Bexley enhances wellbeing for care home residents and encourages integrated health and social care by rolling out remote monitoring to Parkview Care Home in Bexleyheath

Supporting resident wellbeing with remote monitoring

London Borough of Bexley wanted to support resident wellbeing and help residents to be cared for in their homes, while reducing and delaying the need for a move to higher levels of care. The team also wanted to support the diagnosis and monitoring of health conditions, to help staff to be able to quantify and record when a resident becomes unwell and to help rule out health conditions – if and when people need support, advice and interventions around mental health.Supported by funding from NHSX, Bexley chose to expand on a successful pilot, which provides our remote monitoring technology and population health analytics across the UK and has an excellent track record in delivering digital health successfully.The team worked has rolled out the solution across many care homes – this case study relates to the deployment at Parkview Care Home in Bexleyheath – a residential home for older people, including some who are living with dementia. It has 69 beds and a staff team dedicated to the care of its residents. As a residential home, staff are trained carers without nursing qualifications, although all senior care leads have full medication training.

Why use remote monitoring?

The Parkview team wanted to have better communications with the GP surgery, and to be able to express their concerns about unwell residents more quickly and easily. London Borough of Bexley offered an opportunity to use our remote monitoring as part of its scheme to support residents’ health and wellbeing, reduce emergency hospital admissions, support care home staff in their caring role and to enhance contact with GPs.The team wanted to take up the opportunity of using remote monitoring, which enables care home staff to take vital signs and baseline reportsKelly Winship is Deputy Manager at Parkview and explains: ‘As our residents are living with dementia at all different levels, and some can’t say how they feel when they are unwell, we are here to support them and act as their advocates when they need us. We know our residents so we know when unwell and we can raise concerns on their behalf.

’Laura Williams, Head of Integrated Care for older people at Bexley says: ‘The ambition of this project was to reduce health inequalities and to promote and support wellbeing and independence for individuals living in care homes. Using remote monitoring in this project means that we can pick up on ‘soft signs’ of deterioration and act on them more quickly. We wanted to provide a bridge between health and social care – and in doing so – we are putting the person at the centre of what we do. We are using our tools to communicate in the simplest way to support someone quickly and effectively.

As much as we are monitoring health, this is also a social care tool that helps support getting the right outcome for people. This is a great project and really supports NHS England and NHS Improvement’s Framework for Enhanced Health in Care Homes – enabling health and social care to work together and meaning that we can hear and react to ‘unheard voices.’

What is remote monitoring and how does it work?

Remote monitoring uses the DOC@HOME platform to do the following:

•  If a staff member feels a resident is unwell, they can answer a series of questions and record vital signs and symptoms onto the DOC@HOME tablet (using thermometer, blood pressure monitor, pulse oximeter etc).
•  Information is transferred to the local GP surgery.
• Parkview staff can track information on the DOC@HOME system.
• GPs respond to any alerts with a phone call or an email within 2 hours.
• Baseline readings can also be recorded monthly with a ‘Resident of the Day’ process, to help monitor a person’s wellbeing over time. Remote monitoring enables users to update personal healthcare data using different kinds of question sets, which are then recorded and submitted to clinicians using a secure web interface.

Great feedback on the system – empowering staff

Kelly Winship, Deputy Manager at Parkview says: ‘A lot of the time we pick up on signs and signals from our residents, but now we have the blood pressure and other readings that we are able to pass on to the GP. We also now know, for example if one of our residents has a change in behaviour, to check their urine for a possible UTI. If they have ill health like a rash or cellulitis, for example, we can take photo and send it via DOC@HOME. Before we had DOC@HOME we were having issues with emails that were taking too long to download. It’s so much quicker now.

Going though ward rounds and logging concerns is a lot quicker via DOC@HOME. It has saved a lot of time – rather writing and sending emails and phone calls. In the past, if you had a resident you were worried about, you could be on the phone for hours and not resolved the situation.

’Rebecca Watson-Morse, Commissioning Programme Lead, at the London Borough of Bexley says: ‘We are so pleased with the deployment at Parkview. The driver for rolling out remote monitoring – and making it available to as many people as possible – was the need to support people’s wellbeing – and to look at people holistically. We are really happy with what we have achieved across Bexley.’

How does the DOC@HOME system work at Parkview?

Kelly explains: ‘Each unit has a tablet, and we have every resident loaded onto it, with their details and stats. We are able to download details and information for each resident. We keep it updated and when we are doing a check, we follow the multiple questions on tablet and do this step by step. Whether it’s taking blood pressure, checking breathing, etc– it’s very basic first aid.

’We are so pleased with the system. All the information about a resident gets sent over very easily, and the GP comes back to us if anything is picked up that needs checking."

Helping Staff and saving time

Kelly says: ‘It really helps staff as they can collect the information they need to share with the GP – and GPs will phone if it’s urgent. It makes a big difference.’ 

Kelly continues ‘The system suits us really well, as although we are not nurses, we are good at picking up on signs and behaviours when things are not quite right with our residents. I think DOC@HOME gives the team confidence, as when they pick up on things, they are able to get the information they need quickly and back it up with the evidence they’ve taken from the readings. The staff were a bit dubious of using the system at the beginning, but they have now become confident the more they use it.’ 

"It really helps staff as they can collect the information they need to share with the GP - and GPs will phone if it’s urgent. It makes a big difference." Kelly Winship Deputy Manager at Parkview