Better Care Blog Series: Blackburn with Darwen
Telecare in the community
As a small unitary authority in the Northwest with high levels of deprivation, we face multiple challenges in supporting vulnerable people to lead independent lives. From 2008 onwards we have turned to innovative solutions using Assisted Living Technology (ALT) to manage rapidly growing and changing care needs.
- By 2011 more than 1000 FACS-eligible people were using a range of telecare systems.
- In 2012 we formed a partnership with Tunstall to extend further the range of ALT used to meet social care needs, and worked with NHS community matrons to deliver telehealth options.
- In 2013 this evolved into a more formal partnership called ‘Safe and Well’.
The Department of Health’s Care Services Efficiency Delivery (CSED) team assessed the impact of telecare in Blackburn with Darwen between 2008 and 2010 and identified major reductions in escalations of care. Of 50 people who received only a telecare service:
- One was able to stop using 24 hour care
- One no longer needed day care
- 29 no longer required home care
- Two no longer needed nursing care
- Two no longer needed supported living assistance
- Thirteen no longer needed residential care
As well as improved outcomes, ALT has achieved concrete cashable savings through increasing independence at home and reducing demand for domiciliary and residential care: net reduction of £2.2 million through reduced costs of care packages, £300,000 above the target set in 2008. Preventative/early intervention approaches, in conjunction with ALT, then produced a reduction in 2013/14 of £1.2 million (direct budget costs).
Cutting edge solutions
Under the ‘Safe and Well’ partnership, mainstream use of telecare and telehealth has grown rapidly through three workstreams, each piloting new delivery models:
Pilot A worked with 33 service users with learning disabilities all receiving
high-dependency packages of care. The online tool Just Checking enabled
staff and family members to gain a true picture of a service user’s patterns of
day/night activity and better understand abilities and risks. This
enabled a phased reduction of care package size for users as they grew in
confidence. Efficiency savings for the council amounted in one case alone to
£36,000 pa, once ‘night wake and watch’ costs were no longer needed. Other ALT
models included GPS systems and falls detectors, and use of an electronic
‘memory book’ in conjunction with an induction hob to enable a service user to
prepare their own food independently.
pilot B we have worked with HB Villages, a provider of bespoke supported
living, to build two new blocks of individual apartments for adults with
physical, sensory and learning disabilities. These have state of the art wiring
installed at ‘first fix’ stage: from simple telecare alarm units through to
apps - via iPad or TV – which work the lighting system, close blinds, and auto
door opening. This development and the level of technology is the first of its
kind in the UK.
- Pilot C introduced ALT into residential care homes during 2013, with use of new equipment called ‘BAM Labs’ Touchless Health Monitoring. The touch-free sensors/mattress detect trends in heart rate, breathing and motion, and presence or absence. As service users’ sleep patterns improved and night wandering and falls ceased, we saw a reduction in GP and ambulance call-outs and A&E admissions.
Carers, families - and even social care staff - are often initially sceptical about ALT, being accustomed to the traditional ‘care’ model. However, tools like Just Checking enabled us to show carers that their loved one can be safe and well in a community setting, and more independent than their family ever thought possible.
Even among some service providers, ALT was not always welcomed with open arms. When BAM-labs technology showed that fewer night staff were needed in a residential home, staff and management felt threatened; but early engagement won over staff teams who initially were sceptical, and led to positive engagement.
Beyond adult social care: ALT for all
We are making ALT part of mainstream life in the community, by getting local people excited about the opportunities it offers for them and their families.
Through our Prevention Plus model we are training and supporting community coordinators in the benefits of ALT, and they will then – literally – sell it door to door. Social care staff and community development workers will take ‘Avon style’ ALT kits with them around community centre and events, using a ‘try before you buy’ approach. Public ‘pop-up shops’ will follow, with promotional literature relevant and eye-catching to all ages and groups of local people in 2015/16.
In the face of our massive financial challenges in 2015/16 and beyond, work with partners on the ‘mainstreaming’ of ALT is central to our business strategy for supporting local people in community settings.
Sally McIvor is the Executive Director People (DASS) at Blackburn with Darwen Borough Council
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