Digital Inclusion in Person-Centred Care: Avoiding New Forms of Exclusion

Digital enablement must not create new forms of exclusion for people who lack access, confidence, affordability, accessibility or digital literacy. Person-centred technology requires providers to consider how individuals experience digital tools in practice, not simply whether those tools have been introduced. Technology can support independence, but only when people can understand it, use it, trust it and access suitable alternatives where needed.

Within the wider Digital Transformation in Social Care Knowledge Hub, providers are increasingly recognising that successful digital transformation depends not only on technology adoption but also on ensuring people can access, understand and benefit from digital tools regardless of confidence, communication needs, disability, sensory needs or previous experience.

Addressing digital inclusion is therefore central to Person-Centred Technology and closely linked to Digital Inclusion, Assistive Technology and Accessible Information and Total Communication. Without this focus, technology risks reinforcing inequality rather than promoting independence.

Understanding Digital Inclusion in Adult Social Care

Digital inclusion means ensuring that people can access, understand and confidently use technology that supports their care, wellbeing, communication, safety and independence. It includes practical access to devices and connectivity, but it also extends to confidence, trust, affordability, accessibility, language, sensory needs, cognitive processing and support from staff or family members.

In adult social care, digital inclusion is not simply about whether someone owns a device. A person may have a tablet but be unable to use it without support. They may have internet access but not understand online forms. They may be able to use video calls but feel anxious about digital monitoring. They may benefit from reminders but struggle with complex app interfaces. They may prefer non-digital information even where digital records exist.

Strong providers recognise that digital inclusion is part of person-centred support. It asks: who may be excluded by this technology, what barriers exist, and what support or alternatives are needed?

Why Digital Exclusion Is Becoming a Social Care Risk

As adult social care becomes more digital, exclusion risk increases if providers do not plan carefully. Digital care planning, portals, online reviews, electronic communication, telecare, remote monitoring, assistive technology and AI-supported systems can all improve services. However, they can also leave some people behind.

Digital exclusion may lead to:

• reduced involvement in care planning
• weaker understanding of choices and risks
• lower access to information
• reduced confidence using support tools
• greater reliance on staff or family members
• missed opportunities for independence
• increased anxiety or refusal
• inequality between people who can and cannot use digital systems

This matters because digital transformation should improve access, not narrow it. If a provider introduces technology without addressing barriers, the people who could benefit most may be the least able to use it.

Different Types of Digital Exclusion

Digital exclusion is not one issue. Providers need to understand the different ways people can be excluded from technology-enabled support.

Access Barriers

Some people do not have reliable devices, connectivity, charging arrangements or private space to use technology. This is especially relevant where digital tools are used for communication, appointments, reminders or wellbeing support.

Affordability Barriers

Technology may create hidden costs. Data plans, device replacement, repairs, subscriptions, batteries or accessories may be unaffordable. Providers should not assume that people can fund digital participation privately.

Confidence Barriers

A person may have access but lack confidence. They may fear making mistakes, pressing the wrong button, being scammed, losing information or being judged for not understanding technology.

Cognitive and Communication Barriers

People with learning disabilities, dementia, autism, acquired brain injury or cognitive impairment may need information broken down, repeated, demonstrated or presented through accessible formats. A digital tool that looks simple to staff may still be confusing to the person.

Sensory and Physical Barriers

Some people may need voice control, screen readers, larger icons, visual contrast, tactile supports, simplified interfaces, alternative switches, hearing support or adapted devices. Physical disability, dexterity difficulties, visual impairment, hearing impairment or sensory sensitivity can all affect digital inclusion.

Trust and Privacy Barriers

Some people may be reluctant to use digital tools because they do not trust how information is stored or shared. Others may fear monitoring, surveillance or loss of control. These concerns should be taken seriously, not dismissed as resistance.

Digital Inclusion and Human Rights

Digital inclusion is closely connected to rights, choice and control. If technology becomes part of care delivery, people must have meaningful opportunities to understand it, consent to it, refuse it and influence how it is used.

Providers should consider:

• whether people understand the purpose of the technology
• whether accessible information has been provided
• whether consent is informed and reviewable
• whether non-digital alternatives are available
• whether the technology supports autonomy
• whether anyone is disadvantaged by digital-first processes

Technology should never become a barrier to participation. If reviews, feedback, complaints, care planning or family communication move online, providers must still ensure people can participate in ways that work for them.

Operational Example 1: Supporting Digital Confidence

A supported living provider introduced tablets to help people access video calls, activity planning, online forms and visual support resources. Initially, some people showed interest, while others avoided the devices or became anxious when asked to use them.

The provider recognised that digital access alone was not enough. Staff introduced structured digital confidence sessions based around each person’s goals rather than generic training.

The approach included:

• starting with familiar activities such as music, photographs or family video calls
• using short sessions rather than formal lessons
• allowing people to explore devices without pressure
• creating simple visual guides
• matching support pace to the person’s confidence
• celebrating small achievements
• reviewing whether technology reduced or increased anxiety

Over time, several people became more confident using tablets to communicate with family, choose activities and access information. The provider evidenced outcomes through feedback, staff observations, confidence reviews and increased participation in digital-supported activities.

Operational Example 2: Adapting Technology for Accessibility

A provider introduced assistive technology to support daily routines for people with mixed sensory and communication needs. Some people responded well to standard reminders, while others found the screens confusing or the audio prompts difficult to process.

The provider reviewed accessibility rather than assuming the technology had failed. Adjustments included:

• larger visual prompts
• simplified icons
• voice-activated options
• reduced screen clutter
• colour-coded routines
• symbol-supported instructions
• staff modelling of how to use the tool
• quiet spaces for digital learning

The outcome was improved usability and reduced frustration. The provider was able to show that technology was adapted around people’s needs rather than expecting people to adapt to the technology.

Operational Example 3: Providing Alternatives Where Needed

A homecare provider introduced a digital portal for care updates, visit notes and communication with families. While many families found this helpful, some people receiving care did not want their information accessed digitally, and some relatives lacked confidence using the system.

The provider retained meaningful alternatives, including:

• telephone updates where agreed
• printed summaries
• face-to-face review conversations
• accessible letters
• staff-supported explanations
• clear opt-out arrangements

This ensured digital transformation did not become digital exclusion. People were not disadvantaged because they preferred or required non-digital communication. The provider could evidence inclusive practice through communication preferences, consent records and feedback.

Operational Example 4: Supporting People With Learning Disabilities to Access Digital Services

A learning disability service wanted people to be more involved in online reviews and digital support planning. However, some people found standard digital forms inaccessible and struggled to understand online meeting formats.

The service adapted its approach by using:

• easy read explanations
• pre-meeting preparation sessions
• visual agendas
• shorter review sections
• support from familiar staff
• choice about camera use
• communication passports
• post-meeting accessible summaries

This helped people participate more meaningfully. The provider recognised that digital inclusion was not achieved by sending a link to an online meeting. It required preparation, accessible information and support to express views.

Operational Example 5: Digital Inclusion in Homecare

A domiciliary care provider introduced electronic medication prompts and digital visit records. Staff quickly adapted to the system, but some people receiving support felt unsure about what staff were recording on devices during visits.

The provider strengthened transparency by ensuring staff explained:

• what was being recorded
• why it was needed
• who could see the information
• how it supported safe care
• how people could ask questions

Managers also checked whether device use reduced conversation during visits. Where people felt staff were looking at screens too much, visit practice was adjusted so digital recording supported care rather than interfering with relationships.

Commissioner Expectations

Commissioners expect providers to demonstrate that digital transformation does not disadvantage certain groups. Evidence of inclusive practice strengthens commissioning confidence because it shows that technology is being used thoughtfully and equitably.

Commissioners may look for evidence that providers:

• identify digital inclusion barriers
• adapt technology around individual needs
• provide non-digital alternatives
• support people to build confidence
• involve families and advocates appropriately
• monitor outcomes and inequalities
• avoid digital-first approaches that exclude people

In tenders and contract monitoring, providers should be able to explain not only what technology they use, but how they prevent exclusion.

CQC and Regulatory Expectations

Regulators will assess whether providers recognise and respond to digital barriers, particularly where technology forms part of essential support. Digital inclusion links closely to person-centred care, accessible information, consent, dignity, equality and involvement.

Inspectors may explore:

• whether people understand digital tools used in their care
• how communication needs are supported
• whether people can refuse or choose alternatives
• whether technology affects dignity or relationships
• how providers monitor digital risks
• whether people are involved in digital decisions

Technology should strengthen involvement, not reduce it.

Governance and Quality Assurance

Providers should monitor digital inclusion through feedback, audits and reviews. This ensures technology remains accessible and supportive rather than exclusionary.

Strong governance may include:

• digital inclusion audits
• accessibility reviews
• feedback from people using services
• family and advocate feedback
• monitoring of who is not using digital tools
• review of non-digital alternatives
• staff supervision on digital barriers
• quality reporting on inclusion outcomes

Governance should ask who benefits from technology and who may be left behind.

Questions Providers Should Be Asking

• Who cannot access this digital tool?
• Who may struggle to understand it?
• Who needs adapted communication?
• Who may feel anxious or monitored?
• What alternatives are available?
• How do we know the person is benefiting?
• Are staff confident supporting digital inclusion?
• Are families or advocates involved appropriately?
• Does technology strengthen or weaken participation?

These questions help providers avoid assuming that digital innovation automatically improves care.

Impact on Outcomes

When digital inclusion is prioritised, people experience greater confidence, engagement and independence. Technology becomes easier to understand, more acceptable and more useful. People are more likely to participate in planning, communicate with others, access information and use tools that support daily life.

Outcomes may include:

• increased confidence using devices
• greater involvement in care planning
• improved communication with family or professionals
• better access to information
• reduced anxiety around digital tools
• increased independence
• stronger participation in reviews
• reduced exclusion from digital service models

These outcomes should be captured as part of quality and performance monitoring.

Common Pitfalls

• Assuming access to a device means digital inclusion has been achieved.
• Introducing digital tools without checking confidence or understanding.
• Failing to provide accessible information.
• Removing non-digital alternatives too quickly.
• Ignoring affordability, connectivity or device maintenance.
• Using complex systems with people who need simplified interfaces.
• Failing to involve families or advocates where appropriate.
• Not reviewing whether technology increases anxiety.
• Assuming staff are confident supporting digital inclusion.
• Measuring technology adoption without measuring impact on people.

What Good Looks Like

Good digital inclusion means people can access, understand and benefit from technology in ways that suit them. It means digital tools are adapted around individual needs, accessible information is available, staff support confidence-building and non-digital alternatives remain available where required.

Strong providers can evidence:

• barrier identification
• accessible communication
• adapted technology
• digital confidence support
• non-digital alternatives
• feedback and review
• equality and accessibility monitoring
• improved outcomes

Technology should widen opportunity, not narrow it.

Conclusion

Digital inclusion in person-centred care is not a technical extra. It is fundamental to fairness, choice, independence and participation. As adult social care becomes more digital, providers must ensure that people are not excluded because they lack confidence, access, affordability, communication support or accessible tools.

The strongest providers treat digital inclusion as part of care quality. They identify barriers, adapt systems, support confidence, offer alternatives and monitor outcomes. This ensures technology supports independence rather than reinforcing inequality.

Digital transformation is only truly person-centred when people can participate in it. If technology is to improve adult social care, it must be accessible, understandable, inclusive and shaped around the people it is intended to support.

---