Quality Assurance Manager

Job responsibilities

JOB DESCRIPTION

JOB TITLE:Quality Assurance manager

REPORTS TO:Quality Improvement Lead

REPORTED TO BY:N/A

MAIN RESPONSIBILITIES:

• Maintain and develop the Hospices compliance with care standards and all other relevant regulation and best practice guidance throughout its clinical and general operations

• The format and review of clinical and non-clinical policies to ensure compliance with relevant legislation

• To coordinate a holistic clinical and non-clinical audit process, including strategic standard setting, efficient measurement systems, robustfeedbackand the facilitation of action plans

• Act as Health and Safety Lead for the Hospice ensuring compliance with relevant Health and Safety legislation

• To provide quality assurance services to Rossendale Hospice as outlined in the service level agreement

• Senior Information Risk Officer (SIRO)

CORE TASKS

Clinical

• Ensure the Hospice delivers care in an effective, safe,responsiveand well led manner in conjunction with the Clinical Services Manager and Clinical Departmental Managers

• Work with relevant colleagues to develop new and review Hospice policies and procedures asrequired

• Maintain up to date knowledge of all relevant care quality commission standards and ensure these are reflected in Hospice practice and compliance activities

Management and Leadership

• Work closely with the Hospice senior management team (SMT) and all relevant professionals in ensuring that staff and volunteers deliverhigh levelsof service and care at all times

• Contribute to Lead and manage the on-going development of operational policies, procedures and clinical guidelines ensuring their implementation,reviewand monitoring.

• To be an inspirational leader who clearly expresses the hospice vision,valuesand service quality to team membersat all times.

• Sethigh standardsof quality and performance and raise the level of expectations

• Accept accountability for own actions and areas of responsibility

• Compile and present relevant reports to senior managers and Hospice committees asrequirede.g. Audit, Health & Safety, Service user experience

• Involve others in decision making and empower where possible

• To provide out of hours management on call cover

Communication Skills

• Foster good working relationships and effectively communicate with members of the multidisciplinary team, users of the service and other professionals working externally

• Workin accordance withHospice policies to ensure that confidentiality ismaintainedat all times.

Personal and People Development

• Accept responsibility tomaintainand update the skillsrequiredtofulfillthe job role

• Share knowledge and experience with other staff to improve and enhance patient care

• Encourage other staff to share good practice and knowledge

• Ensure that revalidation requirements e.g. NMC, HPC registration are fulfilled

Quality and Service Improvement

• Formulate and execute the Hospices audit schedule, ensuring that all relevant practice and activity is subject to verification against documented policy and procedures

• Ensure that any actions identified as part of the audit process are implement effectively

• Identifyareas for quality improvement and work with the Quality Improvement Lead and relevant staff to implement effectively

• Train and develop staff in clinical and general audit relevant to their job role, focusing on a team approach and encouraging ownership of compliance issues throughout the organisation

• Coordinate the reporting of adverse incidents, accidents, near misses, and errors ensuring that a log of all incidents ismaintainedand any actionsidentifiedimplemented effectively

• Oversee, and contribute as necessary, to the investigation of incident, accident and near miss reports

• Develop andmaintaina communications strategy for cascading relevant safety information e.g. CAS alerts, RIDDOR, ICO etc.

Health, Safety and Security

• Lead the Hospices Health and Safety function (including fire safety) across the organisation

• Ensure that the Hospiceis able todemonstratecompliance with all relevant Health and Safety requirements with particular emphasis on the documentation and maintenance of necessary risk assessments

• Ensure the completion of all risk assessments and implementation ofappropriate actionsas necessary

• Ensure new risksidentifiedare added to the organisational risk register and followed up

• Train and develop staff in health and safety relevant to their job role, focusing on a team approach and encouraging ownership of compliance issues throughout the organisation

• Assist the Clinical Services Manager with the coordination of the Hospice Prevention and Control of Infection Group and development of a strategy that promotes andmonitorsexcellent practice in relation to the prevention of infection

Governance

• Assist the Registered Manager in ensuring that the Hospice meets all necessary Care Quality Commission (CQC) Standards

• Ensure that all Hospice policies and procedures are compliant with relevant legislation and best practice guidance, documented and communicated effectively

• Ensure that Hospice policy and procedural documents are organised andmaintainedin a controlled manner

• Plan and execute a rolling plan for thetimelyreview and amendment of all relevant policy and procedural documents

• Support the Hospice senior management team in ensuring that the Hospice is compliant with all legislative and governance frameworks relating to use of computer systems to include compliance with the NHS Information Governance Framework

• Complete the annual NHSInformationGovernance Toolkitin a timely manner

• Ensure that the Hospice is compliant with the General Data Protection Regulation (GDPR)

• Ensure that Hospice policies, procedures and standards areadhered to at all timeswithparticular regardto those concerning confidentiality, information governance, health and safety, prevention and control infection and medicines management

• Ensure effective outcome monitoring of service delivery

This document is intended to convey an outline of the post and the post-holdersresponsibilities. You may be asked to carry out other duties relevant to your job role.

Disposition & attitude

Essential

• Evidence of an ability to work independently and as part of a team
• Demonstrate an understanding of information governance and confidentiality
• Positive attitude to change and flexible working practices
• A flexible and can-do approach

Qualifications

Essential

• RGN/Allied Health Care Professional qualification and registration (e.g. HCPC or NMC)
• Evidence of CPD and revalidation where appropriate
• Willingness to complete NEBOSH, fire safety and information governance training within first 12 months

Desirable

• Qualification in end of life/palliative care
• Leadership qualification
• Diploma and/or Degree
• NEBOSH (Health and Safety) Qualification
• Information governance training

Health & physical

Essential

• Good attendance record
• Ability to move and handle equipment
• Physically able to carry out risk assessments (e.g. Fire, Health & Safety) across all Hospice premises

Equal Opportunities

Essential

• To have an understanding of, and an ability to promote and implement equal opportunities

Experience

Essential

• Experience of leading multi-disciplinary team working and cross organisational collaboration
• Demonstrate, extensive experience of dealing with issues related to the implementation of high quality care
• Experience of developing implementing and monitoring policies, procedures and national guidelines and legislation
• Demonstrate experience in quality assurance, audit processes and service improvement
• Demonstrate experience of identifying problems, recommending and implementing solutions/change
• Experience in managing competing priorities
• Experience leading and coordinating health and safety compliance including risk assessments
• Experience of data reporting and analysis to identify trends, areas of concern and action planning.

Desirable

• Experience of working with cancer or other palliative care patients
• Experience acting as Senior Information Risk Officer (SIRO) or similar role

Practical Skills

Essential

• Strong leadership skills with the ability to motivate, guide and influence others
• Ability to lead and implement change
• In depth understanding of care quality
• commission standards and able to relate to practice
• Ability to participate in collective decision-making and responsibility
• Knowledge of relevant policies, procedures and legislation required for the role i.e. those relating to clinical governance, information governance, health and safety, infection control clinical quality and quality improvement
• Strong analytical, investigative and problem solving skills including being competent in presenting complex information clearly to different audiences
• Demonstrate excellent time management skills with the ability to priorities and manage multiple tasks effectively
• Ability to manage sensitive information confidentially and professionally
• Excellent communication and interpersonal skills
• High level organisational skills
• Computer literacy including use of Excel, Microsoft Forms, Sharepoint
• Full UK Driving Licence & car driver with access to own vehicle

Desirable

• Knowledge of palliative and end of life care practice

Circumstances

Essential

• Work shifts over 5 days Monday to Friday
• Occasional weekend and out of hours work
• Participate in the management on call rota

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).