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As the social care system ‐ and potentially the health care system and other public services ‐ move increasingly towards a model of personalised support, questions arise about whether and how it can work for people with multiple and complex needs. The evidence is that it is possible to achieve this, and that the outcomes and quality of life can be dramatically improved, but many councils and their partners have yet to move into this demanding activity, and face considerable obstacles in the form of conventional approaches to policy and practice if and when they do. This article draws on the findings of a special study undertaken for the Commission for Social Care Inspection. Alongside some of the difficulties of personalising support for people with multiple and complex needs are inspirational stories of innovative developments which have transformed the lives of people and their carers.

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