10 Signs Your Care Plans Need Improvement (And What to Do About It)

As a care home manager, you know that high-quality care plans are the foundation of person-centred care and CQC compliance. But how do you know when your care plans are falling short?

After 15+ years auditing care plans across residential, nursing, and dementia care settings, I've identified 10 warning signs that your care plans need urgent attention. If you recognise three or more of these signs, it's time to take action.

1. Staff Can't Find Information Quickly

The Problem: Your care team spends 10+ minutes searching through care plans to find basic information like dietary requirements, mobility needs, or medication times.

Why It Matters: If staff can't find information quickly, they won't use care plans effectively. This leads to inconsistent care, increased risk, and frustrated staff.

What to Do: Reorganise care plans with clear sections, consistent headings, and a contents page. Use colour-coding or tabs for quick reference. Test with your newest staff member—if they can't find information in under 2 minutes, your structure needs work.

2. Care Plans Use Generic, Copy-Paste Language

The Problem: Multiple residents have identical phrases like "likes to socialise" or "prefers a shower to a bath" without specific details about their unique preferences.

Why It Matters: CQC inspectors spot generic care plans immediately. They expect to see individual personalities, life histories, and specific preferences—not template text that could apply to anyone.

What to Do: Replace generic statements with specific details. Instead of "likes music," write "loves 1960s rock and roll, especially The Beatles. Enjoys singing along to 'Hey Jude' during activities." Include quotes from residents and families wherever possible.

3. Daily Notes Don't Match Care Plan Goals

The Problem: Your care plan says Mrs. Smith is working toward independent walking with a frame, but daily notes show she's been using a wheelchair for three months with no mention of mobility goals.

Why It Matters: Disconnected documentation suggests care plans aren't being used to guide daily care. CQC will question whether care is truly person-centred if plans and practice don't align.

What to Do: Audit 5 random care plans against the last month of daily notes. Are goals being worked toward? Are interventions being followed? If not, hold a team meeting to reinforce the link between care plans and daily practice.

4. Risk Assessments Are Out of Date

The Problem: You have falls risk assessments from 18 months ago, nutrition assessments that haven't been updated despite weight loss, or moving and handling assessments that don't reflect current mobility.

Why It Matters: Outdated risk assessments mean you're not identifying or managing current risks. This puts residents in danger and your home at serious risk of CQC enforcement action.

What to Do: Create a risk assessment review schedule. High-risk areas (falls, nutrition, pressure care) should be reviewed monthly. All risk assessments should be reviewed at least every 3 months or after any significant change.

5. Families Say "We Weren't Consulted"

The Problem: Family members complain they weren't involved in care planning, don't know what's in the care plan, or weren't consulted about changes to their loved one's care.

Why It Matters: Family involvement is a key CQC requirement under "Responsive" and "Caring." If families feel excluded, complaints and safeguarding concerns often follow.

What to Do: Document every family conversation in care plans. Send families a summary of care plan reviews. Invite families to annual reviews (and document if they decline). Create a "family views" section in every care plan.

6. Mental Capacity Assessments Are Missing or Vague

The Problem: Your care plans either have no mental capacity assessments, or they say "lacks capacity" without explaining what decisions the resident can't make or how capacity was assessed.

Why It Matters: The Mental Capacity Act requires decision-specific capacity assessments. Blanket statements like "lacks capacity" are legally incorrect and suggest poor understanding of MCA principles.

What to Do: Review every care plan for MCA compliance. Ensure capacity assessments are decision-specific (e.g., "capacity to consent to personal care" or "capacity to manage finances"). Document how capacity was assessed and who was involved. Record best interest decisions with evidence of consultation.

7. Care Plans Haven't Been Reviewed in 6+ Months

The Problem: You have care plans with review dates from last year, or reviews that simply say "no changes" without evidence of actual review.

Why It Matters: CQC expects care plans to be "living documents" that reflect residents' current needs. Infrequent reviews suggest care isn't responsive to changing needs.

What to Do: Implement a monthly review schedule for all care plans. Even if there are no changes, document what was reviewed and who was consulted. Use prompts like "Is this still accurate?" and "Have goals been achieved?" to guide meaningful reviews.

8. New Staff Don't Know How to Write Care Plans

The Problem: Your newest care staff or senior carers struggle to write person-centred care plans, rely heavily on copying existing plans, or don't understand the difference between needs, goals, and interventions.

Why It Matters: If staff don't understand care planning principles, quality will decline over time. High staff turnover means this problem compounds quickly.

What to Do: Provide structured care planning training for all new staff within their first month. Create a care plan writing guide with examples of good vs. poor documentation. Pair new staff with experienced mentors for their first 5 care plan reviews.

9. You're Nervous About CQC Reading Your Care Plans

The Problem: When you think about CQC inspecting your care plans, you feel anxious. You know there are gaps, outdated information, or poor-quality documentation that could be criticised.

Why It Matters: Your instinct is usually right. If you're worried about your care plans, CQC probably will be too. Care plans are central to every Key Line of Enquiry, so poor documentation affects your entire rating.

What to Do: Conduct a mock CQC audit of 10 random care plans. Use CQC's Quality Statements as your guide. Identify the top 3 recurring issues and create an action plan to address them within 90 days.

10. Residents' Voices Are Missing

The Problem: Your care plans are written entirely in third person ("Mr. Jones requires assistance with...") with no direct quotes, preferences in the resident's own words, or evidence of their involvement.

Why It Matters: Person-centred care means putting the resident at the heart of their care plan. CQC expects to see residents' voices, choices, and personalities reflected throughout documentation.

What to Do: Add an "In My Own Words" section to every care plan. Include direct quotes about preferences, routines, and what matters most to the resident. For residents who can't communicate verbally, document family insights and observations of what brings comfort or distress.

What Happens If You Ignore These Warning Signs?

Poor care plans don't just risk a lower CQC rating—they put residents at risk and create significant problems for your home:

• CQC enforcement action: Requirement notices, conditions on registration, or even suspension

• Safeguarding investigations: Poor documentation often triggers safeguarding concerns

• Staff confusion and stress: Unclear care plans lead to inconsistent care and anxious staff

• Family complaints: Families lose trust when care plans are poor quality

• Increased incidents: Falls, pressure sores, and medication errors rise when care plans don't guide practice

• Reputational damage: Poor CQC ratings affect occupancy and recruitment

How to Fix Your Care Plans (3 Practical Steps)

Step 1: Audit Your Current Care Plans (This Week)

Select 10 random care plans and score them against these criteria (0-10 for each):

• Person-centred and individual (not generic)

• Risk assessments current and comprehensive

• Mental capacity assessments decision-specific

• Family involvement documented

• Reviewed within last 3 months

• Resident's voice present throughout

• Goals are SMART (Specific, Measurable, Achievable, Relevant, Time-bound)

• Daily notes align with care plan

• Easy to navigate and find information

• CQC-compliant and evidence-based

Total score:

• 80-100: Excellent—maintain quality

• 60-79: Good—minor improvements needed

• 40-59: Requires improvement—action plan needed

• 0-39: Inadequate—urgent intervention required

Step 2: Create an Action Plan (This Month)

Based on your audit, identify your top 3 priorities. Examples:

• Priority 1: Update all risk assessments to current standards (deadline: 4 weeks)

• Priority 2: Add "In My Own Words" sections to all care plans (deadline: 6 weeks)

• Priority 3: Provide care planning training to all senior staff (deadline: 8 weeks)

Assign responsibility, set deadlines, and review progress weekly.

Step 3: Get Expert Support (Before Your Next CQC Inspection)

If you've identified significant gaps, don't wait for CQC to find them. Consider:

• Professional care plan audit: Independent expert review identifies issues you might miss

• Staff training: Upskill your team on person-centred documentation

• Template development: Create consistent, CQC-compliant care plan templates

• Ongoing monitoring: Regular check-ins prevent quality drift

Ready to Improve Your Care Plans?

If you've recognised 3 or more of these warning signs, your care plans need attention. The good news? Most issues can be fixed within 90 days with the right support and action plan.

At CarePlan Assurance, we specialise in helping care homes transform their care planning from "requires improvement" to "outstanding."

Our services include:

• Full care plan audits with detailed action plans (from £350)

• Individual care plan writing and improvement (from £35)

• Staff training on person-centred documentation (from £180)

• Ongoing monitoring to maintain quality (from £120/visit)

Book a free 30-minute consultation to discuss your care plan challenges.

📧 Email: enquiries@careplanassurance.co.uk
📞 Phone/WhatsApp: 07860 129168
🌐 Website: www.careplanassurance.co.uk

Serving care homes across Macclesfield, Cheshire, Greater Manchester, and the North West. Remote services available UK-wide.

About the Author: With 15+ years of hands-on experience in residential, nursing, and dementia care settings, I've conducted hundreds of care plan audits and helped care homes achieve "Good" and "Outstanding" CQC ratings. I understand the challenges care homes face and provide practical, achievable solutions.