JOB DESCRIPTION Clinical Nurse Specialist- North Kirklees Care Homes
BASE Kirkwood Hospice
RESPONSIBLE TO Community Services Manager
ACCOUNTABLE TO DIRECTOR OF CLINICAL SERVICES (DCS)
INTRODUCTORY NOTES
· Kirkwood Hospice is smoke free; the only exception being for in-patients who may smoke in a designated smoking room.
· The employer and employee share responsibility to review and amend this job description in order to reflect any changes in role/development.
· The employee must attend/complete yearly mandatory training provided by the Hospice.
· To work according to the NMC Code of Professional Conduct and relevant professional guidelines for a defined group of patients with complex palliative care needs.
· The employee must maintain a safe working environment in accordance with the Hospice fire and health & safety policies and report any hazardous incident to their line manager.
· Employees should be aware that Kirkwood Hospice produces confidential information relating to patients, staff and commercial information. All employees have a responsibility for ensuring the security of information and to comply with the Data Protection Act (1998) Access to Health records and Computer Misuse Act 1998. Disclosure of personal, medical, commercial information, system passwords or other confidential information to any unauthorized person will lead to disciplinary action.
· The post holder requires a satisfactory disclosure from the Disclosure & Barring Service (DBS).
· The employee is requested to respect the ethos and values of Kirkwood Hospice and it’s services and comply with its policies, procedures and regulations
ROLE SUMMARY
· This post results from additional financial support from North Kirklees Clinical Commissioning Group. These monies will fund a fixed term post for 18 months to support end of life care in designated care homes within North Kirklees. The primary objective of this post is to enable residents to remain in their usual place of residence at the end of life. This will be achieved by supporting the resident, care home staff and the wider primary care team to actively anticipate and address end of life care needs, avoiding unnecessary transfer to hospital.
· The post holder will develop productive partnership working within care homes through the promotion of effective palliative care, particularly advance care planning.
· The post holder will lead and support the embedding of skilled palliative symptom management for care home residents; working collaboratively with the hospice teams, primary and secondary care teams as well as MacMillan Clinical Nurse Specialists for Care Home Education.
· Enable people living in Care Homes in North Kirklees who have specialist palliative care needs to attain the best quality of life and symptom management at the end of life.
· To provide a responsive, flexible, service to patients living in care homes and their families, ensuring that the service delivered reflects the Hospice Business strategy and upholds the Care Quality Commission arrangements.
· The post Holder will be responsible for the delivery of a specialist advisory and support service to promote best possible end of life care in care homes. This will include management of a caseload of residents within identified care homes within North Kirklees.
Key Relationships
With the Executive Management Team: Chief Executive, Director of Clinical Services, Medical Director, Director of Finance and Administration, Director of Fundraising and Marketing.
Community Services Manager
Community Specialist Palliative Care Team
Quality and Education Manager.
Clinical Educator
Heads of Department and wider management team.
Information co-ordinator.
CLINICAL
· Perform comprehensive ongoing assessments and evaluation of patients with sensitive and complex needs related to a diagnosis of a life limiting illness.
· Assess family member/carer needs. Plan, implement and evaluate care delivery according to changing health care needs, wishes and culture. Act as patient/families advocate when required.
· Work with residents and carers in a therapeutic way, addressing physical, psychological, emotional, behavioural, spiritual and social needs acting as a role model.
· Participate in the development of polices, protocols and clinical guidelines necessary to support high standards of care and practice into care homes.
· Facilitate discussions around advance care planning, providing information and assisting with completion of documentation required. Make decisions regarding resuscitation, discussing these with patients and carers as appropriate, communicate with professionals and ensure documentation is complete.
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· Present cases clearly, consistently and professionally in a variety of settings including multi-disciplinary meetings, to GPs and case conferences. Communicate effectively throughout meetings.
· Establish and maintain effective communication, often of a highly complex nature, with patients living with life limiting illness, carers/relatives and professionals across health and social services, using advanced communication, negotiation and diplomacy skills and breaking down barriers to understanding with various individuals. Use interpreters and other communication aids as required.
· Demonstrate comprehensive and in depth knowledge of the Mental Capacity Act (2005) and Deprivation of Liberty (DoLS) legislation relating to end of life care, informed consent and decision making.
· Report safeguarding concerns through the recognised channels adhering to policy and procedure and attend any multiagency safeguard meetings as required.
· To ensure a duty of candour is followed in giving information to patients and/or their representative working in partnership with the multi-disciplinary team.
· Work collaboratively with other professionals internally and externally and other agencies to ensure patient needs are met, especially in relation to on-going care needs, eg. undertaking joint visits, leading reflection and attending Gold Standards meetings as required.
· Work with the care home and family members supporting them to care for patients, prepare them for end of life issues and needs, impending loss and grief, assess need for bereavement service referral and undertake initial post-bereavement support.
· Collect, collate, evaluate and report information, maintaining accurate patient records both written documentation and the electronic database.
· Act as a role model and deliver evidence based practice giving confidence to care home teams.
· Promote a questioning and open culture within practice in order to encourage and support care delivery.
MANAGERIAL/LEADERSHIP
· Manage a complex caseload, for example, admit to and discharge from caseload, prioritise caseload demands to meet a variety of care needs, take into account planned and unforeseen clinical issues; communicate with a variety of professionals and services.
· Maintain up-to-date and accurate records of non-clinical activity and seek and undertake ways of evaluating impact of this.
· Be proactive in improving IT and computer skills and contribute positively to embrace future processes which promote the utilisation of available and emerging IT in the delivery of the service.
· Support the Director of Clinical Services with the implementation of new initiatives, innovative practice for service improvements in accordance with the Hospice strategy as well as local and national strategies.
· Engage with Kirkwood Hospice’s Strategic Business Plan leading on key areas of service development where appropriate.
· Take a lead in representing the Hospice at specific groups/ meetings both internally and externally to influence and advocate palliative and End of Life care.
· Identify opportunities for service development and innovation by participating in service evaluation and anticipating future demand, trends, risks and constraints.
· When appropriate contribute to the expansion and development of the role within care homes by leading on service evaluations and project outcomes.
· Assist with change management in relation to service improvements and to comply with requirements in line with current legislation and the Care Quality Commission requirements.
· Manage time effectively to ensure all aspects of the role and professional responsibilities are fulfilled.
· Monitor standards of care and report issues back using hospice governance structures.
· Identify service users’ views, needs and shortfalls in the service and ensure they are fed back via the relevant channels.
· To participate openly and honestly in any investigation when care falls below expected standards.
· Promote patient and public involvement in activities as much as possible.
· Promote people’s equality, diversity and rights.
· All employees should understand that it is their professional responsibility to comply with all organisational and statutory requirements, eg. Health & Safety, equality and diversity, Data Protection Act upholding the principles of information governance.
EDUCATION
· Identify, generate and utilise appropriate learning opportunities in practice.
· To confidently deliver education to care home staff in collaboration with the Kirkwood’s Clinical Educator and the MacMillan Clinical Nurse Specialists for Care Home Education.
· To contribute to Kirkwood internal and external Education Programme.
· Identify own and others learning and professional development needs, liaising with the Director of Clinical Services and the Quality and Education Manager, attending relevant training as appropriate to individual performance review.
· Complete annual mandatory training.
· Share learning with a wider audience at external forums, writing abstracts and presenting posters/articles regarding the effectiveness/impact of the Care Home Clinical Nurse Specialist.
· Participate in regular professional and managerial supervision, including attending and actively participating in monthly practice development days; recommended training/education.
· Take responsibility for supervision and mentoring of student nurse placements/ short placements for health care professionals and in promoting and providing a learning environment in relation to dementia care.
· Keep records and contribute to reports regarding aspects of education.
· Develop and maintain others’ awareness of own role/service within the speciality/organisation and local networks.
· Maintain political awareness through understanding of the hospice structures and developments, and understanding local and national drivers such as Department of Health and NICE documents relating to specialty and professional role and work with others to integrate and develop into local practice.
· Contribute to annual planning of objectives and the development of an annual plan for the team, considering the Hospices strategic goals and supporting a culture of service improvement and innovation.
· Use effective change management skills to initiate and implement service and practice developments within the team and within Kirklees.
· Represent palliative care services positively to the general public.
· Develop and sustain networks with other experts at local and national level.
· Conduct and document risk assessments in respect of clinical care or self and take appropriate action.
· Ensure lone working procedures and policy is followed.
· Work according to NMC Code of Professional Conduct and Guidance adhering and meeting the requirements of revalidation.
CLINICAL GOVERNANCE/QUALITY AND RESEARCH
· To be appraised annually by the Community Services Manager.
· Actively participate in critical, untoward incidences near-misses, accidents and significant event analysis and address these in a timely way, ensuring appropriate action and communication is taken and reported to the Community Services Manager.
· Ensure care is evidence-based where available and within policies, procedure, guidelines and professional body guidance.
· Contribute to the creation, implementation and monitoring of guidelines, standards, policies and care pathways that impact on other disciplines/services within the team and, the Hospice.
· Work within and in collaboration with the Quality and Education Manager contribute to the quality improvement plan, developing quality assurance systems for the care home Service reporting on progress against objectives as required.
· Disseminate audit findings through presentation to professional groups and publication.
· Identify need for, and contribute to, research, clinical audit and benchmarking, in order to improve effectiveness of patient care.
· Participate in data collection to support project evaluation.
· Develop key performance indicators and evidence progress against them producing reports for the Director of Clinical Services as required.
· Implement a suite of outcome measures to measure and evaluate the impact the service.
· Be aware of current clinical/ research trials being conducted within own specialist area and participate in the Kirkwood Hospice Research group as required.
Person Specification
Specialist Palliative Care Nurse for Care Homes-
Requirements / Essential / Desirable / How AssessedQualifications/Training
First level Registered Nurse / ü / AF
First Degree in relevant area / ü / AF
Advanced communication skills training (or willing to work towards) / ü / AF, I
Current driving licence / ü / AF
Independent Nurse Prescribing Level 6 / ü / AF
Evidence of continuing professional development / ü / AF
Proven experience in Palliative care / ü / AF
Mentorship Qualification / ü / AF
Masters level study/ willingness to work towards / ü / AF
Leadership course / ü
Experience
Evidence of working at a senior role in Palliative Care / ü / AF
Experience and knowledge of symptom management. / ü / AF, I
Experience managing a caseload / ü / AF, I
Experience of communicating regarding complex, sensitive issues with patients, carers and professionals / ü / AF, I
Experience implementing change / ü / AF, I
Experience in working in or with Care Homes / ü / AF, I
Awareness of key policy drivers in palliative care / ü / AF, I
Experience of multi-disciplinary and agency working / ü / I
Understanding of loss and grief and its impact on individuals and families / ü / AF, I
Experience of implementing aspects of the clinical governance agenda / ü / AF, I
Experience of managing and prioritising a variety of responsibilities / ü / I
Experience of delivering teaching or training / ü
Knowledge of service development / ü / AF, I
Knowledge of advance care planning / ü / AF, I
Community experience / ü / AF
Skills/Abilities
Demonstrate clear and advanced communication skills, written, verbal and non-verbal / ü / AF, I
Understanding of and ability to implement aspects of the clinical governance agenda / ü / AF, I
Ability to facilitate change, motivating and influencing staff over whom no management relationship exists / ü / AF, I
Able to establish and maintain credibility with a diverse range of professionals and lay people / ü / I
Able to develop effective interpersonal relationships with a diverse range of professionals and lay people / ü / AF, I
Demonstrate the ability to identify personal development needs, fulfil them and apply the learning to practice with demonstrable outcome / ü / AF, I
Proven teaching skills / ü / AF
Excellent planning and organisation skills / ü / AF, I
Ability to supervise students and other staff / ü / AF, I
Ability to assess risk regarding self and others and take appropriate action / ü / AF, I
Ability to apply effective leadership skills, responsive to a variety of circumstances / ü / AF, I
Able to work independently and deliver objectives within a given timeframe / ü / AF, I
Able to advocate for others, representing their views in an objective manner / ü / AF, I
Able to access information from different sources and use critical appraisal skills / ü / AF, I
Computer literacy with ability to use e-mail, internet, Word, electronic records and literature searching / ü / AF
Experience in taking part in research / ü / AF
Personal Attributes
Ability to form professional relationships within a multi-disciplinary team / ü / I
Excellent interpersonal skills / ü / I
Motivated and enthusiastic / ü / I
Ability to work independently and as a member of the multi-disciplinary team / ü / AF, I
Ability to manage the emotional impact of working within palliative care / ü / AF, I
Demonstrable commitment to anti discriminatory practice and equal opportunities / ü / AF, I
Assertive with well developed influencing or persuasive skills / ü / AF, I
Demonstrates the values and ethos of palliative care / ü / AF, I
KWFORMS JD144CNSNK created by SS/AM 01/7/2017 reviewed 1/8