Service users join watchdog’s inspection team as ‘experts by experience’

People with experience of learning disability or age-related support are contributing to Care Quality Commission inspections

Laura Broughton has worked in social care for just two years, but she is already in demand as a public speaker. After our meeting in London, to discuss how she inspects residential care services, she will fly to Scotland to speak at a conference. She walks into the room confidently, coffee in one hand, suitcase in the other.

Broughton, 36, who has learning disabilities, has been an “expert by experience” with Choice Support, the social care charity that supports her, since 2010. Choice Support manages the experts programme on behalf of watchdog the Care Quality Commission (CQC). The programme involves people with experience of learning disability, age-related or mental health support contributing to inspections.

While the aim is to offer a comprehensive view of standards, thanks to the inclusion of first hand experience, there is a knock-on benefit to the experts. Broughton has paid work (experts earn £17 an hour), new skills, and makes a valued contribution to social care.

“I was quite different before doing this,” explains Broughton. “I’d never had job before, certainly not in offices, I was more shy. Now I’ve done the experts work, Choice Support is getting me involved in slightly different things as well. I’m training [Choice Support staff and CQC inspectors] and have done presentations and workshops. It’s exciting … I’m travelling quite a lot and getting to know the country.”

Sarah Maguire, Choice Support director of quality, adds: “We found early on that people with disabilities were more likely to share their stories and concerns with other people who they felt understood their experience. For example, people talk about their hopes and dreams whereas they might assume people without that shared experience would think it silly.”

There are 300 experts (150 via Choice Support, the rest from other charities) with experience as users or as carers. They accompany CQC inspectors to hospitals, primary care trusts, councils, care homes and home-care agencies, observing and asking questions inspectors might not consider. In 2010, experts took part in 543 inspections of registered social care services, and 34 inspections of council-run social care.

Experts undergo recruitment and training with a criminal record bureau check and they agree to a code of conduct and confidentiality. Broughton was among the experts involved in the CQC’s themed review of 150 learning disability services after Winterboure View that revealed that almost half the services failed to meet standards – many failings were because care was not tailored to individual needs.

At one service Broughton spotted the stairs only had handrails on one side. The weakness in her right side means she needed rails on both sides – something the inspectors might have missed. She adds: “One of the things that comes up a lot on inspections is that staff are doing things for individuals rather than them being able to doing things they can do themselves.”

Another example of something she put into one report – experts write up their visits on the computer, with support if necessary – was that people had drinks only at meal times. “There are no drinks for them considering heating is higher than usual,” she recalls. “But then the person using the service doesn’t necessarily know they need a drink.”

Laura Minett, who has a learning disability and is also supported by Choice Support, has been an expert for two years. She began as a “quality checker” with the charity five years ago. The 39-year-old adds: “We went to this place and the menu board was in writing, not picture format, and none of the service users could actually read that.” She adds: “Service users find it easy to talk to us because we’ve got some of the same problems they’ve got. With an inspector, they feel they can’t talk to them, they can’t open up.”

As Maguire says: “Providers can get focused on long, complicated quality processes, key performance indicators and so on, but we should look at straightforward questions that measure if things are going well for someone … a lot of the things asked for by people our experts meet are simple, something as basic as someone turning up on time to go swimming with them or having a greater choice of options at breakfast.”

One challenge, says Kim Arnold, Choice Support’s national lead on the experts programme, is experts can sometimes find the work difficult “if it brings back quite negative memories about their past experiences with services, which they feel they’ve worked through”. Should this happen, she says, the charity supports people through their emotions.

As for the positive impact, Minett says: “I like getting out and about meeting people and thinking ‘maybe that’s good maybe that’s bad’. I like having a job and talking to the service users – it’s about their quality of life.”

She says that her family “see me as not just Laura but Laura with a job” and the work has made her think about what else she might do: “Like go out, learn computers, and it’s made me think about things in society because I’d not done anything like this before … It’s also opened my eyes to Winterbourne View. It’s opened my eyes up to a lot of things.”