The use of technology in care homes is becoming an increasingly important tool for many care providers in improving both the safety and wellbeing of residents. The Department for Health and Social Care's white paper 'Health and social care integration: joining up care for people, places and populations', aims for over 20% of all care homes in England to be using acoustic monitoring solutions or equivalent technology by March 2024.

Acoustic monitoring in a residential care context uses audio sensors to pick up sounds that indicate that a resident is having difficulties. This may be someone attempting to get out of bed, being unusually restless, becoming unwell (such as coughing/choking) or asking for assistance. Staff are therefore alerted through the system that the resident needs attention rather than needing to carry out routine checks that often disturb residents unnecessarily. This monitoring tends to be used during the night to avoid waking residents.

The non-obtrusive technology allows an acoustic threshold to be set which is individual to the resident, depending on their usual behaviour and needs. This is determined by machine learning algorithms and triggers an alert for staff to respond when sound exceeds or falls below an individual’s set noise level.

There are many perceived positives to the use of acoustic monitoring technology, such as:

• Improved sleep quality for residents due to fewer disruptions
• Provides better privacy for residents whilst in their rooms, avoiding the use of CCTV
• Allows staff to focus on the individual needs of residents and frees them to deal with care planning and support activities
• Can be used where other fall prevention methods are not suitable for the resident such as guard rails or pressure mats
• Picks up concerns immediately allowing staff to provide a quicker response for those residents requiring attention and quicker escalation should an individual require medical attention
• Can integrate with electronic care management systems meaning observations are recorded in real-time
• Allows care staff and medical professionals to identify possible triggers, changes and patterns in an individual’s routine and behaviour

There are however some potential negatives and unknowns with the use of acoustic monitoring:

• It relies on the technology being correctly programmed. Whilst the system may remove the risk of care workers forgetting or missing checks, it is still vulnerable to system error.
• Some systems rely on members of staff to turn the monitoring on at appropriate times
• Systems are costly which may prevent smaller care providers from investing in the technology
• There are still many unknowns such as the legal/insurance ramifications should technology fail or not be implemented correctly

As part of the NHS Digital Social Care Pathfinders Programme which ended in 2021, the UK charity Friends of the Elderly were awarded a grant of £295,000 and implemented wireless acoustic monitoring systems in three of its care homes. Within 6 months, data showed that there had been a 55% reduction in night-time falls and a 20% reduction in hospital admissions alongside a 75% reduction in the number of night-time checks carried out by care staff.

Clearly, therefore, there appears to be practical and safety benefits for providers and those they support in using the technology.

Many of the complaints, investigations, inspections and inquests we assist providers with have stemmed from or have been prompted by an incident at night (usually a fall). We are interested to see how this technology can be used to respond to complaints, investigations, inspections and inquests and to see how it may assist providers in demonstrating appropriate monitoring and person-centred care. Importantly, policies, procedures, risk assessments and training should be reviewed and updated as appropriate to ensure they reflect the use and implementation of new technology.  

Should you require support around inquests, CQC inspections or policies, please get in touch with our regulatory team at regulatory.team@anthonycollins.com