Care plan

What is a Care Plan?

It is a treatment plan agreed between you and your Mental Health Team on what will be done to address your mental health difficulties. It identifies particular problem areas and says what is going to be done about them.

It ensures that you get the most appropriate care at the right time from your Mental Health Team in order to help you recover. It may include assessments of your health, personal and social care needs along with your own contribution.

Your Plan is developed with specific goals and targets. They deal with your priority needs including discharge planning and onward referral.

It must be written in jargon-free language that can be easily understood.

How and when is it drawn up?

To start you draw it up with your Key Nurse who will complete an initial risk and professional assessment when you’re admitted. This will form the basis of your initial Care Plan.

Your care plan will be further developed at the next scheduled Multidisciplinary Team (MDT) Meeting with more input from you (if you are able), and the rest of the multidisciplinary team involved in your care.

It will be reviewed at each team meeting and will be updated as necessary (condition improves, new assessment results etc.)

Will I get a copy?

Yes, unless the Multidisciplinary Team decides that to it would be prejudicial to your health or wellbeing. In this instance, documentary evidence of this must be presented in your clinical file.

Your Care Plan may contain personal and sensitive information. Keep your copy safe.

Can I contribute to my Care Plan?

Yes, it is usually developed with you. You can choose to attend Care Plan meetings or not attend. The Plan will include a review by you of your needs and goals.

Can my family be involved?

Family members can become involved if you want them to.

How often is it reviewed?

Your plan will follow your journey in the service and will be reviewed each week at the team meeting.