Telecare Assessor Training

2 What is Telecare? Telecare is the remote or enhanced delivery of health and social care to people in their own homes, using a combination of alarms, sensors and other equipment to help people live independently. Telecare can raise a call for help in emergency situations, such as a fall, a fire or a flood, as well as monitoring lifestyle changes over time. Telecare is not intended to replace human contact but is designed to support safety, independence and well-being of users, and to support carers.

3 Major benefits over traditional alarm services Passive system, doesn’t need the user to initiate the alarm call Environmental as well as person-centred Preventative as well as reactive

Assistive technology = A generic term for any device or equipment which enables someone to undertake an activity of daily living with greater safety and/or independence. The definition now extended from equipment such as bath seats, wheelchairs and stair lifts, to include newer stand-alone and Telecare home safety and security, lifestyle reassurance and remote vital signs equipment. Assistive technology Stand-aloneTelecare What is the difference? Stand alone used directly by the person or carer (not linked to alarm monitoring centre) Stand alone examples Recorded message memo minders Plug that releases the water in a bath before it overflows if tap left running Telecare automatically sends a signal to an alarm monitoring centre to call for assistance Telecare examples Fall detector raises alert even if user unconscious Door exit monitors that raise alert if person leaves building at inappropriate time

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Telecare System ALARMALARM Wireless sensors Response Team Monitoring Centre Home Hub

Emergency Response Teams Falls pick-up service 24 Hour --Nurse Relatives & friends Duty Social Worker Telecare Control Centre Out-of-hours GP Fire service Ambulance Police Emergency plumber 24 hour Gas fitter Mobile Warden 24 hr. Home Care Rapid Response Unit Air ambulance An appropriate response

8 Telecare Characteristics Not appropriate for every person Not a ‘one-size fits all’ solution Person-centred & needs-based, not equipment-led Promotes independence and safety Supported by a robust response infrastructure Integrates into existing practice, process and service provision Supports health and social care provision Considers ethical issues

9 Entry (Re) assessment of need Care package development Home survey Telecare prescription & response protocol Equipment provision Installation and maintenance Monitoring Call handling Response Review Telecare service integration Source: Barlow & Curry 2006 Social services Primary care Housing services Equipment suppliers Telecare service providers Acute care Social Housing landlords

10 Why use Telecare?

11 ‘Telecare offers the promise of enabling thousands of older people to live independently, in control and with dignity for longer.’ Building Telecare in England DoH July 05 ‘ Telecare is as much about the philosophy of dignity and independence as it is about equipment and services.’

12 Policy Drivers - DH documents Building telecare in England Our health, our care, our say Putting people first Delivering care closer to home Carers’ Strategy NHS Next stage Review- Primary & Community care (Darzi report) Supporting people with long-term conditions Valuing people now National Dementia Strategy

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14 How can Telecare be used?

Environment Pop-up plug Flood detector Smoke detector Gas / CO detector Extreme temperature detector

16 Security Barking dog recording PIR-activated external lighting Intruder alert Bogus caller panic button Door / window contacts Video door entry system

Safety Fall detector Bed / chair occupancy sensor Pull cord Water temperature alert Sounder beacon / vibrating alarm Memo minder Door exit monitor – wander alert GPS tracker / locator

18 Social Telecare 24/7 monitoring may reduce need for pop-in visits Need to be aware of need for contact with real people Consider volunteers to visit at home or integrate into community activities Enable meaningful social interaction Interactive systems, via set- top box, to provide info on local services, health advice, etc.

19 QuietCare Lifestyle Monitoring Passive infra red motion sensors, in various rooms of house, send info every few hours to centre, noteworthy changes flagged-up, appropriate action can be taken before crisis develops. Useful for assessment purposes 19

Health Medication dispenser Epilepsy sensor Enuresis (night-time incontinence) sensor Reminders and coaching by mobile phone (condition management) Remote vital signs monitoring (see next slide)

21 Telehealth peripherals

22 Telehealth Benefits For users and carers: the right care, in the right place, at the right time regular, consistent monitoring of vital signs avoids crises arising timely, proportionate interventions assisted self-management / patient education in keeping well care closer to home fewer surgery and clinic visits fewer hospital admissions better outcomes

23 Telehealth Benefits (cont’d) For health services: Consistent with PCT strategic planning goals, (care closer to the patient, more efficient, pro-active case management of long-term conditions, personalised care, improving health education, improved patient experience, increased numbers of people able to die at home) better use of GP and other health practitioner time better prioritisation for intervention - urgent patients can be seen faster reduced ambulance call-outs reduced trips to A&E reduced admissions to hospital earlier discharge from hospital high quality & value for money

24 Development of in-house response service Since 2009, Portsmouth Rehabilitation and Re- enablement Team (PRRT) have provided a night time (9pm to 6am) response service to support Telecare users’ own responders. They are trained in risk assessment, first aid, moving & handling, use of Mangar Elk (lifting cushion) They feedback to NHS & social care, to close information loop on fallers

25 Impact on Local Services Reducing demand on ambulance services Preventing unnecessary admissions to hospital and residential care Supporting earlier discharges from hospital, community rehab Enabling independence, dignity and choice Improving preventative services Supporting carers Stronger links between health & social care

Cost of Telecare Charges can be taken into account in financial assessment for care package, as disability- related expense No cost is made to the customer for stand-alone equipment if identified need during community care assessment. This is currently recharged to Adult Social Care.

27 Key lessons learnt The technology is only as good as the infrastructure that supports it Telecare = 20% technology, 80% people Telecare must be integrated into existing health and community care Technology package and response must be tailor-made to individual Service must be reviewed and adjusted as necessary

28 Referrals for telecare Individual can self-refer Carer can refer Professional can refer using the on line professional referral form on the web siteprofessional referral form You can phone on or for more information.

29 Useful references