A significant development and challenge in intellectual dis.ability services is ‘person-centredness’, however, it is becoming widely recognised as a vital component of the overall quality of life for people with intellectual disability. Person-centred planning (PCP) is a concept that was developed in the late 1980s, designed to assist individuals with disability to achieve their dreams and aspirations (O’Brien and Lyle 1987). Person-centred means activities which are based upon what is important to the person from their perspective and can be simply defined as a way of discovering how a person wants to live their life and what supports they require to make this possible. The following is a reflective account about the development of person-centred planning on a pilot basis in the Daughters of Charity Service since June 2003.
The Daughters of Charity deliver services to people with intellectual disability through a mix of residential, respite, early services and day activation across ten sites in two separate geographical regions of Ireland. The decision to take the person-centred approach was made following an extensive review of the literature on quality of life in intellectual dis.abilities, culminating in the recommendation that PCP provided a framework for eliciting service users’ personal dreams, aspirations and wishes, together with a means of working towards their achievement.
The PCP Journey
Following the decision to embark on person-centred planning, a project group was enacted with the goal of constructing a model/framework for its implementation. This process, which was guided by the seminal work of Sanderson (2000) and McIntosh (2004) led to the development of eight key principles to underpin the model.
Organisational awareness sessions were then undertaken for all stakeholders to:
a) describe the concept of person-centredness
b) explain the key principles
c) gain support for the process .
These sessions were undertaken at times to facilitate as many people as possible to attend. A significant number of stake.holders attended, which indicated to the service the great interest in PCP and it was encouraging that many family members attended.
The next step was to establish a steering group to guide and oversee its implementation. A project plan was developed and decided to embark on the following actions:
- define person centredness
- appoint project manager
- select pilot sites
- establish awareness campaign for all stakeholders in the selected pilot sites
- identify essential system supports for pilot site/s
- agree documentation/tools
- identify development needs for pilot site run pilot.
While many definitions exist for PCP within the prescriptive lit.erature, the following definition, which received widespread agreement, was developed in conjunction with service users as being the cornerstone of person centred planning within the service:
‘Person centredness is about me, my life, my choice. It’s having an action plan for my life where I AM THE BOSS. It’s about focusing on my abilities, not my disabilities, and it is about finding out where I need help and support and getting my circle of friends and family to help me.’
A project manager was appointed whose main remit was to work towards the completion of the remainder of the action plan in conjunction with the steering group.
The selection of sites then began with some units/departments/service users indicating their immediate willingness to become involved, while in others a random selection of service users across the life span was undertaken. Specific targeted information sessions were held in all selected areas for service users, which were supplemented, as appropriate, with story boards/pictures to ensure that the sessions were user friendly. Each service user was then supported by a member of staff to select their circle of friends and facilitator to support them with their plan. A suite of established tools (such as Maps, Path, Essential Lifestyle Planning) were used to aid the develop.ment of the plan; however, each plan became unique to the individual service user. In total 35 service users are now engaged in developing their own person-centred plan.
The above is a short reflection of how this service undertook the concept of person centred planning. The concept has been embraced well within the service and is congruent with the core values of the Daughters of Charity service; however, like many other initiatives, some challenges emerged as the process developed. The difference between the already developed individual programme plans and the new concept was at times difficult for staff to identify. A specific concern for facilitators was the issue of ensuring that they truly represented the person and that their own aspirations for the person did not cloud their judgment. There was some caution if this process would be highly dependent on both human and financial resources. A further challenge emerged in that staff had concerns about facilitating the wishes, dreams or aspirations of service users who could not readily express their wishes, owing to communication or other difficulties. The process also highlighted the importance of allowing enough time to build relationships if plans were to be successful. Despite these challenges to date, one can confidentially argue that the plans in progress currently do not require significant extra resources, but that on-going support and time for the process to evolve are essential. However, the project is new and we eagerly look forward to the final evaluation of this pilot project.