Simon Arnold, CORC (Commission on Residential Care) Commissioner and MD of Tunstall Healthcare discusses the vision for the future of the care home sector, and how technology can improve quality of care for residents
A large proportion of residents living in care homes have one or more long-term conditions which if mismanaged, can result in unnecessary hospital admissions. Among people living in care homes, hospital admissions for avoidable conditions are also 30% higher for people with dementia.
The care home sector is under increasing public scrutiny over the quality of services it provides for older and disabled people. Perceptions of residential care are largely negative, and many homes face the additional challenge of operating under financial constraints, against the backdrop of a changing health landscape and an ageing population.
Over the last twelve months the Commission on Residential Care (CORC) has brought together experts and practitioners to evaluate the role of residential care in a modern system. With evidence gathered from care providers, current care home residents and staff, DEMOS has published a report which explores the current issues affecting residential care in the UK.
Outlining the need for change
The current residential system needs to change if it is to deliver on the outcomes people value and deserve. But why is the current system failing? In compiling the CORC report we unearthed several key issues which surround the concept of residential care, and prevent its successful delivery. In particular, the report considers how we can reverse the negative perceptions of the traditional ‘care home’, and enable a future where ‘housing with care’ can truly enhance the lives of residents by supporting personalised and relationship-centred support.
Predominantly, the value of ‘housing with care’ doesn’t always translate into public consciousness. Indeed, many disabled and older people feel desperately unhappy at the thought of ‘going into a home’. Those approaching the later stages of life want to retain a sense of independence: they want to feel a sense of belonging and have the opportunity to explore new things; not feel restricted in what they can do.
Of most importance is the desire for dignity; the unspoken addendum to everything that people told CORC representatives they wanted – whether it be in later life or living with a disability – is ‘I want the freedom to come and go as I please, as I would in my own home.’
The step from a person’s existing home into a care home is viewed by many as something that could reduce quality of life. This is partly the result of a perceived lack of proactive choice when it comes to care home admission. Individuals worry that they may be forced into living in ‘institutionalised’ surroundings; and without clear information outlining the range of care options available and the potential benefits residential care can offer, particularly in its use of healthcare technology, this concern is likely to remain.
Changing perceptions – housing with care
Care homes should offer a positive experience for older and disabled people. As outlined in the CORC report, they have the potential to give individuals the opportunity to develop friendships, which can be particularly valuable. Residential care isn’t about restricting people’s lives; it’s about helping people to gain (or regain) independence, and can include the opportunity to learn life skills and achieve empowerment.
But how do we position facilities as ‘housing with care’; emphasising that they are housing first and foremost, with person-centric care packages as secondary? Moreover, how can we ensure that future care schemes offer the services, benefits and support we know to be possible? For the care sector, the answer may lie in taking inspiration from projects where housing with care is working. By integrating personalised support packages with technology, they are transforming services to ensure people maintain independence and autonomy even as their needs change.
In compiling the CORC report, we looked at several case studies, specifically those in which assistive living technology has been used to enhance service delivery. In the case of Hatton Grove, a variety of telecare solutions – including epilepsy, bed occupancy, door and movement sensors – are being used to deliver personalised care and enhance the lives of residents at the facility. Care workers trust telecare and find it a great support to them in their roles, allowing them to spend more quality time with residents by accommodating their individual needs and interests more effectively.
There exists many such examples across the UK to support the health and care needs of people as they move into a ‘housing with care’ environment.
Turning the vision into reality – looking to the future
These case studies demonstrate how care homes, particularly when equipped with assistive living technologies, can be recognised as ‘housing with care’ schemes which enhance the lives of residents and staff. They can be places where, contrary to public perceptions, residents receive personalised and relationship-centred support and are able to play a dignified role in their communities.
A successfully deployed telehealthcare scheme however, is just one step closer to creating a residential care system that is truly fit for purpose. Technology at present is an underutilised tool in the care home sector and can be used to join up services in a straight-forward way. We need to make sure older people are included in the journey, rather than bypassing their access to technology over fears of it being “too complicated” for them.
The sector should make greater use of innovations such as myworld, a customised tablet computer, pre-loaded with simple, easy-to-navigate tools. With this intuitive technology, users are given access to a wealth of information and the means to connect easily with the ‘outside world’.
With greater insight, the ‘care home’ environment can evolve into a virtual support network that can expertly cater for mixed needs, meaning that those with more complex requirements can co-exist in an environment that also accommodates higher levels of independence. This is the vision for the future – moving on from the ‘care home’ to ‘housing with care’.