As a digital care management system provider with care planning at the heart of our provision, CAREis, https://www.careis.net/, are often involved in discussions with staff about care planning and how it can be improved. This question is especially acute when the CQC have been and identified a lack of proper process in care plans or suggest that support planning could be improved, https://www.cqc.org.uk/guidance-providers/regulations-enforcement/regulation-9-person-centred-care. Some staff want CAREis to provide template care plans, but we won’t do this because templates suggest a single approach to care provision which is not person-centred and being person-centred is, as the name suggests, at the heart of good care planning.
Care planning forms the backbone of the plan of care for any service user be they living in a care home setting or at home. Done properly, a care plan can create a very useful template for care, done badly they:
In this blog, we will identify 10 of the biggest blunders care staff make when care planning.
- Failing to consult the service user – it is their care plan after all. How can it be person-centred if they aren’t the main person involved in creating it?
- Writing about the “service user” and not the person. It’s always better to understand what Reg needs or wants than “the service user”. Using their name suggests some consultation has occurred and the care plan is person-centred; “Reg says that he like two sugars in his tea”.
- Failing to use a care plan template can lead to issues which need care planning being missed. Care plan templates, such as that in the care and support element of CAREis, enable users to be holistic in their planning.
- Not using all of the template because something is difficult or embarrassing to talk about. This can lead to unnecessary stress, missed care and neglect! Anyone working in care knows that issues around sexuality are high on the regulatory agenda and need to be discussed openly, honestly and in a grown up way – this then needs to be captured in the care plan.
- Being too brief describing interventions. What does “help Joan clean her teeth” actually mean? How would an agency carer know how to help Joan? A more thorough intervention might say: “Joan needs staff to prepare her manual toothbrush with a pea sized amount of toothpaste and prompt her to clean her teeth. Staff should stay with her and remind her to clean her top and bottom teeth for 2 full minutes. Staff should aid Joan to rinse her brush and wipe her face when she has finished cleaning her teeth. Joan also uses a mouthwash after cleaning, staff should help her take about 20mls from a cup and prompt her to swill it around her mouth for about 30 seconds before spitting it into the sink”.
- Being too complex or too wordy. Interventions need to help the person reading them to provide care as if you, the person writing the care plan, were the one doing it. It’s called continuity of care. If it is too wordy, the meaning may get lost or other carers may just not bother reading it.
- Failing to consult other staff. Often senior care staff or nurses undertake care planning which more junior team members deliver and guess what… it is often those who deliver the care who know what is actually going on. Consultation is key.
- Failing to consult family and friends can mean some care plans, especially for service users living with diminished capacity, don’t cover all they should and therefore miss the context of the person’s life.
- They focus on the person’s inabilities and fail to identify and work to their strengths and abilities. Such care plans are themselves disabling rather than enabling, they fail to identify ways to maximise the individual’s abilities to self-care or be involved in their own care in favour of quick and easy carer led care. This is
- Not consulting, not using a template and being carer centred means many care plans fail to use evidence to inform their interventions – they are not evidence-based. Evidence in this sense means asking people for their input, looking at examples of best practice and putting these together with local and national policies to create interventions which are meaningful.
In later blogs we will consider some aspects of good practice in care planning, but for now it is worth remembering one simple fact, the care plan is about and belongs to the service user and the way information is collected from them and those important to them and the how they are written needs to reflect this.