How do a support plan and a care plan affect the help you get at home?
The support plan and care plan are two different documents, but each has it's place in guiding the in-home support you receive.
If the information you give for either of these plans is not a true reflection of your situation, you won't get as much support as you need.
Understand the differences between these two plans and when they are used. Be prepared and get the help you're eligible for.
What is a Support Plan?
A support plan is the document a person receives after they have had an assessment with one of the assessment teams. This would be the Regional Assessment Service (RAS) or the Aged Care Assessment Team (ACAT).
It’s a summary of the person’s assessment. It contains the following:
- Introduction
- Person’s situation
- Person’s background
- Current situation
- Assessment findings
- Recommendations
The support plan doesn't discuss information that would be considered private. It could include a person's needs and goals that would reflect the kind of support they'd potentially receive from their home care package, though.
The assessor grants approvals and these are the recommendations. For example, the short term restorative care program or a home care package. In the case of a RAS assessment, these would be referral codes for various services.
What is a Care Plan?
When a person is assigned their home care package (HCP), they need to sign up with a provider. A care plan is a document that's developed by the home care provider in conjunction with the recipient of the package.
Whether a provider offers a fully managed model or a self-managed model, they must create a care plan with input from the client.
The care plan should be informed by the support plan.
However, the care plan should expand on the person's needs. The timeframe from ACAT assessment to assignment of the package right now can be up to a year. So while the information in the support plan at assessment and approval is important, it might not be current.
Consider the time that the older person has waited to be assigned their home care package. Their needs may have changed significantly. So the care plan needs to reflect the current needs of the older person.
Information in a care plan matters
When the care plan is developed, the more information provided the better. This is so the provider will have a better understanding of the older person's needs.
The more information that's included in the care plan, the easier it will make it for your provider to say yes when you ask to use your package funding for a service or a purchase.
When you ask to make a purchase and there’s no reference to it supporting anything in your care plan, your provider may ask you for evidence of why you need this purchase. It could mean having a care plan review or getting an assessment from an allied health provider to prove you need the item or service.
We encourage people to share their health issues, including any diagnosed condition. This helps inform a detailed care plan. Health issues and diagnosed conditions reveal how a person might struggle with being independent. This guides what kind of support they'll need to remain at home.
Support plan review
A support plan should be reviewed:
- If a person needed more services at entry level. They could either be given more approvals by the RAS assessor or they could be referred to the ACAT for a home care package.
- If a person was maximising their HPC funding and needed to move to a higher level of HCP.
- After a person has had their ACAT assessment but their needs have increased significantly, and they need to have a higher priority approval to get their HCP sooner.
Information for a support plan review
When asking for a support plan review, detail is important. Consider what’s changed since the last assessment. It might be changes related to functional ability, such as increased falls or a heart attack, or a stroke, or a broken bone that mean the older person needs more support.
It could be cognitive decline. A person whose dementia is progressing will need more support.
Carer ability to continue to provide informal support is also important. If a carer is moving away and can't continue to provide the support that they currently are, this is a very important reason to request a support plan review.
Care plan review
A care plan should be reviewed by the package provider:
- At least yearly
- When there’s any significant change in the person’s health or well being that causes increased or varied service provision
- When the funding is being exhausted, and it's evident that the current level package is not enough to meet the person's needs.
A care plan review would form part of the evidence for going back to the ACAT for a support plan review. The aim is going up to a higher level of home care package.
Detailed information matters
At any assessment stage, it’s important to provide detailed information. Don’t gloss over your ability to maintain your independence at home. If you don't go into detail when you're being assessed, you may not reveal exactly what your needs are. You'll end up being approved for less support than you really need.
It's also essential to highlight how much informal support the older person is receiving. This could be family and friends helping with things like paying the bills, transport, grocery shopping, cleaning and meals.
It's important to tell the assessor how much informal support is being provided, as this will indicate to the assessor how much support you need on a regular basis. You’re not helping yourself if you don't reveal all the challenges you're having in meeting your activities of daily living.
Summary
Good communication with any assessors or your home care package provider is important. It means all your needs are considered and as many as possible are met within the constraints of your budget.
The quality of the answers provided is what will inform the right outcome. This means being approved for the right program to receive the right level of services at home.
If you've read this blog and you aren't sure when you last had a care plan review, ask your home care provider. We offer clinical reviews as a service and these can be funded by your home care package. We'll work out if your needs have changed. If you need more or different services and support, we'll note this for your provider.