Installing some of the latest gadgets and wireless sensors in the home can help older people live independently for longer – while saving local authorities money.
Telecare packages – remote care for elderly and disabled people – are increasingly being offered by councils to replace, supplement or even pre-empt adult social care packages. Telecare is a system of sensors installed throughout a person's home that alert a carer, relative, neighbour or charity if something appears to be wrong.
A typical package can include door and bed sensors that send out an alert if someone has been motionless for a period of time; carbon monoxide sensors that give early warning if gas rings have been left on; flood alert warnings; medication dispensers that allow carers to remotely monitor if medicine has been taken; and pendants that vulnerable people wear around their necks, that alert carers in case of an accident or fall.
In collaboration with international services company Serco and a leading provider of telehealth services, Tunstall, Hertfordshire county council has installed telecare systems in 1300 homes since September – the UK's most comprehensive remote care arrangement yet. Iain MacBeath, Hertfordshire's director of social care, has received a lot of positive feedback from both carers and service users.
The daughter and main carer of an elderly woman in Hertfordshire told MacBeath that having "24 hour unobtrusive observation" had greatly improved her mother's confidence and quality of life. "She appears happier and more content living on her own since having telecare installed. I feel far less worried about her being on her own and happier she is able to maintain her own independence for a longer time," she said.
By April 2014 it is expected that 4000 homes in Hertfordshire will be equipped with these gadgets, said Frazer Dawkins, development director at Serco. Telecare services are likely to save Hertfordshire county council money on home care bills, and referrals into residential care are expected to decrease or be deferred to much later than would normally occur. To continue with the previous model would have seen care costs in the county double by 2026 and instead these costs could be dramatically reduced, wrote Dawkins for the Local Government Network.
In an effort to cope with budget cuts from central government, many local authorities have been forced to change the eligibility criteria for applying for adult social care. More than half of councils that responded to a Guardian survey in March said they were cutting their adult social care budgets. Assistive technology that helps vulnerable people live independently for longer may be one way to offset spiralling costs – an attractive prospect, especially at a time when people are living longer than ever.
And there is evidence of the benefits of telecare, for services users, councils and the NHS. The Department of Health's whole system demonstrator programme – set up to show what telecare is capable of – suggests that correct use of telecare can reduce emergency admissions to hospital by 15%, bed days by 14% and mortality rates by 45%.
Monitoring technology can also ease the pressure on overworked care-workers, because "pop-in visits" simply to check up on someone are no longer required so face-to-face visits can be more useful and targeted at those in greater need, said Dawkins.
It can also be a preventative measure. Of the 1,300 telecare packages provided by Serco in Hertfordshire, 400 are for people who do not receive adult social care but are at risk of requiring it in the future. "We have implemented an integrated point of access for all GP referrals in the county," said Dawkins. "So everyone who needs either a healthcare or adult social care service will come through that system and we can then assess whether those people would benefit from having a telecare system at that point."
As well as expanding telecare services into other local authorities, such as Westminster city council and Thurrock council, Serco is working with the public, private and voluntary sectors to ensure telecare technologies are implemented with best effect. Through a network of partnerships, Serco hopes that any vulnerable person in the county can be reached within an hour, said Dawkins.
Healthcare provider Tunstall installs the telecare systems in Hertfordshire and controls the monitoring centre to which alerts are sent. Tunstall has provided these services for more than 4.8 million users in at least 50 countries.
In Hertforshire, the British Red Cross delivers an alternative response service to those people who are provided with telecare alarms but are not fortunate enough to have relatives, friends, neighbours or carers listed as their responders when an alert is raised. The British Red Cross also steps in when the Tunstall call centre has been unable to contact a vulnerable person's named responders.
Geraldine Spearman, British Red Cross senior service manager for health and social care, said: "The British Red Cross is very experienced in providing time-limited support to those in crisis. By working in partnership with Serco and Tunstall we are able to do just this as one crucial element of the telecare service in Hertfordshire."
Telecare systems are becoming more and more popular, and have often been tipped as the future of adult social care. "There were sporadic pockets of telecare provision in Hertfordshire before this service was launched but there wasn't a ubiquitous county-wide system, which is now providing significant benefit for those who rely on its use," said Dawkins.
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