Last month I spoke, on behalf of the Housing & Support Alliance, at Sitra’s Annual conference and agreed to blog my presentation, so here goes!
The title of the
conference was Innovating for Efficiency. Although Telecare can and does bring
efficiencies, the theme of my presentation was about the role of people in
Telecare. I have seen and heard enough to know that if we want efficiencies
(monetary or otherwise) from telecare then we have to pay special attention to
the roles of people within that process. So, my emphasis was very much on
practical issues; the realities of frontline practice, and the importance of
the relationship between people and technology.
As this is a blog you
don’t get the benefit of the anecdotes, but the presentation
is available online, more about the conference can be accessed here,
and you can, of course, contact me if you would like some training!
I spoke about a number
of the keys barriers to Telecare working efficiently and being taken up more
widely. These include:
- Pinpointing desired outcomes
- Ensuring assessments are relevant and personalised
- Lack of understanding about what equipment is available and how it can be used
- Fears around staff roles, responsibilities and changes to the way people are supported, including fear of social isolation
- Lack of training and ongoing support
Desired Outcomes
Firstly we need to
decide what it is that we actually want to achieve. That sounds obvious and
simple, but so many people are given equipment because it is available or
practitioners are being told to include equipment within assessments but with
no clear idea about what they want to achieve.
So, some outcomes
may be:
- create a safer environment
- protect the building / environment
- give someone greater control, independence and confidence
- (Self) manage conditions
- keep someone at home for longer (reduce hospital/care home stay/admission)
- assist carers to provide more reliable support or less intrusive support
Personalisation and assessments
In terms of
personalisation, we are all now familiar with the concept and, for the most
part, we are providing support which is personalised to the individual in terms
of their needs, wants and aspirations. However, I’m not convinced that we are
doing this when we think about telecare.
Assessors need to
spend time understanding the person’s needs and way of living. Think about how
the individual and their staff will use the equipment. We will not achieve any
efficiencies or decent outcomes if equipment doesn’t fit someone’s needs and
lifestyle. Equipment should work with care arrangements to enhance support
rather than replace it.
What equipment is available?
Almost anything you
need or want!
There are many pieces
of equipment with the same name that work differently so it’s important to ask
questions, source from the whole of the market and remember that one size does
not fit all!
On the powerpoint
presentation I showed examples of three flood detectors: the first needs to
get wet before it signals that there is a flood, the second signals that the
water has reached the overflow in a sink or bath and the third signals that the
water has reached the overflow and shuts off the water supply.
So, this is just one
example to demonstrate that if you limit your procurement to one supplier, or
individuals/staff are expected to purchase from a tick list or a catalogue
without much explanation, then they could end up with something they don’t
want, that doesn’t work properly in the given scenario or environment and
certainly doesn’t do anything to increase efficiencies, confidence or provide
good support.
Which System?
The same can be said
for the system with which the equipment interfaces – panel, pager, mobile
phone, website, call centre etc. If a carer needs to respond immediate (for
example some is about to abscond and run into the middle of the road) then best
to choose a system which provides an immediate response, such a pager for
on-site staff, rather than a website based system that you are going to log into
periodically! Sounds obvious, but again and again I have heard about or been asked
to sort out systems which do not respond in a way which is appropriate to the
circumstances. The biggest offenders are suppliers who insist that alerts need
to be routed to the mobile phone of the carer in the same home! This costs the
user money (mobile phone calls) when a system such as a DECT (cordless) phone
or pager could do the same job with no on-going call costs.
Again, if we get this
part of the assessment wrong at best we don’t make those efficiencies and at
worst we could be putting people in danger.
Information and training
Technology should
support the way people live or wish to live and be supported and not replace
it, but clearly this isn’t happening in every case.
However, some change
is inevitable, and change is scary. Individuals and staff will have to work
with the equipment and become responsible for it in different ways. Processes
will be needed to report activities, faults and for contingency arrangements in
the case of equipment failure. So it will mean change and people need to be
supported through that.
In many cases, people
have been put off by the “failures” they have encountered. If the only
encounter someone has with Telecare is not a good one then they are less likely
to advocate for it or engage with it in the future. We need everyone in the
process – individuals, their families and professionals to be confident about
telecare and other equipment which assists otherwise we are not going to see
efficiencies, good support or regular use of technology in the care sector. So,
people need to:
- Understand the intended outcomes and benefits
- Understand how the equipment works – both its capabilities and limitation
- Know what to do if it doesn’t work – and the consequences
Resource constraints
can lead to training being overlooked or not considered important. Had there
been sufficient training for the people I talked about at the conference, then
I don’t think I would have had those scenarios to mention, as all, in their
different ways, arose due to a lack of understanding in one form or another. Training
around technology definitely needs to be considered as an “invest to save” area.
I talked a lot about
failure at the conference. In fact, the right technology in the right place for
the right reasons can be very effective and I wholeheartedly support the use of
technology in these circumstances. I love gadgets and am always excited by the
possibilities they can bring! There are many reports and good news case studies
available already, so I wanted to provide a slightly different perspective. No
figures, hard facts, citations or specific references (which probably annoyed
some people) but hopefully experience and commonsense which illustrates that people
are the key to success when we start thinking about introducing technology for
the people who need some support or reviewing systems which are in place
already.
I have been working
with colleagues to produce an online Telecare Assessment Tool, which should be
ready within the next few weeks (spring 2013). It enables individuals or staff
to be guided through an assessment process by asking a number of questions
about the potential user. It then suggests a number of pieces of equipment
which can then be considered by real human beings before being purchased! It
works on all platforms – apple, android, blackberry and pc. There will be a
blog about it at some point......
Thank you Claire for this thought-provoking blog. It is SO important for individuals to have telecare support that matches their life-style and not a 'one size fits all'. Excellent.
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