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					                      Addiction Rehabilitation Center (ARC)
                                Facility Guideline




                              DUBAI HEALTH AUTHORITY




DHA hotline 800 342                                           www.dha.gov.ae
       This guideline may be reproduced in whole or in part for reading or study purposes subject to
       the inclusion of an acknowledgement of the source. Reproduction for purposes other than
       those indicated above requires a written permission of the Dubai Health Authority.




       Enquiries concerning this guideline and its reproduction should be directed to:


       Health Regulation Department
       Office #1017, First Floor, Block C, Al Razi Building, DHCC
       Dubai,
       United Arab Emirates

       Tel: +971 4 4298900
       Fax: +971 4 4298520
       Email: regulation@dha.gov.ae
       Website: www.dha.gov.ae




DHA hotline 800 342                                                                      www.dha.gov.ae
                                                               Table of Contents
       1.      Introduction ............................................................................................................................. 5
       2.      Definition ................................................................................................................................. 5
       3.      Facility Licensure Procedures ............................................................................................... 5
       4.      Clinical Services ...................................................................................................................... 5
       4.1     Detoxification........................................................................................................................... 5
       4.2     Structured Rehabilitation Programme ................................................................................. 6
       4.3     Preparation for Independence ............................................................................................... 6
       5.      Administration of Addiction Rehabilitation Centre (ARC)................................................ 7
       6.      Qualified Personnel ................................................................................................................. 7
       6.1     Staffing Levels – Best Practice Guidelines............................................................................ 7
       6.2     Therapeutic and Medical Staff .............................................................................................. 8
       6.3     Management Staff ................................................................................................................... 8
       6.4     Catering/Housekeeping Staff as follows: .............................................................................. 8
       6.5     Support Staff ........................................................................................................................... 8
       7.      Patients' Privacy and Rights .................................................................................................. 9
       8.      Quality of Care ........................................................................................................................ 9
       8.1     Credentials ............................................................................................................................... 9
       8.2     Patient Evaluation ................................................................................................................... 9
       8.3     Informed Consent ................................................................................................................. 10
       8.4     Patient Records ..................................................................................................................... 10
       8.5     Discharge ............................................................................................................................... 11
       8.6     Emergency & Transfer Protocols ........................................................................................ 11
       8.7     Reporting and Data Collection Requirements ................................................................... 12
       9.      Treatment Services ............................................................................................................... 12
       9.1     Care Planning ........................................................................................................................ 12
       9.2     Keyworking ........................................................................................................................... 13
       9.3     Review Process ...................................................................................................................... 13
       9.4     Evaluation of the Treatment Programme........................................................................... 13
       10.     Medication and Detoxification (assisted withdrawal) ....................................................... 14
       10.1 Detoxification and Medication ............................................................................................. 14
       11.     Facilities, Equipments and Environment ........................................................................... 14
       11.1 Facility Physical Environment ............................................................................................. 14
       11.2 Equipments and Safety ......................................................................................................... 15
       11.3 Infection Control ................................................................................................................... 16
DHA hotline 800 342                                                                                                              www.dha.gov.ae
       11.4 Smoking Policy ...................................................................................................................... 16
       12.     Judiciary Involvement .......................................................................................................... 16
       13.     Furnish Information ............................................................................................................. 16
       14.     Authorities Having Jurisdiction .......................................................................................... 16




DHA hotline 800 342                                                                                                       www.dha.gov.ae
       1.   Introduction
       This guideline is not intended to be all-inclusive, but outlines fundamental policies and
       procedures that should be in place to ensure public protection in Addiction Rehabilitation
       Centre (ARC) facility settings.

       Since “Attempts to treat alcohol or drug addiction by means of assisted withdrawal alone
       have repeatedly been shown to have high rates of relapse to dependent use” (SCAN 2006)
       addiction residential rehabilitation centers offering a comprehensive mental rehabilitation
       programme along with detoxification services are widely acknowledged to play a key role in
       treating addiction.

       2.       Definition

       This type of facility provides residential treatment for people recovering from addiction as
       part of continuum of care for effective treatment. It is characterised by a high level of
       psychological and social intervention at a critical stage of recovery. Residential treatment is
       most effective when people are immediately discharged from an in-patient hospital unit, or
       when their addiction symptomology requires a low level of assisted withdrawal and when
       abstinence is a goal of treatment. In addition residential treatment is most valuable where
       there is polydrug misuse, co-occurrence of substance misuse and mental illness or complex
       social and relationship issues.

       3.       Facility Licensure Procedures

       Health facility licensing procedures are described in Dubai Health Authority (DHA) website
       www.dha.gov.ae please visit the website for further details regarding procedures and
       requirements

       4.       Clinical Services
       The Addiction Rehabilitation Center facility shall restrict health services provision in the
       facility to the defined services and restrictions particular to the facility license. The health
       facility shall comply with DHA standards and guidelines.
       Research shows that in general such facilities are most effective in relatively small patient
       numbers (10-30 being ideal), representing a „home‟ style environment with medically
       managed detoxification facilities and care to detoxification:
       Treatment for drug and alcohol addiction and other addictive diseases may be divided into
       three phases:
               Detoxification, which can last from a few days to over a month
               Structured Rehabilitation Programme
               Preparation for Independence

                   4.1   Detoxification
                Detoxification or Assisted withdrawal can either be „medically managed‟ in a hospital
                inpatient environment or „medically monitored‟ in an Addiction Rehabilitation Centre
                (ARC).

DHA hotline 800 342                                                                          www.dha.gov.ae
              Detoxification may be „medically managed‟ for the initial stages followed by „medical
              monitoring‟
              „Medically Managed‟ withdrawal is recommended in the following cases:
             Alcohol withdrawal for those suffering from, severe dependence with a history of
              withdrawal complicated by delirium tremens or seizures; poor physical health, co
              morbid psychiatric conditions or risk of suicide; chaotic polydrug misuse; history of
              previous unsuccessful attempts at withdrawal.
             Polydrug Misuse withdrawal, especially two or more opiods, or one opioid and alcohol


              Detoxification may be „medically monitored‟ in a Addiction Rehabilitation Centre
              (ARC) if the above risk factors are not present and if there is a qualified nurse with
              specialist knowledge of detoxification present 24 hours a day; plus an on-call physician
              who is able to prescribe medication to alleviate withdrawal symptoms.
              The Detoxification process may last up to one month and is rarely successful unless
              accompanied by a full programme of psychological support (phases 2 and 3)

                 4.2   Structured Rehabilitation Programme
              This may begin when clients‟ cognitive functioning is sufficient to benefit from the
              programme. The emphasis of the programme is psycho-social functioning and will
              include:
              Daily group therapy, educational lectures, one-on-one counseling or key working
              sessions, topic focused workshops, relapse prevention work, health promotion advice
              and workshops, peer evaluation, objective setting.
              A program of holistic therapies and exercise programs may also be included such as:
              acupuncture, Reiki, massage, yoga etc.
              In addition „Family Programs‟ to educate and assist the families of patients are
              recommended.
              The most popular Structured Rehabilitation Programs use a cousellor led
              understanding and coping skills program based on the 12 Step Minnesota Model of
              total abstinence (Betty Ford etc.) devised in the 1950s.

                 4.3   Preparation for Independence
              This phase focuses on daily living skills and should include some or all of the
              following:
              Routine setting to overcome chaotic lifestyle, re-establishing relationships, pre-
              employment training, financial awareness, introduction to self help groups such as
              Alcoholics Anonymous and Narcotics Anonymous, devising a program of aftercare
              and or extended care program, liaising with post treatment support facilities where
              appropriate such as social services, health services the judiciary etc. Establishing an on-
              going drug testing and monitoring arrangement.

              All Addiction Rehabilitation Centers (ARC) offering a detoxification program must
              have a registered addictions nurse on duty at all times, an on-call physician and
              psychiatrist; and must have an agreement on file with a general hospital with

DHA hotline 800 342                                                                        www.dha.gov.ae
             psychiatric services or a psychiatric hospital in proximity for those patients who
             require medically managed inpatient care.

       5.   Administration of Addiction Rehabilitation Centre (ARC)

       Administration of Addiction Rehabilitation Centre practices should be administered in a
       manner to ensure high-quality health services while recognizing basic patient rights.

       All Addiction Rehabilitation Centres practices should have policies describing organizational
       structure, including lines of authority, responsibilities, accountability and supervision of
       personnel. All such practices should have a Clinical Director (a qualified experienced
       addiction counsellor and treatment centre manager) that establishes policies and is
       responsible for the activities of the facility and its staff. Each facility should have an on-call
       psychiatrist or part time Medical Director (psychiatrist) to liaise with the Clinical Director to
       assess all patients‟ psychiatric suitability for treatment and also diagnose and prescribe any
       additional psychiatric care requirements.

       The facility shall maintain a written policy with regard to the qualifications of its Clinical and
       Medical Director. He/she shall assure that all procedures are carried out by or under the
       direction of qualified, skilled and experienced licensed professionals, whether employed as
       consultants or directly by the facility itself.

       Administrative policies should be implemented so as to provide quality healthcare in a safe
       environment and ensure that the facility and personnel are adequate and appropriate for the
       type of procedures performed. Policies and procedures governing the orderly conduct of the
       facility should be in writing and should be reviewed annually. All applicable regulations must
       be observed.

       6.    Qualified Personnel
       All healthcare professionals should have appropriate licensure by DHA and the necessary
       training and skills to deliver the services provided by the facility. All personnel assisting in
       the provision of healthcare services must be appropriately trained, qualified, supervised, and
       sufficient in number to provide appropriate care. Functional responsibilities of all healthcare
       professionals and personnel should be defined and delineated. Policies and procedures for
       oversight of healthcare professionals and personnel should be in place. Clinical information
       relevant to patient care should be kept confidential and secure.

       To submit new professional licensure application please visit the DHA website for further
       details and requirements

                6.1   Staffing Levels – Best Practice Guidelines
             The facility staffing is based on many factors including but not limited to diagnosis,
             number of patients admitted in the facility and treatment programme offered by the
             facility; EG: Given the relatively high ratio of patients with dual diagnosis (other
             psychiatric disorders) certainly amongst the local population, it is recommended in
             that such facilities have a full time psychiatrist instead of or in addiction to an ‘on call’
             Medical Director.
             Staffing is dependent on the specific needs of the client and the intensity of the
             treatment program on offer. Assuming that a maximum capacity of twenty beds with

DHA hotline 800 342                                                                         www.dha.gov.ae
              medically monitored detoxification being offered on site, the following staffing would
              apply:

                 6.2   Therapeutic and Medical Staff
             Access to a Medically Qualified Psychiatrist, with a special interest in addiction: „on
              call & oversight‟ to participate in assessment.
             Access to a qualified physician to assess and prescribe detoxification and other
              medication as required.
             On site, one qualified nurse with special interest in addiction providing 24 hour cover
             On site a Medically Qualified Psychiatrist with an interest and experience in addiction
              to support and assist the Medical Director if part time.
             Counsellors – with appropriate qualification and/or accreditation in addiction as key
              workers. The ideal ration would be one full time counsellor to four clients.
             Ideally counsellors should have access to „clinical supervision‟ on a monthly basis
              from a suitably qualified clinical supervisor.
             Professional staff should ideally have accreditation from a recognised accreditation
              organisation such as the Federation of Drug and Alcohol Professionals (FDAP)

                 6.3   Management Staff
             One full time Manager with overall responsibility for the running of the business. Their
              responsibilities will include: financial and business planning, liaison with external
              agencies, recruitment of Clinical Director, staff recruitment and Human Recourse (HR)
              Management, Premises management, policies and procedures, management of
              complaints, safeguarding the rights of clients using the service.
             One full time equivalent Clinical Director to oversee and manage the treatment
              programme, including responsibility for clinical governance. Must be qualified and
              experienced in the addictions field.
             One part time Medical Director to support the clinical director and assess each new
              client and be fully responsible for Medication Management
             One full time equivalent Business Development Manager to specifically attract new
              business to the service

                 6.4   Catering/Housekeeping Staff as follows:
             One full time chef and one full time or equivalent assistant – cover to be available
              seven days per week.
             One full time equivalent housekeeper and one full time equivalent laundry assistant for
              every ten beds occupied.

                 6.5   Support Staff
             One full time equivalent reception/administrative support staff
             Two full time equivalent support staff for 24 hour cover outside the treatment program
              hours to provide security, support and assistance to the nurse on duty.


DHA hotline 800 342                                                                       www.dha.gov.ae
             One full time equivalent maintenance staff – depending upon size of premises and
              grounds.

       7.    Patients' Privacy and Rights
       Patients should be treated with respect, consideration, and dignity. The patient has the right to
       privacy and confidentiality. Patients, or a designated person when appropriate, should be
       provided information concerning the patient‟s diagnosis, evaluation, treatment options, and
       prognosis.

       Patients should be given the opportunity to participate in decisions involving their healthcare
       when such
       participation is not contraindicated. Patients have the right to refuse any medical procedure or
       treatment and be advised of the medical and or psychological consequences of that refusal. In
       some cases refusal may result in the patient being asked to leave treatment. Patients have the
       right to request information about a physician, psychiatrist and counsellor‟s scope of practice
       and license.

       Patients have a right to obtain a copy of their personal patient records. Addiction
       Rehabilitation Centre facilities must comply with all DHA guidelines relating to patient‟s
       rights, a copy of which should be posted in a visible and accessible place in the facility.

       8.    Quality of Care
       Addiction Rehabilitation Centre practices should develop a system of quality assessment that
       effectively and efficiently strives for continuous quality improvement.

                 8.1 Credentials
              Credentials, including delineation of privileges, of all healthcare professionals should
              be established by written policy, periodically verified, and maintained on file.

                 8.2 Patient Evaluation
              Each patient should be evaluated through a multidisciplinary process to ensure a
              holistic approach to client need and suitability for treatment. This assessment should
              involve a qualified psychiatrist or psychologist, counsellor and physician.

           The following key themes should be evaluated during the assessment:

           – Drug or alcohol misuse history

           – Degree of dependence

           – Physical health issues e.g. blood borne viruses, liver disease, neurological
             impairment

           – Mental health issues e.g. depression, anxiety, other psychiatric conditions

           – Psychological issues – relationship breakdown, past abuse, trauma etc

           – Social issues – family, employment, housing, financial problems, child care etc

           – Risk assessment e.g. suicide, self harm, overdose, harm to others, self neglect etc

DHA hotline 800 342                                                                        www.dha.gov.ae
           – Motivation to engage in treatment with/without support of family

           Throughout assessment it is important the patient is fully involved and given appropriate
           information prior to admission to a service. The following themes are important:-


           – Maintaining dignity, privacy and independence of the individual

           – Providing appropriate information about the service and its treatment approach to
             ensure that an informed choice is made about engagement in the service

           – Providing appropriate information regarding the cost of treatment.

           – Sensitivity to Cultural issues which are important to the individual e.g. offering a
             pork free environment

           – Awareness of significant others especially spouses and close family members

           – Legal issues – outstanding court appearances, offences etc

           Finally, assessment of funding sources needs to be made. i.e. can the client afford to pay
           either directly, through insurance schemes or healthcare funding arrangements.

                8.3 Informed Consent
            Informed consent for the nature and objectives of the planned treatment programme for
            each phase of treatment including any agreed participation in an ongoing random drug
            testing programme should be in writing and obtained from patients before admission to
            treatment. Informed consent should only be obtained after a discussion of the risks,
            benefits and alternatives and should be documented in the patient record. All consents
            should conform to DHA regulation rules and regulations. Further details regarding
            Informed consent are provided in DHA consent guideline

               8.4 Patient Records
            A legible, complete, comprehensive, and accurate patient record must be maintained for
            each patient. A record should include a recent history, physical and psychological
            assessment, laboratory reports where appropriate, regular medical and rehabilitation
            programme assessments, allergies, ongoing aftercare plans and any referrals to social
            services, judiciary, healthcare services or similar.

            Specific policies should be established to address retention of inactive records. All
            information relevant to a patient should be readily available to authorized healthcare
            professionals any time the office facility is open to patients or in the event that a patient
            is transferred due to physical or psychiatric complications. Patient information should
            be treated as confidential and protected from loss, tampering, alteration, destruction,
            and unauthorized or inadvertent disclosure.

            Records should be organized in a consistent manner that facilitates continuity of care.
            Discussions with patients concerning the necessity, appropriateness and risks of
            proposed treatment, as well as discussion of treatment alternatives, should be
            incorporated into a patient‟s patient record as well as documentation of executed

DHA hotline 800 342                                                                        www.dha.gov.ae
            informed consent. For further information, see Patient Records guidelines which is
            available in DHA website www.dha.gov.ae

                8.5   Discharge
            Discharging patients is the responsibility of the Clinical Director or Medical Director or
            his/her immediate subordinate and should only occur when the patient has completed
            the treatment programme and is deemed ready for discharge; if the patient needs to be
            transferred to another healthcare facility; or if the patient refuses to continue treatment.
            Such criteria should be in writing and include recommendation for discharge by the
            patient‟s key worker, Medical Director and a closing assessment of the patient‟s
            response to treatment. If a patient is being discharged after completing treatment a
            programme of aftercare should be included. If a patient is being transferred to another
            healthcare facility, a recommendation for future care and treatment after certain
            physical or psychiatric stability is met, should be included.

            A contact phone number of both outpatient facility and the treatment facility should be
            given with an invitation to call any time advice or help is required.

            If a patient is taking medication on discharge, their physician, psychiatrist or ongoing
            healthcare professional should be notified.

           Discharge procedures should include:

           – Criteria for completion e.g. specified length of stay or period of abstinence or
             achievement of specific goals, such as completion of certain steps within a twelve
             step programme or achievement of cognitive awareness etc.

           – On completion of programme – where and how discharged to include
             accommodation and family arrangements

           – If early discharge – in what circumstances this is agreed

           – If unplanned discharge – what arrangements to communicate with referring agent,
             family, local agencies if the person is a risk to themselves or others, what advice has
             been offered e.g. relapse prevention, risk of infection from blood borne viruses etc.

               8.6 Emergency & Transfer Protocols
            Written policies must be in place to ensure necessary personnel, equipment, and
            procedures to handle medical and other emergencies that may arise in connection with
            services provided. At a minimum, there should be written protocols for handling
            emergency situations, including medical emergencies and internal and external
            disasters.

            All personnel should be appropriately trained in emergency protocols. Medications
            must be available in order to stabilize a patient before transfer to another facility.

            There should be written protocols in place for the timely and safe transfer of patients to
            a pre-specified alternate care facility within a reasonable proximity when extended or
            emergency services are needed.

DHA hotline 800 342                                                                       www.dha.gov.ae
                  8.7 Reporting and Data Collection Requirements
               Reporting should be structured in a manner to consistently encourage a free flow of
               information the following should be reported to Health Regulation Department:

                  Any incident during either detoxification or rehabilitation that involves a patient‟s
                    death.

                Any incident during detoxification or rehabilitation that involves a patient‟s attempted
                  suicide or serious self-harm.
               Reporting requirements should be consistent with relevant patient confidentiality
               regulations implemented in DHA.

       Health Regulation Department shall develop a set of clinical performance indicators which
       will enable it to measure the RATC performance in various clinical aspects. Even more,
       RATC shall submit data consistent with e-Health guidelines and standards set by the DHA.

       9.      Treatment Services

       Addiction Rehabilitation Centre (ATC) procedures should be provided by qualified
       healthcare professionals in an environment that ensures patients safety. Each patient should
       be given an individualised programme of care that is reviewed on at least a twice weekly
       basis to ensure they receive the best and most appropriate care through the three stages of
       treatment.

       When planning a patient‟s treatment care programme, the following core elements should be
       considered and included: Care Planning, Keyworking, Review Process, Evaluation of the
       treatment programme and post treatment support arrangements.

                    9.1   Care Planning

       A treatment programme should be devised by the Clinical Director with approval and input
       from the Medical Director and Centre Manager. This programme will then be individualised
       to fit each patient. The treatment programme will include:

            – Goals of treatment and milestones to be achieved – with active participation of patient.
              Areas covered will focus on a range of needs around the four domains of Drug and
              Alcohol use, physical and psychological health, social functioning and criminal
              behaviour.

            – Interventions with family or employers may be arranged directly related to the goals of
              treatment.

            – Medication arrangements must be individualised, especially highlighting stabilisation
              medication, recording of medication administration, consent to medication and
              arrangements for self medication where appropriate.

            – Risk management processes should be in place with plans and contingency plans

            – Allocation of responsibility for achieving these goals – see also keyworking

            – Co-ordination between professionals involved

DHA hotline 800 342                                                                            www.dha.gov.ae
         – Limitations on movement and choices which are agreed with each individual subject to
           risk assessment e.g. not leaving the premises during the initial phase of treatment, only
           leaving the premises during later phases if accompanied and at specified times, contact
           with specified visitors only, not developing intense relationships during treatment,
           limited access to telephones for specific purposes, drug or alcohol testing procedures at
           treatment providers initiative.

         – Discharge procedures – see point 9.5

                9.2   Keyworking

       This is a therapeutic relationship between a specified worker (addictions counsellor) and a
       client. It provides:

         – A personalised overview of the progress of a client through their treatment

         – An individual approach to agreeing and monitoring care plan

         – Allocation of responsibility for tasks within the care plan

         – A therapeutic environment in which to explore personal issues outside group sessions

         – An environment for motivational interviewing, where appropriate

         – Co-ordination of care with other professionals (e.g. psychiatrists, social workers,
           probation offers etc.)

                9.3   Review Process

       This is usually undertaken with the keyworker at frequencies to be agreed at the outset with
       the client and referring agent (if appropriate). As a guideline this should be at least weekly in
       the early stages, less frequently as treatment progresses. The review process with focus on the
       goals agreed in the care plan. Accountability to the centre manager and clinical director need
       to be established as an overview of the treatment process.

                9.4   Evaluation of the Treatment Programme

       This is part of the clinical audit of the treatment facility and will include and analysis of
       outcomes such as:

         – Retention rate achieved

         – Completion rate

         – Complexity of client diagnosis

         – Rate of unplanned discharge

         – Critical incident review

         – Evaluation of admission criteria in the light of the above


DHA hotline 800 342                                                                         www.dha.gov.ae
         – Client satisfaction with service and feedback obtained

         – Referrer satisfaction

       10.   Medication and Detoxification (assisted withdrawal)

       Addiction Rehabilitation Centre (ARC) should have policies and procedures regarding the
       administration and prescription of medication. Medication should be prescribed by a suitably
       qualified physician, available on call 24 hours per day, and administered by suitably qualified
       nurse, on site 24 hours per day.

       On assessment of the patient, the suitably qualified physician and psychiatrist will evaluate
       each patient‟s individual need for detoxification from substance misuse (drugs, alcohol etc.)
       Patients needing medically managed detoxification will be referred to a partner hospital for
       detoxification until they are considered suitable for medical monitoring. Patients who require
       a detoxification medically monitored on site will be assessed at least twice per week by either
       a qualified physician or psychiatrist and will be monitored twenty-four hours per day by
       qualified addiction nurses.

       Medication will be prescribed by a qualified physician and administered and recorded by
       qualified nurse. Medication will be stored in a locked facility accessible only by the nursing
       staff and patients will take the medication voluntarily. Should unplanned or emergency
       sedation or similar be required, this will be administered by a qualified physician.

       Patients will be assessed throughout their detoxification as to their suitability and readiness to
       begin phase two of the treatment programme and will be encouraged, where appropriate, to
       integrate with „the group‟ (fellow patients). A single or shared room away from the main
       patients‟ accommodation will be available for patients who need extra privacy during the
       early stages of detoxification.

             10.1   Detoxification and Medication

       Up to 15% of patients in alcohol withdrawal experience a seizure, so this needs to be
       carefully monitored. The usual medical treatment is benzodiazepines for up to ten days. A
       longer period of time is indicated if there is a history of delirium tremens, head injury or
       cognitive impairment. The usual medication for opioid withdrawal is either methadone,
       Buprenorphine or Lofesicine.

       All detoxification programmes and medication should be prescribed by a qualified physician
       in consultation with the clinical director or direct subordinate and psychiatrist.

       11.   Facilities, Equipments and Environment

             11.1      Facility Physical Environment

       Patients and clients using the service and people who work in or visit the premises should be
       in safe surroundings that promote their welfare. the Addiction Rehabilitation Center facility
       shall be an independent building e.g. villa and can‟t be located with residential or commercial
       building.


DHA hotline 800 342                                                                        www.dha.gov.ae
       As such the facility should be clean and properly maintained and have adequate lighting and
       ventilation. The space allocated for a particular function or service should be adequate for the
       activities performed. The Health Facility Guidelines: 2.4 Rehabilitation Facilities should be
       considered and adhered to where appropriate.

       To facilitate the above, the Addiction Rehabilitation Centre will:-

           – Make sure that the people using the service, staff and others are protected against the
             risks of unsafe or unsuitable premises

           – Ensure that the design and layout of the premises are suitable for the purpose of
             treatment and addiction.

           – Make sure that the premises and grounds are adequately maintained.

           – Take account of any planning or legal requirements concerning such premises.

       Essential elements of the premises should include:

           – Bedrooms with a maximum of three people sharing during

           – Sufficient bathrooms, shower facilities and toilets: one bathroom per four patients
             plus guest, staff and visitor restroom

           – Rooms for Group Therapy – maximum capacity 12 people – 2 rooms

           – Rooms for keyworking/counselling – 2 rooms

           – Treatment room/nursing station close to rooms where people undergoing
             detoxification are situated – also for use by medical staff

           – Office for administration and management

           – Staff room

           – Laundry facilities

           – Kitchen

           – Dining room

           – Communal area for relaxation

           – Space for meetings between clients and their visitors – family, referring agent etc.

            11.2       Equipments and Safety

       The following maintenance and safety measures and procedures should be in place:

           – Effective management of risk e.g. electrical and hot water safety, identification of
             hazards, fire safety etc.


DHA hotline 800 342                                                                       www.dha.gov.ae
             – A system to ensure that décor is maintained

             – A constantly updated maintenance schedule for the premises and grounds

             – Appropriate arrangements for hygiene and infection controls in place

             – The facility must comply with the Dubai Municipality (DM) regulations regarding
               protection of the health and safety of employees.

              11.3      Infection Control

             – Procedures should be implemented to minimize the sources and transmission of
               infections and maintain a sanitary environment. A system should be in place to
               identify, manage, handle, transport, treat, and dispose of hazardous materials and
               wastes whether solid, liquid, or gas.

              11.4      Smoking Policy
             Smoking inside the RATC facility is strictly prohibited in all but designated smoking
             areas. The RATC policy is to be strictly implemented by managers and signboards will
             be in evidence alerting individuals regarding this policy.

       12. Judiciary Involvement
       Dubai Police with coordination with Health regulation Department may enter the RATC
       facility for arresting any patient if he/she is a detainee in court case.

       13.    Furnish Information

       Licensees shall provide upon official request to the Health Regulation Department officers
       access to patient records and information required by the DHA, the Department shall not
       release to any unauthorized individual any information defined as confidential by law or
       jeopardise patients‟ right of confidentiality.

       14.    Authorities Having Jurisdiction

       Health facilities shall obtain approval and comply with all the required regulations and
       standards by authorities having jurisdiction related to health care facilities e.g. Dubai
       Municipality (DM), Department of Economic Development (DED).




DHA hotline 800 342                                                                       www.dha.gov.ae

				
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