ASW - Social Worker

The Hospital Discharge Social Worker is responsible for supporting safe, timely and person-centred discharge arrangements for adults leaving hospital. The post holder will undertake strengths-based assessments, coordinate discharge planning, manage risk, and work in partnership with health colleagues, carers, families and community services to ensure appropriate support is in place following discharge. The role is carried out in accordance with statutory responsibilities, including the Care Act 2014, Mental Capacity Act 2005, safeguarding duties, Social Work England standards and local hospital discharge policy. Main Duties Undertake strengths-based and proportionate social care assessments to identify eligible needs, risks, strengths, desired outcomes and appropriate discharge arrangements. Plan, coordinate and progress hospital discharges in a timely way from the point of admission, in line with discharge to assess and Home First principles. Work directly with adults, families, unpaid carers and advocates, ensuring that the person’s voice, wishes and outcomes remain central to discharge planning. Undertake mental capacity assessments and best interests decision-making where required in relation to discharge, care, accommodation and support arrangements. Prepare and review support plans that promote independence, wellbeing, choice and least restrictive practice. Arrange, recommend or coordinate appropriate services, including reablement, domiciliary care, interim support, residential or nursing placements and community-based interventions. Work collaboratively with hospital staff, therapists, nurses, doctors, brokerage, housing services, providers and community teams to remove barriers to discharge. Identify safeguarding concerns and take appropriate action in line with statutory duties, local procedures and Making Safeguarding Personal principles. Manage a caseload effectively, ensuring that work is prioritised appropriately and escalated where delays or risks cannot be safely managed. Maintain accurate, timely and defensible case records, assessments, support plans, mental capacity documentation and risk assessments. Contribute to multidisciplinary meetings, transfer of care discussions, discharge planning forums and other case coordination meetings as required. Support decision-making relating to funding responsibility, ordinary residence, service eligibility and interface issues between health and adult social care. Provide professional social work advice to health colleagues and partner agencies in relation to legislation, discharge planning and adult social care processes. Promote anti-discriminatory and inclusive practice, ensuring that diverse needs are recognised and responded to appropriately. Work in accordance with relevant legislation, including the Care Act 2014, Mental Capacity Act 2005, Human Rights Act 1998 and safeguarding responsibilities. Undertake post-discharge follow-up and reassessment where this forms part of the service model or is required to review ongoing needs.

Corporate and Professional Responsibilities The post holder is required to maintain current professional registration, comply with Social Work England standards, work within council policies and procedures, and ensure that all practice is lawful, evidence-based and professionally defensible. The post holder will also be expected to contribute to service improvement, equality of opportunity, safeguarding responsibilities, health and safety requirements, and any other duties reasonably commensurate with the grade of the post. Person Specification Essential Qualifications and Registration Recognised social work qualification, such as Degree in Social Work, DipSW, CQSW or equivalent. Current registration with Social Work England. Essential Knowledge and Experience Knowledge of the Care Act 2014, Mental Capacity Act 2005, Human Rights Act 1998, safeguarding duties and relevant hospital discharge guidance. Experience of adult social care practice, ideally within hospital discharge, transfer of care, reablement, safeguarding or a multidisciplinary setting. Experience of assessment, care planning, risk management and working with adults with complex or changing needs. Essential Skills and Abilities Ability to undertake clear analysis, professional judgement and defensible decision-making in a fast-paced environment. Strong communication and relationship-based practice skills when working with adults, carers, families and partner professionals. Ability to manage competing demands, prioritise workload and progress discharges safely and efficiently. Ability to maintain accurate records, produce clear reports and present information effectively in meetings and formal documentation. Commitment to person-centred, strengths-based and anti-discriminatory practice. Desirable Experience of working within a hospital-based adult social care team. Experience of multidisciplinary discharge planning and discharge to assess pathways. Knowledge of local authority systems, recording requirements and panel or funding processes