Detailed job description and main responsibilities

• To provide specialist dietetic assessment and treatment programmes to adult patients in their own homes and intermediate care unit requiring nutritional support, including Home Enteral Tube Feeding
• To make a clinical judgment and explanation of nutritional status and to formulate individualised treatment plans and deliver appropriate interventions.
• To make recommendations to GPs on the appropriate prescribing of oral nutrition supplements and enteral feeds.
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• To provide training, support and guidance on nutritional screening and prescribing practices
• To contribute appropriately to Nutritional Support and Home Enteral Tube Feeding service development.
• To be responsible for own specialist caseload of clients who are at risk of malnutrition, malnourished or enterally fed and maintain associated records.
• To plan, implement and evaluate treatment and management programmes to ensure the identified needs of the individual are met at all stages of the rehabilitation process or disease progression. 
• To educate and advise patients, their families and carers in order to facilitate self-management of their condition and optimise their rehabilitation potential and quality of life.
• To support in the development of new initiatives within the trust.
• To be an active member of the multidisciplinary team working collaboratively with other members of the team and recognising the skills and expertise of others.
• To be proactive in personal professional development.
• To provide support and supervision to rehabilitation support workers and delegated under graduate students.
• To accept clinical responsibility for a designated caseload of patients and to organise this effectively and efficiently with regard to clinical priorities and use of time.
• To maintain clinical records as an autonomous practitioner.
• Work autonomously to provide dietetic advice to patients, their carers and staff with a range of medical conditions in service users home or intermediate care unit within agreed protocols and guidelines and with support from senior colleagues when necessary including:

• Carry out nutritional assessments (interpretation of biochemistry, anthropometrics, clinical condition and diet history) to determine the nutritional problem.
• Calculation of nutritional requirements, Development of treatment plans, Client centred goals and discharge planning including patients on artificial nutrition support.
• Prescription of dietary treatment and ACBS products for conditions where there are limited professional/clinical guidelines available

• To be clinically competent to give dietetic advice, treatment and dietary counselling to patients in their home and intermediate care or group settings.
• To communicate nutrition and dietetic information in an understandable form to staff, clients and carers, requiring negotiations, motivation and counselling skills including situations where there are barriers to understanding.
• Independently interpret complex clinical information and use professional judgement to adapt nutrition care plans in response to changing clinical conditions.
• Assess enteral feeding sites, identify clinical risks, and make appropriate treatment recommendations.
• Produce timely, high-quality reports and discharge summaries for relevant healthcare professionals.
• To work in conjunction with medical, nursing and other MDT colleagues as necessary to facilitate good communications in providing high quality patient care.
• To participate in the health promotion activities of the department.
• Ability to manage own time, deciding priorities for work and balancing other patient-related and professional demands
• To cover the work of colleagues during periods of absence or peak workloads.
• Adhere to professional standards, clinical guidelines, and confidentiality requirements.

• To work within the British Dietetic Association code of professional conduct and Health and Care Professions Council standards.
• To have a working knowledge of clinical guidelines relevant to Dietetics and to translate these guidelines into own practice.
• To actively participate in Personal Development Review by identifying key performance objectives and continuing education needs.
• To actively participate in clinical supervision sessions to identify and develop professional, clinical and service needs.
• To be responsible for gaining valid, informed consent to assessment and treatment interventions, sharing of information following legal and professional guidelines and to follow these guidelines in circumstances where clients do not have capacity to provide informed consent.
• To follow and implement Trust, departmental and professional policies, procedures, guidelines and standards within own work area.
• To be responsible for maintaining detailed and accurate client treatment records and appropriate safe keeping, ensuring confidentiality.
• To be responsible for documenting own professional activity, client activity data, health promotion, training and education data in accordance with departmental standards and trust standards.
• To be responsible for effective time management, meeting deadlines and responding to fluctuating workloads and organising, planning and prioritising clinical and non-clinical workload.
• Maintains an up-to-date knowledge of research findings and new practices within nutrition and dietetics, and apply this knowledge to improve practice.
• To participate in team meetings and other meetings as requested by service manager.

• To actively participate in the planning and delivery of the Community Adult Rehabilitation Service’s in-service training programme.
• To maintain own clinical professional development keeping abreast of new developments in practice, incorporating them into clinical practice.
• To provide teaching and supervision to Rehabilitation Support Workers, including annual appraisal and monthly supervision.
• To supervise, mentor and teach delegated undergraduate students of Dietetics on clinical placements, assisting in the appraisal of their performance and assist in the education of students of other professions.
• To attend relevant clinical educator courses to facilitate effective student education.
• To foster an atmosphere of learning within the service.
• To ensure Trust mandatory and statutory training requirements are maintained.

·       To manage a delegated caseload and work as an autonomous practitioner in the assessment and treatment of patients within the community, evaluating clinical practice and managing clinical time effectively by caseload prioritisation to meet service and patient needs and balancing other professional demands.

·       To maintain up to date electronic diary and outcomes of all appointments as required by the service and ensure that others do likewise.

·       To ensure that accurate and evaluative records of patient care are maintained in accordance with professional and service standards.

·       To participate in the collection of statistical data and audit activity as required by the Manager of the Community Adult Rehabilitation Service.

·       To be aware of Health and Safety aspects at work and follow trust policies as may be required including prompt reporting of incidents and ensuring safety of all equipment used, reporting faulty items and removing them from service.

·       To attend regular meetings within the Community Adult Rehabilitation Service.

·       To maintain effective links with medical colleagues (in the Acute Trust and GPs), other allied health professionals, local authority professionals and voluntary services to maximise patient care.

·       Undertake the supervision of support workers to ensure the smooth running of the service.

• To communicate effectively with the Manager and colleagues within the Community Adult Rehabilitation Service, patients, relatives, GPs, other health and social care professionals, students and other involved agencies.
• To use a range of verbal and non-verbal communication tools to communicate effectively with patients to be able to negotiate, persuade and motivate in order to gain co-operation with treatment programmes, gain informed consent, progress and maximise the effectiveness of treatment and support patients in self-management of their condition.  There will frequently be cases where there may be significant barriers to understanding such as cognitive impairment, behavioural problems, hearing difficulties, denial, memory loss, emotional problems, speech and language impairment or where English is not the first language.
• To provide structured and spontaneous advice to patients, family, carers or other professionals to promote an understanding of both the condition and relevant therapy.
• To liaise with referring practitioners and other professionals involved in patient care in the best interests of both the patients and the service including the provision of written reports.
• To attend and actively participate in the relevant meetings, conferences and events related to patient’s health and care programme.
• To communicate complex patient-related information in collaborative working with Allied Health Professional colleagues, medical practitioners, social care colleagues, voluntary agencies and support associations for the purposes of exchange of information, problem solving, goal setting and discharge planning.
• To communicate information of a complex and sensitive nature and deal with highly stressful, emotional or hostile situations with empathy and professionalism. This will include the giving of unwelcome or difficult to accept information with regard the outcome of treatment, the degenerative nature of the patient’s condition and issues in terminal illness.
• To communicate the results of audit of clinical practice and recommendations and plans for service development to the Team Lead