CHAT Tool - Offender Health Research Network

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Tick NO or YES as appropriate for each question and include additional notes No Yes ENDOCRINE SYSTEM Does the young person appear to be developing as expected (remember that there are wide variations in developmental norms) - height; weight; skin; hair; voice Are there any features of their presentation that might indicate a THYROID DYSFUNCTION e.g. physical changes (neck; eyes; weight; hair; tachycardia) or behaviour (over-excited and excessive fidgeting or under-active, labile, slow speech and thought) Do you have DIABETES – if Yes, history; current medications; dietary requirements; testing regime ACTION FOR CARE PLAN Surname: DOB: Forenames: NHS Number: CHAT Tool Secure Estate (Version 3 - June 2013) 39 | P age
Tick No or Yes as appropriate for each question and include additional notes No Yes MUSCULO-SKELETAL SYSTEM Do you regularly EXERCISE – sport; swimming; walking etc. Do you have any pain when you walk or run Do you have any stiffness or swelling in your joints Is there anything unusual about the young person’s frame, POSTURE or GAIT - observe them sitting and walking; range of movements; alignment and symmetry; length of limbs (remember proportions are age related); deformities or swellings; involuntary movements. Is there any evidence of recent TRAUMA e.g. bruising/dressings sutures, absence of fingers/toes/limbs. Have you ever BROKEN and/or FRACTURED a bone before – it is not uncommon for adolescents to have old bone injuries that were not treated or set properly – particularly observe the knuckles for signs of this ACTION FOR CARE PLAN Surname: DOB: Forenames: NHS Number: CHAT Tool Secure Estate (Version 3 - June 2013) 40 | 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 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 39: Tick No or Yes as appropriate for e
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 81 and 82: Risk Review Tick No or Yes as appro
Page 83 and 84: CHAT NEURODISABILITY ASSESSMENT •
Page 87 and 88: After a head injury or accident som
Page 89 and 90: NARRATIVE TASK Ask the young person
Page 91 and 92:
Learning Disability and Educational
Page 93 and 94:
INFORMATION FROM THE YOUNG PERSON T
Page 95 and 96:
Autistic Spectrum Disorder Start by
Page 97 and 98:
Section 3: In social interactions d
Page 99 and 100:
Risk Review Tick No or Yes as appro
Page 101 and 102:
Name: CHAT CARE PLAN DOB: Date: NHS
Page 103 and 104:
Problem/Issue Intervention/Action R
Page 105 and 106:
Initial Weight: Date: Discharge Wei
Page 107 and 108:
Summary of any current or previous
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CHAT Tool - Offender Health Research Network

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