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Level 5 & 4 Residential Rehabilitation and Recovery Service: Model of Care

Australia Mental Health Services, Tasmanian Government Country Resources Mental Health Service Standards Tasmania 31 December 2008 Guidelines

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Description

Service guidelines for rehabilitation and recovery services for the state of Tasmania.

Key objectives of this document are;

-Provision of comprehensive clinical assessments of persons, in collaboration with the
person receiving care and those involved in their on-going care, ensuring the appropriateness and safety of placement with RR&RS.
- Provision of an Individual Service Plan by clinicians to RR&RS psychosocial rehabilitation
staff.
- Development of appropriate transition processes, including handover of assessment and
treatment details.
- Development and implementation of individualised treatment and support plans with clear
goals, timelines with consumer and staff responsibilities.
- Provision of appropriately planned, intensive clinical treatment and provision of crisis
intervention in accord with agreed protocols for unplanned treatment and support.
- Provision of supervision and monitoring of consumer well-being supported by open
communication between ACMHS and the psychosocial rehabilitation provider of changes in
symptoms, behaviours, treatment and needs.
- Formulate and implement joint transfer of care plans at the earliest opportunity, and ensure provision of appropriate continuing care arrangements.
- Working in partnership with the psychosocial rehabilitation provider to plan and implement
the Individual Service Plan.
- Develop joint policies and procedures between ACMHS and the psychosocial rehabilitation
provider that facilitate entry, management and discharge of persons utilising transitional
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