Senior Rehabilitation Instructor

Thank you for expressing your interest in the above post, please find the following enclosures:

  • Advert
  • Job Description
  • Person Specification

External Candidates

If after reading this material, you wish to apply, you must do so via the eESS website link and register:

Internal Candidates

CurrentStateHospital employees should click on the following link:

For details of your eESS login please contact HR on 01555 842107 or

The Vacancy Name / Number isSenior Rehabilitation Instructor / IRC9019

If you require assistance with your application please contact HR on 01555 842107

Human Resources

The StateHospital

Carstairs

Lanark

ML11 8RP

Senior Rehabilitation Instructor.

1.JOB IDENTIFICATION

Job Title: Senior Rehabilitation Instructor
Responsible to: Senior Staff Nurse
Department: Skye Activity Centre
Directorate: Nursing.
Operating Division: The StateHospital
Job Reference:
No of Job Holders:
Last Update : April 2013

2. JOB PURPOSE

To engage patients in a range of therapeutic social, physical, educational and recreational activities in line with the patients’ treatment plan and personal choice.
To work under the supervision of a registered nurse in clinical matters and participate in the development and maintenance of high quality care in a secure environment, through involvement in the assessment, planning, implementation and evaluation of patient care processes.
To lead a team of rehabilitation instructors in an Activity Centre, providing patients with individually focussed, therapeutic activity.
To work collaboratively with other disciplines in the delivery of services within activity centres. The delivery of this service may require to be delivered out with the designated Activity Centre, e.g. Hub, ward or the Family Centre.
To contribute to an innovative and progressive attitude to the care of the patients who attend the Activity Centre.
3. DIMENSIONS
Direct care of a group of patients. This can be up to 20 patients attending on a sessional basis. The number of patients can far exceed 20 at certain larger functions.
Provide day-to-day supervision and support to new and junior staff (e.g. students, rehab band 3 & 4 instructors, nursing assistants, etc) within the Skye Centre.
The post holder will also be expected to be responsible for the direction of external service providers and volunteers using the department.
To be responsible for maintaining a sufficient and cost effective stock control system within each Activity Centre ensuring that all items produced for purchase are appropriately costed and systems for recording same are in line with Standing Financial Instructions for audit purposes

4. ORGANISATIONAL POSITION

5. ROLE OF DEPARTMENT

The key objective of the Skye Centre is to emulate the activities and services available to the general public within a high security setting to serve patients’ health, vocational, recreational and therapeutic needs.

6. KEY RESULT AREAS

Working with Patients:
Assessment
  • The post holder is expected to be flexible and work across all Activity Centres as and when staffing resources dictate the requirement for this.
  • Participate in discussions at team meetings with regards to the purpose of assessing health and wellbeing needs and explain toindividual patients concerned the purpose and reasons for any assessments being undertaken. Respect individual’s dignity, wishes and beliefs, involve them in decision making and, where appropriate, obtain their agreement/consent prior to undertaking assessment activities.
  • Informally assess patients during activities and general interactions/observations (e.g. observing and assessing concentration, mental state, communication and interactions with others, behaviour, motivation and progress with specific work tasks, etc). Undertake specific delegated assessment activities on individual patients as agreed with the Senior Staff Nurse and/or MDT
in accordance with local policies, procedures and individual care plans.
  • Assessment activities may relate to:
-mental and emotional state
-personal hygiene needs and abilities
-nutritional needs and eating/drinking abilities
-fitness and physical health
-enhanced observation of patients (e.g. assessing patients on level 2 or level 3 observation status)
-risk factors (e.g. relating to self harm, suicide, violence, etc)
  • Where appropriate, complete assessment records (e.g. assessment records related to physical health, fitness, ILPs, etc). Whererequired, and in conjunction with the Senior Staff Nurse, produce and present narrative reports explaining the outcomes of assessments (e.g. at department meetings, MDT meetings, case reviews).
  • Promptly report any observed changes in the patient’s physical or mental state (including improvements or deterioration) to the Senior Staff Nurse/Team Leader (and where appropriate, to ward staff and/or the patient’s Key Worker).
Treatment Planning
  • To play a leading role in planning and implementing patient programmes within the Centre, identifying appropriate activities relating to their needs, wishes and interests and in line with the patients treatment plan.
  • Assist clinical staff in the process of selecting patients to attend activity centres based on care and treatment plan goals, security profiles and other available information. Within the context of the patient’s overarching care and treatment plan goals, and in conjunction with the Senior Staff Nurse and Team Leader,
  • Identify individual patient-centred goals for activities the patient will engage in within the activity centre. Goals may relate to emotional, mental, physical, social or spiritual health and well being needs. Ensure that rehabilitation staff are aware ofidentified needs and planned goals.
  • Assess, plan and deliver therapeutic programmes of activities/treatment interventions and provide support to enable patients to address their specific needs. This might include:
-Setting up equipment/materials required for specific activities.
-Providing guidance, instruction and support during specific activities.
-Motivating and encouraging patients to participate in recreational and social activities.
-Providing information to enhance individual patients’ ability to understand their own health and wellbeing needs (including promoting a recovery based approach).
-Participating in the delivery of individual and group activities and supporting the work of other disciplines (e.g. occupational therapists, psychologists, PTS staff) within the activity centre or other areas of Skye Centre.
-Supporting individuals to maintain and/or enhance their physical health (e.g. undertaking health education and promotion activities; enabling regular access to fresh air; facilitating engagement in physical activities; supporting smoking cessation, healthy eating and/or dieting, etc).
-Enabling and/or supporting patients with activities of daily living such as eating and drinking, general personal hygiene, mobilising, etc.
-Escorting patients (e.g. between Hubs and the Skye Centre, or on occasion external outings).
  • Ensure the environment, equipment and individuals involved are prepared appropriately for the activities to be undertaken and adhere at all times to local policies and procedures (e.g. relating to security, health & safety, etc). Take appropriate action to identify and address any risks to health and wellbeing associated with activities. Risks might relate to incidents/accidents, deterioration in physical or mental state, abuse or self- harm, environmental factors, group dynamics, security risks. Report risks and adverse incidents and, where required, seek support, guidance and advice on how to manage risks from the Senior StaffNurse/Team Leader. Assist, when required, in the control and restraint of patients to prevent immediate risk to their health and safety and that of others (e.g. in the event of violent incidents).
  • Regularly review and evaluate the impact and effectiveness of activities and interventions and adapt activities and activity plans, as required, in conjunction with the Senior Staff Nurse and Team Leader. Provide verbal and written feedback on activities to the Senior Staff Nurseand/or MDT in accordance with departmental procedures.
  • Maintain records of activities that are undertaken in accordance with local policies and procedures (e.g. recording KPIs, updating individual care plans on EPR, recording adverse incidents on Datix, etc).
  • To participate in patients recreation and social events as a part of their continuing care at the hospital.
  • To serve meals to patients.
  • To empathise with patients and assist them to express their thoughts, feelings and needs.
Service Development
  • Contribute to reviewing work practices/procedures within relevant activity centre and wider Skye Centre in conjunction with the Senior Staff Nurse and Unit Team Leader. Identify areas for improvement and service development (e.g. in response to user feedback, adverse incidents, changes to legislation or local policies, advances in information technology, research and recognised best practice, etc). Discuss potential changes to work practices/procedures with line manager and the team and agree a plan for how the changes will be implemented.
  • Participate in team and wider service meetings as appropriate. Put forward suggestions and ideas on how to improve own practice and/or service delivery. Use feedback from others and service evaluation activities (e.g. audits, research, surveys, etc) to help identify where/how improvements can be made.
Finance
  • Assist in managing resources within the department (e.g. ordering supplies and maintaining stock levels within the relevant activity centre), and ensure that time, equipment and materials are used correctly and efficiently. This will includeenvironment-specific equipment and tools (such as those needed for vocational activities, those needed for physical health interventions, information and materials - such as art materials, and learning resources).
Working with Health and Safety and Security:
  • To ensure that hospital policies and procedures are understood and adhered to at all times i.e. Health & Safety, Security and Clinical
  • To take responsibility for Health & Safety Control Book ensuring that records are up to date and risk assessments complete.
  • To ensure that at all times a safe and secure environment is maintained through involvement in audit and acting on concerns.
  • To perform specific directed duties such as, cleaning body fluid/ waste spillages and general housekeeping duties.
  • To be familiar with and understand how to use the hospital radio system and personal alarm system.
  • To report to the nurse in charge any matter relating to the safety of the environment or any breach of security.
  • In conjunction with the Senior Staff nurse carries out relevant risk assessments, and ensures all staff are informed of same.
  • Bring to the attention of the Team Leader/Senior Staff Nurse any health, safety or security risks in work practises or the Skye Centre or specific activity centre environment. Report all accidents, incidents, or near misses and input incident data on Datix.
Working within a management framework
  • To work with the Senior Staff Nurse leading the team in the activity centre discussing work plans and priorities with the staff on duty, e.g. leading team meetings,
  • Provide day-to-day supervision and support to new and junior staff (e.g. students, rehab instructors band 3 & 4, nursing assistants, etc) within the Skye Centre.
  • In the absence of the Senior Staff Nurse the Senior Rehab Instructor assumes responsibility, informing visiting staff nurses of procedures and policies, and delegating activity to staff. When in charge of allocated projects or an activity centre, discuss work plans and priorities with the staff on duty.
  • Provide team members with one-to-one feedback and support. Review assigned work tasks and activities and assist team members to assess their own performance.
Training & Development:
  • To participate in all mandatory or directed training and development activities provided by the hospital.
  • In conjunction with the Senior Staff Nurse and Nursing Team Leader, participate in the NHS KSF process to ensure that this is completed in line with the hospital requirements. Assist team members to prepare for their KSF development review meeting (e.g. helping them to reflect on their performance and to identify any learning needs or additional support required).
  • Reflect on learning activities undertaken and evaluate their impact on own work. Give feedback on learning activities to line manager and colleagues (e.g. at team meetings, rehab instructor meetings, etc).

7a. EQUIPMENT AND MACHINERY

The post holder will be required to use the following equipment for the reasons stated:
  • Moving and Handling equipment to assist patient mobility (hoists, wheelchairs),
  • Cleaning equipment to ensure work areas are maintained and kept clean
  • Using the equipment in the kitchen (dishwasher) during social events
  • IT equipment to input and read information (learning related, organisation related).
  • All mechanical or electrical equipment used in work areas (fitness equipment,
woodworking machinery, kilns, gardening utensils e.g. spades etc,) Certain machinery
may require training.
7b. SYSTEMS
Information will be required to be input to the electronic patient record (RIO) recording daily progress notes.
Email messaging is the normal method of rapid communication within the StateHospital; the Rehabilitation Instructor will be expected to be familiar with this.
Required to be familiar with and use on a daily basis the Electronic Patient Moving Tracking System which records patient movement between Hubs and Skye Centre Activity Centres
Daily input into the Patient Activity Database which records the performance information for the Skye Centre.

8. ASSIGNMENT AND REVIEW OF WORK

Plan, organise and manage own workload, without direct supervision, including dealing with competing demands, and prioritising activities in accordance with service needs. Ensure work tasks/activities are completed on time and to a high standard.
Communicate problems/issues around workload to the appropriate person (e.g. Team Leader, Senior Staff Nurse) so these can be appropriately dealt with and resolved.
The post holder is expected to show initiative and to introduce new activities to their patient groups in consultation with their line manager and team.
9. DECISIONS AND JUDGEMENTS
The post holder will regularly be required to make judgements involving a range of facts or situations, which require the analysis or comparison of a range of options e.g. evident through the design, planning and implementation of appropriate programmes of therapeutic activities for individual patients and groups. The patient involvement and progress in this will be analysed and reviewed by the post holder and modifications made if required.
Decisions will be made by the post holder on a day to day basis as to whether patients or other staff are able or competent to utilise any equipment within their Centre e.g. specialised training to use woodcraft machines.
The post holder in conjunction with the Senior Staff Nurse, will make joint decisions regarding allocation of patient placements.
The post holder is expected to show an understanding of basic financial, budgetary, procedural and
resource implications when planning any new activities e.g. taking into consideration standing
instructions related to Trading Accounts or costs attached to patients’ formal learning opportunities.

10. MOST CHALLENGING/DIFFICULT PARTS OF THE JOB

To maintain a positive attitude towards the care of patients when challenged by negative behaviours from patients
To motivate patients to engage in therapeutic activity when challenged by the negative effects of
mental illness such as lethargy, poor motivation and lack of insight.
11. COMMUNICATIONS AND RELATIONSHIPS
  • The post holder will be expected to communicate effectively with patients, staff, professional visitors, relatives and carers, external and internal suppliers.
  • Providing and receiving complex clinical and security information to/from other staff (e.g. nursing, Rehab colleagues, members of the MDT, social work, security staff, etc) relating to patient care and treatment planning, historical information related to offending behaviour and/or operational issues which may be of a sensitive nature.
  • Engaging and interacting with patients and carers (e.g. about their care and treatment, well-being, etc).
  • Motivating/instructing/guiding/negotiating with patients engaged in activity
  • Providing advice, guidance and support (e.g. to patients, carers and staff)
  • Be alert to potential barriers to effective communication (e.g. noise; lack ofprivacy; different levels of knowledge and experience; literacy and numeracydifficulties; dyslexia; sensory impairment; mental/emotional state; intellectualimpairment; mental health issues; cultural differences; first/preferred language,etc).
  • Adapt the style and form of communication used to meet the needs of therecipient(s), and take steps to manage barriers to communication (e.g. speak in aclear and concise manner; adopt an empathetic approach; keep noise levels to aminimum; ask question to clarify understanding; offer reassurance whereappropriate; use de-escalation techniques to manage anger/aggressionUse communication aids to address barriers to communication where required (e.g. interpreters; large print learning materials; hearing loop; pictures/diagrams, etc).
  • Deal sensitively with confidential issues and with people who have communication difficulties. Many of the patients within the hospital have difficulty with communication; the post holder will be expected to be familiar with both verbal and non-verbal communication methods.
  • To liaise with carers providing information that is in line with clinical and security standards in order to facilitate off ward visits in the Skye Atrium or other social functions within the Skye Centre i.e. planned Patient and Carer social programme
  • To report any concerns to the nurse in charge.
  • Maintain confidentiality and ensure that records and reports are created, shared and stored in accordance with policies, procedures and legislation (e.g. Data Protection Act; Caldicott Guidelines; IT policies, Health Care Support Worker Standards).

12. PHYSICAL, MENTAL, EMOTIONAL AND ENVIRONMENTAL DEMANDS OF THE JOB
The StateHospital is a high secure mental health working environment that cares for individuals detained under mental health and related legislation. Patients detained are considered to pose a grave and immediate danger to themselves and the public. Working at The State Hospital involves being subjected to searching and security procedures, responsibility for keys, and working in a restrictive, locked environment.
Exposure to physical and verbally aggressive behaviour of patients and carers.
Physical demands:
  • There is a frequent requirement to exert intense physical effort throughout the period of work, e.g. responding to emergencies in another area of the hospital or being involved in the physical restraint of a patient.
  • There is a requirement to respond to serious and emergency incidents and support efforts to manage them.
  • There is a requirement to undertake relevant Level 2 PMVA mandatory training and engage in the management of violence and aggression.
  • Occasional driving of vehicles outside the hospital with a patient and other staff as passengers. This requires sustained levels of concentration and observation beyond normal daily demands.
  • Occasional driving of hospital minibus internally to escort patients to and from the Hubs & Skye Centre.
  • There is an frequent requirement to exert moderate physical effort for several short periods whilst working in activity centres, e.g. lifting loads of up to 10kg, digging and carrying out gardening tasks, moving transferring shop stock etc
Mental demands:
  • There is a need for constant awareness of security procedures including searches, patient movement restrictions, special observations levels and emergency procedures.
  • To take responsibility for leading group interventions during which individual patients can present as challenging and aggressive resulting in interruptions and modifications being made to the chosen activity.
  • The use of tools and sharp implements increases the possible severity of an incident, should one occur, and the post holder has the responsibility of checking these tools regularly throughout the day, the monitoring of them while in use, and the mental demand and constant risk assessment to maintain safety and security while providing therapeutic activity.
Emotional demands:
  • Frequent and prolonged exposure to highly distressing or highly emotional circumstances, due to the backgrounds and presentations of many of the patients i.e. verbal and physical aggression. This can present exceptional challenges both in working with the patients and their carers, and in managing personal emotional responses to the work.
Environmental demands:
  • There may be frequent exposure to verbal and physical aggressive behaviour from patients and carers, and the risk of being assaulted by a patient.
  • There will be a frequent requirement to work in areas with exposure to highly unpleasant working conditions. These will include body fluids and soiled linen e.g. patients may be incontinent, become physically sick

13. KNOWLEDGE, TRAINING AND EXPERIENCE REQUIRED TO DO THE JOB

  • The post holder will be qualified to HNC level or have relevant technical/educational qualificationssuch as City and Guilds or SVQ,
  • The post holder will have a minimum of 2 years experience working in a relevant NHS or Third Sector environment and have experience and knowledge of leading groups and motivating patients to participate in chosen activity.
  • Ability to lead a team of Rehabilitation staff.
  • Motivated and committed to work with patients.
  • Responsible and caring attitude.
  • Effective communication and positive interpersonal skills.
  • Ability to give verbal reports or written reports to enable accurate recordings of patients needs.

14. JOB DESCRIPTION AGREEMENT
A separate job description will need to be signed off by each jobholder to whom the job description applies.
Job Holder’s Signature:
Head of Department Signature: / Date:
Date:
STATE HOSPITALS BOARD for SCOTLAND
PERSON SPECIFICATION:
Senior Rehabilitation Instructor – Gardens & Animal Assisted Therapy
Attribute / Essential / Desirable
Qualifications /
  • The post holder will be qualified to HNC level or have relevant technical qualifications such as City & Guilds or SVQ level 3 in the area of Animal Care & Welfare or be able to demonstrate relevant knowledge and experience in this area.
  • Assessor award and have knowledge and understanding of the units to be delivered

Experience /
  • A minimum of 2 years experience working in a relevant NHS or Third Sector environment and have experience and knowledge of leading groups and motivating patients to participate in chosen activity.
  • Practical experience gained in delivering these skills to others within learning or training environment
  • Experience of working in a horticultural environment.
/
  • Experience working with patients in a secure environment
  • Experience of working with and caring for animals in a therapeutic or agricultural environment

Skills and Abilities /
  • Motivated and committed to work with patients.
  • Responsible and caring attitude.
  • Effective communication and positive interpersonal skills.
  • Ability to give verbal reports or written reports to enable accurate recordings of patients needs.
  • Ability to meet objectives

Knowledge /
  • Awareness of Mental Health issues
  • An understanding of Human Rights
  • Legislation relating to The State hospital

Personal Qualities /
  • Sense of humour
  • Warm and friendly
  • Assertive
  • Ability to both challenge and support appropriately to the situation or scenario
  • To maintain dynamic and innovative approach and to delivery a high quality of service to our patients

Senior Rehabilitation Instructor