The title character Derek first appeared in Ricky Gervais's 2001 Edinburgh Fringe show Rubbernecker, years before the TV series was created.

Ricky Gervais said the show was inspired by his relatives who work in care homes, noting that half his family are care workers, including a sister who works with children with learning difficulties and a sister-in-law who works in an Alzheimer's care home.

The series is filmed in a mockumentary style and set mostly in a nursing home called Broad Hill.

Some commentators described Derek as disabled or autistic, though Ricky Gervais denied this characterization.

Karl Pilkington played Dougie, the home's caretaker, as a main character in Series 1 but only appeared as a guest in Series 2.

The first series held a 53% rating on Rotten Tomatoes based on 32 critics and a 64/100 on Metacritic, indicating generally favorable reviews.

The show generated controversy, with critics like Tanya Gold of The Guardian arguing that Gervais's claim of satirizing prejudice against disabled people felt more like "lazy cruelty than satire."

Entertainment Weekly's Kyle Anderson noted that the absence of Karl Pilkington in the second series hurt the show, saying the humor was "a bit less hearty" without him.