Navigation

Assessment and personalised care plan

Quality statement

People with dementia have an assessment and an ongoing personalised care plan, agreed across health and social care, that identifies a named care coordinator and addresses their individual needs.

Quality measure

Structure

Evidence of local arrangements to ensure services are tailored to an individual's needs.

Process

a) Proportion of people with dementia whose individual needs are assessed and whose care plan states how those needs will be addressed.

Numerator: Number of people with an assessment of individual needs and a care plan addressing identified needs.

Denominator: Number of people with dementia

b) Proportion of people with a named health or social care coordinator.

Numerator: the number of people with a named health or social care coordinator.

Denominator: the number of people with dementia.

Description of what the quality statement means for each audience

Service providers ensure that protocols are in place to ensure that personalised care plans identify named care coordinators and address the individual needs of people with dementia.

Health and social care professionals ensure that personalised care plans identify a named care coordinator and address the individual needs of the person with dementia.

Commissioners ensure that services are commissioned that tailor interventions to the individual needs of a person with dementia.

People with dementia can expect to receive a care plan that identifies a named care coordinator and addresses their individual needs.

Definitions

‘Individual needs' arise from:

  • Diversity, including gender, ethnicity, age (younger or older), religion and personal care.
  • Ill health, physical disability, sensory impairment, communication difficulties, problems with nutrition, poor oral health and learning disabilities.
  • The life story and preferences of people with dementia and their carer/s (where possible) including diet, sexuality and religion.
  • Maintaining independence.
  • Information needs.

Data source

Structure

Local data collection.

Process

a) Local data collection. Acute Trusts can collect data on the content of assessments using the National Audit of Dementia casenote audit, section 2.

b) Local data collection. Contained within NICE CG42 audit support, criterion 6.

Dementia
Appropriately trained staff
Memory assessment services
Written and verbal information
Assessment and personalised care plan
Decision making
Emotional, psychological and social needs of carers
Non-cognitive symptoms and behaviour that challenges
Liaison services
Palliative care needs
Respite services for carers

This page was last updated: 18 November 2010

Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright @ 2012 National Institute for Health and Clinical Excellence. All rights reserved.

Selected, reliable information for health and social care in one place

Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright @ 2012 National Institute for Health and Clinical Excellence. All rights reserved.