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How will AI change the social care sector?

Regular readers of CMM will be aware of, and may even be experiencing, care staff shortages. Regular turnover, a shortage of skilled and experienced staff and a rising demand for care workers are all issues faced across the country. We need a solution, but is artificial intelligence (AI) the answer? Lindsay Taylor of Coffin Mew shares her thoughts.

Skills for Care regularly investigates and reports on the state of the adult social care sector and workforce in England. In its September 2018 report, Skills for Care estimated that the sector turnover rate was 30.7% – equivalent to around 390,000 staff members leaving their roles in the previous 12 months. It also found that:

  • The vacancy rate was 8%, or around 110,000 positions at any given time.
  • The estimated sector workforce was 1.26m directly employed staff with the turnover rate increasing by an average of 7.6% between 2012/13 and 2017/18.
  • The turnover rate for care worker roles was noted as the highest at 37.6% and within the domiciliary providers category this figure jumped to 42.3%.
  • Retention of new staff was identified as a huge issue, with the largest proportion of staff turnover a result of workers leaving shortly after joining the sector.
  • Sickness equated to an average of 5.1 days over the preceding 12 months or 6.5m days across the estimated workforce of 1.26m people.

When considering business operations, providers clearly need to prioritise certain essential tasks should there be any shortfall in staffing. Sadly, this can leave precious little time for resident interaction and other less urgent needs, potentially leaving residents at risk of feeling isolated or lonely. With demand for care workers ever-increasing, and with current vacancies not always being filled, there is concern around how the sector will cope, both in the near future and as the years roll on.

The pepper trail

One forward-thinking response has come from a collaboration between the University of Bedfordshire and Advinia Health Care. Utilising £2.5m of funding from the European Union, a trial has been set up dispatching robotic humanoid companions to care homes.

These four-foot-tall robots known as Pepper were designed in France. They are now manufactured and marketed by the Japanese corporation Softbank Robotics with the sole intention of interacting with care home residents.

The robots use an impressive piece of tech that allows the AI to continually learn from their interactions. Imagine a culturally-competent and sensitive robot that has the capability to learn your favourite music but can also remind you to take medication.

The robots are not intended to replace care workers, and indeed they do not have working limbs so cannot undertake manual tasks. Instead they can assist residents in communicating with family members through video calls, either with voice commands or using touch screens.

Using facial recognition, the AI can focus more on topics of discussion that interest the resident and steer clear of anything that might upset them – much like a human companion would. If the humanoid companions can successfully recognise a person in distress, which the trial aims to identify, they will be able to alert a care worker to attend and assist.

Whilst it would be ideal for human care workers to have the opportunity to sit with residents for long periods of time to ensure that loneliness is abated and reminders for important personal tasks are undertaken, this is not always possible. Instead, companions like Pepper could take the strain off busy care staff, ensuring residents benefit from increased social interaction and improved mental wellbeing.

Recently, Pepper even spoke in front of MPs of the Education Select Committee, explaining how AI as a service could cut costs for caring for the elderly. As Pepper explained, ‘Assistive intelligent robots for older people could relieve pressure on hospitals and care homes as well as improve the care delivery at home and promote independent living for the elderly people.’

Care home pets

Similar AI has already been successfully tested in care homes. Kenwith Castle care home in Devon was the venue for the initial meeting between KC the dog, Keno the pony and residents who lived there.

The AI animals responded to residents’ petting and noises and it was noted, in particular, they were are to provide effective and positive interaction with people living with dementia. The pets were not considered a replacement for the live animals that also visited, but as an additional resource. One family was so impressed, they purchased a robot dog for their elderly parent.

These AI companions do not require feeding or upkeep (save batteries or charging) and there is no risk of neglect or need for an alternate caretaker should the owner become ill or incapacitated for any length of time, so they tend to be well-suited for people who receive care services.

There are several other types of AI on the market which could be utilised for the benefit of people using care services. What about the resident who is fiercely independent but cannot feed themselves? A robotic arm at their command could be an excellent replacement, allowing them to eat at their own pace and retain some of their independence, while freeing-up a care worker to assist somebody else.

Moral and practical concerns of utilising AI

These developments in AI have not impressed everyone. Judy Downey of the Relatives and Residents Association charity has said that it is like ‘treating people like commodities.’ Indeed, there is a concern that some could see simply having a robot present as a box being ticked that a person’s emotional needs will be met. However, as Judy argues, human beings are much more complex creatures with individual needs.

Dementia, for example, affects everyone differently, but for many it can mean that they become easily confused. There is then a difficulty in knowing whether people with dementia understand that they are interacting with robots and not live animals or humans. It is unethical to risk causing distress to anyone by using AI which blurs the lines and appears to think and act like a human. Is it fair to expect someone to spend their time with robots, just because of the sheer lack of human care worker availability?

This is where it is important to retain that human factor. A human, whether care worker or family member, can oversee the interactions and determine, with the person being cared for, whether an AI solution is suitable.

It is important to emphasise that the intended aim of AI is to be a tool to support busy care workers and improve the lives of people using the support, rather than to replace proper care. A resident may prefer to spend long periods of time with Pepper, who is in effect catering to their personal emotional needs of companionship. Or they may not enjoy it and other options can be considered, such as ensuring, where possible, they have more human interaction.

From a care worker’s perspective, is there a risk that AI could be seen as an easy and (relatively speaking) cheap replacement? After all, a robot might require maintenance, but it will never call in sick or have other responsibilities than those assigned to it. It is very easy to envisage a small army of Peppers stationed throughout a care home together with other AI which could very well complete manual tasks – overseen by a smaller number of human workers, but we can probably all agree that this is not somewhere we would want ourselves or our loved ones to be cared for.

Despite these concerns, by utilising robots with task-specific AI, it is easy to see how care workers could be freed from repetitive manual labour. For the health and safety of both the person using services and the care worker, guidelines exist regarding correct lifting procedures.

For those who are immobile, it can often take two care workers to move someone. A person who wants to move at a particular time may find that two care workers cannot be freed-up immediately; however, the Japanese nursing-care robot, Robear has the ability to lift patients from their beds into wheelchairs and can even help them to stand up. This AI implementation in Japan isn’t about replacing jobs, but intends to complement existing care by promoting independent living and improving quality of life.

It will be interesting to see the results of the Pepper trial when published and whether it will lead to wider implementation, but when discussing AI, we must never forget who is at the heart of these considerations.

The AI described above may come across as future-shock, but it is currently here to support and care for the most vulnerable in our society – being a companion and lending digital voices to those who need the most support.

Lindsay Taylor is a Lawyer in the care and protection sector at Coffin Mew. Email: LindsayTaylor@coffinmew.co.uk Twitter: @coffin_mew

Are you implementing AI in your business? What encouraged you to do so, or what is holding you back? Let us know by commenting on this article.

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