Detailed job description and main responsibilities

1.                   MDT and inter-agency working

i                       To work as part of the multi-professional team supporting the planning, implementation and evaluation of client care needs in collaboration with the clients, carers and families, and other community/inpatient services

ii                     To work collaboratively alongside care home staff for a defined period of time to support the implementation of interventions specified in the CHIT care plans, promoting staff engagement with these plans, and increasing the ability of care home staff to apply these interventions in their care of other residents in the setting

iii                    To support personalised care planning within the MDT, working closely with clients and their carers. This may include modelling and coaching strategies with care home staff, working to a high standard and ensuring that care plans are evaluated and updated by the MDT as required

iv                    To work in close partnership and maintain effective communication links with other Borough health and social care services and community agencies to ensure the continuity of quality clinical care for clients

v                     to support clients’ appropriate access to local community resources in collaboration with care home staff; to develop a good knowledge of local community resources and wider directorate resources and maintain up to date information on resources for clients. This will include accessing physical health support available as part of the wider multi-disciplinary team of professionals working within care homes in Croydon

vi                    Support care home staff, where appropriate in referring on behalf of clients to community services such as Age UK, Alzheimer’s Society, religious services, and social clubs.

vii                  to attend team meetings and client reviews on a regular basis to feedback on and contribute to the clients’ care plans and support collaborative care planning, also advocating for the needs and perspective of care home staff

viii                to support multi-disciplinary team colleagues to work with clients and to provide STR input on joint visits with colleagues; to participate in the sharing of information and skills with other staff when deemed appropriate; to work with care home staff and social services colleagues to encourage and promote person-centred care and meaningful activity

ix                    To recognise and champion care home staff members’ skills and knowledge, and to empower care home staff to recognise and value their own skills through informal reflection following care interventions

2.                   Clinical skills 

i                       To demonstrate risk awareness with respect to risk assessment and ongoing risk management, practising safely and according to individual client needs and risk management plans.  Working alongside qualified staff to anticipate the individual needs of clients, showing risk awareness and communicating to relevant parties as required

ii                     To provide relevant support to families/friends in relation to their rights as carers and their involvement in the care of the client when they are under the care of the team

iii                    to identify clients’ interests and key relationships which are helpful to their wellbeing and personhood; to actively support clients to maintain key relationships; to support clients to make choices in their own best interest

iv                    To ensure maintenance of clinical records in accordance with good practice and the Code of Conduct for Non-Regulated Clinical Workers. To maintain confidentiality by ensuring information is shared in accordance with Trust standards and guidelines. To record and report untoward incidents, taking appropriate action and ensuring relevant staff are informed

v                     To review behaviour support care plans when clients are re-referred to CHIT, to ensure that care plans are still meeting client and care staff needs, and to work with the multidisciplinary team to update care plans are required.

3.                   Personal development:

i                       Take part in regular supervision and appraisal, to review and reflect on own practice and performance through regular participation in clinical / professional and managerial supervision and appraisal, in line with Trust guidelines and contribute to the well-being of the team by supporting other team members, and treating all colleagues with dignity and respect.  To undertake all mandatory training requirements of the role

ii                     To contribute towards work with service development initiatives involving clients and carers where appropriate. To participate in audit, service evaluation, quality improvement projects and research undertaken by the team

4.                   Personal skills:

i                       To be able to work with distressing and emotional issues whilst remaining caring, courteous and compassionate in line with SLaM’s 5 Commitments in Action. Utilizing formal and informal systems to access support and debriefing where required

ii                     to develop positive relationships with all clients on caseload and to respect the boundaries of own relationship with clients and their carers; to promote a person-centred approach by communicating with clients and carers in a way that meets their needs and respects their views and autonomy

iii                   to independently organise, prioritise, and manage own workload effectively