Using Telecare to Reduce Restrictive Practices While Maintaining Safety
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Telecare is often introduced to improve safety, yet without clear governance it can quietly increase restriction. Commissioners and inspectors increasingly expect providers to show how monitoring reduces, rather than replaces, human judgement. This article builds on learning from positive risk-taking and established safeguarding expectations within safeguarding in tenders.
Why Restrictive Practice Is a Digital Risk
Restrictive practice is not limited to physical restraint or locked doors. Excessive monitoring, constant alerts or blanket surveillance can restrict privacy, autonomy and dignity. Providers must recognise digital restriction as a real and reportable risk.
Inspectors increasingly explore whether technology is applied proportionately and reviewed with the same rigour as physical interventions.
Operational Example: Moving From Blanket Monitoring to Targeted Use
A supported living provider inherited a service where motion sensors were installed in every communal and private area. Alerts were triggered continuously, leading to unnecessary staff interventions and distress.
The provider completed individual reviews, removed sensors from low-risk areas and documented clear thresholds for response. Incidents reduced, staff confidence improved and residents reported feeling more trusted.
Governance Frameworks That Prevent Over-Monitoring
Strong providers apply governance controls to telecare use. These typically include documented rationales for monitoring, senior sign-off, and scheduled review points aligned with care planning cycles.
Without governance, telecare drifts from a support tool into a control mechanism.
Commissioner Expectations on Proportionality
Commissioners expect providers to demonstrate that telecare responds to assessed risk and is the least restrictive option available. This includes showing how alternatives were considered and why monitoring was chosen.
Contract monitoring often explores whether alerts prompt meaningful action or simply replicate staff observation through technology.
Safeguarding Implications of Over-Surveillance
Over-surveillance can mask safeguarding issues if staff rely on alerts rather than observation, conversation and professional curiosity. Providers must ensure telecare complements, not replaces, safeguarding practice.
Clear escalation pathways are essential when monitoring data indicates concern.
Operational Example: Reducing Night-Time Restriction
A provider replaced hourly night checks with sensor-triggered alerts for individuals with epilepsy. This reduced sleep disruption while maintaining rapid response capability. Care plans documented how autonomy improved alongside safety.
Recording Decisions and Reviewing Impact
Documentation should evidence why telecare is used, how it supports outcomes and when it will be reviewed. This includes recording discussions with individuals and families about privacy and consent.
Review records are often the deciding factor during inspection.
Key Takeaway for Providers
Telecare reduces restrictive practice only when its purpose, limits and review processes are explicit. Technology must follow values, not override them.
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