Telecare in Care Homes, Lothian

What was the issue you were addressing or working on?

To reduce the level of emergency admission to hospital from Care Homes by utilising appropriate telecare equipment to reduce the number of falls in residents.


What you did?

Residents were assessed for falls risk using data from the care home’s fall register.  Residents who were either the most frequent fallers or those deemed at very high risk of falls, were then assessed by either the Falls Co Ordinator or the Telecare Advisor in conjunction with care home staff to establish the most appropriate telecare equipment for that resident.

Telecare Equipment

The equipment used was a portable telecare local alarm and telecare sensors including falls detectors, chair occupancy sensors and bed occupancy sensors.

The local alarm receives telecare alerts from the telecare sensors; the alert includes the name or resident and type of sensor.

Fall Detectors are either worn on the trouser belt or in a pouch strapped around the waist, the Fall Detector senses the impact and angle of a fall and sends an alert. Bed/Chair Occupancy Sensors provide an early warning by alerting that the resident has left their bed or chair. They can be set to alert staff either immediately or with a time delay.

If telecare was deemed suitable then consent was sought guided by the principles of the Adults with Incapacity Act, i.e. that the use of Telecare will result in demonstratable benefit to the adult and that such benefit could not be achieved without the intervention. Also the use of Telecare represents the least restrictive intervention possible at this time with regard to the freedom of the adult.

Falls Champion

Each Care Home had a named ‘Falls Champion’ who was responsible for the running of the pilot at the Care Home. Training in the use of the equipment was organised for the staff and during these sessions there was full discussion regarding the project and its aims.  Communications were maintained throughout the project by regular visits and flyers with information for staff, residents and families.

The project ran for four months and data was collected for each resident on the falls experienced during the four months previous to the project, and the four months during the project.

Estimated costs are £200 – £350 per patient for equipment.


What were the outcomes - benefits or otherwise?

On average there was 25% reduction in falls in the care homes.

A number of factors need to be considered to ensure successful implementation of telecare in a care home environment:

  • Introducing a separate / additional telecare alarm sytem often causes problems for staff trying to manage alerts from both this system and their existing nurse call system. This is further compounded for care homes that are poorly designed and/or not purpose built
  • Residents must be individually assessed for the appropriate equipment.  Identification of a Telecare Lead who can carry out assessments and install equipment supports successful implementation.
  • A Telecare Lead acts as a local source of knowledge and assist the other team members in educating them about telecare and suitable options. They give staff, residents and their family / carers confidence in the system.
  • Residents and staff report increased confidence with mobility for those with falls detectors as they feel safer and reassured knowing they will be found quickly.
  • In some instances telecare saves on nursing time as routine checks are no longer required.  This has proved particularly valuable overnight as residents are no longer disturbed by two hourly checks and staff are freed up for other tasks. Residents also value the increased privacy provided through less routine checks.

Contacts - to find out more

Rosalind Eccles
Email: Rosalind.eccles@nhslothian.scot.nhs.uk

Alison Anderson
Email: aanderson@eastlothian.gov.uk