Tunstall, The Chartered Institute of Housing and a harebrained proposition (UK)

Categories: Latest News.

Unfortunately, the post Terminology: ‘telecare’ v ‘assistive technology’ last week came too late to stop Tunstall from hijacking the term ‘assistive technology’ to make it mean ‘telecare and telehealth’ in a publication it has sponsored for the Chartered Institute of Housing. The CIH members deserve better than this ‘How to…’ guide.

Not only that, the TSA should be reviewing Tunstall’s accreditation for peddling the harebrained and dangerous proposition that PIR detectors can provide an ‘I’m ok’ alert through detection of movement to replace morning calls by wardens (page 3)*. Moreover, it is amazing that Contour Housing has fallen for it.

Shame on Tunstall for producing this, and shame on the CIH for publishing it. Tunstall press release. Publication (PDF) How to make effective use of assistive technology in housing.

*To be clear, an ‘I’m OK’ safety confirmation service as properly implemented by Alertacall (see its Housing Proactive site) is an excellent proposition. It’s the idea of trying to do it with PIR detectors that is harebrained.

Comments

  1. Jo

    “What is Assistive Technology?” Answer – The most commonly used terms are telecare and telehealth.

    That may be correct in Whitley Bridge but nowhere else in the world. Sorry Tunstall, this time you are simply and dangerously wrong! Maybe it’s an attempt to claim that the benefits of Assistive Technology that have been proven in numerous studies can also be applied to the teletechnologies when trying to convince Directors of Adult Care that Lifeline and associated boxes can save money.

    But if we are going to criticise Tunstall for such stupidity in their terminology, Steve is right in recognising that all the organisations that have allowed them to get away with this should also go to the bottom of the class.

  2. Steve Hards, Editor

    We also have to send the normally sane Housing LIN to the bottom of the class for publishing an excellent report on the use of telecare and telehealth with people with dementia under the title ‘Assistive technology as a means of supporting people with dementia: A Review’. The authors, Steve Bonner and Tahir Idris, show that they [i][b]do[/i][/b] know better by paying lip service to the wider definition of AT near the beginning but then they focus on telecare and telehealth. (At one point they also refer to it as telehealthcare.) It’s a real shame because otherwise I would be featuring the report and probably recommending it. [url]http://www.housinglin.org.uk/nl/?l=895_1_2_1[/url] (PDF)

  3. cathy

    Either I am reading a different document or the criticism already expressed doesn’t match what I am reading.

    Many sheltered Housing schemes already rely on a warden call system including a pressure mat – no passage across the pressure mat prioritises the warden’s attention for an I’m okay check. Using virtual sensing PIRs potentially offers a more accurate version of this since the sensing is not restricted to that one location which the person did cross before keeling over unconscious.

    The document does not provide the detail to confirm exactly what is being suggested – yes that is the fault of the authors but surely readers need to seek clarification before jumping on a bandwagon?

    Alertacall’s offering has its limitations too – a little like the pressure mat scenario I use, once the button is pressed and it is established the person is okay there is nothing to check they are still okay before the next “I’m okay” button press is due.

    What we should be taking away from this is the diversity of options technology offers and that few of the options work on a totally stand alone basis – so it needs assessment and thought to ensure the appropriate combinations for individuals.

    But yes we should be careful with how we use the terminology and supply definitions as necessary.

  4. Steve Hards, Editor

    Just an update to say that the Telecare Soapbox item from James Batchelor has been received and published. Steve

  5. Editor, for Anon

    Oh dear. Blackadder once said ‘I should have known not to trust a man with the mental agility of a rabbit dropping’ and I fear that by the time this particular rabbit has stopped running, many a dropping will be in its wake.

    Imagine the scene at a sales meeting somewhere near you … Cut to person with cunning plan – ‘Hey, what say we use PIRs to check that residents are still moving around. That’ll solve all of the housing guys problems of reducing funds and increasing demands on service. Think of the kit we’ll sell. Think of all those extra installs. Think of all those batteries that need replacing (if you could, that is)’ Such a pity, then, that the thinking didn’t extend to other questions such as ‘What happens when hundreds, or thousands of ‘em all go off at once ?’ Or ‘How many extra folks might the monitoring centre need at certain times of the day to deal with these inactivities ?’ Or ‘Now what do we do because we’ve potentially got hundreds of clients who may / may not be up and about’. On the face of it, with a good five seconds of thought then you can almost see the idea making sense. Until you consider the full story, the back-end, the telephony, the response protocols, the need to change patterns and so on and so forth. Which clearly someone who dreamt up the idea felt was all a bit too problematic.

    From Blackadder’s rabbit to Laurel and Hardy’s ‘Fine Mess’ this kind of half-baked, ill conceived, rush to market nonsense would be comic but for its implications on people’s lives. Because I simply do not believe that this has been thought through in any way, shape, or form beyond the five second concept other than to be hastily packaged as a solution for housing providers who find themselves between a rock and a hard place and who ultimately put their trust in the supposed experts in these matters.

    Sometimes I shake my head at the utter dearth of clear thought in this beloved industry of ours.

    What else can I do, but sit, quietly in sad reflection. And with a bit of luck my office PIR won’t know the difference.

  6. Hi Cathy

    Only have a few minutes to respond in between meetings, but your response interested me. Checking on someone’s well being isn’t just a case of determining whether they are moving or not, it’s about looking at all the communication with them in context and any changes in that communication – that’s what our service is about. our “OkEachDay” button is really just the tip of the iceberg in terms of determining a resident’s well being. It’s about 20% of what we “do” to deliver a quality service and unfortunately it’s this idea that checking on resident well being is “simple” which has led to a housing provider choosing something which is, I guarantee, dangerous. We have made millions of well-being checks now and understand this with a great level of detail.

    With respect to PIR, whether someone is moving or not is no test of their well being. Only actively engaging with residents through a process that involves cognitive reasoning (i.e. asking them if they are okay or getting them to signal they are okay, or both) can work reliably, and without very large numbers of false positives. If you would like a demonstration of how our system works and how it automatically detects trends in communications patterns to highlight residents with changing support needs I would be very happy to show you.

    Regards
    James Batchelor

  7. Cathy

    [quote name=”James Batchelor”]… it’s this idea that checking on resident well being is “simple” which has led to a housing provider choosing something which is, I guarantee, dangerous. We have made millions of well-being checks now and understand this with a great level of detail.[/quote]
    My observation is that gross assumptions were being made – the excerpt referred to provides no detail at all about what is involved – it mentions PIR sensors – but does not elaborate on how many, whether they are monitoring movement (which seems to be the predominant assumption) or none and whether this is in fact a part of a package of supports. If you can guarantee it is dangerous you must know the detail?

    I compared it to what I know is practice in Local Authority provided sheltered housing. I don’t consider that to be good practice – but it is real life practice.

    [quote] With respect to PIR, whether someone is moving or not is no test of their well being. Only actively engaging with residents through a process that involves cognitive reasoning [/quote]
    My grandmother moved into Sheltered Housing because she was afraid living on her own and because having fallen downstairs she felt safer living on the one level on the ground floor … this did not mean that she needed her housing provider to constantly check up on her – the fact her flat was in a complex provided her with the sense of safety she needed and she continued to socialise with friends in the village, do her own shopping, prepare her own meals (and those of visitors), do her own laundry for many years and so she did not have assessed care needs either.

    By the time she needed the sort of well being checks you are talking about she was beyond cognitive reasoning. I doubt you would have picked up that her meals where going in the laundry hamper? or that there was significant bleeding going on or that she had been out up the road in her nightie to berate the postmaster for not being open to provide her pension at midnight. None of this was about housing support needs it was about much deeper care needs … none of it would have been entirely picked up by either PIR sensing or an “I’m ok” button … Sheltered Housing was no longer the right place for her to be.

    To return to your statements – with respect … someone not moving over prescribed periods, is very much a test of their wellbeing – whether they are dead, injured, gone out for prolonged periods or simply choosing not to move.

    It should always be argued that it may not be adequate alone and that should be evaluated – on the other hand for some people it is preferable to constantly being subjected to cognitive reasoning? and after all they are a tenant – which is a choice not a constraint.

  8. Steve Hards, Editor

    Re-reading Cathy’s comments I see that she was criticising me for the original post – that I had jumped to a conclusion about the PIR system.

    What the ‘Guide’ is says is “…currently installing lifelines and passive infra-red detectors (PIRs)…which will provide an ‘I’m ok’ alert through detection of movement”.

    I think that is perfectly clear. However, as long as the PIRs are working, only non-movement can be interpreted reliably. How can it, then, be offered as an ‘I’m OK’ system? I contend that at best it could only be an ‘I’m dead or nearly dead’ system.

    However, it is still open to Tunstall to tell us more about their PIR system if they think they can justify the ‘I’m OK’ term.

  9. Hi Cathy

    [quote] …this did not mean that she needed her housing provider to constantly check up on her[/quote]
    If your grandmother had fallen whilst at her sheltered flat and been left there for a prolonged period waiting for help to come, would your view on whether she needed someone “checking up” on her be different? Our unobtrusive daily checks, under the control of the resident, are appreciated by the majority of people in schemes that use them.

    [quote]By the time she needed the sort of well being checks you are talking about she was beyond cognitive reasoning. [/quote]
    I think you may have missed what I said in my previous post about detecting trends in people’s communication. Would you not have liked her to have had a system that detected the deterioration in your grandmother’s cognitive abilities? Our system does that through monitoring changes in the consistency, form and frequency of our communication with her. Our experience shows that people who are starting to fail the simple task of pressing a button before an agreed time each day (or who start pressing it at random times) are also starting to have other cognitive problems. When we flag up that someone’s needs appear to be changing the housing provider can determine whether there are other support or housing options to be considered.

    [quote]…they are a tenant – which is a choice not a constraint. [/quote]
    Precisely! Isn’t it good to have a system where the level of contact is under the person’s control rather than being determined by the provider?

    What we are discussing is about knowing whether a resident has, or has not, an increasing need for support. Don’t you find it worrying that housing providers who wish to reduce contact with their residents and replace that contact with PIRs are, whichever way you cut it, increasing the likelihood of people being left without support when they need it?

    Best regards

    James Batchelor
    Housing Proactive

  10. cathy

    [quote name=”Steve Hards, Editor”]Re-reading Cathy’s comments I see that she was criticising me for the original post – that I had jumped to a conclusion about the PIR system.

    However, it is still open to Tunstall to tell us more about their PIR system if they think they can justify the ‘I’m OK’ term.[/quote]

    Rather than criticising Steve I was challenging … and you weren’t the only one taking the leap.

    It is absolutely open to Tunstall or the Housing provider to elaborate and I certainly think the document should be challenged on it’s content – so not criticising you for publishing the challenge at all.

    I guess I am also challenging how people (generally noone specifically on this thread) see the purpose and level of support needed in sheltered housing – not forgetting that there is a distinction between housing support needs and social care needs – whether there should be is a policy matter … and we should challenge policy too!

  11. Annom

    Hi did think that this was a professional site for like minded people to talk and discuss options, I don’t see the point of asking for comments and then having a go at someone because they don’t agree with you. It seems that it is a case of judge and Jury, without all the facts. Cathy was only looking and commenting on her thoughts. Re the other Anon obviously a call centres point of view and fair point, but that is what it should be not a dressing down?

  12. Steve Hards, Editor

    Sorry, Annom, who do you think had given a dressing down to whom? I only see a healthy debate here. Regards, Steve

  13. Cathy

    @Annom I am fully seconding what Steve has replied to you.

    I feel debate like this is important and too often we shy away from challenging the status quo. This is one of the things I appreciate most about Telecare Aware; we can make comment and counter comment without anyone taking their bat home (apologies to readers not familiar with Cricket – what a fabulously strategic game that is!) … and every so often we have a bit of fun too (as in the discussion about the teleparagliding) … but we also have the option of the anonymous posting if we need to [i](for avoidance of doubt I have never felt the need – if I cannot post as me I quietly take my bat home and wait the next discussion)[/i]

    I am employed in the public sector currently – I criticise things that I know are happening if it is ultimately helpful in changing weaknesses to strengths. This isn’t always popular but I don’t think being popular is a priority – I think the services and supports delivered to people who need them is important; I think that personalising the services and supports is important; I think that preventative work is important; I think that Communities are vitally important; but I also think that empowering people to continue doing things for themselves is important – and part of that is about providing them with informed choices.

    I don’t just think these things because they are fashionable – I believe in them and put them into practice whenever I can AND I will stand up for them when I need to.

    So now you know that I am not feeling chastised – I would love to hear more about your thinking on this debate please?

  14. Chris Ho

    Dear Steve

    I have been following this debate with interest and would be grateful if you would include this comment.

    As one of the UK’s more diverse alarm monitoring providers we are well positioned to offer a view on the matter. To cut to the chase and with, as Cathy has suggested would be of value, sufficient detailed knowledge on this sort of issue (and we’ll leave it at that), then I can unequivocally state that the use of a PIR as a wellbeing check is a vastly inferior solution to that which Alertacall provides.

    As a business with experience of several thousand detailed telecare assessments it has never, ever, been considered as an acceptable solution to use a PIR in this fashion to meet this need. I could fill screenfuls of space with the reasons why but there are some key fundamentals which James has already touched upon – the main one being a positive requirement from a client to signal their wellbeing.

    If you couple this with an alarm, or another properly assessed telecare solution then you will have the best option you can, short of moving in with the person. Yes, as with everything there are compromises. However, as any monitoring centre will tell you, assumptions and ‘hope so approaches’ are a recipe for disaster and the proposal at the heart of this thread appears to me to be very much one of these.

    We live in a world of choice – some clients would choose a daily visit from a live-in manager, others would choose to avoid what they may see as interference and be happy to check in if that is part of the housing deal. The hard part is doing everything for everyone in an economically challenging environment. But equally there are some fundamentals to good practice and I for one would vote for a ‘dead man’s handle’ for a train driver every time over a PIR to check that they are still moving, or a vital signs monitor to check that they’re still alive ,or some other solution that was bent to fit. Because ultimately I believe, and so do my colleagues, that PIRs in this instance, via an alarm unit, is a solution bent to fit. And, as the back-end of this particular pantomime horse (the monitoring centre) it is a proposal with issues written through it like a stick of rock.

    Here is a challenge for the readership – if anyone from CIH, or the Telecare Aware reading fraternity is passionately interested in how to do resident checking properly, with all of the added value that is on offer in the market today, then I’ll happily host a seminar / workshop / discussion group and we’ll go through the pros and cons. Then perhaps we can publish something that has been considered, debated, and that is balanced with all the pros and cons.

    Chris
    [url]http://www.seniorlinkeldercare.co.uk/[/url]

  15. Andy Smith

    You can program the lifeline to use one of the integral keys as a I am OK button if needed, in place of a PIR.

    Andy

  16. Hi Andy

    I’m really interested to hear you think that can be done, so just wanted to make a few comments about that. It is in fact NOT possible to program any button on a Lifeline unit to act as an “I am okay” button in any manner that would benefit many service users or, when scaled up, provide anything like a fully functional service.

    Here are 4 points which you might find interesting in relation to this:

    Point 1 – You would never, and I repeat ever, EVER want to put an I am okay button on a Lifeline unit or any unit for that matter the primary function of which is for alarm. Studies have shown that a significant number of alarm users trigger their alarm at the base unit. It would be dangerous, misguided, and dare I say it, “insane” to have an “I am okay” button on an alarm base unit because this would introduce the risk that someone would press the “I am okay” button when they wanted to raise an alarm. If it has been suggested to you that this can be done, it is been suggested by someone who has not given it any thought whatsoever, in my expert opinion.

    Point 2 – As the inventor of the “I am okay” button and having more experience of this than anyone else (simply stating a fact), and having run a constantly improving “I am okay” service for several years now, I can tell you with absolute certainty that no button on a Lifeline unit could be made to work satisfactorily from the users’ point of view as an “I am okay button”. It needs to work in a very specialised way which you only get an understanding of after having asked thousands of people to press such a button over several years. I can think of 8 criteria right now that an “I am okay” button has to fulfill and there is no button that could do this on a Lifeline, or any other alarm unit, at this present time.

    Point 3 – The “I am okay” button and the signalling from it is a tiny fraction of what is required to make a Safety Confirmation service work. We know this, because we do it already. We have the only software platform (called Pellonia) that has “what it takes” to manage such a service. I know this because I have spent time using those other platforms.

    Point 4 – There is no other company apart from ours, anywhere in the world, that has the real world experience, data and knowledge to interpret trends in “I am okay” signalling and communications patterns to identify when service users needs are changing. None. This is a material part of an “I am okay button” solution and anyone else who says right now that they have the knowledge and experience is being completely disingenuous. We’ve been doing it for years.

    None of this of course will prevent another company “saying” they can provide equipment to run an “I am okay” service, but that’s not the same thing is it?

    Our door is open to organisations or companies that want to come and work with us, licence our know-how and want to run a service based on this. I strongly suggest any organisation that wants to develop or run such a service should save itself a lot of pain and give us a call. We’re a family owned and run business, with a strong technology background, genuinely interested in helping people with solutions [b]that work[/b].

    Regards

    James Batchelor
    http://www.housingproactive.com
    Housing Proactive
    Part of Alertacall Ltd

  17. Cathy

    @Chris
    [quote]Here is a challenge for the readership – if anyone from CIH, or the Telecare Aware reading fraternity is passionately interested in how to do resident checking properly, with all of the added value that is on offer in the market today, then I’ll happily host a seminar / workshop / discussion group and we’ll go through the pros and cons. Then perhaps we can publish something that has been considered, debated, and that is balanced with all the pros and cons.[/quote]
    Please count me in as interested – my background isn’t housing support but there is a certain lack of awareness between ‘housing’ and ‘social care’ and we do a dis-service by allowing them to flourish.

    Would need to be something online for me to participate.

    Would need to be not about sales pitches for me to participate

  18. cathy

    James I am going to come back on this just once more – I am thrilled you believe passionately in your product – but whilst I might WANT a chauffeured limo door to door everywhere I go I have public transport available to make the journeys I NEED to make and a chauffeured limo is not only an expensive luxury but would effectively socially isolate me! I get that you have a “chauffeured limo” product – but many sheltered housing residents are still doing just fine with trusty ‘public transport’.

    My comments throughout are not about which bit of kit trumps what – but about making assumptions …

    [quote name=”James Batchelor”]
    If your grandmother had fallen whilst at her sheltered flat … [/quote]
    You have assumed she was at risk of falls – she fell downstairs [u]once[/u] shortly after moving from a bungalow (where she had lived for 40 years before suffering a bereavement) to a nice modern little townhouse that was low maintenance – family thought it a good idea at the time but with hindsight perhaps she should have been supported to stay in her bungalow.

    There are many preventions that should be introduced to avoid falls becoming repeat events – we should not be starting with a wellbeing check but with basics like reducing trip hazards (funny that the social worker gets that one to deal with and yet clutter avoidance is a much better fit to a function of housing?); basic eye tests; good property design; clinical assessments … see not even got to telecare yet but I have suggested things that interface to housing providers, social care providers and health providers …

    [quote]I think you may have missed what I said in my previous post about detecting trends in people’s communication.[/quote]
    No I think I understood you perfectly – at what age would you recommend starting to detect these trends? should I get a system installed now on the off chance I decide to move to sheltered housing in my old age? What determines that someone wishing to feel more confident suddenly steps across a line to needing their cognitive abilities to be trended? and when did it become a duty of housing providers to undertake this?

    [quote]Would you not have liked her to have had a system that detected the deterioration in your grandmother’s cognitive abilities?[/quote]
    She had such a system – family, friends, hairdresser, GP, butcher, baker, small supermarket, postman, local constables and the postmaster – even herself because she was sadly aware of the cognitive decline for a time. It was a network and we were aware of the decline – but there was still a timescale and sequence for adopting new supports to meet her needs (of course I realise not everyone does have a network like this and that is part of evaluating the benefits of any intervention a person may need or want).

    [quote]
    Don’t you find it worrying that housing providers who wish to reduce contact with their residents and replace that contact with PIRs are, whichever way you cut it, increasing the likelihood of people being left without support when they need it?[/quote]
    I find it worrying that (any) providers sometimes decide that every person wants the same supports without allowing them an informed choice about how to meet the needs they have …

    I find it worrying that Housing with Care staff believe that adding a bed occupancy sensor into a telecare enabled flat will be too much extra work for them and so they will actively seek a different tenant with less need … (I have to ask is the clue not in the name of the service they offer?)

    I find it worrying that the public sector thinks it is okay to provide a shopping service rather than supporting a person to go shopping (which involves social contact, handling money, travel, decision making).

    just a few of my worries about poor practice … all of these things are based on financial decision making; this is reality and we do have to find ways of balancing the books – but it should not compromise peoples choice and control over their own life.

    Two of the reasons it does though?
    (a) we don’t work closely enough together
    (b) because we are too fond of starting from risk aversion … we are too scared to start with risk enablement – what will always stick with me was attending a funeral of a toddler at which his mother told us “please do not cry … I am so grateful that I did not know he had a heart defect – had I known I would have wrapped him in cotton wool and we would not be able to celebrate the life he enjoyed with his brothers and sisters and all of you”

    In terms of your passionate sales pitch my question is – How tight do you wish to wrap that cotton wool?

  19. Kevin Doughty

    It’s something of a shame that what could have been a good and important discussion on terminology has been changed to a debate on the relative merits of different models of telecare service delivery.

    If I’ve learned one important thing about telecare over the past 20 years it is that every potential service user’s needs are different and that the form of telecare that should receive is the one that best fits them as individuals and what they need, and the risks that they face, in trying to live as independently as possible. Some will need some simple examples of self-care (and no tele-services whatsoever)- dare I suggest basic assistive technology devices such as reminders? Others, especially those who live alone, will need reassurance services, while people with more complex needs may require a combination of assistive technologies and telecare services.

    Regular Telecare Aware readers will immediately recognise that the starting point has to be good assessment, followed by a prescription based on a knowledge of which devices and services can best satisfy the needs identified through the assessment. Fortunately, as the range of Assistive Technologies and telecare services expands, there will be more choice and more opportunity to match more closely the individual support services that we all desire.

    The UK continues to lead the world in having available the widest possible range of quality options. Healthy competition will help to improve this quality and drive down prices – but this process will not be helped by the wrongful use of terms and by organisations failing to compare like with like.

    This calls for improved knowledge – and this may be achieved through better training. It’s not rocket science – but better assessment and training tend to be fundamental to improving services and outcomes.

  20. This sounds like typical Tunstall dictating to the market.

    Our PIR devices are all designed to give as much feedback and information on events as possible rather than making presumptions that movement means ‘I’m OK’ or similar.

    With the technology we have these days we are all about innovating with sensible ideas and methods such as our focus on establishing 2-way audio feedback with users and by monitoring being done on several different levels including GPS location, fall sensors with calibrated filters, and making it easier for users to control their devices themselves in the event of an incident and having those events logged to establish trends in the usage of PIR devices and their efficiency.

    As a new company in this market we are continually bemused by how Tunstall can get away with their generalisation and how inferior their offerings are.

    For more information on our services take a look at http://www.thecarephone.com or mail me direct.

    Best Regards,

    Ben Lloyd

  21. I’ve mis-understood the PIR’s for PERS devices in my post I believe. But still my point is fairly clear about assumptions when it comes to monitoring vulnerable people and the way Tunstall seems to dictate its methods as being correct and therefore safe.

    Please excuse my bad grasp of the various terminology and abbreviations used in this discussion its difficult trying to keep up with them all and use them where applicable!!

    Best Regards,

    Ben Lloyd

  22. Hi Cathy

    As it happens our service normally costs **less** than a bus ticket a week. Hmm… “A chauffeur-driven service for less than a bus ticket a week!” We may use that in our marketing.

    Our views, I think, are actually much more aligned than it may seem, I 100% agree with you that everyone’s needs are different, that’s why we advocate residents being able to control how much contact they get and when they get it. For some people it isn’t appropriate at all. What we don’t advocate and have to vehemently oppose are solutions which are not fit for purpose but which are sold and marketed as such.

    As for “when did it become a duty of housing providers to undertake this?” well that is a very interesting question – but the intense and often public criticism of housing providers in the wake of someone being left without help is part of that interest – also – there is often a genuine desire for them to want to help and support their older residents which is deep rooted and extremely well intentioned.

    Will probably not comment on this thread again, but would very much enjoy an off-thread discussion with you, if you would be open to it. Have a great weekend!

    Regards

    James

    Housing Proactive
    http://www.housingproactive.com
    Proactive Resident Communication

    P.S. Sent from phone, so apologies for any typos

  23. Leslie Morson

    Caveat Emptor – Far be it for me to start defending Tunstall here, trust me it’s something I would never normally do – but am I missing something here?. What’s the problem, business ethics? exploitation? dodgy business practices? or are we calling Tunstall out for peddling snake oil and sugar water? Tunstall is a business, its first obligations, are to its shareholders. It does not add value to its brand by behaviours that damage the brand, including activities that puts its core service users at risk. Businesses exists to add value, to make profit and increase the value of its assets. So what if it hijacks terminology, even invents terminology for its own benefit.

    That’s life, checkout the OED for new words and terms that didn’t exist just a few short years ago – Carpe Diem, they clearly believe that such strategies give them competitive advantage and well it might, they seem to continue to do well employing the very strategies we all know and love to criticise, myself included.

    So, Tunstall are what now? selling stuff they make! Holy cow, Hold the front page, Naked Harry be dammed, put him on page 3!

    Can PIR’s be used to monitor movement? – well yes, is it an effective and reliable method to monitor the health and wellbeing of residents in sheltered housing? well I wouldn’t recommend it, not in isolation and clearly neither would the vast majority of readers on this site.

    But c’mon now, blaming Tunstall for finding innovative ways to sell kit, is rather like blaming a fox for ‘stealing’ the farmers chickens, like blaming Simon Cowell for the dross on TV of a Saturday evening. Like blaming Boris Johnson for – well being Boris Johnson. Now I read the publication and it seem to me to be a pretty innocuous document. Full of bog standard case studies citing accepted practice in the use of telecare/telehealthcare/assistive technologies (sic) in supported housing.

    The offending passage reads “to replace morning calls by wardens where preferred” I think to suggest this as the harbinger of doom is quite a jump. Were I to choose to play the Devils own advocate here, I would point out that this organisation was introducing a greater level of choice for their residents, regarding how they wished morning check calls to be delivered. There was no indication that wardens were being removed or reduced. Were I living in sheltered housing, I might myself elect to be passively monitored in the morning, rather than have my scheme manager barking down the intercom at me first thing, or knock on the door merely to check that I’d survived the terrors of the night and made it through to a new day unscathed.

    What concerns me is the assumptions that are being made about the quality of the supported housing management in this organisation. Are we really saying that officers in this organisation have purchased said snake oil without even considering impact? That they do not understand the fundamental nature of supported housing, the business they are in? Don’t get me wrong, I am sure that what we are seeing here is change without a doubt. Does that make the change unsafe, unwise unconsidered, unwarranted and unwanted? On the basis of three sentences in a publication, designed to shift product by the leading supplier in the industry, I think not. Clearly you guys (we guys even) are far too savvy for that.

    It’s interesting that where others see stupidity, I see innovation, not on the part of Tunstall, I’ve never considered them innovative. The Korean manufacturer Samsung have stated that their own strategy is ‘fast follow’ on many product lines, I’ve always considered Tunstall to be slow, very slow follow, but that’s another story altogether. I think the innovation rests with the RSL in question. It’s tough out there and it is getting tougher. We should be commending organisations who are able to innovate and path-find. I choose to believe that colleagues in the sector continue to struggle to provide value for money. That means change, it means innovation, it means not quite sleeping with the enemy (I would never go as far as describing Tunstall in any way sexy enough to sleep with), but certainly working jointly and exploiting what they are good at.

    After all, even snake oil has its uses.

  24. Leslie Morson

    [quote name=”Cathy”]James I am going to come back on this just once more – [/quote]
    Cathy – agree whole heartedly with everything you’ve said here.

  25. Sultana

    Oh my! I am a 3rd yr OT student currently trying to wade through an extended essay on Telecare which i have been thinking has to be the most boring subject on earth – until i came across THIS thread! Every point made has opened my eyes to some of the realities of remote monitoring, and much better than the boring journal articles (which say nothing much) or policies (which say the same thing) that i’ve had to trudge through all summer. Thanks to all those interesting people who’ve posted!! (wish I’d stumbled across this sooner…)

  26. Cathy

    @Sultana – it is really good to hear that telecare has got a mention in your studies and glad you found the site. Maybe – if you are feeling brave enough – you might come back and share your essay with us? If that is too daunting please do try to get your essay shared with your student peer group because we desperately need tomorrow’s practitioners to know about and be trained in this area.

  27. I think you need to look at the recent case in Trafford where a gentleman was found after being dead for 10 days in Sheltered Housing. Yes the PIR cannot give someone a health check, and they can even be wandering around their hosue in a confused state and triggering the PIR that they are OK, BUT for cases where the service user wants independence from care checks, doesnt want to be lay on the floor for hours, not being able to get out of bed in the morning due to illness, then a PIR in the bathroom or hallway is a very good tool. yes this may generate more calls and appropriate responses [u](What happens when hundreds, or thousands of ‘em all go off at once ?’ Or ‘How many extra folks might the monitoring centre need at certain times of the day to deal with these inactivities ?’ Or ‘Now what do we do because we’ve potentially got hundreds of clients who may / may not be up and about’ ISNT THAT WHAT WE ARE HERE FOR?