Front-line meanings of person-centred care

: an interpretive policy analysis based on the views of care professionals

Abstract

Person-centred care has become a bedrock of policy relating to adult social services in England, synonymous with high-quality care. In recent decades the idea has gained ‘unstoppable’ momentum as a platform for raising standards. However, person-centred care has become mired in ambiguity. There was no agreed definition of being ‘person-centred’ within the care sector, hampering front line implementation.

An interpretive policy analysis explored how person-centred care was interpreted by workers and managers, and which meanings were attached to the concept within their practice. One-to-one interviews were conducted with 20 care staff by telephone and online. A rich dataset of transcripts was analysed for patterns of beliefs, values and practices. Findings were presented in a typology, which epitomised participants’ interpretations of the concept within three distinct approaches to person-centred practice. These were Nurturing Mental Health; Nurturing Agency; and Nurturing Intimacy.

Within Nurturing Mental Health, professionals applied psychological assessments and creative use of activities to stimulate happiness and reduced anxiety within clients. Practitioners adopting a Nurturing Agency perspective assessed clients’ mental and physical capacity and encouraged decision-making and independence. Practices for Nurturing Intimacy involved seeking consent from clients to provide close personal care, and developing meaningful relationships and friendships with
them.

This thesis could raise cognisance of front-line care staff’s situated knowledge and experiences, which are frequently overlooked in policy debates. Its model offers a new dimension of understanding how person-centred care is understood through distinctive sets of beliefs, values and practices. It offers not only a critique of current policy definitions of the concept, but a path towards rethinking front line interpretation of person-centred care. The typology of meanings could inform a future framework for values-based training and self-reflection as part of a person-centred approach.

Date of Award	6 Dec 2022
Original language	English
Awarding Institution	University of Bristol
Supervisor	Karen West (Supervisor) & Jon Symonds (Supervisor)