Job responsibilities
To be professionally and legally responsible and accountable for all aspects of own working including management of patients.
2. To undertake nutritional assessment and identify treatment goals of referred patients, taking into account medical, social and cultural factors.
3. To provide nutrition support clinical leadership in providing a service to more complex clinical cases in care homes
4. To provide nutrition and dietary advice suitable for the patients medical, social and cultural factors which is evidence-based.
5. To take lead in providing expert dietetic advice to the multidisciplinary team (MDT) in MDT meetings. To liaise with all members of the team to advice on treatment and dietary management for patients with nutrition support needs, and their families and carers.
6. To make recommendations to the medical and care home teams regarding adaptation of medication regimes and nutritional supplementary feeds for the management of nutritional support patients based on interpretation of biochemical parameters and clinical signs.
7. To be responsible for the provision of an effective rehabilitation dietetic service for residents across Hillingdon care homes incorporating clinical and teaching work:
audit all homes for ONS prescriptions not initiated by a CNWL dietitian for clinical suitability, continuation, most cost-effective product, etc.
monitor patients on ONS.
train care home staff on use of fluid and food diaries in order to facilitate accurate assessment.
train kitchen staff and food first principles, enriching foods, menus and homemade milkshake recipes.
Train activity coordinators on food based activities to promote good nutrition and hydration in care home residents.
train care home staff on proactive prevention of constipation and promote reduction in automatic laxative use.
accept referral for other dietetic care needs eg wound healing, diabetes, weight reducing, gluten free, IBS, vitamin and mineral deficiencies.
support end of life care with regards to eating and drinking.
8. To ensure a high standard of clinical and professional practice.
Professional/Clinical Governance:
1. To assess the ability of individual patients to provide informed consent to treatment, working within a legal framework with those patients who lack the capacity to consent.
2. To undertake and document risk assessments as a regular part of the rehabilitation process, guiding the goal-setting process with the patients.
3. To maintain a high standard of clinical expertise by undertaking a variety of continuing professional development (CPD) activities throughout the year and maintaining a portfolio.
4. To keep up to date with clinical developments in the field of dietetics and to implement changes in clinical practice to the service, based on evidence based research and best practice information.
5. To participate in the planning and delivery of in-service training programmes to peers/junior staff.
6. To participate in the CNWL appraisal process.
7. To participate in the Hillingdon Community Healths clinical governance programme by undertaking a range of activities, including departmental audit work, contribution to service development, identification of clinical risk, and incident investigation.
8. To undertake the measurement and evaluation of own work and current practice through the use of audit and outcome measures to meet required KPIs.
9. To represent the service at multidisciplinary meetings so that care is coordinated, and rehabilitation issues form an integral part of case management.
10. To accurately record all assessments and interventions in dietetic records and nursing documentation (nursing homes) in line with Trust Policy and British Dietetic Association documentation Guidelines. To communicate in writing/electronically with other agencies as appropriate, e.g. GPs, district nurses, hospital dietitians, and other members of the MDT about patient care, complying with data protection laws.
11. To support new initiatives in accordance with national guidelines from Department of Health. To maintain contacts with professional bodies and special clinical interest group and quality governance protocols.
12. To participate in the individual development and performance review system.
13. To be fully compliant with all trust mandatory trainings.
14. To undertake management duties as required ensuring the co-ordination and smooth running and effective delivery of the community service.
15. To constructively participate in service meetings; including reviewing and presenting journal articles and preparing CPD sessions for the department and participating in service developments
16. To work as part of the MDT involved in strategic projects
Organisational
1. To ensure that accurate and evaluative records of patient care are maintained in accordance with service standards.
2. To maintain up to date electronic diary and outcomes of all appointments as required by the service and ensure that others do likewise.
3. To participate in the collection of statistical data and audit activity as required by the service.
4. To be aware of the Health and Safety aspects at work and follow trust policies as may be required including prompt reporting of accidents and ensuring safety of all equipment used, reporting faulty items and removing from service.
5. To plan, organise and prioritise patients caseload to meet patient need.
6. To organise appointments and maintain own diary.
7. To attend regular meetings within the service.
8. To work alone as an autonomous practitioner in the assessment and treatment of patient within the community evaluating treatment and managing clinical time effectively by caseload prioritisation to meet patient needs and balancing other professional demands.
9. To maintain effective links with medical colleagues, other allied health professionals, social services and voluntary services, to maximise patient care.
Communication/Training:
1. To communicate highly complex nutritional counselling to patients with differing nutritional needs, motivational skills are required to overcome patients/staff barriers to change.
2. To utilise developed communication and teaching skills to educate the diverse and multicultural population/staff with barriers to understanding.
3. To deliver formal and informal training to other health care professionals, including pre and post registration training for nurses. This will involve planning, delivering and reviewing the teaching/training sessions. To contribute to organising study days in conjunction with the Trust relating to nutrition and dietetics. To educate nursing/residential homes in the use and interpretation of the MUST nutritional screening tool.
4. To contribute to the training of pre-registration dietetic students including clinical supervision, organising specific visits and taking tutorial sessions.
5. To aid supervision of junior staff, facilitating their professional development and postgraduate learning.
6. To be actively involved in new staff/student induction programmes.
7. To act as a resource for specialist dietary information relating to
nutrition support and health promotion for Hillingdon community groups and other related interest groups.
8. To attend the regional groups for Dietitians in BDA specialist interest groups.
9. To be active in the development of resources and forward planning for the future dietetic service.
10. Any other duties required in connection with the work of the department as appropriate to the grade.
