“For every hour someone is on the floor, it’s an extra 24 hours in hospital,” says Kerry Warner, a telecare co-ordinator for North Yorkshire Council. As the risk of falling increases with age, this explains why pendant alarms and bed sensors are the most commonly requested pieces of telecare equipment, enabling older people to maintain independence.
Care services minister Phil Hope recently praised the council as an exemplar authority for its use of telecare. The work started in 2007 when it received a preventive technology grant of £871,000. This non-ringfenced funding totalling £80m was allocated to local authorities by the Department of Health to build telecare infrastructure.
At the time Warner was working as a team manager in a residential home in Harrogate, one of two areas that ran pilots using the grant. Impressed with the results, she applied for the new role of telecare co-ordinator when it came up two years ago.
“The technology gives people back their independence and it’s about doing what somebody wants rather than us saying ‘this is what you can have’,” she says.
She is one of four telecare co-ordinators covering the county’s geographical areas – hers is Harrogate and Craven. The role has been key to mainstreaming telecare to everyone needing adult and community services.
“Our main role is to make sure that telecare is embedded as a first-line service for anyone who comes through our doors,” Warner says.
Training has been mainly on the job and from providers such as Tunstall Healthcare. Between them the co-ordinators have trained more than 3,800 people in a year, including key partners such as the fire service, health, and housing providers, to ensure everyone is aware of the benefits of telecare and how to access it.
They have trained social work staff in assessing need and installing equipment, and regularly update them on new technologies, as well as visiting clients and carers in their homes to demonstrate equipment.
Investment has been critical, says Derek Law, corporate director for adult and community services. “We invested £230,000 in putting technology into older people’s homes. We have maintained a base budget of £425,000 as our core funding in telecare each year. Last year we added a further £260,000 to that and next year we are going to add £300,000.”
And that investment is paying off. “The financial analysis of people using telecare showed a 38% reduction in costs against traditional models of care, either delaying or not requiring residential care or reducing the level of domiciliary care required. This saved over £1m,” says Law.
Savings are expected to increase as more people use telecare. About 75% of telecare users are older people, about 20% are people with learning disabilities and the remaining 5% fall into multiple categories. Equipment costing less than £1,000 is free at the point of delivery and there is a weekly charge of about £6 to cover monitoring and maintenance.
A survey carried out in August 2009 showed user satisfaction to be high: telecare had helped 95% of those surveyed feel safer and more confident and 87% to remain living at home. Kevin Alderson, public sector policy director at Tunstall Healthcare, says there are four key reasons behind the council’s success: “A good business plan with a firm underpinning of investment; strong leadership at senior level; local services that were fit for purpose; and training.
“Nationally it’s a real mixed bag. Few councils have put all four of these key things in place, and although they will make progress, they will struggle to match the outcomes in North Yorkshire.”
Living with telecare in Harrogate Neighbours Housing Association’s Greenfied Court sheltered housing
“The appliances now available are amazing. It gives you a tremendous feeling of security,” says 82-year-old Audrey Wright. She moved to a bungalow in Harrogate Neighbours Housing Association’s Greenfield Court sheltered housing site with her husband in 1997. When he died six years later, the fact that she had staff who could reach her in minutes was a great comfort.
As her mobility and eyesight have deteriorated, several pieces of telecare kit have been installed in the bungalow. An intercom in the hall allows staff in the main building to speak to her wherever she is. A fall sensor, ringpulls in the bedroom and wetroom, and one of the latest pendant alarms – in a watch rather than worn round the neck – all alert staff immediately if she falls. And a bedside lamp with a sensor under the mattress turns on and off when she gets out and back into bed so that she can see her way to the bathroom.
“Without these things I possibly would have to think about residential care. We are all happier in our own home. I have my piano here and I wouldn’t be able to have it in a home and would miss it terribly.”
● Invest financially, in training and with partners.
● Ensure staff are properly trained, and believe in the benefits of telecare.
● Appoint champions, such as telecare co-ordinators.
● Get commitment from the top.
● Ensure partners are involved in training events and are signed up to using telecare.
Published in 4 March 2010 edition of Community Care under headline ‘Going techno in the house’