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Care and support records · CS-284 · Form

Personal Care and Support Plan

Free printable personal care and support plan — what matters to me, how I like things done, what I do myself, what I need help with and who to contact. PDF.

First page of the Personal Care and Support Plan printable — what matters to the person, in their own words
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One page. The A4 and US Letter files are laid out identically, so neither is shrunk to fit.

Print it and write on it

Fillable PDF type and save

Or no download needed

Fill it in online

The fillable versions have real form fields — open them in any PDF reader, type into them and save. Printing help.

Fill it in online

The same sheet, on screen. Tick, type, add or remove rows, then print it or download the completed version as a PDF. Everything stays in your browser — your entries are kept in this browser's own storage on this device, nothing is uploaded, and there is no account.

Who this is for

The plan everyone works from, in the person's own words. What matters, how they like things done, what they do themselves, what they want help with, and who helps.

People arranging their own care or having it arranged for them, families writing down what a parent or partner wants before carers start, and agencies who want the person's own account alongside their assessment.

What this helps you track

  • What matters to the person, in their own words
  • How they like things done — the order, the timing, the small things
  • What they do for themselves and want to keep doing
  • What they want help with, area by area, and who provides it
  • Who to contact, and who agreed the plan

How to use it

  1. Write it with the person, not for them; if somebody else holds the pen, say so at the top.
  2. Fill in the five sections in the person's words. Short and specific beats long and general.
  3. Use the table for each area of help: what the help looks like, who gives it and when.
  4. Agree it with everybody who will use it, and sign and date it.
  5. Read it again when something changes, and write a new one rather than crossing the old one out.
  6. Keep a copy where the carers will see it, or fill it in online and save it in your own browser.

Formats

  • Printable PDF (A4 and US Letter)
  • Fillable PDF with form fields
  • Fill in online, saved in your browser

The printable is laid out inside a box that fits both A4 and US Letter, so the two files are identical and neither one is scaled. The fillable PDF has real form fields. The online version keeps what you enter in your own browser and builds the completed PDF on your device.

How to print

Download the A4 or US Letter file to match the paper in your printer, open it in a PDF reader and print at 100% — not "fit to page", which shrinks the writing space. Both files leave a 14 mm margin, which clears the unprintable edge on home printers. To print the online version with your entries in it, use the Print this sheet button, which prints only the sheet and none of the page around it. More on printing.

Questions

Is this a care assessment?

No. An assessment is done by a professional and belongs to the service that made it. This is the person's own plan, in their own words, for the people who help them day to day. The two sit side by side.

Who decides what goes in it?

The person, first. Family and carers can help them put it into words, but what matters, what they like and what they want to keep doing themselves are theirs to say.

What if the person cannot tell us?

Write what those who know them best believe, and say plainly at the top that it was written on their behalf and by whom. The life story sheet in this group helps gather that.

Does it say what care has to be provided?

No. What is to be provided is set by the care plan from whoever arranged the care, the assessment and the rules where you are. This sheet records what the person wants and how; it makes no claim about what anybody owes them.

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