Blog written by Ed Russell, Director of Innovation and Delivery, at WCS Care.
I still remember how my career in care started over 26 years ago – my first shift was on New Year’s Day in 1992, a few months before WCS Care officially began life and took over the homes from the local authority.
While I thought my role would only be temporary as I figured out what I wanted to do, it introduced me to a career that’s about people – and one where I instantly knew that I could help make someone’s day; somewhere I knew I wanted to be.
Care is very different now to what it was back then with a much more vigorous regulatory framework in response to customer and society’s expectations – in my experience, carers have always cared and worked hard to really understand each person’s individual needs; learning what they like and don’t like, listening and responding to residents’ own ambitions, only now rather than a choice, it’s the statutory minimum standard.
Technology has a greater role in care now too. Back in the 1990s, we barely used computers at work – notes were written by hand and we certainly wouldn’t be using handheld devices to record care interactions on shift.
I didn’t have a work mobile phone until 1999 and I still recall my first text. It was from my brother, asking me what I wanted for my birthday. I had no idea how to reply – if someone had told me at that time that almost 20 years later, I’d be leading on innovation and technology at WCS and helping influence change in the sector, I wouldn’t have believed them!
The development party
WCS were late to the development party – in Holland, some care homes there have been using acoustic monitoring technology for decades and we hadn’t heard of it until three or four years ago.
In India, eye retina scanning is used to keep everyone’s personal details secure – we’re certainly a long way from that but it gives you an idea of what I mean.
It wasn’t until we acquired the freeholds to the homes in the last few years that we stood back and took a hard look at how we deliver care and the tools that were available to support what we were trying to achieve.
We asked ourselves – ‘will it make a difference?’ and ‘why not?’ (one of my favourite phrases).
So, we quickly focused on searching for tools that would help us with our approach to helping make every day a day well lived.
Lighting the way
After a while, we found some great examples including circadian lighting, which mimics natural daylight and can help reset your circadian rhythm (or body clock), which looks after your wake/sleep cycle and, as we are seeing, can influence conditions such as sundowning syndrome. Better sleep can have great benefits to someone’s health and wellbeing.
Circadian lighting is a great example of what I would call a ‘legacy technology’, providing benefits for residents – and staff – year in year out for the whole life of a building, potentially unlike some other technology which quickly goes out of date and needs to be replaced every couple of years or so.
Away with the paper
New versions of electronic care planning mean we’re able to use handheld devices, rather than desktop PCs, to record care instantly at the touch of a button. It means carers can spend more time with residents, rather than taking up to an hour writing up notes at the end of their shift.
Benefits of electronic care planning can include the ability to put in automatic reminders for carers about care and other important appointments, as it’s easy to forget something in the busy 24/7 environment we work in, with multiple shift changes and staff turnover in health and social care.
These prompts can then be monitored at handovers to make sure we have done what we said we would do. Indeed, now staff have the opportunity to push through messages to handover during their shifts, negating the need for both ingoing and outgoing staff shift handovers.
I dread to think how many message books and reams of paper I’ve used over the years, and those lame excuses I’ve heard about poor communication and why someone didn’t know or do something. The computer won’t forget and now all carers invariably have the IT skills to use a smartphone, the future has well and truly arrived!
I would have given one of my ‘eye teeth’ to have a tool like this in place back when I was first a home manager in 1995, trying to improve communication, care standards and accountability across the workforce.
A ‘fluid’ situation
And I would have given the other ‘eye tooth’ to be able to monitor accurately how much residents had drunk and react quickly if they’d not had enough; something we do daily now. I remember moving to a new home in 2003 as a manager and being concerned about the number of residents being admitted to hospital with dehydration symptoms and associated UTIs.
Seeing the impact now of monitoring fluids, the time residents spend outdoors or undertaking activity and occupation, and the potential health and wellbeing correlations to a reduction in falls and hospital admissions etc across the group, has been a vindication of using electronic care planning. The saving on paper costs alone amounted to about 1/3rd of the cost of taking up an electronic system.
Gateway to care
If you’d also said to me a few years ago that we’d be able to open up care notes (with consent) to relatives who could log in to check on their loved one’s care wherever they were with an internet connection, I would have met this with some trepidation.
However, the reality has been different – over 50% of residents across the group have at least one relative signed up to the Relatives’ Gateway and we’ve noticed that care queries and complaints are resolved more quickly, as families are able to hold managers to account and they can respond in real-time, rather than problems building up to something more serious.
Some relatives have told us their visits have improved, as they can instead use the gateway to manage complaints and concerns, rather than ruining a social visit.
A listening ear
Then there’s having the ability to reduce disruptive night-time checks by installing acoustic monitoring, which listens for sounds above a certain threshold at night, alerting staff who can decide whether or not a carer is needed. It means residents are not interrupted, resulting in a better night’s sleep.
We’ve been unintentionally waking people up for years with our night checks and it occurred to us that new acoustic monitoring technology could help us improve residents’ sleep.
If anyone has spent a night in hospital or a traditional care home that doesn’t have acoustic monitoring, you’ll know what I mean.
Reassuringly, our experience of the introduction of technology has helped us improve quality, residents are more awake – sleep patterns have been restored, residents are healthier, and are eating and drinking more. All the improvements listed are underpinned by sound business cases and a great return on investment.
The future is here
As for the future? The future is now…but there is still plenty of room for more. Camera sensors that can monitor people’s pulse, temperature and respiration are already out there; wearable tech that will be able to predict when you’ll have a fall won’t be far away.
You’ve probably seen futuristic films where people have identification chips implanted – maybe these will also play a part in care too in years to come, accurately recording your vital statistics and alerting care staff about hydration levels, blood pressure and blood sugar levels.
And linking this to machine learning software will mean that we will be able to predict falls and illness, and be able to speed up triage by providing timely health statistics to health professionals.
We recently trialed with our local CCG a telemedicine service via a secure video and medical record link, resulting in one care home alone having over 170 fewer accident and emergency admissions in one year.
We thought it was a brilliant example of health and social care working together. In another good example of partnership, we use a trusted assessment process with our local hospital trust for a discharge to assess service, where they log in remotely to our care planning system and we have approved requests for assessments for 265 admissions in the first year in under 1.4 hours on average, resulting in 70% of same day assessments and admissions with no refusals of assessments.
The potential wider impact on our country’s stretched health and social care resources through this sort of partnership working, speaks for itself!
I’ve only scratched the surface here but at least it gets us all thinking about partnership working, a ‘plug and play’ mentality, how we can have more choice depending on our circumstances to use everyday technology to support care.
Don’t get me wrong, care will always be about people – and that is how it should be, but we should challenge the norm and embrace technology that could improve people’s lives enormously. Why not?