Daily notes and records about me

Why people keep daily notes

Support workers may record the help provided, your choices, health changes, concerns and what needs to happen next. Records help people provide safe, consistent care and explain decisions. Registered care providers must keep accurate, complete, up-to-date and secure records. Ask what is written, why it is needed, where it is kept and how long it is retained. Necessary records are different from a running account of every private activity.

How much of my support time should be used for notes?

CQC’s standards on records and staffing do not set a fixed number of minutes or percentage for writing notes. Staff must keep accurate records without undue delay, and the provider must have enough staff to meet your care needs as well as its recording duties. The time needed depends on the support provided and what happened. Some records need completing promptly for safety. Recording should be planned so it does not leave you without the help you need.

Check what your support hours cover

Ask the provider and the council, NHS team or other person arranging your support to explain your care plan and agreement. Do the hours cover individual support, shared staff time, or a visit including care and necessary recording? How much recording time is planned? Talking through a note with you can be useful support if you want it, but should not replace help you need with something else. The national standards do not decide what every contract includes or how each charge is calculated.

If writing notes is taking over

Keep a few examples of how long notes took and what support was delayed, rushed or missed, including agreed activities or help to communicate. Ask the manager to review the recording system, staffing and time available with you and the person arranging your care. Ask what will change and when. If you need immediate assistance while someone is writing, say so; the service must maintain safe support. The solution should allow both care and accurate records, without expecting staff to work unpaid or omit necessary notes.

Are the words respectful?

Notes should describe you as an adult with your own wishes, strengths and reasons. Ask staff to avoid insults, ridicule or labels that replace an explanation. A serious incident or concern still needs an honest record. Clear descriptions of what happened, what you said and how staff responded are more useful than unexplained labels such as “difficult”. Respectful recording does not mean hiding risks or leaving out relevant facts.

Record what happened and what helped

For example, a note that only says “refused care” may leave out important information. Ask whether it explains what was offered, what you said, any reason you gave, and what staff offered or did next. Record an agreed later time or different way of helping where relevant. Staff should distinguish what they saw, what you or someone else said, and their own interpretation. They should not guess your feelings or reasons and present those guesses as facts.

Am I asked what I think?

Ask how you can contribute to notes and care reviews. You might talk through an entry, use pictures or a communication aid, or add your own account with support. Agree when you would like to be asked; you do not have to read every entry. If a note is written as though you are speaking, it should reflect your actual words or a version checked with you. Necessary recording does not depend on you approving or signing every entry.

Who can see my daily notes?

Access should have a clear, necessary and authorised purpose. This may include staff providing your care and authorised people checking quality, investigating a complaint or meeting legal duties. A job in the organisation does not give everyone unrestricted access. Staff must not look out of curiosity. Ask the provider which roles and organisations can access your information, what they can see and why. A handover book or electronic app needs the same care as a formal care plan.

Family, friends and advocates

Being your relative, partner, friend or “next of kin” does not automatically entitle someone to all your records. You can agree what a chosen person may see or help you request. Explain any limits and ask how to change that agreement. If you cannot make a particular decision, the organisation must consider the relevant legal authority, your wishes and applicable safeguards. A learning disability alone does not mean you cannot decide.

Sharing information and asking permission

The service should explain how it uses and shares your information and listen to your preferences. Not all lawful recording or sharing relies on your consent. Relevant information may need to be shared for care, safeguarding or a legal requirement, subject to the rules that apply. Sharing should have a proper basis and be limited to what is needed. Ask for an accessible privacy notice: an explanation of who uses your information, why and with whom.

Why is a worker writing on a phone?

A phone may be an approved way to read your plan or write care notes. It might belong to the provider or be the worker’s own device authorised for work. Ask them to explain what they are doing. Approved secure systems and the provider’s rules should protect your information. Recording on a phone must not leave necessary care or supervision unmet. The home guide explains phone use, attention and how to raise concerns.

Keeping notes private in your home

Paper records should be stored securely and screens protected from people who should not see them. Visitors and other residents should not be able to read your personal notes on a table, noticeboard or unattended screen. Ask where staff discuss handovers so private information cannot be overheard. Staff should use the provider’s approved secure arrangements, including when recording on a phone or tablet.

Can I read the notes?

Ask the service to show or explain the entries about you and agree a practical way to review them. You can also make a subject access request for your personal information, including relevant daily notes. Most requests are free. Some information may lawfully be withheld or have parts hidden, for example to protect another person’s information. Ask for an explanation. The linked guide on seeing your records explains requests, deadlines and support.

If a fact is wrong or something is missing

Identify the entry and date, explain what is wrong or incomplete, and say what correction is needed. You can ask for a correction verbally or in writing; keeping a copy helps. The organisation must consider the request. Corrections may be added alongside the original so the record still shows what happened. A correction does not always mean the earlier entry can be erased.

If I disagree with an opinion

An opinion should be identifiable as an opinion and attributed to its author. Disagreeing with it does not automatically mean it must be deleted. Ask for your disagreement, reasons and relevant evidence to be recorded. If the opinion relied on incorrect facts, point those out too. You can also challenge the care decision or assessment through the appropriate review or complaints route.

If records are disrespectful or shared wrongly

Tell the manager which entry or incident concerns you and what you want put right. For privacy, access or accuracy concerns, ask for the organisation’s data protection contact. Complain to the organisation first; unresolved data protection concerns can be taken to the Information Commissioner’s Office, called the ICO. An advocate can help you explain your concerns. If notes reveal unsafe care or abuse, use the care complaints or safeguarding route as well.

Agree how I will be involved

Use the optional worksheet to record how you want notes explained, how your views will be included and whom you want involved. Ask the service to confirm what it can arrange and any limits, with reasons. Agree who will act and when you will review whether the arrangement works. Keep any completed worksheet private because it may contain personal information.

Why are there notes?

How long should notes take?

What do my support hours include?

If notes take too much time

The words should respect you

Your choices matter

Ask to have your say

Agree when to talk about notes

Who can read them?

Family and friends

Sharing your information

Keep notes private

Reading your notes

If something is wrong

If you disagree

Help to speak up

Make a plan together

What you can do next

More useful links