Unit 17 Lead person-centred practice.
Explain person-centred practice
Person –Centred Practice is a philosophical approach
to service development and delivery. The aim of person centred practice is to
provide support for individuals in a respectful and responsive manner acting on
the individuals preferences, values and needs. Individualised support plans
should be implemented rather than working to a one size fits all pre written
plan. Staff delivering the support will have an understanding that clients are
all individuals and as such need to have support in place that meets their
specific needs, plans can be fluid and altered as and when necessary to support
any changes in the client’s circumstances.
‘Personalisation is about allowing individuals to
build a system of care and support tailored to meet their own individual needs
and designed with their full involvement. Historically, a one size fits all’
approach to care was in practice and this meant the individual having to fit
into and access already existing care
services, whether they were appropriate or not. Now individuals can access
their own budget and decide on which service they will spend their budget.’
Level 5 Diploma in Leadership for Health and Social Care 2nd Edition
Critically review approaches to person-centred
Historically support was provided following
assessment under ‘The Medical Model.’ This model views the
disability, asks what support is needed to overcome the issues raised by the
disability and how to implement them. It was very much a service-led approach and not in any way
‘The medical model
assumes that disability is an individual problem caused by impairment (Lacking
part or all of a limb, or having a defective limb, organism or mechanism of the
body’ (Oliver 1990, p.11)). The focus is on treating the impairment with the
aim of improving or restoring the function that is lost or missing. The focus
is therefore on investing in health care and related resources to research,
identify, diagnose, cure, manage, alter and control illness. It does not
account for social and environmental influences which contribute to an
individual’s level of ‘disability’.’
Social care for
excellence website – what is personalisation and where did it come from.
approach often meant clients were not able to shape the kind of support they
need, or they may not have received the right help. More often it was a case of
the help or support other people thought they needed being provided. At times
it fit more with the support teams requirement to provide the service than it
did with the clients need for support.
‘The social model
of disability proposes that systematic barriers, negative attitudes and
exclusion by society lead to a person being defined by society. Whilst it
recognises that some people may have a physical, sensory, intellectual or
mental impairment, these do not lead to disability UNLESS society fails to take
account of and include people regardless of their individual differences. A
fundamental aspect of the social model concerns equality. Equal rights are said
to give empowerment and the ‘ability’ to make decisions and the opportunity to
live life to the fullest. The approach was originally conceived by disabled
people to understand their situation and claim their civil rights.’
Social care for
excellence website – what is personalisation and where did it come from.
approaches like self-directed support and personal budgets enabled people to
identify their own needs and make choices about how and when they are supported
to live their lives. Clients need access to information, advocacy, if
appropriate and advice so they can make informed decisions. It is client-led
support and should allow the client to make decisions, choices and empower them
to have a greater say in their own support.
There is no single
way to implement person centred support, and several tools are available that
help practitioners and providers implement person centred planning:
Lifestyle Planning (ELP): essential lifestyle planning is a tool that lets you know how someone
wants to live and shows you how they would like it to happen through an
extremely detailed action plan. ELP lets you discover what is important to
service users, what support they need (from their perspective) to remain
healthy and safe. A good plan reflects the perceptions of the service user and
those who love and care for that person. Essential lifestyle plans look at:
Strengths of a service user
What is important to service users
How practitioners can provide the support needed
Identifies successful method of support
Problem solving strategies
ELP is a good way of starting
to get to know someone, and work out what is needed on a day-to-day basis. It
does not focus on ‘dreams’ unlike some of the other methods.
Futures Planning, this is similar to ELP, and includes access to community resources. It
is a way of describing life now and looking at what the person wants in the
future. It provides more of an overview than the detail of some of the other
MAPS: this is similar to PATH, below,
in that it focuses on desirable futures or dreams, and how service users might
try to achieve these. It covers people’s history and identifies their gifts.
PATH: PATH stands for Planning
Alternate Tomorrows with Hope. This is a fast-moving tool that can be quite
graphic and powerful. It pays most attention to the process of change, and
helps a group of people who are committed to the service user to understand the
plan and how it will progress. This is not so much about gathering information,
but planning action. It focuses on the ‘dream’ and works its way back from
there, mapping actions required along the way.
service design: this aims to gain a greater understanding of service users by seeing
the past through their eyes. From this it is possible to identify how services
need to be designed.
of support: a circle of support is a group of people who meet to help someone
along the path to their hopes and dreams: a support network. The focus person asks
the support group to help them to leap over barriers that they might come
across. The support group also helps the person by opening new doors to
opportunities and experiences.
Here you also need
to expand on what you started to touch on in your last paragraph more. The actual methods and tools used in Person
centred work. You should talk about
Essential Lifestyle Planning, MAPS and PATH for example and what each of these
are in summary.
1.3 Analyse the effect of legislation and
policy on person-centred practice
planning was adopted as government social policy in the United Kingdom through
the ‘Valuing People’ White Paper in 2001. This became “Valuing People Now’, a
3-year plan, in 2009. It is widely promoted as a key method for delivering the
personalisation objectives of the UK government’s ‘Putting People First’
programme for social care.
government continued this commitment through ‘Capable Communities and Active
Citizens’ (2010), it sets out the 6 areas that are key to providing
• ‘Personalisation: individuals not
institutions take control of their care. Personal budgets, preferably as direct
payments, are provided to all eligible people. Information about care and
support is available for all local people, regardless of whether or not they
fund their own care.
• Partnership: care and support
delivered in a partnership between individuals, communities, the voluntary and
private sectors, the NHS and councils – including wider support services, such
• Plurality: the variety of people’s
needs is matched by diverse service provision, with a broad market of high
quality service providers.
• Protection: there are sensible
safeguards against the risk of abuse or neglect. Risk is no longer an excuse to
limit people’s freedom.
• Productivity: greater local
accountability will drive improvements and innovation to deliver higher
productivity and high quality care and support services. A focus on publishing
information about agreed quality outcomes will support transparency and
• People: we can draw on a workforce
who can provide care and support with skill, compassion and imagination, and
who are given the freedom and support to do so. We need the whole workforce,
including care workers, nurses, occupational therapists, physiotherapists and
social workers, alongside carers and the people who use services, to lead the
changes set out here.’
communities and active citizens, Department of health, 2010
In 2011 health and social care organisations
set up a sector-wide agreement ‘Think Local, Act Personal’ to transform adult
social care. The vision sets out
how the Government wishes to see services delivered for people; a new direction
for adult social care, putting personalised services and outcomes centre stage.
“The Equality Act
2010 provides a legal framework which can support personalisation in adult
social care. They are both about ensuring individuals receive services that are
respectful, effective and accessible. It is essential that care providers from
all sectors understand the implications for them.
means thinking about care and support services in an entirely different way.
This means starting with the person as an individual with strengths,
characteristics, preferences and aspirations and putting them at the centre of
the process of identifying their needs and making choices about how and when
they are supported to live their lives. It requires a significant transformation
of adult social care so that all systems, processes, staff and services are
geared up to put people first.”
1.4 Explain how person-centred practice
informs the way in which consent is established with individuals
John Obrien has
published several books and articles regarding Person Centred Planning, his
values led approach put great emphasis on inclusion and empowerment. Rather
than other people making decisions and life choices for and on behalf of the
clients he advocated that clients be fully involved and included in all
decisions. Historically a medical model was followed which looked at what is
‘wrong’ with the person and not what the person needs. It creates low expectations
and leads to people losing independence, choice and control in their own lives.
Practice focuses on the client and their wishes and rights.
The right to take part in community life and to live and spend leisure time
with other members of the community.
right to experience valued relationships with non-disabled people.
Choice: The right
to make choices, both large and small, in one’s life. These include choices
about where to live and with whom to live.
Competence: The right to learn new skill and
participate in meaningful activities with whatever assistance is required.
Respect: The right
to be valued and not treated as a second-class citizen.
The nursing and
midwifery council have created some basic principles too consent, these are:
‘In approaching the
care planning process, the assumption is that every adult must be presumed to
have mental capacity to consent or refuse treatment, unless they are:
• Unable to take in or retain
information provided about their treatment.
• Unable to understand the information
• Unable to weigh up the information as
part of the decision –making process.’
1.5 Explain how person-centred practice can
result in positive changes in individuals’ lives
Person Centred Practice is a well-established way
of ensuring health and care staff work in a manner that is respectful and fully
involves people who use services. It is a method of working that that allows
support staff to do things with people rather than to or for them. It works on
building relationships between support staff and the clients they support; it
is fluid and changes as the clients support needs change. Person Centred
Practice focuses on the client’s individual capacities, the quality of life as
defined by the client and plans to provide the support a client requires or
wants at any given time. Person centred practice is one of the cornerstones of
individualised support. It means the person and their support network make
decisions, seeking professional advice as needed, roles are fluid according to
what makes sense for the person.
2010 Equality Act viewed Dec 16th 2017
A new strategy for learning disabilities in the 21st century, viewed Nov
A person centred approach keeps the person with a disability at the
centre of decision making , viewed Nov 7th 2017
A Practical guide to working with people with learning disabilities : a
handbook for care assistants and support workers / edited by Hilary Brown and
Sue Benson. – 2nd ed. London : Hawker Publications
A vision for adult social care: Capable communities and active citizens,
viewed Dec 29th 2017
Expert Guide to Health and Social Care Joint Working, viewed Feb 11th
Improving Partnership Working to Reduce Health Inequalities, viewed Feb
Independence, choice and risk: a guide to best practice in supported
decision making, vewed 01 December 2016
John O’Brien’s Five Essential Service Accomplishments, viewed Nov 7th
Person Centred Planning, viewed Dec 11th 2017
Practice code for Nurses and Midwifes, viewed Jan 4th 2017
Putting people first, viewed Dec 27th 2017
Shifting The Power of Balance Within the NHS, viewed 01 December 2016
T Tilmouth, J Quallington 2016 Level 5 diploma in leadership for health
and social care 2nd edt Hodder Education. London
What is person centred care and why is it important, viewed Nov 11th
What is personalised support, viewed Dec 16th 2017
Working Partnerships, viewed 01 December 2016,