JOB DESCRIPTION. The Richmond Community Rehabilitation Service sits at the heart of integrated health and social care in Richmond.

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1 JOB DESCRIPTION POST: BAND: ACCOUNTABLE TO: Occupational Therapist seconded to HRCH PO2 Assistant Team Manager (HRCH) CONTEXT The Richmond Community Rehabilitation Service sits at the heart of integrated health and social care in Richmond. The new service builds on the best aspects of the borough s reablement and community health intermediate care services in order to offer people a clear care pathway for hospital discharge and the opportunity to receive the level and intensity of rehabilitation services at the time and for the duration they need it, from appropriate highly skilled workers. Following a period of redesign and integration, the multi-disciplinary Richmond Community Rehabilitation team will perform the following functions: 1. Hospital discharge and early supported discharge 2. Crisis and rapid response 3. Community Rehabilitation support Hounslow and Richmond Community Healthcare NHS Trust (HRCH) and The London Borough of Richmond (LBRuT) Council are continually reviewing its structures and ways of working in order to provide the best services possible for residents, in the most efficient way. As a result the key tasks in any job may be varied and the post holder will be expected to take on such variations consistent with the level of responsibility of the post. KEY WORKING RELATIONSHIPS West Middlesex University Hospital Kingston Hospital Single Point of Access (HRCH) The London Borough of Richmond upon Thames (LBRuT) s Social Care Access team Integrated Health and Social Care community teams All departments within Hounslow and Richmond Community Healthcare NHS Trust (HRCH) Other primary health care services including General Practitioners All other departments within the LBRuT s Adult and Community services directorate All other acute and community hospitals JOB PURPOSE The purpose of the Richmond Community Rehabilitation Service is to work with patients and service users and core enablers to maximise their physical and social functioning to enable them to remain within the community for as long as possible. The multi-disciplinary team undertakes all elements of hospital discharge work including hospital liaison and case finding. The aim of the service is to reduce inappropriate hospital admission, minimise hospital length of stay and support vulnerable clients at home, this role works within a multi-disciplinary, multi-agency team and in partnership with primary health care and social care professionals, providing expert case management, clinical assessment, diagnosis and individualised treatment plans, promoting self management. The Occupational Therapist will work with patients and service users and their carers in assessing need, setting goals and reviewing outcomes in order to reduce the need for long-term support. 1

2 The post holder will be a care coordinator accompanying patients and service users throughout their community rehabilitation journey. They will act as the key point of contact for patients and service users and other professionals, coordinating a range of specialist interventions and empowering patients and service users to take control of their own care and support. The Occupational Therapist will be based both in the community and in a hospital setting. KEY RESPONSIBILITIES To facilitate service users and carers in the development of support plans, which meets their needs, outcomes and covers identified risks, offering the widest possible flexibility and choice allowing them to take control of their short-term goals To advise and prescribe rapid response or rehabilitation programmes including levels of care, techniques, goals and methods to achieve maximum levels of independence making best use of multi-disciplinary working skills To actively identify patients and service users who might benefit from community rehabilitation support both in the community and in acute settings To evaluate patient progress through person-centred reviews and adjust support plans if required in partnership with other professionals in the multi-disciplinary team To plan the discharge from the service in partnership with patients and service users and their families/ carers giving advice and information about their options and put appropriate services in place including purchasing of services before handing over to long-term community care To make recommendations for the provision of specialist equipment and adaptations, to arrange for supply of equipment and to train patients and service users and carers in its safe installation and use as required To identify situations where service users are deemed to be at risk, including situations where people may be neglected or abused in accordance with the Inter-Agency Policy and Procedures for Safeguarding Adults To facilitate service user choice and empowerment through promoting independence, in particular through the timely provision of information, advice and support to ensure service users maintain independent for as long as possible To ensure the highest level of data quality for all information recorded, ensuring that the information is consistently timely, accurate and complete to ensure the service meets all statutory recording requirements CLINICAL RESPONSIBILITIES To provide a high standard occupational therapy service, which involves working autonomously and as part of the multidisciplinary team To work to the professional standards as set by the College of Occupational Therapy To independently manage a caseload of complex cases without direct supervision. To carry out assessments of patients, including those with diverse or complex presentations/multiple pathologies using advanced clinical reasoning skills to provide an accurate diagnosis, prognosis, intervention for their condition. This will include implementation of a therapy programme, evaluation of outcome measures and appropriate discharge planning. To use communication, reasoning and negotiation skills to establish a therapeutic relationship on complex cases, managing basic barriers to communication. To address all areas of risk associated with individual client s ability to function independently and minimise the effects of disability within their chosen environment, including planning and carrying out home assessment and being responsible for the clients health and safety during this assessment. 2

3 To demonstrate a broad level of understanding of the effects of disability, providing training and advice on lifestyle changes and adaptations to the client s physical environment. SERVICE DELIVERY RESPONSIBILITIES At all times respecting the rights and choice of the individual including the need to take into account their cultural and religious beliefs. Participate in 7-day working rotas as required including on-call duties Avoid hospital admissions through diverting people from emergency departments and urgent care centres Ensure timely and accurate assessment and support plans which best describe individual needs and offer the most appropriate intervention to restore independence Ensure the service offers a person-centred plan of support to people in their own homes, in hospital or in a care home setting and is jointly delivered by health and social care professionals. Ensure every person has a self-care management plan to empower people to manage some of their own condition and make the best use of new and preventative technology such as Telecare and Telehealth to help people stay independent for longer. MANAGERIAL RESPONSIBILITIES In the performance of all your duties, to implement all Trust policies and procedures necessary to meet customer care needs and to reflect the Trust s vision and values. FINANCIAL RESPONSIBILITIES None TRAINING/EDUCATION RESPONSIBILITIES To provide Occupational Therapy expertise to other colleagues To be responsible for maintaining own competency to practice through CPD activities furthering specialist knowledge within a particular field incorporating evidence based practice. To review and reflect on practise and identify areas for self-development through participation in the annual appraisal system, personal development plan and regular clinical and professional supervision. To plan, actively participate in and contribute to the in-service education programme for the occupational therapy service and multi disciplinary team. To supervise, educate and assess the performance of occupational therapy students; this would be to a graduate standard and involve working with universities to ensure the standard of practise and teaching needs meets the standard set by the degree level qualification. To supervise, educate and assess the performance of therapy assistants, in line with the BAOT s standards of clinical practise RESEARCH AND DEVELOPMENT To take an active role in professional clinical groups, such as Clinical Governance, OT Liaison Group, Peer Review Group and other professional development activities To develop a network of OT colleagues working in specialist areas to facilitate the learning, service development and peer review To identify opportunities to improve the Occupational Therapy Service in order to provide the best possible patient care and to participate in initiatives to improve the service 3

4 ANY OTHER GENERAL DUTIES To participate in rotation across hospital and community functions within the team CONFIDENTIALITY All employees must not, without prior permission, disclose any information regarding patients or staff. In instances where it is known that a member of staff has communicated information to unauthorised persons, those staff will be liable for disciplinary proceedings in accordance with the Trust s Disciplinary Policy. No confidential information may be read, discussed, disclosed or passed on unless it is necessary in the pursuance of the legitimate duties of the role. The Data Protection Act 1998 also renders an individual liable for prosecution in the event of unauthorised disclosure of information. HEALTH AND SAFETY The post holder is required to make positive efforts to maintain his/her own personal safety and that of others by taking reasonable care, carrying out the requirements of the law and following recognised codes of practice. The post holder is also required to be aware of and comply with Trust policies on Health and Safety. All staff must attend mandatory/statutory training and ensure any risk observed is reported in the appropriate way. EQUAL OPPORTUNITIES The aim of Hounslow and Richmond s Community Healthcare NHS Trust s policy is to ensure that no job applicant or employee is discriminated against, either directly or indirectly, on the grounds of race, colour, creed, sex, marital status, sexual orientation, disability, age, nationality, religion or belief, ethnic or national origins. Hounslow and Richmond Community Healthcare NHS Trust is committed to promoting equal opportunities and will keep under review its policies, procedures and practices to ensure that all users and providers of its services are treated according to their needs. Staff have a responsibility to treat colleagues, clients and members of the public with respect. Acts of harassment or discrimination are deemed to be gross misconduct in accordance with the Trust s Disciplinary Policy. This applies to all staff working in Hounslow and Richmond Community Healthcare NHS Trust. RESEARCH GOVERNANCE Hounslow and Richmond Community Healthcare NHS Trust manages all research in accordance with the requirements of the Research Governance Framework. As an employee you must comply with all reporting requirements, systems and duties of action put in place by the Trust to deliver research governance. INFECTION CONTROL Hounslow and Richmond Community Healthcare NHS Trust considers compliance with the Infection Control Policy and Procedures, including hand hygiene, to be the responsibility of all employees who work in clinical areas. Failure to do so will result in disciplinary action being taken against an employee in accordance with the Trust s Disciplinary Policy. PERSONAL DEVELOPMENT All employees are required to participate in the Appraisal and Personal Development Planning (PDP) process, which identifies development and learning needs. As an employee of a health promoting NHS (Darzi Report 2008) all staff should be aware of the borough's public health priorities. These priorities should be reflected, where appropriate, in your work plan in a quantifiable form. 4

5 SAFEGUARDING ADULTS AND CHILDREN All staff are required to ensure that they have the required level of safeguarding training appropriate to their role within the organisation and abide by the Trust s Safeguarding Adults and Safeguarding Children policy. 5

6 Experience PERSON SPECIFICATION Job Title: Occupational therapist 1. Post qualification experience of working as an Occupational Therapist in a Health or Social Care setting relevant to mostly physical rehabilitation e.g. care of the elderly, general medicine, stroke, palliative care, orthopaedic & surgical, social services, supplemented by specialist training & development 2. Experience in undertaking home visits, carrying out assessments and planning, directing and evaluating interventions. 3. Experience of successfully commissioning the provision of specialist equipment and adaptations 4. Experience of identifying and managing risk and planning appropriate interventions. 5. Experience of achieving positive outcomes for service users and the community through multidisciplinary and/ or partnership working. 6. Experience of the use of evidence based practice in the clinical setting 7. Experience of audit, research and understanding quality issues 8. Experience of implementing policy and / or service changes 9. Experience of providing and evaluating practical training Qualifications and knowledge Skills 10. A relevant professional qualification in occupational therapy and current registration with the HPC 11. A sound knowledge of relevant social care and health legislation and relevant policies and the ability to apply these. 12. A good working knowledge of community and intermediate care / Reablement services 13. Willingness to develop a good knowledge of person-centred values, approaches and thinking 14. Evidence of CPD in line with BAOT s guidelines. This could be maintenance of a portfolio including e.g. attendance at recent courses relevant to the clinical fields in rotations 15. Ability to communicate clearly and effectively both orally and in writing, including use of activity and outcome data and the use of IT. 16. To work as an autonomous practitioner and have the ability to organise, prioritise and delegate work 17. Able to carry out moderate physical effort throughout the working day and carry out concurrent activities. Personal attributes 18. Puts people at the centre of everything he/ she does 19. Able to work as a team member being flexible, reliable and committed 20. Ability to demonstrate empathy, sensitivity and tact 21. Able to problem solve 22. Able to reflect and critically appraise own performance 23. Has a positive attitude to change and is prepared to work flexibly to meet the needs of people and the service 24. Confident and self-motivated 25. Ability to travel to multiple sites 26. Current driving license and access to a car 6

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