Dorset Council: acoustic monitoring in care homes

Dorset Council, with funding from the Digitising Social Care Programme (DiSC), are piloting the use of innovative acoustic monitoring in care homes across the whole of the Dorset Integrated Care System (Dorset ICS).

Dorset Council, which is hosting the DiSC team, is responsible for implementing all DiSC related activities on behalf of the Dorset ICS. The team led the procurement process for the Dorset ICS, which includes social care providers across both Dorset Council and Bournemouth, Christchurch and Poole Council (BCP Council).

The Digitalising Social Care (DiSC) programme is supported by the Department of Health and Social Care (DHSC) and aligned with DHSC’s wider strategic aims of transforming adult social care through digital innovation.

Acoustic Monitoring (AM) systems in care homes were identified as a promising technology with the potential for positive outcomes in care by the national DiSC programme team. AM systems help monitor residents at night to improve their care provision. The systems utilise sound to detect events within a given environment, transmit alerts to a central hub and have emerged as a valuable tool for the non-intrusive monitoring of care home residents.

The project aims to achieve a wide range of positive impacts for both residents and social care staff such as:

• Enhance sleep quality and daytime wellbeing by informing care decisions, aiming to reduce the regularity of night-time checks.
• Manage and reduce the risk of unsupervised falls and associated injuries.
• Generate insights and data patterns to enable staff to plan care more effectively and respond proactively to changes in resident behaviour. 

Dorset is adopting an outcome focused approach to assess the impact of implementing acoustic monitoring systems in care homes, closely aligning to key performance indicators.

Six care homes are currently scheduled for installation, with the first commencing in January 2025. A total of 184 sensors will be deployed across these facilities in the region, with the goal of completing installations by March 2025.

To identify suitable sites, Dorset Council invited care homes across the whole ICS to express an interest in participating. Following an initial assessment, discussions were held with interested homes and introduction calls to Ally Labs, the company supplying the acoustic monitoring sensors, were facilitated.

Following suitability assessments, Dorset Council, in collaboration with Ally Labs, conducted site inspections at shortlisted care homes to ensure compatibility with the technology. Essential requirements included the use of a Digital Social Care Records systems (DSCR), strong Wi-Fi connectivity across the home, and power outlets in each resident's bedroom.

The installation of acoustic monitoring sensors is scheduled to begin in late January 2025. Following installation, Ally Labs will provide comprehensive on-site training to care home staff across both day and night shifts. This will be followed by a return visit the next day to reinforce learning and ensure staff feel confident and comfortable using the technology.

Ally Lab’s acoustic monitoring sensors are equipped with a microphone and infrared sensor to enable audio and movement monitoring. Over a period of two weeks, the system will build a typical behaviour profile for a resident using machine learning. To minimise the impact of daytime activities on the data profile, it is best practice to switch off the sensors during the day.

The sensors are linked to an app which can be used on a smartphone or computer -  the app sends alerts to staff when anomalies are detected. Anomalies are identified when behaviour deviates from typical patterns identified by machine learning. Two categories of notifications can be generated: direct alerts and behavioural insights. Direct alerts will occur if a sound is detected such as coughing or speaking, or movement is detected. Behavioural insights are received when there is a deviation in trends from a resident’s typical behaviour such as less sleep or increased coughing. These two types of notifications enable staff to respond promptly to resident needs and enhance the effectiveness of care planning.

The app is built to integrate with DSCR systems so that care notes generated from the technology can be easily incorporated into the resident’s wider records.

The pilot's governance is guided by the DiSC programme, which hosts fortnightly meetings with partners. These meetings provided valuable advice and guidance, which was pivotal during the procurement process. The group developed and scrutinised the evaluation criteria used to score vendor proposals. Furthermore, the governance group actively engages in risk management, facilitating the identification, sharing, and discussion of potential risks and their mitigating actions.

Participating care homes were tasked with implementing specific measures. Each home was responsible for explaining the technology to residents, obtaining informed consent before using the acoustic monitors, and ensuring residents could withdraw consent at any time by simply turning off the sensors. Ally Labs is supporting the delivery of the project by drawing on lessons learned from previous installations, to prioritise resident rights and preferences.

The Dorset DiSC team also helped care homes to conduct their due diligence by helping them gain references from organisations who had previously worked with Ally Labs.

The DiSC team will closely monitor the impact of the acoustic monitoring, with scheduled review points planned at 3 and 6 months following the technology's implementation. A core metric for the technology's success is a reduction in the number of falls. This includes a decrease in the number of undetected falls, a reduction in the number of instances where an ambulance was required, a decrease in the number and duration of any related hospital stays, and any other associated impacts. This data will help the assess the value of the sensors and build a case for future investment.

Furthermore, resident and user satisfaction will be monitored. The aim is to ensure the technology enhances resident wellbeing and improves job satisfaction for care home staff.

The Dorset DiSC team is scoping an additional three care homes to join the pilot, bringing the total number to nine. Over the next few months, the focus will be on ensuring the timely installation of sensors across the approved care home sites, with data collection and analysis from the 184 sensors expected to take place in the second quarter of 2025.