Master Care Plan Synthesis (QMS-F090) INTEGRATED CARE PLAN (QMS-F090) Contact Document Ref: QMS-F090 (Integrated Care Plan)Version: 1.0Confidentiality Level: HIGH (Active Care Record)CQC Alignment: All Quality Statements Service User Full NameService User ID NumberOperating Local Authority- Select -HaringeyIslingtonWaltham ForestBarnetOtherCare Funding & Financial Arrangements- Select -Local Authority Managed (Direct Commissioning)NHS Funded (Continuing Healthcare - CHC)Direct Payments (Personal Budgets)Self-Funded (Full Cost)OtherSECTION 1 - Commissioned Package & Access DetailsCommissioned Daily Visit Pattern Morning Call (AM) Lunch Call Tea / Evening Call Bed / Settling Call Night Care (Waking / Sleep-in) Live-in Care Package Ad-hoc / Respite onlyTotal Weekly Commissioned HoursPrimary Funding Source- Select -Local Authority CommissionedNHS Continuing Healthcare (CHC)Private / Self-FundedDirect PaymentsProperty Access & 'No Reply' ProtocolSECTION 2 - Critical Risk Profile (The Golden Thread)Active Health & Environmental Risks (Select all flagged in previous assessments): Lacks Mental Capacity (Best Interests Decision in place) High Fall Risk Moving & Handling (Requires Hoist / 2 Staff) Medication Administration (Level 3) High Waterlow Score (Pressure Ulcer Risk) Dysphagia / Choking Risk (Requires modified diet/thickener) Diabetes (Hypo Risk) Epilepsy (Seizure Risk) Home Oxygen in use (Fire Risk) Valid DNACPR in placeSECTION 3 - The Person-Centred Routine (Task Breakdown)What matters most to the Service User?MORNING CALL - Step-by-Step InstructionsLUNCH CALL - Step-by-Step InstructionsTEA / EVENING CALL - Step-by-Step InstructionsBED CALL / NIGHT ROUTINE - Step-by-Step InstructionsSECTION 4 - Review Cycle, Consent & Sign-offScheduled Care Plan Review CycleStandard QMS requirement is at least annually, or immediately upon any change in condition.1 Month (Initial Post-Intake Review)3 Months (High-risk or fluctuating condition)6 Months12 Months (Standard Annual Review)Has the Service User (or their legal representative) been involved in creating this plan and consented to its contents?- Select -Yes, signed consent is held on fileNo (Cannot activate plan - immediate action required)Assessor / Care Manager NameDate of AssessmentActivate Master Care Plan
