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The use of telecare to support individuals in Wolverhampton


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The use of telecare to support individuals in Wolverhampton

Wolverhampton recognises the role of telecare as one of the solutions to support or increase independence for individuals with a range of conditions and their carers. Telecare also creates efficiencies by reducing the progression to residential and nursing care.
The aim of the pilots was to support people to maintain their health and independence by focusing on prevention (focused on supporting individuals to remain living independently) and reablement (focused on supporting those with disabling conditions or having experienced illness to regain their independence), and examining individual’s responses in these areas to consider future support levels.

The use of technology is an enhancement to care and offers people more choice and control over their daily lives, replacing intrusion rather than replacing care. Telecare assists and contributes to confidence building while offering on-going support and peace of mind during and after the reablement period.


Identifying the opportunity                                   

Wolverhampton has invested significantly in its move away from residential provision with 16 sheltered and 11 Very Sheltered (Extra Care) schemes for older people, as well as three very sheltered schemes and four sheltered schemes for people with learning disabilities. Some aspects of telecare technology are already implemented within the schemes and used together with the integrated call systems. However, some of the schemes, due to their limited infrastructure and incompatible systems, cannot benefit from these technologies.
With this in mind it was agreed to focus on two different very sheltered schemes (a very sheltered scheme for older people and two smaller 24/7 supported living schemes for people with learning disabilities) and demonstrate the benefits of using Telecare.


Details of the project                                             

Project 1 - Very Sheltered Housing for Older People.
The identified scheme accommodated 35 older people, with a range of individual needs, conditions including memory problems and frailty.

Project 2 - Supported Living Schemes for People with Learning Disabilities.
This included two supported living schemes accommodating a total of 16 people, with a range of individual needs. Both of these schemes had predominantly service users who had previously lived in long-term residential care. Within the supported environment they had limited opportunities for developing independence and were initially very dependent on staff. The move to supported living had already achieved a reduction in their dependence and this project examined the potential to reduce their staff support needs and enable greater independence.

All of these schemes have had access to a range of technologies, including both standalone and linked devices to promote independence, wellbeing and choice.

The types of technology included:
  • Memory promoting equipment 
  • Medication dispensers 
  • Equipment to support safety 
  • Just Checking to be used as part of the assessment tool to gain a greater understanding of capabilities and needs.
Individual outcomes for both projects:
  • Increased confidence, health and well being
  • Reduced dependence on staffing support
  • Increased independence
  • Increased choice and control
  • Improved assessment of need
Outcomes for the organisations:
  • Improved effectiveness of staff and resources
  • Reduced movement within schemes through decreased progression to residential and nursing care
  • Reduced demand for health and social care input.
Other outcomes:
  • Reduction in the number of safeguarding incidents
  • Reduction in the number of complaints
  • Reduction in the number of accidents.
Staff Outcomes:
  • Increased knowledge of Assistive Technology
  • Increased understanding of the range and choice for individuals
  • Acknowledgement of technology as a means of maintaining or increasing independence, health and well being
  • Increased understanding of how traditional models of care can be enhanced
  • Increased understanding of the use of technology to support assessments.

Training and Familiarisation                                

In order to achieve the objectives of the projects Wolverhampton recognised the importance of identifying the barriers to change and use of technology. Part of the funding was used to commission online training which was module and case study based and had to be completed within 60 days. This training was offered to a range of professionals to increase their knowledge and understanding of the technology available and its applications.


Outline of the positive points identified following the completion of the training
  • A high percentage described their knowledge of Assistive Technology as average prior to undertaking the course.
  • Accessing the course was easy.
  • This was an enjoyable and interesting way of learning.
  • The majority of people were satisfied with the range of technology that was explored.
  • Following completion of the course, participant’s concluded that their knowledge and understanding of assistive technology had increased.

Identified barriers to undertake the training as highlighted (identified mainly by staff in the learning disability schemes)
  • Not all staff had access to computers on site.
  • Not all staff had basic IT knowledge and skills.
  • There was no in house basic IT training course.
  • Staffing levels weren’t always sufficient to release staff and majority of staff members works part time.
  • Some staff felt anxious at not being familiar with IT.
A fundamental aspect of this project was to ensure that all those involved fully understood the capabilities of the technology and the benefits it could bring. The Telecare team developed links with all of the stakeholders and provided awareness sessions and demonstrations of the technology. Suppliers where appropriate were involved, as in some cases new technology was implemented particularly within the learning disability scheme

Stakeholders included:
  • Scheme Managers
  • Support staff
  • External providers
  • Service users and carers
  • Occupational Therapists and assistants

Finance                                                                      

The West Midlands Regional Joint Improvement Partnership (JIP) offered support and £10,000 funding to develop and evaluate the pilot project. Wolverhampton City Council match funded this and also provided the following resources;
  • £5,000 match funding committed by the Joint Commissioning Unit
  • £5,000 sought from an external provider (to date not received )
  • Recruitment of project manager to manage range of projects (time specific and funded separately)
  • Recruitment of occupational therapy assistant to complete assessments and review outcomes (time specific and funded separately).

Allocation of Funds                                                
  • 20 places Coventry University online training
  • Range of Telecare equipment
  • Able Link/laptops (Awaiting installation)

Range of telecare package provided:                 
  • Smoke /heat detectors and Home Fire Safety Checks undertaken by the Fire Service
  • Mem-x
  • Enuresis Sensors
  • Pill dispensers
  • Just Checking - assessment tool
  • Able Link (Awaiting installation)

Referrals to the project/outcome of reviews:

The project was evaluated using the CSED evaluation tool. Care plan hours at the start of the project and after the Telecare had been installed. The care hours for the Very Sheltered Housing (VSH) for Older People were never received.


Learning Disability Schemes

The project supported 11 people. Reviews identified the benefits of Telecare from both relatives’ and staff’s perspective.

“Very impressed with the range Telecare equipment that my brother was using and felt it had a positive effect on him and improved his independence. Family who live a distance away are now looking to buy a laptop and set up skype facilities”.

Relative


“The impact of using Telecare has been a driver in contributing to the change in practice, culture and in the delivery of positive outcomes for our service users”.

Julie Green, Team Manager



Very Sheltered Scheme for Older People

The project supported eight people. Three service users had their equipment returned due to it being faulty.




 
 
“There has been a positive take up of the service as a result of the project particularly, within the learning disability schemes, and the technology has been embraced. However, the take up within the Very sheltered scheme was low and there appeared to be some resistance to a change in practice and to explore how the technology could contribute to individual’s independence. A recommendation will be made to ensure further work is undertaken through Commissioning for Older People, the project manager to address this issue and a way to take this further in conjunction with providers”.

Helen Rowney - Telecare Project Manager


Adding up the benefits                                          

Project evaluation findings:

Individual outcomes
  • One service user nominated and won a recent award for his role in being a great ambassador for independent living and is looking to ‘champion’ the use of assisted technology to other people within Wolverhampton.
  • Two service users are able to manage their medication independently or with little support, increasing their self-worth and are very proud of their achievements.
  • One service user is going to be using Skype as an aid for communication with a long distance relative.
  • Tenants were supported to manage risks more appropriately e.g. carers going off site and were reassured the technology would alert should there be a risk situation. The smoke alarm had activated whilst a service was cooking and enabled staff to be alerted to a potential risk situation.

The use of Just Checking provided the following outcomes:
  • Level of assistance required during the night
  • Planning ahead in accordance with individual needs

In one particular case Just Checking identified that a service user was constantly active
throughout the night and had severe epilepsy and also been referred to as ‘lacking
motivation’. Just Checking identified that this particular individual was up a lot during the night
on more than one occasion. This has highlighted several issues and referrals made to a range
of professional to investigate further e.g. a review of medication.

Staff Outcomes                                                       
  • Identifying and working with the barriers to change and the use of technology
  • Basic IT Training
  • New skills and specialism’s
  • Jobs worth – positive outcomes for individuals – motivation
  • Staff started to embrace the technology and started to think ‘outside the box’ more pro-active, promoting independence.
 
Total efficiency savings (only identified in Learning Disability Project)
  • Prior to the project the Learning Disability service was to be reconfigured
  • Care plan hours at start of project were 558 hours now reduced to 435 hours per week.(An average reduction of 11 hours per service user per week)
  • Based on an average of £13 per hour this equates to a total of £82,427 savings pa. Telecare has been a contributory factor to the service reconfiguration.
  • With the implementation of Telecare this has taken the reconfiguration to another level, achieving the level of independence it has given service users and the change in how care is being delivered.

All service users within the Learning Disability scheme are still in receipt of the equipment; Just Checking has now been removed.

The original start date of the project was the beginning of November 2010 for six months with end date of May 2011. Due to resource issues and some technical issues within the Very sheltered scheme, the project was delayed and began in the middle of January 2011.


Formula for success                                             
  • Where managers had the drive and commitment for the project, they were able to champion the benefits of the technology.
  • Staff were fully informed and involved in the project.
  • Effective communication between staff and users and carers.
  • Staff ability to ‘thinking outside of the box’ and see Telecare as an opportunity to enhance independence, supporting reablement and personalisation agenda.
  • Implementing the technology in a phased approach ensuring that users and staff became familiar gradually had a positive effect.

Lessons Learnt. Capability                                 

  • Although senior staff were committed to this project, the limited resources within the VSH were contributing factors to a limited success of this project within this scheme.
  • It’s crucial to involve staff from the very beginning to ensure their full engagement and understanding of potential in using technology.
  • There seemed to be a reluctance to drive the Telecare agenda forward, particularly in the VSH scheme with an emphasis in continuing to deliver services /care in a traditional way, i.e. looking at using the administration of medication.
  • Further projects would benefit from and require named and identified resources.
  • Support hours/visits/case studies were never submitted from one of the providers so the project wasn’t able to demonstrate any efficiency for that particular scheme.
  • To ensure full understanding of the technology and its potential which enables practitioners to continue indentify benefits.

Next steps…                                                           
  • Promoting the positive learning and benefits that have been identified by users and staff, particularly in learning disability services.
  • Providing case studies and learning and adopting the principles across other service areas.
  • To continue to raise the profile of Telecare and strive to embed it within the care management process.
  • Work further with providers to understand and explore why Telecare wasn’t embraced, particularly in VSH.
 

“Being part of this project has enabled us to gather meaningful evidence that is informing the strategic direction for the planning of Telecare here in Wolverhampton, demonstrating the positive impact Telecare can play in supporting independence, improving the health and well-being for individuals and their carers. From a personal point of view, I have known many of these individuals for a number of years when they were living in residential settings. It is a great achievement to see how their lives have been improved with the use of Telecare”.

Joy Dale Commissioner for Long Term Impairments

                                                                                                                                                                                          
Contacts and further information

For more information, please contact:

Helen Rowney
Telecare Project Manager - Telecare
Wolverhampton City Council
Community - Health & Wellbeing
t : 01902 555495 
Helen.Rowney@wolverhampton.gov.uk  
 

 


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