Www.portsmouth.gov.uk Telecare Assessor Training.

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Telecare Assessor Training

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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.

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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

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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-alone Telecare

What is the difference?

Stand aloneused 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

A

L

A

R

M

Wireless sensors

Response Team

Monitoring Centre

Home Hub

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Emergency Response Teams

Falls pick-upservice

24 Hour --Nurse

Relatives& friends

Duty Social Worker

TelecareControl Centre

Out-of-hoursGP

Fireservice

Ambulance

Police

Emergency plumber

24 hour Gas fitter

Mobile Warden

24 hr. Home Care

Rapid ResponseUnit

Air ambulance

An appropriate response

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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

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Entry

(Re) assessment of need

Care package development

Home survey

Telecare prescription&response protocol

Equipment provisionInstallation 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

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Why use Telecare?

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‘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.’

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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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How can Telecare be used?

Environment

Pop-up plugFlood detectorSmoke detectorGas / CO detectorExtreme temperature detector

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Security

Barking dog recording PIR-activated external lightingIntruder alertBogus caller panic buttonDoor / window contactsVideo door entry system

Safety

Fall detectorBed / chair occupancy sensorPull cordWater temperature alertSounder beacon / vibrating alarmMemo minderDoor exit monitor – wander alertGPS tracker / locator

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Social

Telecare 24/7 monitoring may reduce need for pop-in visits Need to be aware of need for contact with real peopleConsider 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.

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QuietCare Lifestyle MonitoringPassive 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

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Health

Medication dispenserEpilepsy sensorEnuresis (night-time incontinence) sensorReminders and coaching by mobile phone (condition management)Remote vital signs monitoring(see next slide)

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Telehealth peripherals

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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

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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

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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

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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

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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.

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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

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Referrals for telecare

• Individual can self-refer• Carer can refer• Professional can refer using the on line professional

referral form on the web site

• You can phone on 0800 731 2228 or email: telecare@portsmouthcc.gov.uk for more information.

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Useful references

• www.dhnetworks.org.uk/telecare• www.wsdactionnetwork.org.uk• www.chubbcommunitycare.co.uk• www.tunstallgroup.com/home.aspx• www.telemedcare.co.uk• www.quietcare.co.uk• www.pivotell.co.uk• www.atdementia.org.uk• www.telecareaware.com