Care Plan Template
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4Care Plan Template
*All care plans from other agencies involved in the service users’ case needs to be entered onto the shared care plan with all agencies involved
having access.
Client Name: ______________
Client Number: ___________ Named Key Worker: ______________
st
nd
rd
Review Date: 1
_______2
_______3
_________
Date objective
Objective/Goal/Issue
Timescale for
How progress will be
Tasks required to achieve objective
Named worker supporting client
Objective Outcome & date -
set with the
achievement
measured
with Tasks or when a referral is
client
required Name it here
Insert the date
State the agreed goal
The timescale
How will the progress or
What needs to be done for the
Name worker supporting service
What is the outcome of the
that the goal
or need to be
for the
onward movement on this
service user to achieve this goal – i.e.
users with task – i.e.
goal – i.e.
was
addressed in this
completion of
goal – i.e.
established
column from the
the
Comprehensive assessment domains
Nurse
was it achieved and if not
onto the care
perspective of what
goal…when
Self-reporting
1-1 counselling sessions
Counsellor DEO
why – could be that timescale
plan
the service user wishes
will the goal be
Lab results
attendance to appointments
CBDI
needed to be adjusted
to gain
achieved. This
Attendance records
Induction to Clinic sessions
Remanded in custody
is assist you in
Urinalysis/oral swabbing
Referral
Exited services
determining
Observation
review dates
Completed education
session post tests
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Parent category: Medical