Outreach Nurse Specialist

Swydd-ddisgrifiad a phrif gyfrifoldebau manwl

·       To provide a locality based outreach service with colleagues to an assigned number of venues on a rotational basis and coordinate the referral and management and move on of clients who are eligible for the service. To assertively initiate contact with clients in the assessment of need and risk and provide a holistic service.

·       To confidential and autonomously navigate the locality to deliver services, at times in rural locations. Following all lone worker policies, use of safety devices and independent travel.

·       To be accountable and responsible for the assessment of care/support needs: the development, implementation and evaluation of programmes of care, setting standards and liaison with other agencies (statutory and non-statutory) relevant to need, particularly in relation to engagement, assessment and early intervention in the treatment of marginalised and vulnerable adults.

·       Reporting to the Clinical Team Manager or designated supervisor the practitioner will undertake a range of necessary tasks identified within the individual care plan. This will involve delivering care and interventions appropriate to the post holders level of experience and competences without direct supervision.

·       To contribute to multi-disciplinary comprehensive, culturally appropriate assessments to establish eligibility for health and social care services.

·       To use highly developed advocacy skills to ensure that a service users’ needs are heard and met within partner services.

·       To undertake continuous dynamic risk assessments and to contribute to effective risk management.

·       Recognising and valuing service users as individuals the post holder will ensure that the care provided respects equality and diversity that is supportive of service users and those important to them. This will include encouraging service users to accept an optimum level of responsibility for their individual programme of care and with their consent, where appropriate; seek the cooperation of friends, relatives and/or carers.

·       Utilising agreed frameworks and guidance such as NICE or evidence based best practice and or local policy and procedure, as well as a range of profession specific tools, the post holder will actively assess, plan and determine the care/support needs of service users. They will undertake and contribute to profession specific and/ or multi-disciplinary team reviews of such care.

·       To demonstrate and explain clinical reasoning in relation to professional input to a service users’ care plan when required.

·       To undertake the physical health care/Social assessments and/or on-going physical health monitoring. Undertake the recording any changes in the service users’ physical health, reporting these to appropriate members of the team and acting appropriately on the advice given.

·       To identify and provide information to service users that promotes their health and wellbeing. Directing them as appropriate to others / other services in order to address any identified needs.

·       The post holder will lead in the support and help for service users in becoming aware of their own physical health and wellbeing and engage service users in addressing these i.e. smoking cessation and obesity. This role will also involve the post holder providing appropriate information and support for other staff.

·       To contribute to the on-going quality of service and care, identifying and promptly reporting any risk issues or other significant factors in relation to the service users’ health and social care.

·       The post holder will participate in and contribute to a range of service led, commissioner driven or nationally directed monitoring or performance management, related to care, care delivery or service provision.

·       Recognise and respond appropriately to any challenging behaviour presented by service users or others. Leading where appropriate on the safe management of client, other staff and the environment.

·       To undertake and assist in the organisation of the day to day smooth running of the service, reporting any issues relating to the fabric or condition of the work environment and Infection Control compliance.

·       At all times to act in accordance with trust policies in relation to risk assessment.

·       To identify safeguarding issues for both children and vulnerable adults and to implement trust procedures as required, inclusive of raising Safeguarding referrals into the Suffolk MASH and Suffolk Social Care systems.

·       To have knowledge, understanding and experience of applying Mental Health legislation.

·       To be aware of personal accountability and responsibility in respect of ensuring that quality of care standards are adhered to and that these are compliant with the Care Quality Commission and other regulatory and professional requirements.

·       For Registered Nurses where required and subject to satisfactory completion of competency assessments will, following trust policy, administer medications.

·       Other professionally registered staff where required and subject to satisfactory competency assessment will, following trust policy, take responsibility for the management of medication for service users.

·       To follow Trust policy in promptly reporting all accidents and incidents and to contribute to undertaking complaints or investigations if required.

·       To deputise as and when called upon to do so for senior clinical colleagues

 Clinical:

 ·       Be responsible for the provision of nursing / social care interventions within the clients’ own environment; satellite clinic or other appropriate setting; ensuring patients receive the highest quality of care.

·       To use a recognised model of care as a base for assessments and managing interventions.

·       To ensure that comprehensive dynamic risk assessment and management strategies are incorporated into all client assessments.

·       To ensure that, wherever possible engagement with service users/families/carers takes place to ensure user participation in the planning implementation and evaluation of services

·       To advise and encourage clients’ and their families / people they trust to develop strategies and manage their own health.

·       To maintain accurate and up to date client records, confidentiality and statistical records as required by the service.

·       To maintain compliance to consent, Information Governance and Information Sharing rules.

·       To work with other professionals to promote multi-disciplinary working, appropriate skills transference and the creation and use of care pathways.

·       To provide care in a manner that at all times reflects professional standards as laid out within post holder’s own disciplinary regulatory body.

·       Comply with Trust policies for personal and patient safety and for prevention of healthcare-associated infection (HCAI); this includes a requirement for rigorous and consistent compliance with Trust policies, procedures and guidelines in relation to all aspects of infection control.

·       To ensure that professional registration requirements are met and that registration is maintained, taking responsibility for revalidation.

·       To be directly accountable and responsible for own practice and to adhere at all times to the relevant Code of Professional Conduct 

·       To be managed by and receive supervision from a nominated line manager, including annual review of performance as part of the trust’s appraisal system. 

·       To provide supervision to nominated junior staff, including annual reviews of performance as part of the Trust’s appraisal system.

·       To be in receipt of and engage with professional supervision and to use this to reflect on clinical and professional practice 

·       To adhere to Trust compliance to mandatory training and utilise opportunities for continuing professional development.