Rationales for Service User Participation in Social Care: A Regulatory Perspective

Over the past two decades, service users have increasingly participated in social care regulation. Regulatory bodies are integrating participation into their strategies and practices, marking a notable shift in the landscape of social care governance toward more inclusive and responsive forms of governance. To date, empirical research has focused on the participatory methods themselves rather than on regulators’ motivations for using them. This study aims to provide a comprehensive understanding of the regulatory perspective on service user participation in social care by exploring the reasons underlying this approach. It asks two questions: what rationales drive social care regulators to promote service user participation? what methods or operative actions do regulators use to implement these rationales? To address these questions, the study employed a qualitative multiple-case study approach, examining service user participation across three regulatory bodies: the Care Quality Commission (CQC) in England, the Aged Care Quality and Safety Commission (ACQSC) in Australia, and the Health and Social Care Inspectorate (IVO) in Sweden. Data collection employed a multifaceted approach, including the gathering of policy documents and relevant legislation on service user participation, along with semi-structured interviews with policymakers. The findings revealed three distinct rationales for promoting service user participation: gaining public trust and legitimacy, improving regulatory processes, and empowering service users. Each rationale is underpinned by different assumptions regarding the role of users in the regulatory process and the regulator's responsibility to foster this involvement. These distinct assumptions correspond to varying participatory approaches—democratic or consumerist, collective or individual