8/4/2019 Example of a Support Plan, Leeds Adult Social Care
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Support Plan
EXAMPLE
This is what the new Support Plan form will look like. During your training
you will look in detail at how to fill in each section this is just a basic
example.
Add the personsdetails in thissection.
Add the customersreference number here.
This could be theirESCR number.
Add the indicativebudget amount here(which you will haveused the RAS tool tocalculate, after fillingin the information
from the SDAQ).
How does the personwant to receive theirsocial care money?
Ask for the persons bank details.
This must be an account in thepersons name, specially set up fordirect payments not the personsnormal current account, or anaccount in the name of anotherfamily member.
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The information on this page should closely matchwhat was said in the self-directed assessment form.
SupportPlan/continued
Supporttomaintainpersonalhygieneandappearance
Supportwithroutinesofdailyliving
Supporttomaintainsafetyduringthedayandnight
Supporttomaintaininvolvementinthecommunity
Supporttopreparemealsandmaintainnutrition
Dont forget to includethe customersreference number on
every page.
CareAgency
worker
MondaytoFriday
Helpwash,dressand breakfast.Supportwithlunch.Undress
and
puttobed.
Yes
FredSmith
(son)
Weekend Support withpersonalcare and
meals. Helparoundthe house.
Takemeoutinthecommunity.
No
TomNg
(neighbour)Weekly Canhelpwith
gardenandgoes
toshops. Willprovideadditional
helpifFredcannotvisit.
No
PA 2daysperweek
Takemeouttopursueactivities
andhelpmecontinuetobe
involvedinthecommunity.
Yes
This bit is aboutwho is able tosupport the serviceuser this could befriends, family orpaid supportworkers.
The informationhere should matchup with what theperson has said
during theirassessment andwhat has beenrecorded in theirSDAQ.
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Lookbelowthesurfacetoclearlyidentifyapersons
genuine,eligibleneeds.Dontbeafraidto(politelyandsensitively)challengewhereyoubelievesomeoneschoices
areunrealistic.
These will reflectthe needs identifiedin the completedSDAQ.
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The information on this page should closely match what wassaid in the self-directed assessment form.
SupportPlan/continued
Gettingout, seeingmyfriendsandbeingpartofthecommunityar
eall
important.Familyisveryimportanttomeeventhoughthey have
hadto
moveaway.Myhealthisimportanttomeandthestrokemademe
think
againaboutwhatIeatandhowIlivemylife.IknowIneedtodo
more
exerciseandeathealthyfood.IthinkifIfelthappieraboutthin
gs
generallythenIwouldfeelmoremotivatedto dothat. Iwantto
feel
safe,independent,andbecomemoreactive.
MostofallIdont wantpeopletofeelsorry forme,ortofeelas
though
Ihavenothinglefttooffer.
Encourage the personto talk about what isimportant to them.What do they like?What kinds of thingshave they done in thepast? Who are theimportant people intheir life?
Ineedsupporttomaintainmydailyroutine,tokeepmehealthy,sa
fe
andwell. Ihavedevelopedagoodrelationshipwiththecarersfr
omthe
agencysoIwouldliketokeepthem. Ineedsupport togetoutan
dabout
andmaintaininvolvement.However,Idontwant togotoatradit
ional day
centrewhichIfindboring. IdratheruseaPAtotakemeoutan
ddothe
thingsIused todo,likegoingtothepaintingclass,bow
lsortosupport
metovisitfriendsandfamily. Mydaughter-in-lawFatimaispregnantand
Iwouldliketobe anactivepartofmy grandchildslife.
This question is more
about how the personwants their life to belike. What would theylike to change? Whatwould they do if theycould?
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Customers reference number
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The final question of this section looks at outcomes andhow the person plans to achieve them ...
SupportPlan/continued
4
Now,telluswhatoutcomesyouhave
fromtheabove,andhowyou
willachievethem.
Getoutmore,
maintaininglinkswith
mycommunity
SupportfromanPAtwicea
weekandsomeextrahelp
fromFredatweekends
PA@8anhour,
8hoursperweek
=64aweek,
3328peryear
Supporttomaintain
personalhygieneand
appearance
Supporttoassistwith
mealpreparationand
maintainnutrition
Supportfromagencywith
wash,dressandbreakfast.
Mealssupportandundress
andputtobed
7.5hours
aweek@14=
105aweek,
5460peryear
Supporttomaintain
safetyduringdayandnight
CareRingandtelecare
personalpendantalarmand
fallsmonitor
Free
Supportfromsonand
neighbour
Free
Supportwithroutinesof
dailyliving
1. Looking back atquestions 4 and 5,work with theperson to identifyoutcomes that is,the things theywould like toachieve. These willnormally be things
to help themimprove their qualityof life, live moreindependently orkeep healthy, safeand well.
2.For each outcome, ask theperson how they plan to achieveit this might be through support
from another person, or use ofequipment, or some other way.
Customers reference number
Lookbelowthesurfacetoclearlyidentifyapersons
genuine,eligibleneeds.Dontbeafraidto(politelyandsensitively)challengewhereyoubelievesomeoneschoicesare
unrealistic.
3. In this column, show whowill provide support and how
much it will cost.
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Questions 6 and 7 are about risks, decisions and choices.
SupportPlan/continued
Customers reference number
Apersonalalarmwillhelpmefeelsaferinthehousealone,knowing
thatifIfell,Icouldcallsomeone. Afallsalarm
willraisehelpifIfall
inthehouseduringdayornight.
Supportof1careworkerwillensureIamsafew
henwashingand
dressing.SupportwithmealswillensureIhavea
goodbalanceddiet.
Smokedetectorswillraisealarmifthereisafire
inmyhome.
AtthemomentIamconfidentinmyabilitytoma
kechoicesand
decisions. MysonFred,andsometimesmydaugh
ter-in-law,Fatima,
helpmetakeanybigfinancialdecisions,butIam
confidentthatIcan
stillmakechoicesaboutmyownlife.AsIgetold
erIknowIwillrely
moreonFredandFatima,butIvaluetheirjudgment.
Ask the person whatrisks there might be inthe outcomes they haveidentified in their plan.How will they managethese risks? What arethe benefits in taking
these risks?
Does the person needany help makingdecisions? What kindof decisions do theyneed help with? Isthere anyone whohelps make decisionsnow? Will someonehelp in the future? Ifso, how does theperson feel about this?Will their views betaken into account?
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Ask the person how they will manage if something goes
wrong ...
SupportPlan/continued
Customers reference number
If my PAisunabletovisit,mysonFredisusuallyable tocomeat
short
notice.Howeverhewill beworkingfull-timesoon. Luckilyhisjobi
s
flexible,butIwillrelymoreonTom,my neighbourandlong-time
family
friend. TomandhiswifeoftenhelpmeifFredisnotavailable. Ift
hings
wentseriouslywrongIknowIcouldcallonmydaughter-in-law.
If support is unavailable, itis important that theservice user has otherways to get support , evenat short notice. Check ifthere are other people whocan help, and people theycan contact in anemergency.
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This is where the person shows how they will spend their budget,
breaking down individual support costs. If there isnt enough
money for everything the person wants to do, help them identify
what is really important to achieve the outcomes that will keep
them healthy, safe and well.
SupportPlan/continued
Customers reference number
PersonalAssistant
CareAgency
PA@8anhour,
8hoursperweek
7.5hoursper
week @14
33285460
8788peryear Add the overall costof the support planhere.
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Again,
rememberto
lookbelowthe
surfacetoclearly
identifyapersons
genuine,eligible
needs...
Remindtheserviceuserthat
theymightbeabletoaddtotheirbu
dgetthroughothersourcesoffundingandsupport,e.g.AccesstoWorkor
SupportingPeople.
List types of support here,along with the hoursrequired and the cost per
hour. Add the total at theend.
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Question 10 is for Adult Social Care use only. Indicate whether
the persons needs in areas such as physical and mental health,
personal care, family responsibilities etc. are low, moderate,
substantial or critical.
SupportPlan/continued
Customers reference number
Tick/check the boxes asappropriate ...
If you answer YES toany of these questions
you must attach thesupporting paperworkas appropriate.
X
X
X
X
X
X
X
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Question 11 is for Adult Social Care use only. This is where you show
the full breakdown of the personal budget, and how the person
would like to receive it.
SupportPlan/continued
Include the personsdetails here ...
Does the serviceuser receive direct
payments or use apersonal budgetalready?
Add the dates asappropriate, andthe name of thesupport planauthoriser ...
Indicate thepersons preferredbudget optionhere...
Show the budgetbreakdown here ...
Here is theweekly amountthe customer willreceive.
Any additionalinformation youfeel is relevant?
Customers reference number
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8/4/2019 Example of a Support Plan, Leeds Adult Social Care
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Question 12 is a summary of the approval process, showing the dates
the support plan was completed, agreed by the team manager,
considered by the gatekeeping panel and the outcome.
There is also space to include the date and outcome if the plan has
been sent to a specialist panel.
SupportPlan/continued
Fill in the dates asappropriate ...
Customers reference number
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