Senior Community Nurse (with special interest in CHC)

Detailed job description and main responsibilities

ROLE SUMMARY

The post holder will have a special interest in Continuing Healthcare assessments and will be responsible together with the CHC coordinator for co-ordination of assessments of patients to identify eligibility for NHS Funded Health Care including entitlement for funding in respect of NHS Continuing Health Care and Funded Nursing care, working closely with the West Essex and Hertfordshire ICB Continuing Healthcare Team.

The post holder will be responsible for providing highly skilled nursing care to the residents of West Essex, promoting the health of the population and reducing the effects of ill health and disability and maximising the individual’s potential for independence. She/he will work closely with General Practices, Social Services and other statutory and non-statutory services to meet the needs of the local population using public health information to support service development.

The post holder will work as an autonomous practitioner within the Community Nursing Team supporting the delivery of care and supporting patients own homes/residential care homes working in collaboration with system partners and as part of the Primary Care Networks and the local neighbourhoods as part of the out of hospital model of care

KEY RESPONSIBILITIES CLINICAL

 Clinical/Professional Duties

• Undertake comprehensive and complex assessment of patients’ needs in conjunction with the patient, family/carer and hospitals in order to determine eligibility for NHS Continuing Healthcare funding in line with the Continuing Healthcare Framework.
• Initiates palliative care packages with multi-agency providers in collaboration with primary, secondary sectors and patient/family.
• To provide a comprehensive service to patients in a variety of community settings including patients’ own homes and residential homes.
• Is aware of current evidence based approaches to patient care and demonstrates this in practice.
• Frequently provide support to patients and their families when they are emotionally distressed as a result of terminal illness.
• Frequently required to deliver complex and distressing information to both patients/family/carers.
• Lead/contribute to the development and review of guidelines/policies.
• Lead and contribute to audit programmes and disseminate/apply findings.
• Assess the need for service aids and equipment and ensure that those provided are used appropriately and safely.
• Report to the Integrated Care Manager any deficiency in the provision of service aids, equipment and staff.
• Maintain accurate nursing records that exist contemporaneously in accordance with NMC guidelines and local policy.
• Responsible for the development and allocation of teaching programmes/practice placement for all pre and post registration nurses and others.

Patient/Client Care

• Work in partnership with the patient to achieve optimum levels of self-care. Demonstrate, teach and supervise the nursing care that families can undertake safely, advising as necessary.  Documenting on the care plan accordingly.
• Advise the family on prevention of illness and accidents. Foster and support a self-management approach to care where appropriate.

Communication Skills

• Organise patient care with other Health Care Professionals, Statutory and/or Voluntary Agencies co-ordinating these through case conferences.
• Work closely with partners in identifying health needs of the practice population, and develop services in response to those needs.

Education and Research

• Attend relevant education and training programmes to maintain personal/professional development and meet NMC requirements.
• Undertake the role of preceptorship/mentorship as required.
• Engage in Nurse Prescribing following V100/V300 qualification and NMC registration and ensure safe prescribing practice within professional and Trust guidelines/policies.
• Lead the team in the development of the skills necessary to deliver the core Community Services.
• Participate in team, Locality and Trust initiatives as required with specific focus on the Nursing Strategy and other relevant modernisation agenda.
• Reflect on practice regularly and plan personal/professional development in order to achieve growth and development. Access Clinical Supervision to enhance reflective practice.

Managerial Responsibilities

• Undertakes risk management in a variety of unpredictable and unavoidable working conditions. For example may involve taking appropriate precautions when dealing with chemotherapy drugs, bodily fluids, threatening patients and unhygienic conditions which may constitute a health risk.
• Ensure that Service Aids and Equipment are used in accordance with manufacturer’s guidance and to notify all known hazards to appropriate personnel.
• The post holder will ensure that in their absence team members are aware of the nominated District Nurse who will support the caseload and the team.
• The post holder will delegate responsibility to the appropriate community nurse within the team to undertake and manage the workload of the teams and any Trust objectives.
• Provide relevant support to other Community Teams in the absence of the senior staff members.
• Report on all incidents and untoward occurrences and implement recommendations.
• Manage informal complaints and implement the recommendations following formal complaints.
• Meet with team members daily to plan, delegate and evaluate patient care and to review and adjust allocation of work accordingly.
• Arrange in conjunction with the Team Leader, Induction Programmes for new members of staff.
• Attend relevant meetings to support the team and locality.
• Meet with team members on a regular basis to disseminate Trust information.
• Ensure statistical returns for the whole team are completed within agreed times scale by self and team members.
• Be responsible for the development of the team through individual staff professional/personal development reviews, supervision and team meetings.
• Implement appropriate operational frameworks and objectives as agreed by the team and locality or the professional forum.

Information Management

• Input data and information accurately.

Policy/Service Development

• Ensure all trust policies and procedures are implemented by staff, recommending and negotiating changes as necessary.

Freedom To Act

• The post holder will at times be required to work unsupervised.

Effort and Environment

• Manage work load effectively.
• Ensure that the environment is safe and is an area that is conducive for learning and for patient care.

Competence

• You are responsible for limiting your actions to those which you feel competent to undertake.  If you have any doubts about your competence during the course of your duties you should immediately speak to your line manager/supervisor.

Registered Health Professional

• Must comply with the Code of Professional Conduct of the Nursing and Midwifery Council, which incorporates the Scope of Professional Practice and the Guidelines for Professional Practice.
• All registered nurses will be required to provide evidence of relevant registration(s) as required.  Failure to do so may lead to disciplinary.
• Responsible for ensuring that the Community Teamwork within relevant Trust guidelines/Policies and ensuring agreed standards of practice are achieved, with the DNS.