Technology is becoming ever more important in the care sector. The Health Plus Care Show in April 2023 had an entire event dedicated to it, the Digital Healthcare Show, and during the two days of this show panels discussed various aspects of digital transformation; data, analytics and Ai; digital futures; and technology-enabled care.
Introducing and increasing the use of technology in care homes is high on the Government’s agenda. The pandemic accelerated the use of technology through necessity, distributing 11,000 iPads to care homes and helping 14,000 care settings to access NHS Mail. In December 2021, the Government announced £150m of funding to drive digitalisation as part of the White Paper, and Matthew Gould, CEO of NHSX, said at the Care England Conference in March 2022 that this funding and strategy need to translate into concrete steps of deployment. He commented that 57% of providers cited budget as the main barrier to digitisation, whilst almost half said that they lacked digital skills. He continued stating that we must remember technology is a means to an end – and the end is providing better care.
Providing better care benefits all stakeholders in the value chain, not just the care providers but also the care receivers, their families, and professional colleagues. In this article, we will look more closely at how the development of technology for care homes can benefit all these groups, from the perspective of improving quality assurance.
The demand for social care has risen over recent years. Statistics provided by The Kings Fund in March 2023 show that the number of people requesting support from their council has returned to pre-pandemic levels, whilst the number of people receiving publicly-funded care fell. The amount of vacancies in the sector is also rising, meaning that staff are stretched and often cannot provide the level of one-to-one time which they would like to. People are living longer with multiple or complex needs, which may lead them to require short or long-term social care, and the introduction of technology allows us to expand our methods of monitoring the service, care and support which residents receive when not even present with them for some key areas of risk. For example, the use of an infrared sensor or sensor mat when supporting individuals identified as at risk of falls significantly reduces this risk in a less invasive manner, whilst allowing the resident to maintain a level of independence.
Dr Tim Ferris, National Director of Transformation at NHS England and NHS Improvement, spoke about the use of this very type of technology at the Care England Conference in March 2022. A scheme he visited in Kent is utilising technology such as beds, which monitor vital signs, reducing the need to wake patients; and infrared digital monitors to reduce the risk of falls.
Whilst this does not replace the dedicated care and clinical support delivered by team members, it does provide an additional layer of safety and oversight. Having a technological ‘safety net’ at times when resources are stretched can only be a positive development in the aim to provide safe, high-quality care.
The use of technology also allows providers and registered managers oversight of multiple residents’ care and support in key risk areas. Many care management software (CMS) packages have a ‘dashboard’ feature, accessible only to senior staff, and by having this high-level access across the whole service as well as at an individual level, trends and/or areas of concern can quickly be identified and proactively addressed before they become a significant issue. It also allows staff to monitor care and support specifically relating to assessed risk, so that decisions can be taken to prevent possible deterioration or harm, responding promptly and proactively in a more effective and ‘live’ manner.
The aim of a quality care provider is to always provide ‘person-centred’, individualised care to residents, and new technology is allowing access on a different level to achieve this. Previously, access to an individual’s care plan for a resident, family or a representative was by appointment only, and during the pandemic this became even more difficult and challenging. The most advanced CMS packages include apps for family and/or representatives, as well as the resident themselves, meaning that a resident and their representatives can drive how they wish to be cared for to a level not seen before. This gives the resident and their representatives real ownership, oversight, and involvement in how they are cared for.
Developing residents’ access to technology ensures that they are involved in choice in a more visible way, and this will in turn allow care providers to monitor individual wellbeing to a different level than was previously possible. Providers are often focused on purely clinical outcomes, to monitor risk or compliance against regulation – yet new and advanced technology will enable them to monitor other areas of the care service. This could include using accumulated data and the care team’s practice in involving a resident in their care, to assess wellbeing.
The involvement of family members does not stop when the care plan has been agreed, as technological advances have introduced Family Apps to CMS solutions. This allows families access to their loved one’s care in a live context, formalising a previously informal monitoring role. The Family Apps go beyond mere photographs and messages to provide information on factors such as nutrition, hydration and care delivered. For family members living many miles away and/or unable to visit, this is a vital way in which they can maintain regular contact with the care facility and their loved one. The peace of mind which comes with this information is invaluable, not to mention the additional benefit of helping families to build strong relationships with the care delivery team.
Technology can also be used to support residents who are bed bound, by giving them access to the whole range of services which the care setting has to offer. These residents often worry about asking for help when they need it, as they do not want to create additional work for busy staff members. As they often do not become aware of the activities programme, they may choose to stay in their room or feel that they could not go to an activity. By giving them electronic access to this programme, technology creates a connection between the resident, their fellow residents, and the staff, thereby reducing the risk of social isolation and instead, forming a bridge to this barrier and increasing wellbeing.
Beyond family and friends, technology is enabling ever-greater access to those professionals supporting the care home. Often when a doctor or nurse visits the home, or a resident is awaiting transfer to hospital, there is a scramble amongst staff to collate the required medical information. Yet this could soon be a thing of the past as current innovations allow this information to be produced at the touch of a button, either as a printed document to accompany the resident or as a PDF document which can be emailed to the relevant department in an encrypted form.
Progress is also being made on making NHS systems compatible with those within the social care sector. Often residents are re-admitted to a care home from hospital without all key relevant information, thus potentially compromising the quality of the initial care provided, not to mention the additional work stress for staff. This technology, aimed at improving communication, partnership working and reducing errors or incidents, is to be welcomed. It is one of the aims of NHSX, which was formed in 2019 and brings teams from the Department of Health and Social Care, NHS England and NHS Improvement together to drive digital transformation and lead policy, implementation and change.
Developing and enhancing effective communication via the use of technology between families, residents and the professionals supporting them is an outcome which everyone in the social care sector wishes to realise. Enabling quicker access to the required, real-time information recorded by nurses and care staff will enable GPs to make informed clinical decisions, and care providers to proactively support residents who lack capacity to make significant decisions.
Technology can also be used to seek the views of all key stakeholders as they happen, thus resulting in quicker resolution of issues with the quality of service maintained and enhanced in a collaborative manner. Care providers often have systems in place to gather feedback such as surveys, regular meetings with families, and complaints procedures, but these are drawn-out processes which lengthen the time taken to learn lessons and make improvements. Having ‘live’ access to feedback changes this significantly, by allowing the stakeholders to offer the prompt opinions which are vital to developing the care provided for individuals, or actions within the wider service as a whole.
The introduction of new technology in a care setting can only have a positive impact on the care delivery team. CMS’s are available on hand-held devices, enabling staff to record seamless real-time point-of-service observations on residents. Intuitive use of technology saves significant administration time which staff can then spend with residents, and also provides accurate, up-to-date records as evidence for colleagues, managers, and inspectors. In addition, real-time recording allows for immediate early warning measures to assure residents’ wellbeing.
A CMS such as PredicAire can also provide a platform to involve and train shift leaders to monitor residents’ care in a more developed way, whilst enhancing their role. The position of shift leader has for many years been an area of development for senior carers and nurses, but the workload is often high. If record keeping is paper based these staff have to visit all areas of the home in order to access records, but if these records are stored in the same place, on a small tablet, they can easily be accessed.
Technology can assist in quality assurance and inclusion at every level of a care home. Audits of infection control, health and safety, and maintenance records where there are different access tiers allow care providers to ensure a safe workspace, and the findings of these audits contribute to and inform the business planning which has a positive effect on the lives of and outcomes for residents. Furthermore, allowing residents and families to take part in the auditing process remotely creates transparency, allowing them to contribute directly to change and provide direct impact and control. This would be hugely beneficial to them both physically and mentally, at a time when people often feel that they are losing control of their lives.
In conclusion, care homes are often seen as a ‘closed shop’, rather like the health service, shrouded in secrecy and only accessible to families and health professionals. In recent years the care sector has suffered from a poor image, caused by some high-profile news cases, and this has undoubtedly contributed to the highly publicised staffing issues.
Technology that is deployed responsibly can help change this, and CMS providers such as PredicAire are on the appropriate journey to lead change in the sector.
The transparency which will develop by allowing different levels of access to stakeholders such as regulators, residents, and local authority workers, will create both a greater degree of trust and arguably an increased focus on quality assurance. Staff will know that every observation which is recorded (or not recorded) will be visible not only to management but to others outside the home. By opening the metaphorical doors to the sector, technology could help the sector to overcome some of the many issues facing care providers and all stakeholders in the value chain.
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