AGENDA FOR CHANGE NHS JOB EVALUATION SCHEME

JOB DESCRIPTION

1. JOB IDENTIFICATION Job Title: CAMHS Community Mental Health Nurse (Tier 4

Child and Adolescent Mental Health Services)

Reports to: CAMHS Nurse Team Lead/Professional Lead

Department, Ward or Section: Child and Adolescent Mental Health Services - Outpatient Service (CAMHS)

Operational Unit/Corporate Department: Inner Moray Firth Operational Unit, Raigmore

Job Reference: SSWCHDRAIGCAMH25

No of Job Holders: 3

Last Update: February 2016

2. JOB PURPOSE

The CMHN will deliver a specialist, comprehensive and therapeutic mental health nursing service within CAMHS, providing mental health assessment, care and treatment to children and young people, who may present with complex emotional, behavioural and social difficulties, Mental Disorder (including Mental Illness and Eating Disorder) and/or multiple needs. Some of these children, young people and their families and/or carers may require specific and more intensive levels of care, treatment and clinical intervention within Tier 3 and Tier 4 of CAMHS.

The CMHN is an integral part of the Tier 4 team, working together with colleagues in CAMHS and will be expected to use their own initiative and act autonomously when making clinical decisions that are safe and effective, in line with their professional Nursing and Midwifery (NMC) Code of Conduct. The CMHN will liaise with and work across a broad and diverse range of agencies/services (Social Care, Education, Specialist Services etc) to ensure that children and young people with mental health problems/mental disorder and their families and/or carers are able to access and engage with CAMHS at the earliest opportunity. Following the mental health assessment process, which will be child centred, involving the parents and/or carers, the CMHN will identify clinical need(s) and formulate individual care/treatment plans, which will include a risk assessment and management plan, encompassing safeguarding and child protection concerns, contingency and crisis planning. The CMHN will provide direct clinical intervention and follow up care and treatment, using an ‘assertive outreach’ approach, depending upon the level of need, in a variety of safe settings within the community. This will include working in the patient’s home, school, local health centre or any other appropriate base within NHS Highlands and on occasions the Tier 4 CAMHS inpatient facility based at Dudhope Terrace (NHS Tayside) and within outpatient facilities

such as The Phoenix Centre. The CMHN will also work with the team to identify the appropriate stage for transferring children and young people between Tier 3 and Tier 4, which may include inpatient services.

The CMHN will promote the principles and practice of Tier 4 CAMHS, establishing and maintaining effective working relationships with colleagues in CAMHS and externally by networking and liaising with other services and mental health services. These may include specialist inpatient facilities, general and specialist health services, including the Paediatric ward at Raigmore Hospital and other hospitals, GP’s, health centres, allied health professionals, LAC services, Social Care services, schools and school nurses, guidance teachers and Lead Professionals (in line with the Highland Practice Model and GIRFEC principles), the education service, non governmental organisations, locally, regionally and nationally.

The CMHN will act as a role model, leading by example, promoting the unique and diverse role of Nursing within CAMHS. The CMHN will ensure that professionals and children, young people and their families and/or carers fully understand the nurse’s pivotal role in the provision of excellence in care and treatment, enhancing the quality of life for children, young people and their families and/or carers and promoting the value and importance of the nurses professional identity within a multi-disciplinary team. The CMHN will work with nursing colleagues to promote standards of care, enhance and implement clinical governance and NHS Highland and national policy, actively developing and participating in new ways of working across agencies/disciplines. The CMHN will actively participate in regular multi-disciplinary meetings, training/team events and is responsible for maintaining their own continuing professional development and Nurse registration. The CMHN will hold a full driving licence and may be expected to use their own transport. The CMHN will work flexibly and may need to work outside of normal hours as required, according to the needs of the service.

The post-holder is an integral part of the Tier 4 team and will:

1. Assess the mental health of children and young people who are presenting with mental health problems, some of which may be complex emotional, behavioural and social difficulties, across a variety of settings (Highland Wide).

2. To formulate comprehensive individual care/treatment plans, including contingency and crisis plans, in conjunction with the child, young person and their family and/or carers. These will include appropriate current risk assessment and any relevant child protection and safeguarding issues or concerns.

3. To provide therapeutic clinical interventions to children, young people and their families and/or carers, which will promote wellbeing and enhance their quality of life, aim to prevent crisis and reduce the risk of deteriorating mental health and risk of harm to self and others.

4. Work closely with Tier 4 team colleagues and the wider CAMHS and across a broad and diverse range of agencies and services.

5. To provide a specialist mental health Tier 4 resource within CAMHS, NHS Highland and to external agencies/services.

3. DIMENSIONS

The post is 37.5 hours per week over a 7 day period.

The CMHN will provide assessment, including emergency assessment and formulating contingency and crisis planning, care and treatment, to children and young people across Tier 3 and Tier 4 CAMHS. The children and young people may require intensive stabilisation and containment due to their severe and/or complex mental health problems/disorder, which may quickly deteriorate, due to specific episodes or complicating factors such as severe distress, self-harming behaviour, Mental Illness, Eating Disorder, developmental problems, parental mental illness, individual or parental substance use/dependency, safeguarding and/or child protection issues, such as various forms of abuse, child sexual exploitation and extreme vulnerability.

The work will involve direct clinical contact with children, young people with severe and/or complex mental health problems/disorder and their families/carers within the community and in outpatient settings and will include home visits, hospital inpatient units/wards and outpatient departments and at the Phoenix Centre on the Raigmore Hospital campus. Flexible working hours will enable the CMHN to support children, young people and their families and/or carers who live in distant localities outside of reasonable travelling distance from Inverness or any other external outpatient establishment.

To actively participate in the ‘Duty Rota’ system and provide cover whenever required. This will include the Triage process of screening incoming referrals to CAMHS, the ‘non-urgent’ telephone call system and to respond to requests for ‘Deliberate Self Harm’ assessments at the children’s ward at Raigmore Hospital. The Assessment process will include a current risk assessment and management plan, a specific individual care and treatment plan, incorporating safeguarding and child protection concerns. Follow up appointments within an agreed appropriate time frame, depending upon the presenting risks, for DSH assessments are a routine requirement.

Adherence to strict record keeping standards and governance, which includes the contemporaneous writing of notes, the safe storage and transportation of medical records, in line with NHS Highland Policy is an essential and ongoing component of the work, in line with the Nursing and Midwifery Professional (NMC) Conduct of Conduct. This includes all patient notes, letters, emails and correspondence internal or external to NHS Highland.

Ability to work autonomously, using own initiative, to make clinical decisions as required without delay, ensuring that the delivery of clinical interventions is fit for purpose, safe and effective and reduces the likelihood of further distress for the child and/or young person and their families and/or carers.

To actively encourage the inclusion and involvement of children, young people and their families and/or carers throughout the process of decision making and care giving, ensuring that they fully understand this and are able to share their own opinions, contributing to their plan of care and treatment wherever possible.

To work closely with colleagues, forming positive working relationships within Tier 3 and Tier 4 CAMHS.

To contribute to the daily team huddle and lead in the absence of other colleagues.

To promote the value and role of the CAMHS Nurse and the specific role and contribution to the team.

To plan and time manage their daily work according to their job plan, using the outlook electronic diary system and a paper diary system as a contingency.

Clinical and peer supervision will be provided within the team as necessary.

Managerial and professional supervision will be provided by the CAMHS Nurse Team Lead on a monthly basis for WTE post-holders and as agreed for part time post-holders as per policy. Supervision contracts and records will be maintained by both parties.

The CMHN may seek specialist regulated clinical supervision within NHS Highlands should they require this to enable them to continue practising and delivering specific clinical interventions.

The CMHN will plan, complete the relevant training requests and participate in active training, including all organisational mandatory training, CPD and maintenance of their eKSF.

The CMHN will prepare for their NMC Revalidation in sufficient time of the date of renewal of their Nurse registration. They will arrange the appropriate meetings required, being the registrant, to

ensure that their registration is renewed, which will allow them to continue practising, preventing loss of registration and complying with their NMC Code of Conduct.

The CMHN will promote an environment of healthy, positive learning, encouraging functional teamworking and participating in clinical and academic training and other team developments.

The CMHN is responsible for requesting the appropriate and necessary equipment to enable them to effectively carry out their work.

The CMHN will normally work flexibly between Monday to Friday and occasionally over weekends depending on clinical need. Occasional overnight stays may be required depending upon the clinical need and location given the geographical nature of the Highlands and the potential for extreme weather conditions.

4. ORGANISATIONAL POSITION

See Attached.

5. ROLE OF DEPARTMENT

CAMHS is centrally based at The Phoenix Centre, in the grounds of Raigmore Hospital, Inverness. The service also uses satellite bases in Lochaber, Skye and Caithness/Sutherland. CAMHS has defined links across the North of Scotland network and specifically with Dudhope Terrace, the young people’s Tier 4 inpatient unit in Dundee via the Network Liaison Nurse.

The role of the department is to provide specialist Tier 3 and Tier 4 Child and Adolescent Mental Health Service to the Highlands population aged 0-18 years (includes only young people over 16 in full time school education) and their families and/or carers.

The department provides specialist mental health services to the Paediatric ward at Raigmore Hospital, usually through the duty rota or via request and to New Craigs Hospital/Adult Mental Health Services as necessary.

Tier 3 CAMHS referrals are received from GP’s, Primary Mental Health Services, Social Care, internal and external specialist services/agencies across the Highlands (may include referrals from education and schools).

Tier 4 referrals will be made by local Tier 3 CAMHS depending upon the nature of the child or young person’s mental health presentation, such as self harming or violent behaviour, level of risk posed, which is not manageable within a usual CAMHS outpatient model (weekly or less frequent intervention), who may require intensive assessment, care and/or treatment to stabilise their mental health.

6. MAIN TASKS, DUTIES AND RESPONSIBILITIES

1. Following referral to Tier 3 or Tier 4 CAMHS and full team discussion, provide specialist nursing assessments and/or joint multi-disciplinary team (MDT) assessments, of children, young people and their families and/or carers, utilising both SIGN and NICE guidelines and adhering to their professional Nursing and Midwifery Code of Conduct (NMC).

2. Following Tier 3 and in particular Tier 4 MDT assessments, actively participate as a CMHN in the decision making process to develop the care and treatment plan, risk management plan and the method of delivering the type of intervention(s), involving wherever possible the child and or young person, family and/or carers.

3. Acquire the full and explicit consent of the young person and their parent(s) and/or carers to the acceptance of the referral, the assessment process, delivery of nursing care and treatment and other relevant therapeutic interventions.

4. Ensure that all children and young people are seen in accordance with the legal requirements, gender specific and determined by their age and competence. (under 16 years should be accompanied by an adult, unless otherwise agreed).

5. To develop and maintain good relationships with children, young people and their families and/or carers, relatives and other professionals involved in the delivery of high quality care.

6. To take responsibility for time managing and arranging direct appointments with parents and/or carers of children and/or young people, taking into account their own personal circumstances and needs/wishes.

7. To communicate at the earliest opportunity with parents and/or carers about any changes and cancellations to appointments that have already been made. This will ensure that parents and/or carers and the children and/or young people are aware of changes, so that they are not disadvantaged or inconvenienced as a result (people may have to travel long distances, take time off work or arrange alternative child care for siblings).

8. To comply with Health and Safety regulations, ensuring personal safety at all times in any environment, reporting back to a designated colleague within the Tier 4 team or the CAMHS Nurse Team Lead if out of hours, referring to NHS Highland ‘Lone Working’ policies and national and professional guidance. The use of a ‘Buddy’ or ‘Pairing’ system would be encouraged.

9. To review the care and treatment plan and its effectiveness of this regularly within the MDT as agreed and to establish how long specialist nursing intervention will be required.

10. To discharge plan and transfer or discharge children, young people and/or their families and/or carers in good time, ensuring that this is directly related to clinical need.

11. To liaise and communicate effectively by telephone and using written correspondence, within a given time frame, to colleagues, the referrer and any other relevant professionals, sensitive and confidential information, respecting dignity and upholding patient confidentiality, in relation to the initial assessment, care and treatment plans, reviews, progress made and transfer/discharge process.

12. To liaise with other professionals and attend or video conference into all relevant multi-agency or MDT meetings relating to the care of the child, young person and their family and/or carers (e.g. Child plan meetings, Core group meetings for Looked After and/or Accommodated Children, Solution Focused meetings, professional meetings).

13. To have firm knowledge and understanding of a range of models of care, in particular nursing models of care, the theoretical basis of these and how to apply the relevant evidence based nursing models to enhance care. This will be determined by the needs of the child, young person and their families and/or carers, to ensure that the formulation of care and treatment plans and the delivery of clinical nursing intervention based on a clear and appropriate framework/model of

care, in line with local and national guidance, recommendations and good practice. This will enable the delivery of safe, effective, quality nursing care, which will help to reduce specific risks associated with mental health problems/mental disorder and co existing behavioural problems, promoting wellbeing and improving daily life in the short and longer term for the child, young person and or their families and/or carers.

14. To understand and apply a range of therapeutic skills in flexible and creative ways as part of the delivery of nursing care and intervention(s).

15. To carry and manage Tier 3 and 4 cases, as part of the specialist Tier 4 team, working closely with colleagues in Tier 4 and CAMHS.

16. The CMHN will ensure that they develop positive working relationships with their colleagues and the Nurse Team Lead, seeking professional advice and guidance from the relevant person(s).

17. The CMHN will plan, participate in and receive regular professional, clinical and managerial supervision from the CAMHS Nurse Team Lead, keeping records of this, as part of their ongoing Continuing Professional Development, in line with the appraisal system and the eKSF requirements and their professional NMC Code of Conduct.

18. The CMHN will jointly develop a good working relationship with their CAMHS Nurse Team Lead and will take responsibility for planning and arranging their own NMC Re validation as a registrant, in sufficient time prior to their re registration with the NMC, to discuss Reflective accounts and seek confirmation of their requirements to practice with their line manager, the CAMHS Nurse Team Lead. This is in line with local NHS Highland policy and is good practice and will strengthen working relationships and enable them to maintain continuous registration as a Nurse, practising safely and legally.

19. The CMHN will inform by telephone, the CAMHS Nurse Team Lead in the event of unplanned sickness and absence from work in accordance with NHS Highland Policy. Text/SMS can be used as an additional method of communicating, however not as the only form of communication in these circumstances.

20. The CMHN will initially contact the CAMHS Nurse Team Lead at the earliest opportunity to discuss any requests for special leave and seek approval for this in line with NHS Highland Policy. In the absence of the CAMHS Nurse Team Lead, the CMHN will contact the CAMHS Service Manager or the Clinical Lead regarding any form of unplanned leave.

21. To update all Tier 3 and Tier 4 paperwork, electronic systems and clinic lists as required, including, Database, Risk Assessment, Care Plans, Formulation Paperwork, Child concern forms as well as the Referral Proforma to access Tier 4 Inpatient beds at Dudhope Terrace YPU following discussion and approval with team colleagues.

22. To work closely with other members of the team that holds joint responsibility for the Tier 4 caseload, making safe clinical decisions which will inform individual care and treatment plans, particularly in relation to specific health problems and disorders such as eating disorders, obsessional compulsive disorder, mood disorders, psychosis, self-harm and para suicide.

23. Contribute to and provide relevant information for Child’s Plans and act as Lead Professional as required.

24. Liaise with colleagues initially, whenever Tier 4 patients are admitted to the Accident and Emergency Department, Paediatric Ward or Acute Medical Receiving Ward, after the patient has exhibited self-harming behaviours. The Tier 4 CAMHS team will risk assess the mental health of the child and/or young person taking into account their family and/or carers needs and views and their previous and/or recent involvement with Tier 3 CAMHS or other services, if appropriate.

25. To attend peer and clinical supervision regularly as determined by NHS Highland and keep

records of these sessions for CPD.

26. To utilise theory, evidence-based literature and research to support evidence-based clinical practice with a particular emphasis on Nursing.

27. To facilitate and participate in relevant educational and academic sessions such as Journal Clubs, peer supervision, case discussion and education meetings.

28. To initiate, develop and promote new ideas that will improve the quality of direct care for children, young people and their families/carers, challenging traditional organisational culture and encouraging new ways of working.

29. To contribute to the development of the CAMHS ‘Nurses’ professional meetings and participate in the organising, chairing, discussions and recording of the issues raised during these meetings.

30. Act as a positive role model for Nursing, promoting professionalism and empowering and leading others by example, within CAMHS and the organisation.

31. Following consultation with the CAMHS Nurse Team Lead, act up in their absence when required.

32. Support colleagues via peer supervision and with agreement, offer specific clinical supervision as required.

33. To actively participate in audit and evaluation processes within the department and the wider organisation as required.

34. To raise awareness and educate colleagues and other disciplines/agencies about the Tier 4 service and the related mental health problems/disorders, case work and case management, within health and across services e.g. Nursing, Primary Mental Health Service (via Primary Mental Health workers), Social Workers, Health Visitors, foster carers, Schools (to include school nurses, guidance teachers, lead professionals, pupil support workers) and looked after children’s services.

35. To provide consultation and relevant peer supervision to professionals within CAMHS and also across external services where appropriate. This will include telephone, electronic and direct face-to-face work, on an individual or group basis, with the aim of providing ongoing support and guidance, particularly in relation to new or existing referrals to CAMHS.

36. To promote knowledge and develop understanding of mental health, wellbeing and healthy living and the effect upon the child and young person in relation to their development and future health, including the impact mental health problems have upon the family/carers and the wider community to raise awareness and reduce stigmatisation.

37. To adhere to local and national polices regarding child protection, the Children’s Act, Children and Young Persons (Scotland) Act 2014, the mental health act, National Service Framework, SIGN and NICE guide lines and NHS Highland.

38. To promote a safe learning environment and facilitate teaching/mentoring for nursing students, junior doctors and other trainees within CAMHS. Teaching across other services/agencies may also be required, following discussion and planning with team colleagues and with the approval of the CAMHS Nurse Team Lead.

7a. EQUIPMENT AND MACHINERY

Mobile phone and charger, especially when working off site and in localities.

Personal computer/lap top and carrying case (Health and Safety).

Use of own car/ pool car for clinical appointments and meetings within the community setting.

Use of audio-visual equipment and Video Conferencing where appropriate.

Dictaphones- hand held or plug in devices for letters and reports.

Telephone.

Photocopier.

Fax machine, printer, paper and ink.

Psychological/clinical tests and rating scales.

Weight scales/height measures

Clinic equipment such as sphygmomanometers, thermometers, urine testing kits, infection control equipment.

7b. SYSTEMS

To carry out all communication in line with NHS Highland Policies.

The post-holder will be required to have knowledge of Microsoft office applications, such as word, power point, excel, access and database and some others as required.

Working knowledge of word processing, internet and emails.

To complete training and CPD request forms and submit in reasonable time to CAMHS Nurse Team Lead for approval. Budget approval may need to be approved by the Service Manager after the Nurse Team Lead has been informed.

To complete mileage and annual leave forms as necessary and submit to CAMHS Nurse Team Lead for approval.

To adhere to Fire, Health and Safety and Infection control procedures and policy.

To record adverse incidents clinical or otherwise on the DATIX system.

To record and share any concerns about safeguarding issues, child protection and risk of harm, in line with protocol and local policy and GIRFEC/Highland Practice Model.

To maintain patient records, including the safe storage and transfer of records/files in line with local NHS Highland policy and the Nursing and Midwifery Code of Conduct, which is a legal requirement.

To record relevant statistical information e.g. patient contact, clinical information for audit purposes and ensure that medical records are easily accessible within the department (not held in desk drawers without an available key).

8. ASSIGNMENT AND REVIEW OF WORK

The CMHN will be allocated appropriate cases via the CAMHS weekly multi disciplinary allocations meetings, the Tier 4 Team and the Nurse Team Lead, taking into account the urgency, intensity and severity of the presenting problems and needs of the child, young person and family and/or carers.

Team members are expected to undertake some organisational tasks following discussion and agreement with the CAMHS Nurse Team Lead.

The CMHN will manage their own caseload with appropriate professional and clinical support from the CAMHS Nurse Team Lead and with clinical support from the CAMHS Service Manager and the Clinical Lead as required.

Professional and Managerial supervision will be provided by the CAMHS Nurse Team Lead.

The CAMHS Nurse Team Lead will operationally and professionally lead and manage the Tier 4 CMHN’s.

The Clinical Lead for the service would ensure that developments within the department fit with national and local CAMHS planning requirements and the broad commissioning arrangements.

The CAMHS Service Manager has responsibility for the overall department, excluding direct line management responsibility for the CAMHS Nurses.

9. DECISIONS AND JUDGEMENTS

The CMHN will make autonomous clinical decisions, for which they are accountable, on a day to day basis, ensuring that they communicate essential information in a timely manner to members of the Tier 4 team and colleagues in CAMHS as required. The CMHN will follow their NMC Code of Conduct at all times and will adhere to the organisational policy framework, protocols, guidelines and procedures, making decisions that are informed by the ethical and legal framework within which they operate.

The CMHN will be responsible for:

Managing their own caseload with the professional and clinical support of their Nurse Team Lead and colleagues in the Tier 4 Team.

The active involvement in therapeutic engagement, assessment, prioritisation of nursing care and treatment of children, young people and their families and/or carers, depending upon their health needs, working flexibly to alter priorities as needs dictate, from the point of referral through to discharge at Tier 3 and Tier 4.

Identifying sudden and gradual changes in the child or young persons condition and respond appropriately to reduce risk of harm. This will include referring to the early warning signs, risk indicators and relapse signature of the child and/or young person as per care plan.

Recognise and respond to emergency situations, using verbal de escalation techniques, without resort to physical restraint methods wherever possible, to minimise clinical risks, making clinical decisions based on the least restrictive options in the community, which are safe and effective.

Identifying and managing clinical risks and completing an up to date and accurate risk assessment, which will include a clear and concise contingency and crisis plan.

Excellent communication within the team, with other professionals and across all relevant services/agencies to share information on a ‘need to know basis’, respecting confidentiality and upholding dignity, which will inform the risk and care planning process and clinical interventions.

For determining whether a child, young person and their families and/or carers have the ability and/or the mental capacity to participate in the planning and delivery of care, making informed choices and taking into account ‘Gillick Competencies’- understanding right from wrong and understanding the process and the implications.

Representing CAMHS and providing a mental health opinion at multi-agency meetings, forums and events.

Implementing Evidence Based Practice and Clinical interventions.

10. MOST CHALLENGING/DIFFICULT PARTS OF THE JOB

Planning, managing and delivering high quality, specialised and intensive nursing care to children, young people and their families and/or carers within Tier 4 CAMHS in a diverse range of environments.

Referrals to Tier 4 CAMHS can arise following an emergency situation and during times of crisis and may involve aggression and conflict. This situation will require a suitably experienced and skilled Nurse, who can demonstrate a sensitive, compassionate, caring approach who is able to effectively manage the situation, enabling the child, young person and family and/or carers to feel safe, confident and reducing their distress.

Communicating and therapeutically engaging with children, young people, their families and/or carers, exploring the reasons for emotional, behavioural and mental health problems/illness, to identify health needs and the appropriate type of clinical intervention to facilitate change is demanding. This can include listening to and engaging with stories of trauma, loss, sadness, abuse, anger and death.

Consultation and/or direct work with colleagues and other agencies for children, young people and their families and/or carers who have complex emotional, social, behavioural and/or mental health problems, acute Mental Illness and Eating Disorders.

Working jointly and sharing information with other services/agencies to facilitate the safe and effective delivery of care, with consent and respecting confidentiality.

Developing and maintaining a therapeutic relationship with a child or young person who has engaged with the service as a consequence of parental or other pressure.

Advocating on behalf of and representing children and young people and their clinical needs at multi-agency meetings and forums, such as Core groups, Child protection meetings.

Sharing difficult information and challenging the opinions of others, e.g. parents or other professionals.

Raising awareness and managing situations involving families and/or carers and relatives and other professionals who are expressing concerns about the presenting risk issues of the child or the young person or risk issues for the child or young person (vulnerability).

Managing and delivering intensive, high quality nursing care during high risk, changeable situations (self harm, active suicidal thoughts and behaviours).

To sensitively and carefully assess and manage families and other groups who may at times may be physically and verbally aggressive.

11. COMMUNICATIONS AND RELATIONSHIPS

The CMHN will communicate in an open, transparent and effective manner with integrity and respecting dignity and confidentiality in line with policy, within CAMHS, NHS Highland and across a range of external agencies and services, using a variety of interpersonal and professional skills.

Sensitive and privileged information may need to be shared, including that relating to risk of harm and child protection. The CMHN will understand and follow the guidance and recommendations within the Caldicott principles, the NMC Code of Conduct, National and NHS Highland policy.

Excellent communication with families and/or carers is required especially in challenging and difficult situations, which may involve some aggression.

CAMHS provide consultation to other professionals and services/agencies. The CMHN will develop strong working relationships to improve communication and understanding of each others area of practice e.g. Educational,

Psychology, Social Work, Health Visitors, Paediatricians, Police, Adult Mental Health Practitioners.

To effectively communicate with the Nurse Team Lead on a daily basis, the CAMHS Service Manager and the Lead Clinician on a regular basis, regarding service delivery and operational matters.

To understand and apply knowledge and skills when communicating with children and young people of differing ages.

To show compassion and sensitivity when working in challenging situations.

To be aware of differences across minority groups, such as ethnicity, race, religion, gender, age, disability and sexual identity and demonstrate cultural awareness and competence.

12. PHYSICAL, MENTAL, EMOTIONAL AND ENVIRONMENTAL DEMANDS OF THE JOB

Physical: Sitting for long periods during sessions. Driving, sometimes to remote and distant locations in differing weather conditions. Carrying clinical equipment, lap top, mobile phone and any other necessary items in a safe

manner. Working with high risk situations, such as self- harming and aggressive behaviours.

Mental: High levels of concentration for assessment, treatment and direct clinical intervention of varying

degrees of intensity, frequency and duration. Managing complex situations and having the capacity for reflection in order to respond in a skilful

and sensitive manner. To be able to formulate working hypothesis centred on evidence based practice. Learning and utilising new skills.

Emotional: Frequent exposure to distressing situations e.g. self harm, suicidal ideation, serious mental health

problems and severe mental disorders, bereavement, complex and challenging family situations, domestic violence, abuse and trauma.

The post-holder will be required to manage their own personal safety and emotions, especially in situations where they may experience distress, aggression and threatening behaviour from patients and/or family members/carer’s.

The work will involve managing a range of extreme emotions. Dealing with personal feelings and emotions, being able to reflect and share experiences within

the service/organisation following serious or critical incidents. Maintaining a non judgemental approach at all times, which is socially inclusive, culturally

competent and promotes high quality nursing care. To be able to formulate working hypothesis biased on evidence based practice in the context of

emotionally distressing histories.

Environmental: The nature of the job may require a high degree of lone working with the support of the Nurse

Team Lead and colleagues. The capacity to work jointly and collaboratively with other team members in CAMHS. Nursing in a variety of settings, which may present challenges.

13. KNOWLEDGE, TRAINING AND EXPERIENCE REQUIRED TO DO THE JOB

Training and Qualifications

First level Registered Mental Health Nurse (R.M.N.) with current active registration. Relevant and substantial experience at Band 5 (2-5 years) in an acute inpatient and/or

community based mental health service, preferably CAMHS. Additional relevant post registration qualifications and/ or evidence of ongoing professional

development.

Experience

Relevant experience as a qualified Mental Health Nurse within a range of settings including acute mental health and/or community mental health services/CAMHS.

Experience and understanding of multi-disciplinary/agency working. Experience of training and presentation skills. Experience of working clinically with individuals who are challenging and present with complex

and/or multiple needs. Experience and the ability to work across various agencies who may have differing values and

priorities, maintaining professionalism, working in an open, transparent and diplomatic manner.

Knowledge

A working knowledge of different theories and nursing models relevant to this area of clinical practice.

An understanding of the legislation and polices relating to child and adolescent mental health services e.g. Children’s Act, Getting it Right for Every Child (GIRFEC), The Scottish Framework for CAMHS, The Mental Health care and Treatment Act 2003.

A willingness to further develop knowledge and skills base through relevant academic training.

14. JOB DESCRIPTION AGREEMENT

I agree that the above Job Description is an accurate reflection of my duties and responsibilities at the date of signing.

Job Holder’s Signature:

Manager’s Signature:

Date:

Date:

APPENDIX

The NHS Health Advisory Service, (1995). Child and Adolescent Mental Health Services, Together We Stand.

Tier One: A primary level of service provided within universal services and including mental health promotion, general advice and identification of mental health problems early in their development.

Tier Two: A level of service provided by mental health professionals working on their own and relating to each other through a network rather than a team. Functions include assessment, care and treatment for children and young people, and consultation and advice to professionals in Tier One.

Tier Three: A specialised service for more severe, complex or persistent mental health problems. Members of multi-disciplinary mental health services will often work in specific therapeutic teams, such that the co-ordinated interventions of several professionals can address the many facets of the problem or bring sufficient skill to bear on specific problems such as eating disorders, substance misuse, traumatic stress, developmental disorders, affective disorders etc.

In addition to the Tasks of Tier 2, the tasks of Tier 3 are The assessment, treatment and management of children, adolescents and their families whose mental health problems and disorders

cannot be managed in Tier Two because of their complexity, risk, persistence and interference with social functioning and normal development, and the consequent need for specialist skills.

To act as gatekeepers, with clearly agreed criteria, for entry to Tier 4 services; to have knowledge of the availability and appropriateness of such care/ and to have relationships which ease the passage of children and young people into such care.

To work within a larger multi-disciplinary team or network of service components to ensure that the full range of teams at Tier 3 is available to children, young people, their families and other agencies working with them.

To ensure a smooth transition of individual cases or families to Tiers 2 and 1 services before completion of the involvement of Tier 3 services

To provide specialist assessments and reports for those who have referred cases for team-based interventions.

Tier Four: Essential tertiary level services such as day units, highly specialised outpatient teams and inpatient units. This tier provides for highly specific and complex problems, which require considerable resources. Assessment and treatment is the core function.