When Good Intentions Go Wrong: Choice, Control & the Reality of Person-Centred Care

In home care, we talk a lot about person-centred support, and for good reason. It’s the core of safe, dignified, lawful care. But here’s the uncomfortable truth we don’t say out loud often enough. One of the biggest barriers to genuine choice and independence isn’t the care provider… it’s the people closest to the individual.

At Bespoke Care & Support Services, delivering award-winning care across central Huddersfield and Kirklees, we see this challenge every week. Families love fiercely. They worry. They want safety and stability. But sometimes, that protective instinct can cross a line, and legally, it matters.

Capacity Isn’t Optional. It’s the Law.

Under the Mental Capacity Act (MCA), adults must be presumed to have capacity unless proven otherwise. That means if a person can understand, weigh up, and communicate a decision, even if the decision isn’t what others think is the “right” one, the choice belongs to them.

Not their daughter.

Not their neighbour.

Not their lovely, well-meaning cousin who knows best.

Them.

And when someone still has capacity, removing their freedom to decide is not just unhelpful — it's unlawful. It’s also the polar opposite of person-centred care.

“But I’m just trying to protect them!”

We hear this a lot. And we get it. Fear can make people controlling without realising it.

But here’s the blunt reality:

A capable adult is legally free to make unwise decisions.

If someone wants breakfast at 2pm, that’s their right.

If they want their care delivered a certain way, that’s their right.

And if they choose something that makes their family sigh dramatically, well, that’s still their right.

In Homecare in Huddersfield, and across all regulated social care, our role is not to enforce what the family prefers. Our role is to uphold what the individual chooses.

The Difference Between Supporting Someone and Steering Them

Families often end up unintentionally speaking for a person, making decisions on behalf of them, or vetoing choices entirely. And every time that happens, the person’s voice becomes a little quieter.

But in professional homecare, we are legally and ethically bound to amplify that voice, not drown it out.

We promote:

• Active participation

• Informed decision-making

• Respect for autonomy

• Tailored Personal Care based on the person’s wishes

These aren’t just nice ideas. They’re standards we must uphold as a regulated provider.

When Families and Providers Work Together

When families understand the legal framework, and embrace it, something brilliant happens. The person at the centre gets:

• more confidence

• more independence

• more control

• more meaningful involvement in their own care
  

And yes, we get far better outcomes. That’s why we built our service the way we did, because honouring choice is part of award-winning care and the gold standard for home care in Kirklees and Huddersfield.

A Final Word — With Love

If you’re a family member reading this, please know: we value you. We need you. Care works best when we’re all pulling in the same direction.

But that direction must always point back to the person receiving support.

Their care.

Their home.

Their rights.

Their life.

Because person-centred care means centring the person, not the loudest voice in the room.

The Laws That Protect Choice — And What the Regulator Expects

Person-centred care isn’t just a warm, cosy idea we all nod along to in meetings. It’s written into law, and the law is very clear about who gets to make decisions when a person has capacity.

Mental Capacity Act 2005 – The Backbone of Choice

The MCA lays out five core principles, and the first two are non-negotiable in Homecare and across all the health and social care sector:

1. Presumption of capacity We must always assume a person can make their own decisions unless a proper assessment proves otherwise.
   

2. Unwise decisions do not equal incapacity Adults have the legal right to choose things their families don’t like. That includes food, routines, personal habits, lifestyle choices — you name it. Disagreement doesn’t magically remove capacity.
   

These legal protections exist to safeguard autonomy, dignity and control, which are central to any safe and effective Personal Care package.

Human Rights Act 1998 – Yes, It Applies to Care at Home

The HRA protects:

• Liberty

• Respect for private and family life

• Freedom from interference
  

If a person with capacity is pressured, overridden or “managed” into decisions they don’t want, this can, in serious cases, amount to a breach of their human rights.

Home care doesn’t take place in an institution. It happens in someone’s own home, which strengthens those rights even further.

Health & Social Care Act 2008 (Regulated Activities) Regulations 2014

This is where the Care Quality Commission (CQC) steps in.

Regulation 9 – Person-Centred Care Providers must design care around the individual’s needs, wishes and preferences. Not the family’s. Not the care team’s. The individual’s.

Regulation 10 – Dignity and Respect People must be treated as the ultimate decision-maker in their own life.

Regulation 11 – Need for Consent Care cannot be delivered without the person’s valid, informed consent unless they lack capacity and a lawful best-interest process has been followed.

What the CQC Expects

The regulator is extremely clear about this, to the point where it forms a major part of inspection outcomes for providers across central Huddersfield:

• People must lead their own care.

• Consent must be actively obtained, not assumed.

• Families cannot override a capable adult.

• Providers must challenge undue influence, even when it’s uncomfortable.

• Records must reflect choices, preferences, and meaningful involvement in decisions.
  

If a provider allows families to make decisions on behalf of someone who still has capacity, CQC does not see that as kindness. They see it as a breach of the regulations, and rightly so.

Why This Matters

These laws and regulatory standards exist for a simple reason:

To protect people’s freedom to live life on their own terms.

As an award-winning care provider in Huddersfield and Kirklees, our responsibility is to honour those rights every single day, even when it means having difficult conversations.

Here are some useful links you can slot into your blog for credibility and further reading:

• Care Quality Commission (CQC) — Regulation 9: Person-centred care.https://www.cqc.org.uk/guidance-regulation/providers/regulations-service-providers-and-managers/health-social-care-act/regulation-9 Care Quality Commission
  

• CQC — Person-centred care: Information for adult social care providers.https://www.cqc.org.uk/guidance-providers/adult-social-care/person-centred-care Care Quality Commission+1
  

• Kirklees Council — Adult Social Care & Health overview.https://www.kirklees.gov.uk/adultsocialcare kirklees.gov.uk
  

• Kirklees Council — Home care services information.https://www.kirklees.gov.uk/homecare kirklees.gov.uk
  

• Kirklees Council — Procedures for Adults & Health (toolkit including MCA etc).https://kirkleesadults.trixonline.co.uk/contents/contents