Telecare Outcomes

Telecare performance reports from social care authorities (2008)

Updated to 27 January 2009

In April/May 2008, CSCI collected performance data from 150 councils with adult social services responsibilities (CASSRs).

Further information about the performance data is available in the November 2008 newsletter. The following reports are available:

1 Spreadsheets with additional user counts and expenditure: National and Regional Breakdowns.

2 Reports on responses to questions about outcomes and mainstreaming of telecare in England: Main Report, Main report with highlighted keywords, Regional breakdowns covering East, East Midlands, London, North East, North West, South East, South West, West Midlands, Yorkshire and Humberside. Keyword Analysis against 150 responses (see November 2008 newsletter for more information).

3 Extracts from 150 CSCI Reports (2008) making reference to telecare.

4 Themed summaries including case studies eg Dementia; Telehealth and Telemedicine; Falls; Carers; Intermediate Care, Hospital Discharge and Re-ablement; Smart Homes and Demonstration Sites; Extra Care; Benefits and Business Case. These themed reports include extracts from the 150 social care returns from 2008. They can be used to identify approaches that have worked successfully in other areas. The examples used provide some self-reported case study evidence against the main aims of Building Telecare in England.

Examples of dementia case studies and examples from social care services reported in 2008 include:

Bath and North East Somerset have used a telecare assessment system as part of their dementia care programme. Outcomes have included improved assessment of behaviour leading to medication reviews, more effective prescribing, increased family/carer re-assurance, strategic use of services to support the individual and an overall reduction in placements. Their telecare pilot concluded that the most significant benefits and the most positive outcomes could be evidenced for people with early to moderate dementia, who were supported to remain at home indefinitely, or for longer than anticipated periods, before being admitted to residential or nursing care.

In Bexley, The Telecare Dementia Project provided more detailed outcomes based on advanced equipment in situ in peoples homes. Carers have responded positively stating that anxieties have reduced and they are now able to undertake tasks such as shopping. In a case example, Mr A, an older man with dementia lives with his wife and daughter. Identified risks included leaving the property alone and becoming lost, flooding the bathroom, and unsafe use of the gas cooker. Various sensor and detector equipment were provided which alert his wife so she can immediately deal with the problem before it reaches a crisis. Mrs A is very pleased with the telecare system as it gives her the reassurance that effective systems are in place. Also she no longer needs to follow her husband around and says she is now able to do more in the garden which gives her pleasure and relaxation.

In Bracknell Forest, a 90 year old man with type 2 diabetes and high blood pressure with short term memory loss has been given a medicine dispenser which saves his son ringing several times a day to remind his father to take his medication. In another example, a 78 year old with Alzheimer's Disease, lives with her daughter and son in law who both work full time. She has good physical health and is quite active. She has a history of wandering during the day and leaving taps on. A flood detector in the bathroom, a property exit sensor and a passive infrared detector for inactivity were installed. Both family members are relieved to know that they will be informed in a timely manner for prompt action should their mother leave the house or leave taps on. They are both able to continue in employment.

In Bradford, carers report that they are reassured about management and reduction of risk and given more personal freedom and support. Assessment equipment (lifestyle monitoring) and a voice prompt system reduced risks to a service user with dementia to live on her own and prevented admission to a care home.

In Richmond, a pilot project assessing effectiveness of telecare for older people with Alzheimer's Disease & carers installed telecare devices (50 sensors) for ten people. This included smoke, natural gas & carbon monoxide detectors, property exit (for wandering) detectors & temperature extreme sensors. Flood, bed, sensor pillow alert & sounder/visual beacon sensors were also installed. Feedback from carers indicates decreased anxiety & stress. Users were supported to continue living at home through this risk management approach. The incidence of wandering, home safety (gas/smoke/carbon monoxide), flooding & falls has reduced.

In Salford, examples include: (1) An elderly man with dementia and a history of wandering, which often involved the police, remained in extra care housing for a further 12 months following the installation of door contacts. Without this provision he would have required residential care (2) A couple, Mrs A with dementia & a history of falls and Mr A is hard of hearing and was not getting any sleep listening out for his wife. The provision of a telecare bed sensor has provided a solution to the problem & enabled him to get a good nights sleep.

In Solihull, one client with Alzheimer's Disease had begun to leave gas appliances on unlit and as a heavy smoker, she also left lit cigarettes in ashtrays. Smoke detectors and a gas detector/shut off valve were installed to manage the risk and as a result the lady was able to continue to live safely in her own home. Carers were also reassured about her safety. Another service user with Alzheimer's lived alone and frequently left her home in the middle of the night. Sensors were installed which ensured assistance was summoned if she left the house and this meant the risk was reduced and her son felt reassured his mother could continue to live in her home rather than need admission to residential care.

In Trafford, Ms X has advanced dementia and due to issues of personal safety (wandering at night, leaving cooker on, bogus caller incident) her son was considering residential care as he could no longer sustain the caring relationship because of the impact on his job. The installation of a bed sensor, wanderer alarm, bogus caller warning and smoke detectors mean that Ms X has been supported to safely remain in her own home, promoting her choice and independence, while her son has been able to remain in employment and has reported a huge reduction in the stress he was experiencing.

In West Berkshire, an older person with dementia, receiving 24 hour care and supervision in own home, was restricted to living upstairs as mobility decreased. A bed occupancy sensor was used to alert the spouse and also to support live-in care to be arranged allowing the spouse to have a respite break.

In Wokingham, family stress and anxiety has been reduced with a wireless alert to the carer which signals when the service user who has dementia leaves her room at night (used to attempt to cook at night in the kitchen which was a gas safety hazard). The carer reported: "I worry a lot less since the equipment was installed". in another case, a husband is now able to sleep at night because he knows he will be alerted by a floor contact mat if his wife, who has dementia, gets out of bed.

Contact Mike Clark at telecare@dhcarenetworks.org.uk for further assistance with analysis and benchmarking of telecare information from around England.

Outcomes from Telecare and Advanced Assistive Technology - Two Years of Progress

Presentations from events at London (27 January 2008), Leeds (29 January 2008), Manchester (4 February 2008), Taunton (7 February 2008), Birmingham (12 February 2008):

Barnet (Guy Dewsbury), Barnsley (Michael Breeze), Birmingham (Andew Sheehan), Bristol (David Baines and Mary Breeze), ChesterCare (Fran Taberner), DH Care Networks - Mike Clark, DH Care Networks - Simon Brownsell, Department of Health Demonstrators (Tim Ellis, Claire Whittington), Havering (Sue Blakeley), Newham (Charles Lowe), Croydon (Kathy Grafham), Lancashire (Steve Sylvester, Mark Luraschi), Lincolnshire (Deborah Shepherd, Alex Newton), London Telecare (Doug Miles, June Curran, John Chambers), NHS Connecting for Health (George Mac Ginnis, Michael Dillon), Southampton (Chris Webb), Southwark (Jacqui McLaughlin), Staffordshire (Jim Ellam), Stoke (Peter Ball), Surrey (Gerry Allmark), Telecare Services Association (Marian Preece, Gerry Allmark, Malcolm Fisk), Imperial College (Jane Hendy and James Barlow), Walsall (Tony Diaram), West Yorkshire Group (Calderdale, Kirklees, Leeds, Bradford, Wakefield - Sharon Jarvis),

DH Care Networks would like to thank all of the contributors to the five events.