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Introduction

The Open University — Thu, 26 Nov 2020 00:00:00 GMT

In this free course, Digital innovation in social care and social work, you will learn about how digital technology has made a difference, both to social care sector and people living in their own communities.

There are many ways in which technology can measure and inform about health and illness, and this course will offer a broader view of how digitalisation can improve the care offered by social services. You will also learn about how incorporating technology in the home and in community settings has a range of benefits to people’s wellbeing and ability to maintain independence in their community setting.

New models of care are driven by the need to create cost-effective and sustainable health and social care services, and in this course you will see some examples of how technology can help create a new model of care (essentially, new ways of doing things in health and social care). However, you will also have to keep in mind some of the challenges, risks and drawbacks of more technology-dependent services in social care.

This OpenLearn course is an adapted extract from the Open University course K102 Introducing health and social care.

Learning outcomes

The Open University — Thu, 26 Nov 2020 00:00:00 GMT

After studying this course, you should be able to:

identify the ways in which digital technologies are used in social care services
evaluate the impact of digital technologies in the home and community on peoples’ wellbeing
evaluate how digital technologies in social care can impact on the cost and sustainability of service provision.

1 Digital technology and social care

The Open University — Thu, 26 Nov 2020 00:00:00 GMT

Going beyond healthcare, there are many different ways in which digital technology has the power to transform both social care and care in the home environment. Across the UK, there is an increasing focus to keep people in their own homes and able to live independently for as long as possible, which corresponds to growing concerns regarding treating and keeping people (particularly older people) in hospitals when they don’t need to be there. In fact, being in a hospital when someone is very old or has signs of frailty can present a risk to their health, so we have a duty to think about the most safe and appropriate places to care for people.

Home care (domicillary care) can be provided by social care services in a person’s home environment. It may include assistance with washing and dressing oneself as well as preparing meals. For example, people with disabilities or people who are recovering from hospital treatment or dealing with illness may require assistance with some of these tasks. Predictions about the future of home care needs show that we can expect major increases in the number of people who need social care services for home care (Wittenberg and Hu, 2015) and that there has been an interest in the way that technology can help cater for the growing needs and future demands for social care and caring in the home environment (Bennett et al., 2018). However, home care has a role in supporting people to regain physical, emotional and social skills and so we might wonder how technology can support people in this – this is an important question to keep asking ourselves as we increasingly adopt technology in the home care environment.

In the following activity, you will read a news article on how technology can change and improve social care.

Activity 1 Weighing up the news

The news article, ‘Can technology fix the social care crisis?’, reports on why technology is being introduced to transform social care. Read the article and make notes in the text box below about the key pros and cons of transforming social care with technology.

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Discussion

Here are some pros and cons you may have considered, along with a summary of what you have learned by doing this activity.

Pros

Technology in social care may save money and the social care sector is under financial strain.
The NHS Digital programme has money attached to it and so presents an opportunity to use some of these resources for the social care sector.
Technology may make communication between individuals more streamlined.
There may be improved record keeping or record management.
Technology may allow individuals to receive home-based care.

Cons

The article suggests that the care sector is behind the times when it comes to incorporating technology so far.

As you can see from the notes you made for your pros and cons list, the article suggests that there are a lot of benefits to incorporating technology in social care but is very scant on the challenges and risks of doing so. This article presents a somewhat simplistic and biased view of technology enhanced care and shows that by looking at the key messages described in the news, we can gain a better understanding of how in-depth and balanced the news article is. It is important to note that even though this article is presented as news, the writers may be supportive of a particular view and may be pushing an agenda in their article. You may have been surprised by how these developments are being presented as an opportunity for money-making and business as this might conflict with our traditional notions of the importance of quality and personal care that is offered for free at the point of use. This is an interesting tension in incorporating technology and digital services in health and social care. Hopefully, this activity will encourage you to see how you can identify bias and think critically when reading the news.

There are many opportunities that come with incorporating technology with care, but you may be able to think of problems as well. With that in mind, it is important to be able to weigh up the benefits and risks to ensure that any decisions regarding the use of technology in care do not go on to discriminate or present poor or inequitable care for people based on their access to and understanding of technology.

2 Digital and technology strategies in the UK

The Open University — Thu, 26 Nov 2020 00:00:00 GMT

All the UK nations – Northern Ireland, Wales, England and Scotland – have put in place their own strategies and priorities for involving technology in their health and social care. This is because each UK nation has the opportunity to govern its own health and social care sector, which means that there will be different focuses and different approaches to how technology becomes part of care. For example, Northern Ireland and Scotland have had a more established relationship between ‘health’ and ‘social’ care (an integrated approach) and so they can make decisions that affect health and social care altogether. England and Wales have traditionally had more separation between ‘healthcare’ and ‘social care’ and both governments are prioritising the need to create ‘joined up’ integrated care.

All three devolved governments in the UK (Northern Ireland, Scotland and Wales) have been able to set their own strategy for how they will include technology in care, which will be explored now.

In the 2018 report, Scotland’s Digital Health and Care Strategy: enabling, connecting and empowering (Scottish Government, 2018), the focus of digital innovation is often linked to empowering people to self-manage and live more independently. The report also describes the need for designing digital services using co-design methods with service users. This means that changes need to be made in collaboration with the people who are the recipients of services so the changes are made with the person at the centre of care. The report also describes how digital technology should be used as a way to ensure that social care systems are linked with health care systems appropriately to make sure that health and social care in Scotland is fit for the future.

In Northern Ireland, the eHealth and Social Care strategy (Health and Social Care Board, 2016) identified their priorities for how digital technology would benefit their care sector. Among these were the ability for the wide range of community and independent health and social care providers (including nursing homes) all being able to securely and consistently access the relevant service user data to ensure good care. There is also an intention to put individuals’ historical records in digital format so that care professionals can have detailed past history across all of the health and social care sector in Northern Ireland. The eHealth strategy also explains that technology will be able to help provide information which can be analysed to improve productivity and avoid waste of resources and effort.

These two examples show how each government can direct its focus on how it wants to use technology to change social care and how each nation can adopt a suitable approach for their particular population and their needs. These are both examples of digital strategies from the nations’ departments of health and social care about how they want technology to improve things. But how digital technology will actually go on to change and transform social care is unpredictable and we all may have our expectations about what will happen and what may or may not work in practice.

Activity 2 What strategy means to you

Thinking about these different strategies that are relevant to where you live, have you noticed any changes in your health and social care (whether you have been a patient, carer/family member, or a professional)? Do you think technology and digital changes like instant sharing of data and information has made care easier or made things more confusing and complicated? Comment on any differences you think you have noticed in relation to digital health and social care changes in the box below.

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3 Smart tech and home care

The Open University — Thu, 26 Nov 2020 00:00:00 GMT

Two key ways in which technology and digital advances are changing social care is through assistive technology and monitoring in homes. Assistive technology refers to products and tools that help people conduct tasks at home in order to remain independent or continue living in their own home. Over recent decades, we have seen how assistive technology has increased individual independence, e.g. using a wheelchair or having a lift installed in the home. However, digital advances and the internet now allow for smart assistive technology. For example, a smart (electronic) pill box can offer reminders when it’s time to take medication, but also can track the medication and offer warnings to family or relatives if a dose is missed. A smart pill box can alert a user if they are leaving the house without taking their medication with them or if they are taking a double dose that day by mistake. This smart assistive technology can, therefore, enhance the safety of someone living at home independently as well as informing the care services or relatives about the user.

This example of a smart pill box has a monitoring function as well as assisting the user in doing their daily tasks (remembering and taking the correct amount of medication). Monitoring is also a key way that assistive technology can help with monitoring an individual while they are living at home. By connecting this technology to the internet, we now have ‘smart’ devices that enable individuals living at home to be monitored, both by care professionals and by relatives who are based elsewhere, e.g. a smart floor pressure mat to identify if someone has had a fall, or a bed pressure mat to determine if someone has been in the same position for long periods of time and may be at risk. Belong Village, a housing scheme in Cheshire designed to support people with dementia, uses smart bed pressure systems to help identify if an individual has been out of their bed for a long time (which might indicate that they have had a fall) (belong.org.uk, 2019). Other types of sensors that can be used to monitor people at risk include ones can be worn, such as wrist sensors designed to monitor for acute events such as seizures in people with epilepsy. Therefore, smart monitoring tools increase the length of time an individual can remain independent and/or live at home, while also keeping safe from a social care or family member’s perspective.

In the next section, you will look at an example from Wales about how technology is transforming social care.

4 Technology-enhanced care in Wales

The Open University — Thu, 26 Nov 2020 00:00:00 GMT

The Welsh Government outlined an intention to use technology to enhance care in Wales in 2015 in its report, ‘Informed Health and Care: A digital health and social care strategy for Wales’. Figure 1 shows the ways in which digital technology is expected to transform care.

Figure 1 Infographic

Long description

Some of the unique challenges for Wales include incorporating the use of the Welsh language in any IT or digital technologies and ensuring the languages are treated with equal parity. This means that if a particular service or app was to be offered to service users, there would have to be some consideration that some Welsh people can only or would prefer to receive this in Welsh (Welsh Government, 2015). Overall, in Wales there is the expectation that technology will enhance care by allowing service users to:

see their own data and information to make better decisions about their care
add information to their data and records (such as linking to their apps and wearable devices)
access and use digital apps and wearable devices
use the internet to connect to social care services and communicate with professionals via video conferencing, email and text
use digitally-enabled services to support them to be able to live independently as long as possible.

For example, Powys, a region in Wales which is one of six locations in Europe that is taking part in a project on technology-enhanced care for older people who have chronic conditions. One hundred people in Powys are included in the project, CareWell. As part of the project, participants’ electronic data and records will be shared between community workers equipped with mobile devices and there will also be a shared record between GPs and hospital doctors. This project is about supporting the service user to remain safely and independently in their own home through all the health and social care professionals who are supporting the service user to all work from and input into the same electronic ‘patient record’ so that care is joined up. As part of the project, the community worker will also be able to communicate using the mobile device with the service user’s informal caregiver using text and picture messaging (Welsh Government, 2015; CareWell, n.d.). The CareWell project is a way to determine how and whether technology-enhanced care actually does work in practice and how it works.

In the next activity, you will learn about the some of the practical issues around incorporating technology into care in Wales.

Activity 3 Changing practice through technology in Wales

Watch the following video, concentrating particularly on the section from 2 minutes 39 seconds onwards, about incorporating technology into social care. The speakers include a social care professional from Wales, England, Scotland and Northern Ireland. They are all discussing both the opportunities and the challenges that this strategy will present for social care in incorporating assistive technologies in relation to their social care workforce in their own national setting. As you watch the video, make a list of all the advantages/opportunities that the speakers mention in the video in the left-hand column below, and all the disadvantages/challenges that are mentioned in the right-hand column below.

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MARED LLWYD

I think there's been a recognition there's a gap in terms of knowledge and skills, learning and opportunities in terms of electronic assistive technology, and how the workforce utilises that, so is aware of, and has the right knowledge and skills to actually embed that in their day to day social care practice.

So the purpose of the work really is to help move that forward, to develop the workforce to have the confidence, the right skills, and knowledge to be able to enable people to live to support independence, choice, well being to increase really and add value to the sort of social care packages and support that is offered at the moment.

DIANE WEBB

I think that also that it's OK that staff do need support and training, and additional learning, because a lot of staff maybe came in to the social care fields. And there was no use of technology when they came in. Then all of a sudden, there's these new types of technology, which can be scary, because it changes your job. So staff do need support.

MARED LLWYD

And we are developing a set of knowledge and skillset, and a strategy, which is about how we will do that. And the knowledge and skillset provides more practical tools really.

REBECCA NANCARROW

I like the fact we've got the implementation plan as well, which helps people put it across. So you've got the high level strategy, which helps us look at it all as an overview. And then we've got the implementation plan, and the real good user friendly skill sets to really introduce the ideas through to the workforce.

TREVOR TAYLOR

Yeah. And I think as well, the skill sets that will be very useful for organisations, both at the local level, as well as regional. And for some organisations, national level, to ensure that their staff have the competency and skills to use the AT if it's required for specific tasks or jobs.

MARED LLWYD

Yeah. And it gives a baseline, doesn't it? That we all work to. Standard across the UK that people can apply.

Obviously, people can build on that. And hopefully, it’ll end in things like qualifications, development, future national occupational standards development possibly.

REBECCA NANCARROW

We've also looked at people like manufacturers, suppliers of equipment, hoping to get them on board. We've got good contacts with them from the work that we do. And it's really nice to have things in the plan and strategy that will include them as well. Yeah.

And there's so many people that have been involved in the workshops around the country. So many people involved. There's an awful lot of different viewpoints that work really well. That come to the same conclusions really.

MARED LLWYD

Yeah, I think it is good. We've had good representation from you four have come forward as champions in your regions, as well as many others. Because they're interested. And they want to see it succeed, and want to see something that will drive the development forward, as we're all trying to meet different challenges in all our countries with less resources.

TREVOR TAYLOR

The thing that we find in our flow and support service, which is community based so it's about our support workers going into people's homes, that we're now introducing things like support staff going out and using tablets. So we can develop, for example, maybe as a part of a support goal, menu planners, healthy eating. So we're able to pick through and flick through things, rather than bring out reams of paper.

And so it's a matter of the person. And if the person is lucky enough to have a printer. And it's also given them the confidence maybe to use if they have a smartphone, to actually start doing these things for themselves. So it’s also about the staff as well learning.

And it's a two way process about the staff learning, along with the service user. And sometimes the service user showing the staff maybe what they can do, which is another good thing as well.

REBECCA NANCARROW

They start off really nervous around the equipment. But now, they go on. They're creating artwork. They're using the drumming software, some people with their eyes, some by touch. They're getting involved in and included in all sorts of stuff.

And you can see the staff are visibly more confident and relaxed around it. And they all get so much out of it.

DIANE WEBB

And that makes such a big difference to the individual. Because if the staff are confident--

REBECCA NANCARROW

Absolutely.

DIANE WEBB

And feel comfortable in using the equipment, then that makes such a difference to them in how they use it, and even how they think about it, or think about getting other types of technology to support them in their life.

MARED LLWYD

I think it can reduce social isolation in some ways, as long as it's not the only thing that's happened. But also in terms of life, leisure, work opportunities, potentially, it opens up so much. But also relieves pressures on people like carers. Assistive technology, whether it's an alarm, or just a buzzer on a door sensor, warning them when their loved one gets up in the middle of the night and starts to go wandering, at least they can get to sleep.

DIANE WEBB

I think that's one of the great things about this strategy. It's not just about environmental aids. It's all about just every day technology.

REBECCA NANCARROW

It is. Yeah.

DIANE WEBB

And how some people that we're supporting are not able to access that every day technology, like mobile phones, like a laptop, internet. And it's about supporting them to access that as well.

REBECCA NANCARROW

And for people who live in remote places, the Tully Care, the Tully Health, it all provides the framework of how to ensure that your staff are comfortable to use all of this innovative stuff really.

TREVOR TAYLOR

Yeah. I think that's going to be a very important thing in the future, particularly for areas like Northern Ireland, which is quite rural. But it is about using assistive technology to bring people who are maybe living in rural areas. Making them feel much closer to their community, and not so much in terms of isolation. And it's about staff as well.

When they're learning the skills, helping people to develop up those skills so they don't feel socially excluded, or marginalised. Not necessarily because of their disability, but because maybe of where they actually live.

MARED LLWYD

Yeah. And to think that was recognised within this strategy, and the knowledge and skill sets, one of the key things is that basic awareness across the sector. Everybody needs some kind of awareness of what it is, what it does, a general understanding people will become more skilled than that. And that's built in too. So building it in into how we recruit and induct, and all of that in the future.

This strategy now has recommendations really just aimed at employers in the main. But it also has clear recommendations of how we can take this forward. So the specific recommendations.

But also, they're relevant for-- well, some of them are specifically relevant for suppliers.

DIANE WEBB

There's the week planner, our learning and training programme for next year. We will just take the knowledge and skill sets and work out what's relevant to us, who is responsible for which area, who needs training in what and more. And then we would just use that and map them across our training programme, and start to introduce those types of training, and also introduce it within inductions, and also across other types of training that we've already got running, like vulnerable adults, introducing some of the IT, introducing that into current courses that we have running.

From my own personal point of view, I was looking for further qualifications and training, and electronic assistive technology. I am actually managing a team and I have experience in using electronic assistive technology. I don't have a specific qualification in that field. And what I've found is there's hardly any training or qualifications out there. And I'm now having to go down to Coventry University to get a qualification, whereas I would rather achieve that in Scotland, and at Oakley.

TREVOR TAYLOR

I think it's important, certainly for the likes of organisations that provide social care services in Northern Ireland to get involved in the action strategy. It's that there's more and more development in this particular technology. And it's continuing to develop at a very rapid pace. And I think at the end of the day the important thing is to remember, if it's going to improve the quality of life for the individuals that we provide services for, that's the very soul of becoming involved, and in the strategy, and taking it on board, and developing up the knowledge and skill sets, and working to those. So I think that's very important certainly for any service provider.

MARED LLWYD

The main reason really is to improve the quality of life, the opportunities, independence for people, and enabling people to stay at home longer, have more choice and control.

REBECCA NANCARROW

I think for me it's to be proactive rather than reactive, because the technology is here. People are picking it up. They're seeing the opportunities. It's exciting. It's innovative, and it's a buzz. And rather than having to get the skills later, let's be proactive and get them now.

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Advantages and opportunities for technology-enhanced care	Disadvantages and challenges for technology-enhanced care
1, Your response 1	2, Your response 2
3, Your response 3	4, Your response 4
5, Your response 5	6, Your response 6
7, Your response 7	8, Your response 8
9, Your response 9	10, Your response 10
11, Your response 11	12, Your response 12
13, Your response 13	14, Your response 14
15, Your response 15	16, Your response 16
17, Your response 17	18, Your response 18
19, Your response 19	20, Your response 20
21, Your response 21	22, Your response 22

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Discussion

Here is an example completed table:

Advantages and opportunities for technology-enhanced care	Disadvantages and challenges for technology-enhanced care
People want to see the strategy succeed	Trying to meet needs with less resources
Relying less on paper and paperwork	Some people don’t have good access to technologies
Support staff can scaffold learning of service users to use internet and technology themselves (as they see it in action)	Need to build in digital skills or literacy into how social care employers recruit, induct and train
The staff themselves will learn and gain confidence using technology	Some managers/employers feel that they need more qualification or training in technologies themselves in order to manage their teams
People using the equipment gain digital confidence – staff and service users	There might not be many relevant training and qualifications to support technology in care in the early stages of adoption
Can reduce social isolation
Relieves pressures on carers
Reduces lack of access to technology
Particularly useful for people who live in remote or rural areas
Can be used to improve quality of life and independence for people, enabling them to stay at home for longer
It’s exciting and innovative to include technology

5 Supporting young people

The Open University — Thu, 26 Nov 2020 00:00:00 GMT

Young people are common users of apps and digital technologies for information and entertainment (Beckman, Bennett and Lockyer, 2014). Research indicates that young people value accessibility and immediacy of information as well as the options to have personalised information which may be provided in digital technologies and apps (Gardner and Davis, 2014).

There is a unique power and potential to how digital technology can influence or support young people assuming they have access to it and it is centred around their needs, which is summed up in this quote from a youth adviser working for RErights, a project championing young people’s rights in the digital age:

Life is a blind lottery. You cannot choose the circumstances of your birth: your gender, your ethnicity, your parents’ wealth, or your disability. Yet technology has the immense potential to even the playing field. Technology can transform the way children learn, connect and discover opportunities for their wellbeing and development. In a world of growing inequalities and uncertainties, technology can be a source of empowerment, enabling children to become the authors of their futures and to rise above the cycle of disadvantage.

(Third et al., 2017, p. 3)

In the activity below, you will learn about Aye Mind, a project in Scotland designed to use the internet, social media and mobile technologies to support young peoples’ mental health.

Activity 4 The minds of young people in Scotland

Part 1

For the first part of this activity, watch the video and read the information page about this intervention using the link below. Make some notes as you watch on the following:

describing what this intervention is
how it could change service users’ experience of their social care.

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FEMALE SPEAKER

If you work with young people, you'll know how hard it can be to help them talk about things that are difficult. They need to feel that their views, wishes, and feelings are being listened to. At the same time, you need to make sure you've recorded those views.

Mind Of My Own apps make all of this easier. Use the One App when you're one to one with a young person using their device or your computer. You can also have an account to use with children who aren't yet old enough to have their own. One App is there to guide the conversation, making it easier for them to express their views and for you to capture them.

For children with additional needs, we have an app called Express. It helps you gather their views in a way that suits them. After seeing the child, you don't need to write up their views. Mind of My Own sends you a PDF of what they said.

A young person can sign up to their own account on One App and use it anytime they want. It helps them structure their thoughts and say what they need to say. They get to choose who to send their views to so they are always in control. Get the Mind Of My Own apps, and open up new possibilities for your conversations with young people.

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Information page about intervention: Mind Of My Own

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Part 2

Now watch this video of Callie, who is describing how she experienced care as a result of the intervention. As you watch, check back on your notes to see if they reflect any of the thoughts you had about how the intervention might change service users’ experience of care, and also whether it raises any additional points for you to think about.

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CALLIE

Hi, everyone. My name's Callie. I'm 18 years of age. And today, I'm going to be talking about Mind of My Own. I discovered Mind of My Own a few years ago. And I mainly used it back last year when my foster placement broke down. My social worker was seeing me in placement, so it was very difficult to tell her about my problems within placement, purely because carers could hear what was going on.

When I discovered Mind of My Own, I told my social worker via the app I wasn't happy. And this resulted in me meeting with her outside placement, which now I'm in a happy placement now here. And I couldn't be more over the moon. It's amazing.

Second of all, it's probably one the easiest ways to communicate with my social worker for me. Sometimes it's difficult trying to get a hold of your worker because they've got about 10 hundred million things to do at once. So Mind of My Own, like it pops up on their dashboard as email. And it's so clear. So for them, as a worker, I know that they know that their young person's trying to contact them.

And even as an app, it takes a face-to-face awkwardness away purely because I know when you're talking about problems, sometimes it's really even to talk about things you don't even want to talk about to a worker. So even if you've done the Mind of My Own statement, it notifies your worker. And you're not seeing them face-to-face. You can do it in your own time. It's purely down to the young person. And it probably is better for the worker as well because they know what's going on in your life.

What do I think about Mind of My Own? I think it's absolutely fantastic. It might not be for every young person, but if every young person does know about Mind of My Own, it could save another person's life, potentially. Without Mind of My Own, I don't know where I would be now. I can't thank the app enough.

It's amazing. It's easy. It's efficient. It's effective. It's brilliant. I can't thank it enough. So yeah, thank you.

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Discussion

Describing the intervention: This intervention is about getting young people with mental health support needs to be able to feel comfortable communicating with care professionals who are assisting them. It also allows young people to document and self-monitor or track their own thoughts and feelings. This intervention comes in the shape of a series of apps called Mind of My Own. One app can be used during one-to-one conversations between the professional and the young person which makes it easier to describe feelings such as through the use of emojis. The app then sends a PDF of what the young person said. A young person can also use the app to structure and understand their thoughts, and they can choose to send it to others if they wish.

Changing care experiences: The app might help young people feel more in control of what they say to social care professionals, as they can make notes and then choose (or not choose) to send this information to social workers. The young people might find it easier to describe their emotions using the emojis as this is a common thing that we often do in text messaging and social media and so this may be a more socially acceptable way to share their feelings.

Reflecting on the video of Callie: This may have been in keeping with some of the thoughts you’d already had, but it was clearer to see how the app can be used to determine or direct the care needed. For example, Callie used this method of communication to say that she was unhappy in a foster care placement and this resulted in her changing placements which she found helpful. You might not have considered how the app could take away the awkwardness of face-to-face encounters with social workers for young people, which Callie describes in her video. Interestingly, Callie thinks the app may not be for every young person, but that every young person should be told about it so they have the option, and it could save lives. Callie also mentioned how her information would come up as a message on the dashboard for her social worker, which might have made you wonder about the effect on the professional. For social workers, they may feel a sense of reduced burden knowing that their young service users have an easily accessible way to reach them. However, they could also feel stressed and worried about being available to be contacted on the app all day, every day.

You may have made other notes and this app offers a lot of room for thought about how technology can be used to change social care experiences for young people.

You have learned about some of the powerful ways that technology can change or enhance social care in helpful ways. However, there are still a number of barriers to these changes and these may come from individuals not wanting to adopt technology or not having access to technology, along with their concerns about digital and technological interventions and tools.

In the next section, you will learn more about the barriers to some of these technological changes to social care.

6 Barriers to transforming care

The Open University — Thu, 26 Nov 2020 00:00:00 GMT

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.

No.	Barriers:
1.	23, Your response 1
2.	24, Your response 2
3.	25, Your response 3
4.	26, Your response 4
5.	27, Your response 5
6.	28, Your response 6
7.	29, Your response 7
8.	30, Your response 8
9.	31, Your response 9
10.	32, Your response 10
11.	33, Your response 11
12.	34, Your response 12
13.	35, Your response 13

Interactive feature not available in single page view (see it in standard view).

Discussion

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

Conclusion

The Open University — Thu, 26 Nov 2020 00:00:00 GMT

In this free course, Digital innovation in social care and social work, you have learned about how technology and digital tools, such as apps and smart assistive technology in the home, is changing social care. You have examined some of the promises and pitfalls of technology; for example, thinking through who is using the technology to transform their care experience and how and whether it works for them. There are lots of challenges of incorporating technology including the anxiety around using new products as well as the fact that many people are digitally excluded to the extent that millions of people have never been online. These are important lessons to bear in mind when designing a digital strategy for an entire nation.

This OpenLearn course is an adapted extract from the Open University course K102 Introducing health and social care.

References

The Open University — Thu, 26 Nov 2020 00:00:00 GMT

Beckman, K., Bennett, S. and Lockyer, L. (2014) ‘Understanding students’ use and value of technology for learning’, Learning, Media and Technology, 39(3), pp. 346–67.

Belong.org.uk. (2019) Belong Villages. Available at: https://www.belong.org.uk/ (Accessed: 2 December 2020).

Bennett, L., Honeyman, M. and Bottery, S. (2018) New models of home care, The King’s Fund. Available at: https://www.kingsfund.org.uk/ publications/ new-models-home-care (Accessed: 2 December 2020).

CareWell (no date) Powys, Wales, UK. Available at: http://carewell-project.eu/ regions/ powys-wales-uk.html (Accessed: 2 December 2020).

Cimperman, M., Brenčič, M.M., Trkman, P. and Stanonik, M.D.L. (2013) ‘Older adults’ perceptions of home telehealth services’, Telemedicine and e-Health, 19(10), pp. 786–90.

Clark, J. and McGee-Lennon, M. (2011) ‘A stakeholder-centred exploration of the current barriers to the uptake of home care technology in the UK’, Journal of Assistive Technologies, 5(1), pp. 12–25.

Cook, E.J., Randhawa, G., Guppy, A., Sharp, C., Barton, G., Bateman, A., and Crawford-White, J. (2018) ‘Exploring factors that impact the decision to use assistive telecare: perspectives of family care-givers of older people in the United Kingdom’, Ageing & Society, 38(9), pp. 1912–1932.

Gardner, H. and Davis, K. (2014) The App Generation. London: Yale University Press.

Health and Social Care Board Northern Ireland (2016) eHealth and Care Strategy for Northern Ireland: improving health and wealth through the use of information and communication technology. Available at: https://www.health-ni.gov.uk/ sites/ default/ files/ publications/ dhssps/ interactive-ehealth-strategy.pdf (Accessed: 2 December 2020).

Sanders, C., Rogers, A., Bowen, R., Bower, P., Hirani, S., Cartwright, M., Fitzpatrick, R., Knapp, M., Barlow, J., Hendy, J., Chrysanthaki, T., Bardsley, M. and Newman, S.P. (2012). ‘Exploring barriers to participation and adoption of telehealth and telecare within the Whole System Demonstrator trial: a qualitative study’, BMC Health Services Research, 12(1), p. 220.

Scottish Government (2018). Scotland’s digital health and care strategy: enabling, connecting and empowering. Available at: https://www.gov.scot/ Publications/ 2018/ 04/ 3526/ 1 (Accessed: 2 December 2020).

Third, A., Bellerose, D., Oliveira, J.D.D., Lala, G. and Theakstone, G. (2017) Young and online: children’s perspectives on life in the digital age. Sydney: Western Sydney University.

Vassli, L.T. and Farshchian, B.A. (2018) ‘Acceptance of health-related ICT among elderly people living in the community: a systematic review of qualitative evidence’, International Journal of Human–Computer Interaction, 34(2), pp. 99–116.

Welsh government (2015) Informed health and care: a digital health and social care strategy for Wales. Available at: https://gov.wales/ sites/ default/ files/ publications/ 2019-03/ informed-health-and-care-a-digital-health-and-social-care-strategy-for-wales.pdf (Accessed: 2 December 2020).

Wittenberg, R. and Hu, B. (2015) ‘Projections of demand for and costs of social care for older people and younger adults in England, 2015 to 2035’, PSSRU discussion paper (DP2900). London: Personal Social Services Research Unit, London.

Acknowledgements

The Open University — Thu, 26 Nov 2020 00:00:00 GMT

This free course was written by Lucy Rai.

Except for third party materials and otherwise stated (see terms and conditions), this content is made available under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 Licence.

The material acknowledged below is Proprietary and used under licence (not subject to Creative Commons Licence). Grateful acknowledgement is made to the following sources for permission to reproduce material in this free course:

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Figure 1: Informed Health and Care, A Digital Health and Social Care Strategy for Wales © Crown Copyright, Reproduced under the terms of the OGL, www.nationalarchives.gov.uk/doc/open-government-licence

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Video 1: Used with permission from Social Care Wales

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Video 3: ‘Callie’s video’. Mind Of My Own Ltd https://vimeo.com/322815023 https://creativecommons.org/licenses/by-nc-nd/3.0/

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