OCCUPATIONAL THERAPIST (05)

Job Title:

Occupational Therapist

Band:

5

Directorate:

CSS

Department:

Occupational Therapy

Base:

Reports to:

Designated Team Lead

Responsible to:

Occupational Therapy Manager / Occupational Therapy Professional Lead

Communication and Key Working Relationships

Use a range of verbal and non-verbal communication tools (e.g. explanation, negotiation, persuasion, motivation and empathy) to communicate effectively with patients in order to progress rehabilitation and treatment programmes. This will include patients who may have difficulties in understanding or communicating. For example, patients may be dysphasic, depressed, and sensory impaired, or who may be unable to accept diagnosis.

To be aware of and appropriately manage sensitive and/or complicated information. To deal sensitively with service users, relatives / carers who have high levels of anxiety and aggression caused by emotional distress, pain, dementia and other presentations. This will include patients with challenging behaviour, terminal illness and degenerative disease.

To represent the Service and/or individual patients at clinical meetings and case conferences to ensure the delivery of a coordinated multidisciplinary service and to ensure that Occupational Therapy is integrated into the overall treatment programme. This will include discussion of patient care, recommendations on best course of action and change to existing plans, patient progress and discharge planning.

To provide written and verbal reports to members of the multidisciplinary team during treatment and at discharge from the service.

Planning and Organisation

To play a key role in planning and implementing discharge, in conjunction with other professionals and agencies. This will include assessment, clinical reasoning, liaison with patients, other professionals, such as Doctors, Nurses, Social Workers, agencies such as Social Services and family/carers and will ensure that the patient is discharged at the appropriate time to the appropriate destination for their needs with the necessary support, e.g. residential home, nursing home, own home, voluntary support and Social Services package of care.

Analytics

Responsibility for Patient / Client Care, Treatment & Therapy

Clinical:

Be professionally and legally accountable for all aspects of professional and clinical work

To undertake comprehensive assessment of patients including those with diverse or complex presentations/multiple pathologies, e.g. Complex social situations, end of life care, people with lower limb amputations, life threatening cardiac and respiratory conditions and complex neurological conditions.

The post holder will be expected to make clinical judgements which require analysis, interpretation and comparison of a range of different treatment techniques and options, to establish physical and cognitive functional levels. These will include personal, domestic, vocational and leisure activities of daily living, assessment and provision of assistive equipment.

Carry out standardised assessments to diagnose physical and cognitive functional levels. Examples of tests that may be used are; Rivermead Perceptual Assessment Battery, to help determine treatment aims and monitor changes in perceptual ability following a Stroke or head injury. Also the Middlesex Elderly Assessment of Mental State (MEAMS), to detect gross impairment of cognitive function in elderly people.

a) Formulate and deliver an individual occupational therapy treatment programme using clinical assessment, reasoning skills and knowledge of treatment skills e.g. activity analysis of functional skills, patient education, manual handling techniques and other alternative options. To do this taking into account the person’s own goals and those of the multidisciplinary team to predict achievable outcomes and recommend the best course of intervention.

b) Assess a person’s understanding of treatment intervention/goals, gain valid informed consent from the patient and have the capacity to work within a legal framework with patients who lack capacity to consent to treatment, e.g. those people with cognitive difficulties.

The post holder will continually reassess and evaluate the person’s progress through assessment and intervention. Treatment programmes will be altered as a result of this.

To carry out clinical risk assessments for patients on own caseload and take action to effectively manage identified risks, e.g. Patients who are difficult to transfer and aggressive patients.

Professional:

The post holder will be responsible for maintaining own competency to practice through Continual Professional Development (CPD) activities, such as external/internal training courses, literature reviews and maintain a portfolio which reflects personal development and complies with the requirements for the Health Care Professions Council (HCPC) registration as an Occupational Therapist.

Maintain and develop current knowledge of evidence based practice in the areas of each rotation developing and building on core knowledge of particular conditions and patient types. The post holder will ensure awareness of and comply with the Trust’s and local team’s policies and procedures relating to clinical governance and that their requirements, along with nationally recognised professional standards, are incorporated within clinical practice.

To ensure continuing professional expertise and standards by conducting literature reviews and by attending and/or presenting at in-service training.

To actively take part in monthly professional clinical groups, such as peer review groups and other development activities, through administrative duties such as chair and minute taker on a rota system, presentation of patient case studies, feedback from training and discussion around relevant topics.

To undertake the measurement and evaluation of own work and current practices through active participation in supervision and peer review using case presentation, article reviews, evidence based practice projects with support and guidance from senior therapists.

To deliver group education/treatment sessions for service users, carers, nursing staff and others, both formally and informally, as and when required.

The post holder will keep comprehensive treatment records for all patients who have been referred for Occupational Therapy in accordance with Royal College of Occupational Therapy standards of practice and local Trust Policy. This will involve recording information in the service users paper or electronic records (medical records, nursing records or RIO depending on rotation)

To maintain patient attendance and treatment using the electronic Maxims/Rio information system and to be competent in the use of and actively access the electronic communication systems within the service and the Trust.

To participate, through verbal information and demonstration, in the clinical education of Occupational Therapy Students to graduate level. To provide support, guidance and training to support staff and to deliver the Occupational Therapy component of the training for multidisciplinary or multi-agency staff. This may be in a formal or informal basis.

Working Environment

The post holder will be expected to carry out assessments in an acute hospital ward. The post holder is responsible for clinical evaluation of the patient, including treatment goals and discharge planning. This may include advising patients and carers of the inability to stay or return home, which can be distressing for all concerned.

To be an active member of the weekend and bank holiday rota. The frequency will depend on the rotation. The maximum commitment will be one weekend in every 6 weeks.

To work as lone practitioner with telephone support from a Senior Occupational Therapist as required. This may be when working on the weekend rota.

The Occupational Therapist will need to work as a lone practitioner in unpredictable environments where there may be an element of risk, e.g. service user’s own home, dangerous pets, volatile carers or relatives. This may also include working in unclean surroundings and coming into contact with, for example, dirt, fleas and lice.

The Occupational Therapist will have exposure to bodily fluids and human waste whilst carrying out assessment and practice of personal and domestic skills, e.g. stump dressings, other surgical wounds, pus, vomit and diarrhoea.

To use moving and handling equipment, specialist therapeutic equipment and wheelchairs as part of treatment programmes on a daily basis; to include transportation of patients, assessment, adjustment and education for individual patients and carers.

To undertake therapeutic moving and handling techniques with patients, e.g. Normalising tone, functional mobility, this will occur for up to 75% of the day with patients of up to 30 stone on a daily basis. This can include long term immobile and morbidly obese patients. This will take place in awkward and confined spaces such as hospital bathrooms, toilets and bed space, home/work environments and cars to transfer patients and equipment for home assessment visits.

To be responsible for the assessment and prescription of minor structural adaptations to the patients home on a regular basis, e.g. rails and ramps.

The post holder will require good physical skills, mental effort and concentration to carry out assessments, write clear and accurate reports, and give clear and accurate information at case conferences.

Policy, Service, Research & Development Responsibility

To undertake as directed the collection of data for use in service audit and research projects. This will occur up to twice a year and will involve completion of questionnaires, interviews with patients, review of medical and Occupational Therapy notes and recording time spent on specific activities.

Responsibility for Finance, Equipment & Other Resources

To be responsible for the safe and competent use of Occupational Therapy equipment and appliances used with individual patients. This will include assessment and prescription of equipment from the Community Equipment Service (CES), to take account of patient need, financial resources and instruction in safe use. Equipment can be up to the value of £250, e.g. wheelchairs, hoists, raised toilet seats and bathing equipment.

Responsibility for Supervision, Leadership & Management

To be responsible for the organisation of work within a specific caseload, delegating work as appropriate to assistants/technicians/APs. To readjust plans as situations, change and arise, e.g. staff absence due to sickness or patient too unwell for intervention.

The post holder will participate in the Service’s supervision and appraisal programme by meeting with their Occupational Therapy supervisor regularly. This may become less frequent depending on experience and competency, but will take place at least once a month. This will be an interactive discussion on performance, personal and service development. The post holder will be responsible for documenting and taking action on the agreed objectives. The post holder will participate in a mid-way and an annual appraisal with the supervising Occupational Therapist and will be responsible for agreeing, documenting and taking action to achieve the agreed performance/ development plan.

Information Resources & Administrative Duties

It is the responsibility of all staff to be aware of their duties under the Health and Safety at Work Act and under specific local or departmental Health and Safety Policies.

The post holder will comply with Confidentiality and Data Protection. It is the responsibility of all staff dealing with any matter of a confidential nature, including particular information relating to patients, their diagnosis and treatment. Individual staff records, details of contract prices and terms must be under no circumstances divulged or made available to any unauthorised persons. It is the responsibility of all staff to be aware of their obligations in respect of the Data Protection Act 1998.