Person-Centred Care

Person-centred care starts from an obvious truth that busy systems keep forgetting: the person receiving care is a whole adult with seventy or ninety years of habits, tastes, loves, dislikes and pride — not "the 8 o'clock double-up" or "bed 12". The task is not to fit the person around the service, but the service around the person.

In practice it is built from small, specific things. Tea in the china cup, not a beaker, because that's what she's drunk from since 1963. Shaving before breakfast because he was a soldier and never once ate unshaven. Music from Lagos on Saturday mornings. Being called "Mrs Adeyemi" until she invites you further. None of this is decoration — for a person losing control over large parts of life, these details are where dignity actually lives.

It also means power: the person decides, wherever they can, with support if needed. Risk is managed with people, not imposed on them. And where a person cannot express their wishes easily, the work deepens rather than stops — families, life story, observation and skilled guesswork keep the person, not the diagnosis, at the centre.

• Regulation 9 (2014 Regulations): care must be appropriate, meet needs, and reflect the person's preferences — with the person (or lawful representative) involved in planning and reviews.
• Care Act 2014, section 1: the wellbeing principle — including personal dignity, control over day-to-day life, and participation — governs how councils assess and plan.
• Regulation 10 (dignity and respect) and Regulation 11 (consent) are person-centred care's legal siblings.
• Mental Capacity Act 2005: wishes, feelings, beliefs and values must shape best-interests decisions when a person cannot decide.
• Equality Act 2010: care shaped to the person includes culture, faith and identity.

This is the heart of the caring and responsive questions. Assessors compare plans to reality: does the plan contain the person's voice ("I like…", "I need you to…"), and does the shift actually deliver it? They watch interactions — names used, choices offered, pace matched to the person — and they ask people and families "do they know you here?". Generic plans, task-timed visits that ignore stated preferences, and institutional routines (everyone up by 9, bathed on their allotted day) all attract criticism under Regulation 9.

• Gather life story properly — a "This is me" style profile: career, family, faith, routines, food, music, fears, pride. Update it as you learn; it is a living document, not an admission form.
• Write plans in the first person where possible, with the person's own words: "I take my tea weak, milk in first. I will tell you if I want help — please don't take over."
• Offer choices at every step, sized to the person: two outfits held up beats "what do you want to wear?" for someone with dementia.
• Protect the person's abilities: set up, prompt, wait. The extra four minutes while someone butters their own toast is the care plan working.
• Match staff where it matters — language, continuity, gender preference for intimate care — and record why it matters to them.
• Review with the person, not about them: "What's working? What should we change?" — and change it.

Example 1. A retired baker in residential care becomes agitated every morning around 5am, and the night team's notes read "resistive to redirection back to bed". His daughter mentions he baked from 4:30 every working day of his life. Staff stop redirecting: they lay out flour and let him "check the ovens" (the kitchenette), and he potters, satisfied, until breakfast. The agitation was biography, not behaviour.

Example 2. A home care package specifies a 30-minute morning call "wash and dress, prompt medication". The worker learns the client, who had a stroke, can dress herself if her clothes are laid out in order and nobody rushes her. The team re-sequence the visit: meds and breakfast first, clothes laid out, encouragement instead of hands. It takes the same 30 minutes. She dresses herself for the first time in a year and tells everyone who visits.