Hand Over the Keys:Co-Producing Your Care Home Through a Resident Panel

THOUGHT LEADERSHIP

Why the people who live in your home should have the final say on how it runs — and why that’s the best business decision you’ll ever make.

By Arlene Bunton  |  Mac Research and Consultancy Limited  |  April 2026

Here is a question that will tell you everything about the culture of a care home: who decided what’s for lunch today?

If the answer is the chef, the manager, or a catering contract signed eighteen months ago — you have a problem. Not because the food is necessarily bad. But because the people who eat it every single day had no say in the matter. And if they had no say in the menu, I can almost guarantee they had no say in the activity schedule, the staffing arrangements, the visiting times, the décor, or the hundred other decisions that shape what it feels like to live in that building.

This is not person-centred care. This is care that happens to people, not with them.

And here’s the thing: the solution is not complicated. It is not expensive. It does not require a policy overhaul or a new IT system. It requires one thing: the courage to hand over the keys.

What Is a Resident Panel?

A resident panel is a formal, recurring forum in which the people who live in your care home are given genuine decision-making authority over the things that affect their daily lives. Not a suggestions box. Not a quarterly satisfaction survey. Not a ten-minute chat during an inspection. A structured, empowered, supported group of residents who meet regularly, discuss real issues, make real decisions, and see those decisions implemented.

Think of it as a board of directors — except the directors are the people who actually live with the consequences.

The panel might meet fortnightly or monthly. It might have a rotating chair. It might include residents with dementia, supported to participate through adapted communication, pictorial aids, or advocacy. It might invite staff, family members, or external professionals to attend — but only as guests. The residents are the members. The residents have the final say.

What Does the Panel Decide?

Everything that a resident can meaningfully influence. Which, if you think about it honestly, is almost everything.

The Menu

What food is served, when, how, and in what choices. Not what the catering manual says is nutritionally balanced — what the people eating it actually want. If Mrs Henderson wants a bacon roll on a Saturday morning, that should not require a care plan review. If the panel decides they want a curry night once a week, an ice cream afternoon, or a barbecue in summer — it happens. Food is one of the last remaining sources of pleasure, autonomy, and cultural identity for people in residential care. Taking control of the menu is an act of dignity.

The Activity Schedule

What happens during the day. Not what the activity coordinator thinks residents should enjoy, but what residents actually want to do. The panel decides whether they want bingo or a book group, a film afternoon or a gardening session, a visiting musician or a trip to the coast. And crucially, they also decide what they don’t want. If nobody wants to do chair yoga at ten o’clock on a Tuesday, it stops. The activity schedule should be co-produced, not imposed.

Staffing and Deployment

This is where it gets radical — and powerful. The panel is asked: do you feel the staff have enough time for you? Are they rushed? Are they present? Do you see the same faces, or does every shift bring strangers? Are there enough staff at the times that matter most to you — mealtimes, evenings, weekends, the middle of the night?

Residents cannot set staffing budgets. But they can tell you, with extraordinary precision, whether your deployment is working. They know when corridors are empty. They know when call bells take too long. They know when agency staff arrive and don’t know their name. This is intelligence that no audit tool can capture. And if you are serious about the Health and Care (Staffing) (Scotland) Act 2019 — which requires staffing decisions to be based on the needs and wellbeing of the people receiving care — then the people receiving care must have a voice in how staff are deployed.

Skills on the Team

The panel can also tell you what skills are missing. Do the residents feel their emotional needs are met, or is every interaction task-focused? Is there anyone on the team who can really sit and talk? Does the night team feel safe? Do residents feel confident that staff know what to do in an emergency? These are questions that residents can answer with a clarity and honesty that staff, constrained by loyalty and hierarchy, often cannot.

The Environment

What the building looks like, feels like, smells like. Whether the communal areas are welcoming or clinical. Whether the garden is accessible. Whether the temperature is right. Whether the signage makes sense. Whether the décor reflects the people who live there, not the corporate brand of the provider.

Complaints, Concerns, and Ideas

The panel is the place where niggles become solutions before they become complaints. It is a standing invitation to raise anything — the food, the laundry, the noise, the heating, the attitude of a particular member of staff, the visiting policy, the Wi-Fi. By the time an issue reaches a formal complaint, it has usually been festering for weeks. A resident panel catches it at source.

Why This Changes Everything

Quality of Life

The MiCareHQ study, funded by NIHR and published in 2021, found a significant, positive association between care home quality ratings and residents’ social care-related quality of life. Critically, the impact of quality was greatest for residents with the highest needs — the very people most likely to be excluded from decision-making. Being rated ‘good’ or ‘outstanding’ for ‘caring’ and ‘well-led’ had the strongest association with quality of life outcomes. A resident panel is the living embodiment of both.

When residents choose their own meals, they eat more. When they choose their own activities, they engage more. When they feel heard on staffing, they feel safer. When they shape their own environment, they feel at home. These are not soft outcomes. They are the outcomes that determine whether someone’s last years are lived, or merely endured.

Grades from the Regulator

In Scotland, the Care Inspectorate’s Quality Framework for care homes assesses services against Key Questions. A resident panel directly evidences quality across every one of them:

•       KQ1 — How good is our care and support? The panel demonstrates that residents’ views shape their care experience, that personal outcomes are pursued, and that the service responds to what matters to the people who live there.

•       KQ2 — How good is our setting? The panel shows that the physical environment is shaped by resident input, not management assumption.

•       KQ3 — How good is our leadership? A resident panel is one of the strongest pieces of evidence a manager can present for participative, person-led leadership. It demonstrates that the service actively seeks, listens to, and acts on the voices of the people it supports.

•       KQ4 — How good is our staff team? Resident feedback on staffing, skill mix, and deployment provides direct evidence that the service is meeting its duties under the Health and Care (Staffing) (Scotland) Act 2019.

In England, the CQC’s Single Assessment Framework asks the same questions under different labels. The ‘Responsive’ domain explicitly asks whether care is person-centred and responsive to people’s needs. The ‘Well-Led’ domain asks whether there are effective governance structures that include the voices of people using the service. A resident panel answers both.

“When you can show an inspector a minute book of resident panel meetings — with real decisions, real actions, and real outcomes — you are not just meeting the standards. You are demonstrating a culture. And culture is what separates a Grade 5 from a Grade 3.”

Reputation

Families choosing a care home are not reading your policies. They are reading the atmosphere. They are watching how staff talk to residents. They are looking for evidence that their mother, their father, their partner will be treated as a person with preferences, opinions, and authority — not as a passive recipient of a service designed by someone else.

A care home with a resident panel can say to every prospective family: the people who live here run this place. They choose the food. They shape the activities. They tell us whether we have enough staff. And we listen. That is a proposition that no amount of marketing spend can replicate. It is authentic. It is provable. And it is irresistible.

Word of mouth is the most powerful marketing channel in social care. And nothing generates word of mouth like a resident who says: “They actually asked me what I wanted. And then they did it.”

How to Set Up a Resident Panel: A Practical Guide

1.     Name it and frame it. Give the panel a name that residents choose. Not “Service User Engagement Forum.” Something that belongs to them. Frame it from day one as a decision-making body, not a consultation exercise. The language matters: this is not ‘feedback.’ This is governance.

2.    Make it inclusive by design. Residents with dementia, communication difficulties, sensory impairment, or limited English must be supported to participate. Use pictorial menus, talking mats, objects of reference, advocates, or proxy representatives where needed. The HSCS Standard 2.3 states: ‘I am supported to understand information and make informed choices, even if this requires more time or support.’ The panel must reflect the whole community, not just the most articulate.

3.     Meet regularly and consistently. Monthly at minimum. Same time, same place. Agendas circulated in advance in accessible formats. Minutes taken and displayed. A staff member facilitates but does not chair. The chair is a resident.

4.    Give it real power. The panel must be able to make decisions that are implemented. If the panel decides the menu changes, the menu changes. If the panel says the lounge needs repainting, it gets repainted. If the panel reports that night staff are too few, the manager must respond with an action and a timescale. A panel that is listened to politely and then ignored is worse than no panel at all.

5.     Report back visibly. Display a ‘You Said, We Did’ board in a communal area. Show residents — and their families, and the inspector — that the panel’s decisions lead to tangible change. Close the loop every single time.

6.    Record it properly. Keep minutes. Record decisions, actions, responsible persons, and timescales. This is your evidence base for inspection, for quality assurance, and for demonstrating compliance with HSCS Standards 1.7, 2.3, 2.4, 2.11, and 4.8.

7.     Review the panel itself. Ask residents annually: is this working for you? Is the panel accessible? Are your decisions being honoured? Co-produce the improvement of the panel just as you co-produce everything else.

The Objections — and Why They Don’t Hold

“Residents with dementia can’t participate.” They can. With the right support, communication tools, and a presumption of capacity. A person who cannot articulate a sentence can still point to a picture of the meal they prefer. A person who cannot follow a meeting agenda can still tell you, through their behaviour and their body language, whether the activity programme is working for them. Excluding people with dementia from decision-making is not safeguarding. It is paternalism.

“We don’t have time.” A monthly panel meeting takes ninety minutes. The time saved on reactive complaints handling, staff disengagement, menu wastage, and poorly attended activities will dwarf that investment. More importantly: if you don’t have time to listen to the people you care for, what exactly are you spending your time doing?

“What if they make unreasonable demands?” In five years of supporting care services, I have never once seen a resident panel make an unreasonable demand. I have seen panels request a second cup of tea at supper, ask for the heating to be turned up, suggest a visit to the garden centre, and ask whether it would be possible to have fish and chips on a Friday. The fear that residents will demand gold-plated bathrooms is a projection of our own anxiety, not a reflection of their expectations. Most residents ask for remarkably little. The least we can do is listen.

“Staff will feel undermined.” The opposite is true. Staff in services with resident panels report feeling more connected to the people they care for, more confident in their decision-making, and more valued — because the residents they support are happier, more engaged, and more appreciative. A PMC-published systematic review of quality improvement in care homes found that when frontline staff are involved in decision-making alongside residents, they are empowered by their efforts and strive to continue best practices. Co-production lifts everyone.

A Final Thought

There is a phrase I use with every care home I work with: your residents are not passengers. They are the pilot.

A resident panel is not a nice-to-have. It is not a tick-box for inspection. It is the single most powerful thing you can do to transform the quality of life in your home, the grades you receive from your regulator, and the reputation you build in your community.

It costs almost nothing. It requires no regulatory approval. It can start next week.

The only question is: are you willing to hand over the keys?

Arlene Bunton is Director of Mac Research and Consultancy Limited and a doctoral researcher in dementia and ageing at the University of Stirling. She can be contacted at arlene@macresearchandconsultancy.co.uk.

References and Further Reading

Towers, A.M., Smith, N., Allan, S., et al. (2021). Care home residents’ quality of life and its association with CQC ratings and workforce issues: the MiCareHQ mixed-methods study. NIHR Health Services and Delivery Research, 9(19).

SCIE (2022). Co-production: What it is and how to do it. Social Care Institute for Excellence.

Research Involvement and Engagement (2022). Approaches to co-production of research in care homes: a scoping review.

PMC (2022). The factors that influence care home residents’ and families’ engagement with decision-making about their care and support: an integrative review.

PMC (2025). How Have Quality Improvement Strategies Been Adopted in Care Homes? A Systematic Review. International Journal of Older People Nursing.

NHS England (2024). How co-production is used to improve the quality of services and people’s experience of care: A literature review.

Rantz, M.J., et al. (2012). Challenges of Using Quality Improvement Methods in Nursing Homes. PMC.

Care Inspectorate (2022/2025). Quality Framework for Care Homes for Adults and Older People.

Scottish Government (2017). Health and Social Care Standards: My Support, My Life.

Health and Care (Staffing) (Scotland) Act 2019.

CQC (2023). Single Assessment Framework.

Arlene Bunton | Mac Research and Consultancy Limited

Expertise. Integrity. Impact.