Supporting People: Towards a Person-Centred Approach draws on a four-year national research and development project funded by the Joseph Rowntree Foundation called ‘The Standards We Expect’. It focuses on three questions:

• • What does person-centred support really mean?

• • What are the main barriers to this?

• • How can these barriers be overcome?

‘The Standards We Expect’ was not envisioned as a research project but was rather about ‘making change’ and uncovering wider lessons about what people want and how this could be achieved. It was delivered by a consortium bid of Shaping our Lives, Values into Action (VIA) and two university centres – De Montfort Centre for Social Action, and Brunel – between 2005 and 2009. The user-led and collaborative research focused on the perspective of service users and social care services rather than policy makers or politicians. Supporting People: Towards a Person-Centred Approach puts this research into context providing a comprehensive overview of recent and current social policy, supported by case studies of social care service users.

Published at a time of increasing demand for social care, ongoing changes to how social care is delivered and limited funding, this book highlights the need for a sustainable and fair social care system which delivers person-centred support. The authors found a momentum for change amongst people who need support, their families and service workers who wanted to see support based on the individual's needs to enable them to achieve the optimum quality of life and fulfilment.

The book highlights the issues around the underfunding of social care compared with the NHS which is free at the point of need. This continues to be a major issue with increasing numbers among the elderly, and a social care system dependent on local authority resources rather than determined by need. The authors suggest that this represents continuity with the nineteenth-century Poor Law, at odds with the universalistic philosophy which continues to underpin the NHS. This lack of funding therefore has major implications on the ability of services to deliver a person-centred approach.

A chapter is devoted to each of eleven standards identified as essential for achieving person-centred support, such as the workforce and funding. There is an interesting discussion on personalisation; how the term is synonymous with person-centred support yet the two concepts are perceived differently by those needing support. The authors suggest that little has been done to adequately define the term ‘person-centred support’, while they see it as an approach that is value-based with good relationships between service users and worker being essential, and note that workers often refer to it as a technique.

There is a good commentary on eligibility for services, which are rationed due to lack of funding, whereby people have to undergo two assessments: a need assessment and a financial assessment. From 2003, this has been based on the government's Fair Access to Care Services (FACS) framework (Department of Health, 2003). They describe how local authorities are allowed to decide which of the four levels they will fund: critical, substantial, moderate or low.

The research found that eligibility for services had become increasingly restricted and, furthermore, the level of services for those who did qualify had tended to focus only on basic care needs, such as washing and dressing. Their research found many people whose service levels had been reduced. A number of service users in their project appeared to get support only when in desperate need.

An important chapter is dedicated to the social care workforce, highlighting some of the current issues, for example the ageing workforce of 1.5m people of whom a third will be gone in the next decade. Yet personalisation and person-centred support requires a highly skilled workforce and good relationships with the service users. Furthermore, whilst demand is expected to rise significantly, there are major issues around pay and conditions, recruitment and retention.

The authors also note training needs in the areas of race equality and cultural awareness in order to meet the needs of individuals from the BME community, and a tendency for social care professionals to make unhelpful assumptions about the abilities of the people they support, which results in a disempowering service culture.

A main theme in the book is sustainability of social care. The authors refer to the six million people – family, friends and neighbours involved in delivering informal support – who have been reframed as ‘carers’, and discuss how the raising of the retirement age means fewer will be available at a time when government policy is increasing the reliance on informal support.

Many people are still living institutionalised lives despite a social policy which aims to move away from this situation; people are disempowered, their confidence and skills are undermined and they remain dependent on others. The often overlooked issue of some people having restricted control by family carers is mentioned and advocacy is suggested as one way to overcome this.

The authors maintain that organisational issues are created by bureaucratisation and managerialism in areas such as risk management and health and safety since risk aversion is not compatible with a person-centred plan – support needs to be risk-aware with a holistic approach to cover all aspects of life.

There is a comprehensive final chapter devoted to the issue of the changes needed in social care if person-centred support is to be implemented, summarising what person-centred support means to people who need support; it is not a technique but a value-based approach where relationships with workers have ‘central importance’. This contrasts with the policy rhetoric which relates to choice and control, but focuses more on the technicalities of implementing it. A number of barriers are identified, such as the limits of resources, the workforce and sustainability of informal carers.

With the two overarching themes – issues of funding and culture – this book powerfully highlights the radical and systematic reform that is needed to achieve person-centred support and is an essential read for both policy makers and practitioners.