Beyond mere existence: The auditing of care plans

Abstract

The importance of auditing and im proving the quality of care plans for people who experience serious ongoing mental health problems is discussed. The development of measures to assess the quality of care planning in a routine clinical setting is described, together with an audit procedure incorporating these assessments in a process of improving the quality of care planning. The assessments performed included the extent to which care plans addressed strengths and problems defined by staff and by the client him/herself in all areas of functioning, and the extent to which the targets set in care plans were based on the results assessments performed and achieved in practice. The results obtained indicated (a) that it was not possible to assume that care plans would be based on assessments performed, (b) that some areas of functioning (especially finances and psychological well-being) received relatively little attention in care plans, (c) that client defined problems were relatively neglected, (d) that care plans focused more on problems than on strengths and interests, (e) that although some 85% of targets set were achieved, achievement rates in some areas were much lower (most notably work/day time activities - 53%, and leisure/spare time activities - 38%), and (f) the proportion of targets achieved in care plans for those living in independent community accommodation was lower than for those in hospital or community based staffed accommodation. The way in which these results were used to enhance the quality of care planning are described.