Quality statement 2: Assessment of care leavers | Drug misuse prevention | Quality standards

Quality statement

Care leavers having a health assessment as part of planning to leave care are assessed for vulnerability to drug misuse.

Rationale

The transition from care is an important time for young people to receive a comprehensive assessment of their physical, emotional and mental health needs, as part of planning to leave care. Assessing a care leaver's vulnerability to drug misuse provides an opportunity to identify risks and give them targeted support.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

Structure

a) Evidence of local arrangements for the use of an agreed brief and valid questionnaire to assess care leavers' vulnerability to drug misuse at their health assessment.

Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by health and social care professionals and provider organisations, for example from service specifications.

b) Evidence of local arrangements for staff to be trained by specialist services in how to assess care leavers' vulnerability to drug misuse.

Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by health and social care professionals and provider organisations, for example from service specifications.

Process

Proportion of care leavers having a health assessment as part of planning to leave care who have an assessment of vulnerability to drug misuse.

Numerator – the number in the denominator where there is an assessment of vulnerability to drug misuse.

Denominator – the number of care leavers having a health assessment as part of planning to leave care.

Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by health and social care professionals and provider organisations, for example audit of local authority records.

Outcome

a) Number of care leavers who misuse drugs.

Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by health and social care professionals and provider organisations. Data collection is required for the Children looked after data return (SSDA903) on whether children looked after by local authorities in England are identified as having a substance misuse problem for each year up to 31 March.

b) Proportion of care leavers misusing drugs who access support for drug misuse.

Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by health and social care professionals and provider organisations. Data collection is required for the Children looked after data return (SSDA903) on whether children looked after by local authorities in England are identified as having a substance misuse problem for each year up to 31 March.

What the quality statement means for different audiences

Service providers (such as primary care services and social care services) ensure that assessments of care leavers' vulnerability to drug misuse are carried out as part of their health assessments. They also ensure that staff are provided with guidance and training from specialist services so that they know the indicators of drug use, how to approach the assessment with sensitivity, how to use brief questionnaires such as CRAFFT accurately, and how to respond to identified needs.

Health and social care practitioners (such as GPs and social workers) use a consistent, locally agreed brief and valid questionnaire, such as CRAFFT, to assess care leavers for vulnerability to drug misuse at their health assessment. They use an approach that is respectful, non-judgemental and proportionate to the young person's presenting vulnerabilities, and consider whether any further action is needed.

Commissioners (NHS England and local authorities) work with providers to produce a strategy to identify young people who are at risk of drug misuse. They ensure that they commission services in which care leavers have an assessment of vulnerability to drug misuse at their health assessment.

Care leavers are asked brief questions at their health assessment to assess whether they are at risk of drug misuse. This is so that their needs can be identified and responded to.

Source guidance

Drug misuse prevention: targeted interventions. NICE guideline NG64 (2017), recommendation 1.2.1

Definitions of terms used in this quality statement

Assessment of vulnerability to drug misuse

An assessment that is respectful, non-judgemental and proportionate to the young person's presenting vulnerabilities that uses a consistent, locally agreed, brief and valid questionnaire, such as CRAFFT. The young person's circumstances should be discussed, taking account of their age and developmental stage. The initial discussion could include:

their physical and mental health and their personal, social, educational or employment circumstances (which may trigger a more in-depth assessment)
any drug use (including the type used and how often).

[Adapted from NICE's guideline on drug misuse prevention, recommendations 1.2.2 and 1.2.3, and College Centre for Quality Improvement's Practice standards for young people with substance misuse problems]

Health assessment

When developing a pathway plan for young people preparing to leave care, an assessment of the needs of the young person should be carried out that includes their health and development. [Adapted from The Care Leavers (England) Regulations 2010]