In March, NHSX launched TechForce19 in partnership with PUBLIC, AHSN and the Ministry of Housing, Communities, and Local Government. A month later, 18 companies were announced as winners of the TechForce19 program and began testing their digital solutions across the UK. In this interview we spoke to Amy Lewis, Director at TechForce19 winner Just Checking, to hear more about the company’s TechForce19 journey deploying their technology to remotely monitor the elderly and vulnerable.

1. What does Just Checking do and why did you embark on this venture? 

Warwickshire based company Just Checking was founded in 2004 to help health and social practitioners understand the needs and abilities of individuals living in the community with dementia.

Over 80% of UK local authorities use the Just Checking activity monitoring system for assessment and care planning across learning disabilities, older adults and reablement, with thousands of professionals and family users logging on every day. Families are able to check that their family member is following their usual activities of daily living without intruding or undermining their independence.

Just Checking is simple to install, and easy to use especially for those who are less digitally aware; users simply place a sensor in each room and plug in the hub to a power socket. There is no need for internet access as the hub has its own SIM. There are no video cameras; the system uses discrete wireless movement sensors to provide insight into how individuals are managing in their own homes.

At the start of the COVID-19 pandemic, the NHS predicted there would be a greater pressure to discharge patients from hospital to free beds and support a rapid influx of individuals requiring acute medical care. This would also impact on social care services who would be required to support a greater number of older adults at home, with potentially fewer care staff due to the virus. Just Checking could see how our existing system could be easily adapted to support more remote domiciliary care services during the pandemic, to maintain quality of care whilst reducing face to face visits and therefore risk of infection.

2. How does your solution help the vulnerable and isolated? 

Just Checking enables health and social care organisations to deliver a more hands-off domiciliary care service when combined with this technology.

The Just Checking system uses discrete wireless sensors placed around a property to send an overview of daily activity to an online app. Family and professionals can see whether an individual is visiting the kitchen to make meals, using the bathroom as expected, or getting a good night’s sleep. Notifications can be set up to alert family and carers if anything out of the ordinary happens, enabling them to respond appropriately, reducing unnecessary visits and minimising risk of infection spread to those shielding and clinically extremely vulnerable.

The project demonstrated that remote monitoring in this way, can play a bigger role in delivering domiciliary care for vulnerable, older and self isolating people by:

– Reducing the number of face to face care visits and their inherent infection risk. – Helping local authorities to safely support more older people with a reduced staff pool.

– Deploying the reduced pool of care staff where they are most needed. – Providing feedback on well-being, remotely (via the activity chart and notifications of specific events).

– Enabling staff who are fit but self-isolating to take part in care/rehabilitation remotely.

– Encouraging care staff to use, in parallel, existing remote methods of rehabilitation/coaching (eg Facetime, exercise video), and enabling them to see progress in rehabilitation. – Like everyone else, older people will still have access to, and be encouraged to make use of, remote social activity (phone, Facetime/Skype/Zoom, email, social media with friendship groups, neighbourhood/ community support etc)

3. How has your company adapted to tackle Covid-19 related challenges? 

Just Checking already benefits from remote working practices enabling us to easily adapt and adhere to social distancing guidance. We were able to immediately respond to the increased need for remote monitoring technology, providing support to our clients during this difficult time.

During the project our partners showed a need for more flexibility in setting up and managing system notifications for individuals in their care. The Just Checking in-house development team responded rapidly, creating custom notifications and a corresponding dashboard to manage notifications and log responses. The new additions to the notification features proved extremely beneficial in keeping people safe, and providing quick access to information to coordinate a collaborative response between all stakeholders of care.

In addition, Just Checking saw a spike in demand for activity monitoring systems and as a result, has created a short term lease model to support the pandemic without requiring long term contracts.

4. Can you tell us more about how you’ve deployed your technology as part of the TechForce19 challenge? 

Just Checking has a significant number of’ K6’ systems in use across the UK. Although this model was superseded In June 2018, we used the K6 during this research project to demonstrate how an existing, widely available model can support services during the pandemic without the need to upgrade. We did this in the knowledge that where systems can be upgraded, the benefits will only be greater.

Due to the urgency of the pandemic a quick response was required – with the project taking place over just 3 weeks. A strategy meeting was held immediately to identify a project lead for each partner, who worked closely with their allocated Just Checking manager to define pathways for referrals and processes for safe installations.

As they are simple to install, the Just Checking systems could be installed by any key worker or family member currently visiting the property – minimising the risk of infection further.

The systems were utilised in the short term to keep people safe. Data was then reviewed to inform care plans moving forward.

5. Have you learned any valuable lessons during this period of change and uncertainty? 

A clear theme emerged from the initiative: the most vulnerable are often the most isolated and social distancing creates new challenges and intensifies those that already exist.

During the project our partners reported that Just Checking was particularly useful in supporting the following:

● Keeping individuals safe whilst adhering to social distancing principles.

● Maintaining staff safety whilst continuing to support individuals.

● Monitoring how implemented care changes are affecting the individual.

● Helping families to support their relatives in absence of staff.

● Utilising a reduced number of staff to continue care delivery.

● Reassuring external care stakeholders such as families carers and providers that daily living activities are being completed.

● Completing remote needs assessments to right size care packages.

● Supporting individuals to avoid or delay a hospital admission / residential placement.

● Monitoring those with cognitive impairment that may wander or have difficulty remembering social distancing rules.

● Better outcomes for individuals whilst working remotely.

● Providing increased information over a shorter period of time.

● Collaborative working between different health and social care departments and also family members.

6. Advice for GovTech founders?

1. In times of crisis, the most successful solutions will be those that are well established and if necessary, can be adapted to suit the current needs/challenges.

2. Buy-in from all relevant stakeholders is essential when introducing new ideas.

3. Create a simple plan that is easy to follow and communicate it well to people at all levels.

4. Nominate a project lead that has a level of responsibility/accountability for the full process and outcomes that need to be delivered.

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