All care homes face an interesting challenge: how do you balance the need to check on vulnerable residents regularly during the night, without risking compromising their sleep and, with it, their health and happiness? Tiptoe at night though we do, some level of disruption is almost inevitable. Until we were introduced to something rather special: acoustic monitoring. We chatted with Jon White, Commercial Director at technology specialists Adaptive IT Solutions, to learn more.
When did you start working with Baycroft?
We’ve been working with Baycroft since 2018. We were brought on board to help with new-build care homes that were still just architectural drawings at the time: Flitwick, Fairfield, Kempston and Carpenders Park. We put together a bespoke design for acoustic monitoring and nurse call for each home, to take in all of the bedrooms and all of the communal areas – WCs, lounges, dining rooms, cinema and other shared rooms.
We’ve also done one retrofit for Baycroft, at the existing home at Orpington. That’s much more complex: we have to install new kit, decommission old kit, swap it over so that staff and residents know which system they should be using at any point, and then train the staff. Plus, care homes are never closed. There’s no downtime, ever, so it takes very careful planning with very restrictive hours you can work.
What is acoustic monitoring and why did you start working in this field?
About five or six years ago I happened across a product called CLB Acoustic Monitoring. This is a widespread technology in care environments in Holland, but it’s still an emerging system in the UK. Baycroft is one of our early adopters. The way that it works is that sensors are mounted in residents’ bedrooms and the system is sensitive enough to recognise when a noise is unusual or above a certain threshold and sends an alert automatically to care staff who can make the decision to intervene. All of this replaces the need for periodic checks, so that care is only given as and when it’s required, and residents aren’t needlessly disturbed.
How does cutting out periodic checks help?
There are huge benefits for residents’ wellbeing. People are better rested because they haven’t had their sleep disturbed. It can take a long time to get someone, especially someone living with dementia, settled and back to sleep and before you know it, it would be time for the next periodic check! Studies have shown that the effect of poor-quality sleep is magnified immensely if you’re suffering a debilitating condition or you’re at an advanced age. You’re less likely to engage, less likely to eat properly.
We’ve already seen the differences that the CLB Acoustic Monitoring system makes. When people are better rested, quality of life is drastically improved. They’re less susceptible to falls, we’ve seen huge reductions in the amount of challenging behaviour, reduced reliance on medication, fewer instances of unexplained weight loss.
When I visited the manufacturers, I thought it was too good to be true. I wondered what the catch was! But the case studies in Holland were positive. So, I started to talk to some potential customers here in the UK, began installing the equipment and before I know it, we’ve got our own case studies. People saying “Thanks for giving me Mum back. She hasn’t been like this in years.”
We’ve picked up medical events, events that would otherwise have gone unnoticed: choking, epileptic seizures, cardiac events. With one particular cardiac event, if the home had still been using periodic checks on a rota, the lady concerned would have had her check – showing she was apparently fine – about five minutes before the event. It might have been another hour, hour and a half, before anyone checked again.
Is acoustic monitoring intrusive at all? Bedrooms are private spaces, after all
We only want to be monitoring when people are in bed, asleep. If they’re awake, watching a film, having visitors, etc, it’s deactivated. The system comes with scheduling software which you can adjust for every individual sensor. So, each resident has their own personal schedule, so the care home can program it according to that resident’s usual routine.
There are some really clever features. And it all still needs human expertise. In traditional nurse call, a bell is pushed – if the resident can get to it – and a staff member goes to that room. With the acoustic system, an alert goes off at the central control station and the attending member of staff can listen in to that room, to hear what’s happening. They can play back the sound that triggered the alert, to identify the problem. And they can open up two-way audio to that room. For example, unusual activity triggers an alert and, by listening in, the carer can tell that the resident is trying to get out of bed. The carer can ask the resident to wait for help using the two-way audio. It means you’re preventing falls from happening.
Where do the alerts go?
The system is generally only active at night, when there is usually one person overseeing the night shift. That person acts as the central operator for acoustic monitoring. They receive the alert, make the necessary decisions, and can either assist themselves or direct another member of the team to respond.
Is the new nurse call different to standard systems?
In some important ways, yes. Nurse call generally hasn’t really changed since about 1990 or maybe even earlier. There are basic ways for residents or staff to call for assistance or communicate with each other. Things like call buttons and pull cords. Those still exist with the new system, of course. But with very vulnerable people and dementia residents, you’re reliant on interactions from the service user, the resident. They need to have the cognitive ability to recognise they need help and the physical mobility to use those facilities.
The old system would trigger an audible alarm that sounds either in one room or everywhere. If that happens in the night, the disruption is incredible. A carer would have to go to a communal alarm board, identify where the call had come from, and then head there. The new system is really good for both resident and staff wellbeing. Instead, alerts go to an app on the carers’ mobile devices, vibrating and sounding a discreet noise. As a carer, you don’t need to go searching for the communal board – everything you need to know is right there on the app. You can accept, which tells the other carers they no longer need to respond. Or you can decline, if you’re busy with something else that you can’t abandon. In which case the alert will continue to sound to all other carers.
The care home gets a full audit trail for every single alert. Where and when it was generated, who responded, how quickly they attended and when they turned off the alert. If they need assistance, the software tracks how the next carer responds. This can help care home management check that the team is working in the way it should and protects the home in an ever-more litigious society – because you have the proof for alerts and response times.
The final new feature is that every resident has a Nurse Call personal pendant that they wear. If they need to trigger it to get help, it notifies care staff in the usual way. What’s clever is that it uses the CLB Acoustic Monitoring sensors to triangulate the location with a fair amount of accuracy. Staff won’t waste precious time trying to find the person who’s called for help, because the system identifies which room they’re likely to be in. That’s generally helpful and less stressful for the resident and staff – and it’s crucial in an emergency.
I found the CLB product by chance, doing general technology research. It’s a great product and, best of all for us, we’ve been able to witness the difference it makes day to day in the care home.