CHAPS Nursing Assistant

Care Home Advanced Practitioners (CHAP’s) are members of the team who have received extra training to enable them to assist the nurse in a wide range of clinical practice.

CHAP’s are not qualified nurses and must not be treated as such or given the full responsibility of a qualified nurse’s role.

CHAP’s are a new development within the Silvercrest Care Group. The role of the CHAP with vary between care homes based on need.

CHAP’s should act professionally at all times using their knowledge and experience
to problem solve and make evidenced based decisions, this will include

• Knowing their limitations
• Have the ability to understand company polices
• Understand and report poor practice that could result in poor health
  outcomes
• Challenge discrimination
• Recognise vulnerability in themselves or their colleagues and take action that
  will minimise risk to health and wellbeing
• Communicate effectively with all members of staff, residents and relatives
• Use their influence to improve care practices within the care team
• Maintain appropriate relationships with relatives
• Provide person centred, sensitive care at all times
• Document all care provided accurately and in real time
• Understand when a resident’s condition has deviated from the norm by
  health monitoring, share findings and inform the nurse in charge of their
  findings and documenting appropriately
• Deliver sensitive, compassionate end of life care to residents whilst
  supporting their families and loved ones to facilitate a good death
• Hold the knowledge and ability to perform a range of nursing interventions to
  ensure residents needs for safe effective person-centred care is met.
• Understand the principles of safe administration of medication in accordance
  with Silvercrest policies.
• Demonstrate the ability to monitor the effectiveness of care and report the
  outcomes
• Understand a resident’s mental capacity and best interest decisions.
• Ensure relevant information is shared to enable immediate safeguarding
  action to be taken
• Support junior members of the team
• Provide written formal supervision for allocated team members
• Ensure any obvious health and safety matters are addressed
• Escalate concerns in a timely manner
• Understand their role and the role of others within the organisation
• Work collaboratively with external professionals
• Understand the difficulties in providing physical health care to a resident with
  diminishing cognitive ability.

Procedures

1. Monitoring for indications and symptoms of physical and psychological
deterioration and improvement

• Accurately weigh and measure height, calculate BMI, know normal ranges
  and the clinical implications of results outside the norm in line with care plan
• Use manual and electronic machines to monitor Blood Pressure, pulse,
  respirations, temperature, oxygen saturations to enable the identification of
  improvement or deterioration.
• Carry out venepuncture when required
• Carry out urinalysis and report back results if outside normal limits
• Carry out blood glucose monitoring and report back results if outside normal
  limits
• Collect sputum, urine and stool samples
• Report and escalate any and all signs of abuse of any kind.
• Report and escalate suspected self-harm
• Take immediate action in the event of burns, choking, fitting and anaphylaxis
• Recognise an emergency situation and administer basic first aid including
  basic life support

2. To support adequate sleep

• Monitor comfort, and sleep patterns in line with care plan
• Use appropriate positioning and pressure relieving techniques in line with
  care plan
• Ensure privacy and dignity at all times
• Ensure pain is monitored and treated accordingly in line with care plan

3. Maintain personal hygiene and maintain skin integrity

• Observe, assess and meet all personal hygiene needs in line with care plan
• Observe, assess and meet all skin integrity needs in line with care plan
  including applying topical medication and documenting
  accordingly/monitoring documentation
• Assess oral hygiene needs,
• Assess eye care needs
• Assess nail care needs
• Inform all care staff of the needs of the residents, monitor the needs have
  been met
• Complete wound care according to care plan, report all new wounds to the
  nurse in charge for professional review and wound care planning.

4. Nutrition and hydration

• Use MUST tool appropriately
• Assist residents who require assistance to eat and drink in line with care plan
• Use appropriate aids as care planned
• Document all nutritional intake

5. Continence support

• Assist with continence needs in line with care plan
• Care of catheter and assist with intermittent self-catheterisation when
  required in line with care plan
• Recognise established bladder and bowel patterns to identify abnormal
  patterns and act accordingly
• Manage stoma care in line with care plan

6. Mobility

• Complete manual handling risk assessment tool to measure the need for
  ongoing planned support. The level of dependence required requires
  accurate care planning
• Complete falls risk assessment on a monthly basis. If falls are problematic
  manual handling risk assessment tool will need to be adjusted accordingly.
• Ensure correct aids are being used appropriately in line with care plan.

7. Respiratory car

• Oxygen administration must be managed using the appropriate rout in line
  with care plan
• Take peak flow and oximetry readings, record and report appropriately if
  results are outside of the resident’s normal range.
• Enable nebulisers to be used safely in line with care plan

8. Infection control

• Respond appropriately to potential infection outbreak following local policies
• Use barrier nursing techniques
• PPE must be used correctly
• Implement isolation procedures
• Ensue all staff use hand hygiene techniques correctly
• Ensure equipment and environment is decontaminated appropriately
• Dispose of waste, laundry and sharps safely

9. Medication Administration

• Safely administer medication following Silvercrest Care Group Medication
  Policy, you will be given a copy of this policy when you begin your new role.

10. End of life care

• Ensure correct care planning, outlining end of life wishes, is in place, ensure
  the resident and their family have had the opportunity to discuss their wishes
  and have indicated their needs i.e. pain relief required, who to be present,
  any last requests (would they like their dog/cat with them). Ensure all
  relevant members of staff are aware of the wishes/needs of the resident.
• Recognise and report any symptoms outside of the norm
• Ensure a DNACPR is in place and staff, external professionals and family
  members are aware of the procedures to follow.
• Ensure a “good death” is facilitated
• Ensure the body is bathed and presentable following death in readiness to be
  seen by their loved ones and going to the undertakers.
• Ensure cultural or religious requirements are met
• Ensure family members are afforded time and privacy to say goodbye to their
  loved one following the death

• Reliable and punctual
• Flexible and adaptable
• Will and able to work, from time to time, outside
  standard work hours (e.g. at weekends, evenings)
• Approachable and friendly
• Confident and assertive
• Diplomatic and tactful
• Enthusiastic and keen to learn / develop
• Patient and understanding
• Positive in outlook and manner
• Self-motivated
• Able to promote a professional image for the
  company at all times
• Able to travel to other homes where needed for
  training / support
• Believe in and work within the SilverCrest Group

• Experience of supporting the organising and
  scheduling programmes of events or activities
• Experience of working and/or engaging with older
  people (both living with and without dementia)
  (desirable)

• A minimum of two GCSE’s, one of which must be
  English Language, at Grade C or above (or
  equivalent)
• NVQ HSC Level 2 or QCF HSC Award 2 (or higher) in
  Health and Social Care (or equivalent) (desirable)
• Having achieved or expected to complete the Level
  2 award in supporting activities provisions
  (Desirable)
• Organisation skills
• Listening skills
• Good written, non-verbal and verbal communication
  skills
• Dementia knowledge (essential for roles within
  Homes specialising in dementia care) (desirable)
• Basic knowledge of and competence in core
  Microsoft Office applications (e.g. Word, Outlook,
  Excel, PowerPoint) and Windows based operating
  environments
• Data management (for record keeping and review)