Maintaining Person-Centred Care During Emergency Situations
Emergencies place significant pressure on health and social care services, but person-centred care remains a core obligation regardless of circumstances. During crises, providers may need to make rapid decisions, alter routines, relocate people, adjust staffing arrangements or implement temporary contingency measures. However, emergency response must never become an excuse for abandoning individual needs, preferences, communication requirements, dignity or rights.
This article supports Emergency Preparedness and connects with Just Enough Support. It also sits within the wider Business Continuity in Health and Social Care Knowledge Hub, which explores resilience, incident response, risk planning and service recovery across adult social care services.
The strongest providers recognise that person-centred care becomes more important during emergencies, not less. When people experience uncertainty, disruption or fear, personalised support can reduce distress, prevent escalation and protect wellbeing. Services that maintain dignity, choice and individualised decision-making during crises are often better able to preserve stability, safety and trust.
Why person-centred care matters during crises
Emergencies often create circumstances where people feel frightened, confused, powerless or disconnected from familiar routines. A power outage, evacuation, infectious disease outbreak, severe weather event or staffing emergency may affect not only physical safety but also emotional wellbeing.
For many people using services, routine provides reassurance and predictability. Sudden changes can increase anxiety, distress, sensory overload or behavioural escalation. This is particularly relevant for:
- People with learning disabilities
- Autistic people
- People living with dementia
- People with acquired brain injury
- Individuals with mental health needs
- People who have experienced trauma
- Individuals with communication difficulties
Maintaining person-centred approaches during disruption helps preserve trust, reduce confusion and support emotional safety. While emergency circumstances may require temporary adjustments, providers should continue asking what matters to the individual and how support can be delivered in the least disruptive way possible.
Balancing safety and individual rights
Emergency situations often require providers to balance competing responsibilities. Services must protect people from immediate harm while also respecting individual rights, preferences and autonomy.
This balance is not always straightforward. For example, an evacuation may require rapid movement from a familiar environment. A staffing shortage may require changes to support arrangements. Severe weather may temporarily limit community access.
However, emergency measures should always be:
- Proportionate to the risk
- Necessary for safety
- Time limited
- Subject to review
- Based on individual assessment where possible
- Clearly explained to the person
Providers should avoid blanket restrictions applied to everyone simply because a crisis exists. What is justified for one individual may not be justified for another. Person-centred practice requires ongoing consideration of individual circumstances even during periods of operational pressure.
Understanding individual emergency needs
Good emergency preparedness begins long before an incident occurs. Person-centred emergency planning should identify how individuals are likely to experience disruption and what support they may need.
Plans should consider:
- Communication preferences
- Sensory needs
- Mobility requirements
- Health conditions
- Medication needs
- Anxiety triggers
- Behavioural support requirements
- Family involvement preferences
- Preferred coping strategies
- Important routines and activities
When these needs are documented in advance, staff are far more likely to maintain person-centred support during real emergencies.
Operational example 1: Adjusting routines sensitively during evacuation
Context: A supported living service experienced a building evacuation following significant water damage. Several people had to move temporarily to alternative accommodation while repairs were completed.
Person-centred approach: Rather than applying a standard relocation process, staff reviewed each person’s routines, preferences and support plans before the move.
Day-to-day detail: Staff ensured individuals retained preferred waking times, meal choices and familiar possessions wherever possible. Key support staff accompanied people during the transition and visual schedules were adapted to explain temporary changes. Families were kept informed and involved in planning.
Evidence of effectiveness: Although routines changed, distress levels remained low and support reviews showed that people adapted successfully because familiar elements of daily life had been preserved.
Operational example 2: Communication adjustments during system disruption
Context: A digital systems outage affected communication tools used within a specialist autism service. Several people relied on electronic resources to understand daily activities and changes.
Person-centred approach: Staff immediately implemented alternative communication methods tailored to individual needs.
Day-to-day detail: Visual boards, printed schedules, photographs, symbols and personalised communication materials were used to explain what had happened and what would happen next. Staff avoided relying solely on verbal explanations for individuals who preferred visual information.
Evidence of effectiveness: People remained informed, anxiety levels were reduced and there was no significant increase in behavioural distress despite the disruption.
Operational example 3: Avoiding unnecessary restriction during staffing shortages
Context: A domiciliary care provider experienced severe staff shortages during a winter illness outbreak. Managers needed to prioritise resources while maintaining safety.
Person-centred approach: Rather than introducing blanket restrictions on activities or community access, managers completed individual risk assessments.
Day-to-day detail: Each person's circumstances, support needs and existing risk management arrangements were reviewed. Some activities continued unchanged, while others were modified temporarily with agreement from the individual and their support network where appropriate.
Evidence of effectiveness: Safety was maintained without unnecessary restrictions on independence, and people reported feeling involved in decisions affecting their support.
Supporting dignity during emergencies
Dignity can be overlooked during crisis response when attention focuses exclusively on operational tasks. However, preserving dignity remains essential regardless of circumstances.
Providers should consider:
- Privacy during evacuation or relocation
- Respectful communication
- Maintaining personal routines where possible
- Access to personal belongings
- Support with appearance and self-care
- Opportunities for choice and control
- Preserving relationships and family contact
Small actions often have a significant impact on how supported and respected people feel during periods of uncertainty.
Staff confidence and training
Person-centred emergency response depends heavily on staff confidence and competence. Staff need more than emergency procedures; they must understand how to apply person-centred principles when routines are disrupted and decisions must be made quickly.
Training should cover:
- Rights-based decision-making
- Least restrictive practice
- Communication during crises
- Supporting people experiencing distress
- Balancing safety and autonomy
- Capacity and best interests considerations
- Person-centred emergency planning
Scenario-based exercises are particularly valuable because they allow staff to practise maintaining person-centred approaches under pressure.
Commissioner expectations
Commissioner expectation: Commissioners expect providers to demonstrate that emergency responses remain person-centred and rights-based. Business continuity arrangements should show how people’s individual needs will continue to be recognised even when services are operating under exceptional pressure.
Commissioners may seek evidence of:
- Individual emergency support planning
- Communication adaptations
- Least restrictive approaches
- Service user involvement
- Family engagement arrangements
- Risk assessment processes
- Post-incident learning
Providers that demonstrate strong person-centred continuity arrangements often provide greater assurance around quality and resilience.
Regulatory expectations
Regulatory expectation: Inspectors assess whether emergency actions respected dignity, choice, independence and least restrictive practice. Even during emergencies, regulators expect providers to demonstrate that people remain at the centre of decision-making.
Inspectors may review:
- Emergency support plans
- Care records
- Risk assessments
- Decision-making documentation
- Communication records
- Feedback from people supported
- Evidence of rights-based practice
A well-managed emergency response should show that safety and person-centred care were maintained together rather than treated as competing priorities.
Review and assurance
Following any significant incident, providers should evaluate whether person-centred care was successfully maintained and identify opportunities for improvement.
Post-incident reviews should consider:
- Whether people felt informed
- Whether communication methods were effective
- Whether restrictions were proportionate
- Whether routines were preserved where possible
- Whether dignity and privacy were maintained
- Whether individuals were involved in decisions
- Whether families felt appropriately informed
Learning should then feed back into business continuity plans, staff training and emergency preparedness exercises.
Common mistakes during emergencies
Providers can unintentionally undermine person-centred care during crises by:
- Applying blanket restrictions
- Failing to communicate changes clearly
- Overlooking individual communication needs
- Ignoring personal routines and preferences
- Making decisions without involving people where possible
- Prioritising operational convenience over individual outcomes
- Failing to review temporary restrictions promptly
Strong emergency response requires providers to remain focused on the individual despite operational pressures.
Conclusion: person-centred care does not stop during emergencies
Emergency situations inevitably require flexibility and adaptation, but they do not remove the responsibility to deliver person-centred care. The strongest providers continue to uphold dignity, choice, rights and individuality even when responding to significant disruption.
By combining effective emergency preparedness with person-centred planning, providers can protect both safety and wellbeing. This approach not only reduces distress during crises but also strengthens trust, resilience and long-term outcomes for the people who rely on support services.