Social Worker, Home Health

1. Provides therapeutic clinical social work services to Home Health clients and their caregivers through methods such as reviewing referrals together with the interdisciplinary team, conducting psychosocial assessments and providing recommendations, treatment planning and consultation in conjunction with other team members. Conducts interventions using a variety of modalities and family counseling, making use of home visits and site-based services. Collects collateral information for team assessments related to competency (personal and financial), provides follow-up and ongoing monitoring of psychosocial situations, and referral services where required.
2. Acts as a member of the interdisciplinary care team by collaborating with team members and by attending team meetings and relevant care conferences. Provides consultation to the team and acts as a resource to colleagues in other programs or community agencies.
3. Provides consultation to clients and/or their caregivers by sharing resource information, facilitating referrals to other services, and offering telephone support. Facilitates client's utilization of appropriate community services by keeping knowledgeable about other services and liaison with them. Acts as an advocate on behalf of clients and their families.
4. Attends and/or leads meetings, in-service and psychosocial educational sessions with groups such as clients, caregivers, staff and community partners, through methods such as collaborating with members of the interdisciplinary team and presenting relevant content. Facilitates linkages with community groups and agencies as required.
5. Participates in research activities and program planning and development relevant to the needs of the client and their caregivers in collaboration with the interdisciplinary team as required through methods such as identifying trends in clinical practice, conducting literature searches, administering surveys and collecting research data for further analysis. Ensures that clinical practices and protocols are consistent with research findings.
6. Participates in Quality Improvement activities by providing input into the development, implementation and evaluation of the program goals, objectives, policies and procedures to ensure effective resource utilization and quality of client care.
7. Completes required reports, records and workload statistics. Maintains files and records in accordance with program standards and procedures.
8. Maintains knowledge of current developments in evidence-based social work practice by methods such as reviewing relevant literature, consulting with other health care professionals, and attending relevant education programs to enhance the delivery of client care. Maintains current knowledge of Federal and Provincial legislation and amendments that impact client care and service delivery (e.g. Adult Guardianship Act).
9. Evaluates effectiveness of direct clinical care and education provided to Home Health clients and their caregivers and provides input to the interdisciplinary team regarding changes required to improve efficiency and/or effectiveness or service.
10. Identifies own learning needs, reviews these with the Team Leader and engages in a variety of activities to meet those needs.
11. Performs other related duties as required.

• Basic knowledge and understanding of counselling skills and clinical practice models relevant to working with individuals, families and groups.
• Demonstrated ability to conduct psychosocial assessments.
• Ability to work as a member of the interdisciplinary team in care planning for complex client situations.
• Demonstrated understanding of the scope of practice of other health care disciplines.
• Ability to make effective referrals, reflecting in-depth knowledge of community resources and strong collaborative skills in working with other community services.
• Demonstrated ability to communicate effectively both verbally and in writing with clients, families, other members of the health care team, and community agencies.
• Demonstrated ability to organize and prioritize workload in a complex environment.
• Demonstrated ability to effectively deal with conflict.
• Ability to facilitate group meetings, processes, and decision-making.
• Basic computer literacy to operate a computerized client/family information system, word processing, and e-mail.
• Physical ability to perform the duties of the position.

Fraser Health is the heart of health care for over two million people in Metro Vancouver and the Fraser Valley in British Columbia, Canada, on the traditional, ancestral and unceded lands of the Coast Salish and Nlaka’pamux Nations and is home to 32 First Nations within the Fraser Salish region.

People - those we care for and those who care for them - are at the heart of everything we do. Our hospital and community-based services are delivered by a team of 48,000+ staff, medical staff and volunteers.

We are committed to planetary health and value diversity in the work force. We strive to maintain an environment of respect, caring and trust. Fraser Health’s hiring practices aspire to ensure all individuals are treated in an inclusive, equitable and culturally safe manner.

Together, we are the heart of health care.

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