A care plan is a detailed document that outlines a person's needs, preferences, routines, and goals, covering dimensions of their life such as physical health, medication, mental wellbeing, and daily habits. Care providers use care plans to make sure your loved one receives the right support at the right time. Care plans are personalised, reviewed regularly, and designed to help your loved one maintain independence and maximise their quality of life.
If your loved one needs some extra care and support, they should have a care plan. For many families, developing a care plan is a new process, and it can feel unfamiliar. However, care plans are designed to make sure your loved one receives the right support.
Anyone who receives care from a home care agency, personal assistants visiting their home, or who lives in a care home will have their own care plan. It means that your loved one and everyone involved in their care know exactly what help is needed. Understanding the benefits of a care plan can make the whole process far less daunting. In this guide, we cover the types of care plans available and how Tiggo Care works with you and your loved one to put the right support in place.
A care plan is a detailed document that outlines a person's needs, preferences, routines, and goals, covering aspects such as physical health, medication, emotional support, and daily habits. Put simply, it is a written record of what your loved one needs, what they want, and how the care team will help them.
Care planning is the process of building this document with your loved one and their care team, so that the support provided makes sense for every part of that person's life. The process of creating a care plan begins with a thorough assessment of the person's care and support needs, which includes reviewing their medical history, current health conditions, and personal preferences. This gives the care team a clear picture of your loved one's health and well-being.
Care plans are personalised, allowing the care team to provide truly person-centred care. Your loved one's care plan should focus on agreed outcomes, the personal goals they are working towards, perhaps avoiding hospital admissions or continuing to prepare their own meals with a little help.
A good care plan covers everything the care team needs to know. Care plans should include clear, measurable goals related to the person's health, the actions needed to achieve those goals, and who is responsible for each action.
The care plan should include:
Many care plans start with a photo of the person, so the care team knows them at a glance. They should also record:
There are several types of care plans. The right type for your loved one depends on their condition and care and support needs.
A nursing care plan may be needed for someone with particular medical needs. People in a nursing home will often have one, but some people receiving home care may need one, too. If your loved one needs support with a catheter, stoma, pain management, or help with certain medical conditions, a nursing care plan may be appropriate.
A dementia care plan is needed when your loved one has a diagnosis of dementia. It often goes into more detail about your loved one's life and history, allowing the care team to get to know them and their personal preferences, even if they sometimes struggle to communicate.
If neither of the above applies, your loved one will likely have a more general care and support plan. This plan will still be personalised and will take their needs, wishes, personal history, and personal preferences into account.
Care plans are vital for the person receiving care and the people involved in supporting them. A good care plan helps your loved one maintain independence and maximise their quality of life. A care plan is not just paperwork; it is the foundation of good health and social care.
Individualised care tailors support to a person's unique personal preferences, values, and lifestyle. Person-centred care involves actively involving people in decisions about their own care, which has been shown to improve mental health and wellbeing. Person-centred care planning requires a cultural shift from traditional models of care, emphasising the unique needs and choices of each person to ensure their care plan reflects what is important to them.
A key principle of person-centred care is to assist people in being as independent as possible and having as much control over their lives, rather than merely focusing on their health conditions.
Care plans help carers and all the professionals involved in your loved one's support to stay coordinated. Coordination aligns multidisciplinary teams, ensuring everyone is working towards the same objectives. Improved coordination through a single, accessible record ensures consistent, non-duplicated support for service users, leading to better communication and more effective relationships between the care team and your loved one.
Carers use the care plan to know what to do during each care visit. This covers everything from care and support needs to personal preferences about food and drink. If there are particular risks, the care plan and risk assessments will include a clear plan of action.
Your loved one can feel confident knowing that their care plan tells them what to expect. They will know who will visit them and what each visit involves. This gives them, and you, genuine peace of mind.
A care plan may also help your loved one better cope with their health conditions. Knowing that a carer will support them to stay as independent as possible can be reassuring when they are adjusting to new limitations, such as dietary restrictions or mobility difficulties. Emotional support is a key part of any good care plan.
Risk management outlines risks and specific steps to mitigate them and prevent emergencies. We’ll complete a range of risk assessments before care begins, designed to keep your loved one safe while enabling them to continue doing things they enjoy.
If you contact Tiggo Care about home care for your loved one, we will talk you through our support planning process from start to finish.
First, our Care Manager will provide a free consultation. We will talk with you and your loved one about their care and support needs. A holistic assessment evaluates physical, mental, and social needs, and is often conducted by a local authority or healthcare professional. Before you speak to our Care Manager, it may help to consider:
Next, we will agree on a visit schedule with you and your loved one. Some people may need regular care multiple times a day, night care, or even live-in care. Others might just need someone to pop in once or twice a week.
Our Field Care Supervisor will then visit your loved one to complete a more detailed assessment. A comprehensive assessment identifies the person's physical, mental, and social needs, along with challenges in daily activities. This forms the basis of the care plan.
Finally, we will introduce your loved one to the carers who will support them. At Tiggo Care, every client has at least two regular carers in their care plan, so even if one carer is away, your loved one will still see a familiar face. Every client also has an individualised care plan and risk assessments on file.
Your loved one should be involved in the care planning process as much as possible. Research indicates that meaningful involvement in care planning is essential for ensuring that care is tailored to the person's unique needs and circumstances. Involving people in their care planning process leads to improved social care outcomes and enhances their mental health and well-being.
Care planning should be a collaborative process where the person receiving care is actively involved in discussions about their care and support needs and personal preferences. This includes supporting them through decision-making, even if they find it difficult. Collaboratively setting SMART (Specific, Measurable, Achievable, Relevant, and Time-bound) goals is part of the care process, helping to make the plan achievable and meaningful for your loved one.
Care plans are flexible and should be regularly reviewed when your loved one's needs change. Care plans should be updated regularly, especially when there are changes in a person's condition or care and support needs, to ensure they remain relevant and effective.
After a new or revised care plan is introduced, it must be reviewed within a reasonable time frame, typically 6 to 8 weeks. Having your care plan reviewed at least once a year ensures it still meets your loved one's care and support needs and personal preferences.
A review may be needed if your loved one has moved to a new environment, their health conditions have changed, or they are now receiving different support from family members. A review may also be triggered if they want to work towards a new goal, such as visiting a day centre, joining a local class, or exploring home adaptations to help them stay independent for longer.
If you or your loved one is not happy with the care plan or worried that it is not being followed, you have a few options.
First, please talk to us. During our initial planning meeting, care needs assessment, and reviews, there will be plenty of opportunities to ask questions. If concerns come up later, please call, email, or speak to a member of the care team. We will share details of our complaints procedure when we arrange the care plan.
You can also raise any concerns with the CQC (the Care Quality Commission) or the Social Care Ombudsman. Your local social services team can also offer guidance if any concerns remain unresolved.
Your loved one's care plan is the foundation of the support they receive. Whether they need home care visits, respite care, social care services at home, or long-term care, a well-written care plan helps them get the right support at the right time. It keeps them informed, helps the care team stay focused, and gives your whole family the reassurance that nothing will be missed.
Tiggo Care is regulated by the Care Quality Commission (CQC), meaning our services are regularly inspected to ensure they are safe, effective, caring, responsive, and well-led. We are also a proud member of the Homecare Association, which promotes high standards in home care, and are recognised by homecare.co.uk as one of the leading home care providers in London. If you would like to find out how we can support your loved one, get in touch with our team today to arrange a free consultation.
Chris Williams is the Founder and Managing Director ofTiggo Care, an award-winning London home care provider that supports adults living in their own homes. He founded Tiggo Care after struggling to find suitable care for his parents, both of whom lived with rare diseases, giving him first-hand experience of the challenges families can face when arranging personalised home care. Chris studied Human Sciences and Epidemiology at Oxford University and previously worked at Kearney and Oxford Sciences Enterprises.
A care plan is a document used when someone needs care and support. It sets out their care and support needs, their wishes, and the agreed outcomes they hope to achieve. The care plan definition covers a person's physical health, mental health, personal preferences, and daily routines. The same definition of care plan applies whether your loved one lives at home or in a care home.
Your loved one may need a care plan if they have care and support needs that require regular help. This could be due to long-term conditions, mental health conditions, age-related needs, or recovery after an illness. A care plan makes sure the right support is in place and that your loved one receives truly person-centred care.
The purpose of a care plan is to set out what support your loved one needs, how it will be provided, and what agreed outcomes they are working towards. It helps care providers, family members, and other professionals involved in your loved one's care to work together and provide consistent, effective support.
A care plan at home is a support plan for someone who receives social care services in their own home. It sets out what a carer will do during each visit, whether that is personal care, meal preparation, medication reminders, help with domestic tasks, or assistance attending appointments. You can arrange personal assistants through a home care agency, or directly through a direct payment from the local authority.
Arranging care and support can involve family members, the adult social services department at the local council, and a home care provider like Tiggo Care. If your loved one has eligible care needs, the local authority may carry out a care needs assessment. It may then help fund their care through a personal budget or direct payment. Councils and social services often call the resulting document a care and support plan. It covers the same ground as a care plan, and your local team can explain the support planning process and which eligible care needs your loved one may qualify for.
If you have care and support needs and receive care from a home care agency, personal assistants, or a care home, you should have a care plan. Your care plan must also be reviewed regularly, and having your care plan reviewed at least once a year is good practice. You must be allowed to be involved in the care planning process, even if you struggle to understand or make decisions. Care providers and family members should not assume you lack mental capacity. They should support your decision-making so you keep as much control as possible over your care plan.
Get in touch with Tiggo Care today to see how we can help you or your loved one.
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