JOB DESCRIPTION 1. JOB IDENTIFICATION Job Title: Operationally Managed by : Professional accountability: Service & Base: Specialist Occupational Therapist, with Children and Adolescent Mental Health Services (CAMHS), Band 6 CAMHS Operational manager CAMHS Advanced Occupational Therapist CAMHS Occupational Therapy Service Therapist s base: Andrew Lang Unit Date this JD written/updated: April 2013 Job Holder Reference: MHS272 2. JOB PURPOSE The postholder plays an integral part in the provision of a high quality, efficient and effective community based CAMHS Occupational Therapy Service and provides input to children who are diagnosed with Autistic Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD) and Learning Disability (LD) and associated Mental Health diagnosis The postholder will be a member of a multidisciplinary team and will contribute to the assessment and diagnoses of children with ASD, ADHDand,LD./ Mental Illness. The postholder will manage a caseload of children with the above 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 CAMHS Operational manager Advanced Occupational Therapist Band 7 37.5 hours ) Specialist OT Band 6 (15 hours) Band 6 Specialist OT Band Band 6 OT 6 (22.5 hours) Band 4 (18.75 hours) 4. SCOPE AND RANGE The postholder provides a specialist CAMHS Paediatric Occupational Therapy (OT) service within a geographical area providing assessment and treatment to children diagnosed with ASD, ADHD,LD and associated Mental Illness,(often from birth up to 18 years) and covers an identified area of the Borders region. The post holder will be part of the multi disciplinary assessment contributing to diagnoses. The post-holder independently undertakes specialist OT assessment of children with ASD, ADHD, LD / Mental Illness who have diverse range of conditions from developmental delay and co-ordination difficulties, to more complex and profound behavioural, physical, cognitive, emotional, sensory and social disabilities and difficulties. 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, integrated childrens services and the voluntary sector. The post holder will link closely with the Community Occupational Therapy Paediatric Service. 5. MAIN DUTIES/RESPONSIBILITIES 5.1 Clinical The postholder 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 simple and complex specialised equipment, in order to maximise function. 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 neurodevelopmental 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 postholder 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 postholder 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 works collaboratively with other professionals of the MDT and refers children to other professionals as appropriate. The postholder has an broad knowledge of specialised simple 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 broad knowledge of correct positioning, and the postural requirements of children with 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 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, with whom ongoing liaison is necessary. 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 may deputise for line manager by carrying out agreed delegated tasks as required. The postholder is responsible for the training and supervision of OT students on fieldwork placements and provides 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 postholder is expected to contribute to the interpretation and application of National and Local policies that impact on Paediatric Services and is required to identify and initiate changes to service delivery/clinical practice that continually improve the service. 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 postholder is responsible for their own continuing professional development and maintaining up to date knowledge of Paediatric OT and in particular on the theory, practice, and research on ASD, ADHD,LD / associated Mental Illness and on effective evidence based interventions. The postholder demonstrates and records in a portfolio ongoing personal development gained through participation in development opportunities, personal reflection and study and will continue to develop research and development skills. The postholder,as required, represents the NHS Borders CAMHS OT service and is actively involved in specialist National Clinical Interest Working Groups. The postholder is responsible for suggesting changes to clinical practice and service delivery as a result of the recommendations from these working groups.
6. SYSTEMS AND EQUIPMENT 6.1 Equipment The postholder 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. The postholder is responsible for the safety of children when positioned on suspended/mobile equipment, and for the safe assembly/dismantling of this equipment. The postholder requires knowledge of moving and handling procedures as he/she may be required to use it. 6.2 Information Systems Internet and Intranet as and when required Borders Ability Equipment Service website as and when required Microsoft Word - for up to two hours on a daily basis Outlook Express (e-mail) for up to one hour daily Epex statistical record keeping computer package for up to 30 minutes on a daily basis E expenses, annual leave requests and study leave - monthly 7. DECISIONS AND JUDGEMENTS The postholder works as an independent practitioner across a designated 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 a range of assessment and treatment options. This requires the postholder to make judgements that are based on the interpretation and analysis of 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 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 policies. The postholder contributes to the screening of referrals to the CAMHS MDT making decisions as to the appropriateness of the referral and the role for OT It is 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 postholder will notify the CAMHS Operational manager and Professional OT Lead 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, sensory impairments/difficulties and challenging behaviour. This may involve using alternative 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 treatment of children with complex needs. The postholder communicates unpleasant or upsetting news and is frequently required to handle situations sensitively using empathetic and reassurance 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, challenging behavioural issues, a lack of emotional attachment/bonding, child abuse/child protection cases. The postholder is required to liaise with referring clinicians/professionals about their referral, OT assessment and intervention. The postholder undertakes regular liaison with the multi-disciplinary teams within CAMHS, and multi-agency teams and is required to contribute to review meetings and case conferences. The postholder provides specialist advice to other professionals (health, integrated children s services) 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 to persuade and negotiate. The postholder provides guidance and demonstration for parents, teachers, classroom assistants and the OTTI, if relevant, 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 Borders region, where the child has a split educational placement. The postholder will promote the awareness of the role of the OT within the multidisciplinary team negotiating priorities where appropriate 9. PHYSICAL DEMANDS OF THE JOB 9.1 Physical Skills/Effort The postholder is frequently required to manually move and handle children of all ages with complex physical and cognitive disabilities, which can make manual handling very awkward. 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 coordination 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. Daily driving in rural settings, often in adverse weather conditions and occasionally with clients/families. 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 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 equipment that has been exposed to bodily fluids and food and may be in an unsanitary state. Exposure to verbal 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 within the Borders region without direct on-site supervision. Providing a service to children living in a rural and dispersed geographical area. Prioritising children on caseload and intervention within existing limited resource. 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 families come to terms with a child s diagnoses or supporting the family if the child is excluded from school. The postholder carried out assessment and treatment sessions in a variety of settings e.g. home, nursery, school. These environments are unpredictable 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 postholder 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. 11. KNOWLEDGE, TRAINING AND EXPERIENCE REQUIRED TO DO THE JOB See separate job specification
JOB SPECIFICATION Qualifications Essential Diploma/Degree in Occupational Therapy HPC Registration Desirable Relevant paediatric post-graduate training, short courses and personal study on child development, paediatric conditions, knowledge in LD / Mental Health, ADHD, ASD assessment and treatment approaches such as Bobath and Sensory Integration. Short specialist courses in and/or formal qualification in counselling are an advantage. Evidence of CPD. Experience Skills Management & Organisation Research and Training Essential Minimum of 4 years post registration experience. Experience of working in a Paediatric OT setting. Demonstrate a high level of understanding of Paediatric OT theory and approaches. Experience of working in a community setting. A sound understanding of current child and Adult protection procedures. Desirable Working in or knowledge of Mental Health MD teams Broad clinical skills and an ability to demonstrate appropriate use of models of practice. Developed clinical reasoning skills. Communications skills Observation skills Time management and organisational skills. Ability to self-motivate. Ability to accurately assess and provide appropriate intervention. Ability to work in partnership to meet the needs of individuals Experience of supervising and teaching more junior and undergraduate members of staff. Experience of delegating work to assistants. Ability to prioritise caseload independently. Experience of and ability to work as part of a broad multi-disciplinary team/cross agency working. Demonstrate a sound understanding of the application of clinical governance, quality assurance, standard setting and clinical audit. To have an understanding of and be able to demonstrate participation in the research process. To be informed of established and current research and effective practice specifically in autism. Personal Qualities disposition and Ability to work as part of a team. Ability to demonstrate empathy, sensitivity and tact. Ability to communicate effectively with children of all ages and ability. Motivated, demonstrating a positive attitude and enthusiasm Ability to work under pressure Ability to creatively use supervision and support constructively
TERMS AND CONDITIONS Grade and salary: Hours of work: Annual leave: Public Holidays: Superannuation: Band 6: 26,041-34,876 per annum Fixed term until 31/03/2015 37.5 hours per week 27 days per annum Details of other types of leave entitlement (such as sick leave) are set out in the Agenda for Change handbooks. 8 days 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. 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. Health and Safety at Work: You must take 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 Wednesday 9 April 2014