JOB DESCRIPTION. Therapist s Base: Children s Therapy Unit, Borders General Hospital

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1 JOB DESCRIPTION JOB IDENTIFICATION Job Title: Responsible to: Service & Base: Community Paediatric Occupational Therapist Team Leader - Paediatric Occupational Therapist Paediatric Occupational Therapy Therapist s Base: Children s Therapy Unit, Borders General Hospital Date this JD written/updated: July JOB PURPOSE The postholder plays an integral part in the provision of a high quality, efficient and effective community based Paediatric Occupational Therapy Service. To manage a caseload of complex cases using evidence based, patient centred principles to assess, plan, implement and evaluate interventions in order to encourage the child/young person s development and independence in self-care, learning and play. 3. ORGANISATIONAL POSITION Head of Profession Occupational Therapy Band 8B Band 7 Team Leader Band 7 Team Leader Band 7 Team Leader Adult and Older People s Physical Paediatrics Mental Health and LD Services Band 6 OT Band 6 OT Band 6 OT Band 6 OT Band 6 OT Band 6 OT (CAMHS) Band 4 OTTI x3 Band 4 OTTI (CAMHS)

2 4. SCOPE AND RANGE The postholder is the sole provider of a community Paediatric Occupational Therapy (OT) service providing assessment and treatment to all children (age range 0-18 years) referred to the department within their allocated geographical area and to the acute hospital setting (Ward 15, BGH) as required. The postholder may also cover other geographical areas as and when required. The postholder independently undertakes highly specialist OT assessment and delivery of treatment packages to children with a diverse range of conditions, from developmental delay and co-ordination difficulties, to more complex and profound physical and cognitive disabilities e.g. cerebral palsy. These children may have highly complex clinical, social and psychological needs. The postholder carries out assessment and treatment sessions in a variety of settings e.g. home, nursery, school. The job involves multi-disciplinary and multi-agency working i.e. health, education, social work and the voluntary sector. OUR VALUES IN ACTION Care and Compassion Quality and Teamwork Dignity and Respect Openness, honesty and responsibility 5. MAIN DUTIES/RESPONSIBILITIES 5.1 Clinical The post holder is skilled in carrying out, analysing and interpreting assessments ranging from observation to more in-depth assessment of the child s motor, sensory and perceptual systems, or assessment for complex specialised equipment. The postholder is competent in administering and interpreting specialist standardised Paediatric assessments e.g Movement ABC, Sensory Profile and the postholder is required to design and implement specialised programmes in order to meet the OT treatment goals that they have identified following assessment. Treatment ranges from support/advice to providing direct therapy intervention, using knowledge of specific paediatric treatment approaches, such as neuro-developmental or sensory integrative treatment approaches. The postholder is independently responsible for regularly reviewing children s progress and for evaluating the effectiveness of OT intervention, altering treatment programmes accordingly. The post holder is actively involved in the discharge process with the child and their family/carers. The postholder contributes to the development and delivery of an effective discharge policy within the Paediatric OT Service. The post holder is expected to provide specialist reports to medical professionals in order to contribute to the accurate diagnosis of the child s difficulties/needs and the postholder may identify the need for case conferences or review meetings and he/she is required to initiate the planning and organisation of these meetings. The postholder refers the child to other professionals as appropriate. The postholder has a excellent knowledge of specialised and complex paediatric equipment e.g. seating for postural management, and is competent to assess children in order to prescribe and recommend the purchase of appropriate equipment to meet their needs. The postholder identifies appropriate equipment using their specialist knowledge of correct positioning, and the postural requirements of children with highly complex and continually changing needs. This assessment involves the comparison and testing of a broad range of equipment options and requires consideration of the budgetary constraints. The postholder is responsible for regular maintenance review of the suitability and safety of equipment. There is a frequent requirement for the postholder to source new and innovative equipment that is not held as core stock within the Borders Ability Equipment Service. The postholder may be required to prescribe, design, and manufacture upper limb orthoses in order to support joints, and prevent or correct deformity. The postholder is requested by other health professionals and external agencies (e.g. education, social work and the voluntary sector) to provide guidance on the management of specific children. This involves recommending and designing treatment programmes to be implemented by staff from these agencies, or devising strategies to enable these services to deliver their intervention more effectively. This has a direct impact on these agencies input with the child, resulting in changes to their service delivery and their human resources. The postholder is required to identify the need for building adaptations and make recommendations in their referral to the relevant agencies e.g. education/housing/social work, with whom ongoing liaison is necessary.

3 5.2 Professional The postholder is responsible for maintaining and storing accurate and up to date written and electronic records of clinical intervention and statistical data in accordance with professional and Board standards. This involves the frequent use of computer software to produce formal reports, departmental policies, information leaflets and treatment programmes, and to create reports on statistical data and the postholder is responsible for the administrative duties required of the post e.g. compiling reports, making appointments, filing. The postholder complies with the College of OT Code of Ethics and Professional Conduct, with HPC standards of proficiency and national and local policies and procedures. The postholder applies specialist skills and knowledge in order to demonstrate professional competence and fitness to practice as a Senior OT. The postholder complies with Health, Safety and Risk Management policies. The postholder is responsible for the planning and allocation of work tasks to the Occupational Therapy Technical Instructor (OTTI) and for their day-to-day supervision in order to check and evaluate their work. This involves the identification of the OTTI s clinical training needs and ensuring that adequate training is provided. The postholder provides professional supervision to the OTTI as required. The post holder deputises and assists the Head of Department by carrying out delegated tasks as required, for instance Annual Leave, Sick Leave and is responsible for the professional supervision of allocated qualified staff. Supervision is provided in accordance with an individuals needs. The postholder is required to manage their own time efficiently to allow for required changes in frequency/duration of supervision. The postholder is responsible for the training and supervision of OT students on fieldwork placement, liaising with colleagues from University and providing written assessments of their performance. The postholder participates in the induction and training of other staff both within or external to the Board. 5.3 Research and Service Development The postholder is actively involved in service review and evaluation and in developing Paediatric OT service policies and standards to ensure a high quality service. The post holder contributes to the interpretation and application of national and local policies and drivers that impact upon paediatric services and is required to suggest changes to service delivery/clinical practice and help implement these when necessary. The postholder has a sound understanding of clinical governance, including an ability to audit their own and the team s practice and demonstrates basic leadership skills through the initiation and management of such projects. The post holder is responsible for their own continuing professional development, maintaining and improving on their current knowledge of Paediatric OT. The postholder demonstrates and records in a portfolio ongoing personal development gained through participation in development opportunities, personal reflection and study. The post holder will guide junior staff to incorporate up to date techniques and ideas of positive practice into treatment programmes and will continue to develop their own research and development skills and motivate junior staff to participate. The postholder represents the NHS Borders Paediatric OT service and is actively involved in specialist National Clinical Interest Working Groups. The post holder is responsible for suggesting changes to clinical practice and service delivery as a result of the recommendations from these working groups and the National Association of Paediatric Occupational Therapists. 6. SYSTEMS AND EQUIPMENT 6.1 Equipment The post holder assesses and carries out clinical interventions using a variety of specialised paediatric equipment e.g. positional equipment, seating, toileting and bathing equipment. This involves the assembly, adjustment and dismantling of equipment. The postholder uses specialised assessment and therapeutic equipment, and a sensory integrative treatment area in order to provide treatment to children with sensory integrative dysfunction. The post holder is responsible for the safety of children when positioned on suspended/mobile equipment, and

4 for the safe assembly/dismantling of this equipment. The postholder uses moving and handling equipment including hoists both in the school and home environment and demonstrates the safe use of such equipment. 6.2 Information Systems Internet and Intranet as and when required Borders Ability Equipment Service website weekly Microsoft Word for up to two hours on a daily basis Outlook Express ( ) for up to one hour daily Epex statistical record keeping computer package up to 30 minutes on a daily basis Mileage claim forms, annual leave requests and study leave - monthly 7. DECISIONS AND JUDGEMENTS The postholder works as an independent practitioner in their own allocated geographical area. The postholder is fully responsible for their practice and is accountable for all aspects of OT intervention delivered to the children on their caseload. The postholder makes his/her own clinical judgements and decisions, some of which are required to be immediate, without direct on-site clinical supervision. Formal supervision takes place once a month with yearly appraisal. The postholder is required to compare and make decisions regarding a range of assessment and treatment options. This requires the postholder to make judgements that are based on the interpretation and analysis of complex information about the child s physical, cognitive, emotional and social development and the child s functional performance. The postholder is competent in interpreting assessment reports provided by other professionals. This involves understanding complex medical and psychological terminology and the psychometric properties of standardised assessments. This analysis is necessary in order for the postholder to determine how the information impacts on OT intervention. The postholder independently determines the expected outcomes of OT intervention with the child, i.e. treatment goals. The postholder is also required to independently identify how these outcomes are best achieved, i.e. treatment planning. In undertaking this process, the postholder works within broad clinical/professional models and policies. The post holder contributes to the screening of referrals to the Paediatric OT service on a weekly basis. It is at the postholder s discretion to determine when it is appropriate to open new cases from the Paediatric OT service waiting list and when to discharge children from their current caseload. It is also the postholder s responsibility to independently prioritise and co-ordinate their workload. The postholder is fully responsible for the management of their own time and for the planning and organisation of their clinical and non-clinical duties. The post holder will support junior staff in their day to day time management The post holder will notify the Head OT of changes or events which may effect OT service delivery 8. COMMUNICATIONS AND RELATIONSHIPS To ensure that the child and their family/carers co-operate with and engage in the OT process the postholder is required to convey complex information in easily understood language and use motivational and persuasive techniques. The postholder is required to communicate effectively with children of all ages and abilities and frequently has to overcome barriers to understanding, e.g. children/carers with learning, cognitive and sensory impairments/difficulties. This may involve using alternative or augmentative communication methods. Communication with both service users and other professionals frequently involves the handling of complex and sensitive information, which may be contentious in nature, e.g. diagnosis, prognosis and

5 treatment of children with complex needs. The postholder communicates unpleasant or upsetting news and is frequently required to handle situations sensitively using empathetic and re-assurance skills. The postholder deals with face-to-face complaints and refers these to the line manager or external agencies e.g. education. The postholder is frequently exposed to distressing or emotional circumstances. This includes dealing with difficult family situations, e.g. children with life-threatening conditions, children with complex physical and cognitive disabilities, behavioural issues, a lack of emotional attachment/bonding, child abuse/child protection cases. The postholder is required to liaise with referring clinicians about their referral, OT assessment and intervention. The postholder undertakes regular liaison with the multi-disciplinary, multi-agency team and is required to contribute to review meetings and case conferences. The postholder provides specialist advice to other professionals (health, education, social work) involved with the management of the child. This may require the postholder to challenge or request changes to be made to the intervention of other paediatric professionals/services. This will require the postholder to sensitively use communication skills. The postholder provides guidance and demonstration for parents, teachers, classroom assistants and the OTTI in order to enable these personnel to safely utilise the recommended equipment, and to carry out treatment programmes or incorporate OT strategies into their management of the child. The postholder liaises with educational establishments that may be out with the postholder s allocated geographical area, where the child has a split educational placement. The postholder will promote awareness of the role of the OT within the multidisciplinary team negotiating priorities when appropriate 9. PHYSICAL DEMANDS OF THE JOB 9.1 Physical Skills/Effort The postholder is frequently required to assess risk and manually move and handle children of all ages with complex physical and cognitive disabilities safely and within recommended guidelines. Demonstration and use of moving and handling equipment including hoists and wheelchairs. Demonstration of wheelchair independence skills. In order to appropriately administer standardised movement assessments and carry out treatment intervention, the postholder is frequently required to demonstrate physical tasks that demand a degree of physical fitness e.g. demonstration of motor skills such as jumping from standing start, climbing wall bars, forward rolls, running for sessions lasting at least 45 minutes. Manual Occupational Therapy treatments requiring dexterity, precision and good sensory co-ordination and strength to perform techniques frequently throughout the day often with sustained effort. Frequent assembling, adjusting, dismantling and lifting/moving large and heavy pieces of paediatric equipment, e.g. specialist seating, or suspended equipment. Frequent moving and handling of Paediatric OT assessment and treatment equipment in a variety of settings, involving the transportation of this equipment by car. Handling children and ensuring their safety whilst they are positioned on suspended/mobile equipment. Ability to travel to meet Service needs. Frequent periods of intense concentration on the part of the therapist, whilst ensuring the continued engagement of the child/children during assessment and therapy/treatment sessions. This often takes place in unpredictable settings/environments Speed and accuracy in word processing skills for up to 2 hours on a daily basis. 9.2 Work Conditions The postholder is required to carry out OT intervention in a variety of settings, including the child s home, and the postholder is frequently directly exposed to highly unpleasant working conditions that are outside of their control. These conditions include: - - unsanitary home environments. - cramped and noisy conditions. - children and families with poor personal hygiene. - body fluids i.e. urine, faeces, vomit, mucus, saliva and sweat. - fleas and lice. OT intervention involves the assessment for and adjustment of toileting, bathing and positioning

6 equipment that has been exposed to bodily fluids and food and may be in an unsanitary state. Exposure to verbal and physical aggression from children with behavioural difficulties or cognitive impairments, or from parents/guardians. Exposure to unrestrained domestic animals. 10. MOST CHALLENGING/DIFFICULT PARTS OF THE JOB The postholder is required to work independently in his/her own allocated geographical area. Providing a service to children living in a rural and dispersed geographical area. Prioritising children on caseload and intervention within existing limited resources. Time management prioritising direct clinical time with indirect administration time. Dealing with unrealistic and conflicting expectations from parents/guardians and external agencies e.g. education. Dealing on a daily basis with the mental demands of an unpredictable and complex caseload. The postholder has to deal with emotional and disturbing situations e.g. supporting a family whose child has been given a terminal illness The postholder carries out assessment and treatment sessions in a variety of settings e.g. home, nursery, school. These environments often provide a challenge to the provision of appropriate intervention and the postholder is frequently required to overcome barriers to intervention e.g. interruptions, limited space or noise. There may be requests from a third party to find an alternative location for OT intervention and this may occur after the intervention has commenced. There are therefore frequently competing demands for the therapist s attention that impact on the therapist s ability to concentrate on intervention. The postholder plays an integral role in managing the integration of children with complex needs into mainstream education where there is often resistance, lack of understanding and limited resources. The post holder is frequently required to quickly respond to requests from parents/carers/external agencies that result in changes to the OT s planned activities, e.g. adjustment/breakdown of positioning equipment. The post holder may have to deal with parents/carers who themselves may have physical/mental health/learning difficulties. 11. KNOWLEDGE, TRAINING AND EXPERIENCE REQUIRED TO DO THE JOB see separate job specification

7 COMPETENCY PERSON SPECIFICATION BAND 6 OCCUPATIONAL THERAPIST ESSENTIAL DESIRABLE 1. QUALIFICATIONS Dip/Degree in Occupational Therapy (OT) HPC Registered 2. EXPERIENCE Evidence of broad based experience within OT for at least three/five years. 3. SKILLS Leadership skills; to include supervision and appraisal of junior staff 4. PERSONAL QUALITIES AND DISPOSITION 5. RESEARCH AND TRAINING Ability to work in partnership with multidisciplinary / multiagency settings to meet the unique needs of individuals. Sound clinical skills and ability to demonstrate appropriate use of models of practice. Ability to creatively develop the OT role within this service Ability to empathise with service users and respect their rights as individuals. Motivated, demonstrating a positive attitude and enthusiasm. Good communicator Good team worker Able to work under pressure Manage time effectively with an ability to prioritise caseload independently Ability to use supervision and support constructively. Evidence of CPD Knowledge of clinical Membership of British association of Occupational Therapists (BAOT) Membership of a special interest group related to (speciality) Fieldwork Educators Course Certificate Post-graduate education related to (speciality). Evidence of specific experience within the field of (specialty) Evidence of contributing to the development of a service. An understanding of current national policy developments and frameworks IT skills. Evidence of playing a key role in extending your knowledge to others.. Evidence of playing a key role in extending the knowledge to others.. Evidence of post-graduate research To have attended training /

8 governance, quality assurance, standard setting and clinical setting and clinical audit issues. short courses or undertaken personal study related to (specialty) 6. OTHER Be able to demonstrate the ability to transfer OT skills from one speciality to another. Reviewed July 2012 Ability to travel to meet the needs of the service.

9 TERMS AND CONDITIONS Grade and salary: Hours of work: Annual leave: Public Holidays: Superannuation: Band 6, 26,302 to 35,225 pro rata per annum 16.5 hours per week, Fixed term for 9 months 27 days pro rata per annum Details of other types of leave entitlement (such as sick leave) are set out in the Agenda for Change handbooks. 8 days pro rata per annum on dates designated by NHS Borders Details of other types of leave entitlement (such as sick leave) are set out in the Agenda for Change handbook. The post-holder is entitled to join the NHS superannuation pension scheme. If Unsuccessful: If you have NOT heard from us within 4 WEEKS of the closing date, then we regret that your application has not been successful on this occasion. However, we appreciate your interest in working with NHS Borders and your time and effort in completing the application form. We would welcome your application for future posts. Equal Opportunities: In NHS Borders, we believe that all staff should be treated equally in employment. We will not discriminate against any member of staff, or job applicant, on grounds of age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion and belief, sex and sexual orientation. Trade Union membership. Disclosure checks: We carry out criminal record checks on new staff who fall within certain staff groups within NHS Borders, through Disclosure Scotland. We send out Disclosure Forms to all shortlisted candidates for these staff groups, and ask for these to be completed and returned at interview. If a successful-at-interview candidate forgets to bring their completed form to interview, then they will be required to return the form (and proofs of identity) within 7 days, otherwise the provisional job offer will be withdrawn. Unsuccessful candidates forms will be shredded. The Rehabilitation of Offenders Act does not apply to this post. Mandatory Induction Standards for Healthcare Support Workers in Scotland: Your performance must comply with the Mandatory Induction Standards for Healthcare Support Workers in Scotland and with the Code of Conduct for Healthcare Support Workers (in line with CEL 23 (2010)), both subject to amendment from time to time, which are attached. If, despite ongoing support, you fail to adhere to the Standards or to comply with the code, your performance will be managed in line with the NHS Borders Management of Employee Capability Policy and could result in the termination of your employment with NHS Borders. Tobacco policy: We have a Tobacco policy in place. When selecting staff, we do not discriminate against applicants who smoke, but staff must observe our policy on smoking. Hepatitis B: We offer Hepatitis B immunisation through our Occupational Health Service (OHS). If you think you may be at risk of contracting Hepatitis B through your job, you should ask for this immunisation at OHS. If your work involves exposure-prone procedures, you must keep to the document Protecting Health Care Workers and Patients from Hepatitis B, and the NHSiS Management Executive Directive on this issue. You must be immune to Hepatitis B, and if you cannot prove that you are immune, OHS will investigate to find out whether you are Hepatitis B positive or not.

10 Health and Safety at Work: You must look after the health and safety of yourself and anyone else who may be affected by what you do at work. You must also co-operate with us to make sure that we keep to legal and organisational safety regulations. You can get more information from the NHS Borders Health & Safety Adviser. The closing date for completed application forms is: 5pm on Thursday 21 January 2016