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Job description

This is an ideal role for an experienced dietitian, to join the established physical health team supporting Service Users across the forensic directorate.

Your role will be to support Service Users with nutrition or hydration needs, whether that is related to risks of malnutrition, dehydration, disease or weight management.

You will be working as part of a physical health team made up of dietitian, health and fitness practitioners, nursing, Physiotherapy and speech and language therapy who collectively work together to ensure the physical health needs of the forensic, adult mental health and learning disability inpatients are met.

You will be working two days per week across the Forensic mental health inpatients and learning disability ward. These services are based across two sites in Stafford and Shrewsbury. This can be delivered either by face to face contact or remote working.

You will possess excellent communication skills, clinical reasoning and take responsibility for a complex caseload of service users with nutritional needs requiring a Forensic admission.

What we can offer you:

• Supervision
• Flexible and home working
• Clear and robust AHP governance structures
• Self-directed professional development with in - house and external training
• Regular specialist meetings across the Trust
• Promote innovations locally and nationally.
• Evidence based practice, outcome measures, audit.

You will lead the implementation of a highly specialist dietetic service to adults during their inpatient mental health admission. Identifying and managing nutritional risk and supporting and training staff where identified as a need. This involves working with patients and multi-disciplinary team (MDT) to identify and address the psychological, physical and social factors that may affect compliance with dietary treatment.

To be an integral part of the multidisciplinary teams, delivering intensive support to people and their families. Provide nutritional advice, education and training to nursing staff, doctors, dietetic students and other health care professionals and clinical supervision to dietitians working within the in- patient mental health services in other areas of the Trust where identified as appropriate.

Midlands Partnership NHS Foundation Trust is an award winning organisation with over 9000 employees. We are one of the largest integrated Health and Social Care providers, covering services across North & South Staffordshire, Shropshire, Hampshire, Buckinghamshire, Isle of Wight and Essex.

We pride ourselves on the services provided to support with the well-being of all of our employees both physically and mentally and offer counselling support and lifestyle information. Opportunities for flexible working are also available depending on the role.
We encourage career development provided by in house training programs and coaching support.

Demonstrating our strong commitment to equality, diversity and inclusion, and in context of our objective aligned to the growth of diversity across the workforce; we are particularly seeking applications from individuals who may be from under-represented groups, such as black, Asian or other ethnic groups, individuals with a disability, or LGBTQ+ individuals who meet the specific criteria.

We are embedding values based and inclusive recruitment practices to ensure that all applicants, from any backgrounds, have an equal chance of success in achieving a role with us.
Main duties and responsibilities (Clinical): • Ensure the delivery of highly comprehensive Dietetic assessment, interventions and evaluation across MPFT forensic In patient services.

• Work flexibly across all in patient forensic wards with diverse presentations and complex multi-pathologies, including people with cognitive impairment.
• Demonstrate high personal standards in clinical practice.
• Use advanced clinical reasoning skills and judgements to inform recommendations regarding appropriate actions/sign posting in consultation with multi-disciplinary in patient staff in accordance with the service specification.
• To ensure interventions are provided in line with NICE Guidance, British Dietetic Association (BDA) guidelines including other relevant local and national documentation. Responsible for prioritising workload, allocation of work to oneself and other staff, and to cover all levels of priority of work within the service.
• Use a range of evidence based dietetic assessments tools, e.g. anthropometric measurements, growth biochemical data, specialised nutritional calculations (e.g. artificially fed service users etc.), computer packages, e.g. nutritional analysis (including data input and interpretation or results), questionnaires, observations, discussion groups etc.
• Plan, advice and support delivery of the dietetic intervention, including gaining valid informed consent. This may involve use of clinical reasoning, education, persuasion and counselling skills, motivational interviewing and behaviour modification techniques, calculation of nutritional requirements and recommending prescriptions of ACBS products.
• Request supplies of diet sheets and other educational literature, nutritional supplements and other equipment.
• Work autonomously for a designated caseload as agreed with operational lead. This may involve working as a lone practitioner without the direct/ immediate support of colleagues. In more complex cases, there will be increased use of investigative and analytical skills to identify the most appropriate intervention.
• Be professionally, legally responsible and accountable for all aspects of own work, including the management and organisation of own work area and/or service user caseload (according to clinical priority, available time and resources).
• Complete and contribute, where appropriate to robust risk assessments and risk management plans.
• Lead the management of a complex caseload, which includes specialist assessment (within service specification), care planning in conjunction with service user and carer, evaluation of individual treatment plans (Care Programme Approach). Attend clinical meetings as appropriate to facilitate a safe and timely discharge into a community setting.
• Provide cover for members of the MPFT dietetic team during periods of absence.
• Knowledge of national, regional and local drivers underpinning service delivery including the provisions of the Mental Health Act 1983 (revised 2007) regulations including Mental Capacity Act (2005), BDA Guidelines.
• Up to date knowledge and experience of clinical developments in Adult Mental Health.
• Adhere to BDA, HCPC Professional Code of Practice , Standards and Guidelines, and understand how to raise concerns if poor practice is witnessed
• Implement highly developed physical skills pertinent to the area of specialism, for example manual handling, computer and keyboard skills, health and safety, de-escalation skills and driving
• Actively maintain and demonstrate an up-to-date knowledge of national guidelines, standards, legislation and professional developments in current methods in the treatment of client’s conditions within the specialism.

Education, Service Development, Research, administrative duties:

• Identify and highlight to the Line manager ( physical health team lead) and AHP Lead relevant issues in relation to the dietetics for people and their carers, assessed using best practice evidence, in order that these are reflected in service planning, development and future provision.
• Develop efficient and relevant health promotion activities to promote health education and ensure that preventative approaches and interventions are used to maintain independence
• As required, supervise junior staff; provide clinical advice/supervision support, leadership and professional supervision, in line with Trust Policies.
• Participate in staff appraisal and performance reviews as identified.
• Provide a learning environment to support students (multidisciplinary) undergoing training and assist new and junior members of staff, peers and other disciplines to develop professional competence.
• Lead on the development and delivery of dietetic inpatient mental health offering education and training to: clients, carers, families’ staff, students and other relevant organisations.
• Actively engage in the organisations clinical governance initiatives, for example to participate and lead in audit, clinical supervision and bringing critically evaluated evidence and research into practice.
• Participate and lead on research within area of clinical expertise where possible to raise understanding and awareness of the benefits of dietetics and reducing the risk of harm.
• To contribute to collective leadership meetings, as agreed locally.

Systems and equipment:

• Ensure knowledge of assistive technology and equipment (e.g. use of tablets, Apps, one consultation) to maximise individuals opportunities to return to their own home where possible. To ensure up to date knowledge of other co-morbid physical conditions that may impact on an individual’s physical function and psychological function.
• Responsible for ensuring actions are carried out where safety alerts are issued..
• Maintain accurate contemporaneous records and other documentation relating to work with service users in accordance within Midlands Partnership foundation Trust Foundation NHS Trust Polices, legal requirement and Professional Code of Conduct.
• Record statistical data as required, using agreed information technology within the Trust utilise technology/equipment to record and input relevant and essential information in line with local and national policies/procedures.
• Although the post is ward based at The Redwoods, the post holder may require access to a vehicle for business purposes e.g. to attend meetings, and events.
• The post holder has a personal duty of care in relation to the safe use of equipment.

Decisions and judgements

• The post holder is expected to work independently on a regular basis. There is an expectation that they will receive managerial/caseload and professional (clinical) supervision on a monthly basis
• The post holder will be responsible for specialist dietetic assessments and care planning to meet identified needs working with a complex client group. Where identified they will be responsible for the delivery of interventions and recommendations or signposting/referring on to enable other service providers to meet needs where appropriate.
• Ensure vulnerable adult procedures are followed as per mandatory and statutory training.
• To lead recruitment, selection and induction of junior/support staff.

Communication and relationships:

• A wide range of multi-disciplinary team members, including Psychiatrists, Social Workers, Mental Health Nurses, Occupational Therapists, Physiotherapists, Speech and Language Therapist, Clinical Psychologists, Support Workers, Peer Support Workers AHP Assistants and administrative staff, to achieve a co-ordinated service to people with mental health problems within the inpatient environment
• Multi-disciplinary colleagues within the mental health inpatient wards, Community mental health pathways and acute hospitals and other care environments.
• Statutory and Third sector providers
• Midlands partnership NHS Foundation Trust Allied Health Professions/ Dietetic clinical networks for supervision, appraisal and professional support.
• The post holder will be expected to use a range of highly skilled communication skills to communicate with this range of individuals. This will include verbal, written, electronic and adapted communication techniques for individual needs.
• Due to the nature of the client group the level of communication competencies needs to be high to enable service users, carers and family to understand what information is being communicated. The situations in which communication takes places will be highly complex, emotional and sensitive which will require empathy, tact, assertiveness and excellent listening skills.

Physical demands of the job:

• The post holder will be expected on a daily basis to implement highly developed physical skills pertinent to the area of specialism, for example manual handling, computer and keyboard skills, health and safety, de-escalation skills and driving.
• The post holder will be expected to sit in a restricted position whilst undertaking assessments or whilst driving.

Most challenging/difficult parts of the job:

• Due to the complex and challenging nature of the client group there will be regular exposure to stressful and emotional situations. It is expected that the post holder is responsible for completing up to date risk assessments and to work closely with colleagues where risk management recommendations have been identified.
• There will be a requirement to undertake periods of intense concentration whilst carrying out assessments and delivering treatment to the client group.
• The post holder should use managerial and clinical supervision to ensure discussion and learning is developed when exposed to stressful and demanding situations.

The post holder will be exposed to potential incidents of violence and aggression from the client group.