How smart phones can improve home care for users and staff

“I’d be really lost without it,” says reablement care worker Jill Johnson of the smart phone she takes to all her appointments.

Johnson, an independent living at home support worker for Barnsley Council, says the phones have improved staff safety and the quality of care for users.

The phones, which are carried by all of the authority’s in-house care workers, provide staff with their daily rosters, clients’ care plans and prompts to help them in their caring role, and updates them on any changes to their schedules in real time.

It also enables workers to inform the council’s control room that they have carried out appointments, if they are going to be late or miss a call, or if any problems occur.

Barnsley is one of eight organisations using the inTouch system provided by IT firm CACI to manage its home care service. Unlike the others, Barnsley Council initiated the development of the system, launched in 2009, and its carers helped design it.

Last year, it won the council the mobile working device category at the National Good Communications Awards for local and central government, one of a number of awards won by Barnsley and CACI for the system.

Improved care and staff safety

“It gives you the vital information that you need on [the service users],” says Johnson (pictured, below). “You can log any concerns [about a service user] on the device so that the next carer [that visits them] can use that information.”

Previously, this information was available on care workers’ time sheets but Johnson says there were confidentiality risks around these getting lost; these are mitigated by inTouch’s security system, under which each care worker has their own unique identification.

She is particularly pleased about its impact on worker safety. “There was an incident where I felt vulnerable when I was working at night,” she says. “Sometimes you have to go round the back of someone’s house at night and it’s quite unnerving. I was able to call central control and they stayed on the line until I got into the property. If you know that someone is on the line it’s reassuring.”

Design and development

Prior to the development of inTouch, CACI had developed an electronic rostering system for council in-house care teams, used by Barnsley, among others. About six years ago, the council approached CACI concerning the level of paperwork involved in its in-house home care service.

Rosters had to be sent out to care staff who would then send back paper time sheets, which would then need to be inputted at the office. Out of these discussions came the idea for inTouch.

The council’s home care business services manager, Paul Higginbottom, says staff and unions were fully involved in the design process, through focus groups.

“We needed to obtain the buy-in from an ageing workforce for technology,” he says. A panic button was built in to the device to answer concerns about worker safety, while a speed dial directory was also introduced, including a contact number for the union, as a result of these discussions.

How it works

Care staff register on their phones that they are on their way to an appointment to help the control room ensure that schedules are on track and make any necessary changes.

The device guides the carer through the day, bringing up information on their phone about the particular household, such as whether there is a key safe, where this is and the code to access it, and what activities the care worker will need to do on this call. This also registers the appointment with the council’s pay roll system.

inTOUCH confirms when the carer arrives and leaves the property which registers the appointment with the council’s system for charging the service user.

Improvement and efficiency gains

Though Higginbottom says the product is “at the top end of the market in terms of cost”, Barnsley has made back its investment in terms of more efficient working and improved performance.

Advantages include for care staff to be able to inform the control room if an appointment needs to last longer than the scheduled time or if the service user is not at the property, triggering enquiries into their safety. The council can also inform all carers about arrangements for working if there is bad weather.

Ollie Watson, business director at CACI, says the mobile system enables councils to employ one control room co-ordinator per 40 carer workers, compared to one per 15 or 20 care workers without.

Barnsley ceased providing long-term home care in-house in April 2011, creating a reablement service instead.

But Higginbottom and Watson say that inTouch is particularly suited to short-term interventions designed to increase people’s independence following crisis, because of the way it can provide real-time information on the service user’s progress.

“If you look at a reablement service, it’s a lot more fluid,” says Higginbottom. “People’s hours are changing and the number of visits they need are changing [as their needs change].”

The council currently has a paper-based weekly scorecard that measures the service user’s progress in regaining independence, but this will soon be incorporated onto the inTouch system.

Downsides

One downside of the system is mobile reception. Johnson says she has lost her signal a few times, meaning the information she needs does not come up as quickly as it should.

This is a particular problem in rural areas, says Peter Williams, IT adviser for home care assistance and reablement at Caerphilly Council, which also uses the system.

“Our biggest negative is that we are in the South Wales valleys and network coverage is a big problem.” “I would say that over 90% [of care workers] are happy with the device,” he adds. “The other 10% live in areas of poor network coverage.”

Watson says the “substantial investment” required to set up the system means that CACI is not targeting it as smaller providers, and focusing on councils and larger independent providers instead. However, he says that in future, councils could look at hosting the technology for independent providers, who would pay a fee to access it but would not need to invest in the system, a point echoed by Higginbottom.

“Technology has to be a means to an end,” Higginbottom adds. “The key questions are: does it improve outcomes for service users and does it give frontline workers the tools to do their jobs?”

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