Co-Production With Families and Circles of Support in Learning Disability Care Planning
Co-production in learning disability services works best when it is structured, evidenced and centred on the person, not the loudest voice in the room. Within family, carer and circle of support involvement, providers need clear processes that align with learning disability service models and pathways, so planning meetings translate into consistent day-to-day practice and defensible decision-making.
This article sets out how providers do co-production well in practice: the routines, documentation and governance that turn “involvement” into measurable impact.
What co-production looks like in regulated learning disability services
In regulated care, co-production should be understood as a repeatable method, not a one-off event. Strong practice usually includes:
• Preparing the person and family separately before reviews
• Clarifying what decisions are being made and by whom
• Using accessible formats to capture the person’s views and preferences
• Turning agreed actions into accountable tasks with deadlines and owners
Without these basics, co-production can drift into informal negotiation, repeated dispute, or “meeting without change”.
Getting the person’s voice into the room
Providers often say “the person is central”, but evidence must show how this happens when communication needs are significant. Practical mechanisms include:
• A “what matters to me” profile that is refreshed after key events
• Observation-based insights from familiar staff (recorded and triangulated)
• Accessible meeting packs (photos, symbols, easy read summaries)
• Where appropriate, advocacy involvement and clear role boundaries
Operational example 1: co-producing a plan where communication is complex
Context: A woman with profound learning disability and limited verbal communication became distressed during personal care, and the family believed staff were “rushing”. Staff felt care was safe but recognised the person was increasingly anxious.
Support approach: The provider used a co-produced review approach that combined family insight with structured observation and a revised care plan.
Day-to-day delivery detail: The team introduced consistent language cues, a predictable sequence, and a two-person approach at key points. Family shared what worked at home, which was translated into “do/avoid” prompts for staff. A manager ran weekly spot checks during peak times to ensure pacing and dignity standards were met.
How effectiveness was evidenced: ABC-style notes and incident logs showed reduced distress indicators over four weeks. The family signed off the revised plan and the provider recorded the review outcomes in governance minutes and supervision notes.
Managing competing views without destabilising support
Families and circles of support do not always agree with each other or with professionals. Providers need a consistent method for handling difference, including:
• Clear chairing and time-limited agendas for reviews
• Written summaries that separate facts, views and decisions
• Escalation routes (e.g., senior review, clinical input, safeguarding advice)
• A documented rationale that ties decisions to risk, rights and outcomes
This protects the person from “stop-start” care and protects staff from inconsistent instruction.
Operational example 2: reconciling disagreement about independence and risk
Context: A circle of support was split: one family member wanted increased community access; another wanted restrictions due to past incidents. Staff were uncertain, and the person’s participation dropped.
Support approach: The provider used a structured risk enablement and review pathway, with co-production focused on “safe steps” rather than “all or nothing”.
Day-to-day delivery detail: Staff trialled a staged plan: short supported outings at quieter times, clear de-escalation steps, and defined thresholds for pausing and reviewing. The manager created a weekly “learning log” capturing what worked, what triggered stress, and what adjustments were made. The person’s preferences were captured using accessible prompts and observation after each activity.
How effectiveness was evidenced: The provider demonstrated improved attendance and reduced incidents over six weeks, with meeting minutes showing how differing family views were considered and how the final plan was agreed and reviewed.
Embedding co-produced actions into routine delivery
The most common failure point is that review decisions do not translate into daily routines. Strong providers build “execution controls”, such as:
• Action trackers owned by a named lead
• Handovers that reference “current priorities” and “non-negotiables”
• Supervision prompts aligned to co-produced outcomes
• Internal audits checking that plans are being followed and updated
Operational example 3: preventing “review drift” through governance and audit
Context: A provider found repeated examples of families reporting “nothing changes after reviews”. Records showed plans were updated, but practice lagged behind.
Support approach: The provider introduced a governance mechanism linking co-produced actions to audit and management oversight.
Day-to-day delivery detail: After each review, the service lead issued a one-page “practice update” for staff and checked understanding during shift handovers. Monthly audits sampled three co-produced actions per person and checked evidence in daily notes, rotas, and supervision records. Non-compliance triggered immediate coaching and follow-up spot checks.
How effectiveness was evidenced: Audit scores improved and complaints about “lack of follow-through” reduced. The provider could show a closed-loop system: review → action → delivery evidence → governance oversight.
Commissioner expectation
Commissioners expect co-production to be meaningful and evidenced: plans should reflect family input appropriately, but remain outcome-focused, stable and deliverable, with clear accountability for actions and review.
Regulator expectation (CQC)
CQC expects people to be involved in decisions about their care in a way that is accessible and person-centred, with providers able to evidence how feedback and involvement lead to improved quality and safety.
Conclusion
Co-production is not “more meetings”; it is a structured method for achieving better outcomes through shared understanding, clear decision-making and consistent delivery. When providers translate co-produced plans into daily routines and governance evidence, families gain confidence and the person’s support becomes more stable, safe and effective.