Developing and Sustaining a Competent and Confident Clinical Workforce through Essential Clinical Competencies for Registered Practitioners

Competency Title: Criteria Led Discharge

Competency Leads: Sue Biggs

Document Author / Authorised Signature
Written by: Sue Biggs
Signed: S C Biggs
Date: 2nd April 2015 / Authorised by:

Signed:
Date: 2nd April 2015
Job Title: Modern Matron/Programme Lead for Patient Flow and Length of Stay / Job Title:
Assistant Director for Organsiation Development
Effective Date: 2nd April 2015 / Review Date: 2nd April 2017
Approval at: Competency Group / Date Approved: 2nd April 2015

Authors:

How to use this Competency Framework

This Competency Framework has been developed to enable the assessment of clinical competence. In light of the Francis Report [and the move towards Foundation Trust status], the Isle of Wight NHS Trust is required to demonstrate that clinical staff are competent to provide quality care for everyone, every time and are all practicing to an agreed level.

Definition of Competence

A definition of competence was agreed by IOW NHS Trust clinical leaders in May 2013 and is detailed below.

“A set of specific and detailed outcomes that need to be achieved in order to a] prove immediate competence in essential skills or b] aid personal and professional development in desirable skills. The competencies must incorporate knowledge, skill, behaviour and demonstration of how these all equate to personal professional accountability for competent care of the patient” (Barnett 2013).

This definition focuses attention on the importance of recognising individual personal responsibility and accountability to deliver high quality care. This means taking appropriate actions following the results of any clinical assessments to ensure the individual needs of the patient are met and this care is delivered with care and compassion. Competency is not about performing the task in hand in a mechanistic way without patient involvement.

Responsibilities

It is the responsibility of the competency lead to develop the competency statements using the agreed framework, present the competency pack to the competency group for approval, develop and co-ordinate the delivery of the master classes, prioritise staff groups requiring assessment, undertake competency assessments and ensure the outcome is forwarded to Development and Training for recording on Pro4.

It is the responsibility of the clinical lead to ensure that they are competent and that their registered staff is competent within their scope of practice. The clinical lead may undertake competence assessments themselves or delegate to Band 6s / Nurse Educators / Nurse Mentors / Clinical Educators who have been competency assessed and who have also attended a recognised course on assessment. The clinical lead should also monitor compliance and escalate any concerns to their line manager and ensure that the essential competencies are reviewed annually at appraisal. The clinical leads are professionally accountable to the Executive Director of Nursing and Workforce and their relevant Professional Body.

It is the responsibility of the individual professional to ensure that they are competent within their scope of practice and that the essential competencies are reviewed annually at appraisal. Individuals are professionally accountable to the Executive Director of Nursing and Workforce and their relevant Professional Body.

1

Written by Sue Biggs

Updated 19th March 2015

The Process of Competency Assessment - Clinical Leaders

Process of Competency Assessment – Registered Practitioners

1

Written by Sue Biggs

Updated 19th March 2015

Name: / Role: / Band:
Work Base:
First Assessor Name and Role: / Second Assessor Name and Role:
Competency Statement
(Core Competencies to be included in all Competency Assessments) / Expected Level of Competency / Level of Competency Evidenced / Signature of Assessor
Registered Practitioners deliver person centred care with sensitivity and compassion respecting the dignity and diversity of patients, relatives, carers, visitors and colleagues. / During this assessment the practitioner is observed acting with respect, kindness, compassion and sensitivity. Demonstrates consistent person centred care with very good professional conduct/behaviour in line with trust expectations.
Registered Practitioners gain consent for all interventions and maintain confidentiality as per Trust policy and professional body requirements. / During this assessment the Practitioner consistently uses helpful strategies to enable people to understand the interventions in order to give informed consent. They consistently recognise the significance of confidential information and acts in relation to who does or does not need to know.
Registered Practitioners provide accurate and meaningful verbal information in a polite and respectful manner to patients, relatives, visitors and colleagues. / During this assessment the Practitioner is able to consistently communicate safely, sensitively and effectively using appropriate methods according to the situation.
Registered Practitioners complete documentation in accordance with Organisational and Professional Body standards. / During the assessment the Practitioner is observed practicing or is able to explain the standards for documentation applicable to the Trust and their Professional Body. e.g.
accurately and contemporaneously with dates, times and signatures.
Registered Practitioners demonstrate professional accountability and act with a ‘duty of candour’. / During the assessment the Practitioner consistently recognises and works within the limitations of their knowledge, skills and professional boundaries, understanding their responsibility and accountability for their own actions and omissions.
Registered Practitioners demonstrate how to safeguard vulnerable adults and children, and when to raise identified concerns through the appropriate channels. / During the assessment the practitioner is observed or is able to recognise and respond correctly when people are in vulnerable situations, at risk or in need of support and protection.
Registered Practitioners demonstrate their professional responsibility and accountability delegating care to non-registered practitioners. / During the assessment the practitioner is able to explain their professional responsibility and accountability for delegating care to non-registered practitioners.
Competency Statement
Subject Specific Competencies / Expected Level of Competency / Level of Competency Evidenced / Signature of Assessor
The Registered Practitioner is able to demonstrate that they have the skills and knowledge to undertake Criteria Led Discharge in line with the standards set. / During the assessment the Registered Practitioner is able to explain what CLD is and the aim of the standard.
The Registered Practitioner is able to Demonstrates awareness of own accountability and responsibility when undertaking CLD / During the assessment the Registered Practitioner is able to explain their accountability and responsibility when undertaking CLD to ensure safe and appropriate discharge
The Registered Practitioner is able to demonstrate how CLD benefits:
(a) The patient, their carer and/or family
(b) The Organisation / During the assessment the Practitioner is able to explain the benefits of CLD for:
(a) The patient, their carer and/or family
(b) The Trust
The Registered Practitioner is able to demonstrate that they are aware of the authorisation required from medical staff for CLD to occur and identify where this particular information is documented / During the assessment the Registered Practitioner is able to explain the level of authorisation and documentation required for CLD to take place.
The Registered Practitioner is able to demonstrate that they have the skills to identify issues and escalate as appropriate to ensure that patients are discharged safely and appropriately. / The Registered Practitioner is able to explain some of the issues that need to be addressed to enable a patient to be discharged using safely and appropriately.
The Registered Practitioner is able to demonstrate effective communication with the patients and/or carers regarding: -
  1. Instructions for follow up care.
  2. Guidance with medication
  3. Home care requirements, social input,
Equipment
  1. Ensure all information leaflets are given as appropriate to support verbal information.
/ The Registered Practitioner is able to explain why effective communication is essential when undertaking CLD.

Assessment Outcome – Please sign in relevant box

Rating / Outcome / Actions / Assessor Signature and date
Initial Assessment / Assessor Signature and date
2nd Assessment / Assessor Signature and date
3rd Assessment
Green / Pass - All essential competencies evidenced. / No action required. Review annually at appraisal. Revisit any development learning points listed below as recommended by assessor.
Red / Refer - One or more competencies not evidenced. / Clinical practice in relation to the specific competency not evidenced is to be supervised and reassessed within 2 weeks.
Learning points to revisit following successful competency assessment:
First Assessors Signature: Registered Practitioners Signature:
Date:
Action Plan following referral at FIRST assessment. To be completed following this assessment in preparation for second assessment.
PART 1
First assessor to tick, initial and date once completed
 Outcome of assessment and feedback given to registered practitioner Initial: Date:
 Line manager informed of referral at first assessment Initial: Date:
 Registered Practitioner signposted to further underpinning knowledge/ Competency Lead Initial: Date:
First Assessors Signature: Registered Practitioners Signature:
ACTION PLAN
PART 2
Individual Learning Plan between line manager and Registered Practitioner. To be completed following this assessment in preparation for second assessment.
Date for re-assessment:
Line Managers Signature: Registered Practitioners Signature:
Action Plan following referral at SECOND assessment. To be completed following this assessment in preparation for final assessment.
PART 1
Second Assessor to tick, initial and date once completed
 Outcome of assessment and feedback given to registered practitioner Initial: Date:
 Line manager informed of referral at first assessment Initial: Date:
 Registered Practitioner signposted to further underpinning knowledge / competency Lead Initial: Date:
Second Assessors Signature: Registered Practitioners Signature:
ACTION PLAN
PART 2
Individual Learning Plan between line manager and Registered Practitioner. To be completed following this assessment in preparation for final assessment
Date for Reassessment:
Line Managers Signature: Registered Practitioners Signature:

1

Written by Sue Biggs

Updated 19th March 2015