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Review - We will check that things are working for you

Reviewing progress

Any plan of care needs to be monitored and evaluated to see how it’s working. It will get out of date in time, and needs to be reviewed regularly to make sure it’s still right. It’s important to check that you are happy with the way things are going.

Reviews should be designed around the needs of the person concerned, and should include contributions from everyone involved in the care plan. Review is an ongoing process, and not necessarily a single meeting.

We want to make sure that your care plan is implemented, flexible, regularly reviewed for effectiveness, changed if it turns out it's not working, and kept up to date to support your changing needs. Reviews are the way we do this.

'The time allocated to me has never been limited. Also the opportunity to explore other opportunities in self direction has always been supported and the pros and cons reflected on.' Service User

  When held:

  • at least once a year, or more often, based on need

  • if the person or anyone involved in providing a service asks for a reviewurgently if:

  • the person wishes to withdraw from their care plan, or part of it, or discharges themselves from hospital against medical advice,or threatens to do so

  • there are specific circumstances where informal carers or relatives should be told if they are likely to be exposed to violent behaviour

  • there is any sudden major change in their mental health, personal or social circumstances.

 

How:

  • Organised by a named person

  • Agreed in advance (date, time and place)

  • Held in a way that means people can take part.

 

What

  • Updating the care plan and services provided based on what needs we’ve identified with you

  • Recorded, and the results shared with the referrer, client/carer/family and others involved.

 

Including such as:

  • Recent Progress

  • Physical and Mental Health. We will contact your GP before your review to make sure we know about any relevant treatment

  • Treatment, including medicines prescribed and being taken, and any associated testing. We will reconcile  medication in our records at least every 12 months to make sure we know what you've been prescribed 

  • Safeguarding Children or Vulnerable Adults

  • Day time Activities

  • Family/Carer Issues and responsibilities 

  • Risk management

  • Any legal requirements

  • Ongoing support

  • Anything else in the care plan

 

Click here to see our leaflet - How to get more out of your appointment with your psychiatrist

 

Outcomes measurement is a method of a person’s functioning at the beginning during and at the end of a period of treatment or therapy to ensure expected progress has been met.

Over the next year we will introduce a variety of outcomes measurement for the different therapies we use. We are currently  using a national Health of the Nation OutcomeScales (known as HoNOS) measurement method.

  • For each person we use the HoNOS score in clinical supervision and in care reviews to monitor a person’s progress and ensure we are achieving the aims laid out in the Care plan
  • Outcomes also help us:

o   Focus on specific areas of need

o   Provide information to patients on their progress

o   Monitor the effectiveness of therapies

o   Focus training on areas of greatest need

We are working towards publishing our overall outcomes on the intranet. We will be using guidance to be published by the Department of Health which will, in the not too distant future, be used by all Trusts.

For more information on Trust outcomes please contact Mark Ridge

Head of Clinical & Operational PbR

Derbyshire Healthcare NHS Foundation Trust Operations,

Performance and IM&T 2nd Floor,

North Mill, Bridgefoot, Belper DE56 1YD

Please visit our National Tariff Payment System (NTPS) Information page to find out more

Standards:

Care Quality Commission Essential Standards of Quality and Safety - Outcome 4 Care and Welfare of people who use services

Provider Prompt: Ensure effective, safe and appropriate, personalised care, treatment and support through coordinated assessment, planning and delivery

4A People who use services have safe and appropriate care, treatment and support because their individual needs are established from when they are referred or begin to use the service. The assessment, planning and delivery of their care, treatment and support:

  • Ensures that plans of care, treatment and support are implemented, flexible, regularly reviewed for their effectiveness, changed if found to be ineffective and kept up to date in recognition of the changing needs of the person using the service.

 

If you require any information about our policies please contact:

Freedom of Information
Ashbourne Centre
Kingsway Site
Derby DE22 3LZ
or email:
foienquiries@derbyshcft.nhs.uk

The way we record will depend on your needs and what works best for you – these are some examples we might use:

Care Plan and Review Form

Structured letter

Standardised Clinical management plan

Entry on electronic database

All prescribers electronic entry and letter

NICE psychosocial intervention Proforma

Health Annual review (specialist services)–minutes put in child health records(CHR) and distributed to all relevant agencies and parent/carer/ young person

Children in Care  review minutes put in CHR

Children in Need review minutes put in CHR

Children on a child protection- report form submitted to core group and minutes put in child health records

Education reviews- minutes recorded in CHR

Care Co-ordinators Underpinning Knowledge (mental health service users)

Bite size training: ‘Reviews’

TOP/electronic database

Transition Processes

Safeguarding core group meeting level 3

Care Quality Commission Essential Standards of Quality and Safety - Outcome 4 Care and Welfare of people who use services

Care Plan review guide – long term conditions NHS Choices.