Delivering person-centred and technology-enabled care for people with learning disabilities
James Mass and Harmindar Sangha
The concepts of person-centred and technology-enabled care can sometimes be perceived as mutually exclusive. Is it possible to bring them together in one package that recognises and meets a person’s social care needs? In Barnet’s recent pilot project, we set out to prove that these things can work together in harmony.
Barnet Council, in collaboration with the PA Consulting led Argenti Care Technology Partnership, recently held an event for local authority colleagues to share learning from a pilot project funded by NHS Digital and managed through Local Government Association. Barnet used the funding to explore how they might use digital technology to support people with learning disabilities in supported living settings.
Tough questions were raised at the event: can we use technology without dehumanising care? Is digital technology replacing one-to-one support and will this result in social isolation and loneliness? Are there negative impacts on health and wellbeing from using digital? And are we giving those as much consideration as the positive outcomes?
We have been asking these questions throughout the process to determine how it is possible to use technology to enhance lives, without losing focus on the person at the centre of care.
Our view is that if technology is considered as one of a range of options (which includes one-to-one support), in a way that is tailored to an individual and not rolled out as a one-size-fits-all solution, then there are real benefits to be achieved. It can support an individual’s care whilst enabling independence and providing greater sense of freedom and control at a lower cost.
To develop and deliver the project, Barnet worked with Argenti and supported living providers in the borough. The aim was to provide non-intrusive digital support to maintain the dignity and independence of people with learning disabilities in supported living facilities.
A range of technologies were used – including the ‘Just Checking’ system, which maps movement – to better understand daily routines and sleeping patterns in care settings such as supported living. By monitoring activity over time, it became clear that as well as responding to needs, support worker checks on people at night were sometimes causing avoidable sleep disturbances. In these cases, Argenti installed sensors as an alternative to physical night time checks. The individuals preferred the reduced intrusion and felt they were being treated like adults, with more independence and control, whilst still being kept safe.
Having been through this process, we would like to share some of the critical factors that determine the outcome of digital social care projects:
- Engagement of all stakeholders right from the start is crucial. This involves supported living providers, the person at the centre of care, families and carers. Be aware of the possible opportunities and barriers to engaging people and think about how you will address them.
- Consent, privacy and ethical considerations are key.
- Mainstreaming technology into social care is easier when it happens at the start of a person’s journey. It’s harder and requires more effort to introduce it when someone is already used to a package of care, although it is possible if engagement is managed effectively.
- Remain person-centred and realistic about whether you can practically and safely support someone with technology. Assess whether it is fit for purpose and can safely meet the person’s needs and manage day-to-day risk.
- Look at what existing care technologies are in place and whether and how new technology will support or replace it.
- Make sure the technology is reviewed regularly. Be clear that supported living providers understand how to use it and how to respond if any problems are identified.
- Work with supported living providers to ensure ongoing support and training is available. This input can be reduced as technology becomes embedded as a mainstream part of the care and support plan alongside risk assessments.
- Ensure your care technology provider has both the technological and personalisation skills to deliver a project of this sensitivity and complexity.
- Keep track of what’s being used, how, and the outcomes achieved. Evaluate the evidence against whether interventions are working to support person-centred care. Monitor and use information to make adjustments. Sometimes it won’t work out and the technology will need to be withdrawn.
We are in the process of mainstreaming digital care technology into all of Barnet’s social care services. This project is another step along the way. It’s clear that using digital technology is a balancing act, but we have shown that if care is taken, service users will see a tangible benefit and the wider costs of providing supported living can be sustainably reduced.
About the authors
James Mass is Assistant Director at the London Borough of Barnet. He has led the growth in adoptions of assistive technology in the borough to improve outcomes and achieve savings.
Harmindar Sangha is Programme Manager for the PA Consulting Argenti Service in the London Borough of Barnet and is a specialist in driving care technology change in learning disabilities and supported living.
About the project
The Barnet Council pilot project was part of the Social Care Digital Innovation Programme, funded by NHS Digital and managed by the Local Government Association.
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