Using Q‐Methodology to Involve People with Intellectual Disability in Evaluating Person‐Centred Planning

Objectives Person‐centred approaches do not easily lend themselves to standard methods of evaluation. This study develops a technique that will involve service users and their circle of support in making individual plans. Methodology Q‐methodology is a phenomenological approach, which enables the researcher to co‐construct the stories of many people. Two people with learning disabilities and seven members of their circle of support were identified to participate in the study. They attended a stakeholder meeting to identify 36 valued activities. The 16 participants then completed a Q‐sort using photographs to represent these activities. These sorts were then interpreted using Q‐methodology. Results There were a number of intercorrelations between the card sorts. Principle component analysis showed that two factors accounted for 73% of the variance of the data. The two clusters represented the members of each person's circle of support. Analysis and comparison of the factors have highlighted the similarities and differences between individuals and their circle of support. Conclusions This study shows that Q‐methodology is a useful adjunct to person‐centred planning. Looking at and interpreting the data, which emerge through Q‐methodology, hashighlighted both similarities and individual differences for goal planning. It has also highlighted potential areas for service change and development. Using Q‐sorts over time may be a way to demonstrate the subjective change in peoples' values that occur through person‐centred planning (PCP).     

Can Person‐Centred Planning Fulfil a Strategic Planning Role? Comments on Mansell & Beadle‐Brown

Policy appears to regard person‐centred planning (PCP) as underpinning strategic planning. While accepting the logic of its role in planning for individuals, this commentary argues that PCP cannot fulfil a strategic planning role because the development of PCP on a wide enough scale to be useful for this purpose is itself a strategic development, which will take considerable time and resources to achieve. There is still a place for population‐based norms or targets based on available epidemiological data to indicate the needed scale of provision and associated resource requirement. Three illustrations are described. In conclusion, it is noted that the current lack of indicative provision targets is a weakness of recently issued policy, an absence which does nothing to safeguard the interests of those who depend on service support.     

Reported Barriers to the Implementation of Person‐Centred Planning for People with Intellectual Disabilities in the UK

Background Research in the US and UK has demonstrated the effectiveness of person‐centred planning (PCP) for people with intellectual disabilities. However, it is important to acknowledge problems that arise when implementing PCP. This paper considers barriers to PCP reported during a longitudinal study of the impact of PCP. Methods Person‐centred planning was introduced over a 2‐year period for 93 people of whom 65 had a plan developed. Information was collected regarding barriers to PCP every 3 months from key informants using self‐completion questionnaires. Results Barriers to PCP were widespread particularly in relation to: availability of trained facilitators; availability of services; lack of time and reluctance of people other than paid support staff to engage in the PCP process. Conclusions Services need to be aware of potential barriers to PCP so that strategies can be developed to overcome them, the first of which should be the ongoing training and support of facilitators.     

Person‐Centred Planning or Person‐Centred Action? A Response to the Commentaries

This paper responds to four commentaries on our original paper in this issue. We respond to issues raised under three headings addressing the scale of the task envisaged in the 2001 White Paper Valuing People, the feasibility and effectiveness of individual planning and how to achieve person‐centred action. We conclude that there is substantial agreement about the goals of intellectual disability services and the processes that need to take place around individuals to help them get what they need and want. We disagree about whether person‐centred planning will deliver this, and about whether it will provide a robust basis for claiming and defending the resources people with intellectual disabilities will need in the future.     

Person‐Centred Planning or Person‐Centred Action? Policy and Practice in Intellectual Disability Services

Background This critical review considers the nature and importance of person‐centred planning in the context of current British policy and service development in intellectual disability. The difference between person‐centred planning and other kinds of individual planning is discussed. Materials and method The scale of the task of implementing person‐centred planning as a national policy initiative is considered. The limited evidence base for person‐centred planning is reviewed and the reasons for the failure of previous attempts at individual planning are analysed. The assumption that person‐centred services will be produced by a new kind of individual planning is questioned. Conclusions Consideration is given to what would be necessary to make services more person‐centred, including changes in power relations, funding arrangements and staff training and supervision.     

Person‐Centred Planning in its Strategic Context: Reframing the Mansell/Beadle‐Brown Critique

Valuing People, the English national strategy launched in 2001 is founded on the twin principles of self‐determination and social inclusion. It promotes a vision of people with intellectual disabilities in the mainstream of life. To achieve this goal, it seeks to integrate a wide variety of elements, in which person‐centred planning (PCP) is one. The Mansell and Beadle‐Brown review makes many interesting points about PCP in this context. We reframe their critique in three main ways: by more fully recognising the extent to which PCP is an intrinsic element of the national strategy, helping to operationalise its core principles; by crediting the ways in which individual planning and action are intended to become part of one continuous process; and by showing how the strategy addresses the challenge of scale by prioritising quality rather than quantity in implementing PCP, with the aspiration of creating a virtuous spiral of positive change.