The Implementation of Person-Centred Plans in the Community-Care Sector: A Qualitative Study in Ontario, Canada

Background: Person-centred planning (PCP) refers to a model of care in which programs and services are developed in collaboration with persons-supported (i.e., persons receiving care) and tailored to their unique needs and goals. In recent decades, governments around the world have enacted policies requiring community-care agencies to adopt an individualized or person-centred approach to service delivery. Although regional mandates provide a framework for directing care, it is unclear how this guidance is implemented in practice given the diversity and range of organizations within the sector. Objective: This study aims to address a gap in current literature by describing how person-centred plans are implemented in community-care organizations. By describing existing practices, we aim to provide insight on how to optimize care delivery to improve outcomes for community-care populations. Methods: We collaborated directly with knowledge users at each stage of the research process (i.e., study design and conception, interview guide development, recruitment, knowledge translation, etc.) through our formal partnership with PHSS, a not-for-profit community-care organization based in a large urban city in Ontario, Canada. We conducted semi-structured interviews with administrators from community-care organizations in the region. We asked participants about their organization’s approach to developing and updating person-centred plans, including relevant supports and barriers. We analyzed the data thematically using a pragmatic, qualitative, descriptive approach. Results: We interviewed administrators across 12 community-care organizations in Ontario, Canada. We identified three overarching themes related to organizational characteristics and the PCP process: (1) organizational context, (2) organizational culture, and (3) the design and delivery of person-centred plans. The context of care and the type of services offered by the organization were directly informed by the needs and characteristics of the population served. The culture of the organization (e.g., their values, attitudes and beliefs surrounding persons-supported) was a key influence in the development and implementation of person-centred plans. Participants described the PCP process as being iterative and collaborative, involving initial and continued consultations with persons-supported and their close family and friends, while also citing implementation challenges in cases where persons had difficulty communicating or were non-verbal, and in cases where they preferred not to have a formal plan in place. Conclusions: These findings provide valuable insight into the implementation of person-centred plans in the community-care sector. The important role of organizational culture and context offers universal lessons for community-care stakeholders. We also identified implementation challenges, highlighting a gap between policy and practice and suggesting a need for comprehensive guidance and enhanced adaptability in current regulations. Policymakers, administrators, and service providers can leverage these insights to refine policies, advocating for inclusive, flexible approaches that better align with diverse community needs.