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Job description

The aim is to provide a service specific to individuals within the local authority catchment. The role will include a range of activities addressing individual health and well-being, the development of pathways into specialist services, training of hostel staff to manage residents out of hours, and improving the overall health inequalities via;

• Health promotion
• General Health Screening
• Engagement in Primary Care services and facilitating access to organised healthcare
• Management of substance use and addiction disorders

The purpose of this role will be imperative in improving integrated pathways to prevent fragmented services that are efficient and effective. The role is specific to support those to improve health outcomes, especially for those who continually consume alcohol where traditional structured treatment will not be appropriate. The role will require a peripatetic nurse-led general health clinic within hostels, supported through general practice.

The collective aim of the service 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 well-being.

We seek an experienced nurse to lead a multidisciplinary team to help engage with the homeless, difficult-to-reach population who use drug and alcohol to help engage in community-based treatment to secure long-term accommodation.

The role will be part of the New Beginnings Addiction service based in Brent, predominantly community-facing, working in sites across the Borough.

You must be a registered nurse (RMN/RGN), experienced in addiction psychiatry, 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

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.

The service is committed to a harm minimisation philosophy and to partnership working. Our main partners are primary care services, social and the third sectors.

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.

• To provide specialist drug and alcohol outreach clinics for local hostels, homeless individuals and organised health services in the local authority catchment.
• 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 assessment including blood glucose and urine multistix tests. 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 including a review of systems to include, neurological, cardiovascular, respiratory, gastrointestinal, hepatic, renal, lymphatic, reproductive health and musculoskeletal.
• 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.
• To be the single point of contact for Primary care services, local Hospitals and other organised health care services.
• Identify and refer dependent drinkers and those assessed to be in need of further input, into specialist alcohol services.
• To develop and provide a training package for those that work within the hostels on providing brief interventions and dealing with out of hours support.
• To develop and provide a training package for primary care services, including other local hospitals and other organised health services.
• 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
• 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, Virology, 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 governance
• The post holder will work within CNWL’s Child Protection Policy and in partnership within all agencies responsible for ensuring compliance with the local Safeguarding Children’s 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 actively promote attendance at antenatal clinics for pregnant substance misusing women.
• To have a clear understanding of the Models of Care and Working Together to Safeguard Children documentation, its application and implementation in the case management of own key working clients.
• 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