Dual Diagnosis Nurse

Job summary
Change Grow Live is one of the UKs leading health and social care charities and the Dual Diagnosis Nurse role is a varied one. You will be supporting people with multi-faceted issues related to the impact of substance use on their physical and mental health.

Nurses working are an integral member of our multidisciplinary teams, offering specialist clinical interventions to people who use our services. Every person who comes into our service is treated as an individual, so understanding the importance of a whole person approach along with being curious, a good listener, a clinically robust practitioner and having a flexible approach are essential skills.

• At Change Grow Live we want to support you to recognise and achieve your goals:
• We hold regular national nurse and HCA forums, and you will have regular 1:1s and appraisals.
• We actively support our nurses to revalidate with protected continuing professional development time, which totals up to 6 days per year.
• We also have a wide range of educational opportunities including free access to the RCNi learning platform and we pay for your NMC fee.
• We offer you the opportunity to use the government backed Apprenticeship Levy fund to develop nursing practice in line with your specific role.
• All our staff are encouraged to take a wellbeing hour every week and access personal well -being resources.

Main duties of the job
Work to the core CGL substance misuse nurse job description with additional role specific requirements:

• Provide bespoke interventions for identified service users, with the aim of engaging people in the most appropriate service for their needs, reducing re-presentations and bringing about positive outcomes.
• Support the development of joint working protocols with mental health services and substance misuse services (including Community Mental Health Teams (CMHTs), Improving Access to Psychological Therapies services).
• Review service users presenting to services and undertake specialist mental health assessments as required.
• Identify the training and support needs of colleagues working with this group of service users and deliver training or provide support as appropriate.
• Identify any gaps in dual diagnosis provision and provide examples of good practice to inform future pathway and service design.
• Improve communication and referral pathways between substance misuse and mental health teams and other services involved in the care and treatment of people with dual diagnosis.
• Provide a case management role for identified dual diagnosis service users as appropriate.

About us
Believe in people
At Change Grow Live, above all else we believe in people. It's the one thing that acts as a foundation for all our work.

If you use our services: we understand what you're going through. We won't judge. We believe you can make positive changes in your life.

If you work or volunteer for us: we believe in your potential. We believe you can do brilliant, life-changing work.

Our mission and vision
Our mission is to help people change the direction of their lives, grow as individuals, and live life to its full potential.

The vision we're working towards is to develop, deliver and share a whole person approach that changes society.

We believe that having diverse people working as part of our team makes us the organisation that we are.

We actively encourage applications from people from all backgrounds to help us to provide the best possible experience for the people who use our services and to make Change Grow Live a great place to work.

The safety of vulnerable children, young people and adults is our absolute priority. We will support you in your role to make sure that you are equipped to support the safety of people who use our services and those around them, to the highest standard possible.

Job responsibilities
Role-specific responsibilities

• Provide bespoke interventions for identified service users, with the aim of engaging people in the most appropriate service for their needs, reducing re-presentations and bringing about positive client outcomes.
• Support the development of joint working protocols with mental health services and substance misuse services (including Community Mental Health Teams (CMHTs), Improving Access to Psychological Therapies services).
• Review service users presenting to services and undertake specialist mental health assessments as required.
• Identify the training and support needs of colleagues working with this group of service users and deliver training or provide support as appropriate.
• Identify any gaps in dual diagnosis provision and provide examples of good practice to inform future pathway and service design.
• Improve communication and referral pathways between substance misuse and mental health teams and other services involved in the care and treatment of people with dual diagnosis.
• Provide a case management role for identified dual diagnosis service users as appropriate.

Clinical Practice

• Undertake physical and mental health assessments for people who access our services when indicated by clinical need and ensure appropriate sign posting/referral to primary care or appropriate secondary health care services for identified health issues.
• Undertake assessments for all alcohol individuals who use our services as indicated in the Change Grow Live Alcohol Policy and Procedure, using the outcome to determine safe detoxification as required.
• Assist in the titration process for opioid individuals who use our services as required by service need to ensure the service user achieves an optimum dose of opioid substitution therapy (OST). This process is supported by good communication to other team members, including community pharmacists.
• Provide education, health promotion and screening for blood borne viruses (BBV). Provide Hepatitis A and or B vaccinations when indicated.
• Work within and consolidate integrated care and treatment pathways for individuals who are identified as being infected with BBVs (Hepatitis B, Hepatitis C and/or HIV).
• Undertake community alcohol detoxification either at the service or at the service users home.
• Support opioid detoxification in the community.
• Undertake phlebotomy, as required, ensuring adherence to identified pathways for blood sample labelling, collection, obtaining results and signposting.
• Use blood results to support the assessment of the current health status of individuals who use our services, the need for specialist medical referral and the suitability for community detoxification.
• Where indicated, refer for specialist inpatient services (including detoxification) and liaise with hospital and inpatient unit staff.
• Contribute to Change Grow Lives Naloxone Strategy by training staff and individuals who use our services in the use of naloxone. Ensuring naloxone is distributed to individuals who use our services at every opportunity.
• Offer wound care assessment and basic wound dressing to individuals who use our services. Organise signposting to other services as required and ensure clear pathways into other treatment arenas as appropriate.
• Have a demonstrable ability to manage emergency situations by being proficient in basic life support, defibrillation and managing a medical emergency e.g., anaphylaxis and overdose until the ambulance arrives.
• Understand and adhere to the legislation surrounding the use of patient group directions (PGDs).
• Utilise psychosocial intervention in both one-to-one and group settings to promote engagement in treatment services and ownership of recovery planning.

Person Specification

• Experience of working in substance misuse and/or mental health settings.
• Experience of working with people with co-morbid mental health and substance misuse problems.
• Experience of managing a caseload of clients with complex needs.
• Knowledge of and skills in appropriate therapeutic interventions for working with people with dual diagnosis.
• Knowledge of current mental health, substance misuse and dual diagnosis policy, guidance, and legislation.
• Qualification in Mental Health Treatment. Relevant registered qualification in Mental Health.

Communication

• Develop therapeutic alliances with individuals who use our services and develop effective partnerships with them to support their individual recovery journeys, offering health promotion and harm reduction advice.
• Ensure that there is good communication of treatments offered, treatment progress and outcome of any investigations to other healthcare agencies, including GPs.
• Maintain a current knowledge of appropriate interventions. Ensure that all revalidation requirements are being met and communicated to line manager.
• Develop and provide health education, regarding problematic alcohol and drug use and alcohol and drug detoxification.
• Attend meetings appropriate to the development and maintenance of the role in agreement with and under the direction of the Lead/Cluster Lead Nurse.

Delivering a Quality Service

• The post-holder will contribute to the service to ensure that people who use substances consistently receive high quality services that adhere to the best practice guidelines and to the highest professional standards.
• Ensure that procedures are constantly reviewed to promote best practice and evidenced based practice in accordance with UK Guidelines on Clinical Management, NICE guidance, and Change Grow Live clinical protocols and procedures.

Leadership

• Provide clinical leadership within the service, including providing support, coaching, and teaching to staff working at the service around harm reduction including BBVS and health promotion.
• Dependent on service structure will provide line management/supervision to named health care assistants, student nurse placements and or volunteers working with the nursing team.

Team Working

• To take part in assessing the suitability for transfer of clients to shared care services within the community.
• To work with others to ensure individuals who use our services have timely access to safe and effective prescribing for community detoxification from substances, across operational sites.
• Contribute to the overall performance of the service to ensure that contractual output targets are achieved.
• Working with colleagues in the service to design and deliver a community opioid and alcohol detoxification plan utilising a care co-ordinated approach to service user care.

Risk Management

• Provide harm reduction advice to injecting individuals who use our services, providing information and equipment and ensure all equipment is disposed of safely.
• Undertake risk assessments and contribute to risk management plans for individuals who use our services engaged in the service.
• Utilise appropriate prevention techniques to reduce substance misuse related harm and to aid in the prevention of multiple physical harms caused by drugs and alcohol.

Managing Information

• Record and input client data and information in order that the service operates within contractual, administrative, and financial requirements.
• Ensure that all data requirements in relation to individuals who use our services are met within defined deadlines.

The above is an outline of the post holders duties and responsibilities. It is not intended as an exhaustive list and may change from time to time to meet the changing needs of Change Grow Live.

Staff will need to work flexibly across operational sites as required and to work flexibly within an agreed number of hours to maintain the most appropriate level of service provision.

This role may involve evening, weekend, and bank holiday working.

The above is an outline of the post holders duties and responsibilities. It is not intended as an exhaustive list and may change from time to time in order to meet the changing needs of CGL.

You'll be based at one of our West Sussex delivery hubs, with the flexibility to work across all service locations to meet the needs of the people and communities we support. Regular travel across West Sussex is an essential part of the role.

Person Specification
Qualifications
Essential

• First level registered nurse and with a current PIN.

Desirable

• Trained in phlebotomy.
• Qualification in substance misuse.

Experience
Essential

• Experience of working in substance misuse and/or mental health setting.
• Experience of working with people with co-morbid mental health and substance misuse problems.
• Experience of managing a caseload of clients with complex needs.
• Knowledge of and skills in appropriate therapeutic interventions for working with people with dual diagnosis.
• Knowledge of current mental health, substance misuse and dual diagnosis policy, guidance, and legislation.
• Qualification in Mental Health Treatment.
• Relevant registered qualification in Mental Health.

Desirable

• Relevant recent experience of working within drug and alcohol treatment.
• Sound and demonstrable knowledge of clinical prescribing issues.
• Knowledge of the issues facing substance misusers including appropriate medical interventions, social care, and health issues.
• Experience of contributing to project development.
• Knowledge of local services and geography.
• Motivational interviewing techniques.
• Clinical auditing skills to inform evaluation of the service and identify areas for development.

Disclosure and Barring Service Check
This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

UK Registration
Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

Applicants must have current UK professional registration.