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AF3: Carry out comprehensive substance misuse assessment

Status: National Occupational Standards (NOS)

About this workforce competence

For this unit you need to assess the needs of substance misusers with complex requirements and/or those people who require more intensive and/or structured care programmes. It covers assessment that is on-going throughout the contact with the substance misuse service and the wider treatment system.

There are three elements:

AF3.1  Prepare for a comprehensive substance misuse assessment

AF3.2  Assess possible risks and the individual's understanding of services available

AF3.3  Assess the individual's substance misuse and related problems.

Users of this competence will need to ensure that practice reflects up to date information and policies.

This is an optional unit in the Health and Social Care NVQ/SVQ at Level 3.

This competence replaced HSC340 during rationalisation of the database.

Links

This workforce competence has indicative links with the following dimension and level within the NHS Knowledge and Skills Framework (October 2004):

HWB2: Assessment and care planning to meet people's health and wellbeing needs
Level 3: Assess health and wellbeing needs and develop, monitor and review care plans to meet specific needs

Keywords

Origin

This unit was developed as part of the Drugs and Alcohol National Occupational Standards (DANOS).

Glossary

This section provides explanations and definitions of the terms used in this workforce competence. In competences, it is quite common to find words or phrases used which you will be familiar with, but which, in the detail of the competence, may be used in a very particular way.

Scope

This section provides guidance on possible areas to be covered in this competence.

Priority

severity of the individual's needs and their urgency

need to maintain individual's; motivation

risk

Information

personal details

treatment history

substances used

reports from courts

probation or care workers

Services

internal to your organisation

external to your organisation

Capability

adults

children and young people

chaotic lifestyles

incoherence

intoxication

Risk

self harm

harm to others

physical health problems

mental health problems

Substance misuse problems

drug use (including type of drug/s, quantity/frequency of use, pattern of use, route of administration, source of drug)

alcohol use (including quantity/frequency of use, pattern of use, whether above "safe" level, alcohol dependence symptoms)

psychological problems (including self-harm, history of abuse/trauma, depression, paranoia, severe psychiatric co-morbidity, contact with mental health services)

physical problems (including complications of drug/alcohol use, pregnancy, blood-borne infections/risk behaviours, liver disease, abscesses, overdose, enduring or severe physical disabilities)

social problems (including child care issues, partners, domestic violence, family, housing, employment, benefits, financial problems)

legal problems (including arrests, fines, outstanding charges/warrants, probation, imprisonment, violent offences, criminal activity)

Other problems

in need of intensive intervention

significant psychiatric and/or physical co-morbidity

in contact with multiple service providers

pregnancy or children ‘at risk'

history of disengagement from substance misuse treatment services

Performance Criteria

AF3.1 Prepare for a comprehensive substance misuse assessment

You must ensure that:

1. you evaluate requests for assessment to determine their priority consistent with your organisation's criteria

2. you obtain information on the individual from previous assessments carried out by other services in line with protocols

3. you obtain further information if the initial information is insufficient for effective assessment to take place

4. you establish any particular needs of the individual which will need to be taken into account during the assessment from the available information

5. you fully and accurately record arrangements for the assessment in line with the organisation's procedures

6. you confirm arrangements for the assessment with the individual

7. you explain clearly to the individual any delays between requests for assessment and assessment taking place

8. you give the individual any documentation which needs to be completed by them to allow them to consider it before the assessment

9. you offer appropriate support to individuals who need assistance to complete documentation.

AF3.2 Assess possible risks and the individual?s understanding of services available

You must ensure that:

1. you inform the individual of the nature and duration of the assessment, the type of information which will be entered in their records and who will have the right of access to these

2. you conduct the assessment in line with locally agreed criteria and using standardised documentation

3. you involve the individual in the assessment as far as possible according to their capability

4. you review information obtained from previous assessments

5. you collect information from the individual, exploring historical factors as well as presenting factors

6. you assess the individual's understanding of services available and readiness to engage in a treatment programme

7. you deal with challenging, abusive, aggressive or chaotic behaviour

8. you assess any risk to the individual which may result from substance misuse according to locally agreed protocols

9. you encourage the individual to ask questions, seek advice and express any concerns.

AF3.3 Assess the individual?s substance misuse and related problems

You must ensure that:

1. you assess the nature of the individual's substance misuse problems and other problems

2. you seek clear conclusions from the assessment to inform the development of a comprehensive care plan

3. your assessment takes account of the individual's needs, any inherent risks and the legal duty of care to the individual and others

4. you keep accurate, legible and complete records of the assessment to inform the development of a care plan and for evaluation purposes

5. you continue assessment at appropriate intervals once the individual has commenced a care plan

6. you provide individuals with accurate and clear information on systems for making complaints about the assessment system and appealing on the decisions

7. you seek support from the appropriate person as soon as possible when there are any problems with the assessment

8. you discuss assessments with other members of the substance misuse service team in order to ensure consistency of approach

9. your assessment records are in a format and level of detail which can be audited against locally agreed standards

10. you record and report changes made and any effect this might have on the individual within confidentiality agreements and according to legal and organisational requirements.

Knowledge and understanding

You need to apply:

Legislation and organisational policy and procedures

K1. the principles of the Children's Act 1989 and the UN Convention on the Rights of the Child 1989

K2. how to obtain information from individuals and other agencies in line with protocols

K3. how to pass information obtained during an assessment to another agency in line with local protocols

Theories and practice

Assessment of individuals

K4. how to evaluate requests for assessment according to their priority in line with your organisations criteria

K5. how to involve an individual in the assessment of their needs

K6. how to assess an individual's understanding of services available and readiness to engage in a treatment programme

K7. how to deal with challenging, abusive, aggressive or chaotic behaviour

K8. how to assess individuals who are intoxicated

K9. who can provide support when there are any problems with the assessment

K10. how to achieve consistency in assessments with other workers in your organisation

K11. the importance of adhering to locally agreed criteria and documentation when carrying out assessments

K12. how to record the outcomes of assessments and use the assessment to inform the development of a comprehensive care plan

K13. how to review assessments at appropriate intervals once an individual has commenced a programme of care

K14. how to involve adults with parental responsibility in the assessment and referral of children and young people

K15. how to take account of a child or young persons age and maturity when involving them in assessment

Information handling

K16. the importance of keeping full and accurate records, and how to do so

K17. the principle of confidentiality: what information may be given to whom

K18. how to support individuals to complete documentation

Monitoring and evaluation

K19. the importance of monitoring the situation regarding an individual's misuse of substances, and how to do so

Risk assessment

K20. how to assess the risk to individuals and to others from their substance misuse and/or co-existent problems

K21. the importance of regularly reviewing risk assessments

Substance misuse

K22. the signs and implications of a range of substance misuse related problems including drug use, alcohol use, psychological problems, physical problems, social problems and legal problems

K23. how to deal with other problems including the need for intensive interventions, significant psychiatric and or physical co-morbidity, contact with multiple service providers, pregnancy or children ‘at risk' and a history of disengagement from substance misuse treatment services

K24. ways of keeping your knowledge about substances and indications of substance misuse up to date

K25. how to understand the jargon used by substance misusers in your locality

Substance misuse services and interventions

K26. sources of information on substance misuse services and treatment interventions

K27. the range of treatment interventions and assessment services available in your locality

K28. the eligibility criteria and protocols for accessing services in your locality

K29. national, local and organisational treatment priorities and resource constraints

K30. how to respond to individuals who do not want to be referred to other services

Values

K31. how to present information in a manner, level and pace appropriate to the individual.

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