Job Description

Job Title: Admiral Nurse– Palliative and End of Life Care Nurse Specialist

Grade: Band 7

Location:

Department:

Garden House Hospice Care

Patient Services

Hours: 37.5 hrs

Reports to: Director of Patient Services

Length of contract: 2 years fixed term

The focus of the Admiral Nurse role is to help improve dementia care within & across the locality that Garden House Hospice Care (GHHC) serves through the provision of specialist dementia nursing and expertise in supporting families affected by dementia. The Admiral Nurse Service will operate across North Herts and Stevenage and surrounding villages, providing in reach to a number of local care homes.

Job Summary: Working as an Admiral Nurse you will provide and lead on the delivery of

specialist nursing assessment, evidenced based intervention, practical advice and emotional support for family carers of people with dementia and where appropriate people with dementia themselves

Enable people living with dementia who have specialist palliative care needs to have the best quality of life possible and have access to symptom management at the end of life.

Provide a responsive, flexible, high quality specialist dementia care service to people living with advanced dementia and their families ensuring that the service delivered reflects the GHHC Business Strategic objectives.

Manage a small caseload of families living with dementia whose primary diagnosis is advanced dementia; clinically assess their future end of life care needs and those of their family / carers using the Admiral Nurse model of care.

Work collaboratively and co-operatively with clinical colleagues, including Admiral Nurse Teams in the Community and Acute Trusts, Specialist Community Palliative Care Teams and local dementia services to

contribute to the development of dementia services and quality of care delivered.

Support Allied Health Care Professionals to identify the palliative care needs of people living with dementia on their caseload, ensuring that they are appropriately reviewed in Multidisciplinary meetings/practice meetings and linked in to hospice services.

Provide expert training, advice and support across the hospice and community, including residential and nursing care homes to facilitate improvements in the way we identify and support people with dementia and their family/ carers and ensure they receive appropriate care within our own and other services.

In collaboration with the Education and Practice Development Manager provide training for hospice staff, volunteers, people living with dementia, family and carers and the wider community to enable services to better support people with dementia at the end of life in the local community, care homes or in hospital.

Contribute to the development and implementation of a dementia care strategy for people living with dementia in the community of North Herts, Stevenage and surrounding villages, ensuring the needs of families with dementia at end of life are recognised.

Accountabilities Responsibilities and duties.

Strategy Development:

To contribute to the development of a local dementia care strategy through local strategic groups across North Herts, Stevenage and surrounding villages.

To develop action plans based on the findings of local service audits, in line with the GHHC Strategic Business Plan, to improve services and care for patients, families and cares to all our services,

To map the recommendations to the East & North Herts CCG End of Life Care (EOLC Strategy).

To disseminate audit findings and action plan development via presentations and publications.

Clinical Duties:

To meet the multiple and often complex needs of families where one or more person is living with advanced dementia. Through ongoing assessment of health and wellbeing, using a range of effective evidence based psychological and social interventions, to promote health and assist with the alleviation, prevention and management of stress, depression, anxiety and other mental health needs of families living with dementia.

Band 7 Admiral Nurse JD GHHC 2

To facilitate discussions around advance care planning, for families living with dementia providing information and assisting with completion of documentation required. Support decisions regarding resuscitation, discussing these with people living with dementia and carers as appropriate, communicate with professionals and ensure documentation is complete.

To identify people living with dementia that have palliative care needs, appropriately review and support them, especially as they approach end of life by undertaking joint visits, leading reflection and attending Gold Standards meetings as required.

To work with family members supporting them to care for people living with dementia, prepare them for end of life issues and needs, impending loss and grief, assess need for bereavement service referral and undertake initial post-bereavement support.

To support family carers and Healthcare Professionals affected by dementia, to develop skills and competencies in understanding and coping with challenges and difficulties they may face, in both individual and group situations.

To work collaboratively with the multidisciplinary team at GHHC and the community care teams and other dementia services.

To recognise the limits of own competency and professional boundaries in self and others and to make appropriate and timely referral in respect of patient and/or client needs.

To be responsibility for oneself, patients, service users and other staff in ensuring the effective Safeguarding of Children and Adults, following the agreed local policies and procedures in both these domains

Demonstrate comprehensive and in-depth knowledge of the Mental Capacity Act (2005) and Deprivation of Liberty (DoLS) legislation relating to end of life care, informed consent and decision making.

To ensure a duty of candour is followed in giving information to patients and/or their representative working in partnership with the multi-disciplinary team.

To maintain clinical records using SystmOne and WANDA shared care electronic record system and provide verbal and written feedback appropriately and as required, to carers, persons with dementia (as appropriate), referring agencies and Health Care Professionals.

Professional:

To attend and actively participate in monthly practice development days, including clinical supervision, mandatory and recommended training/education, including the Admiral Nurse Competency module and the Admiral Nurse Forum at least once a year, as supported by Dementia UK.

Band 7 Admiral Nurse JD GHHC 3

To maintain professional registration in line with NMC guidance including re-validation demonstrating evidence of advanced level practice.

To ensure all nursing practice is carried out in accordance with GHHC policies and procedures, Dementia UK, the NMC Code of conduct and other relevant nursing policy.

To support appropriate practice based, development evaluation, audit and research and to disseminate findings.

To influence and contribute to the development of policies, procedures and protocols relevant to Admiral Nursing.

To work positively with colleagues to maintain clinically effective relationships.

Education and Personal Development:

To identify, generate and utilise appropriate learning opportunities in practice.

To work with the Education and Practice Development Manager to develop and co-ordinate the implementation of a comprehensive dementia end of life training programme across GHHC, primary and secondary care working in partnership with key stakeholders including the Admiral Nursing service, Dementia UK.

To provide training, advice and support for staff and volunteers to enable them to identify, care for and support people living with dementia and their families with increased skill and confidence to ensure people living with dementia receive appropriate care.

To provide and/or lead formal training events such as courses, conferences, seminars and workshops at all levels, maintaining and contributing to higher level educational programmes in dementia care, disseminating Admiral Nursing work and promoting best practice in dementia care.

To provide training and support to care staff working in a defined number of Nursing and residential Care Homes across North Herts & Stevenage

To ensure that all training is evaluated to evidence impact on confidence & competencies of staff to provide quality care, preferred place of care & death and reduction i hospital admissions.

To support quality improvements and integrate into practice current knowledge of dementia and caring, informed by research and other forms of evidence.

To act as a lead clinical role model to others. To develop own competence to practice through use of the Admiral Nurse

Competency Framework, and continuing professional development to an advanced level of practice.

To maintain up to date knowledge base of resources, service provision, policy context, new approaches, interventions and treatments in dementia care and to influence local policy & procedure development and review.

Band 7 Admiral Nurse JD GHHC 4

To promote a research active learning environment, working closely with the Admiral Nurse Directorate at Dementia UK, liaising with researchers, practice developers and educational providers.

To complete annual mandatory training.

Managerial /Leadership and Administrative:

To be an integral member of the GHHC clinical services team. To behave in a professional manner always, reflecting and maintaining

GHHC values and standards of behaviour and generating a positive image of GHHC to all stakeholders.

To support audit and evaluation of service quality using Admiral Nurse Standards and other relevant standards supporting best practice. To ensure that the data is relevant, accurate, complete and captured in a timely manner so that it is fit for purpose.

To contribute to the development of local policies, procedures and protocols relevant to Admiral Nursing through the support of Dementia UK Business Development Team and within the local steering group.

To adhere to all GHHC policies and procedures to ensure that these are maintained always.

To monitor and maintain a safe working environment and working practices always and report any unsafe conditions or potential hazards.

To support the Director of Patient Services with the implementation of new initiatives, innovative practice for service improvements in accordance with the GHHC Strategic Business Plan strategy as well as local and national strategies.

To engage with GHHC Clinical Strategic Business Plan leading on key areas of service development where appropriate.

To take a lead in representing the Hospice at specific groups/ meetings both internally and externally to influence and advocate End of Life, dementia care and services.

To identify opportunities for service development and innovation by participating in service evaluation and anticipating future demand, trends, risks and constraints.

To assist with change management in relation to service improvements and to comply with requirements in line with current legislation and the Care Quality Commission requirements.

To manage time effectively to ensure all aspects of the role and professional responsibilities are fulfilled.

To monitor standards of care and report issues back using hospice governance structures.

To work alongside the quality team to identify service users’ views, needs and shortfalls in the service and ensure they are fed back via the relevant channels.

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To participate openly and honestly in any investigation when care falls below expected standards.

To promote patient and public involvement in activities as much as possible.

Equality & Diversity:

To demonstrate sensitivity and respect for people with dementia and their families from different religious and cultural backgrounds and sexual orientation.

To work in collaboration with colleagues to challenge behaviours that undermines equality and diversity, privacy and dignity.

Additional Requirements:

There is a requirement to comply with all the hospice policies, procedures and guidelines, including those relating to Health & Safety, confidentiality and the Data Protection Act, as required by Information Governance.

Each member of the hospice team has a responsibility to contribute to the clinical governance programme.

Each team member to take appropriate action to maintain the highest level of infection prevention and control.

Additional information

This job description sets out the key tasks and responsibilities. It is not intended to be comprehensive. It is essential that it should be regarded with a degree of flexibility so that the changing needs of the organisation can be met.

This job description will be reviewed with the post holder annually as part of the appraisal process. Any proposed amendments will be with the agreement of the appropriate member of the Hospice Management Team.

"team" refers to all members of staff including volunteers

Band 7 Admiral Nurse JD GHHC 6

Person specification

Post: Admiral Nurse – Palliative and End of Life Care Specialist– Band 7

Essential DesirableQualifications Registered Nurse (RMN/RGN/RNLD)

Relevant teaching qualification

Advanced communication skills training (or willing to obtain)

Degree/ Masters level qualification in dementia / older people’s care

Evidence of further study in end of life care.

Leadership qualification and/or formal management development

Mentorship Qualification

Training in loss, grief and bereavement.

Work Experience & Attainments

Significant post-registration clinical experience of working with people with dementia and their carers/supporter/ representatives at end of life.

Experience of assessing patients and providing pain and symptom control advice.

Experience of communicating regarding complex, sensitive issues with patients, carers and professionals

Experience of recent involvement in practice/ service development.

Experience of working with groups and individuals in a variety of roles and settings

Demonstrated experience of working as an autonomous practitioner

Demonstrated ability to lead and

Experience of specialist palliative care.

Experience of undertaking staff performance reviews and planned development of staff

Experience of working with patients/ clients to develop practice

Band 7 Admiral Nurse JD GHHC 7

manage services

Experience of professional supervision of staff

Experience of audit/ evaluating clinical practice

Skills and Knowledge

In depth knowledge about dementia and how this can affect individuals’ day-to-day life, relationships, family and support networks

Advanced communication and /or counselling skills in both individual and group settings.

Understanding and experience of assessment of people with dementia / family carers

Understanding and demonstrated ability to deliver a range of therapeutic interventions for supporting people with dementia and their family carers

Understanding of and promotion of evidence based best practice including contribution to multi- disciplinary team

Ability to assess risk regarding self and others and take appropriate action

Facilitation skills

Computer literacy with ability to use e-mail, internet, Word, electronic records and literature searching

Knowledge of relevant national policy and practice initiatives.

Ability to develop services and facilitate and manage change

Proven presentation and teaching skills

Demonstrate leadership ability

Knowledge of palliative care and end of life care issues

Knowledge of research methods and methodologies.

Experience in taking part in research

Understanding of competency frameworks

Experience of supporting systematic practice development/ quality improvement

Band 7 Admiral Nurse JD GHHC 8

Evidence of recent continuing professional development

Aptitudes & Attributes

Able to uphold Hospice values.

Excellent communication skills.

Ability to provide supervision, critical companionship and support to team members.

Ability to operate effectively with a constantly developing relationship with key stakeholders and associated agencies.

Able to work independently and deliver objectives within a given timeframe

Able to access information from different sources and use critical appraisal skills

Excellent planning and organisation skills

Ability to work in groups/one to one.

Ability to build constructive relationships with warmth and empathy.

Ability to treat families affected by dementia with respect and dignity, adopting a culturally sensitive approach that considers the needs of the whole person.

Positive mental attitude and a willingness to discuss and negotiate issues and ideas with the appropriate team / individual

Ability to learn through practice

Ability to manage the emotional impact of working within palliative care

Other A full valid driving license and access

Band 7 Admiral Nurse JD GHHC 9

requirements to a car to use regularly for business purposes is essential (unless you have a disability as defined by the Equality Act 2010 and a reasonable adjustment can be made).

Flexible approach to meet the needs of the service.

Good sense of humourWorking Arrangements

Fulltime. Mon-Fri. Post holder may on occasion be expected to work outside normal working hours.

signed

dated

Band 7 Admiral Nurse JD GHHC 10

Shortlisting (*) and interview assessment (+) criteria

Essential: Desirable:Registered nursing qualification * Additional nursing qualification *

Significant post registration experience in care of people with dementia /older people *

Post registration qualification in dementia /older people’s care

Higher Degree i.e. MA, MSc, MPhil *

Evidence of recent and on-going personal and professional development *Experience of working with groups and individuals in a variety of roles and settings *Experience of professional supervision of staff *

Leadership skills (+) Leadership qualification and/or management development *

In depth knowledge about dementia and how this can affect individuals day-to-day life, relationships, family and support networks (+)Understanding and of assessment of people with dementia / family carers (+)

Understanding and demonstrated ability to deliver a range of therapeutic interventions for supporting people with dementia and their family carers (+)Promotion of best practice and working with a multi-disciplinary team

Experience of leading practice development initiatives /quality improvements *

Experience of audit and evaluation *

Good presentation/ teaching skills

Sound knowledge of the health/social care and nursing agendaPresence and confidence to act as an ambassador for Admiral Nursing, host organisation and Dementia UKExcellent verbal and written skills (+)

Enthusiastic and self motivated (+)

Band 7 Admiral Nurse JD GHHC 11