Few topics in social care are more emotive or inspire more debate than the issue of CCTVs in care homes. With campaigners calling for mandatory adoption in order to help avert care home abuse and increase care transparency, CHP takes a look at the arguments on both sides of the debate.
Views on both sides of the CCTV debate are powerfully expressed with those campaigning for legislation to make use mandatory in care homes arguing it is essential to provide reassurance for families and avoid the worst cases of abuse that dominate news headlines.
On the other side of the debate many leaders of government and sector organisations argue that compulsory adoption should be an exception to the rule.
Head of the Campaign for the Vulnerable, Jayne Connery, has been a high profile leader of the campaign for the mandatory introduction of safety monitoring in care home communal areas.
Jayne launched her campaign after her mother, who lives with dementia, suffered abuse at her first care home. Because of this precedent, Jayne then placed a covert camera in her mother’s care home after noticing irregularities with some of the night care.
Within 24 hours of installing the camera, Jayne discovered evidence of failings which she brought to the attention of the home’s managers.
Within a few weeks her mother was then given notice to leave the home on the pretext that it could no longer cater for her needs.
Jayne, who stressed she advocated overt and not covert cameras, said her campaign was focused on the mandatory introduction of CCTV safety monitoring in communal areas of the care home only.
“For us the benchmark to start in communal areas is a good one,” Jayne told CHP.
The campaign director said she would also like to see cameras in residents’ rooms as well, however, provided they had been given consent.
“We do not live in a police state and obviously we do have to protect the privacy and dignity of residents,” Jayne added.
She stressed that her campaign was not about berating care home providers but was a positive opportunity for them to increase trust and offer reassurance to families by raising transparency.
The safety monitoring advocate champions the technology as a way of providing vital support to care workers who may have been unfairly accused of abuse, while also acting as a useful training tool.
“Many carers contact our campaign telling us they have been accused of poor care when in fact that’s not the case,” Jayne noted.
“Care providers are now coming to me and saying we want to know more about this.
“We have had many care providers coming in and saying this has been a huge plus. Carers can look back and see if they have lifted a resident wrongly, for example.”
Jayne also highlighted how camera technology can help care home providers and the NHS avoid the drain on resources caused by unnecessary ambulance call outs.
“There’s been some so many examples of when a carer has found a resident on the floor and the first thing they have done is call an ambulance because it has been unwitnessed and they may have a head injury,” Jayne noted.
“When they look back at the footage they can sometimes see that the resident placed themselves on the floor.”
Andrew Geach, CEO of Shedfield Lodge in Hampshire, said installing CCTV had resulted in an 80% drop in emergency call outs at his home.
Shedfield Lodge has installed 21 cameras in all of its communal areas, including exits and outside areas.
Research by the Daily Express has found that CCTV in care homes could save the NHS £370m each year on avoided ambulance call-outs.
Jayne also cited how adopting CCTV safety monitoring can be used as a positive marketing tool by care home providers.
“We get reports from providers saying their occupancy has increased, families have trust and carers are more content because they know that if anything should happen it can be picked up and offer them some protection,” she said.
Having spent years on spreading her message, Jayne said she had begun to sense a clear shift amongst care home providers towards the technology.
“I do see a positive shift from five years ago when you could see the nervousness in the sector,” Jayne said.
The care campaign director predicted change in the industry would be led by the big providers coming on board with the technology. There is evidence that this is beginning to happen with Orchard Care Homes notable amongst the providers to have taken up the technology.
Orchard Care Homes
Speaking to CHP last year following the launch of a pilot in two homes, CEO Tom Brookes said the systems had been instrumental in bringing the homes out of embargo and had been key to evidencing allegations of poor practice in homes that were no longer part of the group.
“We were able to evidence base that there was good practice going on and if there were any allegations we could go back and examine them,” Tom said.
The CEO said that while staff had been initially suspicious of being under surveillance, they were now fully on board with the system.
“You can’t do it in isolation, it has to be a multi-agency decision involving the CQC, local authority, residents and their families,” he noted.
The Orchard boss said use of the technology was focused on compliance issues as well as falls monitoring.
“It’s a tool in the tool box for turning our challenged homes around,” Tom noted.
Cameras have been deployed in communal areas and in the rooms of residents who have provided consent, with the system able to be adapted to each individual.
While Orchard has begun use of the technology, the UK’s largest care home provider, HC-One, is currently exploring possible deployment.
A spokesperson told CHP the provider was taking a “keen interest” in how other providers had incorporated the technology into their services.
“Any future decision regarding the use of safety monitoring will follow consultation with the people living and working in our homes,” the spokesperson said.
“If they support the use of safety monitoring, then, like all major technology investments, we will complete several pilot projects, review the benefits, and make an informed decision ahead of any estate-wide roll out.”
As well as gaining significant traction with care home providers, safety monitoring has also won some heavyweight backing from the Daily Express. In the political sphere, former Attorney General Dominic Grieve has called for legislation to make CCTV compulsory in all care homes and Health and Social Care Secretary, Matt Hancock, has signalled his backing for the adoption of the technology in communal areas.
While the movement has its backers in Parliament, ministers and MPs, as a whole, remain divided, however.
Minister of State for Care for Health and Social Care Caroline Dinenage has been amongst those opposed to mandatory legislation, arguing installation should be at the discretion of individual care providers.
The official government line on the issue, moreover, stops short of sanctioning safety monitoring in
A spokesperson told CHP the Department of Health and Social Care (DHSC) remained primarily focused on preventing abuse from happening through a “tough inspection regime” and closing down poor quality homes.
The DHSC highlighted CQC guidance focused on the importance of privacy, dignity and consent issues when considering CCTV installation.
Recently appointed CQC Chief Inspector of Adult Social Care, Kate Terroni, has also come out against blanket adoption of the technology arguing it should be an “exception rather than a rule”.
The chief inspector highlighted the risk of breaching the individual’s rights to dignity, privacy and respect through CCTV adoption.
“What is key here is that those who are in charge of running care homes have enough staff who are suitably skilled, trained, supported and valued to do their job well and to always meet the needs of those who rely on good, safe care,” Kate said.
Care England CEO, Martin Green, told us: “CCTV can give assurance to families and residents but it should only be installed after a full consultation with residents and families.”
Martin said CCTV required a “significant capital investment”, adding there was a lack of consistency from the CQC on the issue.
The Care England chief said there was an urgent need for “clarity” from the CQC.
Nadra Ahmed, executive chairman of the National Care Association, added: “The overriding factor in all debates on surveillance has to be the preservation of the privacy and dignity of the people we care for whilst keeping them safe in their chosen environment.
“With that in mind we need to be responsible in our representations whichever path
“I do not believe that there is need for compulsion or dictates in this debate, we must be measured in the approach we take and a lot will depend not only on the quality of the staff and their training in the service but on their leaders – I believe there is no substitute for good leadership and management to deliver safe care to vulnerable citizens in our country.”
Jonathan Papworth, Co-Founder and Director of Person Centred Software, said CCTV cameras offered no “panacea” to ending abuse in care homes.
The tech director said sharing care information through online portals was a far more “inclusive” solution to increasing visibility and transparency, while also noting the “significant” expense of camera installation.
Jonathan argued mobile evidence of care systems offered more affordable and much better visibility of the care environment, while providing real time accountability.
He highlighted acoustic care monitoring as another alternative to CCTV that retained people’s dignity.
Judy Downey, Chair and CEO of The Relatives & Residents Association, also argued that CCTV was “no magic bullet” for the sector.