Sue Yeandle and Gary Fry CIRCLE

1. The Potential of ICT in Supporting the Provision of Domiciliary Carewith particular attention to the case of immigrant care workers and informal carers - the case of the England and the UK Sue Yeandle and Gary Fry CIRCLE Centre for International Research on Care, Labour and Equalities, University of Leeds, UK Presentation at IPTS Seminar, European Commission, Brussels Tuesday 19th January 2010

2. Overview: evidence from England • Prompted by both public sector investments and private sector technology: • ICT / telecare is developing rapidly in domiciliary care • Range of support now available to carers on-line and through assistive technology, enabling them to access information and manage their caring roles • The academic evidence base on the impact of ICT interventions in social care is growing - but has not yet convinced public agencies to make major budget shifts • Case studies show range of support emerging for carers & care workers – impact on home care agencies patchy • Pace, scale and range of developments also constrained by funding, expertise and awareness

3. Methodology used in preparing report • Literature review of academic articles and policy documents in public domain • Identification of organisations/agencies using ICT / telecare to support carers/care workers • Websearch for other initiatives / detailed material • Telephone interviews with representatives of case study organisations/agencies • Interviews/meetings with selected expert informants • Synthesis of material, incl. our recent studies on: • Carers (published 2005-07) • Domiciliary care (published 2006)

4. Social care in the English system • Separate health & social care funding / delivery • Substantial unmet need / ‘self-funding’ growing • Domiciliary care at heart of recent developments • Support to stay at home, earlier hospital discharge • Independence, dignity and choice • Personalisation, Individual Budgets, Direct Payments • Focus on carers well established • National Carers’ Strategies (1999, 2008) • New rights and policies, including Carer Assessment • Robust data about carers – 2001 Census + surveys • Policy Innovations:Carers Grant to LAs, Preventive Technology Grant (2006), Whole Systems Demonstrators (2008)

5. Carers in England • Almost 5m carers, incl. 3.6m of working age • 45-64 is peak age for caring among women and men • Higher concentrations in some EM groups, esp. among younger people of Asian background • over 1m carers provide 20+ weekly hours of care • Health, financial, social exclusion - carer ‘penalties’ • Carers in all social groups - but incidence in areas of socio-economic deprivation highest • Effective ‘carers’ movement’, with policy influence • National level – lobbying, research, information • Local level – carers’ centres, services and support

6. Domiciliary care workers in England • Increasingly delivered by independent sector • Highly feminised, women 50-59 over-represented • Recruitment, retention, unfilled vacancies key problems • Marked regional variations, some IEMs over-represented • Part-time employment, unsocial hours, short bursts of care • Up-skilling and workforce development strategy in place • Skills for Care • Care Quality Commission (replaced CSCI April 09) • SCIE - Social Care Institute for Excellence • Limited engagement with ICT beyond CAS (community alarm systems) – except in LAs piloting telecare

7. ICT / telecare developments in England • Community Alarm Systems now well-established for older people • Preventative Technology Grant 2006-10 • “Building Telecare in England” – DH initiative • Whole Systems Demonstrators • Kent, Cornwall and Newham – funded WSDs in place • 12 further LAs due to start in 2010 • Tunstall: private sector co. manufacturing ‘telecare solutions’, supplies most English LAs, active worldwide • Help-lines and on-line support for carers • On-line training support for DC workers under-developed • Telecare solutions rapidly emerging for people with LDs, dementia and LTCs

8. Case Study 4Carers UK’s online discussion forum • Est. 2005 - successful and popular innovation • 1,500 (anonymous) forum members; 66,000 views per month • Provides peer support, information and networking opportunities, including private messaging • Linked to Carers UK’s main website • Users across wide age range but ethnicity not recorded • Opening forum to care workers as well as carers did not work • Constrained by funding • aiming to expand moderators to 10 • currently operated by 2 volunteers and 2 staff (who have other duties as well)

9. Case Study 7City and Guilds: ICT-based training modules and equipment • ‘Learning For Living’ accredited on-line training for carers, offering 4 modules • Training module for care workers • Certificate in Supporting the Users of Assistive Technology • SmartScreen: ICT-based resource • accessible to tutors and learners working on social care qualifications • 47,000 registered users • Issues and difficulties in developing ICT support in social care sector: limited uptake of ICT courses

10. Case Study 8National Black Carers and Carers Workers Network • Network for carers and carers’ support workers • only national level IEM network for this group identified • Website/ information, network events • Highlighted IEM gap in 1999 National Carers’ Strategy • adopted awareness raising strategy • Identified knowledge gap about ICT / telecare among IEM carers • Published “We Care Too” • Constraints on / limitations of its existing service

11. Key issues from other case studies • Tunstall • manufacturing, developing, promoting and supplying telecare solutions, UK / worldwide • English Local Authorities: • Piloting / introducing telecare/ICT in domiciliary care • Telephone befriending scheme • Low-cost network for carers • HFT/TATE ‘Through Assistive Technology to Employment’ • Using telecare/ assistive technology to support people with LDs and their carers • CTEC (computer-aided training, education and communication for disabled people)

12. Research and policy implications • ICT and telecare expected to emerge as central to sustainable development of social care system - Green Paper* (July 09); Personal Care at Home Bill 2009 – whichever party wins General Election in 2010 • Evidence base in development – not yet viewed as sufficient to support major reallocation of social care / health budgets • Case studies show carers, domiciliary care workers and support agencies believe real benefits can be achieved in home care support • Minimal data about IEM carers / care workers and ICT telecare at present *Shaping the Future of Care Together, Dept. of Health, 2009

13. CIRCLE: Centre for International Research on Care, Labour and Equalities This CIRCLE project has been conducted by • Professor Sue Yeandle • Email s.m.yeandle@leeds.ac.uk • Tel +44 113 343 4442 / +44 113 343 5003 (PA, Rebecca Wilding) • Dr Gary Fry • Email g.fry@leeds.ac.uk • Tel +44 113 343 7314 Address: CIRCLE, School of Sociology and Social Policy, University of Leeds, LEEDS, LS2 9JT, UK Website: http://www.sociology.leeds.ac.uk/circle Recent CIRCLE publications of interest: • ‘Telecare: a Crucial Opportunity to help save our health and social care system’, (2009) S Yeandle: www.bowgroup.org/content.asp?pageid=20 •  ‘A Weight off my Mind: exploring the impact and potential benefits of telecare for unpaid carers in Scotland’, K.Jarrold & S.Yeandle (2009) Glasgow: Carers Scotland, http://www.carerscotland.org/Policyandpractice/Telecareandtelehealth/Research