# 6 Barriers to transforming care

Transforming social care services will be met with barriers. For example, there will be needs, preferences and concerns from the service user groups that need to be considered. There will also be challenges and concerns for the social care professional workforce in expecting or asking them to work in different ways due to the introduction of new technology. There may also be technological barriers in that the digital products or technology may not actually work as they are supposed to. Importantly, changing social care through technology will most likely raise ethical questions that we need to consider.

Some of the barriers to service users adopting technology include not feeling competent or well-trained enough to get to grips with the technology, feeling that some types of technology undermine one’s reliance on themselves or ability to cope, and some have had fears that technology and digital services will result in depersonalisation of the care (Sanders et al., 2012). For some people, how easy, useful and effortful and anxiety-provoking it is to use the technology may be key barriers to adopting technology in their care (Cimperman et al., 2013). More recently, research reports that fears about safety and security and having privacy concerns can be an important barrier to service users adopting technology in their care (Vassli and Farshchian, 2018). This raises some ethical issues about who has access to data from the care technology, and whether it is appropriate to, for example, monitor people all the time in their homes (Clark and McGee-Lennon, 2011).

Sometimes, the decision to use new technology may be a collaboration between the service user and their family or carers and so the perspectives of the carers are also important. Cook et al. (2018) studied family caregivers and their decision to use assistive telecare for older people (for example, smart assistive technologies that may be connected to health and social care services to update them on user information and vital signs, etc.). In their study, they found that the family carer often felt the responsibility to make the decision about the technology as the service user was not always aware or sometimes did not understand what the technology was and what it did. Usability and functionality of the technology was a key issue so if the technology was problematic, difficult, inconvenient or time-consuming to use, this might be a barrier and the technology might not be used. This study reinforces that it is not enough to simply offer technology to ensure better care, but the technology needs to improve services and/or outcomes.

Not all people have access to technology such as mobile devices and smartphones and computers. Some people cannot or have not ever used the internet and we may refer to those as ‘digitally excluded’. In the activity below, you will have the opportunity to consider how being digitally excluded feels for carers in the UK.

## Activity 5 Digitally excluded carers

#### Part 1

First, read pages 21–22, entitled ‘Digital exclusion is a key issue amongst carers’, in the Tinder Foundation’s report, The Health and Wellbeing of Unpaid Carers: Where Can Digital Skills and Community Support Add Value? The relevant section describes the issue of digital exclusion relating to carers.

#### Part 2

In this course you have learned about all the ways that digital technologies can transform social care services. This report highlights some of the barriers that exist in being able to reach some people as well as how it is important not to assume that everyone is as able and willing to use technology in their care.

As you read the findings on pages 21–22, make a list of all the barriers that the findings raise to including and involving digital carers. Write as many points as you can think of in the text boxes below.

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### Discussion

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No. | Barriers:
1. | Lacking basic digital skills
2. | Never having been on the internet
3. | Not having much access to the internet other than at home
4. | Affordability concerns regarding the internet
5. | Not having good internet connectivity
6. | Being restricted to the home, for caring duties
7. | Needing help learning to use technology or the internet
8. | Lacking confidence in their own ability
9. | Not knowing where to get help and support for increasing digital confidence
10. | Worrying about internet safety and anonymity such as for dependents
11. | Feeling that the internet is impersonal
12. | Finding no benefits to being online
13. | Social factors, such as being older, having disability and being in a lower socio-economic group contribute to increased digital exclusion

OpenLearn - Digital innovation in social care and social work
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