CHAT Tool - Offender Health Research Network

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CHAT PHYSICAL HEALTH ASSESSMENT • Every young person admitted will be seen by a member of health care staff and receive a comprehensive assessment of physical health using this tool within 3 days of arrival. • The CHAT Physical Health Assessment can be completed by a Registered General Nurse (RGN) or Registered Nurse (specialising in children; RNC). • Seek information from other assessments, e.g. Looked After Children assessments. Liaise with the LAC nurse or doctor regarding health assessment findings. • Refer to other completed parts of the CHAT to inform the care plan. Surname: Physical Health Assessment: Young Person’s Details Forenames: NHS Number: Admission Number: Gender: DOB: Age: Date & time of Reception Health Screening: Date & time of this Assessment: Completed by (print your name): Your designation: Your signature: OTHER AGENCIES INVOLVED RECENTLY/CURRENTLY (Is the young person currently receiving support from any agency) Request to share information for each agency Permission to Involvement from agency: Worker Name and Contact share information YOT Worker No Yes No Yes GP No Yes No Yes Hospital contact No Yes (outpatient & A&E) No Yes Children’s Services No Yes (LAC, Children’s social care) No Yes Leaving care services No Yes No Yes Surname: DOB: Forenames: NHS Number: CHAT Tool Secure Estate (Version 3 - June 2013) 21 | P age
Substance Misuse Service No Yes No Yes Dentist No Yes No Yes Other (specify) Action plan: (any information to be requested specify the person to complete and timeline for completion) Surname: DOB: Forenames: NHS Number: CHAT Tool Secure Estate (Version 3 - June 2013) 22 | 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 and 10: 5. Do you have DIABETES MELLITUS If
Page 11 and 12: Reception Screen Section Two: Subst
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: CHAT Immediate Care Plan Name: DOB:
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
Page 61 and 62: CHAT MENTAL HEALTH ASSESSMENT • E
Page 73 and 74:
Tick No or Yes as appropriate for e
Page 75 and 76:
Page 77 and 78:
Page 79 and 80:
Page 81 and 82:
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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CHAT Tool - Offender Health Research Network

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