Short Abstract

A presentation on how Choice Care and Akerlof collaborated on an evaluation of the impact of care on residents, families and staff, and in doing so made the case for a move towards outcomes-led care commissioning.

Description

Adult social care in the UK contributes over £55 billion in gross value added and supports 1.8 million jobs, yet it is still widely viewed as a drain on public finances rather than a driver of social and economic wellbeing. This perception limits opportunities to improve the quality of care, in particular for people with complex mental health needs and learning disabilities, where the absence of meaningful data on wellbeing and outcomes has constrained how commissioners and regulators define “good care.”

This presentation explores how Choice Care and Akerlof partnered to challenge this issue through evaluation. Working together for the past two years, we have developed The Real Value of Care (2025), a Social Return on Investment (SROI) study that evidences £2.48 of social value for every £1 invested. More importantly, it provides a framework for how lived experience can shape care and commissioning practices by bringing into consideration the voices of those who we have historically failed to engage.

In our first year working together, we engaged 61 people – colleagues, family, residents and a therapist. This enabled us to understand the impact of care from multiple perspectives. Recognising that some residents could not engage directly, we used proxy voices to triangulate feedback. Moving into our second year of working together, we have developed inclusive communication tools to capture more of the authentic experiences of residents experiencing care. This has enabled us to work with a wider range of people. Over the next three years, we will continue developing tools to ensure more voices are heard. Working with vulnerable people requires care: the questions, methods, and environment must help residents feel safe contributing now and in the future.

Methodologically, the study combined qualitative interviews and surveys with monetised wellbeing outcomes using the Social Value Engine, Measure Up, and Green Book–aligned SROI modelling. Across three homes, we identified consistent outcomes valued most by colleagues and residents—feeling safe, living fulfilled lives, and being supported—and translated these into measurable social value. The additional wellbeing impact equated to £175 million across the organisation, or £84,000 per resident and £46,000 per colleague. Importantly, the process itself strengthened trust and inclusion, showing evaluation can be an intervention as well as a measurement tool.

The impact has been both organisational and systemic. Within Choice Care, findings have informed workforce development, management approaches, wellbeing initiatives, and annual impact reporting. Externally, the evidence has strengthened dialogue with commissioners and regulators, shifting conversations from compliance and cost to value and outcomes. Some local authorities are already beginning to adopt outcome-based commissioning and quality frameworks.

For evaluators, this work offers a replicable approach to influencing programme and policy change by connecting lived experience and wellbeing evaluation to social value and economic argument. As the partnership develops, Choice Care and Akerlof continue refining inclusive, repeatable frameworks linking experience to outcomes. We invite UK Evaluation Society Conference attendees to reflect on how bringing marginalised voices to the fore can lead to meaningful policy and practice change.