Staff Nurse - Supportive Care at Home

JOB SUMMARY Undertake duties under the supervision of the Supportive Care Coordinator, delivering skilled nursing care over a 24 hours period. Deliver evidence based planned care, which is safe, effective, in a manner which is caring, compassionate and person centred, enabling individuals to remain in their own home. Adapt and provide a wide range of nursing care for people suffering from a life limiting illness in their own homes. Be accountable for assessing, planning, implementing and evaluating care for patients, reporting and escalating relevant information to appropriate health and social care professionals. Work in in an integrated and partnership way with primary, secondary, social care, the independent and voluntary sector and others to improve the health and care of individuals, families and communities, particularly the most vulnerable. Undertake and maintain the required statutory, mandatory and core training and preparation to meet the specific clinical needs of the service. Participate with the training of learners and participate in staff inductions where appropriate. Delegate work to other staff members within the team. Establish good working relationships with the Primary Health Care Teams KEY RESULT AREAS: 1.1 Core duties and responsibilities: Act as the named nurse under the supervision of the Supportive Care at Home Coordinator. This includes the first and continuing assessment, planning, implementing and evaluation of care given to individuals in their own homes. In the absence of the service coordinator, manage the caseload and the Supportive Care at Home Team, monitoring standards of care and deploying and supervising team members as appropriate. Participate in the planning and delivery of packages of care, including liaison with other health professionals and statutory and voluntary agencies to deliver skilled nursing care and support any changes. Record all patient contacts and activities accurately and contemporaneously maintaining accurate records and statistical returns as required by the Trust including entering data onto the Trusts systems within the required timeframes. Advise patients on health promotion issues in order to achieve pre-determined local and national health targets. To be a skilled communicator establishing and maintaining excellent relationships with members of the Primary Health Care Team and other Health and Social Care professionals, initiating referrals where appropriate to ensure adequate support for patients and carers. Advise patients on health promotion issues in order to achieve pre-determined local and national health targets. Act as a mentor for HCA and students and participate in all aspects and levels of training in order to consolidate theoretical and practical teaching of staff and learners. To have knowledge of and be able to effectively use available resources. To participate in clinical supervision on a regular basis with a designated person. To carry out duties in a skilled and competent manner in order to provide an appropriate level of skilled nursing care to clients in the community. Demonstrate a range of clinical skills that supports high quality person-centred care for the caseload population in a variety of community settings. Contribute to the delivery of person centred care plans by the Supportive Care at Home team ensuring regular evaluation of care and develop systems to support staff interventions and care quality. Work collaboratively with others to identify individuals who would benefit from technology, with ongoing support and management. Work in partnership with individuals, formal and informal carers and other services to promote the concept of self-care and patient-led care where possible, providing appropriate education and support to maximise the individuals independence and understanding of their condition(s) in achieving their health outcomes. Lead and foster a culture of openness and recognition of duty of candour in which each team member is valued, supported and developed, inspiring a shared purpose to support the delivery of high quality effective care. Contribute to the development, collation, monitoring and evaluation of data relating to service improvement and development, quality assurance, quality improvement and governance, reporting incidents and developments related to community nursing ensuring that learning from these, where appropriate, is disseminated to a wider audience to improve patient care. To be aware of and act in accordance with Trust Clinical Standards and Guidelines and the NMC Code of Conduct and Guidelines maintaining competency and attending training as appropriate. Where the person is a Nurse Prescriber: prescribe medication and appliances for patients via independent and supplementary prescribing arrangements, and within the scope of practice. 1.2 Communication with others: Patients, their carers and families. Colleagues within the larger team to provide workload cover and professional support. The Caseload Holder, Lead Nurse and management team, to provide managerial support and advice in the problem solving process, and to facilitate professional development. The Specialist Palliative Care team - to provide clinical leadership and guidance A whole system relationships approach across health and social care providers and the independent sector. Demonstrating both vertical and horizontal integrated working and develops effective relationships with other service providers where appropriate. For full details of the role please see the supporting documents attached.

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