Eurocarers
European association working for carers
Fold Group-Housing with Care
Summary
The initiative “Housing-with-care” was introduced to Northern Ireland in 1997, by Fold, a not-for-profit housing association, as part of its overall emphasis on service improvement and innovation, and care staff are available 24 hours a day in the association’s housing developments. Even before this, telecare was launched as far back as 1993 as part of Fold’s ongoing mission to develop innovative approaches to supporting older people with housing needs. Telehealth was launched initially in 2003 as part of a ‘Going Home, Staying Home’ project and was subsequently mainstream in 2007. Fold currently covers more than 8,000 people living in sheltered housing in Northern Ireland supported by a social alarm service, as well as approximately 1,250 people living at home with an advanced telecare package funded by a health and social services trust, and about 1,500 people living at home with a self-funded telecare package. Approximately 280 people across Northern Ireland are connected to Fold’s telehealth service (ICT&Ageing, 2010).
The service reaches old people living alone, people at risk of falling, people affected by dementia or other comorbidities, people who have recently been discharged from hospital and carers.
There are four levels of telecare on offer. The basic entry level is the social alarm (involving the Lifeline box and pendant alarm). The second level is known as ‘Community Safety’ and includes a burglar alarm, a flood detector and a bogus caller alarm. The third level is called the ‘Health and Social Care’ level, and targets clients with higher levels of need. It includes bed sensors, entry and exit sensors among other devices. The final level, level E, is only used in the case of clients who are at high risk and require extensive telecare, such as people with dementia or other high risk clients.
The cost of the service varies according to the level of telecare provided: Lifeline unit, Pendant & Monitoring from £9 per month and One off Installation Charge - £45.
The service lives thanks to the customers' payments but also to a well planned fundraising campaign promoted through many initiatives.
The service benefits on old people because helps them to live independently and prevents risk of falls and accidents. It gives support to carers in balancing care and work and impacts positively on the NHS because avoids institutionalizations and hospitalizations.
Description
refers to the target users, kind of service provided, ICTs typologies and devices used
The main aim of the initiative is supporting old people with disability in living independently and safely in their homes, preventing risk of fallings and other types of domestic accidents.
“Housing-with-care”: a service that combines independent living with relatively high levels of care in Northern Ireland from 1997. Care staff available 24 hours a day in the association’s housing developments. Even before this, telecare was launched in 1993 as part of Fold’s mission to develop innovative approaches to supporting older people with housing needs. Telehealth was launched initially in 2003 as part of a ‘Going Home, Staying Home’ project and was subsequently mainstreamed in 2007.
Care Recipients
Informal carers
Paid assistants
Formal carers
Not available
Independent Living
Information and learning for carers
Personal Support and Social Integration for carer
Care coordination
Fold is a not-for-profit housing association providing general housing, sheltered housing and housing-with-care along with telecare and telehealth in Northern Ireland. There are four levels of telecare on offer. The basic entry level is the social alarm (involving the Lifeline box and pendant alarm). The second level is known as ‘Community Safety’ and includes a burglar alarm, a flood detector and a bogus caller alarm. The third level is called the ‘Health and Social Care’ level, and targets clients with higher levels of need. It includes bed sensors, entry and exit sensors among other devices. The final level is only used in the case of clients who are at high risk and require extensive telecare, such as people with dementia or other high risk clients. The telehealth service supports vital signs readings, including blood pressure and oxygen levels, weight, temperature and heart rate.
Sensors, alarms, flood detectors, bogus caller alarms, bed sensors, entry and exit sensors, reading vital signs sensors.
Operational Information
refers to the type of funding, budget, sustainability and organisations involved
Not applicable
Not available
Because of the need for continuous, real-time monitoring, telehealth is currently implemented as a separate service, using a dedicated terminal and specifically trained operator in the response centre. However, Fold is currently examining the possibility of integrating the two in the future.
For improvement the service seeks to:
- Adopt up to date policies, procedures and processes.
- Best Value’ Reviews.
- Benchmarking with best practice inside and outside our sector.
- Maximising the potential of staff through best-practice quality systems.
- Ensuring compliance with Health and Safety legislation.
The service intends to deliver excellent services for all our customers. The delivered services are regulated by the Department for Social Development, the Housing Executive’s Supporting People team and the Regulation and Quality Improvement Authority (RQIA). RQIA inspections take place continuously across all registered supported schemes and describe Fold’s staff and services.
Fold is accredited with the CSHS quality standard for sheltered housing. In addition Fold’s sheltered housing was selected by the Housing Executive’s Supporting People team to pilot their new Quality Assessment Framework (QAF).
The initiative is obtaining new financial resources for being implemented in the next future through fundraising initiatives.
In terms of human resources is important ensuring buy-in from the health and social services teams working in frontline services for telecare and telehealth to be implemented and mainstream in Northern Ireland. Without such acceptance, the service would not receive referrals and therefore would not be sustainable.
Not available
Authorities
Private Care Sector
Health and Social Care Systems
Third Sector
Private Companies
Not available
Informal Carers
Health Professionals
Social Care Professionals
Privately-Hired Care Assistants (inc. Migrant Care Workers)
Volunteers
Not available
Fold’s board is made also by volunteers: they are skilled and expertised in many key areas such as: estates management, housing, governance, finance, health and customer services. Three positions on the board are held by residents and users of our services.
Fold board volunteers in 2009/10 attended at:
- Fold Board and Sub Committee meetings
- Induction, training and strategic review events
- Consultation meetings with Departmental officials and elected representatives
- Official Openings of new housing developments
- Accord Committee and Review meetings
- Senior staff recruitment exercises
25.000 users have been reached by the service.
Events addressed to families: Fold Housing Association held a Family Fun Day attended by over 300 people.
The communications plan aims to.
- Ensuring communication with Fold and Customers.
- Keeping customers, stakeholders and partners regularly informed of Fold’s performance, services and achievements.
- Providing a modern and informative website.
- Keeping all partners informed of key issues.
The 2009/10 marketing campaign focused on the education of the General public, and the benefits of living within Fold’s ‘Apartments for Older People.’ This was delivered through a radio, billboard and poster campaign.
A radio advertisement was run for Telecare with an extended campaign running into the Winter period. Promotional events were held in shopping centres and these boosted private referrals.
The second ‘Fold Insight’ magazine was issued to stakeholders and was well received. Editorials were run in Agenda NI whilst the local press covered openings of new schemes and refurbishment projects.
Website hits during 2009 reached 25,110 against a target of 24,000.
Evaluation
refers to the impact of the service on end-users, care organisations and authorities
This service positively impacts on the quality of life of:
- Informal carers because it reconciles care and work, providing peace of mind, knowing that their old relatives live safely.
- Paid assistants, because the service improves their social life and health, giving them a support in caring their clients
- Elderly people because the service helps them living independently and safely (Fold Group, 2013)
There is evidence that this service benefits on organizations providing care, e.g. an independent evaluation was conducted in 2007 which demonstrated cost savings from telecare; savings in terms of prevented additional care costs were much greater than the costs of providing telecare.
This service positively impacts on private companies and labour market, because it helps the informal carers to reconcile paid work and caring tasks; the service avoids added costs for replacing the worker who has to stay at home with the care recipient (Fold Group, 2013).
According to the service assessment there are benefits of this service on public authorities, NHS and social care services in terms of saved costs of home caring and hospitalisation (Fold Group, 2013).
Strengths:
- Fold TeleCare is leader in Ireland for home monitoring in the social housing market and for specialist telecare support services. In 2009/10 they achieved 4% net growth with connections increasing to 22,744. The number of incoming calls received throughout the year reached almost 395,000, up by 70,000 calls from the previous year. They also provided over 150,000 ‘good morning’ calls during the year. The delivery of the tele-health service, in partnership with the Northern, Western and Southern Health and Social Care Trusts continued throughout the year with vital signs monitoring peaking at over 350 patients.
- An independent evaluation was conducted in 2007 which demonstrated significant cost savings from tele-care; savings in terms of prevented additional care costs were much greater than the costs of providing tele-care.
- A customer satisfaction survey provides evidence of the efficacy of the service (Fold, 2009). Fold Staying Put department surveys its clients on completion of grant works. From the 382 questionnaires returned, 97% of clients were either satisfied or very satisfied with the help and support provided by Fold. 96% said they would recommend the service to others.
- Informal carers also rated the tele-care service highly.
- FOLD TeleCare is the only service provider in Ireland to have received the Industry Quality Mark. Good example of how the impetus for implementation and mainstreaming of ICT-supported services for independent living can come from the housing sector as part of its ongoing programme of service improvement and innovation.
Weaknesses:
- Considering that the service is paid by customers, it has problem of accessibility for those people with low income.
- It is not clear if training for users are provided
Opportunities:
- Tele-care and tele-health can improve the quality of life of care recipients and carers and people will be more aware of this in the near future: the initiative has the possibility to be more mainstreamed because also Public Authorities are receptive more and more.
Threats/challenges:
- Based on their experiences, a key lesson for Fold was the importance of ensuring buy-in from the health and social services teams working in frontline services in order for tele-care and tele-health to be successfully implemented and mainstreamed in Northern Ireland.
The initiative has been able to be developed on larger scale level and to be transferred in different contexts thus increasing for instance geographical coverage or addressing new target user groups.
Further developments are just planned for increasing initiative scalability and transferability in the next future: telehealth is currently implemented as a separate service, using a dedicated terminal and specifically trained operators in the response centre. However, Fold are currently examining the possibility of integrating the two in the future.
More Information
includes contacts, publications and accompanying documents
References
Fold, Annual Review and Accounts (20013), available on http://www.foldgroup.co.uk/uploads/cms_file/1387298407-80.pdf
ICT&Ageing- European Studies on Users, Markets and Technologies (2010), Fold Housing Association – Housing-with-care and telehealthcare, available on http://www.ict-ageing.eu/?page_id=246 (last access: June 2013)