AH7.2014 Support individuals through detoxification programmes

Overview

For this standard you need to work with individuals to achieve stabilisation and/or withdrawal from alcohol or other substance use through a planned programme of treatment and care. Detoxification programmes involve a range of interventions to address individuals' physical, psychological, emotional, social and legal problems and in many cases include the prescribing of substitute medication. This standard relates to substances which may include alcohol, prescription and over-the-counter medicines, controlled or currently legal drugs, and new psychoactive substances. Users of this standard will need to ensure that practice reflects up to date information and policies. Version No 2

Knowledge and Understanding

You will need to know and understand:

1. legal, organisational and policy requirements relevant to your role and the activities being carried out
2. the principle of confidentiality and the implications for your practice
3. local systems, procedures and protocols for safeguarding children and young people
4. how to adapt communication styles in ways which meet the individual's needs, strengths and capabilities
5. how to share information obtained during assessment or treatment with another agency in line with local protocols
6. how to prioritise requests for assessment according to their priority in line with your organisation's criteria
7. how to involve individuals in the assessment of their needs
8. your responsibility and accountability for the wellbeing of individuals
9. how to support the choice and wellbeing of the individual which is appropriate to their needs and preferences
10. how to assess an individual's motivation and readiness to engage in a treatment programme
11. how to review assessments at appropriate intervals once an individual has commenced a programme of care
12. the importance of keeping full and accurate records, and how to do so in line with organisational requirements
13. locally agreed criteria for admission of individuals to a detoxification programme
14. the principles of equality, diversity and anti-discriminatory practice and how they are applied
15. how to arrange for the completion of comprehensive substance use and risk assessments
16. how to establish the appropriate level of urgency for admission to a detoxification programme
17. advice and information required by individuals prior to a detoxification programme
18. how to agree a contract of care, outlining the responsibilities of your organisation and the responsibilities of the individual during the detoxification programme
19. how to involve significant others and carers in an individual's detoxification programme in order to support the individual
20. how to manage an individual's expectations of a detoxification programme
21. how to formulate a treatment and care plan for an individual
22. how to involve members of other service teams in planning and reviewing an individual's care plan
23. how to actively involve an individual in formulating and reviewing a care plan
24. harm reduction good practice including overdose prevention, safer injecting, contraception and safer sex
25. how to arrange for an individual to undergo appropriate health tests in line with organisational procedures
26. how to review expectations and plans with individuals who are not yet able to complete the detoxification programme
27. the available detoxification options, including substitute medications and regimes
28. the possible side effects of withdrawal and detoxification
29. the risks associated with repeat detoxification
30. the risks associated with relapse and reduced tolerance post-detoxification
31. locally agreed criteria for selecting specific detoxification options
32. the evidence base for detoxification programmes and realistic expectations of outcomes
33. how to deal with challenging, abusive, aggressive or chaotic behaviour
34. how to assess the risk to individuals, children, families and to others from an individual's substance use and/or co-existent problems and the appropriate action to take
35. how to recognise the signs of injury, abuse or neglect in the individual and how to raise concerns with the appropriate person or agency
36. the importance of regularly reviewing risk assessments
37. the signs and implications of a range of substance use related problems
38. ways of keeping your knowledge about substances and indications of substance use up to date
39. the range of substance use services offered by your organisation and other organisations, including peer support
40. how to understand the language used by substance users in your locality
41. how to assess and manage complex needs and co-morbidities in the context of detoxification

Performance Criteria

You must be able to do the following:

1. confirm the eligibility of the individual for admission to the detoxification programme in line with locally agreed criteria
2. arrange for individuals to undertake a comprehensive assessment to evaluate their substance use problems and potential risks to the individual and others
3. arrange the start of the detoxification programme with the level of urgency appropriate to the individual's needs and circumstances
4. provide the individual with advice and information about the detoxification programme prior to commencement
5. explain to the individual the risks associated with detoxification, including reduced tolerance and the risk or relapse and how these are to be minimised
6. assess whether the individual's carers or significant others have a role to play in the detoxification programme and if so, include them in the planning and induction
7. agree a contract of care in line with your organisation's policies and procedures
8. support the individual to maintain realistic expectations of the detoxification programme
9. formulate a treatment and care plan with the individual, involving relevant members of other service teams
10. when appropriate, refer the individual to a prescribing service for prescribing of substitute medication
11. maintain accurate and complete records of referrals to other services in line with locally agreed protocols
12. arrange for provision of appropriate services according to the individuals identified needs
13. provide harm reduction advice appropriate to the individuals' needs
14. offer the individual tests for liver function, HIV and hepatitis B and C and refer appropriately where tests are positive
15. regularly review the treatment and care plan with the individual and others involved in service delivery
16. screen the individual for substance use to monitor compliance according to your organisations protocols
17. review expectations and plans with individuals who are not yet able complete the detoxification programme
18. arrange a discharge planning meeting with attendance by other service provider team members in order to formalise an ongoing care plan
19. ensure individuals who are abstinent are referred to sources of further appropriate support
20. maintain active co-ordination between detoxification services and subsequent rehabilitative care
21. encourage individuals who have completed detoxification to be assessed for suitable rehabilitation
22. complete case closure documentation promptly and accurately for individuals who have completed the programme or who have left the programme prematurely
23. review the service to be provided to individuals that have not completed the programme

Additional Information

This National Occupational Standard was developed by Skills for Health.This standard links with the following dimension within the NHS Knowledge and Skills Framework (October 2004): Dimension: HWB7 Interventions and treatments