Care Plan Template Page 2
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4Client Name: Michelle Murphy Client Number: 123ABC456
Named Key Worker: Fergus O’Shea,Cllr
st
nd
rd
Review Dates: 1
_____ 2
______3
_____
Date
Objective/Goal/Issue
Timescale for
How progress will be
Tasks required to achieve
Named worker
Objective
objective set
achievement
measured
objective
supporting client
Outcome & date
with the
with Tasks or when a
-
client
referral is required
Name it here
27.6.11
Referral to inpatient
By 28.6.11
Referral Form
Fill in the referral form and
Cuan Dara
Referral posted
detox Cuan Dara
completed and
meet the criteria for admission
28.6.11
posted
Participation 2x a week in pre-
Susie Allbright,
Admission to
admission week to detox
Intake Counsellor
Cuan Dara
group in Kickham Street
16.7.11
Attended pre-
admission group
27.6.11
Stabilise from 70mls
Fortnight
Attendance records
Kilkenny Methadone
Achieved 50mls
to 50mls methadone
15.7.11
to clinic on daily basis
Comprehensive Assessment
Clinic
methadone
daily in order to
28.6.11
Counsellor
12.7.11
enter inpatient detox
Urines/Swabs
in Cuan Dara
Attend clinic GP/Nurse for
Nurse/GP
Attendance 1.1
assessment & care plan 30.6.11
Attended clinic 12
counselling sessions
sessions
Induction to the Methadone
DEO
Self-report
Clinic
Attended
counselling
Detox agency report
Provide 3 ‘6 am’ samples of
Nurse
sessions: 7
of attendance pre-
urines
sessions
admission
Swabs analysis daily at clinic
Nurse
Completed
urine/swabs
1.1 counselling session 3x week
Counsellor
samples
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