Using Service User Feedback to Reduce Risk, Restrictive Practices and Safeguarding Concerns
Service user feedback is one of the most reliable early warning systems in adult social care, particularly where risk, safeguarding, or restrictive practices are emerging. However, many providers fail to connect feedback to risk management in a structured way. This article sets out how to use service user feedback and co-production to reduce harm, improve rights-based practice, and evidence safer care within quality standards and assurance frameworks that commissioners and regulators recognise.
Why feedback matters in risk and safeguarding
Incidents and safeguarding alerts are rarely sudden. They are usually preceded by subtle indicators: people feeling unheard, routines becoming rigid, staffing changes causing anxiety, or support being delivered for organisational convenience rather than individual need. Service user feedback captures these signals before harm occurs.
When feedback is treated as “soft intelligence” rather than risk data, opportunities for early intervention are lost. Effective providers deliberately align feedback systems with safeguarding, restrictive practice oversight, and positive risk-taking frameworks.
Structuring feedback as a risk indicator
Feedback systems should explicitly tag and triage risk-related themes, including:
- Loss of choice or control (activities cancelled, routines imposed).
- Distress linked to staffing patterns or unfamiliar staff.
- Environmental concerns (locked doors, restricted access, lack of privacy).
- Communication breakdowns with staff or managers.
- Repeated refusals, avoidance, or withdrawal.
These themes should trigger structured review, not informal reassurance. Providers should record when feedback is considered a potential risk signal and how it was assessed.
Operational example 1: Feedback preventing escalation to safeguarding
Context: A person in supported living repeatedly said they felt “watched” and “not trusted”. This was raised through keyworker sessions and echoed by a family member. No incidents had occurred, but staff had increased observation following earlier anxiety episodes.
Support approach: The manager treated the feedback as a potential rights and safeguarding concern rather than a behavioural issue. A co-production meeting was arranged with the person, family, and senior staff to explore what felt restrictive.
Day-to-day delivery detail: Observation practices were reviewed line-by-line with the person. Staff agreed specific times and reasons for checks, reduced unnecessary presence, and introduced clear explanations before entering the person’s space. The person helped redesign their daily routine, identifying where privacy mattered most. Staff received a briefing on dignity-focused observation.
How effectiveness was evidenced: The service recorded reduced anxiety-related incidents, improved engagement, and no further expressions of distress about surveillance. The feedback log showed how early voice prevented escalation into formal safeguarding concerns.
Operational example 2: Reducing restrictive practices through co-production
Context: Several people reported that cupboards containing personal items were routinely locked “for safety”. Feedback suggested people felt infantilised and frustrated.
Support approach: The service treated this as a restrictive practice issue. A co-production workshop was held to identify what risks staff were trying to manage and how these could be reduced without blanket restrictions.
Day-to-day delivery detail: Individual risk assessments were rewritten with people, focusing on capacity, choice, and proportionality. Alternative controls were introduced, such as staff coaching, agreed limits, and visual prompts. Locking was removed where risk could be managed differently. Managers introduced a requirement that any restriction must be justified, time-limited, and reviewed monthly.
How effectiveness was evidenced: The restrictive practice register showed a reduction in locked environments, improved satisfaction scores, and no increase in incidents. Feedback and audit records demonstrated proportionate, rights-based change.
Operational example 3: Feedback improving crisis prevention
Context: People reported that early signs of distress were often missed, leading to escalation and emergency responses.
Support approach: Co-production sessions focused on identifying personal early warning signs and preferred staff responses.
Day-to-day delivery detail: Support plans were updated with individual “distress indicators” and agreed responses. Staff handovers included a mandatory check-in against these indicators. A simple daily wellbeing scale was introduced for people who found verbal feedback difficult.
How effectiveness was evidenced: Crisis incidents reduced, and people reported feeling “noticed earlier”. Managers could evidence how feedback directly influenced risk management and prevention.
Commissioner expectation: proactive risk management
Commissioner expectation: Commissioners expect providers to demonstrate that risk is identified early and managed proportionately. They will look for:
- Evidence that feedback informs risk assessment and review.
- Clear links between feedback, safeguarding decisions, and outcomes.
- Reduction in avoidable incidents and restrictive practices.
Providers should be able to show how feedback prevented harm, not just how incidents were responded to.
Regulator expectation: safe, rights-based care
Regulator / inspector expectation (CQC): Inspectors test whether people feel safe, respected, and listened to. They expect to see:
- Feedback influencing restrictive practice decisions.
- Safeguarding concerns identified through listening, not just incidents.
- Clear records showing proportionate, reviewed risk management.
Services that can evidence early intervention through feedback are more likely to demonstrate effective, well-led practice.