1. Your goal during your stay with us
My Recovery Plan Telford Integrated Community Assessment Team
Service start date:…………..………… Plan Date……………………
Your estimated date of discharge from this service: ……….……….
Your Key Worker:……………..………………...………….……..……
Key Worker Job Title: …………………………………………………
Key Worker Contact details: ………………………………………….
Person’s details Name:
Home Address:
Gender : M/F DOB:
NHS No CareFirst No
Admission details
Your goal during your stay with us
Reason for admission:………………… …………
………………………………… ……………………
Current recovery service provided: … ………….
Review of this plan
Review Target
Actual Date
Reviewed By
Outcome
72 Hour Review
1 Week Review
2 Week Review
3 Week Review
4 Week Review
The recovery service is a short care programme to support you to become more independent. This may be provided following discharge from hospital, as an alternative to hospital admission or to provide a rehabilitation package to promote independence.
TICAT Recovery Plan Page 1 of 2

2. My Recovery Plan Telford Integrated Community Assessment Team
No.
Goal
Action to achieve the goal
By Who - Person, provider, professional
By When
Recovery Plan for: NHS No CareFirst No
This plan was created by: ………………………………………... Role: Signature:………………………………...
Plan Date:……………………………………… Contact details:……………………………………………...
TICAT Recovery Plan Page 2 of 2