Person-centred planning in social care - JRF

1 Person-centred planning in social careA scoping reviewSandra Dowling, Jill Manthorpe and Sarah Cowley in association withSarah King, Vicki Raymond, Wendy Perez and Pauline WeinsteinAn exploration of the relevance of Person-centred planning in social report explores why and how Person-centred planning has spread fromlearning disability services to influence the whole of adult social care . The recentemphasis on self-directed support makes this a timely overview of the origins ofperson- centred study describes how Person-centred planning began, discusses the existingevidence base and explains why many practitioners find it an effective way tosupport people with social care needs.

2 The authors take a critical butconstructive look at the claims for Person-centred planning in the context ofcurrent policy and service developments. They explore issues relating to serviceusers, their families, frontline staff and implementation of the approach. Thereport concludes by identifying barriers to Person-centred planning and possibleways to overcome planning in social care is relevant to debates about individualbudgets, self-directed support and In Control. It will be a resource for policymakers, social care practitioners and students on social work or learningdisability nursing programmes who wish to explore new ideas or evaluatecontemporary approaches to social publication can be provided in alternative formats, suchas large print, Braille, audiotape and on disk.

3 Please contact:Communications Department, Joseph Rowntree Foundation,The Homestead, 40 Water End, York YO30 : 01904 615905. Email: planning in social careA scoping reviewSandra Dowling, Jill Manthorpe and Sarah Cowley inassociation with Sarah King, Vicki Raymond,Wendy Perez and Pauline WeinsteinThe Joseph Rowntree Foundation has supported this project as part of its programme ofresearch and innovative development projects, which it hopes will be of value to policymakers, practitioners and service users.

4 The facts presented and views expressed in thisreport are, however, those of the authors and not necessarily those of the Rowntree Foundation, The Homestead, 40 Water End, York YO30 6 WPWebsite: King s College London 2006 First published 2006 by the Joseph Rowntree FoundationAll rights reserved. Reproduction of this report by photocopying or electronic means for non-commercial purposes is permitted. Otherwise, no part of this report may be reproduced,adapted, stored in a retrieval system or transmitted by any means, electronic, mechanical,photocopying, or otherwise without the prior written permission of the Joseph : 978 1 85935 479 7 ISBN-10: 1 85935 479 3A pdf version is available from the JRF website ( ).

5 A CIP catalogue record for this report is available from the British design by Adkins DesignPrepared and printed by:York Publishing Services Ltd64 Hallfield RoadLayerthorpeYork YO31 7 ZQTel: 01904 430033; Fax: 01904 430868; Website: copies of this report, or any other JRF publication, can be obtained either from the JRFwebsite ( ) or from our distributor, York Publishing Services Ltd, at theabove is Person-centred planning ?3 Terminology3 Philosophy4 Practice5 Interpreting the concept8 Summary93 How services were.

6 How they are now and the contribution of policyin steering service developments10 How services have been10 How services are now11 Policy12 Background to policy changes14 Comment on policy14 Summary154 Organisational structure and working culture16 Resources16 Funding18 Strategic targets19 Inter/multi-agency working20 Mainstream and specialist services20 Service delivery21 Culture22 Summary235 Issues relating to service users and their families25 The scale of the task25 Focus on ability?26 Service users27 Power relations/inclusion27 Relationship between service users and staff28 Cultural diversity29 Families29 Information for families30 Relationship between staff and families30viIssues specific to particular populations31 Summary326 Obstacles and opportunities from the perspective of frontline staff34 Staff abilities34 Training36 Culture staff attitudes37 The role of managers37 Support for staff39 Personal dilemmas39 Summary407 Barriers and bridges to Person-centred planning41

7 Two new initiatives designed around implementing Person-centred planning44 What works in Person-centred planning ?468 Concluding remarks and recommendations for future research48 Recommendations for future research48 References50 Appendix: Methods60viiSummaryPerson- centred planning is at the heart of much recent policy relating to the provisionof social care services. It refers to a family of approaches aimed at enabling peoplewho use services to plan their own futures and to get the services that they the terminology varies between different user groups, the fundamental valuesof the concept are the same embracing the principles of independence, choice,inclusion, equality and empowerment as the foundations of service provision.

8 Asubstantial change is needed in thinking, so that thinking that has long guidedapproaches to support Person-centred planning becomes standard within social , disabled people have been expected to fit into existing services. Theyhave had little input into the design or delivery of the service they receive. There isevidence of a change within services in the direction of Person-centred planning ;however, this remains partial. While Person-centred planning has been widelyendorsed, it has not as yet been fully adopted or implemented across social careservices.

9 Even though the policy focus is on Person-centred planning and it isbroadly accepted as the way forward for service provision, it has proved easier totalk about it than to do services have inherited resource systems that are based on outdatedmodels of service provision. They were often managed and allocated on a whole-service basis without reference to the individual. Likewise, funding arrangementsneed to be restructured in order to give individuals more choice and control indesigning their own support.

10 An increase in the use of Direct Payments is conduciveto increased choice for individuals. Adequate staffing to support work with individualsis needed, together with the allocation of sufficient time for staff to work with serviceusers on devising and delivering Person-centred plans. The potential for Person-centred planning is improved through the development of strategies to support multi-agency working and through mainstream services being accessible to social careservice users. A requirement of these changes is a fundamental change in theculture that permeates services so that the idea of Person-centred planning is of the legacy of traditional approaches to service design, service usersoften feel that they have little impact on the way that services are planned anddelivered.