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Care planning and what you should expect Updated September 2017 A booklet for people who come to our services, and for families, friends, carers and staff: l to explain care planning l to describe the values and quality of care you should expect from our services n Cambridgeshire and Peterborough NHS Foundation Trust
Transcript of NHS Foundation Trust Care planning › Documents › Miscellaneous... · Care planning and what you...
Care planningand what you should expect
Updated September 2017
A booklet for people who come to our services, and for families,friends, carers and staff:
l to explain care planningl to describe the values and quality of care you should expect fromour services
nCambridgeshire and
PeterboroughNHS Foundation Trust
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What is care planning?
The essence of care planning is simple. People come to our serviceswith needs. Together, we make a plan to try to help.
A written care plan should be part of a process of:
l Assessing your needsl Planning how to meet your needsl Checking that your needs are met.
We will give you a named person to contact should you have anyquestions about your care.
(Some people also have a care co-ordinator. Then the same careplanning process is called CPA - the Care Programme Approach.)
But, more important than just having a plan, is the way in whichyou are involved in that planning, and how you should expect tobe treated. This short booklet is about the values and qualities ofservice you should expect from us.
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Our guiding values
You are a “person”
You are first and foremost a personnot a number or a “case”
l You will be treated with kindness, respect and dignity at all times.l You will be treated equally, taking into account your ethnic background, gender, sexual orientation, cultural or spiritual beliefs, and any disabilities.
You are a whole personnot a set of problems or a diagnosis
l All aspects of your individual circumstances will be considered.l Your personal strengths, qualities and choices will be recognised.
You come first
l Your goals, aspirations and choices will be considered first in plansfor your care and support.
l Services will be tailored to you.l You will be supported to have as much control as possible of thewhole care-planning process.
You may have family, friends or carers as part of your life
l We will ask about other important people in your life and considertheir needs, too.
l If you wish, we will involve them in your care planning.
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Quality of care
Honesty
l You should expect us to care about you, to take time to build atrusting relationship, and to be a source of hope and encouragement.
l We will work in partnership with you.
l We will help you to be safe.
l We will give information and explanations about the choices oftreatment and support that are available.
l We will carry out what we have said we will do.
l We will explain when we are unable to help you meet your needs.
l We will record any disagreement.
l We will apologise when we make mistakes, and do our best toput things right.
l We will be clear about what we expect you to do as your part inimproving things for yourself.
Confidentiality
l Health and social care organisations may need to share information about you to make sure you receive the care youneed.
l Your GP will also want to know about your treatment, progressand care plan.
l Information will be passed to other agencies – such as housing orvoluntary agencies – only with your permission and if they have adirect need to know in order to help you.
l Information will usually be shared with your family, friends or carers only with your express permission.
l Sometimes we have to share information about you with the police or social services. You should expect us to tell you when wehave done this.
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Care planning in practice
Good discussions
This is about discussing and writing down your needs and goalsand checking they are being met.
It is not all about complicated forms and meetings.
l Are based on an assessment of your strengths, needs and yoursafety.
l Focus on the things that are most meaningful and valuable toyou, and help you to care for yourself as much as possible.
l Are discussions with you and are collaborative.
l Aim to cover all aspects of your circumstances - that is, be comprehensive:
l Physical as well as mental health needsl Personal relationships and social needsl Employment, education and training needsl Housing and financial needsl Issues of healthy living, addiction and emotional well-beingl Issues of vulnerability, and of being treated unfairly in theworld.
l Address the issues of safety.
l Ensure you have information to make informed choices.
l Include other important people and carers in your life if this isyour wish.
l Recognise issues of confidentiality.
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The written care plan
This is the most important document about our work with you because all staff involved should be consulting it. Your care shouldbe ‘joined-up’ and seamless. You should not be getting differentmessages from different staff.
The written care plan is a summary of the discussions with you andshould clearly state:
l Who has agreed to do what, when, and for how long?
l Goals to help you meet your immediate and long-term needs.
l Safety issues: identifying risks, stating how these will be minimisedor managed and reviewed.
l Contingency plans to deal with foreseeable emergencies. Thesewill include clear information about who to contact in a crisis; giving names and telephone numbers both during working hoursand outside working hours.
l Review dates when there is a check that the plan is being carriedout and that it is still the right plan for you.
l Plans for how you will remain well and flourish after treatment,including how you can re-engage with services at a later date.
l The name of the person you should contact if you have any question about your care plan.
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Clear, concise and above all helpful
l The care plan should be written in language that’s easy to understand, clear and to the point.
l The care plan should also be provided in a form that is useful toyou. This could be a letter, or a few bullet points. How it is presented will change depending on what is going to be mosthelpful for you.
l You may wish to make an addition to your care plan to say thatyou disagree about something.
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We are always trying to improve the quality of your care planning and care plans. So, we would be
most grateful if you could tell us about:
lyour experiences of care planning (both good and bad)
lissues about care planning
lideas to improve care planning in our service.
One quick way to do this is to write down your experiences or thoughts overleaf; cut off the back
page of this booklet, and either hand it in to any member of staff or post it yourself to:
Trac
y Dow
ling
Chi
ef E
xecu
tive
Cambridgeshire and Peterborough NHS Foundation Trust
Elizabeth House
Fulbourn Hospital
Cambridge
CB21 5EF
Help us improve
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$
Dear M
rs Dowling
Date:..............................................................
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............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
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If you would like a response to w
hat you have written, please let us have your nam
e and address (ore-m
ail address).
Name............................................................. A
ddress........................................................................
............................................................................................ E-mail.....................................................
What family and carers should expectfrom care planningIt is an important duty for us to recognise, inform and support those who give their time freely to care.
l Care planning should reflect the importance of carers as partnersin care.
l As the needs and views of carers may differ from service users,the impact of their caring role on their health and well-being willbe considered separately.
l Carers have a right to their own assessment of needs, and a planof support. Even where the person they care for refuses services,the carer(s) have a right to an assessment of their needs.
l Carers should be kept up to date and involved in the care plan, although the service user needs to agree to this.
l Wherever possible, carers will be included in reviews.l Carers can expect to have information and support in their caringrole.
l Carers can expect their views to be kept confidential if they sowish.
l Service user confidentiality may be overridden if the carer isdeemed to be at risk.
l Young carers have recognised needs that should be responded to with great sensitivity, particularly to reducetheir levels of anxiety and feelings of responsibility aboutwhat is going on.
l If you still feel very alone as a carer, then you may find it useful tocontact the national helpline Carers’ Direct on 0808 802 0202.
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Patient Advice and Liaison Service (PALS)
If you have any concerns about any of CPFT's services, or wouldlike more information please contact: Patient Advice and LiaisonService (PALS) on freephone 0800 052 1411 or [email protected]
Out-of-hours’ service for CPFT service users
Call Lifeline on 0808 808 21217pm-11pm 365 days a year
Booklet reviewed September 2017Booklet review date: September 2017
en Elizabeth House, Fulbourn Hospital, Cambridge CB21 5EF.q 01223 219400c 01480 398501
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