Podcast Episode: Care Inspectorate: using digital devices in care homes
Category: Digital inclusion
What follows is a transcription of the audio recording. Due to differences between spoken and written English, the transcript may contain quirks of grammar and syntax.
INT: Near Me in Social Services is a project Iriss has been leading in partnership with the NHS Near Me team and the Scottish Government Technology Enabled Care (TEC) Programme over Autumn/Winter 2020/21. The project is producing new evidence around the priorities, enablers and challenges of using video consulting in social services.
Iriss has supported five services to participate in a rapid Quality Improvement cycle to start using Near Me; provided light touch improvement support to organisations that are setting up Near Me independently within their work, and has developed a Learning Network.
The Learning Network aims to build on and continue the support to these organisations using Near Me, while increasing the scope of support to others. Each Learning Network meeting includes speakers on related topics.
In this episode, Yvonne Leathley, Senior Improvement Adviser at the Care Inspectorate speaks about a project to supply digital devices to care homes to improve connectivity.
Yvonne: I just want to talk through a project that you may be aware of if you’re engaging with care homes that has been undertaken since November which is in relation to providing digital devices to care homes to improve the connectivity. So, I’ll just run you through this project and you can see how it links to potentially your activities with rolling out Near Me. So, care homes in Scotland just initially, a bit of background relating to things. So, there are over 14,00 care homes in Scotland and they provide homes for over 50,000 people. Bit of demographics, 18,000 people are over 8, 25,000 people are living with dementia and 2,000 spaces are for respite care. So, when you start to look at those sorts of figures, you know 2000 people with respite places, coming in and out of homes, wanting to keep connected with their family possibly would be a great advantage. 20,000 people living with dementia means we have to have carers who really know their needs and 18,000 people over 85 is showing that it is an aging population there that we are catering for.
So, background to why we did the piece of work, back in April time as part of the rapid roll out for Near Me in response to the Covid 19 pandemic and trying to ensure that services continued, the Care Inspectorate led on an engagement piece of work and colleagues got in touch with all care homes across Scotland, nye on all 14,000 … I think we had 95% re-engage with, explaining what Near Me is and talking through what care homes needed to have in order to receive and participate in calls and giving them the opportunity to undertake a test call. That gave us some figures relating to connectivity, relating to care homes. Later in the year there were 2 significant pieces of work came forward, the Adult Social Care Winter Plan, which is a government document and in that it identified that there was going to be half a million pounds for the digital care homes piece of work and that’s around ensuring that care homes could receive digital devices with connectivity. And that document also identified how Near Me would be rolling out into the social care sector.
The other document is the Digital Approaches in Care Homes Action Plan which also was released in December and that confirms not only the approach relating to connectivity but a whole range of other actions that we’re hoping to pursue to support the development of care homes becoming more digitally orientated so that looks around the digital foundations so, connectivity, services, what can be provided digitally and indeed leadership so, what skills and training do people need in order to progress. So, that’s a little bit about what we’ve been doing.
So, the Near Me piece of work that the Care Inspectorate’s led on back in, as I say, April/May time identified the connectivity within care homes and at that point in time, we asked the question relating to, as I say, connectivity and people were asked: do they have full, partial or no connectivity in their care. And at that point in time 5% of the care homes said they had no connectivity and 39% said they had partial. So, effectively we had over 45% of people had limited access to digital connections. You know over 55% of people had that opportunity to engage from the care homes should they wish to. So, it’s something that we wanted to try to address and improve.
The piece of work that we’re now engaging with, that was launched in November, it’s giving every care home that applies the opportunity to receive at least one digital device. The forms that people have been completing identify that 9% of care homes actually don’t have a Wi-Fi connection and 36 have partial coverage and 55 have full coverage. Slight difference between the two graphs and I think that comes down to the fact that when we were asking six months ago, we had a different interpretation around what partial coverage meant and care homes were very much at their early stage of understanding and using digital connections. It’s improved significantly and changed significantly over the last six months.
So, 67% of all Scottish care homes have applied for devices and that now means that actually 90% of care home residents have access to digital services should they wish to or be able to. So, again in numerical terms we’ve had over 1500 devices, and they are iPads, sent out to care homes and we’ve supported those with over 600 MiFi units. So, they have gone to the care homes who have either got no or partial Wi-Fi, one of the things that we were really keen on is the ensuring that within the care homes every person would be able to use a digital device within their own private space and quite often the homes that have the partial connectivity, that only actually means that the connections are in their communal areas or only go so far away from the main office.
So, by providing the MiFi units, the residents who live at the very end of the corridors or next to the stairwells, can now utilise a device in their private space, should they wish to. 130 care homes didn’t have the devices and that relates to over 3000 people, so again that’s really improved in connectivity rates and has started to remove the exclusion that had occurred to this point in time. So, it’s a starting point and it’s a huge improvement. But what does this really mean?
Part of the work that we also did was, as you’ve identified in your current piece of work, you did some engagement work, the tech team: we’ve held 4 engagement pieces of work to date and that’s for any care home to come along, we’ve had 120 participants and that was introducing people to the devices, providing ideas of how devices could be used with residents and identifying a whole range of resources that may be utilised as well. The devices are issued by Connecting Scotland and they have run 6 sessions to date and they’ve had 124 participants. And their sessions have engaged a little bit more with how to use your iPad and a little bit more around the actual controls associated with the device. So, it’s great to see we’ve had such numbers in such a small period of time.
One of the things that was identified from both of the different groups of sessions was that care home representatives would like to have some kind of knowledge exchange so we ran two sessions last week and 24 people participated and that was all around how devices could support wellbeing and resilience. And that was for staff and for those living in care homes so, it was around supporting people and identifying resources and we’re hoping to run two or three more sessions in that same manner. The sessions are likely to be just half an hour, 3 quarters of an hour in length and the topics will be based on areas that have been identified and suggested by care home representatives. So, we’re listening to the sector and responding to their requests.
What I want to go through now is, we did some early work: we have a group of six care homes and we did an improvement cycle with one particular care home that was really, really successful in capturing information. So, I just want to share some of the data relating to a care home over a four-month period. That care home, back in November, had a computer in the manager’s office, they didn’t have digital devices at all, this is a really big step change for them. So, back in November they used the digital device for just over 200 minutes in the month, by February they were using it for over 2000 minutes in the month which is a massive, massive increase. During their first month, they had 14 people and that’s the residents, the people living in the care home, use the device and that peaked to 27 people during January. This care home has approximately 35 people living in the care home, so it’s a fantastic engagement level. And one of the things we were keen to see as well was that the number of carers who were actually supporting those living in the care home increased. We were hoping that it wouldn’t just be the activities coordinator that was supplying the support and indeed the numbers have increased.
So, initially we just had four people and that increased to nine, dropped to seven and then has moved to 11 people providing support. Other people in the care home have used the device but that’s just the numbers that are actually providing that one-to-one support. So, we’ve still got a little way to go with that as the care team is, in total, probably about 24, I think it is, so we’ve got a little way to go but more and more people are becoming familiar with the device which is great to see. So, now a bit more around how the care home has used the device and I’ve highlighted three particular figures here.
So, again this is the use over the four-month period and you’re really interested in Near Me, so at the bottom the 8% of use, that’s the total amount of time that the care home has engaged using Near Me out of those 2000 minutes. And that’s fantastic, they were using it on a weekly basis and they have been since December but interestingly, Near Me is only actually one video consultation platform so it’s great to see the fact that a further 12% of that use is used for connections with family and friends. So, the care home and those living in the care home and those providing support are using this device for 20% of the time to engage with video calling and that’s really getting people, giving them the opportunity to become very familiar and indeed, people are becoming extremely confident in participating in calls and creating calls. Interestingly, I know it’s part of your project as well, the 5% figure at the bottom is the number of care reviews that are taking place and this is a care home that isn’t in any of the other projects so they have 5% of the time using the digital device for care home reviews, you know for care planning purposes and that’s even, you know we had a really great success where one individual engaged with their care manager without support so, they undertook that independently which is a fantastic thing to see.
So, the 34% and the 11% figures, that’s relating to activities supporting the care home and those living in the care home, staff training and lateral flow testing for both staff and residents so, that’s all activity that is new to the care home since January so they’re finding having a device absolutely so beneficial because they’re one computer in the office is used quite extensively so all this additional activity that requires digital connections, they’ve found the device to be a great benefit and over on the other side, you can see the range of different actions that care home, those who are living in the care home: the care home residents are using the device for. And that’s quizzes and games, listening to music, participating in watching videos, exercise classes, doing some memory work and looking and reminiscing work, so a whole range of things which absolutely would have been taking place in care homes prior to receiving a device but of course over this last year, the way in which activities have had to be undertaken has changed significantly so, the devices have become really, really an integral part of this care homes actions now.
What I’d say to move forward, you know, your recommendations for moving forward, I would really say, explore a quality improvement approach. Look at personalisation, the care home had access to an iPad, and a Chromebook so it was around which device suited which people best. It isn’t one device that fits everybody, there is the element of choice and it may be that based on an individual’s experiences or how they’re feeling on any particular day, then they wish to participate or not. So, we need to really give people that option of choice.
And experienced care home staff and those living in the care home, every time they’ve used a device, they’ve become more and more experienced in using it and trying to explore more so, it’s really been great to see. And of course, for both the care home staff and those living in the care home, we need to look at further development so through the network that you’ve participated in, I’m sure you’ve had access to a range of opportunities, and there are lots of different things out there so, it is around looking at CPD, to support professionalisation and to support those living in the care home around their own development in using the device, exploring different things, using hot keys, using styluses, using different devices so that people can use what’s best for the activity they want to participate in.
So, if you’ve tried to use a device with somebody and it’s not quite worked, I would really recommend taking a step back, thinking about what you could do differently for the next time to try to make that a different approach both for yourself and for that person you were trying to work with because, absolutely, it’s not the right thing for everybody but a lot of people are finding that this is a tool that they can engage with.
I would reflect finally on the fact that actually today is Global Recycling Day so, talking about digital connections is a great thing to do because much as technology does move on, we don’t all need to have the most highfalutin, fanciest iPhone available in order to connect, we do need to have a strong connection but most devices will enable us to connect and engage and of course this does mean that we don’t necessarily need lots of pieces of paper, we do need to have these big pieces of plastic in front of us but we don’t need as much paper so, you know, maybe just think about how we can recycle some of the devices that we have access to, to support what we do. So, thank you for listening, I hope that was useful for your overall project.
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