Now is the time to embrace technology to enhance the quality and efficiency of social care delivery. The UK Government has stressed for years, the opportunities that digital and technological solutions offer public services. The 2018 Industrial Strategy ‘Innovation in age-related products and services can make a significant difference to UK productivity and individuals wellbeing’ outlined the benefits technology can bring to our over-stretched social care services. Today, as our health and care system is being tested beyond anything most people could have imagined, we need to fast track technology into care homes and our social care services.
Local authorities in South London often come to us at the Health Innovation Network for guidance on using digital solutions to help their social care teams and keep their residents safely in their own homes. To meet this need we ran an Innovation Exchange event that showcased both local projects that are revolutionising health and social care, and introduced 10 digital innovations that address the pressures on adult social care such as telehealth, assistive technology and falls prevention.
The event, delivered in partnership with DigitalHealth.London Accelerator, provided a space to showcase and debate how to use digital platforms that transform social care for older people. We explored the journey to using digital solutions and shared experiences about how it requires careful planning, co-design and involving the right people.
A key lesson emphasised was that the design and co-production of any digital solutions requires planning and asking the right questions. The event kicked off with Chloe Harvey, the External Opportunities Lead from Southwark Council presenting their lessons learnt from the discovery stage of the older people’s falls prevention project delivered with Guy’s and St Thomas’ NHS Foundation Trust and Lambeth Council.
The project defined the problem first: the higher number of falls amongst the over 65s which account for half of all accident related hospital admissions. Their discovery stage sought to ask how they could provide information and support to reduce the risk of falls for people over 65 who live in their own homes. Asking key questions to residents and staff they mapped current support, then a shortlist of technological solutions was drawn up by stakeholders using a robust scoring system for co-production.
The chosen solution was Safe Steps, a secure falls risk assessment app. Safe Steps generates personalised actions plans and tracking interventions, and collates data on fall incidents. Safe Steps is used within 173 health and care organisations resulting in 28 percent reduction in falls. In Southwark they are currently co-designing a community app due to be launched in August 2020. This new bespoke app will be designed for extra care providers and telecare monitoring teams. One of the new functionalities of this community app will be to provide automated referrals and a friends and family companion app. Chloe stressed the importance of research and co-design, and the value of engaging with the right users to safeguard against a lack of adoption by residents and care professionals.
Pushing the barriers
Hampshire County Council has a £1 million-a-day spend on Adult Social Care. They had challenges of recruiting to care roles so decided they needed to try different ways of delivering care. Their Head of Strategic Commissioning, Mark Allen talked through their process for trialling the use of Amazon’s Echo in resident’s homes to support people to live independently.
Through their Argenti Partnership and a wider telecare programme, the Council trialled the use of voice-activated consumer connected devices to deliver two care-orientated needs: ‘where’s my carer?’ and medication reminders.
The pilot selected 50 eligible services users who were supplied with Amazon Echos alongside other internet of things (IoT) such as controlling smart lights and household appliances around the home. Information governance and personal data access were not issues as the account was private between Amazon and the resident. The project worked closely with all 50 residents to design the functionality and tasks including:
- Reminders for medication and calendar appointments
- Activating smart lights, fans and other peripherals for those with severe mobility issues
- Adjusting the thermostat for the bedbound to control their environment.
72 percent of the people taking part in the trial agreed Echo had helped to improve their lives, 68 percent agreed it had helped to maintain their independence and more than two-thirds were able to regain some degree of independence for the first time in years. The real benefits came from the impact on the residents; one reported that the smart control of his washing machine meant that he wasn’t kept awake all night with the beeping of the machine as he could use Alexa to turn it off.
Although the direct savings in costs of care were lower, the benefits to the wider system were evident: keeping residents in their own homes, improving medicine optimisation and reducing social isolation.
Maximising tele-health in Bexley Care Homes
As part of the Bexley Digital Citizen Vision, Laura Williams the Head of Integrated Commissioning for Older People talked about their remote monitoring solution that has been piloted in care homes. Following their successful application to become an NHS Digital Social Care Pathfinder they piloted in a 120-bed care home using Docobo. Adrian Flowerday, Managing Director of Docobo outlined how their Doc@Home solution allows observations and vital signs from residents to be collected by care home staff and then communicated to GPs. This forms part of a track and trigger model for identifying and escalating medical deterioration. The duty GP reviews the resident report and advises the care home of any action required.
The results from the pilot have shown that the care home staff now spend less time on the phone to NHS111 and the GP surgery. There was a 60 percent reduction in unnecessary GP visits to the care home, with 98 fewer A&E attendances over a 7-month period. The next step for the project is to focus on using Docobo in the community, which could currently support the COVID-19 response.
Spotlight on digital solutions
Working with the DigitalHealth.London Accelerator programme, we identified 10 companies that offer digital solutions to the major challenges facing social care. We held an open and rigorous application process for digital health innovators with products and services that can support our social care sector. The successful 10 companies had the opportunity to pitch their innovations to adult social care commissioners, providers and other stakeholders at the event.
The companies that pitched were:
- CareRooms Ltd
- CC2i Digital Care & Support Assessment
- RETHINK Partners – Digital Boomers
- IEG4 – Digital Continuing Healthcare
- miiCARE – miiCUBE
- Maldaba and My Health Guide App
To demonstrate the real-world application of the innovations, we created some fictional scenarios in which they could benefit adult social care and their residents:
Doris has been discharged from hospital after a fall, her District Nurse needs to communicate quickly with her social worker. Between them they use the Hospify app to securely send messages to identify and action Doris’ care needs, helping her to stay safely at home.
Digital Boomers give Doris a tech assessment, to help her choose technology that will suit her lifestyle and care needs, together they selected MiCube. They help install and train Doris on using MiCube and she likes it as it reminds her to take her medication.
Doris has been diagnosed with dementia, her daughter can use Birdie’s Care Companion to provide information, guidance and live online advice from a Care Coach. This helps Doris’ daughter manage and understand her mother’s dementia.
Doris and her daughter watch the educational films about dementia from PocketMedic which give her ideas on how to help self-manage better and adapt her home accordingly.
Giovanni has been discharged from hospital but his first-floor flat now needs to be adapted to meet his changed physical needs. His discharge co-ordinator uses CareRooms to find him a spare room from an approved homeowner who lives nearby. The room has health monitoring technology using Video GP and guest safety devices fitted within it. This means it is a safe environment that meets his physical needs. A carer visits several times a day to help Giovanni.
CC2i assists Doris’ care team visually through an online triage process to determine what her care needs are, whilst retaining the appropriate level of expert/staff intervention. To assess her continuing health care package, they use IEG4’s Digital CHC platform to speed up the assessment process and get Doris the care package she needs faster. Doris’ daughter can input into the assessment through the patient portal.
Doris’ social services team use Lifted care management platform to find qualified carers to support her.
Paul lives in a supported living home; he uses My Health Guide to link all the health professionals helping him by providing personalised information about Paul including his preferences. This helps him to maintain his independence and keep him healthy.
Although these maybe fictional scenarios, they present the huge opportunities that technology has to keep people healthy and in doing that, reduce the demand on adult social care. Many innovations like these have the potential to support older people and people living with learning disabilities to maintain their independence and improve the efficiency of adult social care and healthcare services. Maybe local authorities and NHS trusts could learn from what has worked, and what measures could be taken to maximise the opportunities that cutting-edge technologies offer.
The demand for social care is only increasing and we must act now to adapt and bring in new technologies that can support it.