Central and North West London NHS Foundation Trust
Occupational Therapist/Mental Health Nurse/Social Worker
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Job Overview
We are recruiting for 2 x Band 6RMNs/OTs/Social Workers to work in the Boroughs of Kensington and Chelsea and/or Westminster
The Westminster and Kensington & Chelsea Older Adults and Healthy Ageing Community Mental Health Teams are developing a new primary care pathway to provide early access to support for older adults who are experiencing mental health difficulties. In line with the mental health transformation agenda, the primary care pathway will focus on the integration and development of neighbourhood-based care alongside primary care, local authorities and third sector providers.
Furthermore, the service will focus on early intervention, working proactively with community partners to provide interventions to meet needs, reduce risks and prevent escalation by supporting service users to remain well in the community, thereby reducing the need for secondary care interventions and admissions to hospital.
Main duties of the job
As a member of the OA PCN Team, the post holder will be a team member working in co-operation with other disciplines, statutory, voluntary and private agencies as required. Amongst other tasks, the post holder is expected to:
- Work as a clinician to provide mental health nursing, occupational therapy and social work interventions
- Provide specific assessments and treatment interventions to service users referred to the OA PCN team
- Demonstrate experience of working with older adults/ those with complex physical and mental health needs including functional and organic illness
- Work flexibly and collaboratively across local environments
- Possess strong interpersonal skills
- Manage a caseload as needed, including providing access and/or deliver a broad range of psychosocial interventions for individual patients
- Carry out robust risk assessments and care planning
Working for our organisation
The primary care pathways will sit within the Westminster and Kensington & Chelsea Older Adults and Healthy Ageing Community Mental Health Teams. These are well established dynamic multidisciplinary services providing mental health support to older adults in Westminster and Kensington & Chelsea with functional disorders and dementia. They are co-located with the Westminster City and Kensington and Chelsea Council mental health team, offering a holistic approach to care.
The Westminster team is also involved in the CNWL Open Dialogue project, which promotes person-centred recovery-oriented care.
The teams operate using a case management, intervention-led and recovery-focused model, offering multidisciplinary assessments and interventions for service users with complex needs, as well as their families and carers. Regular multidisciplinary meetings facilitate case discussions, initial assessments, and reflective practice.
A key feature of the services is the integrated older adults home treatment team, which delivers intensive support, crisis management, admission prevention, and helps ensure timely hospital discharges. The CMHT and HTT teams collaborate closely, offering a responsive and flexible service to meet the needs of service users. Coordination with older adults’ inpatient services allows smooth transitions of care.
Detailed Job Description And Main Responsibilities
Clinical
- To triage referrals and allocate work to junior staff as appropriate
- To provide a comprehensive mental health assessment for service users with complex needs which can include anxiety, depression, dementia, physical health co-morbidities; health anxieties; drug and alcohol misuse
- To formulate, implement and review individualised Recovery Care Plans with patients and their carers that aims to address their psychological, physical & social needs
- To assess current risks and identify how the risk and service users’ mental health needs would best be met
- To provide specialist nursing/OT/social worker expertise and collaborative support, contributing to assessment, care planning, interventions and ongoing reviews
- To regularly monitor and evaluate the therapeutic value of interventions and to adjust treatment plans accordingly
- To build and maintain therapeutic relationships with service users and carers and involve them in drawing up care plans
- To provide training and advice to carers, service users and colleagues on lifestyle changes and adaptations to the service users’ social and physical environment
- To ensure support is available to relatives and carers as appropriate and to refer on to relevant agencies as required
- To support and practice Open Dialogue and dialogical practice within the service if relevant
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Communication
- To communicate effectively with service users, carers/relatives, other professionals and agencies, providing assessment, support and information as required, whilst observing the boundaries of service user confidentiality
- To participate in relevant PCN based multi-disciplinary and team meetings, and case conferences
- To support the delivery of specialist training, advice, and ongoing support to PCN colleagues to enhance their knowledge and confidence in recognising, assessing, and responding to the mental health needs of older adults
- To promote service user involvement in service delivery where possible
Documentation
- To ensure that accurate and up-to-date written and electronic records are maintained in accordance with Trust policy
- To ensure the timely completion of required statistical information
- To provide a high standard of reports in keeping with Trust guidelines
Management and Leadership
- To exercise good personal time management and demonstrate reliable attendance
- To work autonomously as required and exercise professional judgement regarding risk management, care planning and discharge planning
- To be responsible for routine departmental tasks
- To ensure Trust policies and procedures are known and adhered to
- To provide clinical supervision for junior staff as appropriate
Professional development
- To apply expert skills and knowledge to demonstrate professional competence and fitness to practice
- To develop one’s own professional and specialist skills and knowledge at the competency level of a senior nurse/OT/social worker
- To undertake activities of Continuous Professional Development (CPD) including identifying own learning needs and to be able to produce evidence of CPD in a portfolio format and proof of current professional registration
- To keep abreast of changing clinical practice, new developments, evidence based practice and research
- To participate in the Trust’s supervision and appraisal systems working towards the agreed Personal Development Plan and KSF requirements
Clinical governance
- To demonstrate understanding and application of national and Trust-wide guidelines and standards of practice
- To maintain the NMC/OT/Social Worker Profession’s standards of practice and ensure other team members are conversant with these
- To co-operate in the monitoring and evaluation of services, assist with audits and clinical governance projects as required and address issues identified by this process in collaboration with team/management
- To enhance standards of care by developing the use of models of nursing/OT/social work practice within the PCN and promoting evidence-based practice
Research and development
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- To ensure continuous professional development, keeping up to date on developments within nursing, OT, social work practice in mental health
- To contribute to activities, which continue to build on a culture of shared learning and evidence-based practice
- To undertake and disseminate research activities in line with local service priorities and the Trust’s Nursing or Occupational Therapy Research and Development strategy
- To make use of the support networks available throughout the Trust which have been established in partnership with the UK Centre for Outcomes in Research and education
Professional ethics
- To adhere to the NMC, Social Work England or College of Occupational Therapists Code of Ethics and Professional Conduct
- To demonstrate the ability to reflect on ethical issues and take appropriate action as required
Staff and student training
- To contribute to the induction of new members of the team
- To participate in the teaching of staff, nursing/occupational therapy/social work students and students of other disciplines as required
- To attend and participate in local multi-disciplinary teaching sessions
- To act as a practice placement assessor/educator for nursing/OT/social work students, attending all relevant meetings and liaising with colleges as appropriate
- To be responsible for the supervision and written assessment of students on practice placement
This job description is intended as a guide to the scope of the duties and responsibilities of the post and is not an inflexible specification. It may be reviewed in consultation with the post holder in line with changing circumstances and in the light of organisational change.
Person specification
Qualifications
Essential criteria
- Qualified OT/RMN/SW with relevant registration to regulatory body
- Evidence of continued professional development
Desirable criteria
- Post registration qualification in Older People ENB 998 or equivalent
- Open Dialogue training or willingness to train
Experience
Essential criteria
- Post-registration experience in a range of clinical areas which includes older adults and/or those with dementia
- Experience of working as member of a Multi –disciplinary team
Desirable criteria
- Experience of managing/supervision of junior staff
- Experience of working in a community setting
- Experience of participating in Open Dialogue network meetings
Knowledge
Essential criteria
- Knowledge of functional and organic mental health conditions older adults
- Knowledge of physical health and frailty related to old age
- Knowledge of needs, Risk Assessment and Risk Management Processes
- Knowledge and understanding of the needs and rights of service users and their carers
- Knowledge of ethical/legal requirements within mental health field
- Knowledge and understanding of legislation relating to the care of Older Adults with Mental Health problems in the community
Skills
Essential criteria
- Effective communication skills both verbally and through written reports
- Ability to assess complex risk and produce care plans to manage this
- Effective leadership skills
- Ability to take responsibility for managing a caseload
- Ability to manage complex decision making situations
- Ability to organize and prioritise own workload
- Ability to supervise junior staff and students
- Teaching and assessing skills
- Ability to work effectively in stressful and emotionally charged situation
- IT skills i.e. Microsoft word, Email, Internet
- Ability to reflect and critically appraise own performance
- Able to manage personal stress
- Previous experience of audit and research
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