Supports and barriers to creating and implementing person-centred plans in the community care sector in Canada: A qualitative analysis of three perspectives
Why this work is in the frame
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Bibliographic record
Abstract
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. 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. 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. 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.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it