Comment: Dignity, Independence and Choice – how telecare can help to support people with learning disabilities

Sandra Taylor of Hillingdon Council reveals how the borough has incorporated telecare into a new model of care for residents in care home settings

In this article, SANDRA TAYLOR, service manager for resources for adults and older people at Hillingdon Council, discusses how the borough has incorporated telecare into a new model of care to enhance the lives of those who live and work within residential care settings

Home to approximately 278,000 people, Hillingdon is London’s second-largest borough. Within a national landscape of care provision that is rapidly changing, the council maintains the vision of ‘putting our residents first’, and we aim to achieve this through the development of forward-thinking and innovative approaches to a range of initiatives –including the delivery of social care.

Our aim is to create a fundamental shift in service provision away from institutionalised care, towards home-based support, risk prevention and early intervention.

Hillingdon Council’s adult social care team, working in partnership with the local NHS and Tunstall, has already developed a new model of care incorporating assistive living technology and reablement services to reduce reliance on residential care. This transformational approach to social care is delivering significant quality-of-life benefits, helping more people to remain living independently in their own homes. It also generates notable financial benefits. In its first year of operation alone, our TeleCareLine service delivered savings of £4.7m in reduced spending on homecare hours, residential/nursing care homes and hospital admissions.

Our aim is to create a fundamental shift in service provision away from institutionalised care, towards home-based support, risk prevention and early intervention

As a result of this success, the Leader of the Council, Councillor Ray Puddifoot, recently announced that the council will be reducing the age at which the telecare service is provided at no charge. From this month this will be offered free to residents aged 80 and over who wish to have the monitoring and alert system installed in their own home.

Our innovative model of care is improving the quality of life for older and vulnerable people. For these individuals, telecare offers a greater sense of independence and better control over their own lives in the comfort of their own homes. But what about those for whom, even with the help of assistive technology, living at home is just not an option? In my opinion, telecare can still be used to its full potential, playing a vital role in supporting residential care users and enabling them to lead full and independent lives.

There will always be a need for provision of care for people who cannot be supported at home, including adults with learning disabilities and more-complex needs. Addressing this issue is a key part of our approach to the delivery of social care across the borough. As well as offering home-based support for vulnerable adults, Hillingdon Council is committed to providing assistive living technology for people in long-term residential care. In doing so, we are able to demonstrate how telecare can contribute to making residential care a place that enhances the lives of the people who live and work there.

An example of the council’s deployment of telecare to improve personalised care within a residential home setting is demonstrated in our Hatton Grove facility. Hatton Grove is a Care Quality Commission (CQC)-registered residential care home in Middlesex, which supports adults with a range of learning and physical disabilities. The home is divided into four separately-staffed units and can support up to 20 adults in total, each benefiting from their own personal living space. The facility also contains a small flat to support a service user who wishes to live independently.

At Hatton Grove, all service users require 24-hour care and support. All have complex health needs and/or physical disabilities, with over half of residents needing a minimum of two members of staff to assist with transfers. Due to the complexity of their disabilities, none of the service users are able to safely access the community on their own. As such, a range of support is offered by the in-house teams, ranging from aromatherapy and speech therapy to helping them access online education. Hatton Grove provides a warm, caring and stimulating environment where residents are able to develop skills and achieve maximum quality of life. Staff aim to encourage the intellectual, emotional and social development of service users through guidance, support and counselling, in addition to providing positive role models.

In its first year of operation alone, our TeleCareLine service delivered savings of £4.7m in reduced spending on homecare hours, residential/nursing care homes and hospital admissions

In 2011, following completion of the Dignity Challenge – a 10-step process designed to ascertain how people’s dignity is respected, staff sought to enhance levels of care within the facility. In particular, night staff requested a better way of ensuring that they could be aware of any seizures, falls or incidents, but without the need to make obtrusive half-hourly checks which sometimes proved unnecessary to service users. Based on the success of assistive technology in other areas, we decided to evaluate the advantages of offering telecare support, and worked with Tunstall to develop a plan for the appropriate use of sensors within the home.

The technology was introduced gradually to Hatton Grove, initially focusing on a small selection of sensors to assess the benefits they could offer for service users in terms of improvements to privacy and safety. The use of telecare was then extended, with sensors being put in place to support the night staff team from 9pm until 6am.

Today, a variety of telecare solutions are being used to deliver personalised care and enhance the lives of residents at Hatton Grove. Epilepsy sensors are used to support service users who have been diagnosed with epilepsy, but are largely seizure free. Staff no longer need to make checks on these individuals at half-hourly intervals during the night, helping to maintain their dignity and privacy. For residents who are at a greater risk of falling when walking unassisted, or for those who become distressed when other service users enter their rooms, door sensors are used to immediately alert staff when doors open during the night. Other solutions employed at Hatton Grove include bed occupancy and movement sensors. Whenever a device is activated, staff are alerted via a CareAssist Pager, enabling them to offer swift support to the correct service user.

The introduction of telecare at Hatton Grove has improved the way staff are able to respect residents’ privacy and dignity. Staff no longer feel that they are invading people’s privacy by making regular checks, or disturbing their sleep, yet still feel reassured that the residents they are caring for are safe. Care workers at Hatton Grove trust telecare and find it a great support to them in their roles, allowing them to spend more quality time with residents by accommodating their individual needs and interests more effectively.

Prior to telecare being used, staff spent much of their time, particularly at night, walking from room to room to check on the welfare of the residents they support. Now they have been able to significantly reduce these regular checks, which has freed their time to undertake more meaningful activities. Staff also have the time to write night reports in a much greater level of detail than was previously possible. This is itself has brought numerous benefits, including enabling all stakeholders to gain a more-holistic and detailed picture of a service user’s health and wellbeing over a period of time, and revealing any decline at an earlier stage than may otherwise be the case.

Residents don’t find the technology intrusive, with many of the sensors largely invisible when in place. The introduction of telecare also helps family and friends to feel reassured that their loved-ones are safely supported.

Telecare has made significant improvements to the levels of privacy and personalised care provided at Hatton Grove, and while it remains a residential care home, it is in no way an institution

This innovative, partnership approach to introducing new ways of working has generated enormous benefits for the residents of Hatton Grove, combining safeguarding with increased autonomy. Telecare is also helping to encourage a cultural change for staff by increasing productivity and enabling them to offer more-individualised support, interacting socially with service users.

The staff at Hillingdon’s Hatton Grove remain committed to providing appropriate, personalised care and support, adapting plans according to the changing needs of the people who live there. The telecare solutions employed will evolve as part of these changing requirements. Over time, new service users will be welcomed to Hatton Grove and their needs will be reviewed to assess how telecare may provide beneficial support.

Telecare has made significant improvements to the levels of privacy and personalised care provided at Hatton Grove, and while it remains a residential care home, it is in no way an institution.

Companies