Let’s not lose the potential of technology in homecare

In August this year Scottish Care published TechRights: Human Rights, Technology and Social Care. It was launched at our event called ‘Tech Care, Care Tech.’ which was the first event of its type held by Scottish Care.

Since the publication of the report a great deal of debate has ensued both in Scotland and further afield not least about the role of robotics and the Internet of Things.

In the months that lie ahead Scottish Care will continue to work with partners on a range of projects relating to technology and its use in social care. One area we are investigating with a wide range of colleagues and academics is the potential to develop inter-operability which would enable providers to use the best software offers for their service delivery and enable them to ‘speak’ to one another in an integrated way. We will keep you up to date on this and related work.

However we have to state that the positive use of technological interventions in order to maximise rather than replace human encounter is facing some real challenges.

The first is the way in which some technologies are being used to restrict rather than to promote human relationship. Scottish Care has long argued that the use of call monitoring hardware and software within the care at home sector needs serious review. There are real benefits to organisations and individual workers not least in terms of safe lone working practices. However, what we have at the moment is the use of systems like CM2000 by Scottish local authorities which serves to effectively treat the frontline workforce in an unacceptable manner. Effectively workers are being electronically tagged and we have clear evidence that workers are leaving organisations who are forced to use this technology – a valuable resource the homecare sector can ill afford to lose.

This needs to be challenged as a matter of urgency or we will witness a whole generation of frontline homecare workers who will be resistant if not hostile to the benefits of technology for frontline care. Call monitoring models need to be person-centred and human rights based in use and implementation and not act like some sort of ‘Big Brother’ device to instil suspicion and mistrust.

A second challenge relates to the data that we are already gathering. Hundreds of homes are increasingly utilising the benefits of smart technology. There is an astonishing breadth of smart technology that is already and very shortly will be taken for granted in most homes. There is as some have commented a danger of ‘tech clutter’ in some of our homes, especially the living room from smart devices like the now commonplace Echo Dot, to music speakers like Sonos, smart televisions in abundance through to heating controls like Nest and Hive.  But less rare but growing are smart lighting devices, alarm clocks, radios, vacuum cleaners, microwaves, kettles washing machines and doors.

The volume of data that is being collected is astonishing but it is not utilised. We could do much better than we are already in using this data to move from a reactive model of homecare to one that is truly preventative and builds the support and care service around the distinctive needs of the individual. Such an emphasis requires resourcing and trust between commissioner and provider. It also requires those creating national data platforms to speak to homecare organisations and providers in order to maximise benefit.

A third challenge is something we alluded to in the TechRights report and that is the extent to which we need to re-envision the role of homecare to enable it to attract people who are technologically confident and competent. But for the tens of thousands of staff who are working already in homecare we need to do more than we are at present to invest in training and development for them, so that they overcome fear and cynicism and see technology as an asset to care. Such training and learning is the first to be cut in contracts during austerity and this is a fatal flaw for the development of a responsive, prevention focussed future model of care in the home.

Lastly the way in which care technology is introduced must bring the wider general public with it, especially as we move to an age of greater use of home robotics and artificial intelligence. At the moment there is a real lack of knowledge on the one hand, and a fear on the other. Such an articulation has to be based on an assertion of what should always remain the essence of homecare. This must surely be the sense that in ultimate terms , not least palliative and end of life care, that contact has to be human and that whilst technology can assist and add value it should do so in order to support and enhance human presence rather than replace it.

We live, as has been numerously said, in very interesting times. As innovation and technological discovery accelerate into areas and abilities we can only imagine, we have to be clear that a rights-based, person led, citizen controlled technology for homecare needs to be a priority in all the design and debate.

Dr Donald Macaskill