The Plymouth Dementia Pathway is operated by a small, specialist multi-disciplinary team including: Consultant Psychiatrists, Clinical Psychologist, Dementia Nurses, Occupational Therapists, Physiotherapists, Community Care Workers, Dementia Advisors, and Administrative Staff/Medical Secretaries. The Plymouth Dementia Pathway will be growing and evolving in order to improve assessment, diagnosis, and care for people with dementia and their relatives/carers. This includes timely and equal access to services, provision of evidence-based treatment, monitoring, and follow-up.
Professional Responsibilities & Patient Contact:
The Post-holder will:
1. Be accountable for the direct patient care/support provided by the Plymouth Dementia Pathway at all times.
2. Maintain high standards of clinical/professional care/support of people with dementia, their family/carers.
3. Work as part of a MDT to ensure that the best possible outcomes are achieved for the person with dementia and their family/carer.
4. Have responsibility for own caseload of patients and take responsibility as lead professional or care co-ordinator as appropriate.
5. Identify and undertake specialist and comprehensive assessments to assist in the diagnosis of people suspected of having dementia including: life history, social and family circumstances, preferences, physical and mental health needs, and current level of functioning and abilities.
6. Inform the person with a suspected dementia and/or their family/carer about the assessment and diagnosis process.
7. Take steps to obtain patient consent to care and treatment in accordance with the Mental Capacity Act.
8. Promote a recovery model that empowers people with dementia and their family/carers to be at the forefront of decision-making.
9. Assess the effectiveness of medication prescribed for the symptoms of dementia and report observations back to the prescriber as required.
10. Advise on, recommend, and provide a range of effective evidence-based treatment and intervention plans at all stages of a person's dementia journey.
11. Promote and maintain independence of people with dementia by addressing activities of daily living.
12. Re-assess people with dementia where there are changes in emotional well-being and behavior.
13. Promote least restrictive practice, maximizing independence and freedom.
14. Undertake risk assessments and implement action plans.
15. Be responsible for decision-making and co-ordination in crisis situations.
16. Complete Social Circumstances Reports and attend Mental Health Act Tribunals as required.
17. Work with staff on the psychiatric inpatient unit to support discharge planning.
18. Recognize end-stage dementia and liaise with specialists within the end-of-life care team.
Communication and Working Relationship Skills:
The Post-holder will:
1. Communicate clearly and effectively with people who have dementia, their family/carers, and other professionals.
2. Be confident in communicating with people who have difficulties when English is not their first language.
3. Demonstrate a positive attitude, attending to people with dementia and their family/carers with respect and courtesy.
4. Receive information, analyze and formulate professional judgments.
5. Manage conflict between individuals as required.
6. Ensure that professional boundaries are always adhered to.
7. Collaborate and plan individual care with other teams and services.
8. Attend and represent the Plymouth Dementia Pathway in meetings.
9. Participate in various forums/steering groups within the organization and community.
Knowledge and Experience:
The Post-holder will:
1. Have experience of working in partnership with people with dementia and their family/carers.
2. Have sound knowledge of dementia including risk factors, signs, symptoms, and types of dementia.
3. Be aware of the assessment and diagnostic process for dementia.
4. Understand treatment options for people diagnosed with dementia.
5. Adhere to Policy and Legislation relating to Dementia/Mental Health.
Planning and Organisational Skills:
The Post-holder will:
1. Support the meeting of targets and provide information regularly.
2. Ensure team members are allocated in accordance with their skill mix.
3. Prioritize and delegate accordingly.
4. Attend multi-disciplinary meetings for the protection of people with dementia.
5. Contribute to the planning and implementation of service developments.
Analytical and Judgement Skills:
The Post-holder will:
1. Support in the triage of referrals to the Plymouth Dementia Pathway.
2. Provide dementia care in the setting most appropriate to meet patients' needs.
3. Take a lead role in crisis assessments.
4. Report incidents of harm or near misses in line with policy.
5. Support in the investigation of complaints and review untoward incidents.
Service Design and Improvement:
The Post-holder will:
1. Act as a role model.
2. Participate in the development, implementation, and evaluation of strategies and service innovations.
3. Monitor and improve quality through compliance with NICE guidelines.
4. Empower team members to participate in implementing change.
5. Provide expert professional advice regarding clinical care and practice.
6. Support in the development of the workforce.
7. Provide mentorship for students and other staff.
8. Work with the Team Manager in the recruitment and selection of staff.
Job description continued on attached document.
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