Occupational Therapist / Lead professional | Central and North West London NHS Foundation Trust

You will manage a caseload of older clients with complex, severe and enduring mental health needs (including functional and dementia) in the community. You will provide a specialist assessment to meet the needs of individuals referred to the Older Adults Community Mental Health Team, taking into account risk and clients' strengths, in order to protect their rights and promote their inclusion, independence and interests.

The service is co-located with the Westminster City Council mental health team to provide a holistic service to our client group. Additionally, we are part of the CNWL project in the implementation of Open Dialogue, an innovative person-centred and recovery-oriented model of crisis and continuing mental healthcare. There is a 0.6 wte OT and 0.4 wte care coordination split, depending on service demands. You will use evidence-based and recovery principles to assess, plan, implement and evaluate treatment offering a variety of therapeutic interventions.

You will participate in the duty system along with other members of the MDT, carry out initial assessments and attend all relevant clinical reviews. You will provide support and advice to clients, carers and other professionals on mental health issues relating to older people and work closely with primary care and statutory agencies. You will supervise students on placement and junior staff in the team as appropriate. They will contribute to the learning and development of themselves and others.

MAIN DUTIES

• To act as lead professional for individuals in line with mental health transformation agenda as appropriate to CNWL Trust policy, managing a defined clinical caseload of service users with complex mental health problems living in the community.
• To carry out holistic mental health assessments, assessing needs and risks of services users, carers and their families following referral to the service.
• To conduct holistic and specialist occupational therapy assessments using relevant tools, treating each person as an individual and respecting their views and wishes.
• Plan and implement a range of therapeutic interventions and measure the outcome of these.
• To work in partnership with the primary care team, local authority, statutory and voluntary agencies to maintain the health and well-being of older people with complex mental health problems.
• Together with service users and carers plan appropriate interventions and support plans to meet their needs, maintaining independence and making the most of their living environment.
• To participate in the duty service of the Older Adults CMHT.
• To supervise band 5 occupational therapist in the OA CMHT if required.
• To act as practice placement educator for OT students and to participate in the training of students from other disciplines and support staff.
• To maintain own continuing professional development in accordance with HCPC guidelines and CNWL policies and procedures.

The Westminster Older Adults and Health Ageing Community Mental Health Team is a dynamic multidisciplinary service providing mental health support to older adults in Westminster with functional disorders and dementia. It is co-located with the Westminster City Council mental health team, offering a holistic approach to care. The team is also involved in the CNWL Open Dialogue project, which promotes person-centred recovery-oriented care.

The team operates using a case management, intervention-led and recovery-focused model, offering multidisciplinary assessments and interventions for service users with complex needs, as well as their families and carers. Regular multidisciplinary meetings facilitate case discussions, initial assessments, and reflective practice. A key feature of the service is the integrated older adults home treatment team, which delivers intensive support, crisis management, admission prevention, and helps ensure timely hospital discharges. The CMHT and HTT teams collaborate closely, offering a responsive and flexible service to meet the needs of service users. Coordination with older adults’ inpatient services allows smooth transitions of care.

The service promotes a friendly, respectful work environment where staff receive professional development, including supervision and appraisals. Involvement of service users and carers is a core element of the service’s design and delivery.

To undertake holistic assessments of service users utilising risk assessment tools and mental state examination in order to provide a high standard of care to service users in the community. To clinically manage a defined caseload of service users with complex mental health problems in a community setting including service users and in line with the Mental Health transformation agenda.

To formulate individualised Care Plans that include recovery goals, with service users and their carers which aims to address their psychological, physical, spiritual & social needs. To deliver appropriate therapeutic interventions to service users utilising a range of evidence-based therapies e.g. graded activity, anxiety management, and problem-solving techniques.

To respond to urgent and unplanned clinical events involving service users known to the CMHT and on own clinical caseload, utilising analytical and problem-solving skills to ensure the situation is managed effectively. To have an in-depth understanding of mental health pathology to manage service users with complex mental health problems.

To monitor service users who are being treated with psychotropic medications, observing efficacy and monitoring any adverse reactions. To report and act on any adverse reaction observed in conjunction with the General Practitioner or Consultant Psychiatrist, as appropriate.

To alert the line manager to any increase in risks to individual service users on a regular basis or immediately as required and seek advice on appropriate action. To be aware of and sensitive to the safeguarding needs of the client and those associated with them. To have an understanding of potential indicators of abuse or neglect and about what to do if they had concerns.

To regularly attend and participate in CMHT clinical reviews. To have a sound understanding and knowledge of current legislation and its application to service users with mental health problems e.g. Mental Health Act, Mental Capacity Act, Care Act, Human Rights Act, Freedom of Information Act, and Data Protection Act.

SUPERVISORY & MANAGEMENT RESPONSIBILITIES:

• To participate actively in clinical supervision, as well as in management supervision and annual appraisal with line manager, and to pursue further professional development and training appropriate to the age range covered by the team, according to a Personal Development Plan and the requirements of the professional body.
• To maintain up-to-date knowledge through networking, training and reading, and to comply with professional requirements for the maintenance of professional registration.
• To act as practice educator for occupational therapy students on placement and support the learning of other students in the team. If appropriate provide line management to junior staff or support workers providing regular supervision and annual appraisal.
• To participate in, and occasionally take responsibility for the recruitment of junior staff.
• To deputise for the Senior Practitioner as needed.
• To provide treatments interventions and plan support plans within the resource limitations.
• The post holder will take action to ensure that the team’s expenditure is within budget parameters by notifying line manager of situations where costs may upscale.
• The post holder will ensure that all financial transactions are authorised and recorded in line with Departmental and/or Trust procedures.
• To assist as required and in the development of the CMHT service in accordance with research and evidenced based practice to ensure a modern and exemplary service is delivered.
• To assist the CMHT management in developing processes that prevent inappropriate admissions, facilitate timely discharge and provide appropriate mental health care and support to service users and carers within the community.
• To engage with service users, carers and other agencies advocating for these groups to ensure they are fully involved in service evaluation, monitoring and development.
• To promote user empowerment, carer involvement and anti-discriminatory practices in the delivery of mental health care, at all times.
• To keep abreast of changing occupational therapy clinical practice and mental health practice, new developments, evidence-based practice and research.
• To continue to build on a culture of shared learning and evidence-based practice.
• To ensure timely booking and attendance of mandatory and statutory training. Failure to do this may preclude further learning and development opportunities.
• To participate in local and trust wide OT service and activities that promote and contribute to the building of knowledge and evidence base for the benefit of the professional body of occupational therapy e.g. participation in clinical networks.
• To maintain a professional knowledge base and act as a resource to others regarding specialist areas of expertise i.e. occupational therapy, health promotion, recovery and social inclusion.
• To participate, along with other members of the CMHT in audit, Quality Improvement and research activities that contribute to improvements in the delivery of care within the CMHT.
• To ensure that own professional practice is maintained in accordance with guidelines from relevant professional body, local procedures and CNWL policy.
• To adhere to all policies and procedures in the prevention and management of areas of risk e.g. Risk Management, Fire Safety, Health and Safety, Lone Worker policy.
• To maintain effective communication links with CMHT team members and relevant external agencies ensuring that service users receive high quality and coordinated service.
• To maintain up-to-date clinical records and documentation in line with the CNWL policy and professional guidelines. Producing detailed occupational therapy reports as required.
• To have a high level of interpersonal and communication skills to deal with a range of highly sensitive and emotive situations e.g. dealing with crisis situations or high expressed emotions from service users and their carers.
• To develop and promote effective communication and liaison with GPs, other primary care professionals, Social Services and voluntary organisations.