Accessible Communication as a Foundation of Person-Centred Planning
Person-centred planning cannot exist without accessible communication. In practice, failures in communication, accessible information and total communication are one of the most common reasons plans become generic, risk-averse or detached from people’s lived experience. This is especially visible where services claim strong values but have not operationalised the core principles and values of inclusion, dignity and autonomy.
Accessible communication is not a specialist intervention. It is a day-to-day delivery requirement that shapes assessment, consent, decision-making, reviews, safeguarding and outcomes. Providers that treat it as a “toolkit” rather than a core practice routinely struggle at inspection and commissioning review.
Why accessible communication is foundational, not optional
People cannot meaningfully influence their support if information is presented in formats they cannot understand or respond to. In person-centred planning, this affects:
- How needs and preferences are identified
- Whether consent is informed and valid
- How risk is understood and agreed
- Whether outcomes reflect the person’s priorities
Accessible communication must therefore be embedded before plans are written, not retrofitted afterwards.
Operational example 1: re-designing assessment conversations
Context: A provider supporting adults with learning disabilities identified that assessments relied heavily on verbal questioning and written summaries. Reviews showed repeated phrases such as “no change” and limited evidence of the person’s own views.
Support approach: The service redesigned assessment conversations using total communication. This included symbols, photographs, objects of reference, short videos, and supported choice activities spread across multiple sessions rather than a single meeting.
Day-to-day delivery detail: Staff prepared accessible materials in advance, tested understanding through supported decision-making, and recorded not just answers but how the person communicated preference (gesture, behaviour, selection, refusal). Managers required evidence of this process before approving care plans.
Evidencing effectiveness: Care plans showed clearer personal outcomes, fewer generic statements, and stronger links between expressed preferences and support strategies. Audits demonstrated improved consistency and inspection feedback highlighted stronger involvement.
Operational example 2: accessible reviews as continuous dialogue
Context: Annual reviews were treated as formal events with limited preparation. People appeared disengaged, and families reported that decisions felt pre-determined.
Support approach: Reviews were reframed as a process, not a meeting. Staff gathered views gradually using accessible formats, including visual timelines, emotion scales, and scenario cards.
Day-to-day delivery detail: Review evidence was collected over several weeks. Staff logged communication attempts and responses in daily notes, which were then summarised into the formal review. The person was supported to validate or challenge the summary using accessible formats.
Evidencing effectiveness: Review records showed genuine change in goals and support approaches. Complaints reduced, and families reported greater confidence that decisions reflected the person’s wishes.
Operational example 3: linking communication to risk and safeguarding
Context: A safeguarding incident revealed that a person had repeatedly tried to express distress but staff interpreted behaviour as “non-compliance”.
Support approach: The provider undertook a communication profile review as part of safeguarding learning. This identified specific indicators of distress and preferred ways the person communicated refusal and anxiety.
Day-to-day delivery detail: Communication profiles were made mandatory in care plans and referenced in risk assessments. Staff training focused on recognising communication as behaviour. Supervision included testing staff understanding of individual communication cues.
Evidencing effectiveness: Incident recurrence reduced, staff confidence improved, and safeguarding reviews demonstrated clear learning and practice change.
Commissioner expectation
Commissioner expectation: Commissioners expect providers to evidence that people are actively involved in planning and review using communication methods that reflect their needs. They will look for demonstrable links between accessible communication, consent, risk decisions and outcomes.
Regulator expectation (CQC)
Regulator / Inspector expectation (CQC): The CQC expects providers to meet Accessible Information Standard requirements and to show that communication is individualised, embedded and effective. Inspectors will test whether people can understand information, express views, and influence decisions.
Governance mechanisms that sustain accessible practice
- Mandatory communication profiles reviewed alongside care plans
- Audit tools that test evidence of involvement, not just documentation
- Supervision frameworks that assess communication competence
- Safeguarding reviews that explicitly consider communication failure
When accessible communication is treated as foundational, person-centred planning becomes robust, lawful and meaningful rather than aspirational.