Home sensors in social care

Picture of a home health care working with her arm around an elderly woman next to a closeup image of a person typing on a smartphone with icons depicting a smart home superimposed above the phone, photos by pikselstock and ParinPS/Adobe Stock, design by Ana Hale

Photos by pikselstock and ParinPS/Adobe Stock, design by Ana Hale

Home sensors used for remote monitoring have the potential to help people receive quality care and support people to live independently in their own homes for longer. Home sensors are usually devices that are used to monitor a person’s environment (e.g. temperature, doors opening, kettle boiling, fridge being opened) or the person themselves (e.g. heart rate, movement). They can be used to alert of behaviours that require an urgent response (e.g. a fall or lack of movement) or they can identify patterns over time (e.g. sleeping, eating or toilet behaviours). However, this technology is not often used as part of usual care across England and there is little understanding as to how this could become part of the usual care people are offered.

What is the issue?

There is a growing need for social care services in a climate of funding cuts and workforce crisis. To help overcome the challenges with meeting the nature and scale of demand, policymakers have proposed the use of digital technology and technology enabled care. The social care system has historically been reactive in responding to people’s care needs, but there is a growing interest in proactive and preventative care to support people before they reach crisis point. Once a crisis point is reached, the care needs are often more complex and resource intensive.

Home sensors for remote monitoring can be used for proactive and preventative care. They can be used in the short-term whilst people are recovering from something (called ‘reablement’) or used long-term to monitor people and detect changes in behaviours that require a response. The use of home sensors has shown some promise in small scale pilots, however, these are often not adopted, adapted or spread to other settings beyond this, meaning they are rarely part of usual care. There is a lack of systematic evidence to help decision makers who are considering whether to adopt, adapt and/or spread the technology in their own settings.

How are we helping?

DECIDE (Digitally Enabled Care in Diverse Environments) is a new centre for rapid evaluation of technology-enabled remote monitoring in health and care, funded by the National Institute for Health and Care Research Health and Social Care Delivery Research (NIHR HSDR). DECIDE is a partnership between the University of Oxford and RAND Europe.

The DECIDE Centre will conduct a rapid evaluation of care pathways that involve remote monitoring based on home sensors used in social care. The Digitising Social Care Transformation Directorate is the policy customer for this evaluation. The aim of this rapid evaluation is to define good practice in the implementation and use of technology-enabled in-home monitoring ‘beyond the pilot’ and draw transferable lessons that can inform spread and scale up across social care. This evaluation will provide novel insights to inform implementation decisions focused on adoption, adaption and spread of in-home remote monitoring sensors used in social care. We hope that the findings will be helpful for informing policy decisions at a national level, support local system improvement and implementation, as well as be of wider interest to charities, diverse populations and scholars from a wide range of disciplines.

The evaluation will unfold in three core phases:

  1. Understanding the landscape of the use of home sensors in social care and selecting three case studies. This will involve scoping conversations with service providers, a literature review and evaluability assessment.
  2. In-depth case studies of three sites implementing home sensors in social care. This will focus on understanding the technology, care pathways and the system within which it operates, understanding stakeholder and service users’ experiences of engaging with the technology, and understanding the economic impact and value of this technology-enabled care pathway.
  3. Learning from cross-case comparisons and testing case-study insights across a range of contexts. We will hold workshops engaging diverse communities such as service users, social care staff, systems leads at regional and national levels and industry from across the United Kingdom, to reflect on findings from the case studies and help further refine learning about adoption, adaption and spread. We will explore implications and distil lessons for wider policy and practice.