Detailed job description and main responsibilities

CLINICAL

• To be professionally and legally responsible for all aspects of own professional activities.  To adhere to and apply The College of Occupational Therapists’ Code of Ethics and Professional Conduct (College of Occupational Therapists 2015)
• To independently manage a caseload of complex cases, providing specialist occupational therapy assessment and interventions to clients with complex physical, cognitive and psycho-social needs arising from their medical conditions. To provide this service in the most appropriate setting to the client, e.g. clients’ homes, workplace and other community settings, working closely with the client, his/her family/carer and other professionals in doing this.
• To be responsible for prioritising the occupational therapy referrals within the service to ensure that clients with urgent needs are seen within appropriate timescales.
• To establish excellent therapeutic relationships with clients/family/carers to gain their participation in the therapeutic process by employing advanced interpersonal skills (e.g. communication, reasoning, negotiation skills, motivational tactics) and overcoming any barriers to communication (e.g. different languages, lack of understanding of the spoken word, visual or hearing impairments, fear, anxiety).
• To assess for and diagnose any functional, physical, cognitive, perceptual, psychological and sensory deficits using functional assessments together with specialised standardised and non-standardised assessment batteries.
• Based on the analysis of the assessment and a risk analysis, to determine occupational therapy aims and treatment goals as part of the overall care plan, and then to formulate intervention options which reduce the impact of disability.
• To attend MDT clinical meetings and have close liaison with the acute stroke services (NMH, RFH and the Homerton) and the hyper acute service (HASU).
• To work closely with the client/family/carers to encourage participation in the therapeutic process.  To negotiate and agree decisions relevant to the client’s management whilst respecting their diversity.  To identify and select with the client/family/carers the most appropriate intervention options, which balance the complex interactions of risk, safety, client choice, independence, areas of conflict, eligibility for services and cost effectiveness.
• To develop specialised occupational therapy treatment programmes in collaboration with clients, carers and other involved professionals (e.g. physiotherapists, speech and language therapists, district nurses, clinical lead professionals, home care agencies) to be carried out in the client’s home or community as appropriate.
• To plan, coordinate and deliver client-centred interventions on either an individual or group basis, using the principles of graded activity and a wide range of treatment techniques e.g. functional and remedial activities, splinting, equipment provision, education and health promotion.
• To use specialised therapeutic moving and handling skills in the assessment for complex neurological conditions, recommending appropriate equipment in line with national and local guidelines; including providing advice and training to client/family/carers on correct handling techniques, having undertaken specialised manual handling risk assessments.
• To provide specialist assessment for and provision of adaptive equipment such as specialist seating in line with national and local guidelines.
• To provide assessments for and where indicated the construction of upper limb splinting for clients in order to promote joint integrity or facilitate function.
• To challenge and improve current practice where appropriate, ensuring practice is evidence based.
• To provide specialist advice on lifestyles, role, functional abilities, self care and the physical environment after taking account of the effects of any medical conditions on the individual and his/her family/carers, e.g. energy conservation, fatigue management.
• To prescribe and coordinate interventions to be carried out by others, such as rehabilitation support workers or home carers, and to train them to carry out the therapeutic programmes as appropriate to the home or community environment.
• To use advanced clinical reasoning, critical thinking and reflection to monitor, evaluate and modify treatment, evaluate outcomes and thus ensure effectiveness of interventions.
• To provide verbal and written information to support the client’s discharge from the service which informs health and social care providers of the outcomes of interventions and of ongoing health and social care requirements.
• To produce accurate and detailed reports, therapy programmes, care plans, advice and information as necessary in a timely manner, reflecting clinical expertise.
• To identify and manage the potential difficulties and risks involved in working alone in a variety of community settings (e.g. verbal or physical aggression, challenging behaviour, working in unhygienic environments) and to do this for staff to whom work is delegated.  To complete incident forms as necessary.

 MANAGEMENT/ADMINISTRATION

• To participate in service reviews and policy, guideline and protocol development and changes to service provision as required by Whittington Health and other services e.g. the stroke association.
• To undertake a team lead role on a day-to-day basis to manage the therapy staff in the Haringey Community Stroke service
• To be responsible for the day-to-day management and provision of occupational therapy assessments and interventions in Haringey by reviewing the appropriateness of referrals, prioritizing referrals and managing junior staff on a day to day basis.
• To identify opportunities, in collaboration with the Clinical Lead, for service development and role re-design
• To support senior staff in the development and implementation of the Trust’s clinical governance strategy, participating in multidisciplinary audits, investigation of complaints, user involvement activity and other mechanisms of service evaluation and monitoring.
• To ensure that the agreed professional and national quality standards of service are maintained by self and designated junior staff.
• To collect relevant statistical information and activity data in accordance with Trust, professional and NCL requirements. To ensure that designated junior staff do likewise
• To maintain accurate and up to date documentation in multi-disciplinary records which is consistent with legal, professional, organisational and NCL requirements. To be responsible for ensuring that designated staff maintain record keeping standards
• To attend and participate in team and professional clinical governance meetings, undertaking tasks which result from these meetings.
• To provide clinical leadership to other occupational therapists in the team. To be involved in recruitment and take responsibility for professional support, supervision and appraisal.

 EDUCATION AND TRAINING

• To maintain, develop and update own professional knowledge and skills in relation to Stroke and neurological rehabilitation occupational therapy.
• To access further education programmes to develop knowledge and skills, and to share learning with the wider team.
• To provide highly specialised advice to Occupational therapy colleagues working in other clinical areas regarding the management of adults with stroke/neurological conditions in the community.   
• To participate in staff and service development through attendance at meetings and in-service training sessions, including taking a lead responsibility for designated sessions.
• To undertake management and leadership training as required.
• To participate in mandatory training
• To actively participate in regular clinical supervision and yearly appraisal using reflection and analysis to inform practice, develop skills and identify training needs in relation to the needs of the service and personal development.
• To provide leadership, support, guidance, teaching, clinical supervision and appraisal to senior/junior occupational therapists and rehabilitationTechnicians.
• To act as a Professional Practice Educator and support senior/junior staff with students, providing training and education for occupational therapy students on professional practice placements and to provide written reports for the relevant academic institution regarding the student’s performance.
• To be responsible for maintaining a CPD portfolio which clearly demonstrates that competencies required within the post are achieved and maintained.

 COMMUNICATION 

• To communicate effectively and work collaboratively with therapy colleagues as well as other community services to ensure the delivery of a coordinated multi-disciplinary service.
• To communicate simple and complex information verbally and non verbally with the client/family/carers during sessions
• Ensure information is understood e.g. where the client does not speak English, has a hearing impairment, altered emotional state, cognitive/learning/emotional disability, or where the client does not understand or accept a clinical decision.
• To work with advocacy and interpreting services for families where English is not the first language
• To adhere to Trust, professional and local policies and standards in relation to confidentiality.
• To work in partnership to develop innovative ways of working, with colleagues within Whittington Health Community services and other organisations (NCL Network). 

 RESEARCH AND DEVELOPMENT

• To support in the monitoring of the effectiveness of the community therapy service through the collation and correlation of data for ongoing audit.
• Contribute to the evaluation of research findings and disseminate them appropriately, including presentations at study days or conferences.
• To support the monitoring of adherence to the stroke strategy within Haringey (Whittington Health).