Goal Setting within Care Environments for Individuals with Intellectual and Developmental Disabilities

Background: Effective person-oriented goal setting in care environments is challenging owing to the complexity of the environment, and the requirement of supportive person-centred care. Health and social care settings, such as the community-care sector, aim to holistically address persons’ care needs, however, much of the guidance in the literature focuses explicitly on health. Effective person-centred care should consider all goals of the person, whether these goals focus on career, relationship, and/or health domains. Person-centred care responds to a person’s wants/needs, with a consideration for how these revolve around their goals. However, little is known about how community-care organizations use tools such as person-centred planning (PCP) to meet the needs and goals of persons-supported. Aim and Methods: To understand how a person-centred participatory goal setting process is carried out in a care environment, we used an integrated knowledge translation approach to collaborate with community care leaders. Our co-designed qualitative descriptive research project explored a community-care’s approach to person-centred goal setting in Ontario, Canada. We conducted 11 semi-structured interviews with community-care staff to understand their perspective of the PCP process, including key components, facilitators, barriers, and impacts. Results: The interviews with staff provide a thorough understanding of the PCP process used by the community-care organization from beginning to end, including the creation and implementation of PCPs. Five themes were strongly exemplified in our study: organizational culture, flexibility, accountability, utilizing staff characteristics to their maximum potential, and the positive impacts of PCPs. The PCPs displayed benefits not only for the persons-supported, but for the people who support and surround them, including family, friends, staff, and the wider community. Moreover, our study demonstrates how a community-care organization has been able to balance the needs of the organization and the persons they serve within a government-mandated planning process. Implications: Our study highlights how a community-care organization can facilitate person-centred services through PCPs and has implications for a wider uptake of PCPs amongst individuals with intellectual and developmental disabilities. The outcomes of this project will inform the spread of PCPs in community-care organizations and encourage other professionals to explore the use of PCPs in their own settings. Additionally, PCPs have the potential to be effectively implemented for other vulnerable populations. Next Steps: Future research should explore the use of a flexible framework to guide the use of PCPs in organizations. Moreover, governments should support organizations in evaluating their programs to support the spread of effective programs and to ensure that future implementation can be successful.