JOB SUMMARY

We have an exciting opportunity for a Band 5 Nurse to join our Living Well After Stroke Team as part of our Integrated Community Stroke Service Team here in Somerset. The role will support our countywide specialist stroke service along with branching out to somerset wide tertiary providers of health and wellbeing.
The successful applicant will manage a clinical caseload of stroke patients, and lead and mentor band 4 nursing and support workers. You will work alongside a multidisciplinary team, including Occupational Therapists, Physiotherapists, Speech and Language Therapists, Psychologists, and Rehabilitation Assistants. As well as forging links outside the NHS with our VCS partners and wider community support services.
Experience in stroke care, mentoring, and clinical supervision is essential. You will possess excellent communication skills and be required to write proficient treatment summaries of the stroke specialist care provided. You will also support the development of the stroke nursing and LWAS workforce, ensuring high-quality care across the county.
The successful applicant will be supported by the Band 6 Integrated Community Stroke Nurse and Band 7 LWAS Lead and have access to ongoing development opportunities.
If you are someone who is innovative, thinks creatively, and is passionate about stroke care and wants to work within a supportive, collaborative team, we would love to hear from you

ABOUT US

At Somerset NHS Foundation Trust, we’re committed to supporting our employees with a range of benefits designed to enhance your professional and personal life. We offer:

• Flexible working options to help you balance work and life
• NHS pension scheme for long-term financial security
• Generous annual leave allowance to recharge and relax
• A strong focus on career development to help you grow and achieve your potential

Additionally, you’ll gain access to our Blue Light Card, unlocking exclusive discounts on shopping, dining, and leisure activities, as well as NHS-specific perks to support you both inside and outside of work.
We are proud to foster a diverse, skilled, and inclusive workforce, and we encourage applications from all backgrounds.
Why Somerset? Somerset offers the perfect blend of idyllic countryside, outstanding areas of natural beauty, and breathtaking coastlines, with vibrant cities like Bristol, Bath, and Exeter just a short drive away - and only two hours to London.
The region is home to excellent educational facilities, and with affordable housing compared to other parts of the country, it’s a great place to build both your career and your future.
Somerset truly has it all - the peaceful countryside and cosmopolitan city life, with something for everyone to enjoy.

JOB DESCRIPTION

Duties and Responsibilities
Communication and Key Working Relationships

To use a range of verbal and non-verbal communication tools (e.g., explanation, negotiation, motivation) to communicate effectively with patients to implement rehabilitation and treatment programmes. This will include patients who may have difficulties in understanding or communicating

• General Practitioners/primary care
• Infection Control Team
• District Nurses
• Community Hospital Ward Manager and Nurses.
• Integrated community stroke team
• Acute Trusts
• Patient / Carers
• Specialist Nurses
• Practice Nurses
• Stroke Team Leaders
• Integrated Community Stroke Nurse Lead
• LWAS Team Lead
• Stroke Service Lead
• Consultant Therapist Stroke
• Other care staff including those from other agencies, e.g. Social Services, Community nurses, Care agencies, tertiary providers as part of clinical work.

Planning and Organisation

• To work collaboratively with both the nursing and LWAS teams in the provision of clinical supervision and leadership for Band 4 support workers and nurses.
• To act as a role model for junior staff, with clear expectations of staff behaviour.
• As an autonomous practitioner, to consistently pursue self- directed support and learning, and formal agreed supervision according to Trust policy. Ensuring appropriate preparation for professional revalidation.

Analytics

• Participate in team audit research.
• Ensure all patient records are completed contemporaneously, up to date and accurate.

Responsibility for Patient / Client Care, Treatment & Therapy

• The post holder will be responsible for ensuring the nursing and LWAS components within an interdisciplinary assessment of patient care needs, the development, implementation and evaluation of treatment plans. To work alongside other professionals within the multidisciplinary team; ensuring high quality care and rehabilitation and effective communication. This will involve delivering care to a caseload of appropriate patients.
• To use specialised skills to provide assessment and treatment of chronically ill/frail stroke patients, taking account of other pathologies and associated complex needs.
• To be aware of and appropriately manage sensitive and/or complicated information. To deal sensitively with patients who may have challenging behaviour, have high levels of anxiety and aggression caused by pain, cognitive change, dementia, limited mobility, terminal illness, degenerative disease etc.
• To develop and deliver an individualised treatment programme and agree patient centred goals in partnership with patients, carers, and other members of the health and social care team.
• To assist with implementation of consistent patient medication self-administration trials post discharge home to increase personal independence.
• To be able to utilise and promote specialist nursing skills e.g. understanding and management for VTE assessment and prophylaxis, physiological monitoring, bladder/bowel dysfunction, understanding and support of management of cardiovascular issues i.e. AF, blood pressure control, monitoring and management, identify complications of stroke and assess secondary prevention regarding reducing further incidence of stroke.
• To act as or support the role of key worker, this may include managing the longer term social, emotional, financial and vocational concerns arising from having had a stroke. Additionally, seeking support of outside agencies.
• To provide specialist nursing and LWAS advice to the wider MDT.
• To work with patients undertaking rehabilitation programmes to support and encourage them to achieve their optimum level of independence and quality of life as directed by team therapists/nurses.
• To deliver six month review assessments in line with the Sentinel Stroke National Audit Project (SSNAP) particularly for patients with identified stroke nursing needs.
• Contribute to the triaging process using skills to identify nursing related stroke needs for a large cohort of patients.

Policy, Service, Research & Development Responsibility

• Engage effectively with research to promote evidence-based stroke nursing practice.
• Comply with all relevant Somerset NHS Foundation Trust policies and procedures in exercising the duties of the role.
• Undertake any necessary skills training, professional updates, continue professional development and mandatory training as appropriate to the post in agreement with the line manager.

Responsibility for Finance, Equipment & Other Resources

• Comply with all Health and Safety guidance in use of equipment, reporting immediately concerns

Responsibility for Supervision, Leadership & Management

• The Band 5 Nurse will provide clinical supervision for more junior colleagues and is accountable for ensuring that the patient care needs are met (with particular regard to medication, physiological monitoring and identifying deterioration and complications and secondary prevention).
• To deputise for the senior stroke nurse, with prior arrangement and with support from the Team Leads.
• To work pro-actively with other partners, such as secondary care, to identify and refer patients for specialist advice
• Contributing to the education of the stroke team in the nursing referral criteria, monitoring of physiological signs of the patient, bladder/bowel dysfunction, secondary prevention and identifying complications associated with stroke.
• To be professionally and legally responsible and accountable for all aspects of your own work including the management of patients in your care, (including care delegated to students and assistant staff). To ensure a high standard of clinical care for the patients under your supervision and support more junior staff to do likewise.

Information Resources & Administrative Duties

• Be responsible for effective time management and effective use of resources available and of the wider nursing and LWAS teams.
• To maintain accurate record of patients’ attendances and treatments using

the relevant IT and audit systems. This includes contributing to patient letters, reports and onward referrals.

Any Other Specific Tasks Required

• To carry out work in a range of locations, including hospital departments, patients’ own homes and other community locations as directed.
• To use communication tools (verbal and non-verbal) to gain valid informed consent with patients where there will often be barriers to effective communication e.g. loss of hearing, altered perception, expressive and receptive dysphasia, pain, fear. To have the capacity to work within a legal framework with patients who lack capacity to consent to treatment e.g. those with cognitive or speech difficulties.
• To use a range of verbal and non-verbal communication tools (e.g. explanation, negotiation, motivation) to communicate effectively with patients in order to implement rehabilitation and treatment programmes. This will include patients who may have difficulties in understanding or communicating.
• Duties as instructed by your manager or appropriate authority, to include work on Trust-wide projects and Quality Improvement.

SKILLS & ABILITIES

Listens to others’ views respecting and valuing individual needs.
Provide enthusiasm, passion and energy to embed the LWAS nursing role in the wider integrated community stroke service team.
Professional and patient focussed approach with inspirational skills, acting as a role model to colleagues and junior staff members.
Excellent organisational skills, ability to manage own time and plan timed activities.
Ability to recognise and manage challenging situations in a calm and professional manner.
Able to take instruction and direction and work effectively as part of a team.

MAIN DUTIES, TASKS & SKILLS REQUIRED

o provide stroke specialist care and advice to patients and their families/carers and to be a key link for the Integrated Community Stroke Service. Also to ensure that all patients in a defined area who have had a stroke, have access to specialist nursing assessment and living well after stroke support.
To provide supervision of Band 4 nursing and support workers.
To consider the patient journey across the whole stroke pathway, delivering nursing and LWAS interventions. To work closely with the acute stroke services and community inpatient wards to ensure a seamless process of care and continuation of nursing and LWAS intervention. Advocating for the patient through leading on the provision of excellent stroke specialist nursing and LWAS care.
The LWAS nurse is autonomous and accountable in practice and has the ability to support the service 7 days a week which may include weekends depending on service need.In addition to direct patient, care the Band 5 LWAS Nurse acts as a touchpoint for whole Integrated Community Stroke Service (ICSS), ensuring optimum patient management in the community.
This role will require the Band 5 nurse to practice autonomously, with support of the senior members of the nursing and LWAS team. To make decisions under their own initiative using professional judgement and drawing on their clinical expertise

Information Resources & Administrative Duties

• Be responsible for effective time management and effective use of resources available and of the wider nursing and LWAS teams.
• To maintain accurate record of patients’ attendances and treatments usin

Any Other Specific Tasks Required

• To carry out work in a range of locations, including hospital departments, patients’ own homes and other community locations as directed.
• To use communication tools (verbal and non-verbal) to gain valid informed consent with patients where there will often be barriers to effective communication e.g. loss of hearing, altered perception, expressive and receptive dysphasia, pain, fear. To have the capacity to work within a legal framework with patients who lack capacity to consent to treatment e.g. those with cognitive or speech difficulties.
• To use a range of verbal and non-verbal communication tools (e.g. explanation, negotiation, motivation) to communicate effectively with patients in order to implement rehabilitation and treatment programmes. This will include patients who may have difficulties in understanding or communicating.
• Duties as instructed by your manager or appropriate authority, to include work on Trust-wide projects and Quality Improvement