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Leeds City Council Telecare Service

Summary

Description

Operational Information

Evaluation

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Summary

Leeds Telecare is a service that supports older and vulnerable people in living safely and independently in their own home monitoring people 24-hours a day through the use of an alert system which sounds if the sensor detects any problems.

Telecare builds upon the existing Care Ring pendant alarm system to offer added security in the home. Sensors are discreetly placed around the house on ceilings, doors and walls or may be worn by the service user in the form of a pendant, watch or belt. Equipment includes:

  • sensors which can detect falls, movement, and bed or chair occupancy
  • epilepsy and enuresis sensors
  • medication reminders and pill dispensers
  • smoke, gas and flood detectors
  • emergency pull cords
  • bogus caller alert

If a Telecare sensor activates in a person's home, an alert is automatically raised to a 24-hour response centre. Staff at the response centre will contact the person to check their safety. They will then respond appropriately - either by providing reassurance or advice, or by contacting a family member, mobile warden or the emergency services. The response centre staff will have information about the person using the service, are able to identify which sensor has been activated and how best to respond. Leeds city council conducts a quality and costs benefits survey of telecare service users which includes a satisfaction question aimed at carers. This is sent to the users 6 weeks after the equipment is installed. So far the majority of carers feel that telecare supports them in their role by reducing stress. For these reasons, the service has a positive impact on the quality of life not only of the impaired persons and their carers, but also on companies and the National Health system because it reduces absenteeism of working carers and prevents falls and domestic accidents.
To get Telecare equipment you have to call on 0113 222 4401 to arrange a community care assessment to discuss the difficulties and work together to assess the client’s needs. Equipment is fitted by Telecare Technical Advisors who visit the home and explain how the service works.

The service is funded by Government and Local Authorities and the telecare equipment is provided free of charge or for a small rental fee based on a needs assessment. Charges are billed on a quarterly basis. National and local authorities are involved in the initiative and and it employs health and social care professionals.

Since October 2006, Leeds Telecare service has provided second generation Telecare equipment to over 4700 people including those with dementia, learning difficulties, head injuries, physical impairments etc. Currently, there are 2,892 people using the service and around 300 people use the Mobile Response Service. Moreover, there are around 4,500 people living in their own homes using first generation Telecare equipment and around 6,000 people living in sheltered housing settings using similar equipment. Thus, the total number of Telecare users in Leeds is over 14,000.

 

Description
refers to the target users, kind of service provided, ICTs typologies and devices used

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Leeds City Council Telecare Service
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UK
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01-05-2006
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Telecare aims to provide equipment and monitoring for people who have difficulty in living safely at home or who have some level of confusion or memory impairment or are prone to falls. As the Leeds City Council believes in the provision of 3rd generation equipment to allow old impaired people to live as independent and inclusive lives as possible, Telecare intends to continuously, automatically and remotely monitor real time emergencies and lifestyle changes over time in order to support vulnerable people. The Leeds service is highly integrated into the care system and is based on a project management methodology involving a range of stakeholders from health and social care, fire, police as well as other support services. GPS location systems are aimed at improving safety and independence outside of the home and work through using satellite navigation.

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The main motivation of the service is to provide 3rd generation Telecare equipment to older people including those with learning difficulties, head injuries, and physical impairments. Moreover the service intends to give carers and relatives peace of mind, knowing that their loved-ones are safe and that any mishap will trigger an alert at a council-run response centre.

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Yes Care Recipients
Yes Informal carers
Yes Paid assistants
No Formal carers

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Not available

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Yes Independent Living
No Information and learning for carers
No Personal Support and Social Integration for carer
No Care coordination

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The service is provided through the use of ICTs for independent living and safety including sensors and alarm systems. The service is provided by calling the local contact centre to arrange a community care assessment in order to install one or more of the following:

  • Safety equipment and alarms;
  • Sensors, alarms and equipment to help the elderly to live more independently at home and in sheltered or extra-care housing.
  • Equipment and adaptations to help the older care recipient at home: assessment of
    daily living and nursing equipment needs as well as physical changes of the home, e.g. handrails or stair lifts;

Moving to a more suitable home: In the case of health or mobility problems or if the current home does not meet the client’s needs, a Medical Housing team can give advice about moving to a more suitable home.

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A sensor is activated and alerts the Leeds response centre which makes arrangements for help. Equipment includes smoke, flood and fall detectors, medication dispensers and bogus caller buttons. Phone for an assessment, which will take place in the user’s home. Since October 2010 the Telecare Team has started to install “3rd Generation” Telecare equipment consisting of lifestyle monitoring systems and GPS location systems. These systems also include fall detection and emergency buttons to alert the Leeds response centre if there is an emergency outside of the property and arrangements for help are made so that the lifestyle monitoring systems are supplied by the Telecare service for a period of assessment to assist assessors when setting up a care package. The system consists of a number of small passive infra-red sensors, which log the movements of a service user and upload this data onto a secure website for carers and/or professionals to analyse. Both the GPS systems and lifestyle monitoring systems incur a monthly subscription fee.

Operational Information
refers to the type of funding, budget, sustainability and organisations involved

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Both public and private
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Public service funding: Government, Regional, Local Authorities, non-profit public entities
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Not available

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Private out of pocket: users pay the service by themselves
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Not available

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The purpose of the service is to help the older person live more independently and safely, and the main strategy to achieve this is by people who want to access the service asking first for an assessment which will take place at home to look at whether the equipment can help to maintain their safety and wellbeing. The assessment will be carried out by a professional from a Social Services or Health Services department, such as an Occupational Therapist, Social Worker or Nurse. This assessment will identify the needs of the patients but does not include a financial assessment. The assessment of need and recommendations is then passed onto the telecare team. Telecare equipment will either be provided free of charge or a small rental fee for each piece of equipment will be charged because it is sustained through local authority budgets. A decision on whether there will be a cost for the Telecare equipment will be provided before the date of installation. Any charges are billed on a quarterly basis and can be paid by direct debit, cheque, postal order or in cash.

 

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The initiative is expected to sustain itself in the long term at the same quality level that it had at the start, taking into account the need to respond to additional demand created by the directives for assessors, to increase the level of activity which has been already significantly growing. In April 2011, a monthly target of 160 new installations per month was set as the number of users of the service and this is predicted to increase further. To expand the service, the initiative needs additional capital (see SWOT analysis).

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€ More than 500,000
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Not available

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Yes Authorities
No Private Care Sector
Yes Health and Social Care Systems
No Third Sector
No Private Companies

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Not available

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Not applicable
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No Informal Carers
Yes Health Professionals
Yes Social Care Professionals
No Privately-Hired Care Assistants (inc. Migrant Care Workers)
No Volunteers

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The service is accessed through community and hospital occupational therapists, district nurses, physiotherapists, social workers and other trusted assessors. Occupational therapists and social workers mainly deal with assessment of needs and make recommendations that are then passed onto the telecare team. 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 for maintenance, sensor and battery changes. There is a service administrator to handle referrals, book appointments and maintain a diary for installations.

Assessors hold the telecare details 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.

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Not involved

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10,001 - 50,000
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More than 14.000 users

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The initiative reaches users through web-site.

Evaluation
refers to the impact of the service on end-users, care organisations and authorities

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The service benefits on the quality of life of :

- Informal carers, because reconciles care and work, improves their social life and health.

- Paid assistants, because improves their social life and health.

- Elderly people, because improves their health and safety helping them to live independently (Schmidt et al., 2011)

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This service provides benefits to companies and the labour market, because it helps the informal carer to reconcile paid work and caring tasks thus avoiding additional costs for replacing the worker who has to stay at home with the care recipient (Schmidt et al., 2011).

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The service impacts on the Health National System because of the falls and accidents that are avoided and helps to lower the costs of home caring and hospitalisation .

The Local Authority is working with NHS Leeds to further the use of Telehealth which monitors and reports on a range of vital signs. The NHS is keen to explore the use of Telehealth based on emerging evidence. According to the 2012 findings of the “Whole Systems Demonstrator” (Steventon A. et al, 2012) for telecare and telehealth, a programme undertaken by the Department of Health since 2007, “if used correctly, telehealth can deliver a 15% reduction in A&E visits, a 20% reduction in emergency admissions, a 14% reduction in elective admissions, a 14% reduction in bed days and an 8% reduction in tariff costs. More strikingly they also demonstrate a 45% reduction in mortality rates”(Schmidt et al., 2011).

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Strengths:

1.The service increases the acceptability of the ICT by the elderly and carers.

2.Carers feel that Telecare supports them in their role by reducing stress

3.The council trains social care assessors on telecare, enabling them to become more aware of the advantages of telecare in their assessment protocols. Monthly training events are provided for staff on the operating procedures. Assessors check if the equipment meets the user’s needs and, if not, the package is changed

4.The service also adaptations provides in the care recipient’s home. If the care recipient finds it difficult to move around home or using the bathroom or kitchen, he/she may be eligible for a Disabled Facility Grant (DFG). This is for adults and/or children who require essential adaptations to make it easier to manage in their home and keep their independence.
This grant is for owner occupiers, private tenants and housing association tenants. They have to contact the local housing office to find out how to be helped. A meeting with an Occupational Therapist (OT) will be arranged to undertake an assessment of the client’s needs and make a referral to recommend certain adaptations to support the client’s independence at home.
Examples of adaptations are:

  • Ramps
  • Wider doorways
  • Stair-lifts
  • Wet floor/walk in showers
  • Major alterations

5.The service provides the Care Ring service, which is an emergency alarm call service involving a pendant-style monitor connected to a response centre. When activated the alarm alerts the response centre trained staff to be on hand to help and reassure the elderly who is eligible to use the service if one or more of the following applies:

  • Is over 60

  • receives care services or community care

  • has equipment or adaptations in your home to assist with day-to-day living

  • receives Meals on Wheel
  • is vulnerable and needs access to help quickly

Weaknesses

  1. According to a report of the Director of Adult Social Services to the service executive Board dated 7th March 2012: “Telecare Equipment for the Leeds Telecare Service 2012/13 – Capital” (Leeds City Council, 2012) without the release of further capital, the service would not be able to meet the demand for Telecare installations and would have to rely upon recycling used equipment. This would result in a waiting list for installations and the service not being able to purchase up-to-date telecare equipment particularly to meet the needs of customers with more complex needs. However the Report conclusions also state that by agreeing to release further capital, Leeds Telecare Service will be enabled to continue to meet the demand for Telecare equipment.

Opportunities

  1. The Telecare Development Group meets monthly as a multi-agency group whose aims are to promote the use of Telecare, develop partnership working with NHS, Universities and Third Sector organizations to increase awareness of the service and its benefits and to monitor service performance via agreed service Performance Indicators.

Threats

  1. More than one assessment is needed in order to check whether the equipment can help to maintain old people safety, needs and wellbeing. The assessment will be carried out by a professional from Social Services or Health, such as an Occupational Therapist, Social Worker or Nurse.

Challenges

  1. The service plan is to further stimulate the demand for Telecare via a process of increased promotion to service users and citizens in Leeds and the training of staff in health and social care. Assessors are required to consider the merits of using Telecare as a standalone service or part of a care package to support people to remain living independently in all their homes.
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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 tested. 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. The service has reached local geographical coverage and at the moment they are not planning to enlarge it.

More Information
includes contacts, publications and accompanying documents

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References:

Schmidt A., Chiatti C., Fry G., Hanson E., Magnusson L,. Socci M, Stückler A., Széman Z., Barbabella F., Hoffmann F. & Lamura G. (2011), Analysis and Mapping of 52 ICT based Initiatives for Caregivers, http://is.jrc.ec.europa.eu/pages/EAP/eInclusion/carers.html

Publications:

Leeds City Council, How do I get telecare?, available on http://www.leeds.gov.uk/Pages/search.aspx?k=telecare%20services (last access June 2013)

NHS, Leeds City Council and LCES (2008), Community equipment and adaptations services in Leeds, available on http://www.leeds.gov.uk/Pages/search.aspx?k=telecare%20services&start1=11 (last access June 2013)

Leeds City council, Equipment for your home, available on http://www.leeds.gov.uk/residents/Pages/Equipment-for-your-home.aspx

Leeds City Council (2012) Leeds community equipments and Telecare services Annual Report, available on http://webcache.googleusercontent.com/search?q=cache:KHDSfZFFE2oJ:www.leeds.gov.uk/docs/Leeds%2520Community%2520Equipment%2520and%2520Telecare%2520Service%2520Annual%2520Report.pdf+&cd=1&hl=it&ct=clnk&gl=it (last access June 2013)

Steventon et al. (2012), Effect of telehealth on use of secondary care and mortality: findings from the Whole System Demonstrator cluster randomised trial, available on http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3381047/ (last access June 2013)

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Social Care Contact Centre on:

Adults: 0113 2224401

Children: 0113 2224403 www.wsdactionnetwork.org.uk/news/wsdan_progress/wsdan_progress.html