Front-line meanings of person-centred care: an interpretive policy analysis based on the views of care professionals
Lead Research Organisation:
University of Bristol
Department Name: Sch for Policy Studies
Abstract
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.
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.
Organisations
Studentship Projects
| Project Reference | Relationship | Related To | Start | End | Student Name |
|---|---|---|---|---|---|
| ES/P000630/1 | 01/10/2017 | 30/09/2027 | |||
| 1926318 | Studentship | ES/P000630/1 | 01/10/2017 | 19/06/2021 | Daniel Lombard |
| Description | Alumni Foundation |
| Amount | £550 (GBP) |
| Organisation | University of Bristol |
| Sector | Academic/University |
| Country | United Kingdom |
| Start | 05/2018 |
| End | 05/2018 |
| Description | School for Policy Studies Academic Support Fund |
| Amount | £500 (GBP) |
| Organisation | University of Bristol |
| Sector | Academic/University |
| Country | United Kingdom |
| Start | 07/2019 |
| End | 07/2019 |
| Description | Extended Project Qualification Mentoring Fair |
| Form Of Engagement Activity | Participation in an open day or visit at my research institution |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Schools |
| Results and Impact | Attended the EPQ mentoring fair, organised by the university's student outreach team. I acted as mentor for two students who were doing projects on social science topics (disability and society, and racism in the police force). I discussed the students' projects and advised on how they might be improved. |
| Year(s) Of Engagement Activity | 2019 |
| Description | International Association of Dialogue Analysis Conference |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Other audiences |
| Results and Impact | Gave an oral presentation to delegates at the IADA on my PhD research project. I made valuable contacts here which could faciltate an overseas visit to an institution |
| Year(s) Of Engagement Activity | 2019 |
| URL | https://www.iada-web.org/ |
| Description | Nordic Congress of Gerontology |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Other audiences |
| Results and Impact | Using a travel grant from the Alumni fund, I attended this important gathering of gerontology experts in Oslo, Norway. I presented a poster based on my research proposal, Exploring Person Centred Care using Conversation Analysis, as part of a poster exhibition. |
| Year(s) Of Engagement Activity | 2018 |
| Description | PGR Student seminar |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Postgraduate students |
| Results and Impact | Gave talk on the problems surrounding the funding of the adult social care system in the UK for a series of seminars for postgraduate students at the School for Policy Studies, University of Bristol |
| Year(s) Of Engagement Activity | 2019 |