Person centred care means that the person receiving support, not the service, is at the centre of every decision about their care: what happens, when, how and by whom. It is a legal requirement in England under Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, a principle of the Care Act 2014, and the standard against which the CQC single assessment framework judges whether a home is Caring and Responsive. Most homes say they provide it. Fewer can show it.
This guide is for registered managers, deputies and owners of learning-disability, mental-health, nursing and residential homes. It explains what person-centred care means in practice, the principles and values behind it, what a person-centred care plan contains, what it looks like on an ordinary shift, and how to evidence it so that an inspector can see it in the records and on the floor.
The short answer
Person-centred care is care built around what matters to the person: their history, preferences, relationships, goals, culture and choices, and their right to take part in decisions about their life. The four principles most often cited are dignity, compassion and respect; coordinated care; personalised care; and enabling people to recognise and develop their own strengths. The values that support it include individuality, rights, choice, privacy, independence, dignity, respect and partnership. In a care home it lives in the care plan, written with the person in their own words where possible, and in the daily record that shows the plan being followed. Evidence is the plan, the record, what the person says and what an inspector sees at 8am and 8pm.
What is person centred care?
What is person centred care, in plain terms? It is the difference between a home that fits the person into its routine and a home that fits its routine around the person. In the first, everyone is up by eight, lunch is at twelve and the bath rota decides when you wash. In the second, the care plan says when you like to get up, what you like for breakfast, whether you prefer a bath or a shower and on which days, and the shift is organised to deliver that.
The person centred care meaning goes beyond preferences. It means the person is involved in planning their care, understands it, and can change it. It means staff know the person as an individual with a history, not as a set of needs. It means the person's strengths and goals are as important as their risks. And it means the person has choice and control, including the right to make decisions others disagree with, subject to the Mental Capacity Act 2005 where capacity is in doubt.
Person-centred care is often described as a philosophy. Managers should treat it as a practice with evidence, because that is how it is inspected.
Where the idea comes from
The term has several roots. In dementia care, Tom Kitwood's work at the University of Bradford in the 1990s argued that the person with dementia remained a person whose wellbeing depended on relationships and respect, not just on managing symptoms. In learning disability services, the government's Valuing People strategy in 2001 introduced person-centred planning as the way to give people choice and control over their lives. In health policy, the Health Foundation set out four principles of person-centred care in 2014, and the NHS Long Term Plan and personalised care agenda followed.
In regulation, the Care Act 2014 placed the individual's wellbeing at the centre of local authority duties, and the 2014 regulations made person-centred care an explicit requirement on every registered provider. NICE guidance on people's experience in adult social care services sets out what people should expect. By 2026, the CQC single assessment framework assesses person-centred care through specific quality statements rather than treating it as a general theme.
The practical point for a manager is that person-centred care is not a fashion. It is the settled expectation of the law, the regulator and the people who use services.
The four principles of person-centred care
People searching for what are the 4 principles of person-centred care usually mean the Health Foundation's framework, which is the most widely used in England.
- Affording people dignity, compassion and respect: treating the person as a whole human being with rights, and behaving accordingly at every interaction.
- Offering coordinated care, support or treatment: so the person does not have to repeat their story, and the home, the GP, the hospital and the family are working from the same understanding.
- Offering personalised care, support or treatment: tailored to what matters to the person, not to a standard pathway.
- Supporting people to recognise and develop their own strengths and abilities: enabling independence and a fulfilling life, rather than doing things for people that they could do themselves.
Each principle can be tested against a care plan. Does it record what dignity means to this person? Does it show who else is involved in their care and how information is shared? Is it about this person or could it be about anyone? Does it say what the person can do and wants to do, or only what they need done?
Person-centred values: how many are there?
A common search is how many values are there that support person centred care, and the honest answer is that no single list is official. Care Certificate standard 5, working in a person-centred way, describes person centred values without fixing a number. The list most often taught in England has eight: individuality, rights, choice, privacy, independence, dignity, respect and partnership. Some versions add care, compassion, courage and competence from the 6 Cs, making twelve.
The number matters less than the use. Each value should be recognisable in practice. Individuality is the care plan that describes the person's history and personality. Rights is the capacity assessment before any decision is made for them. Choice is the menu with real options and the right to refuse. Privacy is the closed door. Independence is the support to do it themselves even if it takes longer. Dignity is the covered body and the quiet voice. Respect is the name they prefer. Partnership is the review with the person and their family in the room.
Managers who want staff to understand the values should ask them to find each one in a real care plan and a real shift, rather than to recite the list.
At a glance: principles, practice and evidence
| Principle | On shift | In the care plan | Evidence |
|---|---|---|---|
| Dignity, compassion and respect | Knock, ask, explain, use the preferred name, never rush personal care | What dignity means to this person; preferred name; personal care preferences | Observation, feedback, daily notes |
| Coordinated care | Handover, hospital passport, GP and family kept in the loop | Who is involved, contact details, what is shared with whom | Contact records, passport, review minutes |
| Personalised care | Routine, food, activity and support delivered the person's way | Life history, preferences, culture, faith, goals | Care plan matched against daily logs |
| Enabling strengths | Support to do, not doing for; graded steps towards goals | What the person can do, wants to learn, and the plan to get there | Goal reviews, activity records, outcomes |
Person-centred care, approach and planning
Three terms are used loosely and it helps to separate them. Person centred care is the care itself, delivered around the person. A person centred approach is the way staff and the organisation think and behave: seeing the person first, asking rather than assuming, enabling rather than doing. Person centred care planning is the process that turns the approach into a written plan the shift can follow.
Person-centred planning has a specific meaning in learning disability services, where it describes tools such as PATH and MAPS and the person-centred plan or PCP that sets out the person's own vision for their life. In those services the PCP sits alongside the care plan and the health action plan, and the three should agree with each other.
A home can have the approach without the plan, and it will be inconsistent. It can have the plan without the approach, and the plan will be fiction. Both are needed, and the evidence has to show both.
Why person centred care is important
Why is person centred care important, beyond being required? The benefits of person centred care are practical. People who are supported in the way they prefer are calmer, eat and sleep better, and are less likely to express distress through behaviour that staff then have to manage. Falls, pressure damage and hospital admissions fall when routines fit the person rather than the rota. Complaints fall when families see the person known and respected. Staff turnover falls when the job is about people rather than tasks.
There is also a moral case that managers should be comfortable making. People living in care homes have often lost their home, their independence and their privacy. Person-centred care is what keeps them a person rather than a bed number. Inspectors, families and staff all recognise a home that has understood this, and they recognise one that has not.
The regulatory case is the simplest. Regulation 9 requires it. The single assessment framework assesses it. Homes rated Requires Improvement or Inadequate under Caring or Responsive have almost always failed to evidence it.
The legal basis
Regulation 9 requires that care and treatment is appropriate, meets the person's needs and reflects their preferences. It requires the provider to carry out an assessment with the person, to design care with them, to enable them to understand and make decisions, and to review the care with them. The Care Act 2014 requires local authorities to promote individual wellbeing and to involve the person in assessment and planning, which shapes what commissioners expect from providers.
The Mental Capacity Act 2005 governs how person-centred care works when a person cannot make a particular decision. The Act's principles, assume capacity, support the person to decide, respect unwise decisions, act in best interests, choose the least restrictive option, are person-centred care in statutory form. A best interests decision that ignores the person's known wishes and feelings is unlawful as well as poor practice.
Managers should be able to point to the sentence in Regulation 9 that each part of their care plan meets. Our guide to the CQC fundamental standards sets the regulation out in full.
What a person-centred care plan contains
A person-centred care plan is organised around the person, not around the home's tasks. The structure below is one that works across residential, nursing, learning disability and mental health services.
About me
Life history, family, work, interests, faith, culture, what matters most, what a good day looks like, what a bad day looks like. Written in the first person where the person can contribute, and from the people who know them where they cannot.
How I communicate
Speech, signs, symbols, objects, behaviour, expressions. How to know when the person is happy, in pain, frightened or saying no. What staff should do to communicate well.
How I want to be supported
For each area of need, personal care, eating and drinking, mobility, medicines, health, activity, relationships, night time, what the person can do, what support they want, how they want it and who they want it from.
My health
Conditions, medicines, professionals involved, appointments, the hospital passport, and the health action plan for people with a learning disability.
My risks and my choices
Risk assessments that record the benefit as well as the hazard, the person's view, capacity where relevant and the agreed plan.
My goals and my reviews
What the person wants to achieve, the steps, and the review dates with the person and family involved. Kiwi's 24-section care plan follows this shape, with easy-read health action plan and person-centred plan sections and review dates on every section, so that the person's own document and the shift's working record are the same thing.
Examples of person centred care on a shift
Examples of person centred care are easier to recognise than definitions.
- A resident who worked nights for forty years is supported to sleep until ten and have breakfast at eleven, and the care plan and the kitchen both know it.
- A woman with dementia who was a seamstress has a basket of fabric and a sewing box in her room, and staff sit with her while she sorts it when she is anxious.
- A man with a learning disability who wants to travel to the day centre alone has a graded plan with a travel trainer, a risk assessment and a review date, and the daily log shows each step.
- A resident who is Muslim has his prayer times protected on the shift plan, halal food from a supplier he trusts and a lift to Friday prayers arranged with a named worker.
- A woman in a mental health rehabilitation home sets her own recovery goals, including returning to part-time work, and the support plan is built around them.
- A man who refuses personal care in the morning is offered it after lunch, when his care plan says he prefers it, and the refusal is recorded without judgement.
In each case the evidence is the same: the plan says it, the record shows it, and the person or their family can confirm it.
Involving the person
Person-centred care starts with the person being involved in their own plan. For many residents that means sitting down with them and writing it together, in their words. For people with a learning disability it means easy-read versions with pictures, time, and a worker they trust. For people with dementia it means life story work with family and the person's own reactions to what is offered. For people who cannot communicate their views, it means the people who know them best and, where there is no one, an independent advocate.
Capacity matters here. A person who lacks capacity to agree their care plan still has wishes and feelings that the Mental Capacity Act requires to be considered, and the plan should record how they were sought. Under the Care Act, people who would have substantial difficulty being involved and have no appropriate person to support them are entitled to an independent advocate for assessment and planning.
The evidence of involvement is the person's own words in the plan, a signature or a recorded reason why not, an easy-read copy on file, advocacy referrals where needed, and review records that show the person present.
Involving family and the circle of support
Families and friends carry the person's history and often their voice. Person-centred care planning involves them from pre-admission onwards, with the person's consent where they have capacity, and as part of best interests where they do not. That means invitations to reviews, a copy of the plan or its summary, a named contact, and regular updates.
It also means being clear about whose plan it is. A family member who wants their mother up at seven because that is what she always did may be right, or may be describing their own preference. The person's current wishes, capacity permitting, come first. Where family and person disagree, the plan should record the disagreement and how it was resolved.
Contact with families should be logged, so that the home can show who was told what and when. That record protects the home when a family member later says they were never consulted.
Person-centred care in learning disability services
In services for people with a learning disability or autism, person-centred care is the whole model. The CQC's Right support, right care, right culture guidance expects people to have choice and control, to be supported to live ordinary lives, and to be central to decisions about their support. The person-centred plan, health action plan and hospital passport are the practical tools, and all three need to be in easy read and reviewed with the person.
Support here is about enabling. The care plan should say what the person can do, what they want to learn and how the home will support them to get there, with graded steps and review dates. Positive behaviour support plans should be built on understanding what the person is communicating, not on managing the behaviour. Restrictive practices, where used, must be the least restrictive option, recorded every time and reviewed towards reduction.
Our guide to person-centred care plan examples for learning disability services gives worked plans.
Person-centred care in mental health services
In mental health rehabilitation and residential services, person-centred care is expressed through recovery. The person sets their own goals, which may be about work, relationships, housing, education or simply stability, and the support plan is built around them. Risk is managed collaboratively, with the person involved in their own risk assessment and safety plan wherever possible.
The care plan should record the person's understanding of their own condition and what helps, their early warning signs and what they want staff to do, their medication and their view of it, and their goals with steps. Where the person is subject to the Mental Health Act, the plan should reflect section 117 aftercare, leave arrangements and any community treatment order conditions in language the person understands.
Evidence is the person's own goals in the plan, progress notes that track them, and review records that show the person leading.
Person-centred care in nursing homes and dementia care
In nursing homes, person-centred care has to coexist with clinical need, and the risk is that the clinical plan takes over. A person with a pressure ulcer, dysphagia and diabetes still has a life history, preferences and the right to choose. The care plan should carry both: the wound care and the fact that she likes the radio on in the afternoon and hates being called dear.
In dementia care, person-centred practice draws on life story, familiar routines, meaningful occupation and staff who know the person well enough to read distress. The plan should record what the person did, who they were, what soothes them and what upsets them, and should be updated as the illness changes. Behaviour that challenges is almost always communication, and the plan should say what the person is likely to be communicating and how staff should respond.
End of life care is person-centred care at its most important. Advance care plans, ReSPECT forms and the person's wishes about place, people and treatment should be recorded early, reviewed and followed.
Person-centred risk
Person-centred care requires positive risk taking. A care plan that eliminates every risk has eliminated the person's life. The approach is to identify the risk, weigh it against the benefit to the person, involve the person and the people who know them, put in place what reasonably reduces the risk, record the decision and review it.
The risk assessment should be written in a way the person can understand and should record their view. Where the person lacks capacity for the decision, a best interests process applies and the least restrictive option is chosen. Where the person has capacity and makes a choice staff consider unwise, the plan records the discussion, the alternatives offered and the choice respected.
Inspectors read risk assessments closely for this balance. A file full of hazards with no benefits, no views and no review dates is a file that shows the home managing itself rather than supporting the person.
The gap between the plan and the shift
The most common failure of person-centred care is not the plan. It is the gap between the plan and what happens at 7am. The plan says the person likes to get up at nine; the shift gets everyone up by eight because that is when the rota allows. The plan says she prefers a bath on Tuesdays and Fridays; the record shows showers on whichever day a worker was free.
Closing the gap means three things. Staff must read the plan, which means the plan must be short enough and accessible enough to read, ideally on the device in their hand. The shift must be organised around the plans, which is a rota and allocation question the manager owns. And the daily record must show what actually happened so that the gap is visible. A daily log that records against the care plan in a few taps makes the comparison automatic. Where the log and the plan disagree for a week, either the plan or the practice needs to change.
How to write a person-centred care plan
- Before admission, meet the person and the people who know them, in their current setting where possible, and gather life history, preferences, communication, health and risk.
- Within the first days, sit with the person and start the About me and How I communicate sections in their words, using easy read or life story tools as needed.
- For each area of need, record what the person can do, what support they want and how, and who they want it from. Ask rather than assume.
- Assess capacity for any decision where it is in doubt, record it, and involve family, advocate or professionals in best interests decisions.
- Write risk assessments that record the benefit, the person's view and the agreed plan, choosing the least restrictive option.
- Agree goals with the person and break them into steps with review dates.
- Produce the plan in the format the person can use: easy read, large print, audio, or a one-page summary, and give them a copy.
- Brief the shift, and check in the first week that the daily logs match the plan.
- Set review dates: at least monthly for a light-touch check, after any significant change, and a full review with the person and family at least annually.
Our guide to how to write a person-centred care plan goes through each section with examples.
Evidencing person-centred care
Inspectors want to see that person-centred care is real, not described. This checklist covers what should exist for every resident.
- A care plan with life history, preferences, communication and goals in the person's words or with a recorded reason why not
- An easy-read or accessible version where the person needs one, and a copy given to them
- Capacity assessments and best interests decisions for any decision made on the person's behalf
- Risk assessments that record benefits, the person's view and the least restrictive option
- Daily logs that show the plan being followed and refusals or changes recorded with what staff did
- Contact records showing family involvement
- Review records showing the person and family present and the plan changed as a result
- Feedback from the person and family, gathered and acted on
- Hospital passport, health action plan and person-centred plan where relevant, all current
Person-centred care under the single assessment framework
The single assessment framework includes quality statements that address person-centred care directly. Under Responsive, the statement on person-centred care asks whether care is tailored to the individual and whether people are involved in planning. Under Caring, the statements on treating people as individuals and on independence, choice and control ask whether people's preferences, strengths and rights are respected in practice. Under Effective, the statement on assessing needs asks whether needs and preferences are properly assessed and reviewed.
Evidence is gathered from people's experience, feedback from staff and partners, observation and records. Inspectors will speak to residents and families about whether they were involved in their plan and whether care matches it. They will read plans and compare them to daily logs. They will watch a mealtime or a morning and see whether people are treated as individuals.
A home whose plans, logs and reviews already hold this evidence does not need to prepare. A compliance view that maps care records to quality statements lets the manager see gaps before an inspector does.
Common mistakes
- Care plans written about the person rather than with them, in the third person, with no life history and no voice.
- Plans that list needs and tasks and never mention what the person can do or wants.
- Preferences recorded at admission and never acted on, so the plan and the shift diverge.
- Risk assessments that record hazards only, with no benefit, no view and no least restrictive option.
- Best interests decisions made without the person's known wishes being sought or recorded.
- Easy-read plans produced once and never updated, or never given to the person.
- Reviews that are a signature on the same plan, with no change and no person present.
- Daily notes that record tasks, so there is no evidence of the person's day at all.
What good looks like on inspection day
The inspector picks a resident and asks to see her care plan. It opens with her life in her own words, recorded with her daughter's help because her memory is failing. It says she likes to be called Peggy, gets up at nine, has porridge, and becomes anxious if the curtains are opened before she is awake. The daily logs for the last month show her up between nine and half past, porridge most days, and two mornings when she was anxious because a new worker opened the curtains, with a note that the worker was shown the plan. The review last month records Peggy and her daughter present and a change to her evening routine.
The inspector asks Peggy about her care and she says the staff know her. The inspector asks her daughter and she says she was involved from the start and is told when anything changes. The inspector asks a support worker how Peggy likes to be supported in the morning and gets the plan back in the worker's own words.
The inspector then looks at a resident with a learning disability and finds an easy-read plan he can explain himself, a health action plan and a hospital passport current to last month, a goal about cooking his own tea with the steps and the progress logged, and a risk assessment for using the kitchen that records what he wants and what the home does to make it safe. That is person-centred care evidenced. The care record did the work because it was built to hold the person, not just the tasks.
Final conclusion
Person centred care is the standard, not an ambition. It means the person's history, preferences, strengths, relationships and choices shape their support, and that the person is involved in planning and reviewing it. The four principles and the person-centred values give staff the language; Regulation 9, the Care Act and the Mental Capacity Act give it force; the care plan and the daily record are where it lives. Write the plan with the person, organise the shift around the plans, record what actually happens, review with the person present, and the evidence for inspection is the same thing as the care itself.
Frequently asked
What is person centred care?
Person centred care is care built around what matters to the individual: their history, preferences, relationships, goals, culture and choices, with the person involved in planning and reviewing their own support. In England it is required by Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and assessed by CQC under the Caring and Responsive key questions.
What are the 4 principles of person-centred care?
The most widely used framework, from the Health Foundation, sets out four principles: affording people dignity, compassion and respect; offering coordinated care, support or treatment; offering personalised care, support or treatment; and supporting people to recognise and develop their own strengths and abilities. Each can be tested against a care plan and a shift.
How many values are there that support person centred care?
There is no single official number. The list most often taught in England, drawn from Care Certificate standard 5, has eight: individuality, rights, choice, privacy, independence, dignity, respect and partnership. Some versions add values from the 6 Cs to make twelve. The number matters less than whether each value can be seen in practice.
What is the difference between a person centred approach and person centred care?
A person centred approach is the way staff and the organisation think and behave: seeing the person first, asking rather than assuming, enabling rather than doing. Person centred care is the care that results. Person centred care planning is the process that turns the approach into a written plan the shift can follow, and in learning disability services it has a specific meaning linked to person-centred plans.
What are examples of person centred care in a care home?
A resident supported to sleep late and have breakfast at eleven because that was her lifelong routine, a man with a learning disability supported through a graded plan to travel alone, a Muslim resident whose prayer times are protected and whose food comes from a supplier he trusts, and a resident who refuses personal care in the morning being offered it in the afternoon as his plan says he prefers. In each case the plan says it and the record shows it.
Why is person centred care important?
People supported in the way they prefer are calmer, eat and sleep better and express less distress, which reduces falls, pressure damage, hospital admissions and complaints. It keeps people who have lost their home and independence recognised as individuals. It is also a legal requirement, and homes that cannot evidence it are rated poorly under Caring and Responsive.
How do you evidence person centred care for CQC?
Through care plans in the person's words with life history, preferences, communication and goals; accessible versions given to the person; capacity assessments and best interests decisions; risk assessments that record benefits and the person's view; daily logs that show the plan being followed; and review records showing the person and family present. Inspectors compare the plan to the logs and to what they observe and hear.
What should a person-centred care plan include?
Sections about the person, how they communicate, how they want to be supported in each area of need, their health, their risks and choices, and their goals and reviews. It should record what the person can do as well as what they need, be written with them in their words where possible, and be available in a format they can use.
Sources
- CQC: Regulation 9 Person-centred care
- The Health Foundation: Person-centred care made simple
- Care Act 2014
- Mental Capacity Act 2005
- Skills for Care: The Care Certificate standard 5 Work in a person-centred way
- Department of Health: Valuing People (2001)
- NICE guideline NG86: People's experience in adult social care services
- CQC: Right support, right care, right culture
