Co-production in social care: What it is and how to do it
Practice example: Thera – Speaking for Myself
About the project
Thera supports people with learning difficulties to have control of their lives. It works through a group of companies that provide care and support and other services to people with learning difficulties.
The Speaking for Myself project aims to develop people’s skills around peer and self-advocacy. It is funded by the Big Lottery and supported by Thera.The project started almost five years ago and was set up after members of local groups and Leicestershire’s Partnership Board who said they needed more support. Thera worked with people to apply for funding and to set up the project in ways that work well for them and for the different people involved.
What has co-production meant to the project
The project goals and milestones were chosen by people supported by the project in Leicestershire.
Self-advocacy groups were set up in the parts of the county where people said they wanted them. Meetings are run in ways chosen by the people who attend them and are chaired by elected self-advocates. Notes and actions are written by self-advocates with support.Self-advocates have worked together to make plans for their group. They have planned events, including an annual project conference.
What has helped in implementing a co-production approach?
Thera is well practised in co-production and employs lots of people with learning difficulties. Each of the Thera companies in the group is run by a managing director and a service quality director in partnership. Service quality directors are always people with a learning difficulty.
This experience in co-production at an organisational and service level gave the project a lot of good experience and learning to draw from.
It has used tried and tested ways to support communication including:
- using communication cards in meetings
- good support for people that worked well with the meetings they took part in
- challenging assumptions about where power and control lay
- paying people for their time
- not using words which label and divide people (e.g. ‘service user’, ‘staff’, ‘client’, ‘user’)
- people with learning difficulties training self-advocates
- having meetings in ways that suit people’s access and support needs
- carefully managing relationships with external stakeholders.
What difficulties were there in implementing co-production?
It was clear from the start of the project that many of the people with learning difficulties who wanted to come to the groups were held back by the language, culture and standard practices of a system which habitually disempowers them.
Thera was only able to offer two hours each month to people in small groups to challenge this. It set up safe places and spaces where people could genuinely take control for that brief time, but it was evident that people found it incredibly difficult to meaningfully lead, self-advocate and challenge the parts of their lives which were not working for them when every other part of their lives discouraged it.It was also a struggle to maintain contact with some people once the groups began to find their feet. Some people were not well supported to engage with the project and some found it difficult to understand what self-advocacy and co-production meant so did not know how to start to engage with it. There was also some resistance from parents and carers, and some service providers were uncomfortable with people stepping outside of the expectations they had of them.
What are the main strengths in the approach that has been taken?
The project worked hard to find ways to put people in charge of every aspect of their particular self-advocacy groups and of the project as a whole.
Speaking for Myself has challenged Thera’s own assumptions and practices throughout the project. It has challenged local and national community assumptions and practices too.The project has supported people in ways that have allowed the consequences of mistakes and poor decisions to happen so that self-advocates have been able to learn from them.
What have been the main outcomes of the project?
Self-advocates have found the confidence and sense of group empowerment to challenge parts of their lives that they find hard to cope with. They have built friendships and peer support networks. People have said they feel in charge of their lives because of Speaking for Myself.
The project has led to changes have been made in local services, commissioning practices and in wider community services because of challenges presented to them by self-advocates.
Members of the project have formed great relationships with the county police, social services, service providers and some health professionals. Some people have also been able to challenge their families to be more positive in how they support them.
How has the project worked to engage all sections of the community?
The project has used local community venues for its meetings. It has encouraged people to bring friends along to the groups and self-advocates have worked with many different parts of the community to ensure they are reaching people and networking as widely as possible. This has included the police, commissioning and contract monitoring teams, health advocates, other service providers, neighbourhood watch groups, social services, the locality groups, partnership board, carer organisations and other advocacy groups and organisations.
What advice would you give to others?
- Get the right staff in place (values, attitude to ways of supporting people and personality matters far more than experience!).
- Be accountable to project beneficiaries first and foremost.
- Learn from everything and make sure lessors become improvements.
- Listen! (with open ears, mind and heart!).