Acare home is not a settingtraditionally associated withnew technology but in just afew months, Covid-19 has

resulted in a digital transformation inresidential care to the extent that familiesare communicating via video to stay intouch, health professionals areconnecting with care homes virtually,and remote monitoring and visitortracking systems have become part ofday-to-day practice.Before Covid-19, “there was little

digitisation in care homes,” says DanielCasson, adviser on digitaltransformation to Care England. “Therewas a slow move towards digital care,”which is partly because many carehomes are small operations and fundingfor these systems was an issue, he says.Pre-pandemic, other challenges social

care providers were facing when it cameto adopting technology enabled careservices included the sector being “riskaverse, and slow to adopt newtechnologies or ways of working”, saysZillah Moore, director at TunstallHealthcare, which provides technologybased solutions and services to health,housing and social care providers.Another challenge, she says, is that

“some care professionals are alsoconcerned about technology replacinghuman contact”.

Accelerated need for technologyBut this year, in response to Covid-19, thegradual and growing interest in, and needfor technology in care home settingsaccelerated. “This acceleration has partlybeen driven by the need to find ways tohelp people stay connected with theirloved ones and for residents to feel liketheir families are still with them, virtuallyif not physically,” says Liz Jones, policydirector, NCF.The rapid rise of technology in the

sector has also been driven by the needfor care homes to be able to safely accessservices from healthcare professionalssuch as GPs, and for staff to be able to

worth £7.5m to care homes acrossEngland, to help residents connect withfamily and help staff access healthcareinformation quickly.NHSX has worked with telecom

providers and government to ensure carehomes could access cheaper internet dealsduring the pandemic, and has producedguidance and resources for care homesduring the pandemic. It is also workingwith NHS Digital to enable care homes toget quick, free access to NHSmail. Themove is “the start of care homes beingintegrated into the health and social caresystem,” suggests Daniel. All care �

technology in care January 2021www.careinfo.org

25

How technology istransforming care

There has been a rapid rise in the use of technology in

care homes since the pandemic. Kathy Oxtoby talks to

those working in the sector about its benefits and

challenges, and how it is changing practice.

Before Covid-19, “there was little digitisation in

care homes,” says Daniel Casson, adviser on

digital transformation to Care England. “There

was a slow move towards digital care”.

Daniel Casson,

adviser on digital

transformation

to Care England

Residents at a Barchester care home using

their ‘magic table’

attend meetings and attend trainingsessions, while minimising the risk ofinfection. The role of virtual technologyhas been critical in achieving this. “Wehave had to find virtual ways of keepingthat communication and support flowingfrom a workforce point of view,” says Liz.This July, a report published by Digital

Social Care, NHSX and the Institute ofPublic Care at Oxford Brookes University,revealed the latest data and informationon how social care providers have beenusing technology during the COVID-19pandemic. The report, The Impact ofTechnology in Adult Social Care ProviderServices, shows the use of technology forsocial care providers has changed rapidlywith the Covid-19.To encourage tech take-up in the sector,

information governance compliancerequirements have been temporarilyrelaxed. And "thousands of care homeshave really made use of tech during thepandemic, enabling their residents to seetheir GPs or their families remotely”, anNHSX spokesperson says.Supporting this use, in September

NHSX distributed up to 11,000 iPads

technology in care January 2021www.careinfo.org

26

� homes have been asked to start usingthe Capacity Tracker as a priority.An established tool developed inpartnership with NHS, local authorities,and care providers, the Capacity Trackerprovides information that supportsdischarge planning processes andenables tracking of care home capacityand vacancies.

Keeping families in touchVideo conferencing is being widely usedby all providers, with the three maindrivers being virtual GP appointments,keeping families in touch, and internalcommunication between dispersed staff,according to The Impact of Technologyreport.“Since the pandemic we’ve seen amuch faster adoption of videoconferencing software and a big rise inpeople using Microsoft Teams andSkype,” says Katie Thorn, digitalengagement manager, registered nursinghome association, and project lead,Digital Social Care.Another major change in the use oftech in the sector during Covid-19 isaround staff recruitment and training,with organisations “using videoconferencing software to do train peopleremotely and interview new staffmembers”, says Katie.

Improving people’s livesWith so much happening in digital techin the sector it is important to captureinformation on the latest innovations andshare good practice. NCF’s ‘Hubbleproject’, funded by NHS Digital’s SocialCare Digital Pathfinders grant, aims to“support and inspire the care sector toembrace digital technology in their caresettings in order to improve people’slives through the use of technologybased, data-enabled care”.

The Hubble Project allows social careproviders to virtually visit ‘innovationhubs’ to learn how other care providershave introduced, used and evaluateddigital technology to improve care. Thehubs are based in three care settings inEngland and showcase a range oftechnologies which include, electroniccare planning, circadian lighting, sensortechnology and telecare.The project’s webinar sessions use amixture of pre-recorded content and liveQ&A, with managers and staffdemonstrating the technology that theyuse and their digital journey. Thisincludes how they came to adopt newtechnology, the challenges and thebenefits of implementing and using it,and the use of data to improve thequality of care.“What’s been great about running thisproject is that people - both big andsmaller providers - are telling us aboutwhat a great difference these projects aremaking to the care of residents, says Liz.“Tech is giving amazing dataintelligence, such as a record of how aresident is feeling, what their favouriteactivities are, or whether they’ve had areaction to medication. And having dataabout them gives us the potential toimprove the way we do things,” says Liz.

Tech benefitsTechnology has the potential to“transform lives and make a significantcontribution towards the ultimate goal ofpreventative health and care” says Zillah.“Solutions not only give users greaterchoice in terms of the care they receive,but also prevent incidents (such as falls)and generate rapid responses, leading toa reduction in the requirement for morecomplex and costly care by mitigatingconsequences,” she says.Technology in care homes “creates

Both big and smaller providers are telling us

about what a great difference these projects

are making to the care of residents

Liz Jones,

policy director

at NCF

“Since the pandemic we’ve seen a

much faster adoption of video conferencing

software and a big rise in people using

Microsoft Teams and Skype”

Katie Thorn,

of Digital

Social Care

value for the person, for the carer, and forthe care organisation”, says Daniel.“Value for the quality of life of the personbeing cared for, value for the carer thatthey can better manage their day and forthe organisation as it makes it moreefficient and it can market itself better”,says Daniel.Katie says that generally peopleworking in the sector are positive aboutthe growing use of technology in care,and that they recognise the time savingand quality benefits of digital recordkeeping, and the “incredible” value ofresidents and their families being able tokeep in touch with video calls when faceto face visits are not possible. And shesays for residents, being able to do onlineactivities such as quizzes, means “peoplecan still do those activities that are soimportant to them.The benefits of technology come at aprice. For smaller organisations cost canbe “one of the biggest barriers” toadopting tech systems, says Katie. In thelong run however, “they can end upsaving staff time”. If cost is an obstacle,then companies could consider takingadvantage of some of the free offeringsand trials available to see the benefits forthemselves, she advises.Liz suggests being a smaller companycan actually make it more nimble when itcomes to introducing new technology, incontrast to larger organisations who willneed to roll out new systems across manysites.But ultimately, as Daniel points out,companies need to maintain acompetitive edge, “so the question forpeople to ask is not ‘can I afford thisdigital technology?’, but ‘Can I afford notto have it?’.Using equipment can be a challenge forproviders with many saying that it’sdifficult to navigate the best options to

technology in care January 2021www.careinfo.org

27

respond to the needs of the people theysupport, themselves and other parties inthe system, according to The Impact ofTechnology report.And lack of strategic technicalguidance, data protection and cybersecurity were all identified by providersas barriers to their uptake of technology,the report finds.Some practitioners may be concernedabout whether technology, in particularremote monitoring software, might affectthe relationship between “the carer andcared for person”, says Daniel.

Lack of confidenceLack of confidence when using newtechnology is a common barrier.“Learning about new tech can bestressful and involve a steep learningcurve,” says Katie.The Impact of Technology reportcontains several recommendations toensure the sector continues to take updigital solutions and details howproviders can be supported, including “areview to ascertain how to prepare theadult social care workforce to deliver thedigital future”.Zillah would like government to“provide greater support to empower allhealth and care providers to becometechnologically enabled and achieve aminimum standard.”And she believes training must beincluded in all health and careprofessionals’ education, to ensure thatdigital solutions are deployedeffectively.”In addition to training, a lack of staffconfidence can be overcome by “goodleadership and understanding thebenefits of technology”, says Katie.“People are more willing to learn newskills if they can see the benefits,” shesays.It also helps for providers to “have avision” of what they want to do with newtechnology in their care homes, and to“share experiences with each other andthe important lessons learned, such ashow to buy systems that ‘talk’ to othersystems”, says Liz.

Here to stayAs for the future of technology in carehomes, the transformation that took placein the first few months of 2020 are here tostay, those working in the sector believe.“This is a permanent change andpeople won’t want to step back from

what we’ve got now,” says Liz. “Ourappetite has been expanded for systemsthat make life simpler and easier and thatjoin up the care around a person. Wecan’t go back to working with bits ofpaper,” she says.For Katie, the landscape of howservices are delivered in residential carewill continue to change. But whileacknowledging the “great benefits” oftechnology to the sector, she believesthere is room for improvement. “In thefuture I’d like to see more joined upsystems working between care homes,GPs and hospitals,” she says.And while welcoming the massiveuptake of technology in the sector, shecautions, “we should never adopttechnology for the sake of it. We need toremember the person being cared for, andto think about what works for thatindividual.”

Using technology in creative waysBefore the pandemic, The Manor House,in Barnard Castle, County Durham, , wasa regular user of technology. This 70-bedcare home, which is part of the AnchorCare Group, was the pilot home for theHealth Call Digital Care Home scheme,which is designed to support electronicreferrals. It also permits the creation andsharing of baseline observations todevelop a record of what is ‘normal’ foreach resident and also identify signs ofdeterioration.Run by Durham County Council andCounty Durham & Darlington NHSFoundation Trust, the system has sincebeen rolled out to 93 care homes acrossthe County. Care homes receive a packwith tablet and medical equipment to usefor remote monitoring plus training andtechnical support.Lynn Cuthbertson, care home managerfor The Manor House, says one of thebenefits of the system is that electronicreferrals reduce time spent waiting inphone queues to request, say, a districtnurse home visit, freeing their capacity todeliver direct care.

Solutions not only give users greater choice in

terms of the care they receive, but also prevent

incidents (such as falls) and a reduction in the

requirement for more complex and costly care

by mitigating consequences

Zillah Moore,

director at

Tunstall

Healthcare

At the start of the pandemic, she saysthe Anchor Care Group equipped itshomes with plug-in portals that amplifysound, helping hard of hearing residentsbetter communicate with their relatives.The home also has three iPads - one foreach unit – and regularly uses video callsfor GP consultations.Lynn says: “Technology is never goingto replace families being able to come tothe home and give your mum a hug. Buttechnology can help people to still feelconnected to their communities.”Traditional community activities havebeen replaced with virtual events. “Thissummer we had a virtual country show,with families taking pictures and videosthat we collated to show residents on ourTV screens, including a dog with thewaggiest tale competition!“We used technology in creative waysto get as close to the countryside as wecould get for our residents. And theyloved it,” says Lynn.

Working hard to support theresidents with new technologiesSouthampton City Council has a well-established programme of support for60 care homes in the area, many ofwhich are small providers. When thepandemic hit and local authoritieswere given infection control funds bycentral government, the council, inpartnership with NHS Southampton CityClinical Commissioning Group (CCG),used £60K of that money to provideiPad Carts to every care home inSouthampton to help keep residents intouch with loved ones and healthcareprofessionals.The city-wide roll out of 60 iPads onmoveable carts comes after a successfulpilot earlier this year at Holcroft House, acare home run by the council, which isregistered to support residents with a �

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continue to keep people close whenvisiting was restricted”. Its homes haveall been supplied with new tablets to helpresidents stay connected with their lovedones.For those looking for care the group

switched to offering digital show-roundsusing video technology. It also providesvirtual tours of the home and sendsdigital brochures.As residents have been unable to go out

of the homes, “our activities teams havehad to bring life inside our homesthrough the use of technology andplanning activities, such as ‘armchairtravels’ and ‘virtual cruises’.Barchester Healthcare has developed an

online visitor booking system “not only tosupport our residents to have visits in ournew Covid-secure visiting suites but alsoto capture vital track and trace informationand ensure we have space between visitsfor infection control processes andcleaning to take place,” the spokespersonsays.For staff, the group has moved its

customer experience training online. Somestaff members “struggle” with newtechnology “but we have supported themwith additional training to help them getto grips with the changes in working waysand new kit” the spokesperson says.Feedback from resident’s families about

staff has been “fantastic”, including praisefor staff for their efforts “to provide phone-in facilities using the house phone, mobilephones, tablet contact with FaceTime andSkype calls”.Some of the positives of Covid-19

“should be embraced for the longer term”,the spokesperson says. For example,while before the pandemic use of Zoommeetings and video calling was sporadic,“now it is a robust part of life at our homeswhich families and residentsrely on”.

Examples of care homes using

their iPad carts include allowing

residents to enjoy a virtual meal

with their loved ones over video

call whilst homes were in

lockdown, use by residents to

access dementia friendly

games, and virtual ‘ward

rounds’ with GP practices.

� diagnosis of dementia. The roll out ofthese devices will enable care homes toconduct video consultations with healthand social care professionals during thecontinued pandemic. Residents can alsouse the devices to use Skype andWhatsApp to keep in touch with familyand friends while Covid-19 visitingrestrictions are in place.Barclays Digital Eagles, as part of a

partnership with NHS Hampshire and Isleof Wight Sustainability andTransformation Partnership, havesupported care homes to set up their iPadsand helped to build skills and confidencewith their functionality as part of thedigital skills training scheme for carehomes across the Hampshire and Isle ofWight region.Examples of care homes using their iPad

carts include allowing residents to enjoy avirtual meal with their loved ones overvideo call whilst homes were in lockdown,use by residents to access dementia-friendly games, and virtual ‘ward rounds’with GP practices.Michelle Fellowes, manager of Holcroft

House, says: “Staff have been workingreally hard to support the residents withnew technologies and we have beendelighted with how our residents have

responded with their family membersonline. They have found this fascinating tobe able to see and speak to their loved oneslive, almost as if they are in the room withthem.”Councillor Lorna Fielker, cabinet

member, health and adult care, says inaddition to the iPad carts, she says thecouncil has ensured every care home in thecity has access to NHSmail, Microsoftteams, and technical support in the form ofmobile device management software.Lorna says that even when life returns to

‘normal’, “digital technology will continueto provide benefits for care home settings”.

A robust part of life whichresidents and family rely onThere has been a “massive shift” in howBarchester Healthcare operates since thepandemic hit. “We were very much a face-to-face business and we have had tochange and evolve extremely quickly,” aBarchester Healthcare spokesperson says.The group has invested around £60K in

new devices and digital subscriptions as aresult of the pandemic. To help familieskeep in touch, the independent careprovider, which runs over 200 care homes,shifted from visits to video calling“immediately, to ensure that we could