Abstract
The extension of user involvement in different aspects of service delivery in health and social care has been a central element of care in the community policy. Purchasers and providers of such services for older people have been exploring ways of tailoring services to meet individual need and ensure that the quality of the service reflects user preference rather than service-provider requirements. This article describes a project involving residents from a random proportionate sample of nursing homes and residential homes for older people in the City of Manchester. The project was designed to bring user views about quality into the service contract specification for the purchase of residential and nursing home care. The process and the outcomes are described. Factors which appear to promote the movement of user involvement into the mainstream of service specification and service development are identified. The role of small-scale initiatives is discussed.
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