Making a plan of the care and support needed

What is a care plan?

A care plan is a record of the help and support needed and is the joint responsibilty of the mental health professionals and the service user. The service user and care coordinator will write it together and it will be reviewed regularly.

A care coordinator is the person who is in charge of the service users care. This will usually be a doctor (psychiatrist) or sometimes a community psychiatric nurse (CPN) or psychologist. They will ensure they receive the care that they need, although others will be involved in their care too.

A care plan will:

  • be designed to support a service user in their recovery
  • include the name of  the care coordinator
  • include a crisis plan – this will help service users and those who care for them, if a crisis arises unexpectedly
  • be reviewed at a time and place convenient to the service user. We want to make sure the support received continues to be relevant to their needs.

Involving friends and family

Family, carers, friends and advocates (someone who acts on a service users behalf),  who support you can be involved in the planning of the care of service users, if they wish.

It is important that the Integrated Community Care and Recovery Service and the care coordinator are aware of the people who are supporting individual service users. This would be discussed at the assessment stage and when the care plan is being developed and reviewed.

The friends and family who care for service users are entitled to a Carers Assessment to find out what help and support is available to them.

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