Complex Outreach Nurse

Job summary

The aim of the service is to provide assertive outreach to adults who find it difficult to engage with the borough's wider substance misuse treatment service and reside in supported accommodation, temporary accommodation, or other council housing . Hospital role will include a range of activities addressing the individual health and well being to improve the overall health inequalities via;

Health promotion General Health screening- Dry blood spot testing, Hep B vaccination, ECG and Fibroscan Engagement in Primary Care services and facilitate access to organised health care Management of substance use and addiction disorders

The purpose of this role will be to improve integrated pathways of hard to reach service users in the community .

The collective aim of the role is to help those with a range of health needs including drug and alcohol to access the appropriate treatment, and to address the physical and mental health of homeless and hostel residents. The service will provide essential health promotion to increase the number of residents engaging with services to address their health and wellbeing. The post holder will provide clinical interventions with the aim of improving health outcomes especially for those who have substance use concerns where traditional structured treatment will not be appropriate. The role will require a nurse led general health clinics within hostels and council estates.

Main duties of the job

An exciting opportunity has arisen to join a new team operating in the community across the London Borough of Hounslow.

Comprehensive assessments that consider service user's support needs holistically and assess any relevant Harm reduction interventions including hepatitis B vaccinations, screening for Hepatitis B/C and HIV, offering needle exchange and safer injecting advice as well as referrals to sexual health, hepatology, and smoking cessation Brief interventions and extended brief interventions to support service users to reduce their harmful use of drugs and/or Where possible, referrals onto wider treatment services for further recovery support such as detox and recovery Clinics/drop-ins in communal areas of supported and temporaryaccommodation to provide service users wellbeing support and advice. the post holder will be expected to carry a caseload .

The role will be part of the (ARC) complex outreach team, but will be predominantly community-facing, working in sites across the Borough.

You will be a registered nurse (RMN/RGN), experienced in working within the community with a demonstrable ability to engage with hard to reach individuals to provide treatment, outside of structured treatment settings. You will have a range of therapeutic skills to engage with individuals as well as knowledge of dual diagnosis, physical health assessment and management.

About us

CNWL Addictions is a well-established NHS provider offering a wide range of high quality drug and alcohol treatment interventions to the diverse and multicultural population across Ealing, Brent, Hillingdon, Hounslow and Milton Keynes. In addition, we also have the tri-borough Club Drug Clinic as well as our National Problem Gambling Service.

Treatments are provided across all our clinical centres. Clinical Governance framework is well established and the service prides itself in its continuous development towards becoming a learning organisation.

The successful applicant may have contact with patients or service users. As an NHS Trust we strongly encourage and support vaccination as this remains the best way to protect yourself, your family, your colleagues and of course patients and service users when working on our healthcare settings.

Job description

Job responsibilities

To provide specialist drug and alcohol outreach clinics for local hostels and other services in the local authority of Hounslow. To work as a member of the multidisciplinary team in the management and treatment provision of a range of specialist services to problem drinkers and problematic drug takers including harm minimisation approaches, motivational interviewing, relapse prevention, ITEP care planning, individual intervention, general health assessment, wound assessment and management, injecting site assessment, lifestyle assessment and physical health assessments. The role includes using skills in mental health assessment and referral to appropriate mental health services and group work. To promote health and wellbeing and improve health inequalities by completing a range of health checks. To be able to assess residences general health and provide early intervention treatment, sign posting and referral to other organised health services. To develop and maintain pathways into specialist services to ensure the health and well-being of residents is met, including primary care services To promote engagement in Primary Care services and facilitate access to organised health care for residences. To sign post service users to the appropriate health care settings to meet their needs. Identify and refer dependent drinkers and those assessed to be in need of further input, into specialist alcohol services. To provide training for those that work within the hostels on providing brief interventions and drug and alcohol awareness. To assess continuously the psychological, emotional, social and rehabilitative needs of own clients/patients, taking into account the needs of family, local community and developing systematic plans for care and evaluation of treatment plans. To be able to assess and case manage clients who inject drugs, in particular assessing injection sites and be conversant with the precepts of harm minimisation. To use agreed and established Outcome Monitoring Tools (TOP) and any other relevant quality measures. To manage the transfer of individuals between agencies and services. To counsel individuals about their substance use, using motivational interviewing, relapse management and other evidence-based interventions, To provide clinical advice and support to other colleagues within the health care setting and to other agencies concerned with substance misuse. To be responsible for the safe and effective storage and administration of drugs, exercising responsibility for the custody and maintenance of statutory records of such drugs in accordance with the Trust Policies/Procedures on the supply and carriage of drugs in the community, example Naloxone. To ensure full risk assessments and risk management is delivered effectively. To undertake dry blood spot testing for BBV and urinalysis when required. To screen clients at risk of, or affected by, blood borne diseases and to plan and agree service responses according to needs. To provide education and to assertively promote Hepatitis A & B vaccination for clients who are at risk of contracting the virus. To administer Hepatitis B vaccination in accordance with CNWL Medicine Policies and Protocols. To provide pre and post-test discussion to clients screened for blood borne viruses in accordance with CNWL guidelines. To ensure the CNWL Hepatitis care plan is used for all clients. To actively promote attendance at the hepatology clinic for clients affected by liver disease. To collaborate with the individual Statutory, Non-Statutory teams, GPs, Primary Care Services, MINT, Chemical Pathology and Liver/ Gastroenterology Departments, and provide expert care without direct medical supervision, using clinical guidance documents and patient group directions as agreed by the Trust. To assist in the transfer of individuals between the Hepatitis Project and Hepatology/Gastroenterology and other relevant agencies To be familiar with the Trust and local Resuscitation, Infection Control and Needle Stick Injury Policies and Procedures. To attend mandatory yearly updates on CPR and Anaphylaxis training. To ensure an understanding and implementation of clinical and information governance. The post holder will work within CNWLs Child Protection Policy and in partnership within all agencies responsible for ensuring compliance with the local Safeguarding Childrens Board working practices. To prepare reports and attend client meetings such as professional net work meetings, Child Protection Case Conferences and Core Group meetings as required. To plan and agree service responses which meet the individual need and circumstances of clients at risk of, or affected by, substance misuse during pregnancy. To recognise the professional duty of care to protect where clients present a risk to themselves or others, and comply with statutory requirements regarding Safeguarding Children, Child Protection including the Children Act 1989 and Hidden Harm guidelines. To work within the harm minimization model. Assess risk behaviours of clients, provide information and implications of any risks identified on health and social well being and work with clients to address and modify risk behaviours to promote positive changes. Person Specification

Qualifications

Essential

RMN / RN Evidence of continuing personal development and post-registration training in the nursing care, assessment and treatment substance misuse clients.

Desirable

Diploma in Drugs and Alcohol Studies or equivalent qualification Training in Cognitive Behavioural Therapy Completed the Motivational Interviewing Training Module

Experience

Essential

Extensive post-registration experience in Mental or general Health Relevant previous post-registration experience of working with drug and alcohol users Experienced in the supply and administration of Hepatitis vaccines Experienced and competent in the supply and administration of CNWL Trust Hepatitis Patient Group Directions Extensive clinical experience Case management experience Experience in undertaking Risk Assessments and Risk Management Teaching and Assessing qualification ENB 998 / SLICE or equivalent eg: mentorship

Desirable

Community Nursing Experience Experience of working in and delivering services to injecting drug users Experience of teaching others and willingness to undertake Teaching and Assessing qualification within six months of commencing post.

Skills and knowledge

Essential

Sound clinical knowledge and understanding of current NHS policies and national drug issues/policies. Good verbal, written and presentation skills. Good interpersonal skills in order to communicate and negotiate effectively, both inside and outside the Trust. Ability to work independently and to prioritise effectively Ability to assess and treat people with dual diagnosis Evidence of effective leadership and organisational skills. Evidence of the ability to work in a changing and stressful situation. Evidence of ability to teach/disseminate knowledge and skills Ability to treat service users with respect and dignity at all times, adopting a culturally sensitive approach, which considers the needs of the whole person. Able to build constructive relationships with warmth and empathy, using good communication skills IT literate: competent using Microsoft Word and able to report clinical activity data on patient information systems.

Desirable

Experience of working with stimulant users and people with alcohol problems. Experience of group facilitation Experience of managing a caseload within the community Awareness/knowledge of research skills Awareness of counselling models Motivational Interviewing skills / Relapse Management skills

Attitudes, aptitudes, personal characteristics

Essential

Committed to multidisciplinary team work Committed to User involvement Flexible & responsive to a developing service. The post holder must have the ability to understand and implement the Equal and Diversity policy at a level appropriate to the job

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