Author and Publication
Author: Ben Slater, Registered Social Worker, Founder and Managing Director of Nellie Supports
Reviewed by: Kerry Slater, Director of Operations
Last reviewed: 20 July 2026
Citation
1. Department of Health and Social Care (2022) National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care. Available at: https://www.gov.uk/government/publications/national-framework-for-nhs-continuing-healthcare-and-nhs-funded-nursing-care
2. Department of Health and Social Care (2022) NHS Continuing Healthcare Decision Support Tool.
3. R (Grogan) v Bexley NHS Care Trust and others [2006] EWHC 44 (Admin).
4. Social Work England. Professional standards. Available at: https://www.socialworkengland.org.uk
Copywright
Copyright © 2026 Nellie Supports Ltd. All rights reserved.
This article is made available for general information, education and professional reference. It may be downloaded, printed and shared for non-commercial purposes, provided that it is reproduced in full, is not altered in any way, and is properly cited as the work of Nellie Supports Ltd. This material must not be edited, adapted, sold, republished, incorporated into commercial products, or used for commercial training, assessment, report-writing or advisory services without prior written permission from Nellie Supports Ltd.
This article does not constitute legal advice, clinical advice or a substitute for a decision-specific professional assessment. Where legislation, government guidance, court forms or external professional materials are referred to, those materials remain subject to their own copyright, licensing and re-use terms.
Abstract
This guide explains how care plans are used as evidence in NHS Continuing Healthcare cases. It covers what a care plan demonstrates, the significance of behaviour support plans and risk assessments, why a plan evidences need rather than its absence, the limitations of plans as evidence, how to identify plans that understate need, and how to use them alongside records.
Using care plans as CHC evidence
A care plan is a statement of what a person requires, written by professionals before any funding dispute arose. That makes it some of the most useful evidence available, provided you understand what it does and does not show.
What a care plan demonstrates
It records what has been assessed as necessary: the interventions, their frequency, the staffing, the equipment and the risks being managed. Because it is written to guide care rather than to argue a case, it carries a credibility that material produced during a dispute does not. It shows what professionals concluded was needed when nobody was watching.
Behaviour support plans and risk assessments
These are the most valuable of all, because they set out what triggers a problem, what strategies are required, what staffing is needed and what happens when the strategies fail. A behaviour support plan is direct evidence of assessed need and it is frequently held by the provider and never reaches the assessment. Ask for it by name.
A working plan evidences need
This is where families sometimes go wrong. A plan that is working, and a person who is settled as a result, is evidence of significant managed need, not of low need. The plan describes what it takes to produce that stability. Submit the plan alongside the point that the person's presentation depends on it.
Where plans fall short
A plan states what should happen, not what does. It may be out of date, may not have been revised as needs increased, and may describe an ideal rather than the reality. It also tends to omit the overnight picture and the time actually taken. Plans need care records alongside them to show what was delivered.
Plans that understate need
Some plans are written thinly, particularly where a provider uses a template or where the plan has not been reviewed for a long time. Where a plan understates what is actually being provided, say so and evidence the gap with daily records and staffing rotas. A thin plan is not evidence that the need is small.
How to use them
Submit the current plan, any behaviour support plan, moving and handling and other risk assessments, and any earlier version showing how provision has increased over time. The comparison between an old plan and a current one is a particularly effective way of demonstrating deterioration.
Key takeaway
Care plans show what professionals assessed as necessary before any dispute existed, which is what makes them credible. Ask for behaviour support plans by name, argue that a working plan evidences need, and pair plans with records to show what was actually delivered.
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Frequently asked questions
Why are care plans useful evidence?
Because they record what professionals assessed as necessary before any funding dispute arose. That gives them a credibility material produced during a dispute does not have.
Does a working care plan weaken our case?
No. It evidences significant managed need. The plan describes what it takes to produce the person's stability, which is exactly what the well-managed need principle requires to be recorded.
Which plan matters most?
The behaviour support plan where one exists, since it sets out triggers, strategies, staffing and what happens when strategies fail. Ask for it by name, as it is often held by the provider and never reaches the assessment.
Related NHS Continuing Healthcare pages
These links take you to the most relevant Nellie Supports service page and to the supporting guides that explain the surrounding process.
Speak to an independent CHC specialist
Nellie Supports prepares independent needs evidence for NHS Continuing Healthcare assessments, reviews and appeals across England and Wales. Our reports are written by registered social workers on a permanent employed team, with internal peer review before release. Call 0333 987 5118 or send an enquiry and we will talk through where you are in the process.