Person Centred Care in Name Only? A Growing Concern in Weymouth and Portland

Person centred care is now the accepted language of adult social care. It appears in council strategies, inspection frameworks and public assurances. We are told it is the foundation of modern care.

But for many providers working across Weymouth and Portland there is a growing concern. The system that champions person centred care may in practice be making it harder to deliver.

This is not an argument against regulation. Care must be safe, transparent and accountable. Families deserve reassurance. Oversight is essential.

Yet there is an uncomfortable gap between what the system says it values and what it enables on the ground.

What Person Centred Care Really Requires

At its heart, person centred care is relational. It depends on time, continuity, trust and professional judgement. It means staff knowing someone properly, not simply managing tasks.

It requires flexibility. People’s needs do not fit neatly into standard time slots. Good care involves responding to emotion, memory, history and changing health, not just completing a checklist.

Few would disagree with that in principle.

The difficulty is that the way care is commissioned, funded and inspected can pull in the opposite direction.

The Loss of Smaller Local Homes

Over the years, Weymouth and Portland have seen a number of smaller care homes close. Many of these were valued for their homely atmosphere and long standing relationships with residents and families.

Providers say that increasingly rigid expectations and inspection criteria have made it harder for smaller, family style homes to survive. The very qualities that made them feel domestic rather than institutional do not always sit comfortably within standardised regulatory frameworks.

When compliance requirements grow more complex and financial margins shrink, smaller homes often struggle first. Each closure reduces choice for local families and further concentrates care provision into fewer, larger settings.

The Financial Reality

Across Dorset, as in much of the country, local authority budgets remain under pressure. Commissioning is described as collaborative and focused on outcomes. In practice, providers say cost containment often dominates.

Rising wage expectations, inflation, food costs, utilities, insurance, training requirements and compliance demands have all increased operational costs. Fee uplifts do not always keep pace.

One local manager explained:

“We are delivering exactly what they say they want, just not at a price they are willing to pay.”

In home care especially, short time and task visits remain common. Fifteen minute calls can include medication, personal care and emotional reassurance, leaving limited room for meaningful connection.

“You cannot build relationships in fifteen minute windows,” one manager said. “But that is often what the system buys.”

When care is commissioned in units of time rather than around lived outcomes, flexibility becomes harder to sustain.

Inspection, Support and the Fear Factor

Inspection is a necessary safeguard. It protects vulnerable people and promotes improvement. But some managers describe a culture where support that is framed as constructive can feel threatening in practice.

Providers speak of inspectors asking leading questions or focusing on theoretical expectations without acknowledging clinical realities.

One example shared locally involved a resident who was bed bound, living with severe dementia and without motor skills. Her care plan recorded that she had enjoyed baking earlier in life. During inspection, the home was criticised for not assisting her to bake every week.

Staff say this overlooked the obvious reality of her condition and the adapted ways in which they supported sensory engagement instead. Yet the written expectation, once noted, became a compliance issue.

In another case, a long established personal preference for a resident, agreed with family and clearly in her best interests, was questioned because it did not align perfectly with written protocol.

“The care was right,” one manager said. “Everyone involved understood that. But it did not sit comfortably on the form.”

This creates a difficult tension. Care that is compassionate but imperfectly recorded can feel riskier than care that is thoroughly documented but less humane.

When help is couched as supportive but arrives with increased monitoring and scrutiny, providers may become cautious about transparency. Trust can erode.

As one provider reflected:

“We do not ask what does this person need first anymore. We ask how would this read in an inspection.”

Pressure on Registered Managers

Registered Managers carry legal accountability for services shaped by factors often outside their control. Staff shortages, rising complexity of need, funding constraints and shifting regulatory interpretation all sit with them.

The role has expanded significantly. Managers are leaders, human resources advisers, safeguarding leads, compliance officers and often emergency shift cover.

“The goalposts keep moving,” one said. “Just when you think you are compliant, expectations shift.”

Another described constant strain:

“I spend much of my time firefighting, covering gaps, rewriting policies, supporting anxious staff and worrying I have missed something.”

This is not resistance to high standards. It is a question of whether expectations are matched with resource and realism.

A National Crisis Felt Locally

The pressures facing care in Weymouth and Portland reflect a wider national failure to resolve social care funding.

For years, successive governments have acknowledged that social care requires reform. Reviews have been launched and promises made. Yet long term, stable funding has not materialised.

Social care is expected to support hospital discharge, manage increasingly complex health needs and relieve pressure on the NHS, without equivalent financial security or workforce investment.

Each delay at national level filters downwards. The consequences are experienced locally by providers, staff, families and residents.

This is a national crisis that has not been adequately addressed by recent governments.

A Call for Leadership

Dorset Council operates within financial constraints and local commissioners face difficult decisions. But meaningful change requires national action.

We therefore call on our local Member of Parliament to press for sustained social care reform in Parliament. Weymouth and Portland deserve representation that recognises the seriousness of this issue and advocates for structural change rather than short term measures.

Person centred care cannot rely on goodwill alone. It requires stable funding, proportionate regulation, realistic inspection practices and genuine partnership between national government, local authorities and providers.

Without that change, smaller homes will continue to close, managers will continue to burn out, and the burden will fall on those least able to advocate for themselves.

If person centred care is truly our shared value, then the systems surrounding it must make it possible in practice, not just in principle.