3715 A qualitative evaluation exploring co-production in care homes

Abstract Introduction Co-production approaches are increasingly used in research. However, they are not often evaluated in care home settings. The study aimed to explore how co-production occurred in a series of workshops around falls management in care homes. Methods Sixteen stakeholders (care home residents and relatives, care home staff, health and social care professionals) participating in co-production workshops in a systematic action research study were invited to take part in a qualitative evaluation. The workshops were developing a model for delivering falls training in care homes across Nottinghamshire. Non-participant observations of workshops explored stakeholder interactions. Nine stakeholders participated in reflection meetings to share their experiences of the process. Framework analysis mapped key themes to the National Institute for Health and Care Research’s (NIHR) co-production principles. Results Nine themes were identified. Sharing power was influenced by opportunities to challenge dominant voices, resulting from the influence of the research team and separate stakeholder groups, and wider integration challenges across the health and social care system. Inclusion of all perspectives was affected by variable involvement of key stakeholders in the workshops and supported by a flexible approach. Respecting and valuing knowledge was influenced by self-confidence and supported by appreciating diverse stakeholder expertise and experiences. All stakeholders reported benefits of participating in co-production workshops, for example helping others and learning about falls management. However, reputational concerns and fatigue were potential harms of participation. Team dynamics changed as relationships developed. Conclusions Co-production was largely a positive experience for stakeholders and the NIHR’s key principles were partially achieved based on our qualitative findings. Co-production in care home settings is a complex process affected by multiple factors, including the individuals involved, stakeholder relationships, organisational priorities, and integration across the system. Future research should consider organisational power dynamics at all stages and create safe spaces for inclusive participation.