Good Practice: the use of telecare (assistive technology) in East Cheshire, South Wales and Hackney, London

    Telecare systems can make savings while helping people to stay independent for longer, but it is best to start off small. Report by Andrew Mickel

    For all the obvious promise that telecare holds the best ideas can come from the strangest of places. “About five years ago I was having a conversation with this guy in a pub whose job it was to install smart home technology for luxury apartments where they can press a button to lock down the house,” says Peter Russell, head of community solutions at Community Lives Consortium, a support provider for adults with learning disabilities in South Wales.

    “What struck me was that most people we work with need staff to do most of the basic things for them. In the morning it’s about things like opening windows and putting music on,” he says.

    Starting small

    Before supporting such extensive needs, however, Russell had to start small. He kitted out two test properties, including one for a woman who was often getting up at night.

    “Before the installation, someone would go and check on her to make sure she was OK, but she said that while it was nice people were doing that, she was just getting a drink and was getting annoyed,” he says. “We installed a bed occupancy sensor which only alerted someone if she hadn’t returned to bed after 20 minutes.”

    That one example has been followed up with other technologies. Incontinence sensors in beds, for example, mean that staff don’t have to disruptively check on users during the night, and can quickly react when necessary.

    While this is potentially expensive work, a monitored intruder alarm system is typically fitted to a property and is paid for by housing benefit. That provides the main communication line in and out of a house which other technologies can be attached to cheaply.

    More savings come from being able to often replace the cost of someone working waking shifts with someone who can sleep and just be alerted when alarms are sounded. In some cases, it may now be possible to move to replace on-site staff entirely with a rapid response team.

    Telecare is now being used in 70 of the consortium’s 80 properties across Swansea and Neath and Port Talbot. For people hoping to replicate the model, Russell says: “Don’t see new projects as pilot schemes as they have a limited shelf life – just start things small. The success will spread by word of mouth once the technology is proven.”

    Flood and fire prevention

    Hanover Housing is working with Hackney Council to support telecare arrangements in the homes of 947 older people. So far, 461 monitored smoke detectors and 176 monitored flood detectors have been installed in people’s homes which will alert a central call centre when triggered, but the technology is being used in conjunction with less hi-tech innovations to ensure the least intrusive system is in operation.

    Bruce Moore, chief executive of Hanover Housing, says: “A flood detector is put on the floor of the bathroom and it can trigger an alarm in the property if, for example, someone with dementia blocks a sink with a flannel.

    “But we also fit magiplugs as standard, a basic device that opens itself to drain once it has a certain weight of water on it. That doesn’t need monitoring and only costs a few pounds.”

    Hanover’s approach of coupling hi-tech with the low-tech is matched by keeping the focus on using the technology in conjunction with people. “You need someone to be able to respond straight away,” he says. “Equipment is the trigger for the services but what is important in telecare is the follow-up. The first response goes to the family or carers of a user; our own response team is just the last line of defence.”

    Including tests and false alarms which comprised roughly half of all calls, last year there were 428 alerts on the smoke detectors and 253 on the flood detectors.

    Easing a return to independence

    Cheshire East Council will be starting a re-ablement programme in July and it will include a telecare element. But rather than work out what technologies are needed from scratch, it is learning from work it has done with other groups.

    One example helps to ensure that people are settling in to independent living properly, says Jon Wilkie, the council’s lead for assistive technology. “We had someone with a learning disability who was living independently for the first time, and we heard concerns from their parents that he was being targeted by people to clean him out of food and drink,” he says.

    Wilkie’s team installed an assessment system called Just Checking as a temporary measure for three weeks. A series of door sensors and beams, similar to those used in burglar alarm systems were installed to record and send information over the internet to show what was happening in the house over a 24-hour period.

    “Their movements suggested that wasn’t happening,” he says. “And we can now use it for an older person to see if someone could manage on their own. If we think they can stay on their own it could give them more independence.”

    Wilkie projects that over 20 people a week on the programme could use telecare as part of their re-enablement plan.

    Published in the 18 June edition of Community Care under the heading ‘In the Realm of the Sensors’

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