Background
The DiTSoW project has been running as part of the National Priorities Programme of Adult Social Care and Social Work, funded by the National Institute of Health and Care Research since 2021. This topic was selected as a priority area as digital Technology is being seen by UK governments and regional authorities as vital to a sustainable future of social care and they are keen to harness the power of digital technology to address the needs of their citizens with greater efficiency, speed and relevance. This has been acknowledged in the Social Care White Paper alongside investment commitments of £150m targeted at several key areas such as care technology, the development of digital care records, investment in infrastructure and cybersecurity, and a focus on improving digital skills and confidence across the social care workforce. Covid-19 necessitated an accelerated adoption of Digital Technology (DT) within health and social care and increased innovation and interest in this domain.
The original DiTSoW study set out to explore how digital technologies were being used by older adults and people in social care, and to see if and how this was supporting social wellbeing. DiTSoW II built upon the findings of DiTSoW. We learnt that there is a role for technology to support people with vision loss and people living with dementia live independent and connected lives. However, both groups have unique support needs for successfully adopting technologies and are at an increased risk of digital exclusion. Additionally, we found that the successful implementation of technologies requires a better evidence base and research capacity within social care.
For this study the definition of digital technologies has been kept broad to include:
- Everyday technologies such as phones, tablets, voice-controlled devices and ‘Apps’.
- Commissioned technologies that you may have through health and social care providers such as telecare and remote monitoring.
- Assistive technologies such talking clocks, screen readers or other visual, memory or physical aids.
DiTSoW II has had workstreams.
- The first worked with the Vision Loss community and professionals in this field to gain a better understanding of the challenges and facilitators of digital technology use for older adult with vision loss, and conduct a priority setting for research, policy, and practice.
- The second workstream worked with a local authority using technologies to support people with dementia and run workshops with their social workers to build capacity in the collection and use of evidence.
For this study the definition of digital technologies has been kept broad to include:
- Everyday technologies such as phones, tablets, voice-controlled devices and ‘Apps’.
- Commissioned technologies that you may have through health and social care providers such as telecare and remote monitoring.
- Assistive technologies such talking clocks, screen readers or other visual, memory or physical aids.
Project Aims
- WP1: supported better understanding of the challenges and facilitators of digital technology use for older adults experiencing vision loss and to conduct a priority setting for research and practice in this field.
- WP2: explored the effectiveness of Action Learning Sets (ALS) in mobilising knowledge and informing practice among social care practitioners on the collection and use of evidence related to digital technology use for people with dementia.
Project Activity
WP1: With the support of a lived experience and professional advisory group, and in collaboration with several vision loss charities, project activity included:
- Four in-person workshops with older people (60+) who had visual impairment. These workshops aimed to understand how people with vision loss use (or don’t use) digital technologies, the challenges and facilitators, and how their experiences could be improved.
- A survey of older people (60+) with visual impairment about their technology experiences and priorities in this field.
- One mixed stakeholder workshop to sense check findings and support the development of recommendations for policy and practice.
WP2: A series of ALS’s were facilitated with social work practitioners in relation to specific technologies being used to support people with dementia. The ALS’s provided social workers with an opportunity to share and develop their knowledge of generating practice-based evidence and delivering evidence informed practice. The evaluation of these ALS’s took the form of:
- Focus groups;
- Interviews;
- Reflective diaries;
- Short pre and post questionnaires
Project update and key impact
Work undertaken with people with vision impairment supported the development of recommendations for practice and policy. Taken together, these recommendations highlight the need for a whole-system approach to digital inclusion for people with vision impairment, spanning design, commissioning, service delivery and ongoing support.
- Digital technologies can play a meaningful role in supporting independence, connection and wellbeing for older people with vision impairment. They should be implemented to complement, not replace, human support and equitable non-digital routes to access services must be maintained.
- Accessible and inclusive design is central to whether people with vision impairment can use digital technologies confidently. Existing accessibility guidelines should be consistently applied by designers, developers and commissioners. Accessibility features should be considered and embedded from the outset of design.
- Attention must be given to the affordability, infrastructure, accessible system design and ongoing support of digital technologies to prevent the risk of reinforcing existing inequalities.
- Timely and proactive signposting to services and technologies can support wellbeing and independence and reduce the need for additional intervention. Accessible information should be routinely provided at all key touch points, including hospital appointments, eye clinics and health or social care contacts. Effective approaches include audio-based information, radio advertising, libraries, and verbal signposting during appointments.
- Printed materials can be helpful for people who are partially sighted or supported by sighted people, but consideration needs to be given to accessibility in, for example, the form of contrast, font size, uncluttered and screen reader friendly layouts.
- Access to appropriate, ongoing and person-centred training and support for people with vision impairment is critical to successful technology use, rather than rely on informal or family-based support. Training and support should be delivered by people with a clear understanding of different visual impairments, their impacts, and the relevant accessibility features that can support use.
- Peer learning was consistently valued by people with lived experience and professionals. Policymakers and commissioners should consider investing in services that facilitate peer-to-peer learning, including partnerships with local and national vision impairment charities and community organisations.
To support all these recommendations, there is the need for meaningful co-production with people who represent the full spectrum of visual impairments. Input is needed at every stage of the design, development and delivery of technology to ensure relevance, usability and acceptability.
Work package 2 produced and delivered the report, ‘Action Learning Sets for Enhancing Evidence-Based Practice: Essex Adult Social Care’, to Essex County Council. This output provided recommendations to enhance evidence-based practice and outlined the potential for Action Learning Sets to support Essex ASC in addressing its wider strategic challenges.
Outputs and publications
All dissemination activity were conducted in collaboration with PPI members (e.g. through co-presenting and co-authoring).
Planned next steps and follow on work
The SODA theme has priorities related to digital inclusion, digital technologies and vision impairments. This work will feed into new research projects and ongoing activities.
Who was involved?
- Professor Kathryn Almack (PI), University of Hertfordshire
- Dr Alison Tingle / Research Fellow, University of Hertfordshire
- Dr Steve Owen/ Research Fellow, University of Hertfordshire
- Dr Madalina Toma / Research Fellow, University of Kent
- Dr Chloe Waterman Research Associate, King’s College London
- A Research Advisory Group of 8 Older Adults
Contact:
Professor Kathryn Almack, k.almack@herts.ac.uk
Project SALLT08
Project MH57
Project PEDHSC47
Project SALLT07
Project SALLT02
Project SALLT06