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Aims and Method  Annual audits of the enhanced care programme approach (CPA) were conducted from 2002 to 2005 to evaluate and improve the implementation of CPA in two inner-London community learning disability services. The CPA standards included those stipulated by the Department of Health. The notes of all patients on enhanced CPA were analysed using a structured data collection form.    Results  There was a gradual improvement in the attainment of targets by both services. Areas of strength included allocating a date for the next CPA review, crisis plans and documentation of service users' comments. Areas of weakness included completion and review of risk assessments and the availability of a care plan for the previous 6 months.    Clinical Implications  Completing the audit cycle and reauditing improves attainment of targets and encourages service development, but further progress is required.

Auditing the care programme approach for people with learning disability: a 4-year audit cycle