1.1 Describe the difference between a daily care or support plan and an advance care plan

This guide will help you answer 1.1 Describe the difference between a daily care or support plan and an advance care plan.

In health and social care, plans are used to record a person’s needs, wishes and the agreed way to meet them. Two common documents with very different purposes are the daily care or support plan and the advance care plan. Both are important for good care, but they work in different ways and cover different information.

What is a Daily Care or Support Plan

A daily care or support plan sets out how a person will be supported with their day to day needs. It is written for the present time and covers regular routines, preferences and current health or support requirements. Staff use it each day to guide the care they give.

It includes information such as:

• Help needed with washing, dressing and toileting
• How the person likes to take meals and at what times
• Medicines they are taking and the timing of doses
• Mobility support, such as walking aids or assistance to transfer
• Social or leisure activities the person enjoys
• Communication preferences
• Religious or cultural needs

The aim is to make sure care is consistent, safe and based on the person’s wishes. Staff can refer to it at any point in the day. It can change often if the person’s needs change.

What is an Advance Care Plan

An advance care plan is different. It records a person’s wishes, values and preferences for their future care. It is often used to guide decisions if the person becomes unable to express their choices. While a daily care plan is current and focused on routine activities, an advance care plan looks ahead.

It can include:

• Preferred place of care in the future, for example at home or in a hospice
• Wishes about medical treatments, including any treatments the person would refuse
• Advance decisions to refuse treatment (ADRT) where legally valid
• Who the person wants to be involved in making decisions on their behalf
• Religious or spiritual needs at the end of life
• Wishes for comfort or emotional support in serious illness
• Information for health professionals on goals and priorities

An advance care plan can be made at any time but is common when someone has a serious or long-term condition. It can be updated if the person’s wishes change.

Timeframe and Focus

The biggest difference is the timeframe and focus of the plans.

A daily care or support plan:

• Focuses on the present
• Sets out current routines and support
• Can be altered with short notice if needs change

An advance care plan:

• Focuses on the future
• Sets out choices if the person cannot decide later
• Guides serious decisions, often near the end of life

Who Creates the Plans

A daily care or support plan is usually created by care staff with input from the person receiving support. Family or friends may be involved if the person agrees. It is based on current assessment of needs and practical arrangements.

An advance care plan is usually created in discussion with the person, supported by health and care professionals. The person leads the conversation about their values and wishes. Family or friends may be invited if the person wishes them to be part of the process.

How Plans are Used

The daily care or support plan is a working document. Staff read it at the start of shifts and refer to it throughout the day. It helps maintain consistency between different staff.

The advance care plan is stored so it can be accessed by health and care professionals if needed. It is used in situations where the person cannot state their wishes, for example if they are unconscious, have severe illness or advanced dementia.

Review and Updating

A daily care or support plan is reviewed regularly. Changes can be made at any time if the person’s needs alter. For example, after hospital discharge the care plan may include new medication or physiotherapy exercises.

An advance care plan is also reviewed but usually less often. It should be revisited if the person’s health changes, or if they change their mind about future care.

Legal Status

A daily care or support plan is not a legal document. It is part of professional record keeping and best practice in providing person-centred care.

An advance care plan can have legal parts. For example, an Advance Decision to Refuse Treatment (ADRT) is legally binding in England and Wales if it meets set rules in the Mental Capacity Act 2005. The rest of the plan may not be legally binding but is still respected by professionals.

Examples of Each

Example of a daily care or support plan entry:

• Breakfast at 8.30am in bedroom
• Tea with two sugars, toast with jam
• Assistance with showering and applying moisturising cream to legs
• Walking frame to be used at all times
• Medication: one tablet with breakfast, one at 6pm
• Likes to watch television in the lounge from 10am

Example of an advance care plan entry:

• If seriously ill with little chance of recovery, prefers to be cared for at home
• Does not want resuscitation if heart stops
• Avoids hospital admission if care can be given at home
• Wants daughter Jane to be involved in future care decisions
• Wishes for quiet music to be played in room during final days

Recording Preferences and Needs

In a daily care plan, details are precise and about today’s needs. For example, “prefers shower in the morning” or “drinks tea, not coffee”. It supports everyday quality of life.

In an advance care plan, details are broader and about important life values. For example, “prefers comfort over life-extending treatments” or “wishes for family to be present in final hours”.

Training and Staff Awareness

Workers must understand the difference so they can contribute correctly. Mixing the two types of plan can lead to mistakes. For example, putting an advance refusal of treatment in a daily care plan could mean it is overlooked in an emergency.

Staff training covers:

• How to read and use a daily care plan
• How to record updates in it
• Awareness of advance care planning and how to support conversations
• Keeping both types of plans in the right place in the record system

Impact on Quality of Care

When daily care or support plans are accurate, the person’s day runs smoothly and their needs are met with respect. When advance care plans are in place, future care matches what the person wanted.

Without a clear daily plan, routines may be missed, leading to discomfort or frustration. Without an advance care plan, decisions during illness may go against the person’s values.

Communication Between Staff and Services

Daily care or support plans are used mainly within the current care setting. Advance care plans are shared more widely, for example between hospital teams, GPs and care homes. This ensures that everyone knows the person’s future wishes.

Good practice is to keep both plans up to date and share relevant parts with those who need to see them, always with the person’s permission.

Respecting the Person’s Voice

Both types of plan put the person at the centre of care. In the daily care or support plan, this means listening to how they want their day to run. In the advance care plan, it means respecting their decisions for future care and treatment.

Staff should use clear language when explaining the plans to avoid confusion. Both documents should be written in a way the person can understand.

Differences in Summary

Key differences include:

• Purpose: Daily plan is for current care. Advance plan is for future care when the person may not be able to decide.
• Content: Daily plan has routine tasks and needs. Advance plan has values and wishes for future care decisions.
• Timeframe: Daily plan is about now. Advance plan looks ahead.
• Use: Daily plan is used every day by staff. Advance plan is used in significant health situations.
• Legal aspects: Daily plan is not binding in law. Advance plan may have legal parts like ADRTs.

Final Thoughts

The daily care or support plan and the advance care plan work together to give a full picture of the person’s needs and wishes. One makes each day run more smoothly, while the other protects the person’s choices for the future.

In practice, you may work with both. You may read the daily plan every day you are on shift. You may see an advance care plan only when a person’s condition changes. Both need careful attention and respect. Understanding the difference will mean you know which plan to use in each situation. This helps provide safe, person-centred and respectful care at all times.