disciplinary professionals, using knowledge and skills to manage risks.
  2. To assist in the identification of need and work towards addressing their needs for information and advice and helping them take advantage of opportunities and make choices for their support.
  3. To agree with service users and carers clear and achievable outcomes and devise appropriate support plans
  4. Where appropriate, to proactively promote preventative activities, resources and universal services including creative Telecare solutions where appropriate, to improve health and wellbeing as part of the assessment and review of support plans.
  5. To work collaboratively with other health, mental health and social care services to ensure a smooth transition from service to service and to support the provision of preventative or longer term services wherever appropriate.
  6. To be willing and ready to work as part of an integrated health and care approach which seeks to put the service user at the centre of all that happens on their behalf.
  7. To apply the principles of personalisation by working in partnership with clients and carers using person-centred approaches to facilitate their involvement and choice, and actively seeking ways to maximise their independence and promote their well-being. To use Advocacy whenever appropriate and understand different types of advocacy.
  8. To apply an approach which sees the strengths and assets of the service users their personal and community networks instead a deficit view which
  9. To robustly manage a caseload of new clients and carers with various levels of care needs under the direction of a Team Manager or Senior Practitioner.
  10. To be aware of the financial implications of providing services, and take responsibility for the decisions made.
  11. To ensure all documentation is of high quality and accessible to relevant stakeholders and that service users and carers are routinely kept informed.
  12. To be responsible for recognising and assessing of vulnerable people and following agreed procedures to record, investigate and respond with appropriate and timely support and interventions.
  13. To actively assist with safeguarding adult enquiries, assessing, analysing and managing risk and devising multi-agency safeguarding adult plans. To undertake training and development within the area of safeguarding that illustrates personal learning from SARs and Making Safeguarding personal principles.
  14. To lead and co-ordinate safeguarding adults cases, present information in case conferences, reviews, complaints and meetings as appropriate and ensuring any reports that are required are prepared and presented with evidence of the involvement of clients, families and carers.
  15. To comply with the roles and responsibilities within the Safeguarding/Risk Management framework and deliver this to a high level of competence. This includes Mental Capacity Act, Deprivation of Liberty Safeguards, Best Interest Assessments and the protection of service users financial affairs where required.

Record Keeping and Performance Monitoring

  1. To maintain accurate, timely and comprehensive records and ensure service users have information about their assessed needs and agreed support plans.
  2. To produce high quality and within allocated timescales, accurate records of all work undertaken, and ensure contact and assessment information is updated regularly and accurately on the appropriate client and document management databases in line with the requirements for local and national standards and performance indicators.
  3. To report progress against performance objectives and use supervision to discuss caseload action plans and record progress made and mitigating circumstances.

Equal Opportunities

  1. To demonstrate through personal and professional example a commitment to equality of opportunity for all groups of staff and service users and to challenge discrimination, racism, sexism and other forms of unjust behaviour.
  2. The post holder is expected to be committed to the Council’s core values of public service, quality, equality and empowerment and to demonstrate this commitment in the way they carry out their duties.

OTHER DUTIES AND RESPONSIBILITIES:

  1. To maintain an up to-date working knowledge of legislative framework, policy and practice developments in adults social services and the service area.
  2. To work flexibly in line with health and social care integration priorities.
  3. To take responsibility for own continued professional development and undertake training as required in order to maintain a high standard of performance and to meet the requirements of professional registration.
  4. Any other duties that might from time to time be required within the overall grading and general responsibilities of the post.
  5. To undertake the role of a “Champion” for a specific area of practice.
  6. To be willing to train as a Best Interest Assessor and complete assessments as required.
  7. To ensure statements for Court and reports are prepared and presented to a high standard and to attend Court hearings when required.

NB: All employees are expected to adhere to the Council’s Diversity & Equality and Health and Safety Policies.

Delivery

  1. Experience of carrying out comprehensive social work assessments using the Care Act wellbeing principles and being able to offer a personalised and strengths based approach to people and carers with long term conditions and varying levels of need and risk from diverse inner-city communities.
  2. Experience of providing information, advice and signposting, to enable them to make informed decisions.
  3. Experience of working in partnership with people, their carers and service providers to produce personalised, budgeted and outcomes-focused support plans that facilitate independence. Experience also of using Direct Payments would be advantageous.
  4. Demonstrable ability to monitor and review the impact of support plans against the agreed outcomes to ensure they are effective.
  5. Demonstrable ability to produce high quality recording, contact details, assessments, and support plans using appropriate electronic case recordings and using these to monitor work.
  6. Ability to prepare and present high quality reports for use in legal cases including the Court of protection.
  7. An understanding of and commitment to actively supporting and promoting equalities within the workplace and within the community and equity of access to services for residents.

Decision Making

  1. Able to make judgements of need using clinical reasoning and record these accurately.

Working Together

  1. Able to work collaboratively with service users, carers and a wide range of stakeholders at all levels and across a variety of organisations.

Communication Skills

  1. Able to communicate effectively, confidently and assertively whether in writing or verbally. This will also involve presenting complex information sensitively and matched to the needs of the audience and in line with organisational policy and practice.

Personally Effective

  1. Demonstrable ability to carry out work under their own initiative, in an organised fashion, managing their own workload and co-ordinating with colleagues as part of a team. In doing this they will be able to prioritise work under pressure, adapt

their priorities to changes in demand and deliver to agreed deadlines.

  1. Demonstrates a personal and professional demeanour which generates credibility and confidence amongst colleagues, managers and other stakeholders.
  2. Able to acquire new skills with a strong commitment to continuous professional development.

Knowledge of Adult Social Care

  1. Good demonstrable understanding of the Care Act, and The Mental Capacity Act /DOLS.
  2. Good working knowledge of the London Multi Agency Adult Safeguarding policy and procedures and all related adults legislation, including Making Safeguarding Personal.
  3. Knowledge of current best practice and integration initiatives across health and care areas.
  4. Knowledge and understanding of the needs of Adults at Risk and those with a Long term conditions and complex needs.
  5. Good understanding of the issues relating to the delivery of assessment and support planning for people within a diverse community setting and the range of solutions available to facilitate their independence from a strengths based perspective.

Technical Skills

  1. Working knowledge of a wide range of typical IT tools including database, word processing, email and spreadsheet applications.

Qualifications

  1. A recognised degree in Social Work, DipSW or CQSW.
  2. A current Enhanced Criminal Records Bureau assessment.
  3. Social Work England Registration

NB: All employees are expected to adhere to the Council’s Diversity & Equality and Health and Safety Policies.

INFORMATION FOR ASYE SOCIAL WORKERS

Hackney Adult Social Care provides newly qualified social workers with a comprehensive and supportive environment to start their careers working within our four core principles of Working Together, Communicating Honestly, Encouraging Wellbeing and Being Accountable and Learning. The role of the Continuous Professional Development Lead gives support to ASYE Social Workers by co-ordinating regular peer support groups, reflective practice sessions, case clinics and being a consistent point of contact to ASYE Social Workers as they complete their protected first year in social work practice. Hackney Adult Social Care have a thriving culture of supporting practice learning through apprenticeships, social work placements and having great relationships with universities. By working for Hackney Adult Social Care you will be part of a vibrant team who will enable you to grow and flourish in a safe and supportive work environment. The wellbeing of staff is a main priority in Hackney Adult Social Care and staff are encouraged to provide critical feedback in their role and be active in their learning opportunities.