CHAT Tool - Offender Health Research Network

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11. Are you taking any prescribed MEDICATION If Yes please provide details below: 12. Are there any unexplained SKIN rashes or spots These may be indicative of communicable infection but do not include acne, eczema, or sweat rashes. If Yes please provide details below: 13. Have you suffered a RECENT TRAUMA (within last 2 weeks) - E.g. wounds, sutures, bandages or bruising. May attempt to cover-up any injuries sustained during custody/enroute to custody (establish if safeguarding referral is needed) If Yes please provide details below: 14. Are vital signs abnormal E.g. blood pressure, pulse, respirations. Respiration Pulse Blood Pressure PER MINUTE PER MINUTE SYSTOLIC/DIASTOLIC 15. Is there evidence of SHOCK – is there evidence of pallor, fainting, thready pulse etc. If Yes please provide details below: 16. Is the young person disorientated in time, place and/or person If Yes please provide details below: Surname: DOB: Forenames: NHS Number: CHAT Tool Secure Estate (Version 3 - June 2013) 9 | P age
Reception Screen Section Two: Substance Misuse If young person is showing signs of withdrawal symptoms (any YES to questions 5 – 10) then discuss immediate clinical management with a member of the clinical team (doctor/nurse) and complete RELEVANT SECTIONS of the Substance Misuse Assessment BEFORE first night. If using alcohol or substances regularly (every day within the last month) and/or previously experienced withdrawal symptoms:-include closer monitoring for withdrawal symptoms in Immediate Care Plan and discuss with substance misuse team the next working day whether the Substance Misuse Assessment should be completed sooner. Otherwise complete within 5 days. Tick No or Yes as appropriate for each question and include additional notes No Yes 1. Have you RECENTLY (within the last month) taken drugs If Yes: Which substance(s), how much, how frequently and by what route When did you last use any substances 2. Have you RECENTLY (within the last month) drunk alcohol If Yes: How much alcohol per day do you drink How long have you been drinking like this for (If there is regular recent use then complete AUDIT–PC. If they score 20 or above on AUDIT-PC, arrange for immediate examination by a clinical team member) Surname: DOB: Forenames: NHS Number: CHAT Tool Secure Estate (Version 3 - June 2013) 10 | P age
Page 1 and 2: Comprehensive Health Assessment Too
Page 3 and 4: Mental Health Assessment No Yes Is
Page 5 and 6: CHAT RECEPTION SCREEN • Every you
Page 7 and 8: Medical and Psychiatric History Doc
Page 9: 5. Do you have DIABETES MELLITUS If
Page 13 and 14: 6. Is the young person withdrawing
Page 15 and 16: Tick No or Yes as appropriate for e
Page 19 and 20: Documents you have access to at the
Page 21 and 22: CHAT Immediate Care Plan Name: DOB:
Page 23 and 24: Substance Misuse Service No Yes No
Page 25 and 26: Is the young person subject to a CH
Page 27 and 28: MMR BCG HPV Hep A Hep B Typhoid Flu
Page 43 and 44: Disability and Impairment Invitatio
Page 45 and 46: Physical Health Summary/Review Summ
Page 47 and 48: Do the accompanying documents or in
Page 49 and 50: Drug/Alcohol History and Misuse (Co
Page 51 and 52: Drug/Alcohol History and Misuse (Co
Page 53 and 54: Withdrawal - These symptoms are der
Page 55 and 56: DRUG/ALCOHOL USE Where do you usual
Page 57 and 58: Employment E.g. lack of qualificati
Page 59 and 60: Risk Review Tick No or Yes as appro
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CHAT MENTAL HEALTH ASSESSMENT • E
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Tick No or Yes as appropriate for e
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Risk Review Tick No or Yes as appro
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CHAT NEURODISABILITY ASSESSMENT •
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After a head injury or accident som
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NARRATIVE TASK Ask the young person
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Learning Disability and Educational
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INFORMATION FROM THE YOUNG PERSON T
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Autistic Spectrum Disorder Start by
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Section 3: In social interactions d
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Risk Review Tick No or Yes as appro
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Name: CHAT CARE PLAN DOB: Date: NHS
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Problem/Issue Intervention/Action R
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Initial Weight: Date: Discharge Wei
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Summary of any current or previous
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