Are individualised care plans ‘the basics’ in Mental Health care?
This is the essence of a question I was asked recently when visiting a team. This prompted quite a discussion with a range of views presented. My view is that having an individualised care plan is part of ‘the basics’; that it captures where someone is now and where they want to get to. Without this ‘basic’ I am unsure how the direction is clear and how reaching the destination is known. I was challenged that this view doesn’t take into account the reality of current practice and that people who use services are mostly not interested in their care plan.
What I hear from people who use the service is that the quality of the relationship with their mental health worker is the thing that matters most. I hear that people don’t always have a copy of their care plan and that yes, it would be nice to see the care plan but that this doesn’t cause a problem when the relationship is good. Nowadays, people accessing services are aware that they should have a care plan, they know what a care plan is.
As accountable professionals, we are required to ‘plan’ people’s care, support and treatment. We know that if we don’t involve and engage the person, then the likelihood of success of the care, support and treatment is limited. So where does this leave us? Do we involve the person because we have to or because it’s the right thing to do? Does our believe about this impact on the experience that the person has, on the relationship? And how do we demonstrate that we have involved the person?
The current standards in relation to Planning Care come from a range of places, including: Department of Health/ NHS England, CQC outcomes, CQUINS, Nice Guidance and Monitor (in many cases these standards are developed from feedback from and working alongside service user groups). Ultimately, it’s about working in a service user focused way to promote wellbeing and recovery, here are some ‘basics’ to help ensure we get it right:
- Provide written information about Planning Care (for example, Care Programme Approach)
- Develop the Care Plan with the individual
- Write the Care Plan to reflect the person’s involvement and perspectives
- Include the individual’s own goals
- Ensure that physical health needs are identified and plans to address these are clear
- Clearly identify if the person has a carer(s) and any support the carer needs
- Develop an individualised contingency & crisis plan (early warning, triggers, actions to take – person and services, contact names and numbers )
- Ensure the person receives a copy of their Care Plan
- Record when/how the person received a copy of their Care Plan
- Review to be person centred, flexible approach to engaging the individual and in a timely way
- Record that the review took place
What is your experience or view of individualised care plans?