Job Description

To provide support and work directly with people with learning disabilities in their home, including working with their families and Care & Support providers To provide day to day clinical support to any current or future LD team members To ensure all practice is based upon the principles of Valuing People, rights, independence, choice and inclusion To work with the individual, their carers and members of the multi professional team in the formulation, implementation and review of a person-centered care and support plan. This will include risk assessments and management plans that will outline the support the individual requires to continue to live successfully within the community To undertake learning disability health checks on all patients on the learning disability register aged 14 and above on an annual basis To identify any training needs required for carers -family and providers- and when appropriate contribute to the delivery of this training to enable them to be successful in supporting the service user and to meet their individual needs To promote the health needs of the individual and provide health facilitation support to them, this will also include completion of annual learning disability health checks and supporting them in the development of quality health action plans To support the mainstream services to ensure the delivery of good quality general health care to people with learning disabilities To liaise with, train and support the PCN team to better meet the health care needs of people with learning disabilities To work closely PCN GP practices, both GP and practice staff, in raising awareness of the health needs of people with learning disabilities To support the individual in attending their GP to ensuring that they receive an annual comprehensive health check To support the individual to attend health appointments as required and to provide information in an accessible format regarding and prescribed treatment To support the individual with their prescribed medication, to assist them with any changes to their medication and provide a monitoring role; to report any concerns on behalf of the individuals back to the GP/-Consultant To provide support, monitoring and advice to individuals who have epilepsy To oversee and coordinate care for individuals under the Care Programme Approach, ensuring adherence to relevant policies, and to take responsibility for managing the care of those assessed as eligible for Continuing Healthcare To undertake a care management role when it has been identified most care required is health care and it is felt that there is an added benefit to the individual for a nurse to undertake this role. This will include co-ordinating meetings to review the quality and delivery of care To undertake carers assessments to ensure all needs are met to enable them to support their relative and ensure any unmet needs are highlighted To ensure compliance with the Policy in the Protection of Vulnerable Adults and ensure all practice actively helps safeguard vulnerable people. This will include reporting any issues of concern as laid down in the policy and contribute to the development of adult protection plans To prepare and review the effectiveness and progress of the care plan with the individual and others; to initiate any action that may be required to assist them in achieving their choice To provide advice, which includes both clinical and management strategies, regarding the management of individuals who are exhibiting challenging behavior To organize and lead group work with people with learning disabilities, this may include issues such as anxiety management and healthy living To participate in reviews, preparing reports for the multi-agency meetings.



To maintain a high standard of record keeping and case notes in line with NMC guidelines To be aware of the implications and responsibilities relating to the Mental Health Act -1983- 1.32 To ensure compliance with the Mental Capacity Act To ensure that all care plans have been developed within the guidance of the Mental Capacity Act and where appropriate to involve advocacy To undertake comprehensive nursing assessments, behavioural assessments, and any other assessments appropriate to the individual To work closely with staff within the community teams and care and support providers to ensure a person-centered approach is always maintained To liaise with members of the multi-agency teams, attending and contributing at reviews or meetings and communicating appropriate information as required To ensure that any information provided regarding any aspect of their care is available in an accessible format when required To undertake comprehensive nursing assessments, behavioural assessments, and any other assessments appropriate to the individual To interpret and understand behaviour to develop individual care packages