ARCH Initiatives - Birchwood Residential Treatment Centre

Birchwood is a mixed, fourteen bed, Residential Treatment Centre operated by ARCH Initiatives. The Centre offers individual drug stabilization or detoxification treatment programmes for adults over the age of 18 years. The treatment programme is in line with the Department of Health’s "Models of Care for Treatment of Adult Drug Misusers" and complies with the standards set by "Quality in Drug and Alcohol Services" (QuADS). The house is registered with the "Commission for Social Care Inspection" (CSCI).

There are no set limits to either the amount, or the range, of client drug use when determining suitability for admission to Birchwood. Care plans are developed in conjunction with the client and there is a daily group programme, in which all clients are required to participate. Referring agencies are encouraged to stay in touch with Birchwood and to participate in agreeing the client discharge plan, if appropriate.

Birchwood Residential Treatment Centre will:

Fully assess the psychological, psychiatric, social and physical status of the client,
using clearly defined assessment processes.

Define a programme of care to meet individual client need.

Deliver prescribing and treatment services to meet the client’s agreed programme of care.

Offer appropriate health care, including - with client consent - testing for HIV and hepatitis B & C,
dental care and basic health screening.

Assess the longer-term treatment needs of the client and formulate an appropriate discharge plan.

Assess and refer clients, as appropriate, to other treatments such as trauma therapy, longer
term counselling etc.

Refer clients to Aftercare Services, when they become drug free.

:
Man leaving Birchwood The usual length of stay in Birchwood is between two and eight weeks, depending on the client’s needs. Length of stay to be recommended would be determined at assessment and agreed between the client, the Case Co-ordinator and the funding agency.

There is no fixed treatment length and Birchwood is open to discussing an extended stay for clients, if this is needed. We will also consider admission for short stays: for instance if a client needs one to two weeks before entering a Rehabilitation Unit, or if stabilisation is required.

Although Birchwood provides individual packages of care to suit the client’s needs, the following options are available:

Detoxification from opiate based substances using the following medications,
according to client need:
1. Methadone
2. Lofexidine
3. Buprenorphine (subutex)
4. Dihydrocodiene (if client is already prescribed this medication)

Stabilisation programmes for clients who need to stop using street drugs and / or
who need to stabilise on their prescribed medication.

Stimulant programmes:
1. A stimulant detoxification programme using selected medication and alternative therapies.
2. Detox from stimulants whilst remaining on opiate prescription

Benzodiazepines:
Detoxification from Benzodiazepines. Regimes will depend upon length of drug use and amount used.

Alcohol
An alcohol detoxification programme is not presently offered, but combined drug and alcohol problems
are considered.

Birchwood provides individual sessions with named key-workers to all clients.

Birchwood also provides group work based on the following:
Relapse prevention.
Offending behaviour.
Triggers - and how to deal with them.
Coping with psychological and physical withdrawal effects.
Alternative therapies, massage and relaxation sessions.
Confidence building: including an arts and crafts programme and computer studies.
Escorted recreational outings.
A range of sessional speakers, e.g. from Aftercare Services, local colleges, NA etc.

Birchwood is staffed 24 hours a day with a multi-disciplinary team (single staffing is never permitted and there is always at least one fully qualified staff member on evey shift), as follows:
A prescribing GP
Residential Service Manager (CSCI Registered Manager)
Service Manager (Group programme)
7 Substance Misuse Workers (forming a therapeutic staff team recruited from a range of disciplines,
including nursing, substance misuse counsellors, social workers etc.)
6 Residential Support Workers (team of support and domestic staff).
2 Cooks.
Administration Officer
Range of Sessional Staff e.g. providing massage, recreation activity etc.

The therapeutic staff team is trained in providing both group sessions and in one-to-one work. An enhanced Criminal Records Bureaux check in undertaken for all Birchwood staff, before employment is commenced.

Full client assessment, case co-ordination and overseeing of care plan delivery is undertaken by ARCH Initiatives’ Case Co-ordination Unit.

ARCH Initiatives provides the full range of support services for Birchwood via the HR Manager, Finance Manager, Quality Assurance & Monitoring Manager and the Office Services Manager. The Birchwood Residential Services Manager is line-managed by the Chief Executive of ARCH Initiatives.

Severe Dependence
Pregnancy
DTTO or other orders that require immediate admission
Vulnerable clients e.g. homeless clients

Serious acute psychiatric morbidity.
Serious physical morbidity (life threatening illnesses).
Couples wishing to detox together.

Referrals are accepted from:
Drug treatment agencies with access to funding streams
Other agencies with access to funding
DIP staff
Self referral when privately funded

Agencies wishing to make a referral to Birchwood can either do this in writing, or by telephone with a following letter confirming the referral and the funding source.

Clients wishing to access Birchwood must undergo an assessment undertaken by ARCH Initiatives’ Case Co-ordination Unit staff.

In circumstances where the client lives outside the immediate area then a telephone assessment will be arranged, but the relevant information must be in ARCH Initiatives’ possession before admission can be agreed e.g. confirmation of prescribed drugs etc.

An admission date will be giving to both the client and to the referring agency as soon as a suitable vacancy becomes available.

On many occasions we are willing to consider an assessment with immediate admission, if this is in the best interest of the client.

Clients will be given an admission date and time, clients travelling long distances to Birchwood will be given an admission time later in the day.

On admission all clients can expect:
An individual induction to life in Birchwood, including:
- health & safety
- rules and regulations applying to their stay at Birchwood.
- information about the group programme and the requirement for full participation during their stay.
To be seen by a doctor within 24 hours of admission.
To receive a full assessment of need and to take part in developing an agreed care plan which would
meet their assessed need.
To be allocated their own key-worker for the duration of their stay.

On discharge after completing the programme all clients can expect:
An agreed discharge plan.
That relevant agencies, involved in after-care of the client on discharge, will be contacted.
That the referring agency will be notified of discharge and will receive a copy of the discharge plan,
if appropriate.

The referring agency will be informed if the client is discharged for non compliance with the programme.

Cost per bed night £121.45

Cost per week £850

These costs are for the period 1st. April 2005 to 31st March 2006.

Copyright © 2004 ARCH Initiatives. All rights reserved.