Sustainable Social Care: The Potential of Mainstream “Smart” Technologies

Kate Hamblin

doi:10.3390/su14052754

Abstract

Recent proposals for reform in England have presented widely available “smart” mainstream digital devices as a means to address some of the challenges facing adult social care and as alternatives to unsustainable analogue “telecare” systems. Drawing on 40 interviews with experts from local authorities, the care and technology sectors, and people with lived experience of social care services, we explored how mainstream technologies are being used in practice in England and critically examined their potential to contribute to policy priorities of wellbeing and sustainability. Across all expert groups interviewed, examples were cited in which the use of mainstream devices supported the economic sustainability of adult social care and/or enhanced aspects of wellbeing, moving the role of technology in care beyond monitoring and managing risks. However, when viewed through a three-dimensional conceptual lens that includes material, relational and subjective wellbeing, the use of smart devices in practice also created tensions and trade-offs between the dimensions, with implications for sustainability. The various ways mainstream devices are being used in adult social care also raised complexities related to risks, responsibilities, and inequalities and required “wraparound services”, tempering their ability to deliver cost savings. To address these issues, we suggest a person-centred approach to technology across local authorities, with investment in wraparound services and to mediate inequalities associated with the “digital divide”.

Highlights

IntroductionThe “Crisis” of Adult Social Care in England
In England—the focus of this paper—the delivery of publicly-funded adult social care is the responsibility of 152 local authorities, and receipt of services is contingent on both a means and a needs test
We explored emerging trends and practice related to technology in adult social care and found many examples of local authorities piloting or trialling mainstream devices, including voice-controlled virtual assistants and smart speakers (e.g., Amazon’s Alexa, Echo, Dot, and Spot; Google’s Assistant and Home), wearables such as smart watches, and other Internet of Things-enabled (IoT) devices

Summary

Introduction

The “Crisis” of Adult Social Care in England. Whether we consider our demographics, our use of resources or the financial forecasts, it is widely accepted that the current health and care system is unsustainable without radical transformation”. Statutory responsibility for adult social care policy in the UK has been devolved to the national administrations in England, Scotland, Wales, and Northern Ireland since 1998. Each nation can introduce its own care legislation and standards and allocate funding according to its own priorities [3]. In England—the focus of this paper—the delivery of publicly-funded adult social care is the responsibility of 152 local authorities, and receipt of services is contingent on both a means and a needs test.

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