<p>Tender Submission Form INPATIENT DETOX</p><p>NAME OF ORGANISATION</p><p>CONTACT NAME </p><p>Please note that these are the contact details of the person completing this submission</p><p>Registered Office: Unit 14/15, Third Floor, 12 Hilton Street, Manchester, M1 1JF Registered in England: Charity No: 515691 Company No: 1842240 1. COST OF SERVICE</p><p>TYPE OF COST PER NIGHT COST PER WEEK SUBSTANCE (£) (£)</p><p>DRUGS</p><p>ALCOHOL</p><p>Providers will be asked to review their costs on an Annual basis </p><p>NB. Having assessed the clients level of need and determined which provider can meet that need the final decision will be based on lowest cost, see Appendix 1 - Instructions on how the Standing List will operate.</p><p>Inclusive/exclusive of VAT (delete as appropriate)</p><p>Registered Office: Unit 14/15, Third Floor, 12 Hilton Street, Manchester, M1 1JF Registered in England: Charity No: 515691 Company No: 1842240 CONTACT DETAILS: These details will be used to form part of a directory of services for use by our Treatment Providers so the information in this section needs to reflect the contact details of the establishment if this is different from the organisation.</p><p>NAME AND ADDRESS OF ORGANISATION</p><p>WEBSITE ADDRESS</p><p>EMAIL ADDRESS</p><p>TELEPHONE NUMBER</p><p>CONTACT </p><p>Registered Office: Unit 14/15, Third Floor, 12 Hilton Street, Manchester, M1 1JF Registered in England: Charity No: 515691 Company No: 1842240 Registered Office: Unit 14/15, Third Floor, 12 Hilton Street, Manchester, M1 1JF Registered in England: Charity No: 515691 Company No: 1842240 DETAILS ABOUT YOUR SERVICE:</p><p>Please complete the table below giving us details about the service you offer using the key at the bottom of this page. l t s s s s e e e e e e d s i l o s r n e n g g g s e g a e h m c a e r o a a n o i a i c c t t o e a v m t T n r m c m s t c S r</p><p> c / l e R g a e s i e A</p><p> s i e l t r d F d a A d t f i e</p><p> r S g r / R g n i</p><p> t i d g d d e A e R o o y a</p><p> e l h r l l r A A n</p><p> c i s h</p><p>D a T a P a r e C c e</p><p> l u m S e M s k R Q e a r D g h C e F t o u h r O</p><p>W Programme Length of D W /</p><p>E Programme T E</p><p>KEY TO RESPONSES</p><p> y Yes n No l Limited a Alcohol only d Drugs Only f Female only m Male only</p><p>Registered Office: Unit 14/15, Third Floor, 12 Hilton Street, Manchester, M1 1JF Registered in England: Charity No: 515691 Company No: 1842240 Tender Questions (Please provide your answer in the box below each question which will expand as required). Please keep your answers short; as a guide most questions could be addressed in 400 words.</p><p>1. Please provide details of your approach to providing in-patient detoxification services. Please include in your response how you ensure that staff have the appropriate knowledge and skills to deliver high quality services for people with alcohol & drug related problems and behaviours. </p><p>2 Please outline your experience of providing, managing and delivering in- patient detoxification services to people with alcohol & drug related issues, including examples of your achievements in this service area. ?</p><p>3. Using examples, please demonstrate how you prevent disengagement. What are your strategies to avoid unplanned discharge? </p><p>4. Do you offer specialised services for any particular groups of clients and how do you ensure you meet a diverse </p><p>5. How do you ensure appropriate clinical governance, please include evidence of audit cycles</p><p>Registered Office: Unit 14/15, Third Floor, 12 Hilton Street, Manchester, M1 1JF Registered in England: Charity No: 515691 Company No: 1842240 This tender submission has been prepared by:</p><p>Name in print: …………………………………………………………………….</p><p>Position held: …………………………………………………………………….</p><p>Organisation: …………………………………………………………………….</p><p>Date: …………………………………………………………………….</p><p>Registered Office: Unit 14/15, Third Floor, 12 Hilton Street, Manchester, M1 1JF Registered in England: Charity No: 515691 Company No: 1842240</p>