Head of Nursing- Complex Care

1. PURPOSE OF

THE ROLE Unicares complex care division delivers nursing interventions in peoples own homes under the regulated activity of Treatment of Disease, Disorder or Injury. The people we support depend on that care being clinically correct every time: a tracheostomy mismanaged, a ventilator alarm misread or a rescue medication given late has immediate and irreversible consequences. The Head of Nursing holds professional and clinical accountability for that practice.

The postholder sets the clinical governance framework for the division, owns the competency and delegation architecture on which safe delivery depends, assures that clinical standards are met in every package, and provides the professional line for the registered nurses delivering it. The post reports directly to the Chief Executive Officer so that clinical objection to a commercially attractive package is heard at the level where the decision is made.

This is not an operational management post. The authority of the role is professional, not managerial, and rests on clinical credibility, evidence and the direct line to the Chief Executive.
2. ORGANISATIONAL CONTEXT Unicare Complex Care Specialist Ltd is a CQC-registered, nurse-led provider operating nine supported living services and community outreach across Surrey, Sussex, Berkshire and South London, and registered for Treatment of Disease, Disorder or Injury. The complex care division delivers nurse-led and nurse-delegated clinical care to adults and children in their own homes, including tracheostomy care, invasive and non-invasive ventilation, enteral feeding, suctioning and oxygen therapy, seizure and rescue medication management, bowel care, catheter and stoma care.

A substantial part of the divisions registered nursing capacity is engaged through contracts for services rather than employment. The clinical governance framework must therefore hold consistent standards across a workforce that is not uniformly employed a defining challenge of this post and a point on which CQC will test us. Scope and boundaries To avoid ambiguity between senior clinical roles, the following boundary applies:
In scope: all nursing and nurse-delegated clinical practice within the complex care division; clinical governance, competency and delegation for that practice; clinical assessment of complex care referrals and packages; and the clinical content of complex care training. Out of scope: mental health nursing practice, restrictive practice reduction and Positive Behaviour Support, which sit with the Head of Mental Health Nursing.

Operational management of services, staffing and rota delivery sits with the Head of Care. Commercial negotiation of package rates sits with the business development function, informed by this posts clinical assessment. Where a person we support has both complex physical health and mental health needs, the postholder and the Head of Mental Health Nursing are jointly responsible for an agreed, documented clinical position.

3.

KEY RESPONSIBILITIES Clinical governance and assurance Design, own and maintain the clinical governance framework for the complex care division: clinical standards, policies, procedures, audit programme, clinical incident review and learning from serious incidents. Run a rolling programme of clinical audit and package-level quality review, report findings and required actions to the Chief Executive and Board, and evidence what changed as a result.

Maintain the clinical assurance evidence required by CQC, ICBs, commissioners and safeguarding partners, and represent Unicare clinically during inspection and quality visits. Lead clinical incident review and, where the threshold is met, serious incident investigation, ensuring the duty of candour is discharged and actions are tracked to completion. Provide the Chief Executive with an independent clinical view of risk, including where it differs from the operational or commercial position.

Competence, delegation and the unregistered workforce Own the competency framework for every delegated clinical task, defining what competence means for each intervention, how it is assessed, how often it is reassessed and what triggers its withdrawal. Set the professional standards under which registered nurses delegate clinical tasks to Healthcare Assistants and Support Workers, and assure in practice that delegation, supervision and accountability are correctly distinguished and correctly recorded.

Assure that no delegated clinical task is carried out by a person whose competence for that specific intervention, for that specific individual, has not been assessed and signed off. Maintain a live, auditable record of competence across the division that can be produced on demand. Provide professional direction to the complex care clinical training function, including curriculum content, clinical accuracy and the standard required to pass.

Professional leadership of the nursing workforce Act as the professional line for all…