Online care plans give people more control

This project explored the development of online care accounts for service users and carers, enabling them to complete tasks such as updating demographic information or downloading care plans.


Care plan accounts Kirklees - screen shot
Care plan accounts online - screen shot

In Kirklees there are 15,800 users of adult social care services and 4,000 registered carers. Many carers have complex life situations, which can make accessing services during office opening hours challenging. At present service users and carers have no direct access to real-time information held about their care or services received. The Care Act 2014 indicates that local authorities must allow citizens access to records and care accounts.

The project focussed on the problem:

How might we enable service users and carers to access information about their care services to give them more control?

The project investigated the options available for the provision of an online care account and challenged the technology market to provide a user-focused solution.

Key aims and achievements

  • Increased service user and carer satisfaction with access to information and review bookings.
  • Meeting legislative requirements in relation to providing access to adult social care information for service users and carers.
  • Meeting legal requirement to deliver reviews for all service users within 12 months.
  • Forecast cash savings of £244,578 based on a 30 per cent uptake of the self-service account over 10 years.

Implementation

The implementation phase built on the user research completed in the discovery phase to design, prototype and build the Kirklees digital care account, which will give service users and carers access to their care plans and other relevant documents, and the ability to request changes (eg updates to contact details) and book appointments for social care reviews.

To ensure the product developed was of benefit to service users and carers, each feature within the care account was developed through a series of design sprints. The process for each feature included: design workshops and iterative prototyping, testing and feature build via Granicus, a leading provider of citizen engagement technologies (accompanied by functional and technical testing by the council). Design sprints were developed in an agile environment, based on the priority of the feature and availability of resources. However, the availability of social work resource proved to be a particular challenge. Once built, the care account was piloted with service users and carers (conducted from December 2020 through to February 2021).

In addition, there has also been a great amount of work done to ensure that the care account aligned with GDPR regulation. Work was also undertaken with Granicus to ensure that the care accounts were being displayed correctly on devices with no data protection issues (ie a service user could only see their own personal information).

User research and prototyping

  • After initial collaborative workshops on features, the new care account features were prototyped in Adobe XD (a user experience design tool for web and mobile apps) and tested with participants. This testing was completed using dummy data. Some features were grouped for testing, due to challenges around GDPR guidelines.
  • A pilot of the care account commenced in December 2020 (phase 1) with 30 service users. An additional 30 service users were onboarded into the pilot in January 2021 (phase 2). The pilot involved all of the features which had been developed and live data from the care system. Whenever a pilot participant uses a feature on their care account, they complete a feedback form, so the team can explore any issues which may have occurred.
  • In addition to the feedback from participants (via feedback forms, phone calls, etc.), Google Analytics is being used to gain a better understanding of how service users and carers are using the accounts (and frequency of use).
  • From a technical perspective, a range of accessibility / functionality testing on the care account, through BrowserStack (a cloud-based, cross-browser testing tool), has been undertaken so the project team could test all the functionality of the care account in a range of different browser types.
  • The user research completed in the discovery phase is currently being re-visited, in preparation for the wider roll-out of the care account. This includes looking at satisfaction, experience, access to devices and technology.
  • The user research completed during both the discovery and the implementation phases has significantly influenced product development, from the wording, to functionality, and how the product was transformed between the prototyping and pilot phases.

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User involved in testing

Financial and social benefits

Throughout the implementation phase, project teams were asked to produce reports forecasting the cash, non-cash, societal and quality benefits. The following benefits have been forecast (over the next 10 years):

Forecast benefits
Benefit Description
Non-cash
  • £244,578 based on a 30% uptake of the self-service account (from 2021/22 onwards plus pilot savings. Based on the pilot of 30 participants (over a six-week period), the actual savings to date were £235.
Quality
  • Increased service user and carer satisfaction with review appointment booking (Service users/carers).
  • Increased service user and carer satisfaction with access to information (Service users/carers). This benefit was realised during the piloting phase.
  • Meeting legal requirement to deliver reviews for all service users within 12 months (Kirklees Adult Social Care).
  • Meeting legislative requirements in relation to providing access to adult social care information in the manner best suiting the service user/carer (Kirklees Adult Social Care). This benefit was realised during the piloting phase.

 

Measuring success

During the discovery phase, the council developed a logic model to guide the implementation phase and to help in quantifying the inputs, activities, outputs, outcomes and impacts which are likely to result from the delivery of this project.

Key outcomes and impact measures:

  • improved transparency, satisfaction and control for service users (being measured as part of the pilot)
  • improved satisfaction and reduced stress for service users
  • reduced dependence on council services
  • increased independence and control for service users and carers
  • improved access to support for service users and carers
  • more timely updates to support to match care needs
  • contact made more quickly and efficiently causing less stress to service users and carers
  • council staff able to use their time more effectively, increasing time for staff to focus on complex enquiries

Outcomes are being reviewed as a part of the pilot analysis during the implementation phase to explore whether any additional outcomes are being achieved.

Project benefits

  • The importance of teamwork and camaraderie in the development of the care account. The team have been committed and resilient, and are proud of building a fully integrated care account in 12 months, with the backdrop of the pandemic.
  • Agile working, has allowed the project plan to shift (due to Covid-19 restrictions and securing Adult Social Care resource) and adoption of new technologies to conduct this work (e.g. feature development workshops and design sprints) in a remote working environment.
  • Funding from the Social Care Digital Innovation Programme has allowed ringfenced resources to focus on this development within adult social care. This has brought digital advances and solutions for a specific target group.

Challenges and lessons learned

  • Recruitment of experienced adult social care resource (eg social workers). Recruitment of resource and mitigation plans need to be considered before embarking on future transformation projects.
  • Issues around securing resource (both adult social care, comms and marketing etc) for this project caused difficulty and led to repeated onboarding. Plan for incremental / flexible onboarding.
  • Staff had to adapt to new ways of working and job roles were less defined. Create time for communication and collaboration between the project team to ensure team members are supported.
  • Changes to the European GDPR legislation impacted the delivery of remote testing. However, the project team adapted to deliver the project remotely.

Future potential

The project team hope to launch the Kirklees’ care account to all eligible service users and carers. To support this, there will need to be support from the Senior Leadership Team to secure sufficient front-line resources (in particular to resource the review booking functionality). In addition, there is a need to explore and agree next steps for the logistics of signing people up and advertising the care account. In the future, the team also want to be able to add additional features through further development of the care account.

Replication of the product elsewhere would require the development of a package including:

  • Guidance on the processes that Kirklees have developed; and
  • Discussions with the technology provider to get the secure front page

If the organisation replicating the product used the same case management system as Kirklees (CareFirst and Wisdom), the project team would be able to hand over the application programming interface directly. If not, this will need to be developed; the technology provider has agreed to support any required developments at a reasonably cost-effective rate to ensure the product can be scaled up and replicated across organisations.

Find out more

Sarah Hill: [email protected]

Stephanie Fossey: [email protected]

Related links

Social Care Digital Innovation Programme 2019-21 | Kirklees Council

Social Care Digital Innovation Programme 2019/21 - Kirklees Discovery Review