WSDAN Progress: Telecare in Leeds
Martin Kennard, Donna Lancaster, Marianne Howard
This article was prepared by Mike Clark, co-project lead for WSDAN, and is based on the presentation made to the WSDAN regional event on the 11 June 2009 at the Leeds Marriott Hotel. The presentation can be accessed on our past events archive.
One of the aims of the WSDAN regional events is to showcase the important work carried out around the country in developing telecare services. In this example we feature the Leeds City Council telecare service that was recently a category winner in the regional Yorkshire and Humber Health and Social Care Awards.
Leeds City Council has built its telecare approach on the firm foundation of its previous work on integrating community equipment services. A telecare pilot was set up in advance of Department of Health grant funding so that service users would be early beneficiaries from the two-year £1 million Preventative Technology Grant allocation that the city would receive from April 2006.
The Leeds service used a project management methodology from the outset involving a range of stakeholders from health and social care, fire, police as well as other support services.
A telecare project leader was employed and targets set – 750 additional users in the first year (2006–7) of the grant and 1,250 in the second year (2007–8). These targets would be in addition to the provision of a basic pendant alarm system.
The service developed operating processes, training programmes for assessors as well as information for staff and public. Knowledge of equipment was developed and a range of protocols were agreed with partners, for example, fire services. An important service development was a new mobile response service for people without key holders. These people would now be able to receive services for the first time. There is no service charge for eligible service users.
In October 2008, the service was mainstreamed as part of its community equipment programme. Since April 2009, telecare has been fully funded by adult social care. The response service has been funded by Supporting People funding since April 2009.
In terms of staffing, there is a service manager plus two technical advisers who can advise on telecare and other equipment that may be available, for example, what equipment can be used in certain installations to meet user needs. There are two part time technicians covering six days a week. This covers maintenance, sensor and battery changes. They can undertake small installations, and there is a service administrator to handle referrals, book appointments and maintain a diary for installations.
Equipment can be accessed by community and hospital occupational therapists, district nurses, physiotherapists, social workers and other trusted assessors. Assessments are carried out mainly by occupational therapists and social workers. The assessment of need and recommendations is then passed onto the telecare team.
Monthly training events are provided for staff on the operating procedures. What is telecare? How does it work? Training is provided on the equipment available from a range of suppliers and staff are kept updated. Assessors hold the telecare details on their caseload and highlight if the telecare is not meeting the identified need so that the package can be adapted. Joint visits are carried out between telecare staff and assessors. Maintenance and battery change visits are used as an opportunity to see if services are still appropriate for the individual.
Since October 2006, 3,889 requests for telecare have been processed. 3,176 people have telecare services, 640 people have cancelled or ceased service, for example, have moved into residential care. The figures do not include basic pendant alarm users. Since February 2008, 208 people have been included on the mobile response service arrangements. A weekly log of calls from the in house service is analysed to review which sensors are triggering and to pick up any potential problems at the earliest opportunity.
A number of case studies demonstrate the value that telecare services can apply and the imaginative solutions of the dedicated staff. In a particular case, a set of equipment was installed for a woman who was crossing a busy road 10–15 times per day to visit a neighbour to ask what the time was. On some occasions, it was claimed that her purse had been stolen from her property. A combination of sensors, messaging and reminder systems with a customised alert response in addition to a basic sensor package met the needs of the service user and her neighbour and reduced risks.
The importance of a good case manager was stressed when working with users and their carers to work out the best telecare solutions.
For the future, Leeds City Council is looking to include telecare in its Assistive Technology Service to improve co-ordination and develop a single point of access for service users and self-funders. New equipment will be trialled. An evaluation of progress will be completed and further work will be carried out on an independent living project for people with learning disabilities who are moving from hostels into tenancies.