Dietitian - Nursing Care Services
- Post Date:14th August 2019
- Views 200
- Salary £41,400
|Department:||Nursing Care services|
|Full/Part Time:||Full Time||Hours of Work:||37.5 per week
but out of hours as appropriate
|Post holder Reports to:||Director of Care Services|
|Chief Executive officer NGH
The post holder will work with the Multidisciplinary Team do develop innovative and creative strategies, implement and review these in line with our quality assurance framework. The post holder will manage a caseload of residents at risk of malnutrition and dehydration in the nursing and residential units of Nightingale Hammerson; requiring food first intervention and oral nutritional support, working with their own initiative and with access to support from Nutrition & Hydration leads and Wandsworth Community Dietitian.
They will provide a key role in the management of residents at risk of malnutrition particularly those with increased risk of developing pressure ulcers and providing nutritional support for residents currently experiencing incidences of pressure ulcers and moisture lesions. This will include assessment and screening, with regular reassessment and monitoring on a monthly basis or sooner if required. They will provide intervention strategies based on the South West London Alliance MUST Management Guidelines for Care Homes.
The post holder will be the lead in communicating dietary treatment plans with catering provider within Nightingale to provide holistic approach in treating malnutrition and dehydration risk. In addition to these duties, they will undertake teaching on MUST Tool training, Dysphagia Workshops and Mealtimes Matter.
Nightingale Hammerson is committed to achieving equality of opportunity both in delivering its services and in the employment of people and expects all employees to understand and promote equality of opportunity in their work.
- To ensure that all Fundamental standards from CQC and other Local Authority and National bodies such as the British Dietetic Association are implemented and evidenced in practice.
- To support the Director of Care and Deputies in overall strategic, operational, clinical and management of dietary wellbeing in line with the 5 year operational plan for NGH.
- To be a source of specialist nursing, palliative and dementia care advice to colleagues and staff across all services. To create a culture of innovation, creativity and learning in delivering therapy services across the organisation.
- To lead in evidence based practice in rehabilitation, goal attainment, dementia and end of life care whilst providing/facilitating education, coaching and training to staff in NGH.
- To liaise, integrate and co-ordinate internal care services with other professionals in relation to admissions, discharges between services and developing care plans to support residents with their wellbeing.
- To support and facilitate research projects on the unit in partnership with selected universities and care organisations.
- To support the implementation NGH’s organisation’s 5 year strategic goals relevant to the unit level. This will include Teaching Care Home Project, workforce management & development and succession planning.
- To promote NGH values whilst contributing to the vision and mission of the organisation.
- To fully participate in the Care Quality Improvement system for the organisation.
- To undertake all the required duties, responsibilities and accountabilities in Regulation 6 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 and ensure that the Essential Standards of Quality and Safety 2010 and Care Act 2014 are embedded, adhered to and evidenced wherever achievable in every aspect of the delivery of NGH care services.
- To take overall leadership and responsibility, for the assessment, planning and delivery of innovative, safe and effective dietetic care for all residents and their families on the nursing units.
- Lead and manage the team of Nutrition & Hydration Leads on each Unit.
- To ensure that specialist dietary assessments, advice and support is always accessible to colleagues and staff across all services 24 hours a day with regards to residents care and nursing needs.
- Lead and support the knowledge and skills development related to caring for at risk of malnutrition, dehydration, or complex dietary requirements.
- Ensure that the NGH Care Quality Improvement Board (CQIB) framework is embedded and understood at appropriate levels and all care practises are delivered within this framework
- Champion a robust Nutrition, Hydration and healthy eating programmes to raise awareness to all stakeholders.
- Ensure, in liaison with the HR team and Education & Development Lead, Unit Managers, Senior Lead nurses, that a fit for purpose training & development programme is in place, managed and delivered for all care team members
Main tasks and responsibilities
1 Nutritional assessments and malnutrition screening
- The post holder will assess nutritional and hydration needs of residents upon referral by the nursing and residential units for residents (MUST calculations) with a malnutrition score of one or more and for those with a score of zero with weight loss identified.
- To provide first-line advice in specific situations for example prescribing oral nutritional support, according to Nightingale Nutrition & Hydration Policy and South West London Alliance Prescribing Guidelines for GPs and Primary Care Clinicians.
- Provide nutritional support for residents with category 1, 2, 3, 4 and unstageable pressure ulcers in line with current guidance for wound healing through nutritional and hydration interventions.
- To follow through guidance from Wandsworth Community Dietitian when requested and update care plans accordingly.
- To understand food service and menu systems, particularly around food allergy, texture modified diets, thickened fluids, supporting, and advising unit staff.
- To plan, manage and prioritise resident caseload dependent on risk level of pressure ulcer and malnutrition risk within the context of close multi-disciplinary working and access to Wandsworth Community Dietitian.
- Support staff with the referral process and ensuring that recommendations are being followed through for residents on thickened fluids and texture modified diet.
- Have a working knowledge of International Dysphagia Diet Standardisation Initiative (IDDSI) guidelines for the mixing of fluids with the use of thickener and texture-modified foods.
2. Working in partnership with catering provider
- To liaise closely with the catering department regarding provision of appropriate meals, food fortification and nourishing snacks.
- Ensure that an up to date list is completed of residents on texture modified meals and that they are compliant with in IDDSI guidelines.
- Work with the team in reviewing the menu items and ensuring that options are suitable for residents dependent on preferences and eating ability across all units.
- To be actively involved in product development particularly for residents at risk of malnutrition, pressure ulcers and those living with cognitive impairment including dementia.
- Tasting of meals on the units and reporting outcomes both positive and those which require improvement to aid with delivering meals which are good quality and consistent for the needs of our residents.
- Analyse quarterly menu and support with nutritional input and suggestions.
- Education and training
- Raise awareness and educate N&H leads on research based strategies to improve practice through bimonthly N&H forums.
- Lead on health promotion activities for Nutrition and Hydration week annual event, providing unit support and educational display stands.
- Taking a supervised role educating groups of residents about healthy eating where feasible.
- Organise and lead the production of presentations and posters for health promotion for unit staff, residents, relatives and volunteers.
- Deliver and co-ordinate training sessions with external providers on subjects relevant to the education and development of staff knowledge including but not limited to MUST tool training, Dysphagia Workshops and Mealtimes Matter training.
- Policy development
- To comply with Nutrition and Hydration Policy and involved in their regular review.
- To abide by Nightingale Hammerson policies, procedures and legislation.
- Service development
- Collate data from N&H monthly audits and weekly Pressure Ulcer audits, review nutritional action and treatment for residents at increased risk and formulate new treatment plan with multidisciplinary team.
- Identify key trends using data from audits and present findings, areas of improvement and progression plan in quarterly Care Risk meetings.
- To be responsible for producing an up to-date audit for residents on oral nutritional supplements.
- To participate in research and audit projects in the areas of nutrition, hydration and dietetics when appropriate.
- To participate in dietetic, nutrition, and hydration meetings for Nightingale Hammerson as required.
- To participate in evaluating the service on a regular basis such as resident satisfaction surveys, assisting with audits within own area and relevant project work.
- To work as part of a multidisciplinary team to ensure the best service for residents.
- Be able to communicate with residents who may be terminally ill or have barriers to understanding (e.g. poor cognition.)
- Liaison with representatives from nutritional companies with regard to, keeping product information and on-going feeding pump training for all units within the Nightingale Hammerson.
- Educate care staff on the principles of nutritional assessment and support.
- Organising link meetings with catering staff.
- To participate in identified teaching, training or education programs, working collaboratively with other Dietitians. This may include development, training programs, displays, handouts and evaluation tools using appropriate IT packages e.g. Microsoft PowerPoint, Excel, and Publisher.
- Information management
- To record own activity, accessing patient information though IT systems and liaison with care teams.
- To provide statistical information as may be required by the Director of Care Services
- To be responsible for maintaining records demonstrating engagement in Continuing Professional Development (CPD), Dietitian competencies, according to any guidelines laid down by the British Dietetic Association for Dietetic Practitioners.
- To develop knowledge by attending relevant courses and conferences as guided by Director of care services.
- To always act in accordance with the British Association of Dietetics with particular reference to ensuring the limitations of competence, conduct and personal accountability are fostered throughout the care service
- To carry out other duties as required such as sharing expertise on recommendations and dietary interventions at multidisciplinary meetings.
- To demonstrate an active pursuit of life-long learning and development.
- Such other duties, within the competence of the post holder as may be required from time to time.
This job description is intended as a basic guide to the scope and responsibilities of the post and is not exhaustive. It will be subject to regular review and amendment as necessary in consultation with the post holder.
It is a requirement for all staff throughout Nightingale Hammerson to maintain the core values of:
The requirements listed below are considered to be either essential to successfully undertake the duties and responsibilities of the post or are considered desirable.
Criteria Essential or Desirable
|British Dietitian Association Mentorship||Essential|
|3.||Certified Post Graduate Education in Dietetics
|4.||Experience of working in a residential nursing environment, or leading a care pathway for elderly care in an acute unit.
|5.||Proven experience working as a Dietitian in a clinical team caring for older people with dementia, either in an acute or community setting.
|Experience of managing dementia and complex care needs.
Demonstrable experience of providing clinical support and expertise in nutrition science and diet planning.
|8.||Evidence of experience in directly supporting the practice development and professional education of MDT
|9.||Able to demonstrate experience of applying clinical governance to every day practice
|Evidence of undertaking and leading clinical audit and evaluation
Evidence of budgetary planning and management
Experience of project management and leadership, and embarking upon service developments from pilot to mainstream.
|Demonstrable knowledge of current legislation in relation to older people.
In-depth knowledge and evidence of application of the Health & Social Care Act 2008 and the Essential Standards of Quality & Safety
|Knowledge of current national initiatives and clinical and social care practice development with respect to caring for older people||Essential|
|Evidence of continued professional development including education relating to the field of Dementia care||Essential|
|17.||Evidence of effective clinical leadership and organisational qualities, including an in-depth knowledge of communication skills required to effectively manage staff and other resources.
|18.||Demonstrable ability to function at a high level, including during emergencies, giving reassurance to residents, whilst ensuring confidence and setting an example to staff.
|19.||Evidence of ability to proactively supervise staff teams & individuals to continuously develop performance, acting as a facilitator to promote accountability.
|Demonstrable ability to teach, support and mentor nurses and carers to continue their professional development.
Demonstrable evidence of ability to lead, empower and motivate teams
|Ability to work on a rostered basis, including evenings, weekends and public holidays in order to meet the needs of the service.||Essential|
|23.||Ability to develop to undertake clinical on call and site management as part of a team of unit managers