| SU001, CA001, CC001 | All respondents agree that care planning is collaborative, and agree on the importance and central role of the care plan itself. Care co-ordinator describes it as a ‘live’ document, and service user uses it as a guide. All feel service user and carer are fully involved, and that risk is openly discussed | Service user refers to care plan regularly, whereas carer does not. Service user likes the idea of an app, but care co-ordinator thinks service users are usually not much good with technology and do not like it. Carer feels care plan is not service user-friendly and contains too much jargon: a view not shared by service user and care co-ordinator | This is the only linked case study in which care planning and co-ordination appears wholly collaborative. Care co-ordinator’s positive, active, yet realistic approach (along with their focus on service-user empowerment and shared ownership of the care plan) filters through to carer and service user | Care plan signed by service and care co-ordinator with carer present
Service user’s views are included and co-production adhered to
Service user not involved in previous risk assessment
Service user’s views taken into account in risk management, but not in crisis plan |
| SU002, CA002, CC004 | None | Service user and carer say they have never had nor seen a care plan, but would have referred to one had it existed. They describe their experiences of mental health care as a ‘disappointing service’: service user says safety and risk have never been discussed, and that they have no idea who should be contacted in an emergency
Care co-ordinator’s view is the direct opposite: describing care plans as a ‘guide’ – a way of ensuring that the same ‘pathway’ is followed by everyone. Care co-ordinator sees care plans as an important point of reference, a way of keeping service users informed, and feels that service users own their care plans | Despite care co-ordinator’s seemingly positive attitude towards care plans, they note that they tend to focus on discharge as the ultimate aim of each new referral. They also describe care plans as too vague and lacking in consistency | Most recent care plan completed by crisis resolution team, so is only partly complete: it is suggested that service user ‘lost contact’ and that a full care plan was never drawn up as a consequence
Care plan not signed by service user (no reason given) although the notes under coproduction say that service user ‘reports good engagement’
States that service user’s views were considered in risk assessment/management and that they know who to consult in a crisis. Not clear if copy given to service user |
| SU003, CA003, CC002 | Service user and carer both feel that they lack engagement with the care plan, and that it needs a better contingency plan for potential crises. They both agree that current care plan is at least 2 years out of date. Care co-ordinator notes that the current electronic system makes it difficult to keep care plans properly updated; care co-ordinator notes that she has had no adequate guidance for writing risk assessments. Service user, carer and care co-ordinator agree that care plans lack consistency and coherence | Care co-ordinator feels that care plans set out aims and goals for service user, but neither service user nor carer have any sense of this | Care co-ordinator notes that caseloads are too big and that there is too much pressure on staff to discharge service users. Carer says that there is a lack of information sharing between parties involved in care plan | Care plan not signed by service user (no reason given), but signed by care co-ordinator: copy not given to service user
Service user’s views included co-production ‘not evidenced’. Service user views in risk assessment not known, no risk management plan evidenced
Service user’s views in crisis plan included |
| SU004, CA004, CC005 | Both service and care co-ordinator feel inadequately involved in care planning and relevant discussions, agreeing that care plan is only partly helpful and that more support is needed | Care co-ordinator sees care plan as very important, helpful for aims/goals, and that service user has a say and a choice in writing it | Care co-ordinator suggests that care plans are owned by mental health services, not by service users, and cites limited staff and big caseloads as a hindrance, as well as the duplication of information created by electronic systems | Care plan not signed by service user (no reason given) but is signed by care co-ordinator. Unknown if copy given to service user
Notes that service user did not attend risk assessment appointment and that further service-user input is needed in order to do a risk management plan |
| SU005, CC003 | Service user and care co-ordinator seem to agree that care planning is collaborative, although both parties would like more time in which to write it | None | Service user wants more set goals, and feels current care plan focuses on the ‘negatives’ of their illness, rather than on empowerment. This is echoed in care co-ordinator’s description of care planning as ‘firefighting’: they feel that there is too much paperwork and lack of time | Care plan signed by service user and care co-ordinator and copy given to service user
Service user’s views are included and service user makes good use of opportunities for co-production
No information included about risk assessment management (fields left blank) |
| SU006, CA006, CC006 | Neither service user nor carer have a copy of the care plan, and they agree that they are inadequately involved in care planning/co-ordination | None | Service user and carer describe feeling continually let down by care co-ordinator, who repeatedly fails to set up meetings that have been promised. Carer feels wholly unsupported as service user’s only helper. Care co-ordinator feels that it’s possible to ‘do without’ care plans altogether, and that care co-ordinators (not service users) own them | Care plan not signed by service user: signed by care co-ordinator. Copy not given to service user
No coproduction: service user ‘seems not to have been present’
Service user views included on risk assessment and crisis plan but not on risk management
Care plan includes service user’s views |
