Features: March 6th, 2013

In the wake of Gloria Foster’s tragic and avoidable death, Mark Thomas, dscusses why care monitoring is vital in helping local authorities to save lives – and money.

Hitting headlines across the country, 81 year-old Gloria Foster was discovered in an emaciated state at her home this January, after being left for nine days without the care she relied on.

A stroke victim, Gloria depended on agency care staff who visited her home four times a day to help provide food, water and medication. She died soon after she was found and admitted to a local hospital.

After the agency responsible for Gloria’s care had been closed down for allegedly employing illegal immigrants, it claimed that all details of those receiving care were handed to Surrey County Council by the police.

Quite what happened next was unclear, but what is clear is that if Gloria’s care had been monitored by the Council, her death could certainly have been avoided.

Monitoring to limit risk of failure

There’s no doubt that local authorities are under enormous pressure to ensure high quality care is commissioned whilst operating within ever-tightening budgets. With the best will in the world, mistakes happen and care visits are delayed or missed all together, as in Mrs Foster’s case.

However, if a council doesn’t know that commissioned care is being missed or not provided at all, who is safeguarding these vulnerable service Users?

The CQC asks providers to ‘self-monitor’ the quality of service they provide – a questionable and reactive control, which fails to tackle many cases such as Mrs Foster’s. Meanwhile, local authority contract monitoring officers, who would typically oversee the quality of services being provided by contracted suppliers, have mainly been decommissioned (or have little resource to manage the size of services now being provided).

This perhaps explains why many councils are now relying on electronic care monitoring to empower all stakeholders with real-time quality control of all care being delivered within the community.

Information provided by an electronic monitoring system is not onerous to manage and works on exceptions. If care delivery does not go to plan, and visits become late or missed, office or on-call staff will be alerted.

This can be crucial, particularly in cases where critical visits are planned to coincide with important requirements such as dietary needs, medication, or helping with readiness for a follow on service.

To have an over-arching view of all care being delivered, councils need to implement one monitoring solution across all care providers. Allowing contracted providers to choose their own system and ‘self-monitor’ provides none of the real-time visibility, transparency and service delivery insight (as demonstrated by this tragic case). Monitoring technology also highlights variations between commissioned, planned and actual care – again allowing councils to manage by exception and review care need trends appropriately.

Monitoring in practice

CM2000 works closely with 82 Local Authorities and 700 care providers / healthcare organisations across the UK, offering a range of different care monitoring methods. The majority prefer to use a system whereby care workers log visits using the service user’s landline to call a dedicated number. The service costs nothing to the care worker or service user because the call doesn’t connect, but cleverly knows which care worker has been to whom and where, and flags the date, time and duration of the visit.

This monitoring method can also capture from the care worker what tasks / duties were provided, leave messages for office staff, as well as quality scoring and outcomes information.

Of course, not everyone has a landline and so a wide range of complementary and alternative technologies are available to cover all potential care service needs. For example, reablement staff carry mobile phones that provide more sophisticated two-way communication (between the office and field worker), utilising the mobile phone’s NFC or GPS technology, providing accurate visit authentication.

Regardless of the method used, the financial arguments in favour of care monitoring are compelling as it ensures councils (the tax-payer), family and advocates only pay for care delivered.

Spend on social care is one of the biggest financial outlays for local authorities and with care monitoring in place, councils stand to save as much as 10 per cent of their annual social care expenditure – through accurate charging and automated billing. That’s a considerable amount of money that could be diverted into front line care or contribute to Councils’ savings plans.

More importantly, those depending on care are some of the most vulnerable members of society and by having these systems in place, councils can be sure that they’re receiving the care they depend on. Across the UK, there are close to 5,000 providers of care services being used by local councils. If much of this care isn’t being monitored, how long will it be before another tragic case hits the headlines?

Mark Thomas is Managing Director of CM2000.