The Columba Project in Runnymede Dr. R. G. Curry Telecare Advisor, N Surrey PCT Research Fellow, Tanaka Business School, Imperial College London Housing LIN, Brighton, Jan 05

Columba Project Partners Surrey Social Services N Surrey PCT Woking Area PCT Runnymede Careline Evaluation: Imperial College Technical: Tunstall Telecom

Columba Objectives  reduce the need for residential home placements  use of telecare to support people at home

Columba Background  65+, loosing confidence,  RH, motivated  Telecare as part of a re-ablement and skills gain programme followed by appropriate support package in the patients’ homes  Uses telecare in 4-bed RA Unit (Brockhurst) and in patients’ home  Trial involved 25 patients over 1 year  First patients in March 2003

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Schematic Operational Procedure Early Patient Identification Patient & Carer Interview Selection to Project or standard homecare delivery Visit to Brockhurst Objective Setting and Re-ablement Planning Regular Reviews Home Adaptation Re-ablement Target Reached Home Visit Skills Gain Programme Delivery Home Support Delivery Regular Reviews

Telecare Equipment in Brockhurst Standard Package  LifeLine 4000 with Pendant, Fall Detector, Bed Occupancy Sensor, Pull Cord, Temperature, Smoke Alarm Fridge Door Sensor, Flood Sensor, Additional Package  Door Open Sensors, Carbon Monoxide Sensor, Movement (PIR) Sensors,

Columba Results The approach of social, functional and physical re- ablement coupled with telecare (The Columba Process) has demonstrated its effectiveness with:  Two thirds of patients in the pilot project being diverted from residential care (7 still at home).  Continuous monitoring by the Careline service provided information to community care teams that allowed an intervention and prevented a hospital re- admission.  Now part of routine service delivery in N Surrey

Columba Lessons Learnt  The Columba project has demonstrated the strength of partnership working by PCT, County and Borough Councils to support independent living  Telecare is a small but important component in Brockhurst (10%) but is key to returning people to the community to live independently (50%).  The small size of the Columba unit at Brockhurst provides a continuity of care and an opportunity for in- depth client assessment  The staff have gained a tremendous amount of knowledge in assessing clients for telecare and using telecare as part of the care packages but diffusing this knowledge is slow.  Changing established ways of working is difficult and requires continuity of leadership and project management.

Telecare Checklist  The patient or client group to be supported  The care process to be enhanced through telecare  The care setting  The scale of the proposed service (the number of patients or clients served)  The scope of the proposed service (the functionality of the service)  The referral process into the service  The equipment installation, maintenance and monitoring service  The response service  The fit with existing care teams  The capacity of existing care teams to provide the response  The training needs of new and existing staff  The distribution of costs and benefits amongst stakeholders  The role of private sector suppliers

Telecare as part of Extra Care  Sheltered accommodation has the technical and organisational infrastructure  Telecare supports the concept of independent living – just checking  Telecare creates more flexible accommodation giving options for residents, owners, PCTs and social services

Acknowledgments and Contacts Prof. James Barlow and Dr. Steffen Bayer Tele:

Information & communication, e.g. health advice, triage, access to self-help groups Safety and security monitoring, e.g. Bath overflowing, gas left on, door unlocked Personal monitoring: Physiological signs Activities of daily living Electronic assistive technology, e.g. environmental controls, doors opening/closing, control of beds Improving functionality Mitigating risk The individual in their home or wider environment Features of a Telecare Service

Response protocol Call centre Response provider : neighbour, relative, ambulance, HCA, fire, police NCRS Response: home visit, emergency services, remote change Alarm ! Check status Record event The individual in their home Check The Emerging Infrastructure  Assessment & referral  Equipment  Monitoring  Response  Review