Assessment, Care Planning and Review
Aim: The care home will understand holistic assessment and its relevance to advance care planning.  They will explore systems to discuss, record, review and share assessments appropriately

Objectives:

  • Recognise the importance of the assessment, planning and review of holistic care
  • Be able to provide individualised Advance Care Planning to support residents wishes
  • Understand the implications of the Mental Capacity Act, Best Interest Decision Making and Lasting Power of Attorney
Joint and shared resources
Attendance register
A register that can be used at any events and workshops. Download: Attendance Register
Evaluation form
Provides feedback to the facilitators, which will help continually develop and improve the delivery of the programme. Download: Evaluation form
Six Steps Organisational Programme Resources
Holistic common assessment guide
Guidance to understand a patient’s needs, preferences and priorities for care. Download: Holistic Common Assessment Guide
Planning for your future care
A simple guide to Advance Care Planning and the different options open to people approaching end of life. Download: Planning for Your Future Care
Preferred Priorities for Care document
Useful planning guide to help an individual decide their preferences and wishes to plan for the future. Download: Preferred Priorities for Care Document
Guide to Preferred Priorities for Care
Provides information on how the Preferred Priorities for Care Document can be used. Download: Guide to Preferred Priorities for Care
Mental Capacity Act guide
A guide on the Mental Capacity Act for those working in Heath and Social Care. Download: Mental Capacity Act Guide
Mental Capacity Act guidance
A guide to help health and social care professionals to help people who are are unable to make some decisions for themselves. Download: Mental Capacity Act Guidance
Capacity care planning
Provides information on capacity and care planning for health and social care professionals. Download: Capacity Care Planning
Best Interests at end of life
A guide that provides information on the Mental Capacity Act for those working in Heath and Social Care. Download: Best Interests at End of Life
The Route to Success in End of Life Care - LGBT
A guide to Achieving Quality for lesbian, gay, bisexual and transgender people on end of life issues. Download: The Route to Success in End of Life Care - LGBT
Palliative Care and End of Life Care for Black, Asian and Minority Groups
Provides guidance of end of life issues. Download: Palliative Care and End of Life Care for Black, Asian and Minority Groups
Step 2 to do list
Provides a checklist of actions to be carried out for the next workshop. Download: Step 2 To Do List
Six Steps to Learning Resources
Case study
A learning aid providing a case study around a person who has had a stroke. Download: Case Study TO USE WITH – Care plan template to record an individual’s needs. Download: Care Plan
Support Sheet - Holistic assessment
Provides information on how holistic assessment should be carried out. Download: Support Sheet - Holistic Assessment
Support Sheet - MCA
Information on the Mental Capacity Act. Download: Support Sheet - MCA
Support Sheet - BID
Information on Best Interest Decision Making. Download: Support Sheet - BID
Support Sheet - ACP
Provides information on Advance Care Planning. Download: Support Sheet - ACP
Support Sheet - ADRT
Provides information on Advance Decisions to Refuse Treatment. Download: Support Sheet - ADRT
Support Sheet - PPC
Provides information on Preferred Priorities for Care. Download: Support Sheet - PPC
Doris - Dementia case study
A learning aid providing a case study around a resident with Dementia around Advance Care Planning. Download: Doris - A case study for a person with dementia
Doris - Dementia case study with facilitator notes
Notes for facilitators for the case study around a resident with Dementia and ACP. Download: Doris - A Dementia Case Study with Facilitator Notes
Betty - An interactive discussion of future wishes (ACP) (A set of eight videos)
A set of videos that provide a learning aid in the form of a case study around Betty, a resident, to discuss her future wishes. This is followed by a discussion with Louise, Betty’s daughter, who has different views to her Mum. There are follow up videos with Betty, Louise and the nurse, Mandy where they reflect on the discussions. Download: Interactive discussion of ACP wishes videos