Social Care at the iESE Conference

Delegates at the recent iESE Conference heard from an esteemed panel on issues around digital and technology in the social care sector. Here we draw out some key highlights from the conversation.

Panellists included:

- Dr Jules Maitland, Founder and managing director of human-centred design agency all in.

- Joanne Harding, Executive Member for Adult Social Care at Trafford Council.

- Mark Allen, Head of Tech and Digitally Enabled Care at Hampshire County Council.

- Craig McArthur, Director of Health and Social Care at East Ayrshire Health and Social Care Partnership.

- Chaired by Dr Andrew Larner, Chief Executive at iESE.

Dr Andrew Larner (AL): What is the need for the humancentred approach to services, why is it important and what does that mean?

Jules Maitland (JM): “When we have top-down approaches to fixing especially complex problems they often break apart and they often break apart because there is no one viewpoint that can solve these complex problems. Clinical experts are important, but they are not experts in the lives of the people that are impacted by these complex social problems. The people experiencing the problems and those delivering the care on a daily basis are not traditionally at the table when decisions are made about policy or programmes or technology solutions. Taking a human-centred design approach elevates that voice.”

Joanne Harding (JH): “One of the things we need to be ever mindful of when we think about our solutions for the future is that we don’t lose sight of the people that we are trying to serve and represent. We all know that social care is a very hot topic at the moment and there have been lots of conversations about funding, but to me it isn’t just about how we fund social care, it is about how we reform social care and we reform social care by involving the people in receipt of care and also those people delivering care. Whatever we do in the future around digital transformation and saving lives, we make sure that we include and involve people who are in receipt of care and staff who are delivering that care and that to me is imperative, we have to involve the people who have that lived experience.”

Mark Allen (MA): “My job in Hampshire County Council is to implement technology in a social care setting and it isn’t about technology, it is about how can we deliver effective and efficient care services for vulnerable people. The approach we take is very much outcomes based. All the time we are looking at how we can integrate technology into the care process. It is very easy to get caught up in the shiny object and new thing but what we try to do is make sure that we can blend that in with different sorts of care so that people’s holistic needs are met as far as we possibly can. Use of technology enables us to do things that are less intrusive, easier for people to use and are available 24/7 which is really a key element of it and actually can be bespoke to those individuals, which for me is a really important part of this – when we look at technology, how useful is it going to be to Mr Jones.”

Craig McArthur (CM): “Digital is not always the answer. We always have to remember that people should be at the heart of what we are doing, sometimes a digital solution is the right solution but there is a process to get there and that is understanding and talking to people and seeing what they want and seeing what the best delivery method might be. One of the challenges for us is accessibility to the technology to actually access the service in the first instance and that is a big part of what we need to build into those design processes as well, understanding how we can make it as accessible as possible to everybody. We can’t lose sight of the fact that what we are is a people business, it is about our staff talking to people who use the services and fundamentally we are about that level of engagement and if digital can help the process that is great, but we can’t lose sight of the people part.”

AL: What technology are you currently exploring using?

MA: “We are using robotics to assist care delivery. When we look at these things we look at the challenges we face and the problems we have got and start to ask the question how can we address them, there might be traditional ways of doing it but there may be other ways. We are looking at a deficit of carers in the Hampshire County Council area of about 6,000 by 2025, that is a huge challenge for us and we are also understanding challenges of being a carer, it is a tough job and when we were looking at this we thought what could we do in that space, we fell on the idea of potentially using robotics so we embarked on a whole process of trying to explore what was available. We are now working with a company in Japan which is supplying us with co-bots which the carer wears. It is lumbar region thing that someone wears like an exoskeleton.”

CM: “Some of the technology enabled solutions we wanted to put in place have been prohibitively expensive before and are now very easily available and tie in naturally to what you want to do anyway. We have seen real opportunities there to reduce some of the 24-hour care we had in place, so people perhaps getting care overnight, sometimes that just involved the carer being there at night and sleeping just in case something happened but now the technology can alert you and you can respond to that really quickly. It is about the consumer type product now rather than medically specialist.”

JH: “Social care is not just about caring for older people and people with long term chronic conditions. Social care is about supporting people to regain and retain independence. As well as the grand ideas I think we should be paying attention to some of the small basic things that make people’s lives better.”

JM: “It is a balance between being forward-looking but not overlooking those simple solutions and what can seem like a small problem to a health authority. To individuals in the home social isolation is crippling. The trick is to look at what technology is good at and use it for those purposes. Really good technology will free up the humans to do what humans are good at, let’s look at where humans excel and use technology to amplify those skills.”

AL: We have talked about residents but in terms of the care workers themselves are you seeing digital technology helping them?

JH: “A lot of staff at the moment are firefighting and trying to do day-to-day delivery and making sure that care packages are in place. One of my concerns is about changing culture sometimes in organisations and staffing teams. Some people are genuinely terrified of digital technology.”

MA: “One of the challenges for us is how to embed use of technology into systems and make it accessible and fair. We have embarked on a long process of culture change and getting social workers to accept this and bed that in there

so that when they are assessing someone’s needs they are thinking much more broadly than the traditional arsenal of approaches they may have taken previously. In Hampshire we have 1,300 people that we support using technology. We are starting to move beyond that into our workforce being curators of knowledge that can be passed onto people. It is about empowering our social workers to say ‘you might want to use this in this way’.”

CM: “The use of technology across the whole care sector is changing and we are seeing it changing. Eighty per cent of time spent on record keeping is clearly not acceptable but there always has to be some record keeping and if we can make that as quick as possible rather than something being handled [multiple] times, if you can do that once at the point of contact and streamline everything down that has to be good for everybody, including the end user. There are a number of issues in there about legacy systems, around the cost of upgrading systems, at a local level these are all challenges that you are trying to tackle just now. There are a number of new systems coming in all designed to improve that efficiency because it is the right thing to do in terms of governance but also the right thing to do because you can provide so much care for the same initial amount of money and that money goes so much further.”

AL: Is the ability to have some foresight [through data] something you are seeing already in social care?

CM: “We have got all the data and refer to ourselves as being data rich but intelligence poor, we don’t know what to do with it sometimes as there is so much of it. If we could understand and analyse it better, we could then use that to be so much more predictive in what we do and hopefully start to see problems coming before they are even there. Some of that is about the early intervention stuff that the technology will be able to flag up to us, a lot of it is just about understanding what the demands of the future are likely to look like and getting a workforce in place to be able to deal with it rather than where we are right now, which to be brutally honest is on the back foot and responding to crisis after crisis, we need to try and get ourselves more on the front foot.”

MA: “There are loads of sources of data and joining those up is really challenging. The issue around predictive stuff is that there is a lot of technology starting to emerge that claims to be predictive and give you data, it is lacking in evidence as far as I am concerned at the moment. There is nothing we are seeing that is giving us real quality information. If we could sit and look at data coming in, for example, for very frail over 85s about their frailty increasing, if we could start to understand that effectively, not only would it impact on social care delivery, it would impact on health. Those things are key and they will be the future but they are not here yet.”

JH: “We are bombarded with data but a key thing we miss is that we have all these reports that tell us everything but we very often neglect to ask people. Asking questions of people – what would make you happy? It is dead easy really, it isn’t a trick question. We can be over prescriptive in social care, we decide what people want. For me, a richness of data comes from the people who are living that life and we should go back to basics and just say what makes you happy, what would improve your life and how could we make that happen?”

• To watch the complete talk visit: https://www.youtube.com/watch?v=Tl7bJ29fjtA