Private Care Sector Workforce Initiative
Care and Support Planning in Health and Social Care Services
Key national stakeholders, led by Scottish Care, met to consider ways to develop guidance and knowledge that will increase the capacity of service providers to better understand and improve care and support planning.
Why has this come about?
Feedback from Scottish Care members suggests there is need to provide clear and up to date guidance on proportionate care and support planning in registered adult social services in Scotland, focusing initially on services for older people. The guidance needs to cover both the content of care and support plans and the process of care and support planning.
What is the background?
It is acknowledged there is a lack of consistency and agreement around care and support planning within registered adult social care services for older people in Scotland. In part this is due to there being a range of models and systems currently in place, across different agencies and subject to different expectations and scrutiny.
Based on the National Care Standards, the Care Commission expects that each person in receipt of a care service will have a personal care and support plan detailing needs and preferences, setting out how they will be met and reviewed. However, the standards do not prescribe which models, or guide on content or structure, the onus being on providers to identify and implement care and support planning.
Local authorities, in commissioning social services, will generally require care and support planning to identify responses to specific areas of need but the level of information and support provided by social work staff to care services in relation to care and support planning varies considerably.
The NHS in providing health services also makes use of a range of planning models and tools to assess, plan, deliver and review care. Providers often have to recreate new care plans for people who use services as they move between health and social care pathways. This is despite a basic principle that a care plan belongs to the individual and despite the rhetoric and emphasis on integration and reduction in duplication. The net result is that there remains a significant difference in what is meant by a care and support plan within the range of social care and health settings.
In addition, there is other information which can impact on care and support planning but the connection is not always clear or the information either made available or fully utilised, for example the single shared assessment and the life history of a person. Where the care is complex, care and support planning requires and benefits from the use of additional tools for the management of e.g. medications, advanced/anticipatory care, mobility, prevention of falls and challenging behaviour. The expectations for care and support planning over the piece has continued to increase in response to advances in tissue viability, nutrition, dementia and palliative care and support management.
The development of any care and support planning will be required to be consistent with the personalisation agenda. For example, of significance is the move to combine user and carer involvement with an outcomes approach to planning, delivery, evaluating and improving services. This is shown in the work to develop ‘Talking Points’, an approach based on user and carer defined outcomes. This approach aims to shift engagement with people who use services away from service-led approaches.
From April 2011, the new social care regulatory body in combining the functions of Social Work Inspection Agency and the Care Commission will also be able to look at the process of care planning and review from initial referral and assessment in the community, through the commissioning and placement phases, to the delivery of the appropriate care package.
What is happening?
As members would welcome guidance on the issue of care planning, taking account of the evolving regulatory and policy framework, Scottish Care has drawn together a reference group to consider the issues. This is not intended to provide guidance which is prescriptive or mandatory, but rather should it should serve to bring some greater consistency for all concerned in the process. In keeping with the emphasis on self-evaluation, it might also serve to assist those in supervisory and management roles to audit their service’s care plans and care planning activity against current expectations.
Through the reference group key national stakeholders are now meeting to consider ways to develop the capacity of service providers to ensure high quality care and support planning. It includes health and social care providers, Scottish Government and the regulatory agencies.
Arising from these meetings, some initial steps include creating a ‘resource’ to be available online and in DVD format which is aimed at providers of services to :
• promote an understanding of the shift towards a person-centred outcomes-based approach
• provide examples of a service user journey from assessment to review
• further exemplify and consider the process through the use of videos, case studies and exercises
• inform prospective users of which elements might be included in a care & support plan, with examples of template/recording documents (not intended to be prescriptive).
The resource will be sufficiently worked up for consultation by the reference group, which met on 6 April We also hope to consult service users at the same time, with the final product being available by end June.
All will be reported on through the Workforce Initiative website and the Scottish Care Bulletin in due course.
In addition, if you wish further information on any of the above please contact David Rennie on 07946 607532 or
