Technology constantly changes all of our lives – from apps on our phones which let us record TV programmes from anywhere, to fridges that can order you more milk when you are running low.  Technological advances are improving all of our lives and making things easier, and the same is true for care at home.

Basic comforts and improvements to someone’s quality of life can be achieved through speech-recognition “home assistant” devices, which allow individuals to control their TV or radio, or phone/ video call friends of family members quicker and more easily than before, and smart-home technology makes it easier for heating and lighting to be controlled or monitored by a carer.

From a safety point of view, perhaps the most important area is sensors, which can be used to passively monitor behaviour or raise an alarm if someone is in distress.  Personal alarms are now commonplace when considering care at home but there is a risk that they are not close-by if something happens, and other sensors or alarms can now easily be installed at low cost to provide additional comfort and reassurance.

Remote monitoring devices can allow friends, family or carers to be informed of unusual behaviour (or lack of behaviour) through simple sensors fitted to socket outlets, and can easily be retro-fitted in existing properties.  For example, a device on the kettle can inform people how often it is boiled, or a shower, to let someone see how often it is used.  The early warning signs of someone not having a shower, or making a cup of tea may be an alert to something having happened, or the early signs that additional support is required.

More advanced sensors can detect movement in a home using infra-red cameras, so an alarm can be raised if someone has not moved from a bed or a chair for an unusual length of time.  Wearable technology can also record someone’s heartrate (many of us wear a fitness wristwatch which does exactly that).

Thanks to better connectivity, information can be shared and an alarm raised in real time, allowing for immediate action if something happens.  As technology continues to advance, using “machine learning” we can also programme computers to “learn” typical behaviour and then by observing sensor results predict if something changes, to inform a carer of a likely event, increasing the possibility of pro-active response rather than re-active, which may already be too late.

Of course, adding devices is not a replacement for qualified carers or other medical advice and consultation, but by recording the information and results from a range of sensor systems, OTs and other medical professionals can more easily identify trends or changes in an individual over time.

We are frequently involved in alterations and extensions for individuals who require more suitable homes, and although technology will not solve all of the problems, it can improve someone’s quality of life and provide reassurance and comfort for friends and family.

Colin Hastie

Director, Bruach Design and Cosultancy

Social care is vital to our society.

Thanks to changes in society itself, advances in science and technology, alongside the high quality of healthcare provided by the NHS, as a population we are enjoying longer lives. This does mean, however, that people are living longer with more complex needs.

In Scotland we are proud of our social work and social care system’s focus on human rights as it supports thousands of people with short term difficulties in their lives, disabled people and people with long term conditions to live full lives in their communities and carers to have a life alongside caring.

However, it’s becoming clear that our traditional approaches and services weren’t designed for how quickly demand for care and support is growing.

‘Scaling up’ the current system to meet growing demand isn’t sustainable, and doesn’t address the types of changes that need to be made to make the system stronger.

We need to think differently about what social care is, the value we place on it as a society, and how people can access the support that is right for them. That also means thinking about where change is required, what change is already being shaped, and how best to bring it forward.

In thinking widely about how to address the issues faced by the system, a pressing question arose: is there a role for national government and partners in supporting local reform of adult social care? What should that be?

From conversations we’ve had so far, there is no clear cut answer. Speaking with people and organisations and reviewing research has thrown up different views on:

• what the biggest challenges are in social care in Scotland
• what should be done about them
• what a national programme should focus on / what it should do

In asking these questions, responses have been coloured with everything from energy, experience and enthusiasm to frustration and exhaustion.

In addition to that spread of emotion, this told everyone involved something that they already knew: There is no single answer; if it were easy, it would have been done by now.

Rather than debate the diverse spread of issues down to the last speck, it was agreed that time would be better spent crafting a shared agenda – an agenda that would identify change and improvement in the system, and one that would allow everyone involved to see the value and importance of their part in the bigger picture.

Change will be – and is being – led locally, by workers, organisations, people, partnerships and communities.

With this in mind, we needed to start the conversation. Speaking to stakeholders, they have begun to identify a number of priorities where a collective national  programme might bolster what was happening at a local level:

• Raising the profile of social care in Scotland, as well as awareness of its value for individuals and society.
• Working to fully embed self-directed support and clear up its many misconceptions.
• Expressing our vision and ambition for adult social care. The national programme offers an opportunity to develop and promote this.
• Looking at the rich provider landscape and how services and support are planned, designed, developed and delivered – all of which will be key to reform.
• Allowing a platform for an honest discussion about the cost of social care, and how care is paid for.
• Barriers to progress come up frequently, and so a national programme would be one route to identify these and then make or support changes necessary to overcome them.
• Leadership of social care reform must be far-ranging, and so a key focus of the national programme would be on creating the right environment for collective decision-making.

We recognise that a lot of people and organisations are already doing, or have already done, extensive great work, and there’s something to be said about making space for creativity and innovation in addressing the issues faced by our social care system.

Moreover, we know that reforming social care is something that can only be achieved through collaboration.

Crucially, it needs to have people with lived experience of using the social care system at its core, fully engaged in the discussions around reform.

@SG_SDSPolicy

Andrew Scott

Adult Social Care Reform, Scottish Government

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