What are your top 3 ‘makes a difference’ messages you would give to the people planning and providing your care, support and treatment?
I am keen to include the ‘individuals’ voice’ in training. Why? Because what’s the point in providing training if it doesn’t make a difference to the people accessing services. Training can become a standards checklist unless it relates directly to people’s care support and treatment in a meaningful way. The training has to resonate with the participant on some level if it is to have an impact and influence or change practice. The training has to have some value.
In the NHS we are super keen to measure everything, and it’s not that I am against this; it’s just that the measurable bits are often ‘hard’ – concrete and tangible, but it might be that the ‘soft’ bits are where the quality sits. So for example, with Care Programme Approach, one of the standards is that everyone should have a review at least once a year. This is a ‘hard’ standard; it is a distinct event with a time-frame; it is one that is ‘counted’ and reported on. The quality or ‘soft’ aspect in this standard is harder to count but impacts on the persons experience of care support and treatment – the review should include the person’s views, should be held in a way that the person prefers, the review should be held when needed (a year is a long time when you want to be moving forward……) and the review might be a series of discussions and information gathering to inform the care plan rather than a formal, chaired event. It tends to be the ‘hard’ bits that drive practice. My concern here is that practice gets distilled down to the hard bits and the soft bits fall by the wayside. Don’t get me wrong, often it’s the hard bits that get the job done #performance, but is it at the expense of the soft bits #experience? Perhaps a blend of both is best, but have we got the balance right?
So, what are your top 3 ‘makes a difference’ messages you would give to the people planning and providing your care, support and treatment?
People receiving care, support and treatment from Leeds and York Partnerships Foundation Trust (LYPFT) should have a care plan and this should be reviewed regularly. Care may be arranged through ‘Care Programme Approach (CPA)’ or through ‘Standard Care Plan’ if needs are more straightforward.
LYPFT sent out a brief questionnaire to people on CPA to find out what their experience of their review was; you can read a bit more about the questionnaire here.
The results from the questionnaire, the full report can be found here:
- People being offered or given a copy of their care plan was 54.5%.
- Understanding what is in the care plan, being involved in agreeing the goals and being aware that other people could be involved in the review are areas identified for improvement.
- Areas where the results should be celebrated are that people are aware of who their care coordinator is, that they were asked how they were feeling, that they had their say and that they found the review overall helpful.
- Results from 2013 to 2014 are overall improving.
- The response rate to the questionnaire was lower than anticipated at just over 7%.
In response to the questionnaire results LYPFT are focusing training on improving service user involvement in planning care. There are monthly awareness sessions across Leeds and York – dates for these are available here; they are open to people accessing services and carers as well as members of staff across LYPFT and partner organisations. The Planning Care Workplan Implementation Group are tasked with overseeing LYPFT activity in relation to planning care – you can find out more about this group here.
Many thanks to those of you who participated in completing the questionnaires.
Donna Kemp | CPA Development Manager
According to a number of sources, including NICE and Department of Health, people should be involved in planning their care; care plans should be developed jointly and people should be given a copy of their care plan. The care plan should be reviewed at an appropriate time (but no less than annually). The care coordinator or lead professional writes up the agreed care plan (the individual can write it if they want to) and this sits on the electronic patient record called PARIS in Leeds and York Partnership Foundation Trust. The clinician then prints this out to share with the service user for accuracy and then shares with the agreed people, including the service user as a final record.
Should we develop the care plan with the individual? Short answer is yes. Involving the person adds to the sense of empowerment and self determination; is respectful; increases the likelihood of engagement with the plan and therefore improves health outcomes; contributes to the therapeutic relationship and works towards the person’s recovery and wellbeing on their terms. #whywedontengage emerged via Twitter recently; click here to read what people using services said about why they don’t engage – it’s (brutally) honest and not censored by services.
So who does the care plan actually belong to? My answer would be that it belongs to the individual concerned yet responses from the National Service User Survey and local audits suggest that people are not always being given a copy of their care plan and therefore the owner of the care plan becomes PARIS.
If the care coordinator or lead professional has worked collaboratively with the individual to negotiate and agree the plan of care – the goals, who is going to do what and when, then does it matter if the person has a copy of this written down in a care plan or not? As a pedant, I would say that yes, it matters – why go to the trouble of working closely with someone to then not bother capturing it in a personalised care plan. Professionally, clinical staff have to write a care plan anyway so it may as well be done in a way to reflect the involvement that the individual had in agreeing the plan. I would also add that the care plan should be presented in the format that the person prefers, taking into account their communication requirements. You might consider different font size, paper colour, audio tape, language, Braille etc – all depending upon the need of the person. Click here for information leaflets and more about Care Programme Approach.
I have had my say about the questions posed but what is your view? Post on the blog or email firstname.lastname@example.org
If you are receiving care, support and treatment from Leeds and York Partnerships Foundation Trust (LYPFT) then you should have a care plan and this should be reviewed regularly. Your care may be arranged through ‘Care Programme Approach (CPA)’ or through ‘Standard Care Plan’ if your needs are more straightforward.
There is more information about CPA in this leaflet:-
Click here for more information about CPA in York, click here for more information about CPA in Leeds.
LYPFT are now sending out a brief questionnaire to people on Care Programme Approach (CPA) after they have had a review in the community to find out how it was. This is what we send out (click to see):-
The questionnaire was developed with people who use the service; over time the feedback themes will be shared and we can all think about what this means for development.
So, if you have recently had a review, you should be getting the questionnaire through the post soon. Alternatively, you can fill in the questionnaire below, its anonymous (but drop me an email if you want to be in the prize draw – not so anonymous 😦 ).