Supports and barriers to creating and implementing person-centred plans in the community care sector in Canada: A qualitative analysis of three perspectives

Abstract

Background

The community care sector manages the delivery of health and social services in people’s homes and local communities. The sector supports individuals with intellectual and developmental disabilities, physical disabilities, and complex medical needs. Person-centred plans (PCPs) have been recognized as evidence-based practice across various care settings, however there is limited literature on the factors impacting this process. This study aims to identify the supports and barriers to creating and implementing PCPs in the community care sector.

Methods

We partnered with PHSS, a not-for-profit community care organization based in Ontario, Canada. We conducted a total of 42 semi-structured interviews, 18 with persons receiving care (i.e., persons-supported) at PHSS, 1 with a family member of a person-supported, 11 with frontline staff at PHSS, and 12 with representatives from different community care organizations in Ontario, Canada. We asked participants about the PCP process at their organization, including relevant supports and barriers. We analyzed the data thematically, using a pragmatic, qualitative, descriptive approach.

Results

We identified four key factors impacting the creation and implementation of PCPs: (1) the health and capacity of the person-supported, (2) community care sector challenges, (3) integration across community care and health sectors, and (4) community connections, accessibility, and inclusion. Participants described how the health and capacity of the person-supported could impact the PCP process, particularly for individuals who were non-speaking or had difficulty communicating. Inadequate funding and staffing were described as community care sector challenges. Participants also described a need for increased integration with other sectors including acute care systems. Strong connections with the community were integral to implementing PCPs; participants also encountered barriers to inclusion and accessibility.

Conclusions

The creation and implementation of PCPs is impacted by individual health and capacity, organizational funding and staffing, intersectoral integration, and broader community factors. These findings highlight the importance of addressing challenges through targeted intervention strategies designed to optimize PCP creation and implementation and ensure equitable outcomes across diverse populations.