The characteristics of person-centred care in residential services for children and adults with disabilities: a scoping review protocol

Caroline Walsh; Cathy Duggan; Catherine Waldron; Elena Vaughan; Fiona Geaney; Marie Carrigan; Valerie Ferguson; Niamh O’Rourke; Rachel Flynn

doi:10.12688/hrbopenres.14120.2

Home Browse The characteristics of person-centred care in residential services...

ALL Metrics

Views

Downloads

Get PDF

Get XML

Export

▬

✚

Study Protocol

Revised

The characteristics of person-centred care in residential services for children and adults with disabilities: a scoping review protocol

[version 2; peer review: 1 approved, 1 approved with reservations]

Caroline Walsh ¹, Cathy Duggan², Catherine Waldron¹, [...] Elena Vaughan³, Fiona Geaney², Marie Carrigan¹, Valerie Ferguson², Niamh O’Rourke¹, Rachel Flynn²

Caroline Walsh ¹, Cathy Duggan², [...] Catherine Waldron¹, Elena Vaughan³, Fiona Geaney², Marie Carrigan¹, Valerie Ferguson², Niamh O’Rourke¹, Rachel Flynn²

PUBLISHED 03 Nov 2025

Author details Author details

¹ Health Information and Quality Authority, Dublin, Ireland
² Health Information and Quality Authority, Cork, Ireland
³ Health Information and Quality Authority, Galway, Ireland

Caroline Walsh
Roles: Methodology, Writing – Original Draft Preparation, Writing – Review & Editing

Cathy Duggan
Roles: Conceptualization, Funding Acquisition, Methodology, Supervision, Writing – Review & Editing

Catherine Waldron
Roles: Methodology, Writing – Review & Editing

Elena Vaughan
Roles: Methodology, Writing – Review & Editing

Fiona Geaney
Roles: Methodology, Writing – Review & Editing

Marie Carrigan
Roles: Methodology, Writing – Review & Editing

Valerie Ferguson
Roles: Writing – Review & Editing

Niamh O’Rourke
Roles: Conceptualization, Funding Acquisition, Writing – Review & Editing

Rachel Flynn
Roles: Conceptualization, Funding Acquisition, Writing – Review & Editing

OPEN PEER REVIEW

REVIEWER STATUS

Abstract

Introduction

In 2022, almost 74,000 people with disabilities engaged with a disability service in Ireland. Of those, 7,486 people were living in a residential service, while overnight respite was provided to 3,196 people. National standards for health and social care promote practice that is up to date, evidence based and consistent. Since the publication of the National Standards for Residential Services for Children and Adults with Disabilities in 2013 by the Health Information and Quality Authority (HIQA) in Ireland, there have been significant changes in the sector, including an increased focus on a human rights-based approach to care, and legislative changes. The scoping review aims to identify and describe the evidence-based characteristics of person-centred care for children and adults with disabilities living in residential services.

Methods

This scoping review will be conducted using the Joanna Briggs Institute framework for scoping reviews. The Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for scoping reviews (PRISMA-ScR) will be used to guide the reporting. A search of electronic databases (Medline Complete via Ebscohost, The Cochrane Library via Wiley, CINAHL Complete via Ebscohost, Embase via Elsevier and PsycInfo via Ebscohost) will be conducted to identify appropriate articles for inclusion. Data extraction will be completed using a template and guidance form designed for this review, and a narrative summary will describe how the results relate to the aim of the scoping review.

Conclusion

The findings of the scoping review will inform a potential update of the National Standards for Residential Services for Children and Adults with Disabilities in Ireland.

Keywords

Disability, disabilities, disable, person-centred care, patient-centred care, residential facilities, care home, residential setting, residential service.

Corresponding author: Caroline Walsh

Competing interests: No competing interests were disclosed.

Grant information: The review is funded by the Health Information and Quality Authority (HIQA). Rachel Flynn, Director of Health Information, HIQA, is the project sponsor.

Copyright: © 2025 Walsh C et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

How to cite: Walsh C, Duggan C, Waldron C et al. The characteristics of person-centred care in residential services for children and adults with disabilities: a scoping review protocol [version 2; peer review: 1 approved, 1 approved with reservations]. HRB Open Res 2025, 8:57 (https://doi.org/10.12688/hrbopenres.14120.2) First published: 29 Apr 2025, 8:57 (https://doi.org/10.12688/hrbopenres.14120.1) Latest published: 03 Nov 2025, 8:57 (https://doi.org/10.12688/hrbopenres.14120.2)

Revised Amendments from Version 1

We would like to thank the reviewers for their comments and suggestions. We have addressed the points raised by the reviewers on a point-by-point basis in the responses to each reviewer. Specific amendments made to the protocol include:

The introduction section has been restructured and updated to highlight the evidence gap and that the scoping review is to inform the update of national standards. More detail has been added to the introduction on person-centred care and to better define residential care for people with disabilities and why this is the focus of this scoping review. It is noted that four principles of person-centred care have been used as the analytical framework for this review.

A rationale has been included for not conducting a grey literature search (introduction section) and to explain why quality appraisal was not conducted (methods section). Additional detail has been added to the methods section to provide clarity on screening, data analysis, presentation, and accessibility. Text has been added to the methods section to note that Table 4 is the form to be used for data extraction and operational definitions have been added to Table 4. The exclusion criteria have been updated to include ‘theses’. The search strategy for all databases is now provided as supplementary material.

See the authors' detailed response to the review by Owen Doody
See the authors' detailed response to the review by Jialiang Cui

Introduction

It is estimated that 16% of the global population (1.3 billion people) experience disability¹. In the European Union, this figure is estimated to be 101 million, with over one million people living in institutions^2,3. In 2022, almost 74,000 people with a disability were engaging with a disability service in Ireland. Of those, 7,486 people were reported to be living in a residential service, while overnight respite was provided to 3,196 people⁴.

In 2013, HIQA published National Standards for Residential Services for Children and Adults with Disabilities that set out what a good quality, safe residential service for people with disabilities should be (Health Information and Quality Authority 2013)⁵. Since then, there have been significant legislative advancements, with an increased focus on a human-rights based approach to care, including the ratification of the United Nations Convention on the Rights of Persons with Disabilities (UNCPRD) in 2018 and the commencement of the Assisted Decision-Making (Capacity) Act 2015^6,7. As a result of these legislative changes, the National Standards for Residential Services for Children and Adults with Disabilities require updating⁵. This scoping review is intended to inform a potential update of the National Standards for Residential Services for Children and Adults with Disabilities⁵.

Service delivery has shifted from a task-oriented way of working to a person-centred approach in the last few decades⁸. Person-centred care is a holistic approach to care, in which people are provided with the support needed to enable them to participate and make decisions about their own care, and care is tailored to their individual needs⁹. A person-centred approach to care has been shown, in some studies to have many positive benefits delivering better outcomes for those receiving care, including people with disabilities^9,10. However, a systematic review in 2016 on the effectiveness of person-centred planning for people with intellectual disabilities concluded that clearer descriptions of person-centred planning and its components are needed¹¹. The World Health Organization (WHO) Global report on health equity for persons with disabilities published in 2022 stated that people with disabilities have an equal right to the highest attainable standard of health. However, despite substantial progress in many countries, there is still disparity in the standard of care, owing to the persistent health inequities that persons with disabilities experience¹. Setting national standards is a quality improvement intervention deemed effective in establishing consistency in the delivery of high-quality care¹². National standards for health and social care promote practice that is up to date, evidence-based and effective¹³.

In Ireland, the Health Information and Quality Authority (HIQA), is an independent statutory authority established to promote safe, high-quality care for people using health and social care services. Informed by evidence and best international practice, HIQA has statutory responsibility for setting standards for health and social services, including residential services for children and adults with disabilities, and has a role in checking compliance against those standards¹⁴. HIQA has provided the care sector with a widely accepted and used interpretation of residential services for people with disabilities in Ireland:

a ‘residential service’ is one that is comprised of both accommodation and care and or support services provided to children and adults with disabilities living in residential settings, on a short or long-term basis, whether or not it is their sole place of residence¹⁵.

People with disabilities have a right to live in the community, with support to be active participants in society¹⁶. Since 2011, there has been a shift in Ireland towards supporting residents to transition from large, campus-based settings into smaller living arrangements in the community or to individualised services¹⁷. Historically, large or congregated settings have been associated with institutionalised practices that infringe on resident's human-rights and prioritise organisational needs or work patterns over resident’s needs. While smaller residential services can provide more opportunities for people with disabilities to become active members of society and enable them to enjoy their human-rights, it is understood that institutional practices and ways of thinking can often be found in residential services in the community¹⁶. Recognising this, HIQA promotes a person-centred approach to care and support in its role as a standards setting body and regulator for residential services for people with disabilities in Ireland, with a focus on protecting the human rights and welfare of residents living in all residential services, to ensure that they are supported to live fulfilling lives¹⁸.

In 2021, HIQA developed a set of principles to underpin all national standards for health and social care services¹⁹. The four principles of a human rights-based approach, safety and wellbeing, responsiveness, and accountability, work together with the goal of achieving person-centred care and are used as HIQA’s standards development framework¹⁹. These four principles of person-centred care will be used as the analytical framework for this review. The National Standards for Residential Services for Children and Adults with Disabilities were developed incorporating person-centred care, since then however there has been an increased focus on a human-rights based approach to care and person-centred care. Updating the standards under the four principles of person-centred care would strengthen the focus of person-centred care within the standards, align the standards to the UNCRPD and support improvement in services for people with disabilities living in residential services.

The scoping review, to which this protocol applies, is part of a larger evidence review to inform a potential update of the National Standards for Residential Services for Children and Adults with Disabilities⁵. We will conduct a scoping review of the peer-reviewed academic literature to identify the characteristics and definitions of person-centred care in residential services for children and adults with disabilities. A separate review of grey literature will be undertaken to find relevant international standards and guidance, policies and strategies. The findings of the scoping review and the grey literature review will be synthesised to inform the standards.

Review question

What are the characteristics and definitions of person-centred care in residential services for children and adults with disabilities?

Methods

The scoping review will be conducted in accordance with the Joanna Briggs Institute (JBI) methodology for scoping reviews and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping reviews (PRISMA-ScR)^20,21. The protocol has been registered with Open Science Framework²².

As it is a scoping review, it will be designed to identify the range of the available evidence, and will be presented as a mapping of the identified data, without particular reference to methodological quality of the sources of evidence²³.

Eligibility criteria

Population

Inclusion criteria: Children and adults of all ages with permanent or likely permanent intellectual, sensory and physical disabilities; studies from the perspectives of the service users, their families and residential service staff members.

Exclusion criteria: People with age-related disabilities only; children and adults with mental health illnesses only; patients receiving palliative care or people at end of life.

Concept

Inclusion criteria: Articles reporting on person-centred care and or patient-centred care.

Exclusion criteria: Articles reporting on interventions, treatments, or the use of technological aids, unless they consider person-centred care.

Context

Inclusion criteria: All residential services and residential respite services.

Exclusion criteria: Home care, domiciliary care, non-residential services care, rehabilitation centres and articles focused on primary care, community care, hospital or acute care settings.

Table 1 outlines the population, concept, context (PCC) mnemonic framework.

Table 1. The research questions and the PCC mnemonic framework.

Research question	Specific question	Population	Concept	Context
How does the peer-reviewed literature characterise person- centred care for children and adults with disabilities living in residential services?	What are the definitions and characteristics of person- centred care in residential services for children and adults with disabilities?	Children and adults of all ages with a permanent, or likely to be permanent, intellectual, sensory and physical disabilities.	Person- centred care or patient- centred care.	Residential services and residential respite services for children and adults with disabilities.

Types of evidence source

The scoping review will consider peer-reviewed literature and will include all study designs. In addition, reviews and systematic reviews that meet the inclusion criteria will also be considered and examined for relevant studies. Study type is included in the data extraction table, so that it can be reflected in the evidence review report.

Inclusion criteria: Peer-reviewed literature, all study designs.

Exclusion criteria: Non-peer-reviewed literature, protocols, theses.

Time frames

Inclusion criteria: Articles published in or after 2013.

Exclusion criteria: Articles published before 2013.

There will be no exclusions based on language or publication status (that is published, in press, in progress, or pre-print) for peer-reviewed literature. For documents in languages other than English, DeepL Translate will be used to translate.

Table 2 outlines the eligibility criteria.

Table 2. Eligibility criteria.

Inclusion Criteria	Exclusion Criteria
■ Children and adults of all ages with a permanent or likely permanent intellectual, sensory and physical disabilities. ■ Evidence from the perspectives of the service users, their families and residential service staff members.	■ People with age-related disabilities only ■ Children and adults with mental health illnesses only. ■ Patients receiving palliative care or people at end of life. ■ Evidence focused on outcomes for staff only.
■ Evidence related to person-centred care and or patient- centred care.	■ Articles reporting on interventions, treatments, or the use of technological aids, unless they consider person- centred care.
■ All residential services and residential respite services.. ■ For the purposes of this review, the HIQA definition of residential services will be used: A ‘residential service’ is one that is comprised of both accommodation and care and or support services provided to children and adults with disabilities living in residential settings, on a short or long term basis, whether or not it is their sole place of residence.	■ Evidence related to home care, domiciliary care, non- residential services care. ■ Articles focused on primary care, community care, hospital or acute care settings. ■ Rehabilitation centres.
■ Peer-reviewed literature, all study designs.	■ Non-peer-reviewed, protocols, theses.
■ Evidence published in or after 2013. ■ No filters will be applied to the search strategy.	■ Evidence published before 2013.

Search strategy

The bibliographic database searching will follow a three-step strategy, as per JBI methodology²⁴.

The first step will involve undertaking an initial exploratory search of Medline via Ebscohost, Embase and Google to identify key articles on the topic. The terminology contained in the titles and abstracts and the index terms (subject headings e.g. MeSH) will be analysed.

In the second step, the librarian will develop a comprehensive search strategy using identified keywords and index terms. The search will be run in the following databases: MEDLINE Complete via Ebscohost, The Cochrane Library via Wiley, CINAHL Complete via EBSCOhost, Embase via Elsevier and PsycInfo via Ebscohost.

Table 3 outlines the search strategy developed for Medline Complete. The identified keywords and terms will be translated for each included database and made available as supplementary material on Open Science Framework. A date limit from January 2013 will be applied. Prior to running the search, the search strategy will be peer-reviewed by a Health Service Executive (HSE) Librarian using the Peer Review of Electronic Search Strategies (PRESS) checklist²⁵.

Table 3. Search strategy for Medline.

SEARCH STRATEGIES

Database Name	Medline via Ebscohost
Date search was run	18 February 2025

#	Query	Limiters/Expanders	Results
S1	(MH "Persons with Disabilities+")	Expanders - Apply equivalent subjects	76,962
S2	(MH "Intellectual Disability+")	Expanders - Apply equivalent subjects	109,337
S3	(MH "Communication Disorders+")	Expanders - Apply equivalent subjects	71,353
S4	TI Disable* OR AB Disable*	Expanders - Apply equivalent subjects	30,533
S5	TI disabilit* OR AB disabilit*	Expanders - Apply equivalent subjects	269,578
S6	AB ( (intellect* OR cognitive OR learning OR physical* OR mental) N3 (deficien or difficult* or disab* or disorder* or handicap* or impair* or incapacit) ) OR TI ( (intellect OR cognitive OR learning OR physical* OR mental) N3 (deficien or difficult* or disab* or disorder* or handicap* or impair* or incapacit*) )	Expanders - Apply equivalent subjects	311,915
S7	S1 OR S2 OR S3 OR S4 OR S5 OR S6	Expanders - Apply equivalent subjects	703,211
S8	(MH "Residential Facilities+")	Expanders - Apply equivalent subjects	60,423
S9	(MH "Nursing Homes+") OR (MH "Respite Care")	Expanders - Apply equivalent subjects	47,259
S10	AB ( (residential OR nursing) N1 (home* or facilit* or setting* OR centre* OR center* OR service* OR institution) ) OR TI ( (residential OR nursing) N1 (home or facilit* or setting* OR centre* OR center* OR service* OR institution*) )	Expanders - Apply equivalent subjects	60,569
S11	(TI "care home" OR "respite care" OR "supported accommodation") OR (AB "care home" OR "respite care" OR "supported accommodation")	Expanders - Apply equivalent subjects	8,002
S12	AB ( ("continuing care" or disabled or "long term care") N2 (lodge* or facilit* or home* or residence* or centre* or center) ) OR TI ( ("continuing care" or disabled or "long term care") N2 (lodge or facilit* or home* or residence* or centre* or center )	Expanders - Apply equivalent subjects	10,379
S13	S8 OR S9 OR S10 OR S11 OR S12	Expanders - Apply equivalent subjects	102,105
S14	(MH "Patient-Centered Care+")	Expanders - Apply equivalent subjects	25,892
S15	AB ( (patient* or person or people or individual or "service user" or client) N3 (tailor* or centered or centred or centric* or focus* or oriented) ) OR TI ( (patient* or person or individual or "service user" or client) N3 (tailor* or centered or centred or centric* or focus* or oriented) )	Expanders - Apply equivalent subjects	141,863
S16	S14 OR S15	Expanders - Apply equivalent subjects	154,250
S17	S7 AND S13 AND S16	Expanders - Apply equivalent subjects	362
S18	S7 AND S13 AND S16	Limiters - Publication Date: 20130101-	248

In the third step, the reference lists of all included sources of evidence will be screened for additional studies using Citationchaser²⁶.

The literature search will be conducted in February 2025. A search of grey literature will not be included as part of this scoping review, as a separate review of international grey literature, including relevant standards and guidance, policies and strategies will be conducted. The findings of the review of international literature will be synthesised with the findings of this scoping review and the overall findings will be published in a report.

As this is a scoping review of peer review literature, it will be designed to identify the range of the evidence available and will be represented as a mapping of the identified data, without reference to methodological quality of relevant studies, as per scoping review norms²⁰.

Evidence selection and screening

All identified citations will be collected and imported into Endnote V20 and duplications will be removed. Pilot screening at both the title and abstract and full text screening stages, will be carried out in Covidence as per JBI methodology to ensure consistency across the review team²⁴. Once 75% agreement is reached in a pilot, the full screening process will commence. For titles and abstracts that appear to meet the inclusion criteria, full text articles will be retrieved and screened against the inclusion criteria. Two reviewers will work independently at each screening stage to review articles and will meet to discuss the results; any disagreements that may arise between the reviewers at each stage of the screening process will be resolved through discussion. If consensus cannot be reached on an article, it will be referred to a third reviewer.

The articles that meet all inclusion criteria will be included in the review. Reasons for exclusion of full texts will be recorded and reported. The results of the search and the article inclusion process will be fully reported in the final scoping review and presented in a PRISMA flow diagram.

Data extraction

Data extraction will be completed using Microsoft Excel with a template and guidance form, as per the JBI scoping review methodology. The data extraction and guidance form (Table 4) was designed specifically for the purpose of this review^24,27. Bibliography information about the article will be identified, as well as findings relating to the population, context, concept, the research questions and the four HIQA principles of person-centred care.

Table 4. Data extraction and guidance form.

Formatted Reference	Country	Aim/ Objective/ research questions	Study Design	Study Design	From the perspective of...	Populations included in paper	Description of PWD	Age	Context	Includes a definition of person- centred care	Definition(s) of Person- centred Care	Includes descriptions of characteristics	Description(s) of Characteristics	Relevant citations
From Endnote.	Country, where study was undertaken, or affiliation of first author if not a study.	As described by the authors.	Dropdown menu options: Quantitative Qualitative Mixed- methods Review Other.	Free text or copy a brief description.	Dropdown menu options: Person with a disability Family member Staff in residential service Multiple perspectives* Other.	Capture all populations included in the article.	Free text or copy a brief description.	Dropdown menu options: Under 18 Over 18 Between 18 and 65 Over 65 Mixed ages Not reported.	Dropdown menu options: Institution /congregated centres (10+) Smaller settings (<10) respite service mixed settings unspecified* Other.	Dropdown menu options: Yes No Unclear	Free text or copy a brief description. Enter “not reported” if no definition is provided.	Dropdown menu options: Yes No Unclear	Enter free text. Enter “not reported” if no specific characteristic is identified.	Add details of any particularly relevant citations.

* Multiple perspectives describes articles that include a combination of one or more perspectives form people with disabilities, family members and or staff in residential services.

** Mixed settings describes residential services that provide a combination of settings.

*** Unspecified means the type of residential service is not stated or described clearly and cannot be determined.

A pilot of the data extraction exercise will be independently undertaken by two reviewers on 10% of the articles, in order to calibrate the reviewers and test the template. Any disagreements that arise between the reviewers will be resolved through discussion, or with a third reviewer. The data extraction of the remaining articles will be undertaken by one of two reviewers. A third reviewer will check 20% of all extracted data to ensure it is accurate and complete.

Data analysis and presentation

The data will be presented in diagrammatic or tabular form and a narrative summary will describe how the results relate to the research question. Deductive analysis will be used to map the data to the four HIQA principles of person-centred care, including a human rights-based approach, safety and wellbeing, responsiveness, and accountability¹⁹. Data mapping will be conducted and agreed by three reviewers. The data will be presented in tabular form in Microsoft Word. The table will be included as an appendix to the scoping review. The results will be reported using the PRISMA-ScR guidelines²⁸. Disparities in the findings in relation to the type of residential services or length of stay will be noted in the narrative summary. While accessible versions of the scoping review will not be developed, for future phases of the project accessible resources will be developed as appropriate.

Dissemination

Dissemination of the results is planned through publications on HIQA’s website, conference presentations, and HIQA provider forums. It is intended to use the scoping review findings to inform whether an update of the National Standards for Residential Services for Children and Adults with Disabilities will be conducted at this time, and the content of the standards, if updated⁵.

Study status

Step 2 of the search strategy has been completed.

Ethics

Research Ethics approval is not required for this scoping review.

Discussion

The scoping review will provide an overview of the characteristics and definitions of person-centred care in residential services for children and adults with disabilities. The findings from this review will be mapped to the four HIQA principles of person-centred care to inform a potential update of the 2013 National Standards for Residential Services for Children and Adults with Disabilities in Ireland.

Ethics and consent

Research Ethics approval is not required for this scoping review.

Data availability

Underlying data

No data are associated with this article.

Extended data

Prisma_P checklist:

OSF | Scoping review PRISMA-P checklist_OSF.pdf

https://doi.org/10.17605/OSF.IO/UR2GX²⁹.

Translated search strategy:

https://osf.io/ur2gx/files/4axp6

Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0).

Faculty Opinions recommended

References

1. World Health Organization: Global report on health equity for persons with disabilities. 2022; Accessed on: 12 December 2024. Reference Source
2. World Health Organization: The WHO European framework for action to achieve the highest attainable standard of health for persons with disabilities 2022–2030. 2022; Accessed on: 12 December 2024. Reference Source
3. European Disability Forum: Independent living and de-institutionalisation policy. Accessed on: 12 December 2024. Reference Source
4. Casey C, Fanagan S, O'Sullivan M, et al.: National Ability Supports System (NASS): overview of people engaging with disability services, 2022. 2023. Reference Source
5. Health Information and Quality Authority: National standards for residential services for children and adults with disabilities. 2013; Accessed on: 19 September 2024. Reference Source
6. Assisted decision-making (Capacity) act 2015. Ireland, 2015; Accessed on: 26 September 2024. Reference Source
7. United Nations: Convention on the rights of persons with disabilities. 2006; Accessed on: 13 December 2023. Reference Source
8. Jackman-Galvin V, Partridge M: Relationships and power: an exploration of person-centredness in an intellectual disability service in Ireland. Health Soc Care Community. 2022; 30(6): e6294–e6302. PubMed Abstract | Publisher Full Text
9. Cramm JM, Nieboer AP: Validation of an instrument to assess the delivery of patient-centred care to people with intellectual disabilities as perceived by professionals. BMC Health Serv Res. 2017; 17(1): 472. PubMed Abstract | Publisher Full Text | Free Full Text
10. Rissanen L, Ehrlich C, Kendall E, et al.: Realizing person-centred care in residential care facilities for young adults with complex and chronic disabilities: the understanding, perception and beliefs of workers. Eur J Pers Cent Healthc. 2014; 2(2): 190–200. Reference Source
11. Ratti V, Hassiotis A, Crabtree J, et al.: The effectiveness of person-centred planning for people with intellectual disabilities: a systematic review. Res Dev Disabil. 2016; 57: 63–84. PubMed Abstract | Publisher Full Text
12. World Health Organization: Delivering quality health services: a global imperative for universal health coverage. World Health Organization, 2018. Reference Source
13. O'Dwyer V, Behan L, Weir L, et al.: Translating national standards into practice: supporting social care professionals. Journal of Social Care. 2020; 3(1): 1. Publisher Full Text
14. Health Information and Quality Authority: International review of the methodologies for developing national standards and guidance for health and social care services. 2018; Accessed on: 12 December 2024. Reference Source
15. Health Information and Quality Authority: What is a designated centre? A guide to understanding the definition of designated centres. 2022; Retrieved 29 September 2024. Reference Source
16. Beadle-Brown J: Residential care and community living. In: Textbook of Psychiatry for Intellectual Disability and Autism Spectrum Disorder. M. O. Bertelli, S. Deb, K. Munir, A. Hassiotis and L. Salvador-Carulla. Cham, Springer International Publishing, 2022; 921–940. Publisher Full Text
17. Health Service Executive: Time to move on from congregated settings: a strategy for community inclusion. 2011; Retrieved 10 October 2024. Reference Source
18. Health Information and Quality Authority: 10 Years of regulating designated centres for people with disabilities. 2024; Retrieved 24 December 2024. Reference Source
19. Health Information and Quality Authority: Standards development framework: a principles-based approach. 2021; Accessed on: 10 October 2024. Reference Source
20. Peters MDJ, Godfrey CM, Khalil H, et al.: Guidance for conducting systematic scoping reviews. Int J Evid Based Healthc. 2015; 13(3): 141–6. PubMed Abstract | Publisher Full Text
21. Moher D, Shamseer L, Clarke M, et al.: Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) 2015 statement. Syst Rev. 2015; 4(1): 1. PubMed Abstract | Publisher Full Text | Free Full Text
22. Walsh C, Duggan C, Waldron C, et al.: The characteristics of person-centred care in residential services for children and adults with disabilities: a scoping review protocol. 2025. Reference Source
23. Munn Z, Pollock D, Khalil H, et al.: What are scoping reviews? Providing a formal definition of scoping reviews as a type of evidence synthesis. JBI Evid Synth. 2022; 20(4): 950–2. PubMed Abstract | Publisher Full Text
24. Aromataris E, Lockwood C, Porritt K, et al.: JBI manual for evidence synthesis. 2024; Accessed on: 11 November 2024. Reference Source
25. McGowan J, Sampson M, Salzwedel DM, et al.: PRESS Peer Review of Electronic Search Strategies: 2015 guideline statement. J Clin Epidemiol. 2016; 75: 40–6. PubMed Abstract | Publisher Full Text
26. Haddaway NR, Grainger MJ, Gray CT: Citationchaser: a tool for transparent and efficient forward and backward citation chasing in systematic searching. Res Synth Methods. 2022; 13(4): 533–45. PubMed Abstract | Publisher Full Text
27. Pollock D, Peters MDJ, Khalil H, et al.: Recommendations for the extraction, Analysis, and presentation of results in scoping reviews. JBI Evid Synth. 2023; 21(3): 520–32. PubMed Abstract | Publisher Full Text
28. Tricco AC, Lillie E, Zarin W, et al.: PRISMA extension for Scoping Reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018; 169(7): 467–73. PubMed Abstract | Publisher Full Text
29. OSF | Scoping review PRISMA-P checklist_OSF.pdf. https://osf.io/wb5rt

Comments on this article Comments (0)

Version 2

VERSION 2 PUBLISHED 29 Apr 2025

Author details Author details

¹ Health Information and Quality Authority, Dublin, Ireland
² Health Information and Quality Authority, Cork, Ireland
³ Health Information and Quality Authority, Galway, Ireland

Caroline Walsh
Roles: Methodology, Writing – Original Draft Preparation, Writing – Review & Editing

Cathy Duggan
Roles: Conceptualization, Funding Acquisition, Methodology, Supervision, Writing – Review & Editing

Catherine Waldron
Roles: Methodology, Writing – Review & Editing

Elena Vaughan
Roles: Methodology, Writing – Review & Editing

Fiona Geaney
Roles: Methodology, Writing – Review & Editing

Marie Carrigan
Roles: Methodology, Writing – Review & Editing

Valerie Ferguson
Roles: Writing – Review & Editing

Niamh O’Rourke
Roles: Conceptualization, Funding Acquisition, Writing – Review & Editing

Rachel Flynn
Roles: Conceptualization, Funding Acquisition, Writing – Review & Editing

Competing interests

No competing interests were disclosed.

Grant information

The review is funded by the Health Information and Quality Authority (HIQA). Rachel Flynn, Director of Health Information, HIQA, is the project sponsor.

Article Versions (2)

version 2

Revised

Published: 03 Nov 2025, 8:57

https://doi.org/10.12688/hrbopenres.14120.2

version 1

Published: 29 Apr 2025, 8:57

https://doi.org/10.12688/hrbopenres.14120.1

© 2025 Walsh C et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Download

Export To

metrics

VIEWS

364

downloads

Citations

SEE MORE DETAILS

CITE

how to cite this article

Walsh C, Duggan C, Waldron C et al. The characteristics of person-centred care in residential services for children and adults with disabilities: a scoping review protocol [version 2; peer review: 1 approved, 1 approved with reservations]. HRB Open Res 2025, 8:57 (https://doi.org/10.12688/hrbopenres.14120.2)

NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article.

track

receive updates on this article

Track an article to receive email alerts on any updates to this article.

Open Peer Review

Version 2

VERSION 2

PUBLISHED 03 Nov 2025

Revised

Views

Reviewer Report 25 Nov 2025

Owen Doody, University of Limerick, Limerick, County Limerick, Ireland

Approved

https://doi.org/10.21956/hrbopenres.15716.r51201

CITE

Report a concern

Respond or Comment

Version 1

VERSION 1

PUBLISHED 29 Apr 2025

Views

Reviewer Report 14 Aug 2025

Jialiang Cui, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong

Approved with Reservations

https://doi.org/10.21956/hrbopenres.15518.r48861

Thank you for the opportunity to review this protocol – I think it’s a good idea and addresses a genuine need in disability care. However, there are a few points the authors may wish to address.

One is the significance of this review. The third paragraph on page 3 could be strengthened. While person-centredness is a well-researched topic in social services, the protocol currently only offers a broad conceptualisation of “person-centred” care and its benefits. What are the most significant characteristics compared with a “system-centred” approach? How is person-centredness actually demonstrated in the disability field? More importantly, is there anything potentially unique about person-centred care in the context of residential care (so we need a review of characteristics)? This would help justify the rationale for conducting such a scoping review.

The concept and practice of residential care also need some clarification. How is it defined internationally, and specifically in the Irish context? Why is it an important focus, given that residential care has often been discouraged, especially for children with disabilities (see Rosenthal’s paper on the “Residential Care Controversy”)? Also, residential care in disability services can vary widely – by disability type, length of stay, level of support, operational model, etc. (I assume this complexity exists in Ireland as well, although the authors haven’t discussed it). How will these disparities be accounted for when synthesising the characteristics of person-centred care for disability residential care as a whole?

The aim of informing the update of the National Standards for Residential Services for Children and Adults with Disabilities is repeatedly mentioned as the practical contribution of this review. However, it’s not clear how “person-centred” care was incorporated into the 2013 standards. Was it a major focus, and how was it represented? A brief explanation of this would help clarify why an update is needed after the ratification of the CRPD or ADM.

Also, the sixth paragraph on page 3 introduces new principles developed by HIQA. I found it confusing why this appeared at that point – it didn’t seem clearly connected to the rest of the content until later, when I realised these new principles might form the analytical framework, as mentioned in your Discussion. You could clarify their importance earlier, either in the introduction or methods section.

A few minor issues:

Page 3, review question: Why is the definition of person-centred care mentioned only in the specific questions? The review question and specific question seem almost the same, except for that emphasis, which hasn’t been previously justified.
Page 4, evidence type: Will you consider theses in this review?
Page 5, search terms: In some contexts, person-centred care is also referred to as “personalised” care.
Page 5, screening: Who will be doing the title and abstract review, and how many reviewers will there be?
Page 5: “The literature search will be conducted in February 2025” – has this already been done? If so, what are the preliminary results?

Is the rationale for, and objectives of, the study clearly described?

Partly
Is the study design appropriate for the research question?

Yes
Are sufficient details of the methods provided to allow replication by others?

Partly
Are the datasets clearly presented in a useable and accessible format?

Not applicable

Competing Interests: No competing interests were disclosed.

Reviewer Expertise: disability service, residential care, mental health

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above.

CITE

Report a concern

Author Response 05 Nov 2025

Caroline Walsh, Health Information and Quality Authority, Dublin, Ireland

05 Nov 2025

Author Response
We would like to thank the reviewer, Jialiang Cui, for the time you have taken to read and review our protocol and for your valuable suggestions. Revisions have been made ... Continue reading
We would like to thank the reviewer, Jialiang Cui, for the time you have taken to read and review our protocol and for your valuable suggestions. Revisions have been made and are individually outlined below. These revisions, informed by your comments, help refine the rationale and methodology of the scoping review protocol.

Italic text: reviewer’s comments.

Response from the Authors

1. The third paragraph on page 3 could be strengthened. While person-centredness is a well-researched topic in social services, the protocol currently only offers a broad conceptualisation of “person-centred” care and its benefits. What are the most significant characteristics compared with a “system-centred” approach? How is person-centredness actually demonstrated in the disability field? More importantly, is there anything potentially unique about person-centred care in the context of residential care (so we need a review of characteristics)? This would help justify the rationale for conducting such a scoping review.
Response: Thank you for raising this point. The description of person-centred approach has been moved to the third paragraph in the Introduction. We have reviewed the use of the term “system-centred” approach and updated the text. We have updated the sixth paragraph of the Introduction highlighting some of the challenges with residential services for people with disabilities and why it is important that:
‘HIQA promotes a person-centred approach to care and support in its role as a standards setting body and regulator for residential services for people with disabilities in Ireland, with a focus on protecting the human rights and welfare of residents living in all residential services, to ensure that they are supported to live fulfilling lives.’

2. The concept and practice of residential care also need some clarification. How is it defined internationally, and specifically in the Irish context? Why is it an important focus, given that residential care has often been discouraged, especially for children with disabilities (see Rosenthal’s paper on the “Residential Care Controversy”)?
Response: Thank you for highlighting this. For context an interpretation of residential services in Ireland has been added to the fifth paragraph of the Introduction as follows:
‘HIQA has provided the care sector with a widely accepted and used interpretation of residential services for people with disabilities in Ireland:
a ‘residential service’ is one that is comprised of both accommodation and care and or support services provided to children and adults with disabilities living in residential settings, on a short or long-term basis, whether or not it is their sole place of residence.

We have updated the sixth paragraph of the Introduction as follows:
‘Since 2011, there has been a shift in Ireland towards supporting residents to transition from large, campus-based settings into smaller living arrangements in the community or to individualised services.⁽¹⁷⁾ Historically, large or congregated settings have been associated with institutionalised practices that infringe on resident's human-rights and prioritise organisation needs or work patterns over resident’s needs. While smaller residential services can provide more opportunities for people with disabilities to become active members of society and enable them to enjoy their human-rights, it is understood that institutional practices and ways of thinking can often be found in residential services in the community.⁽¹⁸⁾ Recognising this, HIQA promotes a person-centred approach to care and support in its role as a standards setting body and regulator for residential services for people with disabilities in Ireland, with a focus on protecting the human rights and welfare of residents living in all residential services, to ensure that they are supported to live fulfilling lives.⁽¹⁹⁾

3. Residential care in disability services can vary widely – by disability type, length of stay, level of support, operational model, etc. (I assume this complexity exists in Ireland as well, although the authors haven’t discussed it). How will these disparities be accounted for when synthesising the characteristics of person-centred care for disability residential care as a whole?
Response: Thank you for raising this point. Wording has been added to the Methods section under the subheading Data analysis and presentation as follows:
‘Disparities in the findings in relation to the type of residential services or length of stay will be noted in the narrative summary.’

4. It’s not clear how “person-centred” care was incorporated into the 2013 standards. Was it a major focus, and how was it represented? A brief explanation of this would help clarify why an update is needed after the ratification of the CRPD or ADM.
Response: Thank you for highlighting this. The manuscript has been updated and now includes the following in the seventh paragraph of the Introduction:
‘The National Standards for Residential Services for Children and Adults with Disabilities were developed incorporating person-centred care, since then however there has been an increased focus on a human-rights based approach to care and person-centred care. Updating the standards under the four principles of person-centred care would strengthen the focus of person-centred care within the standards, align the standards to the UNCRPD and improve support improvement in services for people with disabilities living in residential services.’

5. The sixth paragraph on page 3 introduces new principles developed by HIQA. I found it confusing why this appeared at that point – it didn’t seem clearly connected to the rest of the content until later, when I realised these new principles might form the analytical framework, as mentioned in your Discussion. You could clarify their importance earlier, either in the introduction or methods section.
Response: Thank you for your comment. Additional wording has been included in the seventh paragraph of the Introduction to provide more clarity on the use of the four principles to form the analytical framework for the review as follows:
‘These four principles of person-centred care will be used as the analytical framework for this review.’

6. Review question: Why is the definition of person-centred care mentioned only in the specific questions? The review question and specific question seem almost the same, except for that emphasis, which hasn’t been previously justified.
Response: Thank you for highlighting this point. Following consideration of your comment we have reduced the research and specific questions in the Introduction to one research question as follows:
‘What are the characteristics and definitions of person-centred care in residential services for children and adults with disabilities?’

7. Evidence type: Will you consider theses in this review?
Response: Thank you for your comment. Theses were not included in this review and we have added this to the exclusion criteria in Table 2.

8. Search terms: In some contexts, person-centred care is also referred to as “personalised” care.
Response: Thank you for highlighting this. At the time of publication of the scoping review protocol the search strategy was complete. The search strategy was reviewed by an expert research librarian, however for future scoping reviews personalised care will be considered for inclusion in the search terms.

9. Screening: Who will be doing the title and abstract review, and how many reviewers will there be?
Response: Thank you for the comment. The wording in the Methods section under subheading Evidence selection and screening, has been updated as follows:
‘Two reviewers will work independently at each screening stage to review articles and will meet to discuss the results; any disagreements that may arise between the reviewers at each stage of the screening process will be resolved through discussion. If consensus cannot be reached on an article, it will be referred to a third reviewer.’

10. “The literature search will be conducted in February 2025” – has this already been done? If so, what are the preliminary results?
Response: Thank you for your comment. At the time of publication, the literature search had been completed.
The evidence review, including the scoping review to which this protocol applies, has now been published on the HIQA website and can be found at the below link:

https://www.hiqa.ie/sites/default/files/2025-09/Evidence-review-Residential-services-for-children-and-adults-with-disabilities.pdf
We would like to thank the reviewer, Jialiang Cui, for the time you have taken to read and review our protocol and for your valuable suggestions. Revisions have been made and are individually outlined below. These revisions, informed by your comments, help refine the rationale and methodology of the scoping review protocol.

Italic text: reviewer’s comments.

Response from the Authors

1. The third paragraph on page 3 could be strengthened. While person-centredness is a well-researched topic in social services, the protocol currently only offers a broad conceptualisation of “person-centred” care and its benefits. What are the most significant characteristics compared with a “system-centred” approach? How is person-centredness actually demonstrated in the disability field? More importantly, is there anything potentially unique about person-centred care in the context of residential care (so we need a review of characteristics)? This would help justify the rationale for conducting such a scoping review.
Response: Thank you for raising this point. The description of person-centred approach has been moved to the third paragraph in the Introduction. We have reviewed the use of the term “system-centred” approach and updated the text. We have updated the sixth paragraph of the Introduction highlighting some of the challenges with residential services for people with disabilities and why it is important that:
‘HIQA promotes a person-centred approach to care and support in its role as a standards setting body and regulator for residential services for people with disabilities in Ireland, with a focus on protecting the human rights and welfare of residents living in all residential services, to ensure that they are supported to live fulfilling lives.’

2. The concept and practice of residential care also need some clarification. How is it defined internationally, and specifically in the Irish context? Why is it an important focus, given that residential care has often been discouraged, especially for children with disabilities (see Rosenthal’s paper on the “Residential Care Controversy”)?
Response: Thank you for highlighting this. For context an interpretation of residential services in Ireland has been added to the fifth paragraph of the Introduction as follows:
‘HIQA has provided the care sector with a widely accepted and used interpretation of residential services for people with disabilities in Ireland:
a ‘residential service’ is one that is comprised of both accommodation and care and or support services provided to children and adults with disabilities living in residential settings, on a short or long-term basis, whether or not it is their sole place of residence.

We have updated the sixth paragraph of the Introduction as follows:
‘Since 2011, there has been a shift in Ireland towards supporting residents to transition from large, campus-based settings into smaller living arrangements in the community or to individualised services.⁽¹⁷⁾ Historically, large or congregated settings have been associated with institutionalised practices that infringe on resident's human-rights and prioritise organisation needs or work patterns over resident’s needs. While smaller residential services can provide more opportunities for people with disabilities to become active members of society and enable them to enjoy their human-rights, it is understood that institutional practices and ways of thinking can often be found in residential services in the community.⁽¹⁸⁾ Recognising this, HIQA promotes a person-centred approach to care and support in its role as a standards setting body and regulator for residential services for people with disabilities in Ireland, with a focus on protecting the human rights and welfare of residents living in all residential services, to ensure that they are supported to live fulfilling lives.⁽¹⁹⁾

3. Residential care in disability services can vary widely – by disability type, length of stay, level of support, operational model, etc. (I assume this complexity exists in Ireland as well, although the authors haven’t discussed it). How will these disparities be accounted for when synthesising the characteristics of person-centred care for disability residential care as a whole?
Response: Thank you for raising this point. Wording has been added to the Methods section under the subheading Data analysis and presentation as follows:
‘Disparities in the findings in relation to the type of residential services or length of stay will be noted in the narrative summary.’

4. It’s not clear how “person-centred” care was incorporated into the 2013 standards. Was it a major focus, and how was it represented? A brief explanation of this would help clarify why an update is needed after the ratification of the CRPD or ADM.
Response: Thank you for highlighting this. The manuscript has been updated and now includes the following in the seventh paragraph of the Introduction:
‘The National Standards for Residential Services for Children and Adults with Disabilities were developed incorporating person-centred care, since then however there has been an increased focus on a human-rights based approach to care and person-centred care. Updating the standards under the four principles of person-centred care would strengthen the focus of person-centred care within the standards, align the standards to the UNCRPD and improve support improvement in services for people with disabilities living in residential services.’

5. The sixth paragraph on page 3 introduces new principles developed by HIQA. I found it confusing why this appeared at that point – it didn’t seem clearly connected to the rest of the content until later, when I realised these new principles might form the analytical framework, as mentioned in your Discussion. You could clarify their importance earlier, either in the introduction or methods section.
Response: Thank you for your comment. Additional wording has been included in the seventh paragraph of the Introduction to provide more clarity on the use of the four principles to form the analytical framework for the review as follows:
‘These four principles of person-centred care will be used as the analytical framework for this review.’

6. Review question: Why is the definition of person-centred care mentioned only in the specific questions? The review question and specific question seem almost the same, except for that emphasis, which hasn’t been previously justified.
Response: Thank you for highlighting this point. Following consideration of your comment we have reduced the research and specific questions in the Introduction to one research question as follows:
‘What are the characteristics and definitions of person-centred care in residential services for children and adults with disabilities?’

7. Evidence type: Will you consider theses in this review?
Response: Thank you for your comment. Theses were not included in this review and we have added this to the exclusion criteria in Table 2.

8. Search terms: In some contexts, person-centred care is also referred to as “personalised” care.
Response: Thank you for highlighting this. At the time of publication of the scoping review protocol the search strategy was complete. The search strategy was reviewed by an expert research librarian, however for future scoping reviews personalised care will be considered for inclusion in the search terms.

9. Screening: Who will be doing the title and abstract review, and how many reviewers will there be?
Response: Thank you for the comment. The wording in the Methods section under subheading Evidence selection and screening, has been updated as follows:
‘Two reviewers will work independently at each screening stage to review articles and will meet to discuss the results; any disagreements that may arise between the reviewers at each stage of the screening process will be resolved through discussion. If consensus cannot be reached on an article, it will be referred to a third reviewer.’

10. “The literature search will be conducted in February 2025” – has this already been done? If so, what are the preliminary results?
Response: Thank you for your comment. At the time of publication, the literature search had been completed.
The evidence review, including the scoping review to which this protocol applies, has now been published on the HIQA website and can be found at the below link:

https://www.hiqa.ie/sites/default/files/2025-09/Evidence-review-Residential-services-for-children-and-adults-with-disabilities.pdf
Competing Interests: No competing interests were disclosed. Close
Report a concern
Respond or Comment

COMMENTS ON THIS REPORT

Author Response 05 Nov 2025

Caroline Walsh, Health Information and Quality Authority, Dublin, Ireland

05 Nov 2025

Author Response
We would like to thank the reviewer, Jialiang Cui, for the time you have taken to read and review our protocol and for your valuable suggestions. Revisions have been made ... Continue reading
We would like to thank the reviewer, Jialiang Cui, for the time you have taken to read and review our protocol and for your valuable suggestions. Revisions have been made and are individually outlined below. These revisions, informed by your comments, help refine the rationale and methodology of the scoping review protocol.

Italic text: reviewer’s comments.

Response from the Authors

1. The third paragraph on page 3 could be strengthened. While person-centredness is a well-researched topic in social services, the protocol currently only offers a broad conceptualisation of “person-centred” care and its benefits. What are the most significant characteristics compared with a “system-centred” approach? How is person-centredness actually demonstrated in the disability field? More importantly, is there anything potentially unique about person-centred care in the context of residential care (so we need a review of characteristics)? This would help justify the rationale for conducting such a scoping review.
Response: Thank you for raising this point. The description of person-centred approach has been moved to the third paragraph in the Introduction. We have reviewed the use of the term “system-centred” approach and updated the text. We have updated the sixth paragraph of the Introduction highlighting some of the challenges with residential services for people with disabilities and why it is important that:
‘HIQA promotes a person-centred approach to care and support in its role as a standards setting body and regulator for residential services for people with disabilities in Ireland, with a focus on protecting the human rights and welfare of residents living in all residential services, to ensure that they are supported to live fulfilling lives.’

2. The concept and practice of residential care also need some clarification. How is it defined internationally, and specifically in the Irish context? Why is it an important focus, given that residential care has often been discouraged, especially for children with disabilities (see Rosenthal’s paper on the “Residential Care Controversy”)?
Response: Thank you for highlighting this. For context an interpretation of residential services in Ireland has been added to the fifth paragraph of the Introduction as follows:
‘HIQA has provided the care sector with a widely accepted and used interpretation of residential services for people with disabilities in Ireland:
a ‘residential service’ is one that is comprised of both accommodation and care and or support services provided to children and adults with disabilities living in residential settings, on a short or long-term basis, whether or not it is their sole place of residence.

We have updated the sixth paragraph of the Introduction as follows:
‘Since 2011, there has been a shift in Ireland towards supporting residents to transition from large, campus-based settings into smaller living arrangements in the community or to individualised services.⁽¹⁷⁾ Historically, large or congregated settings have been associated with institutionalised practices that infringe on resident's human-rights and prioritise organisation needs or work patterns over resident’s needs. While smaller residential services can provide more opportunities for people with disabilities to become active members of society and enable them to enjoy their human-rights, it is understood that institutional practices and ways of thinking can often be found in residential services in the community.⁽¹⁸⁾ Recognising this, HIQA promotes a person-centred approach to care and support in its role as a standards setting body and regulator for residential services for people with disabilities in Ireland, with a focus on protecting the human rights and welfare of residents living in all residential services, to ensure that they are supported to live fulfilling lives.⁽¹⁹⁾

3. Residential care in disability services can vary widely – by disability type, length of stay, level of support, operational model, etc. (I assume this complexity exists in Ireland as well, although the authors haven’t discussed it). How will these disparities be accounted for when synthesising the characteristics of person-centred care for disability residential care as a whole?
Response: Thank you for raising this point. Wording has been added to the Methods section under the subheading Data analysis and presentation as follows:
‘Disparities in the findings in relation to the type of residential services or length of stay will be noted in the narrative summary.’

4. It’s not clear how “person-centred” care was incorporated into the 2013 standards. Was it a major focus, and how was it represented? A brief explanation of this would help clarify why an update is needed after the ratification of the CRPD or ADM.
Response: Thank you for highlighting this. The manuscript has been updated and now includes the following in the seventh paragraph of the Introduction:
‘The National Standards for Residential Services for Children and Adults with Disabilities were developed incorporating person-centred care, since then however there has been an increased focus on a human-rights based approach to care and person-centred care. Updating the standards under the four principles of person-centred care would strengthen the focus of person-centred care within the standards, align the standards to the UNCRPD and improve support improvement in services for people with disabilities living in residential services.’

5. The sixth paragraph on page 3 introduces new principles developed by HIQA. I found it confusing why this appeared at that point – it didn’t seem clearly connected to the rest of the content until later, when I realised these new principles might form the analytical framework, as mentioned in your Discussion. You could clarify their importance earlier, either in the introduction or methods section.
Response: Thank you for your comment. Additional wording has been included in the seventh paragraph of the Introduction to provide more clarity on the use of the four principles to form the analytical framework for the review as follows:
‘These four principles of person-centred care will be used as the analytical framework for this review.’

6. Review question: Why is the definition of person-centred care mentioned only in the specific questions? The review question and specific question seem almost the same, except for that emphasis, which hasn’t been previously justified.
Response: Thank you for highlighting this point. Following consideration of your comment we have reduced the research and specific questions in the Introduction to one research question as follows:
‘What are the characteristics and definitions of person-centred care in residential services for children and adults with disabilities?’

7. Evidence type: Will you consider theses in this review?
Response: Thank you for your comment. Theses were not included in this review and we have added this to the exclusion criteria in Table 2.

8. Search terms: In some contexts, person-centred care is also referred to as “personalised” care.
Response: Thank you for highlighting this. At the time of publication of the scoping review protocol the search strategy was complete. The search strategy was reviewed by an expert research librarian, however for future scoping reviews personalised care will be considered for inclusion in the search terms.

9. Screening: Who will be doing the title and abstract review, and how many reviewers will there be?
Response: Thank you for the comment. The wording in the Methods section under subheading Evidence selection and screening, has been updated as follows:
‘Two reviewers will work independently at each screening stage to review articles and will meet to discuss the results; any disagreements that may arise between the reviewers at each stage of the screening process will be resolved through discussion. If consensus cannot be reached on an article, it will be referred to a third reviewer.’

10. “The literature search will be conducted in February 2025” – has this already been done? If so, what are the preliminary results?
Response: Thank you for your comment. At the time of publication, the literature search had been completed.
The evidence review, including the scoping review to which this protocol applies, has now been published on the HIQA website and can be found at the below link:

https://www.hiqa.ie/sites/default/files/2025-09/Evidence-review-Residential-services-for-children-and-adults-with-disabilities.pdf
We would like to thank the reviewer, Jialiang Cui, for the time you have taken to read and review our protocol and for your valuable suggestions. Revisions have been made and are individually outlined below. These revisions, informed by your comments, help refine the rationale and methodology of the scoping review protocol.

Italic text: reviewer’s comments.

Response from the Authors

1. The third paragraph on page 3 could be strengthened. While person-centredness is a well-researched topic in social services, the protocol currently only offers a broad conceptualisation of “person-centred” care and its benefits. What are the most significant characteristics compared with a “system-centred” approach? How is person-centredness actually demonstrated in the disability field? More importantly, is there anything potentially unique about person-centred care in the context of residential care (so we need a review of characteristics)? This would help justify the rationale for conducting such a scoping review.
Response: Thank you for raising this point. The description of person-centred approach has been moved to the third paragraph in the Introduction. We have reviewed the use of the term “system-centred” approach and updated the text. We have updated the sixth paragraph of the Introduction highlighting some of the challenges with residential services for people with disabilities and why it is important that:
‘HIQA promotes a person-centred approach to care and support in its role as a standards setting body and regulator for residential services for people with disabilities in Ireland, with a focus on protecting the human rights and welfare of residents living in all residential services, to ensure that they are supported to live fulfilling lives.’

2. The concept and practice of residential care also need some clarification. How is it defined internationally, and specifically in the Irish context? Why is it an important focus, given that residential care has often been discouraged, especially for children with disabilities (see Rosenthal’s paper on the “Residential Care Controversy”)?
Response: Thank you for highlighting this. For context an interpretation of residential services in Ireland has been added to the fifth paragraph of the Introduction as follows:
‘HIQA has provided the care sector with a widely accepted and used interpretation of residential services for people with disabilities in Ireland:
a ‘residential service’ is one that is comprised of both accommodation and care and or support services provided to children and adults with disabilities living in residential settings, on a short or long-term basis, whether or not it is their sole place of residence.

We have updated the sixth paragraph of the Introduction as follows:
‘Since 2011, there has been a shift in Ireland towards supporting residents to transition from large, campus-based settings into smaller living arrangements in the community or to individualised services.⁽¹⁷⁾ Historically, large or congregated settings have been associated with institutionalised practices that infringe on resident's human-rights and prioritise organisation needs or work patterns over resident’s needs. While smaller residential services can provide more opportunities for people with disabilities to become active members of society and enable them to enjoy their human-rights, it is understood that institutional practices and ways of thinking can often be found in residential services in the community.⁽¹⁸⁾ Recognising this, HIQA promotes a person-centred approach to care and support in its role as a standards setting body and regulator for residential services for people with disabilities in Ireland, with a focus on protecting the human rights and welfare of residents living in all residential services, to ensure that they are supported to live fulfilling lives.⁽¹⁹⁾

3. Residential care in disability services can vary widely – by disability type, length of stay, level of support, operational model, etc. (I assume this complexity exists in Ireland as well, although the authors haven’t discussed it). How will these disparities be accounted for when synthesising the characteristics of person-centred care for disability residential care as a whole?
Response: Thank you for raising this point. Wording has been added to the Methods section under the subheading Data analysis and presentation as follows:
‘Disparities in the findings in relation to the type of residential services or length of stay will be noted in the narrative summary.’

4. It’s not clear how “person-centred” care was incorporated into the 2013 standards. Was it a major focus, and how was it represented? A brief explanation of this would help clarify why an update is needed after the ratification of the CRPD or ADM.
Response: Thank you for highlighting this. The manuscript has been updated and now includes the following in the seventh paragraph of the Introduction:
‘The National Standards for Residential Services for Children and Adults with Disabilities were developed incorporating person-centred care, since then however there has been an increased focus on a human-rights based approach to care and person-centred care. Updating the standards under the four principles of person-centred care would strengthen the focus of person-centred care within the standards, align the standards to the UNCRPD and improve support improvement in services for people with disabilities living in residential services.’

5. The sixth paragraph on page 3 introduces new principles developed by HIQA. I found it confusing why this appeared at that point – it didn’t seem clearly connected to the rest of the content until later, when I realised these new principles might form the analytical framework, as mentioned in your Discussion. You could clarify their importance earlier, either in the introduction or methods section.
Response: Thank you for your comment. Additional wording has been included in the seventh paragraph of the Introduction to provide more clarity on the use of the four principles to form the analytical framework for the review as follows:
‘These four principles of person-centred care will be used as the analytical framework for this review.’

6. Review question: Why is the definition of person-centred care mentioned only in the specific questions? The review question and specific question seem almost the same, except for that emphasis, which hasn’t been previously justified.
Response: Thank you for highlighting this point. Following consideration of your comment we have reduced the research and specific questions in the Introduction to one research question as follows:
‘What are the characteristics and definitions of person-centred care in residential services for children and adults with disabilities?’

7. Evidence type: Will you consider theses in this review?
Response: Thank you for your comment. Theses were not included in this review and we have added this to the exclusion criteria in Table 2.

8. Search terms: In some contexts, person-centred care is also referred to as “personalised” care.
Response: Thank you for highlighting this. At the time of publication of the scoping review protocol the search strategy was complete. The search strategy was reviewed by an expert research librarian, however for future scoping reviews personalised care will be considered for inclusion in the search terms.

9. Screening: Who will be doing the title and abstract review, and how many reviewers will there be?
Response: Thank you for the comment. The wording in the Methods section under subheading Evidence selection and screening, has been updated as follows:
‘Two reviewers will work independently at each screening stage to review articles and will meet to discuss the results; any disagreements that may arise between the reviewers at each stage of the screening process will be resolved through discussion. If consensus cannot be reached on an article, it will be referred to a third reviewer.’

10. “The literature search will be conducted in February 2025” – has this already been done? If so, what are the preliminary results?
Response: Thank you for your comment. At the time of publication, the literature search had been completed.
The evidence review, including the scoping review to which this protocol applies, has now been published on the HIQA website and can be found at the below link:

https://www.hiqa.ie/sites/default/files/2025-09/Evidence-review-Residential-services-for-children-and-adults-with-disabilities.pdf
Competing Interests: No competing interests were disclosed. Close
Report a concern

Views

Reviewer Report 12 Aug 2025

Owen Doody, University of Limerick, Limerick, County Limerick, Ireland

Approved with Reservations

https://doi.org/10.21956/hrbopenres.15518.r48866

This protocol outlines a scoping review to identify and describe the evidence-based characteristics of person-centred care (PCC) for children and adults with disabilities living in residential services. The review will be conducted using the Joanna Briggs Institute (JBI) methodology and ... Continue reading

The high number of people with disabilities using residential services in Ireland.
Legislative and policy changes since the 2013 National Standards for Residential Services for Children and Adults with Disabilities, particularly the adoption of a human rights-based approach.
Evidence gaps in clear definitions and operational characteristics of PCC for this population, as noted in prior reviews.

The protocol sets out:

Eligibility criteria using the PCC mnemonic.
Search strategy (PRESS-reviewed) across multiple databases.
Screening using Covidence with dual independent reviewers.
Data extraction using a structured template (Table), piloted before full extraction.
Analysis plan to map findings to the four HIQA principles: human rights, safety & wellbeing, responsiveness, and accountability.The authors state the results will inform whether an update of the National Standards is warranted and guide their content.

The rationale for, and objectives of, the study could be sharpened:

Bring the evidence gap (lack of definitions/characteristics) earlier in the introduction to hook the reader sooner.
Explicitly state in the opening section that the primary purpose is to inform national standards — currently this appears later in the introduction.
Briefly justify the focus on peer-reviewed literature only in this review, noting that grey literature is being reviewed separately.

Study design appropriate for the research question - minor considerations:

Explicitly state that quality appraisal will not be conducted (as per scoping review norms) and justify why.
Provide a short paragraph explaining why the grey literature search is excluded from this component but handled separately.

Are sufficient details of the methods provided to allow replication by others? - Gaps to Address:

Provide translated search strings for all databases (or note they will be in supplementary material).
Clarify whether you will calculate inter-rater reliability (e.g., Cohen’s κ) beyond reporting percentage agreement in the pilot.
Expand the data analysis plan to explain whether coding will be inductive or deductive and how themes will be developed.
Specify how non-English articles will be translated and validated (e.g., bilingual reviewer check where possible).

Are the datasets clearly presented in a usable and accessible format? - Gaps to Address:

Add operational definitions for ambiguous codes (e.g., “mixed settings,” “unclear”).
State whether Table 4 is exactly the form to be used in data collection or a condensed version.
Indicate whether the final dataset will be made publicly available (and in what format, e.g., CSV, Excel).
If sharing, note any plans for accessible formats (important for disability stakeholders).

Recommendations for Improvement -

Clarify search reproducibility
Include full search strings for all databases or specify they will be made available as supplementary material.
Expand data analysis detail
Describe whether coding will be inductive or deductive, and how mapping to the HIQA principles will be standardised across reviewers.
Justify scope decisions
Explain exclusion of grey literature in this component and describe integration (or non-integration) with the parallel grey literature review.
Clarify inter-rater reliability
State whether you will report a formal statistic (e.g., κ) and how you will handle discrepancies beyond the pilot phase.
Refine extraction categories
Provide operational definitions for any codes in Table 4 that might be interpreted differently by different reviewers.
Consider adding social science databases (e.g., SocINDEX) to capture broader conceptual literature on PCC.
State whether translated articles will undergo secondary verification by a bilingual reviewer.
If data will be shared, indicate repository and format, and consider accessible dissemination formats.

Overall Assessment
This protocol is methodologically sound and well-aligned to the research question. With the above essential clarifications, it will be fully replicable and maximally useful for policy and practice. The improvements focus mainly on transparency (search strings, coding approach, reliability measures) and scope justification (grey literature handling), which are common points for peer reviewer scrutiny.

Is the rationale for, and objectives of, the study clearly described?

Yes
Is the study design appropriate for the research question?

Yes
Are sufficient details of the methods provided to allow replication by others?

Yes
Are the datasets clearly presented in a useable and accessible format?

Yes

Competing Interests: No competing interests were disclosed.

Reviewer Expertise: Intellectual disability, scoping reviews, qualitative.

CITE

Report a concern

Author Response 05 Nov 2025

Caroline Walsh, Health Information and Quality Authority, Dublin, Ireland

05 Nov 2025

Author Response
We would like to thank the reviewer, Owen Doody, for taking the time to review our protocol and providing thoughtful and detailed feedback. Revisions have been made and are individually ... Continue reading
We would like to thank the reviewer, Owen Doody, for taking the time to review our protocol and providing thoughtful and detailed feedback. Revisions have been made and are individually outlined below. We believe these revisions, informed by your comments, enhance the scoping review protocol by improving transparency so that it will be fully replicable and of maximum use for policy and practice.

Italic text: reviewer’s comments.

Response from the Authors

1. Bring the evidence gap (lack of definitions/characteristics) earlier in the introduction to hook the reader sooner.
Response: Thank you for your comment, we have moved some of the wording including the following sentence up to the third paragraph of the Introduction as follows:
‘However, a systematic review in 2016 on the effectiveness of person-centred planning for people with intellectual disabilities concluded that clearer descriptions of person-centred planning and its components are needed.’

2. Explicitly state in the opening section that the primary purpose is to inform national standards — currently this appears later in the introduction.
Response: Thank you, the primary purpose of this review, which is to inform national standards, has been moved to the second paragraph of the Introduction as follows:
‘This scoping review is intended to inform a potential update of the National Standards for Residential Services for Children and Adults with Disabilities.’

3. Briefly justify the focus on peer-reviewed literature only in this review, noting that grey literature is being reviewed separately.
Response: Thank you for your comment. The updated manuscript now includes the following justification in the last paragraph of the Introduction as follows:
‘The scoping review, to which this protocol applies, is part of a larger evidence review to inform a potential update of the National Standards for Residential Services for Children and Adults with Disabilities. (5) We will conduct a scoping review of the peer-reviewed academic literature to identify the characteristics and definitions of person-centred care in residential services for children and adults with disabilities. A separate review of grey literature will be undertaken to find relevant international standards and guidance, policies and strategies. The findings of the scoping review and the grey literature review will be synthesised to inform the standards.’

4. Explicitly state that quality appraisal will not be conducted (as per scoping review norms) and justify why.
Response: Thank you for highlighting this. Wording has been added to the Methods section under the subheading Search strategy as follows:
‘As this is a scoping review of peer review literature, it will be designed to identify the range of the evidence available and will be represented as a mapping of the identified data, without reference to methodological quality of relevant studies, as per scoping review norms.’

5. Provide a short paragraph explaining why the grey literature search is excluded from this component but handled separately.
Response: Thank you for your comment. As mentioned in the earlier response (see comment number 3 for wording), the points relating to grey literature have been expanded to provide a more detailed explanation as to why grey literature was omitted from this scoping review.

6. Provide translated search strings for all databases (or note they will be in supplementary material).
Response: Thank you for your comment. The updated manuscript includes clarification in the Methods section under the subheading Search strategy, as follows:
‘the identified keywords and terms will be translated for each included database and made available as supplementary material on Open Science Framework.’ The translated search strategy is now available on Open Science Framework using the following link: https://osf.io/ur2gx/files/4axp6

7. Clarify whether you will calculate inter-rater reliability (e.g., Cohen’s κ) beyond reporting percentage agreement in the pilot.
Response: Thank you for noting this. Inter-rater reliability will not be calculated as part of this scoping review.

8. Expand the data analysis plan to explain whether coding will be inductive or deductive and how themes will be developed.
Response: Thank you for the comment. The updated manuscript now includes the following sentence in the Methods section under the subheading Data analysis and presentation:
‘Deductive analysis will be used to map the data to the four HIQA principles of person-centred care including a human rights-based approach, safety and wellbeing, responsiveness, and accountability.’

9. Specify how non-English articles will be translated and validated (e.g., bilingual reviewer check where possible).
Response: Thank you for the comment. We used DeepL Translator, a high-quality leading AI-powered tool that provides accurate translations for documents. A reference to DeepL Translator has been added to the protocol.

10. Add operational definitions for ambiguous codes (e.g., “mixed settings,” “unclear”).
Response: Thank you for highlighting this. All codes were reviewed by the three researchers, and a tip sheet was developed for use by reviewers. Operational definitions have been added to the data extraction and guidance form in Table 4 for terms deemed ambiguous as follows:
‘Multiple perspectives describe articles that include a combination of one or more perspectives form people with disabilities, family members and or staff in residential services.
Mixed settings describes residential services that provide a combination of settings.
Unspecified means the type of residential service is not stated or described clearly and cannot be determined.’

11. State whether Table 4 is exactly the form to be used in data collection or a condensed version.
Response: Thank you for the comment. The updated manuscript now includes the following sentence in the Methods section under the subheading Data extraction:
‘The data extraction and guidance form was designed specifically for the purpose of this review (Table 4).’

12. Indicate whether the final dataset will be made publicly available (and in what format, e.g., CSV, Excel).
Response: Thank you for pointing this out. Additional wording has been added to the Methods section under the subheading Data analysis and presentation, as follows:
‘The data will be presented in tabular form in Microsoft Word. The table will be included as an appendix to the scoping review.’

13. If sharing, note any plans for accessible formats (important for disability stakeholders). Response: Thank you for raising this point. The development of accessible formats is a consideration for all the documentation and resources developed by HIQA for both stakeholders, and children and adults who use services. The manuscript has been updated to include the following wording in the Methods section under the subheading Data analysis and presentation:
‘While accessible versions of the scoping review will not be developed, for future phases of the project accessible resources will be developed as appropriate.’

14. Provide operational definitions for any codes in Table 4 that might be interpreted differently by different reviewers.
Response: Thank you for your comment. As mentioned in the response earlier (see comment number 10 for wording), operational definitions have been added to the data extraction and guidance form in Table 4 for terms deemed ambiguous.

15. Consider adding social science databases (e.g., SocINDEX) to capture broader conceptual literature on PCC.
Response: Thank you for highlighting this. At the time of publication of the scoping review protocol the search strategy was complete.

16.State whether translated articles will undergo secondary verification by a bilingual reviewer.
Response: Thank you for your comment. As the included documents were all in English, this step was not necessary for this project. To ensure good quality translation of documents we use a high quality, regarded translator software - DeepL Translator.

17. If data will be shared, indicate repository and format, and consider accessible dissemination formats.
Response: Thank you for the comment. The updated manuscript now includes the following sentence in the Methods section under the subheading Data analysis and presentation:
‘The data will be presented in tabular form in Microsoft Word. The table will be included as an appendix to the scoping review.’

18. Describe whether coding will be inductive or deductive, and how mapping to the HIQA principles will be standardised across reviewers.
Response: Thank you for the comment. The updated manuscript now includes the following sentences in the Methods section under the subheading Data analysis and presentation:
‘Deductive analysis will be used to map the data to the four HIQA principles of person-centred care including a human rights-based approach, safety and wellbeing, responsiveness, and accountability. Data mapping will be conducted and agreed by three reviewers.’

19. Explain exclusion of grey literature in this component and describe integration (or non-integration) with the parallel grey literature review
Response: Thank you for highlighting this point. As per point 3 above, wording has been added to the last paragraph of the Introduction to clarify why grey literature will not be included and how both reviews will be integrated.

20. State whether you will report a formal statistic (e.g., κ) and how you will handle discrepancies beyond the pilot phase.
Response: Thank you for noting this. A formal statistic will not be calculated as part of this scoping review. As mentioned in the Methods sections under the subheading Evidence selection and screening, ‘any disagreements that may arise between the reviewers at each stage of the screening process will be resolved through discussion. If consensus cannot be reached on an article, it will be referred to a third reviewer.’
We would like to thank the reviewer, Owen Doody, for taking the time to review our protocol and providing thoughtful and detailed feedback. Revisions have been made and are individually outlined below. We believe these revisions, informed by your comments, enhance the scoping review protocol by improving transparency so that it will be fully replicable and of maximum use for policy and practice.

Italic text: reviewer’s comments.

Response from the Authors

1. Bring the evidence gap (lack of definitions/characteristics) earlier in the introduction to hook the reader sooner.
Response: Thank you for your comment, we have moved some of the wording including the following sentence up to the third paragraph of the Introduction as follows:
‘However, a systematic review in 2016 on the effectiveness of person-centred planning for people with intellectual disabilities concluded that clearer descriptions of person-centred planning and its components are needed.’

2. Explicitly state in the opening section that the primary purpose is to inform national standards — currently this appears later in the introduction.
Response: Thank you, the primary purpose of this review, which is to inform national standards, has been moved to the second paragraph of the Introduction as follows:
‘This scoping review is intended to inform a potential update of the National Standards for Residential Services for Children and Adults with Disabilities.’

3. Briefly justify the focus on peer-reviewed literature only in this review, noting that grey literature is being reviewed separately.
Response: Thank you for your comment. The updated manuscript now includes the following justification in the last paragraph of the Introduction as follows:
‘The scoping review, to which this protocol applies, is part of a larger evidence review to inform a potential update of the National Standards for Residential Services for Children and Adults with Disabilities. (5) We will conduct a scoping review of the peer-reviewed academic literature to identify the characteristics and definitions of person-centred care in residential services for children and adults with disabilities. A separate review of grey literature will be undertaken to find relevant international standards and guidance, policies and strategies. The findings of the scoping review and the grey literature review will be synthesised to inform the standards.’

4. Explicitly state that quality appraisal will not be conducted (as per scoping review norms) and justify why.
Response: Thank you for highlighting this. Wording has been added to the Methods section under the subheading Search strategy as follows:
‘As this is a scoping review of peer review literature, it will be designed to identify the range of the evidence available and will be represented as a mapping of the identified data, without reference to methodological quality of relevant studies, as per scoping review norms.’

5. Provide a short paragraph explaining why the grey literature search is excluded from this component but handled separately.
Response: Thank you for your comment. As mentioned in the earlier response (see comment number 3 for wording), the points relating to grey literature have been expanded to provide a more detailed explanation as to why grey literature was omitted from this scoping review.

6. Provide translated search strings for all databases (or note they will be in supplementary material).
Response: Thank you for your comment. The updated manuscript includes clarification in the Methods section under the subheading Search strategy, as follows:
‘the identified keywords and terms will be translated for each included database and made available as supplementary material on Open Science Framework.’ The translated search strategy is now available on Open Science Framework using the following link: https://osf.io/ur2gx/files/4axp6

7. Clarify whether you will calculate inter-rater reliability (e.g., Cohen’s κ) beyond reporting percentage agreement in the pilot.
Response: Thank you for noting this. Inter-rater reliability will not be calculated as part of this scoping review.

8. Expand the data analysis plan to explain whether coding will be inductive or deductive and how themes will be developed.
Response: Thank you for the comment. The updated manuscript now includes the following sentence in the Methods section under the subheading Data analysis and presentation:
‘Deductive analysis will be used to map the data to the four HIQA principles of person-centred care including a human rights-based approach, safety and wellbeing, responsiveness, and accountability.’

9. Specify how non-English articles will be translated and validated (e.g., bilingual reviewer check where possible).
Response: Thank you for the comment. We used DeepL Translator, a high-quality leading AI-powered tool that provides accurate translations for documents. A reference to DeepL Translator has been added to the protocol.

10. Add operational definitions for ambiguous codes (e.g., “mixed settings,” “unclear”).
Response: Thank you for highlighting this. All codes were reviewed by the three researchers, and a tip sheet was developed for use by reviewers. Operational definitions have been added to the data extraction and guidance form in Table 4 for terms deemed ambiguous as follows:
‘Multiple perspectives describe articles that include a combination of one or more perspectives form people with disabilities, family members and or staff in residential services.
Mixed settings describes residential services that provide a combination of settings.
Unspecified means the type of residential service is not stated or described clearly and cannot be determined.’

11. State whether Table 4 is exactly the form to be used in data collection or a condensed version.
Response: Thank you for the comment. The updated manuscript now includes the following sentence in the Methods section under the subheading Data extraction:
‘The data extraction and guidance form was designed specifically for the purpose of this review (Table 4).’

12. Indicate whether the final dataset will be made publicly available (and in what format, e.g., CSV, Excel).
Response: Thank you for pointing this out. Additional wording has been added to the Methods section under the subheading Data analysis and presentation, as follows:
‘The data will be presented in tabular form in Microsoft Word. The table will be included as an appendix to the scoping review.’

13. If sharing, note any plans for accessible formats (important for disability stakeholders). Response: Thank you for raising this point. The development of accessible formats is a consideration for all the documentation and resources developed by HIQA for both stakeholders, and children and adults who use services. The manuscript has been updated to include the following wording in the Methods section under the subheading Data analysis and presentation:
‘While accessible versions of the scoping review will not be developed, for future phases of the project accessible resources will be developed as appropriate.’

14. Provide operational definitions for any codes in Table 4 that might be interpreted differently by different reviewers.
Response: Thank you for your comment. As mentioned in the response earlier (see comment number 10 for wording), operational definitions have been added to the data extraction and guidance form in Table 4 for terms deemed ambiguous.

15. Consider adding social science databases (e.g., SocINDEX) to capture broader conceptual literature on PCC.
Response: Thank you for highlighting this. At the time of publication of the scoping review protocol the search strategy was complete.

16.State whether translated articles will undergo secondary verification by a bilingual reviewer.
Response: Thank you for your comment. As the included documents were all in English, this step was not necessary for this project. To ensure good quality translation of documents we use a high quality, regarded translator software - DeepL Translator.

17. If data will be shared, indicate repository and format, and consider accessible dissemination formats.
Response: Thank you for the comment. The updated manuscript now includes the following sentence in the Methods section under the subheading Data analysis and presentation:
‘The data will be presented in tabular form in Microsoft Word. The table will be included as an appendix to the scoping review.’

18. Describe whether coding will be inductive or deductive, and how mapping to the HIQA principles will be standardised across reviewers.
Response: Thank you for the comment. The updated manuscript now includes the following sentences in the Methods section under the subheading Data analysis and presentation:
‘Deductive analysis will be used to map the data to the four HIQA principles of person-centred care including a human rights-based approach, safety and wellbeing, responsiveness, and accountability. Data mapping will be conducted and agreed by three reviewers.’

19. Explain exclusion of grey literature in this component and describe integration (or non-integration) with the parallel grey literature review
Response: Thank you for highlighting this point. As per point 3 above, wording has been added to the last paragraph of the Introduction to clarify why grey literature will not be included and how both reviews will be integrated.

20. State whether you will report a formal statistic (e.g., κ) and how you will handle discrepancies beyond the pilot phase.
Response: Thank you for noting this. A formal statistic will not be calculated as part of this scoping review. As mentioned in the Methods sections under the subheading Evidence selection and screening, ‘any disagreements that may arise between the reviewers at each stage of the screening process will be resolved through discussion. If consensus cannot be reached on an article, it will be referred to a third reviewer.’
Competing Interests: No competing interests were disclosed. Close
Report a concern
Respond or Comment

COMMENTS ON THIS REPORT

Author Response 05 Nov 2025

Caroline Walsh, Health Information and Quality Authority, Dublin, Ireland

05 Nov 2025

Author Response
We would like to thank the reviewer, Owen Doody, for taking the time to review our protocol and providing thoughtful and detailed feedback. Revisions have been made and are individually ... Continue reading
We would like to thank the reviewer, Owen Doody, for taking the time to review our protocol and providing thoughtful and detailed feedback. Revisions have been made and are individually outlined below. We believe these revisions, informed by your comments, enhance the scoping review protocol by improving transparency so that it will be fully replicable and of maximum use for policy and practice.

Italic text: reviewer’s comments.

Response from the Authors

1. Bring the evidence gap (lack of definitions/characteristics) earlier in the introduction to hook the reader sooner.
Response: Thank you for your comment, we have moved some of the wording including the following sentence up to the third paragraph of the Introduction as follows:
‘However, a systematic review in 2016 on the effectiveness of person-centred planning for people with intellectual disabilities concluded that clearer descriptions of person-centred planning and its components are needed.’

2. Explicitly state in the opening section that the primary purpose is to inform national standards — currently this appears later in the introduction.
Response: Thank you, the primary purpose of this review, which is to inform national standards, has been moved to the second paragraph of the Introduction as follows:
‘This scoping review is intended to inform a potential update of the National Standards for Residential Services for Children and Adults with Disabilities.’

3. Briefly justify the focus on peer-reviewed literature only in this review, noting that grey literature is being reviewed separately.
Response: Thank you for your comment. The updated manuscript now includes the following justification in the last paragraph of the Introduction as follows:
‘The scoping review, to which this protocol applies, is part of a larger evidence review to inform a potential update of the National Standards for Residential Services for Children and Adults with Disabilities. (5) We will conduct a scoping review of the peer-reviewed academic literature to identify the characteristics and definitions of person-centred care in residential services for children and adults with disabilities. A separate review of grey literature will be undertaken to find relevant international standards and guidance, policies and strategies. The findings of the scoping review and the grey literature review will be synthesised to inform the standards.’

4. Explicitly state that quality appraisal will not be conducted (as per scoping review norms) and justify why.
Response: Thank you for highlighting this. Wording has been added to the Methods section under the subheading Search strategy as follows:
‘As this is a scoping review of peer review literature, it will be designed to identify the range of the evidence available and will be represented as a mapping of the identified data, without reference to methodological quality of relevant studies, as per scoping review norms.’

5. Provide a short paragraph explaining why the grey literature search is excluded from this component but handled separately.
Response: Thank you for your comment. As mentioned in the earlier response (see comment number 3 for wording), the points relating to grey literature have been expanded to provide a more detailed explanation as to why grey literature was omitted from this scoping review.

6. Provide translated search strings for all databases (or note they will be in supplementary material).
Response: Thank you for your comment. The updated manuscript includes clarification in the Methods section under the subheading Search strategy, as follows:
‘the identified keywords and terms will be translated for each included database and made available as supplementary material on Open Science Framework.’ The translated search strategy is now available on Open Science Framework using the following link: https://osf.io/ur2gx/files/4axp6

7. Clarify whether you will calculate inter-rater reliability (e.g., Cohen’s κ) beyond reporting percentage agreement in the pilot.
Response: Thank you for noting this. Inter-rater reliability will not be calculated as part of this scoping review.

8. Expand the data analysis plan to explain whether coding will be inductive or deductive and how themes will be developed.
Response: Thank you for the comment. The updated manuscript now includes the following sentence in the Methods section under the subheading Data analysis and presentation:
‘Deductive analysis will be used to map the data to the four HIQA principles of person-centred care including a human rights-based approach, safety and wellbeing, responsiveness, and accountability.’

9. Specify how non-English articles will be translated and validated (e.g., bilingual reviewer check where possible).
Response: Thank you for the comment. We used DeepL Translator, a high-quality leading AI-powered tool that provides accurate translations for documents. A reference to DeepL Translator has been added to the protocol.

10. Add operational definitions for ambiguous codes (e.g., “mixed settings,” “unclear”).
Response: Thank you for highlighting this. All codes were reviewed by the three researchers, and a tip sheet was developed for use by reviewers. Operational definitions have been added to the data extraction and guidance form in Table 4 for terms deemed ambiguous as follows:
‘Multiple perspectives describe articles that include a combination of one or more perspectives form people with disabilities, family members and or staff in residential services.
Mixed settings describes residential services that provide a combination of settings.
Unspecified means the type of residential service is not stated or described clearly and cannot be determined.’

11. State whether Table 4 is exactly the form to be used in data collection or a condensed version.
Response: Thank you for the comment. The updated manuscript now includes the following sentence in the Methods section under the subheading Data extraction:
‘The data extraction and guidance form was designed specifically for the purpose of this review (Table 4).’

12. Indicate whether the final dataset will be made publicly available (and in what format, e.g., CSV, Excel).
Response: Thank you for pointing this out. Additional wording has been added to the Methods section under the subheading Data analysis and presentation, as follows:
‘The data will be presented in tabular form in Microsoft Word. The table will be included as an appendix to the scoping review.’

13. If sharing, note any plans for accessible formats (important for disability stakeholders). Response: Thank you for raising this point. The development of accessible formats is a consideration for all the documentation and resources developed by HIQA for both stakeholders, and children and adults who use services. The manuscript has been updated to include the following wording in the Methods section under the subheading Data analysis and presentation:
‘While accessible versions of the scoping review will not be developed, for future phases of the project accessible resources will be developed as appropriate.’

14. Provide operational definitions for any codes in Table 4 that might be interpreted differently by different reviewers.
Response: Thank you for your comment. As mentioned in the response earlier (see comment number 10 for wording), operational definitions have been added to the data extraction and guidance form in Table 4 for terms deemed ambiguous.

15. Consider adding social science databases (e.g., SocINDEX) to capture broader conceptual literature on PCC.
Response: Thank you for highlighting this. At the time of publication of the scoping review protocol the search strategy was complete.

16.State whether translated articles will undergo secondary verification by a bilingual reviewer.
Response: Thank you for your comment. As the included documents were all in English, this step was not necessary for this project. To ensure good quality translation of documents we use a high quality, regarded translator software - DeepL Translator.

17. If data will be shared, indicate repository and format, and consider accessible dissemination formats.
Response: Thank you for the comment. The updated manuscript now includes the following sentence in the Methods section under the subheading Data analysis and presentation:
‘The data will be presented in tabular form in Microsoft Word. The table will be included as an appendix to the scoping review.’

18. Describe whether coding will be inductive or deductive, and how mapping to the HIQA principles will be standardised across reviewers.
Response: Thank you for the comment. The updated manuscript now includes the following sentences in the Methods section under the subheading Data analysis and presentation:
‘Deductive analysis will be used to map the data to the four HIQA principles of person-centred care including a human rights-based approach, safety and wellbeing, responsiveness, and accountability. Data mapping will be conducted and agreed by three reviewers.’

19. Explain exclusion of grey literature in this component and describe integration (or non-integration) with the parallel grey literature review
Response: Thank you for highlighting this point. As per point 3 above, wording has been added to the last paragraph of the Introduction to clarify why grey literature will not be included and how both reviews will be integrated.

20. State whether you will report a formal statistic (e.g., κ) and how you will handle discrepancies beyond the pilot phase.
Response: Thank you for noting this. A formal statistic will not be calculated as part of this scoping review. As mentioned in the Methods sections under the subheading Evidence selection and screening, ‘any disagreements that may arise between the reviewers at each stage of the screening process will be resolved through discussion. If consensus cannot be reached on an article, it will be referred to a third reviewer.’
We would like to thank the reviewer, Owen Doody, for taking the time to review our protocol and providing thoughtful and detailed feedback. Revisions have been made and are individually outlined below. We believe these revisions, informed by your comments, enhance the scoping review protocol by improving transparency so that it will be fully replicable and of maximum use for policy and practice.

Italic text: reviewer’s comments.

Response from the Authors

1. Bring the evidence gap (lack of definitions/characteristics) earlier in the introduction to hook the reader sooner.
Response: Thank you for your comment, we have moved some of the wording including the following sentence up to the third paragraph of the Introduction as follows:
‘However, a systematic review in 2016 on the effectiveness of person-centred planning for people with intellectual disabilities concluded that clearer descriptions of person-centred planning and its components are needed.’

2. Explicitly state in the opening section that the primary purpose is to inform national standards — currently this appears later in the introduction.
Response: Thank you, the primary purpose of this review, which is to inform national standards, has been moved to the second paragraph of the Introduction as follows:
‘This scoping review is intended to inform a potential update of the National Standards for Residential Services for Children and Adults with Disabilities.’

3. Briefly justify the focus on peer-reviewed literature only in this review, noting that grey literature is being reviewed separately.
Response: Thank you for your comment. The updated manuscript now includes the following justification in the last paragraph of the Introduction as follows:
‘The scoping review, to which this protocol applies, is part of a larger evidence review to inform a potential update of the National Standards for Residential Services for Children and Adults with Disabilities. (5) We will conduct a scoping review of the peer-reviewed academic literature to identify the characteristics and definitions of person-centred care in residential services for children and adults with disabilities. A separate review of grey literature will be undertaken to find relevant international standards and guidance, policies and strategies. The findings of the scoping review and the grey literature review will be synthesised to inform the standards.’

4. Explicitly state that quality appraisal will not be conducted (as per scoping review norms) and justify why.
Response: Thank you for highlighting this. Wording has been added to the Methods section under the subheading Search strategy as follows:
‘As this is a scoping review of peer review literature, it will be designed to identify the range of the evidence available and will be represented as a mapping of the identified data, without reference to methodological quality of relevant studies, as per scoping review norms.’

5. Provide a short paragraph explaining why the grey literature search is excluded from this component but handled separately.
Response: Thank you for your comment. As mentioned in the earlier response (see comment number 3 for wording), the points relating to grey literature have been expanded to provide a more detailed explanation as to why grey literature was omitted from this scoping review.

6. Provide translated search strings for all databases (or note they will be in supplementary material).
Response: Thank you for your comment. The updated manuscript includes clarification in the Methods section under the subheading Search strategy, as follows:
‘the identified keywords and terms will be translated for each included database and made available as supplementary material on Open Science Framework.’ The translated search strategy is now available on Open Science Framework using the following link: https://osf.io/ur2gx/files/4axp6

7. Clarify whether you will calculate inter-rater reliability (e.g., Cohen’s κ) beyond reporting percentage agreement in the pilot.
Response: Thank you for noting this. Inter-rater reliability will not be calculated as part of this scoping review.

8. Expand the data analysis plan to explain whether coding will be inductive or deductive and how themes will be developed.
Response: Thank you for the comment. The updated manuscript now includes the following sentence in the Methods section under the subheading Data analysis and presentation:
‘Deductive analysis will be used to map the data to the four HIQA principles of person-centred care including a human rights-based approach, safety and wellbeing, responsiveness, and accountability.’

9. Specify how non-English articles will be translated and validated (e.g., bilingual reviewer check where possible).
Response: Thank you for the comment. We used DeepL Translator, a high-quality leading AI-powered tool that provides accurate translations for documents. A reference to DeepL Translator has been added to the protocol.

10. Add operational definitions for ambiguous codes (e.g., “mixed settings,” “unclear”).
Response: Thank you for highlighting this. All codes were reviewed by the three researchers, and a tip sheet was developed for use by reviewers. Operational definitions have been added to the data extraction and guidance form in Table 4 for terms deemed ambiguous as follows:
‘Multiple perspectives describe articles that include a combination of one or more perspectives form people with disabilities, family members and or staff in residential services.
Mixed settings describes residential services that provide a combination of settings.
Unspecified means the type of residential service is not stated or described clearly and cannot be determined.’

11. State whether Table 4 is exactly the form to be used in data collection or a condensed version.
Response: Thank you for the comment. The updated manuscript now includes the following sentence in the Methods section under the subheading Data extraction:
‘The data extraction and guidance form was designed specifically for the purpose of this review (Table 4).’

12. Indicate whether the final dataset will be made publicly available (and in what format, e.g., CSV, Excel).
Response: Thank you for pointing this out. Additional wording has been added to the Methods section under the subheading Data analysis and presentation, as follows:
‘The data will be presented in tabular form in Microsoft Word. The table will be included as an appendix to the scoping review.’

13. If sharing, note any plans for accessible formats (important for disability stakeholders). Response: Thank you for raising this point. The development of accessible formats is a consideration for all the documentation and resources developed by HIQA for both stakeholders, and children and adults who use services. The manuscript has been updated to include the following wording in the Methods section under the subheading Data analysis and presentation:
‘While accessible versions of the scoping review will not be developed, for future phases of the project accessible resources will be developed as appropriate.’

14. Provide operational definitions for any codes in Table 4 that might be interpreted differently by different reviewers.
Response: Thank you for your comment. As mentioned in the response earlier (see comment number 10 for wording), operational definitions have been added to the data extraction and guidance form in Table 4 for terms deemed ambiguous.

15. Consider adding social science databases (e.g., SocINDEX) to capture broader conceptual literature on PCC.
Response: Thank you for highlighting this. At the time of publication of the scoping review protocol the search strategy was complete.

16.State whether translated articles will undergo secondary verification by a bilingual reviewer.
Response: Thank you for your comment. As the included documents were all in English, this step was not necessary for this project. To ensure good quality translation of documents we use a high quality, regarded translator software - DeepL Translator.

17. If data will be shared, indicate repository and format, and consider accessible dissemination formats.
Response: Thank you for the comment. The updated manuscript now includes the following sentence in the Methods section under the subheading Data analysis and presentation:
‘The data will be presented in tabular form in Microsoft Word. The table will be included as an appendix to the scoping review.’

18. Describe whether coding will be inductive or deductive, and how mapping to the HIQA principles will be standardised across reviewers.
Response: Thank you for the comment. The updated manuscript now includes the following sentences in the Methods section under the subheading Data analysis and presentation:
‘Deductive analysis will be used to map the data to the four HIQA principles of person-centred care including a human rights-based approach, safety and wellbeing, responsiveness, and accountability. Data mapping will be conducted and agreed by three reviewers.’

19. Explain exclusion of grey literature in this component and describe integration (or non-integration) with the parallel grey literature review
Response: Thank you for highlighting this point. As per point 3 above, wording has been added to the last paragraph of the Introduction to clarify why grey literature will not be included and how both reviews will be integrated.

20. State whether you will report a formal statistic (e.g., κ) and how you will handle discrepancies beyond the pilot phase.
Response: Thank you for noting this. A formal statistic will not be calculated as part of this scoping review. As mentioned in the Methods sections under the subheading Evidence selection and screening, ‘any disagreements that may arise between the reviewers at each stage of the screening process will be resolved through discussion. If consensus cannot be reached on an article, it will be referred to a third reviewer.’
Competing Interests: No competing interests were disclosed. Close
Report a concern

Comments on this article Comments (0)

Version 2

VERSION 2 PUBLISHED 29 Apr 2025

Open Peer Review

Reviewer Status

Reviewer Reports

	Invited Reviewers
	1	2
Version 2 (revision) 03 Nov 25	read
Version 1 29 Apr 25	read	read

Owen Doody, University of Limerick, Limerick, Ireland
Jialiang Cui, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong

Comments on this article

All Comments(0)

Add a comment

Back to all reports

Reviewer Report

6 Views

25 Nov 2025 | for Version 2

Owen Doody, University of Limerick, Limerick, County Limerick, Ireland

6 Views Cite this report Responses(0)

Approved

You plan to translate using DeepL is appropriate, but there is no mention of how to mitigate translation bias ? add a statement that, where possible, translated data will be sense-checked by a reviewer familiar with the language or terminology.
Consider -
Respite services can be short-term and may not include life-planning, yet PCC characteristics extracted may differ from long-term care so ? explain how respite-specific findings will be treated (separately? or integrated and contextualised?).
The protocol acknowledges disparities but does not specify how such variation will be coded in result synthesis. ? expand the plan to state that findings will be stratified or at least narratively compared by model (size, length of stay, disability type).

Competing Interests

No competing interests were disclosed.

Reviewer Expertise

Intellectual disability, scoping reviews, qualitative.

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard.

Respond to this report

Responses (0)

Back to all reports

Reviewer Report

14 Views

14 Aug 2025 | for Version 1

Jialiang Cui, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong

14 Views Cite this report Responses(1)

Approved With Reservations

Is the rationale for, and objectives of, the study clearly described?

Partly
Is the study design appropriate for the research question?

Yes
Are sufficient details of the methods provided to allow replication by others?

Partly
Are the datasets clearly presented in a useable and accessible format?

Not applicable

Competing Interests

No competing interests were disclosed.

Reviewer Expertise

disability service, residential care, mental health

Respond to this report

Responses (1)

Author Response

05 Nov 2025

Caroline Walsh, Health Information and Quality Authority, Dublin, Ireland

We would like to thank the reviewer, Jialiang Cui, for the time you have taken to read and review our protocol and for your valuable suggestions. Revisions have been made and are individually outlined below. These revisions, informed by your comments, help refine the rationale and methodology of the scoping review protocol.

Italic text: reviewer’s comments.
Response from the Authors

1. The third paragraph on page 3 could be strengthened. While person-centredness is a well-researched topic in social services, the protocol currently only offers a broad conceptualisation of “person-centred” care and its benefits. What are the most significant characteristics compared with a “system-centred” approach? How is person-centredness actually demonstrated in the disability field? More importantly, is there anything potentially unique about person-centred care in the context of residential care (so we need a review of characteristics)? This would help justify the rationale for conducting such a scoping review.
Response: Thank you for raising this point. The description of person-centred approach has been moved to the third paragraph in the Introduction. We have reviewed the use of the term “system-centred” approach and updated the text. We have updated the sixth paragraph of the Introduction highlighting some of the challenges with residential services for people with disabilities and why it is important that:
‘HIQA promotes a person-centred approach to care and support in its role as a standards setting body and regulator for residential services for people with disabilities in Ireland, with a focus on protecting the human rights and welfare of residents living in all residential services, to ensure that they are supported to live fulfilling lives.’

2. The concept and practice of residential care also need some clarification. How is it defined internationally, and specifically in the Irish context? Why is it an important focus, given that residential care has often been discouraged, especially for children with disabilities (see Rosenthal’s paper on the “Residential Care Controversy”)?
Response: Thank you for highlighting this. For context an interpretation of residential services in Ireland has been added to the fifth paragraph of the Introduction as follows:
‘HIQA has provided the care sector with a widely accepted and used interpretation of residential services for people with disabilities in Ireland:
a ‘residential service’ is one that is comprised of both accommodation and care and or support services provided to children and adults with disabilities living in residential settings, on a short or long-term basis, whether or not it is their sole place of residence.

We have updated the sixth paragraph of the Introduction as follows:
‘Since 2011, there has been a shift in Ireland towards supporting residents to transition from large, campus-based settings into smaller living arrangements in the community or to individualised services.⁽¹⁷⁾ Historically, large or congregated settings have been associated with institutionalised practices that infringe on resident's human-rights and prioritise organisation needs or work patterns over resident’s needs. While smaller residential services can provide more opportunities for people with disabilities to become active members of society and enable them to enjoy their human-rights, it is understood that institutional practices and ways of thinking can often be found in residential services in the community.⁽¹⁸⁾ Recognising this, HIQA promotes a person-centred approach to care and support in its role as a standards setting body and regulator for residential services for people with disabilities in Ireland, with a focus on protecting the human rights and welfare of residents living in all residential services, to ensure that they are supported to live fulfilling lives.⁽¹⁹⁾

3. Residential care in disability services can vary widely – by disability type, length of stay, level of support, operational model, etc. (I assume this complexity exists in Ireland as well, although the authors haven’t discussed it). How will these disparities be accounted for when synthesising the characteristics of person-centred care for disability residential care as a whole?
Response: Thank you for raising this point. Wording has been added to the Methods section under the subheading Data analysis and presentation as follows:
‘Disparities in the findings in relation to the type of residential services or length of stay will be noted in the narrative summary.’

4. It’s not clear how “person-centred” care was incorporated into the 2013 standards. Was it a major focus, and how was it represented? A brief explanation of this would help clarify why an update is needed after the ratification of the CRPD or ADM.
Response: Thank you for highlighting this. The manuscript has been updated and now includes the following in the seventh paragraph of the Introduction:
‘The National Standards for Residential Services for Children and Adults with Disabilities were developed incorporating person-centred care, since then however there has been an increased focus on a human-rights based approach to care and person-centred care. Updating the standards under the four principles of person-centred care would strengthen the focus of person-centred care within the standards, align the standards to the UNCRPD and improve support improvement in services for people with disabilities living in residential services.’

5. The sixth paragraph on page 3 introduces new principles developed by HIQA. I found it confusing why this appeared at that point – it didn’t seem clearly connected to the rest of the content until later, when I realised these new principles might form the analytical framework, as mentioned in your Discussion. You could clarify their importance earlier, either in the introduction or methods section.
Response: Thank you for your comment. Additional wording has been included in the seventh paragraph of the Introduction to provide more clarity on the use of the four principles to form the analytical framework for the review as follows:
‘These four principles of person-centred care will be used as the analytical framework for this review.’

6. Review question: Why is the definition of person-centred care mentioned only in the specific questions? The review question and specific question seem almost the same, except for that emphasis, which hasn’t been previously justified.
Response: Thank you for highlighting this point. Following consideration of your comment we have reduced the research and specific questions in the Introduction to one research question as follows:
‘What are the characteristics and definitions of person-centred care in residential services for children and adults with disabilities?’

7. Evidence type: Will you consider theses in this review?
Response: Thank you for your comment. Theses were not included in this review and we have added this to the exclusion criteria in Table 2.

8. Search terms: In some contexts, person-centred care is also referred to as “personalised” care.
Response: Thank you for highlighting this. At the time of publication of the scoping review protocol the search strategy was complete. The search strategy was reviewed by an expert research librarian, however for future scoping reviews personalised care will be considered for inclusion in the search terms.

9. Screening: Who will be doing the title and abstract review, and how many reviewers will there be?
Response: Thank you for the comment. The wording in the Methods section under subheading Evidence selection and screening, has been updated as follows:
‘Two reviewers will work independently at each screening stage to review articles and will meet to discuss the results; any disagreements that may arise between the reviewers at each stage of the screening process will be resolved through discussion. If consensus cannot be reached on an article, it will be referred to a third reviewer.’

10. “The literature search will be conducted in February 2025” – has this already been done? If so, what are the preliminary results?
Response: Thank you for your comment. At the time of publication, the literature search had been completed.
The evidence review, including the scoping review to which this protocol applies, has now been published on the HIQA website and can be found at the below link:

https://www.hiqa.ie/sites/default/files/2025-09/Evidence-review-Residential-services-for-children-and-adults-with-disabilities.pdf

View more View less

Competing Interests

No competing interests were disclosed.

Back to all reports

Reviewer Report

27 Views

12 Aug 2025 | for Version 1

Owen Doody, University of Limerick, Limerick, County Limerick, Ireland

27 Views Cite this report Responses(1)

Approved With Reservations

The high number of people with disabilities using residential services in Ireland.
Legislative and policy changes since the 2013 National Standards for Residential Services for Children and Adults with Disabilities, particularly the adoption of a human rights-based approach.
Evidence gaps in clear definitions and operational characteristics of PCC for this population, as noted in prior reviews.

The protocol sets out:

Eligibility criteria using the PCC mnemonic.
Search strategy (PRESS-reviewed) across multiple databases.
Screening using Covidence with dual independent reviewers.
Data extraction using a structured template (Table), piloted before full extraction.
Analysis plan to map findings to the four HIQA principles: human rights, safety & wellbeing, responsiveness, and accountability.The authors state the results will inform whether an update of the National Standards is warranted and guide their content.

The rationale for, and objectives of, the study could be sharpened:

Bring the evidence gap (lack of definitions/characteristics) earlier in the introduction to hook the reader sooner.
Explicitly state in the opening section that the primary purpose is to inform national standards — currently this appears later in the introduction.
Briefly justify the focus on peer-reviewed literature only in this review, noting that grey literature is being reviewed separately.

Study design appropriate for the research question - minor considerations:

Explicitly state that quality appraisal will not be conducted (as per scoping review norms) and justify why.
Provide a short paragraph explaining why the grey literature search is excluded from this component but handled separately.

Are sufficient details of the methods provided to allow replication by others? - Gaps to Address:

Provide translated search strings for all databases (or note they will be in supplementary material).
Clarify whether you will calculate inter-rater reliability (e.g., Cohen’s κ) beyond reporting percentage agreement in the pilot.
Expand the data analysis plan to explain whether coding will be inductive or deductive and how themes will be developed.
Specify how non-English articles will be translated and validated (e.g., bilingual reviewer check where possible).

Are the datasets clearly presented in a usable and accessible format? - Gaps to Address:

Add operational definitions for ambiguous codes (e.g., “mixed settings,” “unclear”).
State whether Table 4 is exactly the form to be used in data collection or a condensed version.
Indicate whether the final dataset will be made publicly available (and in what format, e.g., CSV, Excel).
If sharing, note any plans for accessible formats (important for disability stakeholders).

Recommendations for Improvement -

Clarify search reproducibility
Include full search strings for all databases or specify they will be made available as supplementary material.
Expand data analysis detail
Describe whether coding will be inductive or deductive, and how mapping to the HIQA principles will be standardised across reviewers.
Justify scope decisions
Explain exclusion of grey literature in this component and describe integration (or non-integration) with the parallel grey literature review.
Clarify inter-rater reliability
State whether you will report a formal statistic (e.g., κ) and how you will handle discrepancies beyond the pilot phase.
Refine extraction categories
Provide operational definitions for any codes in Table 4 that might be interpreted differently by different reviewers.
Consider adding social science databases (e.g., SocINDEX) to capture broader conceptual literature on PCC.
State whether translated articles will undergo secondary verification by a bilingual reviewer.
If data will be shared, indicate repository and format, and consider accessible dissemination formats.

Is the rationale for, and objectives of, the study clearly described?

Yes
Is the study design appropriate for the research question?

Yes
Are sufficient details of the methods provided to allow replication by others?

Yes
Are the datasets clearly presented in a useable and accessible format?

Yes

Competing Interests

No competing interests were disclosed.

Reviewer Expertise

Intellectual disability, scoping reviews, qualitative.

Respond to this report

Responses (1)

Author Response

05 Nov 2025

Caroline Walsh, Health Information and Quality Authority, Dublin, Ireland

We would like to thank the reviewer, Owen Doody, for taking the time to review our protocol and providing thoughtful and detailed feedback. Revisions have been made and are individually outlined below. We believe these revisions, informed by your comments, enhance the scoping review protocol by improving transparency so that it will be fully replicable and of maximum use for policy and practice.

Italic text: reviewer’s comments.
Response from the Authors

1. Bring the evidence gap (lack of definitions/characteristics) earlier in the introduction to hook the reader sooner.
Response: Thank you for your comment, we have moved some of the wording including the following sentence up to the third paragraph of the Introduction as follows:
‘However, a systematic review in 2016 on the effectiveness of person-centred planning for people with intellectual disabilities concluded that clearer descriptions of person-centred planning and its components are needed.’

2. Explicitly state in the opening section that the primary purpose is to inform national standards — currently this appears later in the introduction.
Response: Thank you, the primary purpose of this review, which is to inform national standards, has been moved to the second paragraph of the Introduction as follows:
‘This scoping review is intended to inform a potential update of the National Standards for Residential Services for Children and Adults with Disabilities.’

3. Briefly justify the focus on peer-reviewed literature only in this review, noting that grey literature is being reviewed separately.
Response: Thank you for your comment. The updated manuscript now includes the following justification in the last paragraph of the Introduction as follows:
‘The scoping review, to which this protocol applies, is part of a larger evidence review to inform a potential update of the National Standards for Residential Services for Children and Adults with Disabilities. (5) We will conduct a scoping review of the peer-reviewed academic literature to identify the characteristics and definitions of person-centred care in residential services for children and adults with disabilities. A separate review of grey literature will be undertaken to find relevant international standards and guidance, policies and strategies. The findings of the scoping review and the grey literature review will be synthesised to inform the standards.’

4. Explicitly state that quality appraisal will not be conducted (as per scoping review norms) and justify why.
Response: Thank you for highlighting this. Wording has been added to the Methods section under the subheading Search strategy as follows:
‘As this is a scoping review of peer review literature, it will be designed to identify the range of the evidence available and will be represented as a mapping of the identified data, without reference to methodological quality of relevant studies, as per scoping review norms.’

5. Provide a short paragraph explaining why the grey literature search is excluded from this component but handled separately.
Response: Thank you for your comment. As mentioned in the earlier response (see comment number 3 for wording), the points relating to grey literature have been expanded to provide a more detailed explanation as to why grey literature was omitted from this scoping review.

6. Provide translated search strings for all databases (or note they will be in supplementary material).
Response: Thank you for your comment. The updated manuscript includes clarification in the Methods section under the subheading Search strategy, as follows:
‘the identified keywords and terms will be translated for each included database and made available as supplementary material on Open Science Framework.’ The translated search strategy is now available on Open Science Framework using the following link: https://osf.io/ur2gx/files/4axp6

7. Clarify whether you will calculate inter-rater reliability (e.g., Cohen’s κ) beyond reporting percentage agreement in the pilot.
Response: Thank you for noting this. Inter-rater reliability will not be calculated as part of this scoping review.

8. Expand the data analysis plan to explain whether coding will be inductive or deductive and how themes will be developed.
Response: Thank you for the comment. The updated manuscript now includes the following sentence in the Methods section under the subheading Data analysis and presentation:
‘Deductive analysis will be used to map the data to the four HIQA principles of person-centred care including a human rights-based approach, safety and wellbeing, responsiveness, and accountability.’

9. Specify how non-English articles will be translated and validated (e.g., bilingual reviewer check where possible).
Response: Thank you for the comment. We used DeepL Translator, a high-quality leading AI-powered tool that provides accurate translations for documents. A reference to DeepL Translator has been added to the protocol.

10. Add operational definitions for ambiguous codes (e.g., “mixed settings,” “unclear”).
Response: Thank you for highlighting this. All codes were reviewed by the three researchers, and a tip sheet was developed for use by reviewers. Operational definitions have been added to the data extraction and guidance form in Table 4 for terms deemed ambiguous as follows:
‘Multiple perspectives describe articles that include a combination of one or more perspectives form people with disabilities, family members and or staff in residential services.
Mixed settings describes residential services that provide a combination of settings.
Unspecified means the type of residential service is not stated or described clearly and cannot be determined.’

11. State whether Table 4 is exactly the form to be used in data collection or a condensed version.
Response: Thank you for the comment. The updated manuscript now includes the following sentence in the Methods section under the subheading Data extraction:
‘The data extraction and guidance form was designed specifically for the purpose of this review (Table 4).’

12. Indicate whether the final dataset will be made publicly available (and in what format, e.g., CSV, Excel).
Response: Thank you for pointing this out. Additional wording has been added to the Methods section under the subheading Data analysis and presentation, as follows:
‘The data will be presented in tabular form in Microsoft Word. The table will be included as an appendix to the scoping review.’

13. If sharing, note any plans for accessible formats (important for disability stakeholders). Response: Thank you for raising this point. The development of accessible formats is a consideration for all the documentation and resources developed by HIQA for both stakeholders, and children and adults who use services. The manuscript has been updated to include the following wording in the Methods section under the subheading Data analysis and presentation:
‘While accessible versions of the scoping review will not be developed, for future phases of the project accessible resources will be developed as appropriate.’

14. Provide operational definitions for any codes in Table 4 that might be interpreted differently by different reviewers.
Response: Thank you for your comment. As mentioned in the response earlier (see comment number 10 for wording), operational definitions have been added to the data extraction and guidance form in Table 4 for terms deemed ambiguous.

15. Consider adding social science databases (e.g., SocINDEX) to capture broader conceptual literature on PCC.
Response: Thank you for highlighting this. At the time of publication of the scoping review protocol the search strategy was complete.

16.State whether translated articles will undergo secondary verification by a bilingual reviewer.
Response: Thank you for your comment. As the included documents were all in English, this step was not necessary for this project. To ensure good quality translation of documents we use a high quality, regarded translator software - DeepL Translator.

17. If data will be shared, indicate repository and format, and consider accessible dissemination formats.
Response: Thank you for the comment. The updated manuscript now includes the following sentence in the Methods section under the subheading Data analysis and presentation:
‘The data will be presented in tabular form in Microsoft Word. The table will be included as an appendix to the scoping review.’

18. Describe whether coding will be inductive or deductive, and how mapping to the HIQA principles will be standardised across reviewers.
Response: Thank you for the comment. The updated manuscript now includes the following sentences in the Methods section under the subheading Data analysis and presentation:
‘Deductive analysis will be used to map the data to the four HIQA principles of person-centred care including a human rights-based approach, safety and wellbeing, responsiveness, and accountability. Data mapping will be conducted and agreed by three reviewers.’

19. Explain exclusion of grey literature in this component and describe integration (or non-integration) with the parallel grey literature review
Response: Thank you for highlighting this point. As per point 3 above, wording has been added to the last paragraph of the Introduction to clarify why grey literature will not be included and how both reviews will be integrated.

20. State whether you will report a formal statistic (e.g., κ) and how you will handle discrepancies beyond the pilot phase.
Response: Thank you for noting this. A formal statistic will not be calculated as part of this scoping review. As mentioned in the Methods sections under the subheading Evidence selection and screening, ‘any disagreements that may arise between the reviewers at each stage of the screening process will be resolved through discussion. If consensus cannot be reached on an article, it will be referred to a third reviewer.’

View more View less

Competing Interests

No competing interests were disclosed.

Alongside their report, reviewers assign a status to the article:

Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested

Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit.

Not approved - fundamental flaws in the paper seriously undermine the findings and conclusions

[1] 1. World Health Organization: Global report on health equity for persons with disabilities. 2022; Accessed on: 12 December 2024. Reference Source

[2] 2. World Health Organization: The WHO European framework for action to achieve the highest attainable standard of health for persons with disabilities 2022–2030. 2022; Accessed on: 12 December 2024. Reference Source

[3] 3. European Disability Forum: Independent living and de-institutionalisation policy. Accessed on: 12 December 2024. Reference Source

[4] 4. Casey C, Fanagan S, O'Sullivan M, et al.: National Ability Supports System (NASS): overview of people engaging with disability services, 2022. 2023. Reference Source

[5] 5. Health Information and Quality Authority: National standards for residential services for children and adults with disabilities. 2013; Accessed on: 19 September 2024. Reference Source

[6] 6. Assisted decision-making (Capacity) act 2015. Ireland, 2015; Accessed on: 26 September 2024. Reference Source

[7] 7. United Nations: Convention on the rights of persons with disabilities. 2006; Accessed on: 13 December 2023. Reference Source

[8] 8. Jackman-Galvin V, Partridge M: Relationships and power: an exploration of person-centredness in an intellectual disability service in Ireland. Health Soc Care Community. 2022; 30(6): e6294–e6302. PubMed Abstract | Publisher Full Text

[9] 9. Cramm JM, Nieboer AP: Validation of an instrument to assess the delivery of patient-centred care to people with intellectual disabilities as perceived by professionals. BMC Health Serv Res. 2017; 17(1): 472. PubMed Abstract | Publisher Full Text | Free Full Text

[10] 10. Rissanen L, Ehrlich C, Kendall E, et al.: Realizing person-centred care in residential care facilities for young adults with complex and chronic disabilities: the understanding, perception and beliefs of workers. Eur J Pers Cent Healthc. 2014; 2(2): 190–200. Reference Source

[11] 11. Ratti V, Hassiotis A, Crabtree J, et al.: The effectiveness of person-centred planning for people with intellectual disabilities: a systematic review. Res Dev Disabil. 2016; 57: 63–84. PubMed Abstract | Publisher Full Text

[12] 12. World Health Organization: Delivering quality health services: a global imperative for universal health coverage. World Health Organization, 2018. Reference Source

[13] 13. O'Dwyer V, Behan L, Weir L, et al.: Translating national standards into practice: supporting social care professionals. Journal of Social Care. 2020; 3(1): 1. Publisher Full Text

[14] 14. Health Information and Quality Authority: International review of the methodologies for developing national standards and guidance for health and social care services. 2018; Accessed on: 12 December 2024. Reference Source

[15] 15. Health Information and Quality Authority: What is a designated centre? A guide to understanding the definition of designated centres. 2022; Retrieved 29 September 2024. Reference Source

[16] 16. Beadle-Brown J: Residential care and community living. In: Textbook of Psychiatry for Intellectual Disability and Autism Spectrum Disorder. M. O. Bertelli, S. Deb, K. Munir, A. Hassiotis and L. Salvador-Carulla. Cham, Springer International Publishing, 2022; 921–940. Publisher Full Text

[17] 17. Health Service Executive: Time to move on from congregated settings: a strategy for community inclusion. 2011; Retrieved 10 October 2024. Reference Source

[18] 18. Health Information and Quality Authority: 10 Years of regulating designated centres for people with disabilities. 2024; Retrieved 24 December 2024. Reference Source

[19] 19. Health Information and Quality Authority: Standards development framework: a principles-based approach. 2021; Accessed on: 10 October 2024. Reference Source

[20] 20. Peters MDJ, Godfrey CM, Khalil H, et al.: Guidance for conducting systematic scoping reviews. Int J Evid Based Healthc. 2015; 13(3): 141–6. PubMed Abstract | Publisher Full Text

[21] 21. Moher D, Shamseer L, Clarke M, et al.: Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) 2015 statement. Syst Rev. 2015; 4(1): 1. PubMed Abstract | Publisher Full Text | Free Full Text

[22] 22. Walsh C, Duggan C, Waldron C, et al.: The characteristics of person-centred care in residential services for children and adults with disabilities: a scoping review protocol. 2025. Reference Source

[23] 23. Munn Z, Pollock D, Khalil H, et al.: What are scoping reviews? Providing a formal definition of scoping reviews as a type of evidence synthesis. JBI Evid Synth. 2022; 20(4): 950–2. PubMed Abstract | Publisher Full Text

[24] 24. Aromataris E, Lockwood C, Porritt K, et al.: JBI manual for evidence synthesis. 2024; Accessed on: 11 November 2024. Reference Source

[25] 25. McGowan J, Sampson M, Salzwedel DM, et al.: PRESS Peer Review of Electronic Search Strategies: 2015 guideline statement. J Clin Epidemiol. 2016; 75: 40–6. PubMed Abstract | Publisher Full Text

[26] 26. Haddaway NR, Grainger MJ, Gray CT: Citationchaser: a tool for transparent and efficient forward and backward citation chasing in systematic searching. Res Synth Methods. 2022; 13(4): 533–45. PubMed Abstract | Publisher Full Text

[27] 27. Pollock D, Peters MDJ, Khalil H, et al.: Recommendations for the extraction, Analysis, and presentation of results in scoping reviews. JBI Evid Synth. 2023; 21(3): 520–32. PubMed Abstract | Publisher Full Text

[28] 28. Tricco AC, Lillie E, Zarin W, et al.: PRISMA extension for Scoping Reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018; 169(7): 467–73. PubMed Abstract | Publisher Full Text

[29] 29. OSF | Scoping review PRISMA-P checklist_OSF.pdf. https://osf.io/wb5rt

The characteristics of person-centred care in residential services for children and adults with disabilities: a scoping review protocol

Abstract

Introduction

Methods

Conclusion

Keywords

Revised Amendments from Version 1

Introduction

Review question

Methods

Eligibility criteria

Table 1. The research questions and the PCC mnemonic framework.

Table 2. Eligibility criteria.

Search strategy

Table 3. Search strategy for Medline.

Evidence selection and screening

Data extraction

Table 4. Data extraction and guidance form.

Data analysis and presentation

Dissemination

Study status

Ethics

Discussion

Ethics and consent

Data availability

Underlying data

Extended data

References

Comments on this article Comments (0)

Open Peer Review

Comments on this article Comments (0)

Open Peer Review

Reviewer Status

Reviewer Reports

Comments on this article

Are you a HRB-funded researcher?

Thank you!

The characteristics of person-centred care in residential services for children and adults with disabilities: a scoping review protocol

Abstract

Introduction

Methods

Conclusion

Keywords

Revised Amendments from Version 1

Introduction

Review question

Methods

Eligibility criteria

Table 1. The research questions and the PCC mnemonic framework.

Table 2. Eligibility criteria.

Search strategy

Table 3. Search strategy for Medline.

Evidence selection and screening

Data extraction

Table 4. Data extraction and guidance form.

Data analysis and presentation

Dissemination

Study status

Ethics

Discussion

Ethics and consent

Data availability

Underlying data

Extended data

References

Comments on this article Comments (0)

Open Peer Review

Comments on this article Comments (0)

Open Peer Review

Reviewer Status

Reviewer Reports

Comments on this article

Competing Interests Policy

Stay Updated

Are you a HRB-funded researcher?

Thank you!