At a recent conference I attended one of the speakers made a statement almost as if it was a fact that ‘the social care sector has a Luddite attitude to technology and digital innovation.’ When I’ve mentioned that sentence to a few others they have confessed some agreement with his sentiment. I want to suggest in this blog that it is a wrong representation on two grounds. The first is that it’s historically inaccurate and more importantly, the second reason is that it couldn’t be further from the truth.

The Luddites were a radical group of English textile workers and weavers who just over 200 years ago in the Nottingham area destroyed weaving machinery as a form of protest. The Luddites were not against the machines themselves but against how they were being used to undermine what today we would describe as ethical working practices and health and safety. Unfortunately, the term has become adopted  to mean someone opposed to automation or new technologies per se. What has been lost is the sense of protest against the misuse not the existence of technology and automation.

Before turning towards the second assumption that the care sector is antithetical to technology I want to reflect a little upon the critical contribution of technology.

Paul R Daugherty and H James Wilson have recently published a book called ‘Human + Machine: reimagining work in the age of AI.’ It is a very good read and explores the potential of Artificial Intelligence (AI) in the work environment against the framework of a generally suspicious cultural narrative. They explore the way in which popular culture not least in examples like the ‘Terminator’ movies or ‘2001: A Space Odyssey’ suggest a polarised man versus machine view of things often depicting a future when human beings are replaced by machines. The knee-jerk reaction and negativity is echoed when we explore the debate around social care and technology.

Daugherty and Wilson forcibly argue that key to understanding the contribution of AI in any context, including the care sector, is to understand its transformational power. If we only think of AI in social care as something which will automate certain functions and tasks, then we will miss its power. Rather they argue that we need to recognise the potential of AI to complement and augment human capabilities. They envisage organic teams that partner humans with advanced AI systems. Can we imagine a mixed care team of robots and humans? Is that the stuff of dreams or nightmares? For some it is already a reality as evidenced in some Advinia care homes in England. 

The authors suggest that we are about to enter a ‘third wave’ of societal and workplace transformation. The first wave, they argue, was when people like Henry Ford introduced ‘standardised’ procedures. The second consisted of the automation of processes. The third, they suggest is the ‘missing middle’ where humans and machines interact. In this space human and machines are not fighting each other for dominance but seeking to complement the role of the other. But this requires new skills and employee roles, a new understanding of team and management, and maybe even a new understanding of work. Personally, I think there is real potential here for social care to take the lead in creating workplaces where AI contributes to a reformed and developed role of the social carer. It is not a case of one or the other but both contributing. As I have often said, technology can enable human presence but it should never replace it.

Dougherty and Wilson argue the leading organisations are already riding the ‘third wave’ by adopting a MELDS Framework – comprising mindset, experimentation, leadership, data and skills. What might a MELDS Framework look like for social care in Scotland? We need to find out and engage in that discovery sooner rather than later.

Already there are an amazing group of highly innovative and entrepreneurial social care companies and technology developers trying to enable a new approach to care. The next few years will be critical for shaping that future as one with the person at the centre rather than the process. It is becoming time critical that we work together to shape person-led and person-centred models of technology in care. I am confident that we can achieve models of AI which are truly grounded in a human rights based approach to technology enabled care.

As part of that journey, Scottish Care is delighted to announce that we are hosting our first ever event dedicated to technology and social care. ‘Tech Care, Take Care.’ will be held on the 24th August at the University of Strathclyde Centre for Technology and Innovation. It’s an event which will bring together some of the best designers, technologists and innovators from across Scotland and further afield. But it is also an event where we will spend some time looking at how we develop an ethical, rights-based approach to technology and care in Scotland. We hope to publish on the day a study on the relationship between human rights and technology in social care. We will explore the contribution and also the limitations of AI amongst other areas of innovation. We will consider the personalisation of care from a technological perspective in this ‘missing middle.’

So the only sense in which the term ‘social care Luddites’ fits is in the desire to develop an ethical personalised approach to technological innovation rather than a desire for social care to break up the machine! It’s going to be an intriguing ‘third wave’ to ride, why don’t you join us?

Dr Donald Macaskill

@DrDMacaskill

 

We are just two days out from the annual Scottish Care, Care at Home and Housing Support Conference which will be held in Glasgow on Friday 18th May. If you haven’t already got your tickets there is still time to join us at what looks to be an intriguing and enjoyable day.

This year’s conference is entitled ‘Practical promise: making the vision of home care real.’

The word promise is an interesting one. In strict definitional terms a ‘promise’ is a ‘transaction between two persons where the first person undertakes in the future to render some service or gift to the second person’

What’s that got to do with care in someone’s home? – I would suggest everything.

At a very basic level the concept of promise is at the heart of the human exchange which good care and support offers. Every time an act of care takes place there is a service offered and a gift exchanged. Not a gift in the literal sense but the gift of support and person-led care which enables an individual to live their life to the full. At its heart that is what good home care is – it is an enabling process which offers an individual the prospect and ability to live as independently as possible for as long as possible.

All too often in some of the debates I take part in about the future of care and support in our community there is a presumption that care at home and housing support are about maintenance – keeping people safe and healthy. Of course, that is part of the story, but it is by no means the whole.

People who require to be supported in their own home require that support not just to keep healthy but to enable them to lead as fulfilling and as rewarding lives as possible. Life does not just stop with a diagnosis it moves to a different level. Affective, human-centred care at home and housing support is about providing the support to enable people to still dream their dreams, achieve their goals, and create their future. Homecare should never be seen as maintenance – it is always about the promise of a life still to be lived; good homecare is not about a set of tasks to be performed but enabling people through support to achieve their full potential, regardless of age.

The relationship of care is infused with promise at its very centre. It says that I as I support you and care for you, I will be here to make sure that you have a life which is as full and meaningful as possible; that you are not limited by your need of care or support, that you have contribution to make and abilities to share.

But there is also another sense to the word promise which will no doubt be reflected upon during our conference on Friday – and that is the degree to which a promise has a future orientation and perspective. Within the word promise there is a sense of hope, of expectation, of things yet to be achieved… a sense that things will be better and that new direction will be found.

The care at home and housing support sector is at a critical juncture in Scotland at the present time. We are living and working in extremely challenging financial environments, and with great uncertainty and fear for the sustainability of the care at home and housing support sector. But there needs to be promise.

With political conviction and appropriate financial investment, the future direction can indeed be one of promise. Rather than disintegration and paralysis. There simply has to be a future vision of homecare where grounded in the realities of day to day care-giving, we can create a social care system in Scotland which values the human rights of the individual, treats all with dignity and respect regardless of their chronological age, and which seeks to ensure that the individual person is in control not only of their care but of the direction in which they want their living and dying to move. There has to be a vision which gets us beyond the reckoning of support by segments of time for allotted tasks, which seeks to purchase that care at the cheapest price and pays lip service to the principles of choice, control and involvement of the supported person.

We all know what the ‘promise of care’ in the future needs to look like. It is a rooted, grounded practical vision of a Scottish society which cares and manifests that care not just in word but in action. The time is surely here for fulfilling that promise and building that vision into practical reality rather than uttering yet more pious platitudes.

That is the promise – a system which would make all of us who do the work of care and support rightly proud – a social responsibility for a nation. Join us as we continue creating that practical vision rooted in the promise of dignified support and care.

Dr Donald Macaskill

@DrDMacaskill