Overcoming the barriers to co-production

By Deborah Ivanova – Deputy Chief Inspector Adult Social Care (London and South) Care Quality Commission

At the Care Quality Commission I have the pleasure of taking part in our bimonthly adult social care co-production events which are invaluable both to the organisation and to me personally.  The success of co-production lies in the impact it makes: at CQC we do things differently as a direct result of our sessions, but it’s not always easy.  We work to overcome the barriers to co-production by creating accessible, interesting, well attended and useful events. 

Making co-production events worthwhile is all about including a wide variety of people, which we do by inviting a mix of providers, experts by experience, public representatives, voluntary groups and more. The diversity is part of what makes them so special and we are always inviting new faces to make sure we have a mix of people who have unique ideas and points of view. 

When we have the right people around the table it’s important to make sure the discussions are focused. We look at topics which people are really passionate about and we have facilitators to draw everyone together to make sure we have a focused discussion.  I often take on the role of facilitator, which can be challenging when not everyone has the same opinion! As each table discussion draws to a close we present the key points visually and verbally, making sure we have agreement on what is important to take forward.

Making co-production events accessible to everyone is important and we try to structure the day to make sure everyone can get involved. If anyone has special requirements, such as where they sit or needing information in different formats we make sure this happens. We want everyone to feel they can contribute their views and have open conversations.

To make co-production real we need to recognise what the barriers are and create events which people want to attend and where they are listened to. I look forward to discussing this more on the panel at the upcoming SCIE co-production festival, and hope to see you there.

Calling on evidence co-producers

By Pippa Coutts, Policy and development manager, Carnegie UK Trust

I am becoming a veteran of alliances, such as the Alliance for Action and the Alliance for Useful Evidence, as well as working in various third, statutory and academic collaborations. Not surprisingly, I believe in the value of working together to try to overcome complex problems: and perhaps co-production is the holy grail of collaborative activity, when power and roles are truly shared. However, preparing for a talk today on the co-production of evidence, I was struck again by the huge potential but degree of change that’s needed for co-production to happen.

An appetite for co-produced evidence

Carnegie UK Trust has a long standing interest in the use of evidence in the pursuit of improved societal wellbeing. It also believes that giving people more control enables wellbeing. These objectives have led us to think about the possibility of co-produced evidence. The appetite for this was demonstrated in a recent survey where over two thirds of respondents reported they participate in the co-production of evidence. This also hints at one of the issues that might be hindering co-production: lack of conceptual clarity. What do people mean when they say they participated in the co-production of evidence? If we were to measure that activity against the principles of co-production how far would it measure up?

We want to hear your ideas

One of the reasons that I ask this is because, looking around it is difficult to find many instances of co-produced evidence. In the discussion paper, the Scottish Approach to Evidence, we concluded that the Scottish policy context with a focus on partnership and people is ripe for the co-production of evidence, but the evidence base lags behind. This includes both examples of co-produced evidence and evidence for the impact of co-production on outcomes. Two different concepts, but ones that have sometimes been conflated, to the possible detriment of co-produced research. Last year, to encourage more co-produced evidence, at a Roundtable with Newcastle University’s Institute for Social Renewal, we called for more clarity on what is good quality co-produced evidence. Following this, The Trust is continuing to explore how to assess the rigor and value of co-produced evidence, and I’d be delighted to hear your ideas.

Co-producing the development of Later Life Groups in prison

Contributors: 

Ahmed, prisoner 

Jolie Goodman, Programmes Manager for Empowerment & Later Life, Mental Health Foundation.

Jamie Bennet Governor HMP Grendon and Spring Hill

Jolie: The Mental Health Foundation has a decade of expertise in peer support and self-management initiatives, including running self-management groups at Parc Prison Wales.  I have managed the Standing Together project, facilitating peer groups in the later life housing sector. 

I’m co-producing the development of later life groups with staff and prisoners at Grendon and Spring Hill Prisons. I want to use the blog to reflect on the process and through conversations with a prisoner, Ahmed and Jamie Bennett the Governor of both prisons. Grendon is a closed therapeutic prison and Spring Hill, is an open prison. 

Prisons are major providers of social care for men in the country. The later life groups will be a combination of self-management and peer approaches., using the expertise of prison staff and prisoners to co-produce this work, through meetings, focus groups and a loneliness survey. 

Ahmed: During my experience in my role as Diversity and Equalities orderly I have spoken to many prisoners over the age of 50 about the stresses of being in prison and the impact this would have later in their life when they are released back into the community.

Bringing people together and enabling them to know that they are not alone is a form of empowerment and connection that I have experienced through group-work in prison. The recent focus group that took place in HMP Springhill showed the need of such an initiative. Residents are eager to be involved and are looking forward to the next step in the introduction of the loneliness survey.

Jamie: Prisons are having to respond to the needs of a changing population, including the rapid growth in the number of older prisoners. As a result, prisons are considering how they adapt. For example, how does the physical environment have to alter? What activities should be provided? What help do people need for life after prison? Which organisations does the prison need to connect with?

Although working with professional experts is part of the answer to these questions, much of this can come from the men themselves. They have hopes and aspirations for the future. They have time and energy to invest. They have skills and talents to contribute. 

Developing the capacity for self-help and empowerment is a way of improving the quality of service we provide and enabling the men to use their individual and collective abilities to support each other. 

Jolie: The findings  of the co-produced loneliness surveys will support and shape the funding bids for the later life groups.

This is what co-production looks like

By Sharon Allen, Chief Executive, Skills for Care

As I was sitting at our national conference earlier this year, listening to Disability Rights UK Ambassador Sir Bert Massie, Tina Coldham, Chair of SCIE Co-production Committee and TLAP chair Clenton Farquharson, being very clear about what people who need care and support need to think about when recruiting staff, I thought; "this is what co-production looks like".

Their lively and utterly frank discussion was one of the highlights of our conference and in this Co-production Week, a reminder of why we must include the lived experiences of fellow citizens in everything we do.

It’s something I’ve been committed to throughout my career because it is obvious to me that if we don’t include the voices and experiences of people who actually use care and support services, we end up doing things that neither work nor are person centred.

One the key drivers in our sector is leadership and leaders like me have to model in our organisations, that co-production is not an optional extra.  I'm fortunate that colleagues in Skills for Care get this and we work together to make it happen.

A great example of co-production is our information hub for individual employers which came out of a sector roundtable event. A smart idea, driven from day one by individual employers who provided invaluable insight and experience when the specification for this hub was being developed. They continued to guide and advise the project all the way through and in 2016/17 there were more than 40,000 page views on the hub.

Our Employing Personal Assistants toolkit was another project co-produced with employers. We worked with members of People Hub (the Personal Health Budgets Network) to ensure this resource was equally relevant to holders of Personal Health Budgets. The toolkit has proved popular because it is fit for purpose with 6066 people accessing the toolkit and 16000 page views.

Underpinning this was the creation and implementation of a participation policy so people offering their expertise are appropriately supported and reimbursed as no one should be out of pocket when they support co-production.

Our recently published autism guides were co-produced with people with lived experience so they were able to shape guides that could actually have an impact. Some of that co-production group also made videos to increase the awareness and understanding of autism which can be viewed here.

More recently we had a representative from West of England Centre for Inclusive Living on our Adult Care Trailblazer group which has done some brilliant work in creating the new apprenticeship standards for our sector.

These examples are illustrations that we are making progress and I am also aware there is more we can and must do.

That’s why I’m making a pledge this week to continue to drive our co-production work forward. Not only is it the right thing to do, it makes sense if we want to create products and services that actually make a difference.

Co-production in Jersey

Paul Michel and Sophie Holmes are both physiotherapists from Jersey General Hospital, who work within a newly formed co-production group where service users and staff members have combined forces, to drive positive user-led changes. Here is their summary of how the process is going so far:

Why did we start co-production?

As physiotherapists we feel we know what our patients want and always have done. We are empathetic, good listeners and keen to implement change. On the other hand however, we value patient feedback, and so we were keen to embrace a new way of working in partnership. Although initially daunting, we wanted to see what feedback we would receive, and were excited about the direction that would take us, in terms of shaping our future service.

how did we start the process?

In November 2017, we invited service users to our first ever co-production workshop. The day was a great success, we received training from the Social Care Institute for Excellence (SCIE), completed a variety of team bonding exercises, and co-produced our core values (see picture).  Many improvement ideas were generated and we formed a steering group with service users, who were kind enough to give their time to help drive change.

Where are we now?

We’re in the infancy of our group, 6 months in, enjoying tackling some of the main issues head on. It’s really interesting listening to what our service users truly want compared to what we previously perceived they wanted! We were told that co-production is challenging at our training, and it is, but my word is it rewarding!

Our values ensure we don’t get upset by what we hear, we respect that we don’t know everything and that’s not a bad thing. It’s no longer a ‘them and us’ mentality, it’s us all working with equal power together. The great thing is that the work we are doing and recommendations we are making are being fully acknowledged and supported by the physiotherapy Senior Management Team. This breeds confidence that change can and will happen. And that is exciting!

Co-production to improve services

By Hilary Oakley, Academic Liaison Librarian, University of Sunderland 

The Social Care Institute for Excellence (SCIE) is hosting a free two-part webinar called Breaking Down the Barriers to Co-production from 1400-1500 on 5 July.

The webinars are running as part of Co-production Week and are interactive.  Co-production Week promotes not only the positive impact of social care services, its users and carers collaborating on service provision and development but also focuses on  sharing best practice. Co-production Week has been running for three years and this year again asks you to:

• tweet about co-production by using the hashtag #coproweek
• share stories about it with the SCIE
• take part in the week by writing for the SCIE Co-production Week blog
• SCIE’s Co-production Network and SCIE’s Head of Co-production, Pete Fleischmann will be delivering the webinars. These will look at a range of different settings as cases of co-production in  local authorities, voluntary organisations and health care. The discussion will examine common problems in collaborating and suggest ways to overcome barriers.

As a webinar participant you will be able to take part through the ‘chatbox’ feature which will give you opportunities to answer questions and vote during the session.

If you would like to book a place on the webinar go to the Eventbrite page Webinar: Breaking Down the Barriers to Co-production. The webinar is also repeated from 1500-1600 on Eventbrite on 5 July so you can also book for that.

Ahead of the webinar the SCIE has also produced a handy guide on co-production entitled Co-production in Social Care: What it is and How to do It which includes practice examples. The guide is free to download.

This blog originally appeared on the University of Sunderland Library Blog

Where's Your Head At? The Importance of Expressing Emotions at Every Age

By Jolie Goodman, Programmes Manager for Empowerment and Later Life, Mental Health Foundation

A longer version of this article can be found on the Elder.org website 

The Standing Together Project aims to improve the emotional health and community connections of older people living in supported housing. Over the Project’s two-and-a-half-year run, it has facilitated groups in 19 different housing schemes. 

The Project was set up in 2015 as a partnership between the Mental Health Foundation and Housing & Care 21, a UK housing organisation providing social housing and support to people in later life, including those living with dementia.

Since then, we have run weekly self-help groups for periods of six months, in retirement and extra care housing (where the people are actually tenants in their own flats, but then buy in different quantities of care as needed) for those experiencing memory loss, mental health issues, learning disabilities and significant loneliness. Notting Hill Housing became an additional partner in the second year of the project.

My background is in working in adult mental health, but I was attracted to the job of managing the Standing Together Project because I felt it was a real opportunity to build connections between people - and also to find out about people’s identity, life stories and passions.

Obviously, the later life housing sector has undergone a lot of change and has born the brunt of cuts in local authority funding for care services. Loneliness and isolation are increasing across the generations, but particularly in later life.

In later life, there are many reasons for isolation. The front door can be a huge barrier for people; people might not get out of their flats that easily, and sometimes it is because of their frailty, but often it’s a psychological barrier. Another key reason is if someone has been with a partner for 60 years and they have died - then the whole balance of their life is changed.

Someone who has lost a spouse has to adapt to living a very different life, and that can make them feel lonely, so it was very positive to be able to do something that really addressed that loneliness.

We have secured funding for a Welsh version of the project. This Autumn we will be launching a toolkit so that the housing sector can buy in our expertise in co-producing this type of  initiative, to address loneliness and improve wellbeing, in later life.