Care Plan - Dementia residential / Nursing home

Chris Edgerton

Registered User
Oct 22, 2003
73
0
Warwick District
As a nominated person, relative of a person in a Dementia residential /nursing homes, have you asked for a copy of the Care Plan you have be asked to sign.

I have, present nursing home manager is “humming and ahhing” at present to give me a copy? Old dementia residential care home gave a copy of care plan with no questions?

What’s your experience?
 

littlebrownbird

Registered User
Jul 16, 2010
62
0
Teesside
Hi Chris,
I am, at last, going to see my husbands care plan this week. He has been in the home since September and every time I have asked about it I have been told it isn't finished as he is very complex! The few bits I have seen say they should be reviewed in a months time but it was more than a month after it had been done when I saw them. His named nurse is on holiday at the moment so I am going over it with the Manager. Am I just being cynical or might it be happening now because we are seeing his consultant this week for the first time since he went into the home?
I will ask for a photocopy of the care plan so my daughter can look it over as well (thanks for that).
If you have already seen and signed it I can't see a problem with them giving you a copy or are you wanting a copy before you sign it? Maybe they don't want you to be able to study it in depth. Again I may just be cynical but you get that way after a while don't you?
I have been told that you can see ANYTHING that is on file so, if they won't copy it for you, could you take it out to be photocopied. If not I would take a note book, hand copy the lot and get them to sign it.
Good luck,
LBB
 

TinaT

Registered User
Sep 27, 2006
7,097
0
Costa Blanca Spain
Cold comfort for you but I not only see my husband's care plan but I actively participate in any changes. I don't know if this is because my husband is in an LA home as opposed to a private care home. There seems to be a determined attempt to be transparent in all actions which I think is a part of the LA's safeguarding policy.

I had an example of my active participation today. There has been a problem givng my husband the pain killers he needs as he has trouble swallowing them even when they are broken in two. The manager called in the doctor this morning. When I arrived at lunch time neither the manager or myself was happy about the doctor's decision just to increase the dose but not the method of administering the dose. I hadn't been present when the doctor spoke to the manager so she gave me the doctor's number and I phoned from her office and spoke to him myself.

There doesn't seem any rhyme or reason as to which care home is open about seeing care plans and which isn't. I would be asking is there a valid reason why you cannot see and photocopy your relative's care plan? The reason that the care home has given doesn't hold water. If they review it each month, then why cannot you see it each month? After all a care plan is never complete but changes from day to day as the condition of the resident changes. So does that mean you will never be able to see the plan because it is a document which is constantly changing?

By the way one of the 16 core outcomes which the CQC look at is the resident's participation in the management of the care they receive. As you are the nominated person I would think they are in breach of this outcome. You can see the CQC outcomes on their website.

xxTinaT
 
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Chris Edgerton

Registered User
Oct 22, 2003
73
0
Warwick District
Care Plan

I have not signed the car plan because I do want to discuss it with someone else.

The care home is a national chain, it would seem the manager cannot do anything without the consent of the national management team.

It is interesting as with previous home which did give me a copy that I was the only one to have asked for a copy of the car plan.

Where else would a person sign a document and not ask for a copy?

One of the issues is that a care plan is very complex to a none care /nurse worker like myself.

Yes a care plan should be revised every month, or when a change is achange in the needs of the person.

I did note a previous dementia care home care plan noted no change, despite changing circumstances. The CSCI now CQC inspector did note this on the car homes report, but that’s all.
 

Lucy Lastic

Registered User
Nov 30, 2009
135
0
Dorset
My Mother has been in a care home since 2 March and I have never seen a care plan nor heard one mentioned. I had been wondering what is the "norm" regarding care plans as I had to sign one when she was in hospital.

I attended a review meeting at the care home with the local mental health team in April and it was not mentioned then either. I thought they would have asked to see a care plan, but no!

Is this unusual?
 

craftyviola

Registered User
Feb 17, 2012
254
0
Malvern
I was given a draft care plan two weeks after Mum was admitted to a care home - I was invited to look at it and amend and sign the final care plan.

I would have thought it was quite usual to have been allowed to share this information and the home was very keen that I was involved. I certainly can see no reason why they are hesitating to give you a copy, unless there is someone else thee who has POA for instance. I have had an assurance that apart from myself, they do not show it to other parties except on a "need to know" basis.
 

Aasha

Registered User
Jan 1, 2012
9
0
Speke Liverpool
Aasha

Hi , my husband has been in an EMI residential home since Feb 2012 and I haven't signed or seen a care plan , should I have , I would be interested in your views on this .
 

Zolemole

Registered User
Jun 11, 2012
2
0
Workers point of view

Hi all. Sorry if this isn't much help but I work in a large care home. The only reasons I could think we would be reluctant to show a family the care plan was if it was a) not up to date or b) had negative/upsetting information in that the family may not like to read. We personally update our care plans daily (as all care homes should- at least personal hygiene and fluid intake charts) so are not ashamed. I hope you get the answers you deserve.
 

Chris Edgerton

Registered User
Oct 22, 2003
73
0
Warwick District
Care PLan V Daily report

I have seen resent nursing homes report, wanted me to sign there and then. I want a copy so I can think about all the issues carefully and also discuss with my sister. The manager has so far not provided a copy. I find it very hard to make a decision, as from past experience many issues are hidden by the nature of the care plan to the unskilled in health care.
Yes, a care home should provide a copy, but can take up to a year in this case to gather all the information.
Very often care mangers still see a care plan as a tick box scenario, and as such do make mistakes. As pointed out earlier, a care home manger kept on writing “no change” in care plan, this was picked up by CSIS now CQC inspector because there had been changes.
This is the main care plan which should be revised once a month or sooner when a change occurs.
The daily issues which was mention is the daily report, or if required more the one report in a day, this is not the care plan. You can also ask to see the daily reports, can be interesting and give a better understanding how person is.
 

Sue J

Registered User
Dec 9, 2009
8,032
0
Dear Chris

I don't know if this idea would help you but just a thought. If the care home are not giving you a copy could you ask them to give you a blank care plan form - I can hear you saying 'What good is that?'. Maybe it would help you and your sister to think about what your relatives needs are - you could write them on the form. I know you're not 'qualified' but you are qualified in knowing your relative. You could then take the form and give it to them and this may help them in their own completion of the care plan and also to understand, where you are coming from, if you think they are missing things. All carers have different levels of expertise and experience and the care plan should be drawn up using the knowledge from all carers looking after someone. Immediate needs should be assessed on admission but other more subtle, personal needs are identified over time and indeed, as you say, change. This is why it is important for good communication between staff, patient and relatives. If my above suggestion is not a good one for you and you recognize something that you think has been missed by the staff I would simply write it on a piece of paper and give it to a named carer and ask that it be mentioned when they have their care evaluation meetings, or report time (whatever they call it). On my subsequent visit I would try and see the named carer and ask what the outcome was.

Sorry if this doesn't help you, or I've missed the point, but have written in the hope that it might.

Best wishes
Sue
 
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Boudeca2007

Registered User
Oct 29, 2011
92
0
Through my own experience I would always ask to see the care plan and daily records sheets on a regular basis. My late Mum had been in various nursing homes for 9 years and in the 1st one she broke her hip on 2 separate occasions being put to bed overnight with no medical input until lunchtime the following day. When I complained to the manager she said they had been having a problem dealing with her behaviour - we were totally unaware of this. So the manager put the blame on us for not asking to see the care notes !! The CSCI [ Commision for Social Care Inspection ] didn't agree with this manager and upheld our compaint about this nursing home.

Care plans are a vital part of the whole nursing/care package.

More recently I asked her 2nd nursing home for copies of all care notes. They refused at first but I persisted. They are doing this now [ hopefully ] and they are only allowed to charge £50.00 maximum. Same goes for hospital and GP notes. Sorry went off track there.

If the manager will not let you have a copy then I would just take a photo of it [ if the notes are left in the persons room ] I have done this on many occasions. As far as I'm concerned my Mum was a self funder ergo she was paying huge amounts for her nursing care so therefore the notes were hers/ her POA's to see - discuss and take a copy from.

A lot of CQC [ Care Quality Commision , formerly known as CSCI ] reports highlight insufficient record keeping in nursing homes so keeping them on their toes is not much to ask as guidelines stipulate that this is what they should do.
 

Spursgirl

Registered User
Jul 19, 2011
5
0
Cheshire
Do not Resuscitate

I have just seen the care plan for my Dad, who has been in a LA CH since Sept 2011 (think they didn't show it before on purpose, as I have been a strong advocate for my Dad). There is a note that my Dad has a "Do not resuscitate" notice, placed by a GP (of whom I have never heard). This doesn't seem right to me. Surely this is something which should have been discussed with my Mum (Dad's wife of 50+ years) and me?
 

Boudeca2007

Registered User
Oct 29, 2011
92
0
Errrr well hell yes they should have discussed it with you !! :mad:

Good grief !! The nursing home asked me and little sis about a DNR and then recorded our reply in the care records.

I'm disgusted at this and just shows how vital it is to look at care plans on a regular basis !!
 

Chris Edgerton

Registered User
Oct 22, 2003
73
0
Warwick District
Care Plan / DNR / End of life / Brain donation

The strangest thing in social care is that for anything to be done there has to be a trend, one of the present trends /standards is to make sure there is an “End of life” statement in the Care Plan.

Yes, next of kin able to consent should have been asked for their wishes regarding “DNR”, do not resuscitate. This is one of the reasons I have requested a copy of the Care Plan, so there is no confusion as to what I am about to sign.

Remember you do not have to sign any part of the Care Plan and most certainly not the end of life which includes the DNR is you are not sure .

As an additional comment to End of Life issues. My sister and I have made provision for our dementia mother to have a brain donation. This in fact is a brain autopsy, you will have the body to bury or cremate. There are a number of universities which accept brain donations, and as such you will also be able to see the brain report, say conformation of Alzheimer’s.


PS manger still not responded to my request for a copy of Care Plan