Service users and carers: enabling, facilitating and supporting care

Find out more about preparing and enabling service users, their carers, friends and family to support the ongoing management of their speech and language needs

You may also wish to view our information on delegation 

Last updated: February 2026

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RCSLT Guidance Info
The RCSLT develops guidance to promote good clinical and professional practice in line with HCPC standards. Please read our statement on guidance to understand how it is developed and how to use it.
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Introduction

 

SLTs play a vital role in equipping service users, families and carers with the knowledge and skills needed to promote independence and self-management. We use the term ‘enabling’ to mean a service user, their families or carers feeling equipped and empowered to participate in their care. Through such collaborative working and shared decision-making, SLTs foster autonomy and empower individuals to actively participate in their own care. By using delegation and providing appropriate support, SLTs can ensure long-term benefits for individuals and their support networks which extends beyond direct therapy sessions.

This document is designed to guide SLTs in this process, offering principles and practical considerations to help them facilitate service users and their carers to participate in their own care. By embedding these approaches into daily practice, SLTs can strengthen the capacity of those around the individual, ensuring that communication support is sustainable, person-centred and aligned with professional standards.

Our guidance on delegation provides more details.

This guidance outlines:

  • the principles of enabling in speech and language therapy practice
  • the benefits of delegation and support for service users and carers
  • professional accountability and HCPC standards
  • resources for further learning and best practice

What is enabling?

 

Enabling service users, families and carers is a core responsibility of SLTs. At its heart, enabling is about working alongside people to equip them with the tools, strategies and confidence they need to live healthier, more connected and more fulfilling lives. By embracing shared decision-making, respecting individual autonomy, and delegating effectively in line with professional standards, SLTs foster collaborative, person-centred care. This approach creates sustainable, empowering support systems that not only enhance long-term outcomes but also uphold the values of ethical and inclusive practice.

A commitment to shared decision-making with service users and their carers is central to enabling. This includes actively involving individuals in their care, valuing their insights and preferences, and supporting their right to make informed choices about treatment and goals. Promoting autonomy fosters trust, strengthens engagement and ensures that interventions are meaningful and relevant to each person’s unique circumstances.

Enabling within speech and language therapy is not simply about skill-building. It is about enhancing health, wellbeing and social participation. By working collaboratively, SLTs empower service users to take ownership of their communication and health needs, strengthening their ability to participate in education, employment, relationships and community life.

In practical terms, enabling means working with and equipping service users, families and carers with the knowledge, skills and strategies to:

  • continue therapy techniques outside of clinical sessions
  • support communication and eating and drinking needs in everyday life
  • create environments that promote long-term progress and inclusion
  • engage meaningfully in assessment, goal setting and review
  • understand their diagnosis or needs, leading to more informed and collaborative care
  • develop self-support and self-monitoring skills to confidently identify when additional help is needed and to self-advocate for this to strengthen autonomy and contribute to person centred care
  • work towards personal goals via facilitation to enhance their wellbeing and enrich their lives in ways that are meaningful to them.

Examples of enabling in speech and language therapy practice

 

  • Training family members to use communication aids (e.g. signing, graphic symbols, voice output devices).
  • Supporting service users to use Augmentative and Alternative Communication (AAC) to self-advocate or engage in decisions around their support
  • Providing opportunities for service users to advocate for themselves around their goals.
  • Supporting carers in reinforcing speech and language strategies at home.
  • Encouraging schools to adopt communication-friendly approaches for children with speech, language and communication needs (SLCN).
  • Collaborating with families to enable them to complete person centred activities and interventions.
  • Partnership working between SLT services and charity groups, community groups, tertiary services and voluntary organisations e.g. Parkinson’s UK, Stroke Association etc.

Benefits of enabling service users and carers

 

Enabling service users and carers:

  • empowers individuals to manage their own communication and health needs
  • enhances therapy outcomes by embedding techniques in everyday routines
  • reduces reliance on SLTs by enabling families and carers to provide effective support
  • encourages person-centred care and shared decision-making, making interventions more meaningful and sustainable
  • supports the development of self-advocacy and self-management skills to enable choice making and service user wellbeing
  • promotes interdisciplinary collaboration and respects service user autonomy.

Professional accountability

 

Professional responsibility

SLTs must uphold high professional standards when providing guidance to service users, carers and families. The focus should always remain on what will best enhance the service user’s health, wellbeing and participation in daily life. To achieve this, SLTs should:

  • clearly define roles and responsibilities so that everyone involved understands how their contribution supports the service user’s goals
  • provide supervision, coaching and training that builds confidence and competence in those supporting the service user and in the service user themselves
  • ensure that enabled tasks are meaningful, safe and appropriate to the service user’s needs and context
  • raise and address concerns where enabled tasks do not support, or may compromise, the service user’s outcomes and safety

 

Ensuring Safe and Ethical Practice

SLTs remain responsible for ensuring that any enabled tasks are safe, effective and person-centred. This includes:

  • considering the abilities, confidence and context of carers, families and staff when agreeing tasks, and ensuring they are supported with the right training and resources
  • maintaining clear and accurate records of support, strategies or tasks given, linking them directly to the service user’s goals and the outcomes being monitored
  • reviewing and adapting enabled tasks regularly with the service user and their support network to ensure they remain effective, relevant and empowering.

Accountability in dysphagia management

Dysphagia (eating, drinking and swallowing) is a key area of accountability for SLTs who are enabling service users and carers. More information and guidance around enabling service users and their carers and families regarding this can be found here:

 

HCPC guidance on enabling service users and families

Effective enabling of service users is essential for safe and ethical practice. SLTs must follow the professional standards set by the Health and Care Professions Council (HCPC) when assigning tasks to others.

Several HCPC standards cover the standard of delivery and care when enabling service users and their families. SLTs should refer directly to these standards to guide this practice.

Resources and further guidance

Professional development

 

SLTs should engage in continuing professional development (CPD) to enhance their skills in enabling service users. Useful resources include:

National policies and best practice

 

Reflection question for SLTs

 

What steps could you take to enhance the ways that you already enable service users and carers in your work?

Contributors

 

Lead Author

  • Paula Walker, Highly Specialist speech and language therapist

Supporting Authors

  • Jo Bradburn, Deputy Director of Allied Health Professions and speech and language therapist
  • Natacha Capener, lecturer and speech and language therapist
  • Nicola Holmes, Chair of ASLTIP
  • Wing yee Lam, Practice Development Speech and Language Therapist
  • Maria Luscombe FRSCLT Fellow
  • James Martin, Highly Specialist Speech and Language Therapist (Head & Neck)
  • Katie Masters, Specialist Speech and Language Therapist
  • Claire Matheson, Service Lead Adult Learning Disability
  • Rosalind Gray Rogers, Programme Director for Speech and Language Therapy
  • Jo Taylor, Speech and Language Therapist