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Business Clinic
Body cameras in the social care sector: can they improve outcomes?

The idea of CCTV in care homes gets a lot of coverage in the media and divides opinion amongst staff, residents and families. However, some companies are looking to take this one step further and trial body cameras in social care too.

Calla, an organisation which is looking to trial body cameras in care homes, has developed a camera that can be worn by staff, so that they can record certain situations or events. The cameras are worn at all times, but can be switched on when the wearer wants to record something in line with policies.

The idea behind the cameras is that they make staff and the people they’re supporting feel safer. Much in the same way as CCTV is intended to make sure that negative incidents don’t occur, these cameras are trying to reduce potential risks to staff and residents, ensuring that each party has protection and evidence should an incident be reported.

The cameras

The body cameras have a front-facing screen, so that people are able to see if and when they are being recorded; this aims to take away the issues surrounding people not being aware of the cameras and means that staff must be honest about what they are recording.
The footage is securely encrypted on the camera and it cannot be deleted or edited. It is then decrypted by a computer app and is automatically transferred to an online account.
These accounts are built with the same level of security as the systems police are using.
The footage can then only be accessed by an authorised person logging into the account and all actions are recorded by an audit log. Every item is given a retention period, which can be set by the account holder.

This ensures that videos are only stored for the amount of time that they are needed. They are then deleted automatically after this time period so that nothing is kept that isn’t necessary. Footage that is required for a case or for evidence is kept for longer, until it is no longer required.

Previous evidence

Calla has already been conducting trials with Northamptonshire Healthcare NHS Foundation Trust. The hospital where the cameras have been trialled provides inpatient mental health services for adults and older people, as well as services for people with learning disabilities.
Although some employees were sceptical at first, staff suggested that the use of the cameras may have altered the behaviour of patients.

For example, a gentleman who had a habit of hitting staff stopped when the cameras were on. The NHS Foundation Trust published a paper with findings that resulted from equipping nurses with specialist body cameras. This outlined the feasibility of using the technology in an inpatient setting and noted a reduction in emergency restraints as a result.
A number of NHS Trusts are now also rolling out or planning their use of body cameras on nurses. In November 2018, 16 NHS Trusts from around the country met at a conference dedicated to the use of body cameras in healthcare, with a view to progressing projects and rolling out cameras to staff.

A spokesperson from Calla said, ‘We think body cameras could have a similar impact in care homes, where staff may face abuse or aggression from people using the services. Body cameras record an independent account of events, which have been shown to increase confidence of both staff and the people they support.’

The aim is that providers can use the video collected to help with addressing complaints quickly, maintaining reputation and resident trust.

The challenges

Despite its ultimate success, the NHS Trust pilot did initially face some scepticism.
Staff in particular were unsure of the impact the cameras might have, but after using the technology and seeing the results, these uncertainties were no longer an issue. Similar reservations are expected to be seen in care home pilots.

Alongside this, there could be hesitation from family members and the residents themselves, who may object to being recorded or who are unable to provide consent.
Calla is hopeful that these issues can also be overcome, by ensuring that all parties involved have the necessary information on the safety and effectiveness of the body cameras and supporting care homes to implement the cameras.

Hopes for the trials

Body cameras have had an impact in policing across the world. In this context, they are shown to alter and diffuse aggressive or challenging behaviours, as well as capturing the true sequence of events.

In policing, body cameras are usually used to protect the wearer. This is also the case in other sectors where body cameras are being rolled out, such as retail and education.
Calla is hoping that in social care, the cameras will serve as protection for all involved, including the people being supported.

Over to the experts…

Will these body cameras fulfil their aim to make people safer? Are they a good idea for the care sector? What are the potential barriers to the project? How can they be used to improve safety for the people being supported?

We must establish a shared purpose

This is an area where it is very valuable to be having a more public debate. Over the next few years, as portable technology of this sort becomes more readily available to the care sector, we will find ourselves needing to have a clear set of measures against which we view these increasingly accessible and affordable pieces of kit.

The proposition is that body cameras are a way of making people safer. The safety of the workforce is of course a huge priority for employers across the sector, and indeed, employers should be considering positively anything that becomes available to increase the safety of their staff. However, it is less clear how people receiving care will benefit.

This seems in contrast to other discussions around the use of surveillance monitoring, where either the monitoring is continuous, or is triggered by sound, activity or incident. Where I have heard of this being introduced effectively, there is the potential for a more ‘shared benefit’ discussion with people receiving care and their families. Here there are opportunities to discuss how the use of cameras will enable early identification of distress or safety concerns, and the opportunity to film and record a successful resolution.

I think, for me, one of the measures of success for the introduction of new technology is that we can establish a shared purpose, where the technology enhances both the life of people receiving care and benefits the workforce.

It will be key that the trials of this new approach provide answers to this, and that we get this potentially positive tech to focus on enabling and to shake off its enforcement roots.

Vic Rayner, Executive Director, National Care Forum 

Requires a thorough approach

The use of covert recording in care homes is not new to the care sector, nor is the use of CCTV surveillance. However, the proposed use of overt surveillance using body cameras represents a step change. The Protection of Freedoms Act 2012 provides a code of practice about surveillance camera systems, including body cameras.

The key legal issues relate to balancing privacy with the legitimate aims of the provider, all within the context of data protection requirements.

Article 8 of the Human Rights Act 1998 provides a qualified right to the protection of a private, family and home life, with residents viewed as being at home when living in a care home. Recording residents infringes this privacy, even if the recording is overt. Providers must be able to show that this is both ‘legitimate and proportionate’ on the basis that it protects staff and safeguards residents.

Providers must deal with video or audio recordings in line with the General Data Protection Regulation (GDPR) and the Data Protection Act 2018. They would also need to let people know they are being recorded using appropriate signage.

Providers must comply with requirements enforced by the Information Commissioner’s Office (ICO), and by the Care Quality Commission (CQC) who view recordings in care homes as part of the care provided and therefore covered by regulations under the Health and Social Care Act.

There are strong arguments to be put forward by providers for the use of body cameras. There are obvious benefits for both residents and staff. With a thorough approach, the legal and compliance risks are capable of being resolved to the benefit of all affected.

Errol Archer, Consultant Solicitor Advocate, Scott-Moncrieff & Associates Ltd 

Allows greater transparency in care

The precedent for the use of surveillance cameras in care homes has already been set, with cameras being used in other environments like mental health wards and clinical settings in acute medicine. To date, use of cameras within care homes has mostly been highlighted when safeguarding concerns and cases of abuse have arisen, often detected via covert use of surveillance cameras.

The use of cameras in care homes has therefore often been associated with a defensive style of care delivery. However, there are examples where surveillance cameras have successfully been used as part of a continuous quality improvement strategy, e.g. staff development and managing violence.

When use of cameras is known to all, the ethical and legal issues are less challenging to overcome. Consent of all parties should be sought utilising guidance relating to the management of personal information.

Privacy impact assessments should be completed prior to deployment to consider what personal and sensitive information will be captured and how this could affect those involved.

The validity and utility of using cameras has been questioned by those who argue that care workers might adapt their behaviour when in the presence of cameras, negating the potential benefit of detecting wilful unsafe acts. It is more likely that, as people become accustomed to surveillance, their natural behaviour will prevail.

In the era of duty of candour and greater transparency in care, the ability to capture footage that can be later referred to is one of the strengths of using surveillance.

Taffy Gatawa, Chief Information and Compliance Officer, everyLIFE Technologies Ltd 

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