Social Care's Digital Divide

Imagine if a care worker could communicate with someone they support via the person's TV, without interrupting their viewing.
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Imagine if a care worker could communicate with someone they support via the person's TV, without interrupting their viewing.

Nottingham Community Housing Association (NCHA) has developed exactly this TV set-top box technology, SMaRT Messenger ("support, management and response team"). The system means that text, pictures and videos can be sent directly to someone's television screen without affecting their normal TV viewing.

The sender gets an alert to say the message has been received and read, and the recipient can respond using their remote control. Social care staff can incorporate the device into a personalised support plan and friends and family can download a free app to exchange messages too.

The system offers an additional way to stay in touch, rather than a replacement for personal visits or telephone calls. As NHCA explains in the SMaRT Messenger user guide, "we see the system adding regular interest and contact for someone who may other wise not be included in modern day to day messaging communication. It's about greater inclusion."

NCHA is one housing, care and support provider that uses digital to boost people's inclusion and independence. This kind of work, however, is not widespread. Technology is transforming how we live and work, but the rate at which the adult social care sector is embracing such developments is relatively slow (compared, for example, with the health service), despite a growing recognition of its potential.

Organisations that fail to get on board with the digital future risk being outpaced by change. Meanwhile providers that become technology trailblazers are moving forward in isolation from their peers.

Social care must bridge this digital divide, as VODG explains in a new publication on how technology increases efficiency and enhances individuals' lives. Technology is changing the way we live. Can it also transform the way we deliver adult social care? There are positive impacts for both the individuals being supported and the staff who support them. To understand why technology is so vital, you need only look at social care's operating context. Cost is not the only driver, but technology can provide information faster, reduce paper-based activity and help staff work efficiently.

In addition, there is a strategic push towards digital, as underlined by the Health and Social Care Information Centre changing its name to NHS Digital. But the lack of reference to social care in the new name is disappointing to many in the social care sector and the rebrand risks digital being viewed as some elite NHS activity.

But we know that many organisations working in the social care sector are embracing technology. VODG members report using IT systems to help in reporting on quality and regulatory compliance. In the home care sector, commissioners require many to use electronic call monitoring to evidence the delivery of contracted hours which is also helping to improve quality and safety.

As for the benefits to people using services, early adopters of digital systems say applying technology to service delivery can increase choice, dignity, control, independence and safety. Personalised technology can be part a core service package, or may be "added value".

Our members use a vast range of systems. There are movement sensors within the home that can indicate if support packages need adjusting or that inform risk assessments. GPS systems define an area within which a person can move about and alert staff if the person moves outside the defined area. Then there are tablet or other touch-screen technology to help communication or front door fingerprint recognition. Some of our members use apps enabling people with learning disabilities to communicate about health issues. Other gadgets include automated medication dispensers and "talking" microwaves.

The ethical proviso to all of this is, of course, that the surveillance of people who use services must be done with their full consent, as CQC guidance illustrates.

As for the benefits to organisations, VODG members are improving back office functions and support for frontline staff. Examples include improved management information or increased use of video conferencing. Social media, meanwhile, can improve engagement with stakeholders or be used in recruitment. Professional development can be supported by e-learning and smart phones offer frontline staff instant access to support plans.

With a raft of benefits for both individuals and care professionals, why is the technology take up so slow?

The main barriers were reported in a Housing LIN (Learning and Improvement Network) report and are echoed by VODG members. Challenges include a cultural reluctance to change, worries about safeguarding, uncertainty about funding and issues in commissioning and procurement (like moving to outcome-focused care planning and individualised commissioning).

In addition, VODG members suggest other fundamental problems, such as poor internet connectivity which is still an issue in both rural and urban areas. Another technical barrier is that few systems are tailored to the needs of care and support organisations; IT solutions can be costly to change or integrate with existing systems.

Such problems can be solved with greater collaboration. Organisations that share challenges could jointly design and deliver shared technological solutions, with potential savings realised through collective purchasing power. We could also do with more combined efforts between providers to improve relationships with commissioners. This could properly address how risks and rewards are shared when investments are made in technology.

It is VODG's role to support such collaborative work, while also ensuring that the rapid pace of technological change does not leave behind those currently digitally excluded. Tackling the barriers to greater use of technology together, care providers will work more efficiently, develop shared intelligence about suppliers and share knowledge and practice about how to lever digital benefits in a time of austerity.

Technology does not replace human contact, but it can support inclusion and help people to live their lives in a way they want to.