3.3 Explain how co-production can support effective quality audits in adult social care

This guide will help you answer 3.3 Explain how co-production can support effective quality audits in adult social care.

Co-production is an approach where individuals who use services, care workers, and organisational leaders work together to design, assess, and improve services. In the context of quality audits in adult social care, co-production ensures that audits are meaningful, person-centred, and grounded in the real experiences of those who give and receive care. By involving everyone affected by a service, co-production can transform quality audits into powerful tools for improving care delivery.

What is Co-Production?

Co-production goes beyond traditional consultation. Instead of simply gathering feedback, it actively involves service users, care staff, and other stakeholders as equal partners in decision-making. The principle is that everyone has expertise to contribute:

• Service users bring their lived experiences.
• Care workers share their knowledge of practical care delivery.
• Managers and leaders contribute strategic insights.

This inclusive approach shifts the focus from “doing things for” service users to “doing things with” them.

What is a Quality Audit?

A quality audit is a process of systematically reviewing the care provided within a service. The aim is to ensure it meets established standards, complies with regulations, and delivers the desired outcomes for those receiving care. Audits involve:

• Measuring care delivery against criteria or benchmarks (like Care Quality Commission standards).
• Identifying areas for improvement.
• Highlighting good practices.

Quality audits may cover areas such as safeguarding, medication management, infection control, or the quality of person-centred care.

How Co-Production Supports Quality Audits

Co-production and quality audits complement each other. Integrating co-production into the audit process ensures that the people most directly impacted by care delivery have a say in shaping and assessing its quality. Here’s how it works at different stages of a quality audit:

Setting Objectives for the Audit

When determining the focus and goals of the audit, co-production ensures these objectives address what’s important to care users and care workers, not just senior management or regulators. For example, service users might raise issues about delays in personal care, while care workers might highlight concerns about outdated equipment. Both perspectives help shape audit priorities.

This makes audits more relevant because they address real challenges rather than relying solely on generic benchmarks.

Developing Audit Tools

Co-production can involve service users and care workers in creating the questionnaires, checklists, or data collection tools used during the audit. Their input ensures these tools are flexible and able to capture a realistic picture of what happens day-to-day in the service.

For example, service users could suggest including questions about how supported they feel in making decisions about their care. Care workers might recommend including checks on whether communication between teams is effective. Without co-production, these critical areas could be overlooked.

Gathering Evidence

During an audit, co-production might involve care workers and service users actively participating in the evidence-gathering process. Methods could include:

• Service user involvement: Service users could provide feedback through interviews, surveys, or even through one-on-one sessions as co-auditors.
• Staff involvement: Staff might help collect data or share perspectives on how policies and procedures impact their day-to-day work.

This makes the evidence collected richer and more comprehensive, as it includes viewpoints from everyone affected.

For instance, service users participating in a safeguarding audit might highlight gaps in how concerns are reported or addressed. These insights provide context that a management-led audit might miss.

Analysing Findings

The analysis phase benefits significantly from co-production. Service users and staff can help interpret the data and provide real-world insights into what it means. For example:

• Service users might highlight how certain practices have improved their independence or wellbeing.
• Staff might explain why certain targets are hard to meet, such as understaffing or vague guidelines.

Their contributions ensure the findings are not just quantitative (e.g., numbers on a chart) but meaningful in practical terms.

Creating and Implementing Action Plans

Once gaps or areas for improvement are identified, co-production ensures that action plans address the needs of all stakeholders. Service users can suggest solutions that work for them, while staff can offer practical guidance on how these changes can realistically be achieved.

For example:

• If audits reveal that mealtimes are rushed, service users might suggest more flexible dining hours.
• Care staff might point out that schedule adjustments would involve reassigning tasks – something that management would then need to address as part of the plan.

This collaborative approach boosts the chances of sustainable improvements.

Monitoring and Reviewing Progress

Co-production doesn’t stop after the action plan is implemented. It continues into the review process. Regular involvement from service users and staff ensures that changes are being sustained and areas still needing progress are identified.

For instance, care workers or service users might sit on a review panel to discuss progress made after an infection control audit. They could provide feedback on whether new hygiene protocols are effective or suggest further refinements.

Benefits of Co-Production in Quality Audits

Using co-production in quality audits provides numerous benefits for adult social care services. These include:

• Person-Centred Assessments: Because service users are directly involved, audits focus on what matters most to them. This ensures care standards align closely with their needs and preferences.
• Improved Trust and Transparency: Involving service users and staff helps build trust. People feel valued and heard. For service users, this can promote confidence in care quality. For staff, it fosters a sense of ownership and pride.
• Better Solutions: Service users and care workers offer practical insights that lead to more effective and realistic improvement plans. Proposed solutions are more likely to address root issues and be sustainable over time.
• Compliance with Standards: Regulators like the Care Quality Commission (CQC) encourage services to involve people in shaping their care. Co-production demonstrates the service is meeting these expectations.
• Enhanced Relationships: Co-production encourages collaboration between staff, management, and service users. This teamwork lays the foundation for a positive and inclusive culture.

Challenges and Overcoming Them

While co-production offers many benefits, it can also present some challenges. These might include:

• Power Imbalances: Some users or staff may feel their voices won’t be valued. Clear communication and equal partnership in decisions can help address this.
• Time and Resources: Co-production can take longer than traditional audits. Planning and dedicating specific resources to involvement can support the process without overburdening staff.
• Reluctance or Resistance: Staff or service users may be hesitant to get involved initially. Encouraging open dialogue and providing support for participation can help.

Final Thoughts

Incorporating co-production into quality audits in adult social care makes them more meaningful, inclusive, and effective. It ensures that all voices – whether from care users, staff, or management – are heard and valued. By fostering collaboration at every stage of the audit process, co-production strengthens the ability of services to identify issues, develop practical solutions, and achieve sustained improvements. Ultimately, this approach enhances the quality of care delivered and the satisfaction of everyone involved.