Ongoing assessment and planning to ensure that the care recipient receives the care and services they need:

• that is undertaken on at least a monthly basis; and
• that includes the following:

• regularly assessing the care recipient’s needs, goals and preferences.
• reviewing the care recipient’s home care agreement and care and services plan.
• ensuring the care recipient’s care and services are aligned with other supports.
• partnering with the care recipient and the care recipient’s representatives about the care recipient’s care and services.
• ensuring that the care recipient’s care and services are culturally safe.
• identifying and addressing risks to the care recipient’s safety, health and wellbeing