Implementing digital social care records: Case studies

Dorset Integrated Care System (ICS)

Dorset ICS (comprising Dorset Council, Bournemouth, Christchurch and Poole Council and NHS partners) have published a booklet ‘Providing Care in a Digital World’.  The immediate offer is up to £4,000 one-off payment to help providers introduce a DSCR system, to be used for DSCR software installation costs and licence fees, DSCR software training costs and handheld devices for documenting care notes but the booklet helps generate a sense of excitement for the benefits. 

In one of the case studies – Culliford House in Dorchester - these benefits include a welcome cultural change - a new-found enthusiasm for digital skills among staff, which has also trickled down to the residents themselves. A group of residents even made their own short film using iPads called ‘The Surprise’ when they filmed one of their friends receiving a surprise gift.

“Using DSCR has made life much easier for staff as they can now update care records in real time. Gone are the days of staff having to stay beyond their shifts to catch up on writing up records. The records are also shared across agencies, which means hospitals can have instant access to residents’ needs when they become in-patients – and likewise, when they are discharged, care home staff can see what post hospital treatment has been prescribed.”

In another case study, the regional manager of Bournemouth’s Adams Court care home addresses the issue of digital connectivity and infrastructure capability: “We did have to invest a significant sum in improving the broadband in our home, which also required electrical re-wiring. It is unlikely most homes will need as much work as we did to improve their connectivity. Most homes with only need wi-fi boosters to do the trick. 

My advice is to investigate your connectivity and how it can be improved while you plan to move to digital. I’m a technophobe but I knew we had to make this move and I don’t regret it at all. It gives you real time data, makes care plans ultra personal, saves paper and money and my staff love it. The investment is so worth it, and the best reward is the time you get back in caring for your residents.”

Nourish with Priory Group

‘Time to care’ is also an important theme in a case study provided by Nourish and the Priory Group, where DSCRs are now being used at all of Priory Group’s 190 care homes, and directly impacting the care of more than 2,300 residents, partners claim “saving on duplication of paper records, ensuring increased consistency of record keeping, and freeing up thousands of hours of our colleagues’ time, so they can even better support people to live their life.”

This case study indicates that Priory’s primary concern regarding digital implementation was centred on the outcomes of their residents but throughout the implementation process they routinely checked in with their teams and residents for updates on their experiences with the new system. Both residents and staff noticed that there was “more time to care.” 

The study also outlined the benefits of the digital care records system also enabling the people supported to “build their own profiles and input into how the care provided to them is delivered.”

Priory anticipates a time-saving benefit of one hour per colleague per week - a £1.1 million saving in 2024, along with an increase in occupancy levels due to enhanced quality and reputation, resulting in a revenue boost of £258,000. In addition, a £25,000 reduction in stationery and printing costs is predicted. Overall, the anticipated ROI is 161 percent, with a payback period of seven months after the implementation.

In terms of breaking down barriers, The Priory Group emphasises its relationship with their system supplier, Nourish, to help the provider realise its own ambitions, through a collaborative effort, and confidence-building, with a combination of expertise across technology and care provision and the belief that the partnership can be longer term, to take care of ongoing issues of maintenance, growth and a changing technology environment.

Lancashire and South Cumbria 

Lancashire and South Cumbria Integrated Care System (ICS) comprises Lancashire and South Cumbria Integrated Care Board (ICB) and Blackburn with Darwen Borough Council, Blackpool Council, Lancashire County Council, North Yorkshire Council, Westmorland and Furness Council and Cumberland Council.

Lancashire and South Cumbria ICS made a decision in 2023 that they were going to build into their contracts for ‘Living well at home’ (largely domiciliary care) an expectation that providers expecting to be a part of the contractual framework (a dynamic purchasing system) would need to adopt digital social care records. As such, the contract reads: 

“As we move into an increasingly digital world, we want people who have additional support needs to have every opportunity to feel connected and immersed with a digital offer. Service providers will refer people to the technology enabled care (TEC) service when appropriate and propose creative solutions to increase independence, connectivity with health providers, safety, privacy, choice, and control for people utilising the very best in tech enabled support. Successful service providers will keep up to date with the latest innovations and will proactively promote new technology as it comes available.

"The national goal is all health and social care partners are connected to an integrated life-long health and care record by 2024, enabled by core national capabilities, local health records and shared care records, giving individuals, their approved caregivers, and their care team the ability to view and contribute to the record. 

"The authority expects the service provider to be compliant with the requirements by March 2024 and that all service providers work towards digital social care records by March 2024”.

The ICS used the leverage of the contract, together with the financial incentives provided through the national Digitising Social Care programme, to urge all providers towards adoption and by the end of March 2024, 100 per cent of framework providers for ‘Living Well at Home' have adopted DSCRs. The next goals are to achieve the same for care home providers and for any providers contracting individually, ‘off framework.’ 

Birmingham City Council

Birmingham City Council’s 2023/24 recommissioning of Home Support introduces a mandatory move to including DSCRs into their framework contracts. 

Soft market engagement sessions advised providers of key information, such as the introduction of new contract clauses and Birmingham judged that the market was ready to absorb the change.

Birmingham say that the introduction of the contract clauses has given extra weight and authority to the messages given out by the West Midlands Care Association (a Digital Social Care partner). Following a ‘grace period’, if the care provider has not complied, they will find themselves in breach of the local authority contract.  Birmingham report no adverse impact on relationships with care providers. 

Birmingham report care home DSCR uptake at “well over 80 per cent” and expect to see a similar upturn in the home care sector.

Devon Integrated Care System

Devon Integrated Care System (Devon, Torbay, and Plymouth Councils with NHS partners) reported that, by March 2023, their project to work with provider partners to adopt DSCRs had ‘stalled’. There was little cohesion on direction, although communication had been extensive, it had been ineffective and the Devon baseline at 65% was not feeling healthy. 

A year later, the Devon system is one of the highest adopters with an 82% adoption rate. The system has strong multidisciplinary and organisation cohesion, targeted communications and 6 weekly steering groups leading the way to an 80% adoption rate. 

Devon have now advised a number of other systems on how to create success:

• Have a strong project manager
• Build strong, open, and honest relationships between all organisations – no one organisation can achieve in isolation
• Create strong relationships with providers
• Adult social care needs to understand the vision, but feel like they have a choice, and the choice is their choice
• Reduce the process lags – give money directly to suppliers where possible
• Know your data and keep it up to date
• Keep going and try new things
• Keep relationships alive – by phone, email, groups, social media, visits, letters
• Make everybody feel part of something
• Understand the barriers and whether they are moveable
   

This learning note is based on experiences collected in 2024 following the rollout of digital social care records (DSCR) into adult social care registered provision. The white paper People at the Heart of Care made policy commitments to improve and increase the digitisation of social care through the digitising social care programme and set a target of 80 per cent adoption by registered care providers.