Co-production in social care: What it is and how to do it

Practice example: Royal Borough of Greenwich’s Learning Disability Housing Strategy

The Royal Borough of Greenwich commissioned Golden Lane Housing to work with it to develop a housing strategy for people with a learning disability.  The strategy aimed to:

• improve the standard of local accommodation for people with a learning disability
• identify bespoke housing solutions for people with a learning disability
• identify existing properties that are not suitable to meet the need of people with a learning disability
• identify options for delivering sufficient local capacity to accommodate people with a learning disability
• ensure that people who use services are put at the centre of service design
• develop a plan for the delivery of the strategy.

What has co-production meant to the project?

The Royal Borough of Greenwich had reviewed its in-house provision for people with a learning disability a few years earlier but had not properly engaged with people who use services, their families or wider stakeholders and the subsequent consultation was poorly managed.  Consequently, it was recognised that a new approach was needed. The adult social care directorate realised that it did not have the relevant expertise in housing and decided to engage an external partner who could bring expertise, independence, candor and challenge within a co-production approach to the new strategy. Golden Lane Housing, part of Royal Mencap Society, has nearly 20 years of experience of working with individuals and their families on housing solutions and putting them at the heart of their housing plans.  

What has helped in implementing a co-production approach?

From the outset it was important to be candid and recognise the mistakes made in the past.  However, it was also important that people understood that change was required to ensure that services could provide good quality housing, and support that met local demand and was affordable. It was also important that people understood that the Royal Borough was committed to putting the service user at the centre. Co-production meant engaging with everyone connected to current and future housing provision. This involved inviting all 900 adults with a learning disability known to services, their families, carers and advocates, young people and their families as well as other key stakeholders to a series of events to share the plans and seek their involvement on the project. We explained that the co-production approach would work alongside key workstreams:

• Data analysis to assess future demand
• Research supply of accommodation
• Gap analysis including capital funding strategy

We fed back to everyone who came and as a result over 130 people confirmed that they would like to be involved in some way in the development of the strategy.  We worked throughout the project with one of the five ‘MPs’ elected by people with a learning disability to their Learning Disability Parliament.  We also held an open Q&A session with support provider staff to share plans. Engaging with politicians was also a key aspect of implementing the strategy and the Cabinet lead for Adult Social Care launched the first event and has been a critical friend throughout the project.

What difficulties were there in implementing co-production?

One key lesson has been to not rush co-production. It takes time for the change process for service users and the wider population and we underestimated the time it took to get final sign-off by politicians. But the overall engagement by politicians and the agreed outcomes was far more positive and vital for the future success of the delivery stage. We also need to acknowledge that for a low small minority, particularly some families of current residents, there remains some unhappiness and mistrust about change. It is therefore important that we continue to engage with them on a one-to-one basis on the delivery of the strategy. 

What are the main strengths in the approach that has been taken?

Our approach for regular, succinct communication was important throughout the project and we sent out monthly update newsletters. We reported back what we think they said and what that meant for progress. We met residents, staff and families at most of the existing properties and carried out structured interviews. Our approach showed that people can engage at a strategic level but it does take time to capture and to aggregate what they want to see in a strategy. We provided opportunities to comment on the development of the strategy including shaping the issues and recommendations which culminated in the draft strategy being sent out to all stakeholders for feedback.

What have been the main outcomes of the project?

By ensuring everyone had an opportunity to shape and develop the strategy, we developed a draft strategy that received positive feedback from the Healthier Communities and Adult Social Care Scrutiny Committee. Positively they wanted the recommendations in the strategy to become real pledges that were owned by the whole Council – signed up to by the Chairs of Housing and Anti-Poverty & Children’s Scrutiny Committees. The revised accessible eight-page strategy – supported by substantial separate written evidence – was subsequently adopted in December 2017 and the implementation stage of the strategy began. 

How has the project worked to engage all sections of the community?

A wide range of people were involved in the co-production of the policy including voluntary organisations, housing associations, and support providers. We also met with people who are currently not receiving services – such as school parents – for their views on future provision.

What advice would the project give to others?

• Engage an independent organisation to lead co-production – provides impartial view
• People need to understand why change is needed
• Building honesty and trust – helps to unfreeze any resistance to change
• Support staff are key – trusted by families and they can have a positive (and negative) effect on the way messages are received and reacted to
• Communicate, communicate, communicate – and actively listen
• Stakeholder management critical – helps build positive relationships
• Remember current and future users of services have the answer
• Implementing a strategy by co-production is different but more challenging and rewarding than agreeing a strategy on paper