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The Emergence of Person-Centred Planning as Evidence-Based Practice

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Recent research (Robertson et al, 2005) has demonstrated that person-centred planning (PCP) leads to positive changes for people. This research shows how PCP is associated with benefits in the areas of community involvement, contact with friends, contact with family and choice. This paper briefly describes this research and its recommendations. In addition it explores the implications for managers and professionals supporting people with learning disabilities.
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18 Journal of Integrated Care Volume 14 Issue 2 April 2006 © Pavilion Publishing (Brighton) Ltd
ABSTRACT
Recent research (Robertson et al, 2005) has
demonstrated that person-centred planning (PCP)
leads to positive changes for people. This research
shows how PCP is associated with benefits in the
areas of community involvement, contact with
friends, contact with family and choice. This paper
briefly describes this research and its
recommendations. In addition it explores the
implications for managers and professionals
supporting people with learning disabilities.
KEY WORDS
: PERSON-CENTRED PLANNING;
EVIDENCE-BASED PRA
C
TICE; LEARNING
DISABILITY
; SERVICE DEVELOPMENT
Contact details:
helen@helensandersonassociates.co.uk
Introduction
The White Paper
Valuing People
(DoH, 2001) made a
significant step towards making person-centred
planning (PCP) av
ailable to people who wish to
plan their lives in this way. In support of this
ambitious goal, a number of initiatives ha
ve been
introduced to support people in implementing PCP
.
One such development was the research (Robertson
et al
, 2005) carried out as part of the Learning
Disability Research Initiative. In this article we
contend that, because of this research, PCP can now
be considered as evidence-based practice, and we
look in detail at the implications for policy and
practice.
The article will analyse a number of different
issues. It will explore the impact that the
introduction of PCP can have on the life
experiences of people with learning disabilities, the
costs associated with the introduction of PCP and
the organisational factors that can impede or
facilitate its introduction and effectiv
eness
. Finally
,
the practice relevance of the research will be
addressed through exploration of the roles
professional are able to play in supporting both the
research and PCP.
The research
Robertson has led the largest international
evaluation of the outcomes of PCP to date. It was a
longitudinal study that explored the efficacy,
effectiveness and costs of introducing PCP for 93
people with learning disabilities. The research took
place o
ver two years in four localities in England.
The Emergence of Person-
Centred Planning as
Evidence-Based Practice
Helen Sanderson
CONSULTANT AND EXPERT ADVISOR (PERSON-CENTRED PLANNING) TO THE VALUING PEOPLE SUPPORT TEAM
Jeanette Thompson
LOCALITY MANAGER, LEARNING DISABILITY SERVICES, YORK
Jackie Kilbane
INDEPENDENT CONSULTANT
knowledge
base
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The four sites were selected on the basis of
perceived commitment to PCP, and included:
an inner London Borough
a large rural area in the South of England
two metropolitan boroughs in the North of
England.
The sites also represented a variety of social, cultural
and economic groups. One was a generally affluent
area, a second was a diverse community, and one
area was among the 10% most materially deprived
in the UK.
The participants were the first 25 people in each
site to be offered a plan. They are described as
having a ‘full range of intellectual disabilities’, and
were aged between 16 and 86; 61% were men.
Most people (73%) lived in supported
accommodation.
Table 1
, below, highlights the approach used in
the research to answer each of the questions that
were the focus of the research.
Outcomes of the research
The outcomes of the research can best be
demonstrated by consideration of the three key
areas the research set out to consider: impact on life
experience, costs and supporting structures. It is the
positive outcome noted in each of these areas that
indicates that PCP is evidence-based practice.
The impact of PCP on the life experiences of
people with learning disabilities
Perhaps the best way to indicate the impact of PCP
on the life experiences of people with learning
disabilities is to consider Luke’s story (
Box 1
,
overleaf).
Baseline data from the research demonstrated
that there was little change in people’s lives before
the introduction of PCP. After its introduction, for
those who received a plan, positive changes were
found in six areas: social networks, contact with
family, contact with friends, community activities,
scheduled day activities and choice. PCP resulted in
a 52% increase in the size of social networks, a
140% increase in contact with family members, a
40% increase in the level of contact with friends, a
30% increase in the number of community
activities, a 33% increase in hours per week of
scheduled day activities and 180% more choice
.
Essentially, therefore, the research supports the
current emphasis in health and social care policy
on using PCP to impro
ve the life chances of people
with learning disabilities.
Table 1: RESEARCH QUESTIONS AND APPROACHES
What impact does the introduction of PCP have Training in PCP and support was provided to the four
on the life experiences of people with learning localities. The researchers followed the first 25 people
disabilities? who had a person-centred plan in each site for a two-
year period. Interviews and questionnaires were used at
this stage.
What costs are associated with the introduction
The researchers documented the costs associated with
of PCP? developing and implementing PCP in each of the four
sites. In addition they determined the impact of the
introduction of PCP upon the costs of support for the
first 25 people who formed the population sample.
What organisational factors impede or facilitate The researchers undertook interviews with managers
the introduction and effectiv
eness of PCP? and practitioners in each of the four sites. They also
reviewed documentation and attended relevant
meetings.
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In addition to these benefits, the research found
that people were 1.5 times as likely to be perceiv
ed
as at risk, either in or out of the home or in traffic,
and had a 67% increase in the number of health
problems reported. It appears that PCP had no
apparent impact on building inclusive social
networks, employment, physical activity or
medication, leading to the statement in the
r
esearch report that PCP may be helpful but is not
sufficient to promote social inclusion to the
desirable level.
The research also found that PCP worked better
for some people than others. If someone had
mental health, emotional or behavioural problems,
autism, health problems or restricted mobility, they
were less likely to get a plan.
Costs associated with the introduction of PCP
PCP was found to be largely cost-neutral, and
therefore is described as being both efficacious and
effective in improving the life experiences of people
with learning disabilities.
The direct training and implementation costs
per participant were £658 if calculated across all 93
participants. However, these costs are likely to fall
over time, as local capacity is built and training is
carried out by external trainers but undertaken in-
house. The average weekly cost of the service
provided to individuals in the study rose by 2.2%,
but this increase was not statistically significant.
Organisational factors that impede or facilitate
the introduction and effectiveness of PCP
The research suggests five factors that lead to
improved outcomes for people who are supported
by services. They are:
a facilitator committed to PCP
, which the research
found to be the most powerful predictor of
successful outcomes for people
a facilitator who had planning as part of their
formal job role – planning was more effective
where people had dedicated time and an
acknowledged planning role. (Interestingly, the
research found that having a facilitator who was a
member of support staff was associated with
benefits for the size of social networks
, but had
disadvantages for community activities, contact
with friends and contact with families.)
personal involvement of the individual in
accordance with the guidance for PCP (DoH,
Box 1: LUKE’S STORY
Luke used to attend a large day centre with about
70 other people. He was described as being
unmotivated and shy, and seemed to prefer his
own company, isolating himself within the large
building. Although he was enthusiastic about
helping out in the kitchen, most of each day Luke
preferred to sleep. This caused problems with his
sleep pattern, which in turn affected his
behaviour and his family.
Luke was part of the research and began his
essential lifestyle plan in 2001. As a result, he left
the day centre and is now supported from a
community base by support workers.
Luke now plays snooker at a local club, and he
shops with little support around his local
precinct, where all the shop assistants know him.
He uses the local railway station and enjoys a
drink and a game of darts at his local pub, The
Elizabethan. Luke’s weekly visits to the gym have
improved his weight and health and he has
started cooking. He is a member of his local
library, where he knows all the assistants; he
enjoys having his own library card and delights in
choosing his own books.
There are activities that Luke has tried out but
chosen not to continue. For example, he played
badminton with three other people at a local
sports hall but didn’t enjoy his time there. F
or the
first time Luke w
as confident enough to be able
to tell his staff that he would rather play snooker.
T
oda
y Luke is confident and health
y
. He is
happy, and so is his family.
PCP was a crucial part of the changes in Luke’s
life. He has more control over his life and spends
more time doing the things that are important to
him. His family describes him as happier and
healthier.
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2002), which stressed the importance of people
having an opportunity to lead planning; this was
s
upported by the research findings, as people who
took an active role in PCP (for example in
directing their own meetings) had more positive
change in their lives
a person-centred team (Sanderson, 2002);
‘leadership, stability of staff and evidence of the
prior existence of person-centred approaches’
were associated with improved outcomes
managers actively involved in planning; several of
the PCP facilitators were first-line managers, and
this was again associated with better outcomes.
The research report concludes with a number of
recommendations, including an exhortation to:
maintain and enhance investment in Person
Centred Planning. Develop robust procedures for
ensuring and monitoring equity of access to and
the impact of planning and to develop local
capacity for change. In order to achieve this,
services will need to invest in leadership in
Person Centred Planning, build the capacity of
first line managers to use person centred
thinking and planning, and find effective ways
to support facilitators and link learning from
planning to organisational change.
Continued learning about the conditions under
which Person Centred Planning delivers
maximum benefits for people with learning
disabilities is essential.
These findings mean that PCP clearly is evidence-
based practice, is largely cost-neutral yet results in
people having more choice and more to do in their
lives. This obviously has implications for both
managers and professionals.
Implications of the research for practice
These findings create an imperative for managers
and professionals to consider how they can
contribute to ensuring that PCP is used to enable
positive changes for people. It is no longer
acceptable for people to dismiss PCP as another fad,
unsubstantiated by research.
What does this mean for managers?
The direct implications for managers include
choosing and supporting facilitators and
developing person-centred teams.
Choosing and supporting facilitators
Traditionally, selection of people for courses has
been based on their formal role (for example all
senior support workers), or on getting
representation from geographical areas or services.
Smull and Sanderson (2005) suggest that potential
facilitators could be classified as ‘naturals’, ‘learners’
or ‘unlikely to have any talent for facilitation’. The
naturals in an organisation are those who clearly
demonstrate person-centred values and continually
seek to improve the ways in which they translate
them into practice. Learners are people who broadly
share the values, but need extra support in finding
ways to put them into practice. When managers are
considering whom to begin to train as facilitators of
person-centred planning, they should begin with
the naturals. The research supports this view, as the
commitment of facilitators to PCP, and therefore to
the values of inclusion, is the most significant
predictor of success.
Providing people with training to be facilitators
is a beginning, but it is not enough. In the research,
facilitators w
ere giv
en training and ongoing
support, for example through action learning sets,
facilitator buddy groups and directly through a
PCP co-ordinator.
Managers also have a significant role in
supporting facilitators, through supervision as well
as by ensuring that they have time to plan and
attend support meetings or action learning sets.
Investing in ongoing support is a way to retain
facilitators and ensure their effectiveness in using
PCP to enable people to make positive changes in
their lives
. Some organisations use a joint approach
to training, b
y training facilitators and their
managers together. The programme teaches
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facilitators and their managers person-centred
thinking skills, then the facilitators learn about
f
acilitation while the managers learn about
developing person-centred teams, then they come
back together to learn about implementing plans.
Developing person-centred teams
PCP is based on deep listening to discover what is
important to people, what support they need, and
their hopes and dreams for the future. In
developing person-centred teams (Sanderson,
2002) managers extend these principles to how they
support and lead staff. Thinking about leadership as
a collective capacity for creating something of value
(Senge, 1990) underpins the person-centred team
approach. Managers can use person-centred
thinking tools (Smull & Sanderson, 2005) to
develop a strong sense of valued purpose, clarity
about where staff can use their creativity and
judgement and what their core responsibilities are,
as well as getting a better match between service
users and the staff who support them. There are
specific tools, for example learning logs and ‘four
plus one questions’, that managers can use to help
the team record and act on what they are learning.
The development of person-centred teams is based
on research on implementing person-centred plans
(Sanderson, 2000), and is further supported by the
recent research, which particularly indicates that
plans are more likely to be successful where there is
leadership and the team is using person-centred
approaches in its work.
This research also suggests that individuals do
different things with their time as a result of
developing and implementing a person-centred
plan; this often involves increased contact with
friends and family or greater participation in
community activities. These shifts in experience
naturally require changes in the way that teams
manage their time to support people to do
different things. Teams need to be flexible in order
to support a person to make these changes in their
lives, and be responsive to further changes. A team
that invests time and resources in person-centred
team development could result in better outcomes
for individuals as a result of PCP.
P
CP therefore requires a different way of
working, reflecting different priorities – as one
manager, Lucy, describes (
Box 2
, opposite).
What does this mean for professionals?
The ways in which professionals are able to engage
in PCP were articulated in the model proposed by
Kilbane and Sanderson (2004), in which
professionals were identified as having four ways
in which they could contribute to PCP:
introducing, contributing, safeguarding, and
implementing/integrating PCP. For each of these, a
summary of possible involvement is offered, with
implications from the research highlighted in
order to inform any specific practice implications
for professionals.
Introducing PCP
Introducing the idea of PCP to an individual or
their representative can happen during
conversations with professionals, whether in a
meeting or when visiting a person’s home. This
discussion includes offering people information
about how to get started with PCP, and supporting
them to lead their own plans or find a facilitator.
Introducing PCP to an individual or family
requires a level of knowledge about it, for
example what it is
, styles
, applications and
resources. Also important is the local
infrastructure that needs to be in place in order to
support planning, such as implementation
groups, courses and contacts.
Key factors to be considered therefore include
that professionals can:
help ensure that people who are less likely to get
a plan, according to the research findings, have
information about PCP and how to dev
elop a
plan if they wish to
support people to lead their o
wn plans, or work
with families in this w
ay (see
Box 3
, opposite).
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Contributing to PCP
The contributions that any professional could make
to a plan include facilitating the plan (if they are
trained and experienced), being a member of the
planning process throughout the whole planning
process or just a part of it, and contributing to
actions resulting from the plan as part of
implementation.
In order to contribute to a plan, a professional
must be invited to do so by the person whose plan
is being developed. This requires clarity about the
focus of their contribution and commitment to
completing any resulting actions.
Key implications of the role of professionals in
delivering this aspect of PCP include the follo
wing.
The research suggests that the role of managers is
a key factor in the success of plans. It is possible
for professionals to collaborate with and support
Box 2: A DIFFERENT WAY OF WORKING
Because of Kevin’s learning disabilities, he has
spent most of his life in an institution. He has
received residential services for as long as can
remember; he is very quiet and passive, and
does not make great demands.
At one stage, he was resettled and lived with
two other men. Over a couple of years these
tw
o men died, and the service was looking at
the best way to support Kevin.
I managed the service and was the budget
holder, and was trying to find the best solution
for him. I decided that he could not remain in
a three-person tenancy, but we could not afford
to support him on his own. I managed another
tenancy about three miles away, and the men
there and Kevin had shared some activities and
got on well enough, so I suggested that Kevin
could move into this property. At the time, he
appeared happy with the arrangement.
We started to develop person-centred plans
as part of the research project, and supported
Kevin in developing an essential lifestyle plan.
When we introduced person-centred planning,
Kevin said, ‘I want to stay here. I don’t want to
move in with them’.
I am ashamed to say that, because all the
plans were in motion, I blocked this idea and
set about persuading K
evin to move.
Thankfully
, the staff team felt empo
w
ered
enough by their person-centred planning
training to challenge m
y decision.
When I reflected on the team challenge to
my decision, I was amazed that the urge to
manage my budget efficiently had completely
overshadowed my responsibility to Kevin. At
the time, I had not considered that he had the
right to change his mind, and that m
y
responsibility w
as to him and not to financial
expediency. This was a shocking revelation, as I
ha
v
e alw
a
ys believed myself to be person-
centred by nature.
Following this challenge, I completely
altered the w
a
y that I w
as looking at K
evin’
s
housing needs. My priority became to find
ways of keeping Kevin in his present home. He
could not afford to live on his own, and so I
met the landlord and managed to change the
tenancy from three-person to two-person. We
introduced Kevin to another man, and when
they had got to know each other they decided
that they could share the accommodation.
Kevin now lives happily in his new home. He
gets on very well with his co-tenant.
Box 3: SUPPORT FOR PCP
Lucas chose a student nurse to help him with his
plan. He lived with three other men and wanted
to move. The local self-advocacy group, People
First, was running a course called Listen to Me for
people who wanted to use person-centred
planning to make changes in their lives. Lucas
asked John, a student nurse he knew, to help him.
John supported Lucas to think about and record
how he wanted his life to be, and supported him
to arrange and speak up at his meeting, and to
follow up on actions. Six months later, Lucas is
living in his own place.
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managers in ensuring that plans are
implemented.
Professionals can by actively involved in
supporting PCP; for example, a speech and
language therapist could support people to find
ways to ensure that people who do not use words
to speak are enabled to be at the centre of their
planning process. The research indicates that this
is a factor in positive outcomes for people from
PCP.
Consider training to become a facilitator.
Safeguarding PCP
Professionals have a significant role in safeguarding
the quality of plans and planning. A professional
who has knowledge, experience and understanding
of person-centred styles and approaches could
identify aspects of a plan that are of low quality and
do not reflect key features of PCP (DoH, 2001).
Learning from professionals about how to make
plans happen can be shared with local
implementation groups.
To be successful in safeguarding PCP so that
more positive outcomes are achieved, professionals
should understand its key features and know the
elements of the various planning styles and the
criteria that represent quality. In addition, it is
important for them to be familiar with the quality
process being used by local services and the local
PCP implementation group, as well as keeping up
to date with dev
elopments in PCP
.
Key implications
Professionals are in a strategic position to
contribute to safeguarding the quality of PCP over
time. They can work with implementation groups
to highlight emerging evidence about factors that
increase positive outcomes from plans, and to
share learning from and with colleagues. For
example, a PCP co-ordinator attends the
community team meeting once a quarter. She
asks the team what, from their point of view, is
working and what is not working in the local
implementation of PCP. She feeds this important
information back to the implementation group,
who use it as part of their quality process.
Use specific research evidence to inform the focus
of efforts to safeguard PCP. For example, learn
about and share ways to support people to
become active in development of their own plan,
and contribute to team development to increase
positive outcomes from plans and ensure that
plans are available to everyone.
Integrating PCP
Once a professional has experience of introducing,
contributing to and safeguarding PCP, integration
of PCP in professional practice can take place at
individual, local and system levels. For all
professional interventions, person-centred thinking
and approaches can be integrated into everyday
professional practice by:
spending time with the focus person and their
supporters, reading the plan and increasing
understanding of the person through the plan as
part of any initial work
using information from plans to influence
practice, for example arranging meetings or
activities with the person in the mornings if their
plan indicates that this is a good time, or using
learning logs
recording outcomes, new learning and actions
resulting from professional interventions in
individual person-centred plans
using person-centred thinking tools to enhance
existing practices; for example, a care manager,
when reviewing a contract, might use the process
called ‘working and not working’ in reviews to
gather information about what is working and
not working from the person’s, the family’s and
staff’s perspective (
Box 4
, opposite).
Conclusion
In this article we ha
v
e outlined the essence of the
major research initiative that has just ended, and
which has clearly identified person-centred
planning as evidence-based practice
. We have
discussed the outcomes of the research in relation
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to quality of life indicators, cost and factors that
increase the likelihood of successful plans for
people. We have also considered the implications of
this research for professionals and managers
involved in supporting people who have a learning
disability to achieve the lives they want for
themselves. A core message of the research is that
these issues are not too complex for managers and
professionals to address, and that they cannot
continue to ignore PCP, because we now have the
evidence that it makes a positive difference for
people.
References
Department of Health (2001)
Valuing People: A New
Strategy for Learning Disability for the 21st Century
.
London: DoH.
Department of Health (2002)
Planning with People:
Towards person-centred approaches
. London: DoH.
www.doh.gov.uk/learningdisabilities.
Kilbane J & Sanderson H (2004) ‘What’ and ‘how’:
understanding professional involvement in person-
centred planning styles and approaches.
Journal of
Learning Disabilities
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Robertson J, Emerson E, Hatton C, Elliott J,
McIntosh B, Swift P, Krinjen-Kemp E, Towers C,
Romeo R, Knapp M, Sanderson H, Routledge M,
Oakes P & Joyce T (2005)
The Impact of Person Centred
Planning
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Sanderson H (2000) Critical issues in the
implementation of essential lifestyle planning
within a complex organisation: an action research
investigation within a learning disability service.
Unpublished PhD Thesis. Manchester Metropolitan
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Sanderson H (2002) Person-centred teams. In: J
O’Brien & L O’Brien (Eds)
Implementing Person
Centred Planning
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Senge PM (1990)
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B
ox 4: INTEGRATING PCP IN PRACTICE
V
era, a physiotherapist, used a person-centred
thinking tool called ‘four plus one questions’ as
p
art of the review of a dysphagia group. For each
individual who attended the group they explored
four questions.
What have we tried?
What have we learned?
What are we pleased about?
What are we concerned about?
and then agreed what they would do next. The
physiotherapist said that it helped them to focus
on how dysphagia affects the person rather than
on the actual swallowing problem.
... An implication for both schools and EPs is that, in order to embed the use of PATH and PCP approaches within schools, EPs could provide staff with training to be facilitators as, although the facilitators in Childre and Chambers' (2005) study were teachers, caution is needed as the facilitators' skills and commitment can be the most powerful indicator of positive outcomes (Robertson et al., 2005;Sanderson, Thompson, & Kilbane, 2006). Sanderson et al. (2006) state that providing people with training to be facilitators is not enough, and as Corrigan (2014) notes, maintaining the fidelity of PCP requires coaching, supervision, time and support for facilitators. ...
... An implication for both schools and EPs is that, in order to embed the use of PATH and PCP approaches within schools, EPs could provide staff with training to be facilitators as, although the facilitators in Childre and Chambers' (2005) study were teachers, caution is needed as the facilitators' skills and commitment can be the most powerful indicator of positive outcomes (Robertson et al., 2005;Sanderson, Thompson, & Kilbane, 2006). Sanderson et al. (2006) state that providing people with training to be facilitators is not enough, and as Corrigan (2014) notes, maintaining the fidelity of PCP requires coaching, supervision, time and support for facilitators. Therefore, a careful plan with an identified PCP team (Sanderson et al., 2006) and training model will need to be implemented within the school with EP support. ...
... Sanderson et al. (2006) state that providing people with training to be facilitators is not enough, and as Corrigan (2014) notes, maintaining the fidelity of PCP requires coaching, supervision, time and support for facilitators. Therefore, a careful plan with an identified PCP team (Sanderson et al., 2006) and training model will need to be implemented within the school with EP support. ...
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El presente artículo desarrolla la idea que, desde un enfoque de derechos humanos, los group homes (viviendas colectivas para personas con discapacidad) pueden fomentar y asegurar el derecho a la ciudad para las personas con discapacidad intelectual. Lo anterior resulta posible debido a los servicios de la sección 1915(c) de la Ley de seguridad social en lo que a exención para hogares y servicios comunitarios se refiere, junto con algunas actividades y estrategias adicionales
... The concept of being 'person-centred' is now well established in health and social care policy in England. Having been developed in the 1980s (O'Brien & Lyle O'Brien, 1988), it was originally established as a means of collaborative life planning in the learning disability field (Sanderson, Thompson, & Kilbane, 2006). The concept was adopted more broadly as successive New Labour governments aimed to make adult social care services more 'personal' by increasing the possibilities for people to have choice about and control over their use of social care services (Department of Health, 2005). ...
... The term was applied to a model of life planning with adults with learning disabilities as they moved from long stay institutions to community-based settings (O'Brien & Lyle O'Brien, 1988). Resting on the premise that the provision of support was already established, person-centred planning focused on organising support so that the right 'environmental conditions' were created for individuals to identify and achieve their own goals and became an increasingly widespread model of support planning in the field during the 1990s (Dowling, Manthorpe, & Cowley, 2007;Mansell & Beadle-Brown, 2004;Sanderson et al., 2006). ...
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The social care assessment is a ‘key interaction’ between a person and the local authority with ‘critical’ importance for determining a person’s needs for care and support. In order to achieve this, the guidance requires that assessments must be ‘person-centred throughout’. The concept of person-centred practice is now routinely invoked, but there remains little empirical evidence on how it gets put into practice. Findings This paper draws on interview data from 30 practitioners about their experiences of conducting social care assessments in England. While there was widespread support for the principles of a person-centred approach, tensions emerged for practitioners in three ways: the way in which ‘chat’ was used to build a relationship or conduct the assessment, whether to conduct the assessment via a conversation or by following the sections on the agency form and the extent to which the assessor should involve and negotiate the contributions of family members. Applications We argue that each of these dilemmas represents an occasion when a commitment to person-centred practice is negotiated between professionals and service users and sometimes compromised as a result. We consider the possibilities for and constraints on achieving person-centred assessments in a post-Care Act environment and discuss the implications for social work practice and research.
... Under SEN reforms, person-centred planning (PCP) and multi-agency working (between education, health and care sectors) are key principles for supporting SEN (Department for Education & Department of Health, 2015). A person-centred approach recognises the expertise of young people and their families in understanding their needs, and aims to empower these individuals to take the lead in decision-making (Sanderson, Thompson and Kilbane, 2006). The benefits of PCP within a SEN context are promising, with increased engagement from pupils during review meetings (Hayes, 2004;Taylor-Brown, 2012), tailored outcomes from individual education plans (Corrigan, 2014;Keyes and Owens-Johnson, 2003) and increased parental collaboration in general (White and Rae, 2015). ...
... Establishing infrastructures and integrating PCP into the organisational culture of stakeholders have been identified as steps towards meeting person-centred outcomes (Holburn, 2002). The efficacy of this approach can also be impacted by ongoing commitment from stakeholders, clearly defined roles, and appropriate training, supervision, time and resources (Robertson, Emerson, Hatton, et al., 2006;Robertson, Hatton, Emerson, et al., 2007;Sanderson, Thompson, and Kilbane, 2006). ...
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In England, Education, Health and Care (EHC) plans are used to identify children's educational, health and social needs, and describe the additional support required to meet those needs. Replacing statements of special educational needs (SEN), the intent was to improve the process of accessing SEN provision through the greater participation of families in decision‐making processes, and increased collaboration between education, health and care sectors. Special educational needs co‐ordinators (SENCOs) play a pivotal role in the implementation of education reforms, and are often responsible for the application of EHC plans. As such, gaining insight into their experiences of initiating applications and transferring statements of SEN into EHC plans can help identify whether these documents are meeting their objectives as person‐led, wraparound care plans. This qualitative study used semi‐structured interviews to explore 16 SENCOs’ perspectives on the effectiveness of the process of applying for and transferring EHC plans. Thematic analysis of responses elicited three key themes: the perceived role of the SENCO in the EHC plan process; procedural challenges and changes – an evolving process; and difficulties in accessing an EHC plan for children with social, emotional and mental health needs.
... Although studies cite its use for post-school transitions, person-centred planning could also be useful at all stages, especially if it were linked with Individual Education Plans and Transition Plans It is seen to be beneficial due to choice, community involvement, contact with friends, contact with family, social networks and scheduled activities (Robertson, Emerson, Hatton, Elliot, McIntosh, Swift et al., 2007;Sanderson, Thompson & Kilbane, 2006). For example, Tobin et al. (2012) developed an ecological transition programme called STEP-ASD as a low-intensity intervention for reducing problem behaviours and distress in children with autism spectrum disorder as they transition to mainstream secondary school. ...
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Educational transition is a dynamic and ongoing process of adaptation due to a move from one educational context and set of interpersonal relationships to another (Jindal-Snape, 2010). The educational context can involve a change in educational systems or moving across different stages of education, such as moving from one class to another, moving from primary school to secondary school, or from a special school to a mainstream primary or secondary school. The changes in interpersonal relationships involve leaving old peers and staff behind and forming relationships with the people in the new environment. Further, transition also involves a change in identity, for example from a primary to a secondary school student, with subtle and hidden changes in expectations and rules in the new educational context (Bronfenbrenner, 2009). Transitions trigger fundamental changes in personal circumstances and can be a period of intensive learning, with the individual experiencing multiple, and in some cases, simultaneous phases of accelerated change (Griebel & Niesel, 2004; Mays, 2014). The child’s educational transitions are therefore embedded in other simultaneous, multiple transitions. Their transitions trigger transitions for significant others, such as their family and professionals, and vice versa. Therefore, transitions are multiple and multi-dimensional (see Multiple and Multi-dimensional Transitions Theory, Jindal-Snape, 2016).
... Based on the results we propose the introduction of person-centred planning in temporary shelters and its legal anchoring. Person-centred planning is broadly accepted as evidence-based practice in many countries throughout the world (O'Brien and O'Brien 2000;Mansell and Beadle-Brown 2004;Sanderson, Thompson, and Kilbane 2006). It is based on a completely different way of seeing and working with people (Sanderson 2000). ...
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In this paper we lay the foundation for research into the concept of hope in homeless people in the Czech context. The text is based on partial data from a broader empirical study. The main aim of the paper is to gain a complex understanding of the role of hope in setting goals for homeless people living in shelters. Specifically, we have focused on how homeless people conceptualise hope and how their concepts of hope can be used to set future goals as part of individual planning in a shelter? In the research, we used a qualitative strategy combining traditional techniques such as in-depth interviews and case studies with projective technique. We have identified four main concepts of hope and a range of sources and limits of hope in homeless people living in a shelter. Based on the findings, the possibilities of implementation of person-centred planning in shelters in the Czech Republic are discussed herein.
... Existing successful small scale demonstrations of the effectiveness of PCP in improving the quality of life of people with ID provide cautious optimism for this approach. Some have argued that PCP can now be considered as an evidence based practice (Sanderson, Thompson, & Kilbane, 2006), however, as suggested by Hagner et al. (1996), the challenge of the application of PCP on a wider scale remains. The question is therefore not whether PCP should be implemented, but how its effectiveness can be sustained in ordinary practice. ...
Thesis
Background: Deinstitutionalisation and the movement of people with intellectual disabilities (ID) to the community have seen the emergence of care philosophies aimed at tailoring services to individuals’ needs. Person-centred support has been widely advocated and considered synonymous of good care. It is useful to investigate if day-to-day support provided by paid carers in the community is person-centred. / Aims: 1. To explore person-centred support and choice in adults with ID and challenging behaviour. 2. To investigate correlates of person-centred support, including challenging behaviour. 3. To investigate whether the results of self-report questionnaires and direct- observations are comparable. / Methods: 1. Self-report measures of person-centred support typically used by staff supporting older adults with dementia were adapted for use by staff supporting adults with ID and challenging behaviour. A measure of choice availability was also updated. 2. A cross-sectional study of 109 paid carers supporting adults with mild to severe ID was conducted to address aims 1 and 2. 3. Naturalistic observations of eighteen participants with ID were conducted to complement the results of the cross-sectional study. Data was collected using momentary time-sampling and narrative descriptions. / Results: Paid carers reported high levels of person-centred support and choice availability for service-users. No significant associations were found between person-centred support and characteristics of the living environments, however choice availability was significantly higher in supported living compared to residential care homes and in living environments with fewer residents. Carers who reported higher levels of person-centred support experienced less subjective burden in their jobs. There was an association between choice and service-users’ adaptive behaviour. No association was found between person-centred support/choice and global challenging behaviour; stereotyped behaviour however was negatively associated with autonomy and carers’ knowledge of individuals with ID. The findings from the observations showed lower levels of person-centred support than those reported by paid carers, suggesting desirability effects in carers’ responses. Low levels of engagement in meaningful activities, assistance and contact from staff were observed, although there was much variability at the individual level. There were few instances of challenging behaviours and these mostly consisted of stereotyped/repetitive movements which were prevalent in disengaged participants. / Implications: The support for people with ID and challenging behaviour requires improvement but quality evaluation criteria adopted by inspectors and regulators may need to be reconsidered. Improvements in day-to-day support could reduce stereotyped behaviour but input from skilled professionals may be required for other types of challenging behaviour.
... The implementation of this Act is still in its infancy but critics have warned previously that legislation of this kind could lead to an oversimplification of support needs based on a rigid, indiscriminate, prescriptive approach defined simply by within-child characteristics (e.g. Sanderson et al., 2006). Furthermore, the reliance on standardised assessment measures for support, the constant form-filling to which parents in this study referred, also tacitly implies that greater value is given to the expertise of the professionals who create and interpret the assessment measures than parents' own understanding of their support needs (Dempsey et al., 2009) and can lead to parents seeing themselves as viewed as a category rather than an individual member of a wider community. ...
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Much research has documented the elevated levels of stress experienced by families of autistic children. Yet remarkably little research has examined the types of support that these families perceive to be beneficial to their lives. This study, co-produced by researchers and school-based professionals, sought to establish these families' support needs from their own perspectives. In total, 139 parents of autistic children with additional intellectual disabilities and limited spoken communication, all attending an inner-city London school, participated in an initial survey examining parental wellbeing, self-efficacy and the extent to which they felt supported. Semi-structured interviews were conducted with a subgroup of parents ( n = 17), some of whom reported in the survey that they felt unsupported, in order to gain their in-depth perspectives. The results from both the survey and the interviews suggested that existing support (particularly from formal support services) was not meeting parents' needs, which ultimately made them feel isolated and alienated. Parents who were interviewed called for service provision that adopted a relational, family-centred approach - one that understands the specific needs of the whole family, builds a close working relationship with them and ensures that they are supported at times when the parents and families feel they need it most.
Chapter
Like all young people, adolescents and young adults with intellectual and developmental disabilities (IDD) make major decisions about their life trajectory during their high school and postschool years. Transition planning and services are essential supports that may help adolescents and young adults with IDD to make decisions in major areas of their life, such as postsecondary education, employment, independent living, and financial matters. This chapter provides an overview of key areas of decision making for adolescents and young adults with IDD and research-based strategies that can help support young adults with IDD to make decisions about their life trajectories, including self-determination skills, student-directed IEPs, person-centered planning, and other accommodations and supports for decision making. This chapter also provides an overview of curricula that support the acquisition of self-determination skills, decision-making skills, and self-direction for adolescents and young adults with IDD. Lastly, in this chapter we discuss the importance of decision making and self-direction in transition planning for the postschool success of adolescents and young adults with IDD.
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This paper provides a knowledge‐based perspective to understanding public value management (PVM). As distinct from other approaches to public administration, PVM focuses on collaborative capacity building for the creation of public value. To develop the notion of PVM further, we explore the role of a knowledge‐based strategy in a case study of change implementation in 18 disability service organisations in Western Australia. Our findings show important inter‐relationships between knowledge management strategy, adopting a person‐centred approach to service provision, and sustainability of change implementation. We discuss the implications of the study for disability sector change management and for the further exploration of the strategic role of knowledge management capabilities in the study and practice of PVM in public sector administration. The paper explores the relationship between an organisation's knowledge capture and sharing systems and processes and its ability to implement change in a way that generates long‐term benefits for both public sector employees (e.g., engaging with key stakeholders to generate innovative solutions for serving client needs) and clients (i.e., increased well‐being through better service design and support).
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Person-centred planning is central to Valuing People. This has resulted in lots of planning activity, but implementing plans in services is deeply challenging. Developing person-centred teams is a key to implementing plans. This article presents a model for developing person-centred teams based on research. Examples of how teams worked to implement plans are shown to illustrate this process and clarify why it requires a change in thinking as well as a change in practice.
The Impact of Person Centred Planning
  • J Robertson
  • E Emerson
  • C Hatton
  • J Elliott
  • B Mcintosh
  • P Swift
  • E Krinjen-Kemp
  • C Towers
  • R Romeo
  • M Knapp
  • H Sanderson
  • M Routledge
  • P Oakes
  • T Joyce
Robertson J, Emerson E, Hatton C, Elliott J, McIntosh B, Swift P, Krinjen-Kemp E, Towers C, Romeo R, Knapp M, Sanderson H, Routledge M, Oakes P & Joyce T (2005) The Impact of Person Centred Planning. Institute for Health Research, Lancaster University.