Agenda for Change s2

AGENDA FOR CHANGE NHS JOB EVALUATION SCHEME

1. JOB IDENTIFICATION

Job Title: Occupational Therapy Assistant Practitioner Band 4

Reports to:HCPC registered Occupational Therapist

Professionally Accountable to:HCPC registered Occupational Therapist

Department, Ward or Section:

CHP, Directorate or Corporate Department:

Job Code: GENNHSHCOMMOCCT01

No of Job Holders:

Effective date of this job description:

2. JOB PURPOSE

The post holder will be expected to independently manage a designated caseload of individuals defined as ‘non complex’ providing assessment and interventions on behalf of an Occupational Therapist within predetermined guidelines. Supervision will be available from a registered Occupational Therapist. Individuals identified as complex will be managed by a registered Occupational Therapist. The service provided should be consistent with both local and national standards.

3. DIMENSIONS

NHS Highland serves a population of 310,000 across the largest land area of any health authority in the UK. NHS Highland has two delivery units which are the Highland Health &Social Care Partnership and Argyll & Bute Community Health Partnership. The Highland Health &Social Care Partnership delivers integrated care to the adult population of Northern Highland via three operational units: North/West (Caithness, Sutherland, Skye, Lochalsh, West Ross, and Lochaber); South/Mid (East & Mid Ross, Inverness, Badenoch and Strathspey, and Nairn) and Raigmore Hospital. Argyll & Bute Community Health Partnership deliver health care to the populations of Oban, Lorn and the Isles; Mid Argyll, Kintyre and Islay; Cowal and Bute; and Helensburgh and Lomond.

4. ORGANISATIONAL POSITION

5. ROLE OF DEPARTMENT OR SECTION Occupational Therapy (OT) staff work both autonomously and as members of multi disciplinary teams.

People often present with health and social care needs that cross diagnostic boundaries, and OT staff work creatively with the person to understand their needs and priorities and they work together to identify solutions.

OT staff will consider the impact a health and social care need has on the person’s life: roles including day to day life, culture, work, leisure and physical health and well-being. This can be working with individuals and their families and indirectly working in partnership with communities, statutory organisations and the third sector. While working to improve access to community services OT staff will promote social inclusion OT assessments, treatments/interventions are carried out in a wide range of environments such as health facilities; people’s homes; and within local community settings.

OT staff work with people as early as possible in order to minimise the impact of long term conditions on peoples lives; endeavouring to deliver a comprehensive and seamless service.

The post holder may be required to travel throughout the locality to provide a service to individuals in the most appropriate location to meet their needs. The post holder may be required to travel considerable distances each month.

6. MAIN TASKS, DUTIES AND RESPONSIBILITIES

Direct Therapy Contact  With support and supervision from a qualified Occupational Therapist, identify those people who have the potential to benefit from OT intervention within guidelines and protocols developed by NHSH Occupational Therapy service; prioritising those who will benefit most balancing the need to promote productivity, quality of life, prevention of ill health and reduction of risk.  Act independently to identify those individuals who have the potential to benefit from OT intervention within guidelines developed by NHSH Occupational Therapy.  Use defined OT assessment tools to assess the individual’s needs in partnership with the person. To handover to a registered OT if more complex needs emerge.  Analyse assessment information. In collaboration with the person set achievable, measurable goals and an intervention plan within pre-determined options defined by an OT.  Provide a range of rehabilitation/reablement interventions to enable independence, self management and promote health and well being.  In collaboration with the person, review, modify and adapt interventions throughout rehabilitation/reablement.  With the person evaluate the effectiveness and outcomes of interventions  Support people to access health information that enables them to plan for their own future.  Participate in MDT health promotion programs, which requires an OT contribution, to provide preventative education to specific client groups (e.g. falls, exercise therapy, nutritional awareness, joint protection, energy conservation or stress management)  Refer on for additional assessments or services from other relevant professionals/agencies.  Share progress with relevant team members, other professional staff, families and carers within data protection guidelines.  Communicate with, and make recommendations to, all relevant disciplines of staff to maximise outcomes and promote multidisciplinary working.  Participate in multidisciplinary activities around triage, single point of referral and allocation of referrals.  Involve the person in the discharge planning process, developing discharge plans with appropriate relapse prevention/wellness/crisis plans.  Be responsible for materials/equipment in use, notifying the team manager of any defect, and taking action to remove defective equipment from use.  To be responsible for maintaining stock, advising on resources required to carry out your job.

Community Activities  Work in partnership with local communities, statutory agencies and third sector to improve accessibility of local resources to people using OT services.  Share the wider knowledge and skills of the OT service to support local communities, statutory agencies and the third sector to promote social inclusion.  Empower people with disabilities to be actively involved in the delivery of OT, exploring opportunities that are led by people using services.

Professional  Keep up-to-date with recent advances in defined are of practice evidencing this through eKSF.  Actively participate in own supervision.  Ensure the most effective and efficient utilisation of resources.  Support OT’s to teach and mentor OT students.  Show willingness and interest in continuing professional development improving knowledge and skills relevant to the post.  Participate in/contribute to the delivery of the in-service training programme within the team.  Participate in the OT quality assurance programme i.e. audit, research, and standard setting.  Actively engage with NHS Highland personal development and review appraisal system according to NHS Highland/team policy for self-development. The post holder will receive an annual Personal Development Plan and Review along with supervision.  As part of continuing professional development, attend relevant courses and be prepared to give talks/demonstrations to colleagues and other disciplines.  Proactively contribute to new protocols and procedures developed for the defined area.  Adhere to OT standards of practice and code of confidentiality.

Managerial  Will support and act as mentor and role model to Senior HCSW and HCSW.  Maintain day-to-day administrative records, returns and data collection as required.  Co-operate/assist in all matters necessary to the efficient management and development of the department in accordance with the team and NHS Highland policy.  Observe the Health and Safety at Work Act at all times, and to take responsibility for maintaining a designated area along with the OT team.  Participate in the implementation of local and national policy and service development within the OT team.  In addition to the duties, activities and responsibilities listed above, the job holder may be required to perform other duties assigned by the line management from time to time, they will be within the general scope and grade for the post.

7. EQUIPMENT AND MACHINERY USED Mobility Equipment e.g. walking aids, stand aids, wheelchairs, transfer equipment such as transfer boards, hoists, sliding sheets, stair lifts etc..

Activities of Daily Living Equipment (ADL) e.g. mobility, personal care, kitchen, feeding/eating/nutrition equipment. Augmentative/Alterative communication equipment. Telecare.

Therapy Equipment and Treatment Modalities e.g.E-link (Microcomputer Upper Limb Exerciser), thermoplastic splinting equipment, joint/grip measurement equipment, remedial activities.

Assessment Equipment e.g. Range of standardised and non-standardised assessments as defined by the OT.

Information Technology e.g. PC, Printer/photocopier/fax, E-Mail/Intra/Internet, power point, video conferencing

Miscellaneous e.g. Mobile telephones, Telephones, Answering machines, Driving.

Mainstream equipment/facilities e.g. use of facilities in the public and third sector that will involve a wide range of activity and equipment such as leisure centres and the equipment, wide range of outdoor vocational activities in keeping with the persons own rehabilitation plan

8. SYSTEMS

 Maintain accurate and up to date patient records – these may be kept manually or electronically in respect of day to day interventions. All records must adhere to the College of Occupational Therapists Guidelines and NHS Highland standards.  Keep statistical data up to date.  Contribute to OT student reports.  Produce, interpret and discuss statistics through audit that may lead to service development such as trends in activity  Incident reporting  Equipment ordering, monitoring stock levels.

9. ASSIGNMENT AND REVIEW OF WORK With overall supervision from a registered OT the post holder will:  Be responsible for a caseload of individuals defined as non-complex by the OT.  Prioritise own caseload organising care effectively and efficiently with regard to clinical and other priorities  Decide which interventions are required within guidelines developed by the OT service. The OT Assistant Practitioner will seek guidance or hand over to the qualified OT should needs become complex.  Work within the Code of Ethics and OT Standards, NHS Scotland Code of Conduct for Health Care Support Workers, NHSH policies, protocols and procedures.  Be expected to anticipate problems/needs and take steps to resolve them within own designated area.  Regularly discusses all aspects of activity as relevant with the supervising OT, immediate multidisciplinary team.  Attend and participates in relevant meetings  Receive regular support and clinical supervision from an supervising OT.  Participate in personal development planning and review, will take place in line with NHS Highland policy.

10. DECISIONS AND JUDGEMENTS

 To interpret a range of clinical and non-clinical facts relating to individuals, seeking supervision from a registered OT when this becomes complex.  To assess, plan and implement an appropriate programme of care for individuals using clinical reasoning to determine the most appropriate interventions from a range of predetermined options defined by the OT service.  Recognises own limitations in the provision of care and refers to a registered OT when issues become complex.  Recognises own learning needs and actively seeks out opportunities to develop practice.  Contributes to local service development.  The post holder does not have budgetary responsibility however, they have the responsibility to highlight unmet need and to identify improvements to service delivery to the registered OT.

11. MOST CHALLENGING/DIFFICULT PARTS OF THE JOB  To participate in service change re integration, modernisation & development, whilst continuing to fulfil high standards of care.  Need to adapt to the variable and unpredictable demands of workload.  Balance the competing demands of health and social needs to ensure continuity to the provision of an equitable service.  Need to undertake a mentally and physically demanding job, while at the same time taking care to safeguard own health and safety.  Maintain and continually develop clinical knowledge in a range of practice areas working within the community and hospitals.

12. COMMUNICATIONS AND RELATIONSHIPS General  Early identification of conflicting perspectives of choice of care options between staff, individuals and their carers, using negotiation and counselling skills to achieve compromise and the best outcome for the person, referring on to registered OT where appropriate.  Maintain effective communication across all parties involved in the delivery and receipt of care.  Observe confidentiality in accordance with College of Occupational Therapy, NHS Scotland Code of Conduct for Health Care Support Workers, NHSH policies.  Contribute to the shared assessment process.  Provide as appropriate verbal/written reports regarding outcomes of OT interventions.  Deal with verbal complaints and challenging behaviour, including aggression.

Direct Therapy Contact  Where available, provide and receive information regarding assessment, diagnosis, prognosis and treatment to encourage active participation. This involves an ability to interpret information, modifying communication skills to respond to the needs of the person, and explaining it in a manner appropriate to them.  Use developed reasoning, persuasion and reassurance skills to establish a therapeutic relationship in non-complex cases. To gain co-operation and maximise individual and carer involvement in identifying and selecting appropriate therapeutic goals and interventions which balance the complex interaction of risk, safety, individual/carer choice, areas of conflict and eligibility for services.  People may have communication problems which can cause barriers to understanding or communicating needs (e.g. dementia, sensory impairment, cognitive impairment, expressive and / or receptive language difficulties).  Promotes social inclusion and diversity of individuals respecting rights to privacy and confidentiality  Provide ongoing education, support and reassurance to relatives/carers as appropriate.  Prepare individuals and relatives for self management and discharge from the service

Occupational Therapy Staff  Liaise with OT staff for the purposes of receiving guidance and advice and with all other staff groups for the exchange of accurate clinical and other information. This includes OT colleagues within and out with the service on the transfer of an individuals care.  Utilise team support for emotional and demanding issues.  Liaise with Registered OT to ensure service quality is maintained and resources optimised. Others  Negotiate and liaise with all appropriate professionals and agencies to optimise care and ensure efficient service delivery.

13. PHYSICAL, MENTAL, EMOTIONAL AND ENVIRONMENTAL DEMANDS OF THE JOB

Physical  Moving and handling of individuals: transfers, mobility, exercise programmes, positioning of individuals e.g. to enable feeding  Moving and handling of equipment: regularly moving of equipment/strength to move heavier items of equipment - daily.  Risk assess areas of work and take appropriate action to enhance space etc… as necessary - daily  Fine motor skills and dexterity during therapy interventions – daily e.g. assisting individuals with washing and dressing, adjusting wheelchairs, demonstrating and fitting a range of disability equipment in the person’s home, therapeutic craft activities.  Exposure to body fluids, faeces, emptying urinals, catheter bags – occasional  Community based work: driving within the Highlands: a car (daily) or mpv (weekly or fortnightly) for varying distances  Standing, Static postures, walking for long periods of time

Mental  Concentration, decision making and organisational skills to cope with competing demands.  Using personal management skills: time management, prioritisation, problem solving.  Concentration required while undertaking assessments, writing reports, using computer.  Community based unpredictable working environments, family dynamics.  Occasional Physical or Verbal abuse  Constant awareness of need for ongoing risk assessment.

Emotional  Dealing with the emotional effects of caring for terminally ill people and their families  Dealing with challenging behaviours including working with people demonstrating verbal and/or physical aggression and potential for self-harm. Using acquired skills to prevent situations becoming volatile  Discussing sensitive issues and emotional impact on self of traumatic situations

Environmental  Undertaking assessments/interventions in a range of settings: person’s home which may be unpredictable: levels of hygiene, structurally unsound, infested, unpleasant odours, variable temperature etc…Ward or department based where space/privacy may be limited.  Contacts with bodily fluids eg vomit, urine, handling soiled linen.  Using community resources and other venues which are not ideal for meeting clients’ needs 14. KNOWLEDGE, TRAINING AND EXPERIENCE REQUIRED TO DO THE JOB

Training and Qualification: · SVQ 3, HNC, Professional Development Award (PDA) or equivalent skills acquired through in-service development or experience and ability to undertake qualification during the first two years of employment (distance learning) · Current UK Driving Licence (essential)

Experience: · Previous experience at relevant Senior HCSW level: Occupational Therapy, rehab nursing, relevant area of social care or • Pre-registration student exiting prior to completion of programme.

Knowledge and Skills · Ability to work as part of a team as well as on own in a range of settings · Basic understanding of the relationship between illness/disability and social issues and their impact on an individuals health and well being · Ability to teach practical skills to individuals/ carers · Good observation skills · Good personal management and organisation skills · Basic appreciation of the broad context of health and social care policy, risk assessment. · Understanding of behaviour and conduct in practice. · Basic appreciation of clinical governance. · Basic computer literacy

Disposition  Flexible approach to working practices.  Well developed communication and interpersonal skills.  Willingness and ability to learn.  Open to change.

15. JOB DESCRIPTION AGREEMENT I agree that the above Job Description is an accurate reflection of my duties and responsibilities at the date of signing. Job Holder’s Signature: Date: Manager’s Signature: Date: