Community Frailty Nurse

Working with primary, secondary and community colleagues, you will: - Be an autonomous practitioner who holds delegated responsibility for a defined caseload, coordinating care, undertaking specialist assessments and planning safe discharges for patients within the Community Frailty Service. - assess patients in their own home or clinic setting: plans, implement and review care of patients with complex on-going health and social care needs. - carry out specialist assessment and treatment including the prescription of essential equipment as part of a package of rehabilitation. Specifically assessing issues related to the barriers which prevent the patient carrying out activities of daily living e.g. mobility, moving and handling, functional restrictions, activity tolerance, hand eye coordination, positioning, cognitive impairment, environmental restrictions etc. - ensure that patients receive the care they need linking into other services and agencies (statutory and voluntary) as appropriate and ensure the patients understand their medical conditions and medications they are taking. - create outcome goals for the patient to achieve during their time within the CFS and lead on the development, implementation and monitoring of the patient specific care plan to ensure these goals are achieved. - Work in the community as a lone practitioner in line with the Trusts Lone Worker Policy.