Frailty Nurse-INT Frailty Team 3 Harbours and Bosvena

Summary

This is an exciting opportunity to join our Integrated Frailty Team across 3 Harbours and Bosvena INT. You will be working alongside our Nurse Consultant, care coordinators, clinicians, Pharmacy Technician, OT, and community nursing teams as well as volunteer and community sector providers to support those patients who are considered frail, long-time or acutely housebound, as well as supporting nursing and residential homes within our Integrated Neighbourhood.

With knowledge and skills in frailty, physical assessment and clinical reasoning, diagnostic reasoning , actioning the necessary long-term condition and medication reviews, you will use these skills to assist in the recognition and support of early symptoms of frailty, disease exacerbation, acute illness and injuries.

Main duties of the job

• Be able to respond to urgent referrals for patients, carers and the multi-disciplinary team.
• Case manage and coordinate with adult social care for packages of care
• Work within the framework of an MDT
• Be responsible for assessing, diagnosing, planning, organising and reviewing complex packages of care, including case conferences.
• Provide holistic evidence based/best practice care to patients in accordance with National Organisational approved policies/procedures and individual care plans.
• Ensure privacy, dignity and human rights are respected for all patients and carers.
• Undertake comprehensive risk assessments of all situations associated with the care of patients to ensure professionals’ and the carers’ safety.
• Work alongside Occupational Health colleagues to assist with assessments which might include the provision of equipment ensuring it is used safely and within the manufacturer’s guidance.
• Report and record all incidents according to health and safety policy, guidance and legislation.
• Document and maintain confidential, accurate, and legible records using an agreed reporting / clinical system.
• Be expected to oversee the standard of patients’ records by audit or peer review and have regular open discussion with team members.
• Be required to comply with all infection control policies and guidance, attend relevant updates and report issues of concern to their immediate line manager
• Consider safeguarding in line with organisational policy

Our Integrated Neighbourhood team footprint spans coastal, town and rural Cornwall including Bodmin, Fowey, Lostwithiel and Par. We have developed a well established Frailty Team, working with social care, community partners, secondary care and voluntary sector providers, to deliver high quality, patient centred health care across our geography.