Care Planning

EXAMINE THE INFLUENCE OF THEORETICAL MODELS AND METHODS OF ASSESSMENT AND PLANNING IN PRACTICE IN THE WORKPLACETheoretical perspectivesSocial care theory, behaviour theory, psychodynamic approaches, solutions-focused and task-focused perspectives, theories of change, system approach, applicable principles of legislative and regulatory frameworks supporting equality and diversity in the assessment process, referral, care and protection of individuals with additional mental health considerations, promoting equality and diversity and the cultural implications for care and effective communication, data protection e.g. GDPR(2018), data protection Act (1998)Models of assessmentThe nursing process APIE (assessment, planning, implementation, evaluation)Assessment, systematic nursing diagnosis, planning, implementation, recheck and evaluation (ASPIRE, Barrett et al, 2012Medical and social models of assessmentTypes of assessment in HSC settingsCare planning, care pathways and care bundles e.g.: care needs assessment, outcomes-based assessment, risk assessment, joint assessment, face-to-face assessment, structured interviews, self-assessment, evidence-based assessment, single assessment framework.IMPLEMENT CARE PLANS IN THE WORKPLACE TO MEET DESIRED OUTCOMES FOR INDIVIDUALSOwn roles and responsibilities, duty of care, provide appropriate care, safeguarding and protection, focus on the individual, promote independence and empower the individual, develop clear assessment methods, develop strategies in partnership with the individual, family and carers, follow the setting policies and procedures, ensure records are kept accurately and safely, maintain own training and update professional practice, support other staff in team including mentoring new staff, listen to the individual and be supportive, gain feedback on quality of care provided, review and develop care plan in line with care planning process, person-centred and holistic planning, person-centred approaches that are seamless and proactive, support independence, promote quality of life e.g. the ability to contribute fully to our communities, tailored to the religious, cultural and ethnic needs of individuals, promote value-driven practice based upon inclusiveness, respect and dignity, working proactively to include the most disadvantaged groups, approaches that take into account individual physical, psychological, public health, social, economic, spiritual and learning needs and considerationsOutcomes based assessment in care planningPersonalised care, strengths based approach, record-keeping, data collection, assessment tools.Types of interventions reflected in care plans:Medical interventions, social care interventions, therapeutic interventions, multi-disciplinary approaches, providing personal care, hygiene, meeting dietary needs, cleanliness of the living and working environment, supporting daily living activities, SSKIN (surface, skin inspection, keep moving, incontinence/moisture, nutrition/hydration)Communication with the service user throughout the care processInvolving friends and family as appropriate, referral and problem-solving, use of risk assessment tools, recognising norms and implications of deviations, reporting concerns effectively, checking measurements, accuracy in recording, interpreting results to inform care planning, setting realistic targets to make improvements in conditionsREVIEW THE CHALLENGES AND BENEFITS OF PLANNING PERSON-CENTRED CARE IN THE WORKPLACEerson-centred holistic approaches, challenges(challenges of agreeing roles and responsibilities, ineffective communication, dealing with conflict, poor care practices and unethical approaches, complexities of taking into account the range of the individual needs and considerations in planning and provision, availability of resources, challenges around the resources, skills and facilities to ensure appropriate safeguarding, protection and respect of confidentiality, challenging in obtaining consent, feeling unsafe to raise concerns, or report incidents and accidents, overcoming barriers to inclusionENEFITSActive participation of individual, clear communication channels, early identification of issues/gaps in service, promote team work, guide provision of care, allows for effective service provision, allows for planning of services, enables preventative practices, partnership approaches and effective communication in resolving challenges: agreed ways of working in teams, clarity of roles and responsibilities, agreed outcomes, input from individual and family, friends and carersTARGET SETTINGSMART (specific, measurable, achievable, realistic, timely) targets, risk assessment and risk-takingREFLECT UPON THE IMPACT OF THE PLANNING OF ON PRACTITIONERS, INDIVIDUALS, FAMILY AND CARERS IN RELATION TO OWN PRACTICEFamily and friends as partners in planning: valuing family and friends importance of communication between individuals, family, friends and professionals, consideration of what is important to the individual, recognition of the individual as part of the family unit, promotion of the rapport with the individual, family, friends and professionals, recognition of the right of family and friends to be involved, provision of individualised care and support, addressing issues which affect care plans, basing plans on an individual’s priorities in alliance with family, friends and professionals, use of facilitators.IMPACT OF CARE PROCESSES ON INDIVIDUAL, FAMILY AND FRIENDSPositive impact: reassuring, shared-decision making, feel involved and empowered, allows them to ask questions, they feel that they are being listened to, increased knowledge and understanding, they can recognise outcomes and work towards shared goals, give structures and purpose to care processes, enable advocacy support.FEATURES OF INEFFECTIVE ENGAGEMENT: INTRUSIVE, DISRUPTIVE, TIME-CONSUMINGTEAMWORK AND LEADERSHIP: processes and impact:Leading the care processWorking in partnershipSupporting care teams, multidisciplinary approachesPromoting best practice in the best interest of the individualReflective review, identifying gaps in service to improveCollecting and interpreting data and drawing conclusionsReviewing measures and terminating ineffective processesRegulation and monitoring: benchmarks and standard settingCritical incident analysis and serious case reviewsHigh quality service provisiomproved job satisfaction and customer experience of the serviceSupervision and management: review of practice, review of policiMeasuring outcomes, data analysisQuality assurance, meeting regulatory standards, benchmarking.

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