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Barbara McIntosh and Helen Sanderson review the findings of a major evaluation of person-centred planning for people with learning difficulties and find grounds for optimism among the challenges

Five years after the government published the white paper Valuing People, which aimed to place people with learning difficulties at the centre of service planning, there are encouraging signs for service users, but areas of concern remain.

This first and only evidence-based evaluation of person-centred planning (PCP) has been carried out by several organisations working in partnership in four sites. Called Impact of Person Centred Planning, it found that person-centred approaches can radically improve an individual’s quality of life and identify health needs that might have gone unnoticed.

Each site had links to staff from the research project who provided training in PCP. Facilitators from each site, including staff and family members, were trained over 18 months and a person-centred plan was developed for 65 people.

The research highlighted that people with learning difficulties who had a person-centred plan experienced a 30 per cent increase in the size of social networks, 2.4 times more contact with family, 41 per cent increased contact with friends, and a 35 per cent increase in activities.

If facilitators and their managers were committed to PCP, people with learning difficulties were more likely to have their own plans. There were key factors that made a difference: facilitators should be committed to person-centred planning and, to achieve this, they should be chosen carefully. Facilitators should have planning as part of their formal job role as the research found that this was more effective when people had dedicated time and support and an acknowledged planning role.

The research suggested that managers should be supported to work in a person-centred way in their own team. Managers should also be involved in planning. They needed support to understand how to implement person-centred plans as PCP should have an impact on how a manager looks after their staff.

The most positive changes to service users’ lives came about when they were leading their own plans.

However, there are barriers to this type of working that need to be overcome. Local authorities are deemed to be the leads in supporting people with learning difficulties but their large size
sometimes results in a bureaucratic and hierarchical culture. Working in an individualised way and creating unique opportunities for one person at a time can mean a big change from the previous culture of large day centres and group homes. Care management, which is often crisis-driven and led by financial restrictions, can appear to be a counter-culture to person-centred approaches. High staff turnover and delays in appointing key managers also complicated the implementation phase.

Other issues that proved challenging included: