Long before the pandemic there was widespread concern about how our social care system would cope with the demands of an ageing society and a looming shortfall in the care workforce. By 2035, one study estimates the social care sector will need an extra 800,000 workers to meet demand.
Post lockdown, there are additional concerns about the physical and emotional toll on carers, and a dawning realisation that multiple paid carers routinely entering the homes of vulnerable people is untenable.
There is understandable speculation about how Government will address the challenges facing social care. However, like the green paper on social care reform, promised since 2017, change won’t be swift. When it arrives, it may not address the fundamental issue that the ratio of care givers to care receivers is increasingly unbalanced.
PA Consulting has been working with Hampshire CC to understand if technology could form part of the solution. Specifically, we’ve been trialling the use of collaborative robots or ‘cobots’. These can enhance carers’ ability to provide safe and effective care, though the concept can be daunting for those with traditional views of how care should be delivered.
The cobots we use are lightweight, battery-powered devices, which carers wear around their lower back. The technology within these ‘lumbar devices’ does two things: it picks up movement in the wearer and supplements it with sophisticated motors. The effect is hard to describe, but the majority of those who have used it in the trial have been very positive. Carers have said: ‘It makes holding a person in a position where we can wash them so much less of an effort’; ‘it reminds me to adopt the right posture before I attempt to reposition a service user’ and; ‘at the end of my shift I am just not as tired as usual’.
The cobot is an investment for the carers, so they report feeling more valued. Some predict it could enable them to continue in this demanding role for longer. New technology may attract younger people into the sector, and the protection from injury may mean they worry less about the physical risks in care delivery. This technology reduces the requirement for ‘doubling up’ in a care visit, meaning the workforce can be deployed more flexibly to meet growing demand. Crucially, during the COVID-19 crisis, solo carers felt less exposed to the risk of infection.
A reduction in double-up visits gives cash-strapped commissioners an alternative to simply arguing for lower hourly rates. By sharing these benefits, providers could be incentivised to schedule a solo carer plus a cobot.
For care providers, the potential advantages of blending a human and cobot workforce include reduced staff sickness absence, lower turnover and a consequent reduction in recruitment effort and costs. Combining solo carers with cobots means providers will be able to support a larger number of clients. We’ve seen that working individually also offers carers more freedom to develop risk-assessment, decision-making and relationship-building skills. Empowering staff in this way benefits the employer. Trusting individuals, delegating, relying less on black-and-white policies and rules that constrain how care is delivered can help to personalise the service. Hence, the paid-for care experience can become closer to that of an informal family carer.
Importantly, the person receiving care has fewer people entering their home and is more likely to see a familiar carer. Getting one carer to arrive at an agreed time is simpler than coordinating multiple carers, reducing the perennial frustration of delayed visits. When care is delivered one-to-one, a better connection can be made.
What needs to happen next?
Whilst Hampshire CC has been characteristically bold in its sponsorship of the cobots trial, central government should now take a bigger role in the development of solutions to the care workforce challenge. Investment in initiatives like this would be money well spent. UK PLC should seek ways to develop technologies of this sort to alleviate a problem that may affect every one of us at some point in our lives. It’s ironic that the UK is world-leading in the use of robotics in product-picking for online retailers, selling this capability to Japan, and yet we don’t currently make a device like the cobot to support care in the UK, relying instead on importing Japanese technology.
If the care sector is to thrive and become the high status service we would wish for ourselves and our loved-ones, we must enable experienced carers to remain in the profession for longer; fit, healthy and motivated. Early indications from the trial in Hampshire suggest that cobots may be one way in which that can be achieved.
Graham Allen is director of adults health & care at Hampshire County Council and Steve Carefull is social care technology expert at PA Consulting