Integrated Impact Assessments – Mobile Workforce Scheduling Tool and Smartphones

Mobile Workforce Scheduling Tool and Smartphones

Replacement of existing scheduling software for home-based care and reablement and introduction of smartphone devices for social care workers and assistants, community therapy assistants and homecare organisers.

This is primarily a workforce focused solution and engagement interviews and focus groups have been held within the SE and NW localities regarding the proposal.

The Fairer Scotland Duty

Yes, this is a significant new proposal for a substantial workforce.

30 March 2021 and 8 April 2021

Name Jot title Date of IIA training
Hazel Stewart
Programme Manager (Edinburgh Health and Social Care Partnership – Transformation) Value
Claire Bennett
(Evidence Template and Report Writer)
Project Manager (EHSCP – Transformation) 22/12/20
Derek Masson ICT Programme and Delivery Manager
Julie McNairn Homecare and Reablement Lead
Pauline Wilson South East Homecare Manager
Gail James South East Hub Manager
Siobhan Murtagh HR Consultant
Ian Mullen Branch Officer, Unison Health and Safety
Caroline Todd Programme Manager (care at home commissioning)
Sarah Bryson Planning and Commissioning Officer
Debbie Raychoudhury Black and Minority Ethnic Equality Workers Forum / Business Support Office North East Locality
Evidence Available – detail source Comments: what does the evidence tell you with regard to different groups who may be affected?
Data on populations in need Population information and data outlined in the current Joint Strategic Needs Assessment for Edinburgh (2015) indicates an increasingly ageing population and an increase of those with complex and long-term care needs within the adult population, notably those in the higher age groups who are considered more at risk from social isolation which can impact on health and wellbeing and the rise in conditions such as dementia. Population growth is predicted to be rapid to increase to 619,000 by 2037.

Edinburgh Population Profile: (current size 487,500 people)

Estimates of future numbers of older people are sourced from National Records of Scotland (NRS) population projections for local authority areas. Of particular interest in terms of anticipated needs for support is the population aged 85 years and over. The number of people aged over 85 is expected to double by 2032 to 19,294. Within 20 years the number of people living with dementia could rise by 61.7 % to 11,548 people.

  • Projections envisage a 28% growth in those aged 85+ between 2012 and 2022, a group that makes more intensive use of care services. The number of people aged 85+ is projected to more than double in Edinburgh by 2037 (110% increase from 10,100 to 21,300).
  • North West locality has the highest one-third (33.5%) of the very elderly population aged 85+.
  • The population of Edinburgh is projected to grow by almost 30% over the next 25 years. The number of older people over 75 living in the city is expected to grow by over 75% and the number of people requiring intensive levels of support, including those with complex physical and mental health needs, is expected to increase by 61% during the same period.
  • Social isolation and loneliness can have significant adverse effects on people’s health and well-being, and age and living alone increase the risk of social isolation and loneliness (evidence from Scottish Parliament’s Inquiry into Age and Isolation, 2015).
  • At any one time, around one in four people (over 120,000 people) in Edinburgh experience a mental health problem. Anxiety and depression are the most common mental health problems, but others include schizophrenia, personality disorders, eating disorders and dementia.
  • The Scottish Government report, the ‘Same as You’ indicated that 2% of the population have a learning disability with the vast majority being unknown to services. NHS Lothian Community Learning Disability teams within Edinburgh are in contact with 1,520 people. The City of Edinburgh Council knows of 3,405 people with learning disabilities in the city.
  • Edinburgh is estimated to have 30,735 adults aged 16-64 with moderate to severe disabilities.
  • Around 20% of Edinburgh’s population experience either hearing loss or significant sight loss. The majority of those with a sensory impairment have hearing loss.
  • There are estimated to be 65,084 carers in Edinburgh, or 13.7% of the population. One in five of these carers provides over 50 hours of care a week. Carers can, for example, prevent avoidable hospital admissions and contribute to people’s overall health and wellbeing. Therefore, as well as there being a strong case for supporting carers based on human rights and quality of care, there is also a compelling economic case. By providing appropriate and timely support to carers resources are saved in the long term.
    • More flexible short breaks tailored to individual needs and more breaks for carers from their caring role.

The results from the National Censuses between 1971 and 2011 tell us that:

  • In 2011, 7.8% of Edinburgh’s population was “White other” (non-British or Irish) – the fifth highest proportion in the UK
  • At 2011, among non-White ethnic groups, Chinese was the most common (around 8,000 people), followed by Indian (just under 6,500), Pakistani (just under 6,000) with other Asian and Black African both having around 4,500
  • Censuses since 1971 show an increasing proportion of single person households (from 23% to 39%)

The size of the LGBT community in Edinburgh is not known but estimated to be at least 5% to 7% of the population.

Support services for those with particular needs:

  • ‘Adequate care and support, and making better use of modern technology, can help people to remain independent at home or in a homely setting in the community and reduce the need for high cost formal care and unplanned hospital admissions.


  • The health sector is a major source of labour demand and accounts for 45,700 jobs or 15% of total employment In Edinburgh. The sector is expected to grow by 13,000 in Edinburgh, Fife and Lothian regions from 2012 to 2022. This is a higher rate of growth than any other sector. Skill shortages and hard to fill vacancies are persisting and growing within the health sector. This presents a number of challenges in this growing and sizable area of employment in Edinburgh.

Empowering the workforce and streamlining the day to day could help with staff retention and autonomy in their roles.

Data on service uptake/access • EIJB Strategic Plan 2019-2022
• Internal Service Reports
EIJB Strategic Plan:

Increased need for homecare, reablement or outreach services:

  • Advances in health care and standards of living means more of us are living longer
  • More of us are living with frailty and multi-morbidity, placing more pressure on carers and the traditional approach to publicly funded health and social care services.
  • In addition, society and government are becoming increasingly aware and taking account of the effect of mental illness, living with disabilities and a range of long-term conditions.
  • As overall demand increases, the supply and related costs of health and social care come under increasing pressure.
  • Within cities this is further heightened by the gradual effect of urbanisation and a rise in inequality.
  • Audit Scotland: recent report reviewed the changes being introduced through the integration of health and social care. The report sets out the challenge of increasing demand for services and growth over the next 15 years in Scotland. Among the pressures identified were:
  1. 12% increase expected in GP consultations
  2. 33% increase in the number of people needing homecare
  3. 31% increase in those requiring ‘intensive’ homecare (defined as 10 + hrs pw.)
  4. 35% increase in demand for long-stay care home places
  5. 28% increase in acute emergency bed days and
  6. 16% increase in acute emergency admissions.

Service information:

  • Combined care at home (externally commissioned) and homebased care (internally supported) deliver over. 5 million hours of care and support every year
  • Externally commissioned care and support is delivered to 4,443 people on average a week (108,000 hrs pw) by 90+ care providers of varying sizes and scale across the city through spot contracts and individual service funds (ISF).
  • Internal services unsustainable in current form deliver a higher amount of long-term care support than reablement. We support on average 900 people a week (7000 hrs pw). The breakdown of this support is;
    • Average of 800 hours pw supporting adults (under 65)
    • 6000+ hrs pw support older people (over 65)
  • Unmet need currently indicates on average of 500 people at any one time currently waiting for support to remain independent in their own homes (acknowledging data quality issues with time lapse since initial referral). Maximising capacity in our workforce could help to support more individuals in need.
Data on socio-economic disadvantage e.g. low income, low wealth, material deprivation, area deprivation JSNA:

  • Mental ill health is not evenly distributed across society and is more common in socio-economically deprived areas.
  • Being old is also a risk factor for poor mental health with depression affecting one in five older people living in the community and two in five living in care homes.
  • Dementia is far more prevalent in people over 60 with the incidence increasing further with age.
  • Research shows that people living in areas with higher levels of deprivation also have poorer physical and mental health throughout their lives. However, health inequalities are not restricted to areas of multiple deprivation – up to 50% of people experiencing poor health do not live in the most deprived communities.
  • Social isolation and loneliness which are associated with higher mortality rates among older people – we know that the number of single households in Edinburgh is increasing, and that a substantial proportion (around 38%) of older people live alone.
  • The Christie Commission highlighted that the greatest challenge facing public services is to combat the negative outcomes for individuals and communities arising from deep-rooted inequalities
  • EHSCP will embrace the Three Conversations approach as a combined cultural reorientation and delivery philosophy, which will produce a deeper understanding of how to support communities. This approach is particularly important in areas of multiple economic disadvantage, where individuals and families can experience multiple needs being met with well intentioned, but uncoordinated public services.

We need our workforce to have the tools to enable them to communicate and effectively engage in the 3 conversations approach to supporting individuals and delivering quality of care in their own homes and to signpost to wider activity and support in their community.

Data on equality outcomes • EHSCP Edinburgh ‘Offer’ Pact Consultation 2019
• EHSCP IIA Strategic Plan 2019-22
• BME Equality Workers Forum Statement
Edinburgh Offer Pact Consultation raised themes for the citizens of Edinburgh around:

  • Making information accessible
  • Equality /SIMD
  • Aware of those who do not have a voice
  • Fairness
  • Meaningful consultation (allowing time to respond)

We would like to explore solutions for data to be shared with individuals and carers and to move toward the longer-term goal of paperless care plans and having immediate interactions with those we support, to ensure needs are met in a responsive and timely way and can change as per need.

EHSCP IIA Strategic Plan 2019-22:

There is considerable data available on health inequalities showing significant inequalities throughout all parts of Edinburgh as well as inequalities for some nongeographic groups.

  • In Edinburgh, by 2041, compared with 2016, there will be 32% more people aged 65 and older and 78% more people aged 75 years and over. The implication of this for health and social care is significant because as people age, they are more likely to need the support of statutory services.
  • The EHSCP knows of 25,510 people with a physical disability, of which 1,540 are in receipt of services from the Partnership. This population is estimated to rise annually by 1.4%.
  • It also knows of 8,684 people with a learning disability and supports 1,335. The national population of adults with a learning disability is predicted to increase by 2% each year.  People with learning difficulties often have poorer health outcomes compared to the general population and are at risk of dying from causes that are preventable.
  • In 2010/2011, there were twice as many GP consultations for anxiety in areas of deprivation than in more affluent areas in Scotland. People with mental health problems are more likely to have serious debt problems, increased social isolation, poor physical health and live in areas of deprivation.
  • The Scottish Household Survey (2011) estimates there are 65,084 carers living in Edinburgh, this equates to 13.7% of the population. Those who provide 50+ hours per week, amount to 13,761 people.

Mobile devices would enable social care workers to be able to apply the three conversations good practice approach to check information online for individuals and to support improved communication through use of mobile apps where English is not first language. From the people we support around 2% are from black, minority ethnic backgrounds. Workers will have the ability to research culturally specific support requirements or to make identify and share community resource information through signposting.

Taken from a statement provided by the BME Equality Workers Forum regarding equality issues within the workforce:

According to the records gathered by SSSC (2019), in the City of Edinburgh Council local authority, within the public sector care at home and housing support services, 79% of staff are female and at least 60% of staff are over 45 years old. Unfortunately, SSSC has not yet gathered ethnic origin data. However, according to the data held by Scottish Government gathered through Annual Population Survey (2018), the majority of workers from ethnic minority backgrounds are employed in health, public admin and education sector (inclusive of social care) with 43% of Black workers holding employment in this sector. Other estimates of Scottish workforce within health and social care suggest 20% of social care workforce to be from European Union.

These figures indicate that a large proportion of home care staff are people from ethnic minority backgrounds, largely female and older than the general working population. The council is not able to verify this data, as again the newly implemented campaign to gather equality data relies on employees’ access to the MyHr System. The lack of access to the systems of the employees characterized as above who are in one of the lowest paid jobs within Edinburgh Heath and Social Care Partnership, contributes to the digital inequality experienced elsewhere in their lives, again exacerbated by the Covid-19 pandemic. The digital inequality is associated with socioeconomic status, age and disability (UK Parliament Data, 2021). The current conditions of their work within Health and Social care partnership through lack of digital tools is evident in this context.   As stated in Carnegie report on Social Justice and Digital Access (Whyte, 2016), the digital means can be ‘a driver to greater socioeconomic equality but just as surely can be a great barrier to such equality too’.

Research/literature evidence Scottish Government – National Health and Social Care Integrated Workforce Workforce:

Priorities within the Digital Health and Care Strategy outlines that:

  • technology has the potential to have a positive impact on workforce demand, but we need our workforce to have the necessary digital skills to take advantage of these opportunities. Workforce development is an important part of the Digital Health and Care Strategy and focusses on four key areas of skill development:
  • Digital Leadership: The skills required by all staff at all levels to champion digital as an enabler in transforming health and care;
  • Workforce Skills: The digital skills required by the general workforce to effectively deliver services to meet patients’ and service users’ expectations;
  • Workforce Skills (specialist): The skills and development of those in specialist digital roles (ICT staff) to deliver digital solutions in health and care;
  • Future Workforce: The skills that will be required and shaped by our ongoing transformation of services, in line with patient and service user demand.
  • identifying solutions that bring the most modern of technologies to our business and administrative requirements, freeing up staff to focus on frontline services
  • providing productivity and collaboration services and tools, such as shared calendars, email, video and instant messaging, to support effective, efficient and secure ways for working across organisational boundaries.

Efficient Use of the Workforce

  • Alongside growth and retention, we need to make more efficient use of existing resources. This will involve a range of approaches, including improvements in rostering.

We understand from our frontline workers that in order to pick up information for their working day ahead, they often must communicate on their days off or for those who use their personal devices they have not separation for work life balance.

Having adequate access to information on the day of their work will support workers to be off on their 4 days downtime and not have to be available to take a call each Friday for their next week’s rota or at other points when Rota’s change both on days off or on shift breaks in the middle of the day.

Public/patient/client experience information • EHSCP Satisfaction Consultation Feedback March 2021 (live).
• Feedback example from family to locality team – on importance of access to information
• Edinburgh Pact consultation 2019
EHSCP Satisfaction Consultation Feedback early findings indicate areas of support individuals and carers value the most for the care and support they receive through external care providers – 65 respondents so far.

  • Preference for fixed timing and visit length over flexibility but need to accommodate both options –
    • at the same time and for the same length each time? 42 (64.62%)
    • at different times so it can change when you need it to? 23 (35.38%)
  • Consistency of carers supporting – 16.92%
  • Good communication with provider – 6.15%
  • Social isolation – 6.15%
  • Gender preferences of carers supporting – 4.62%

The dynamic scheduling will enable us to set constraints and preferences for individuals and their carers around their specific needs and provide more tailored and flexible quality of care and support. Greater access to information on the move will equip social care workers with the information they need and greater confidence to best support the individual.

Family testimonial regarding how they currently value technology for their parents care and support, delivered by their care providers;

…’my care provider invited me to join, so I could read the carers report and also see the bookings for the week ahead. Having access to their system allows me to see what time they arrived and what they did. It’s really useful as I can also leave feedback on their report that is then emailed to them. I’ve had a phone call fairly quickly after I questioned the time spent on site by one of the carers which they then clarified to me. I do check it every day, as I can see from everyone’s notes how my parents have been’.

Edinburgh ‘Offer’ Pact Consultation 2019:

Themes of feedback relevant to this proposal include:

  • ‘Culture’ key. Requires focus and energy.  Require to empower staff.  Build infrastructure. Value and develop workforce.
  • Supporting carers and families
  • Skilled and equipped workforce to implement community-based support
  • Building networks/support and relationships in the local community
Evidence of inclusive engagement of people who use the service and involvement findings • Independent Review of Adult Social Care (2021) Independent Review Adult Social Care in Scotland

  • Culture shift values human rights, lived experience, co-production, mutuality and common good
  • Shift attitude towards technology and data sharing to improve people’s experience of social care to help them live independently
  • Focus on improving performance through greater transparency, innovation and use of digital technology
  • Implementation of the Fair Work principles to improve workers’ working conditions; peer support and supervision; and a more consistent approach to providing high quality training for staff
  • Greater integration at a local level driven by better partnerships, collaboration and local delivery
  • People must be able to access support at the point they feel they need it
  • Move away from time and task and defined services to commissioning based on quality and purpose of care – focused upon supporting people to achieve their outcomes, to have a good life and reach their potential, including taking part in civic life as they themselves determine
  • Evidence of unmet need
  • Internal Service Reports Data
  • Internal Engagement with Workforce Focus Groups and Interviews
  • Independent Review of Adult Social Care (IRASC)
Internal Service Reports

Evidence of unmet need and capacity

  • Around 500 people at any one time waiting in the community for support equating to approximately 4000-5000 unmet need hours across the city
  • Actual support ‘contact time’ when a social care worker or assistant is delivering support, is averaging at 40% with the remaining time admin or travel. This is the makeup of a normal day, not including other ad hoc admin or training time.

Increased route optimisation, reduction in paper-based admin and maximising on the capacity potential in real time as needs change, will enable us to meet the needs of more people needing support to live independently in their own home.


As the older population has increased and resources have been focused increasingly on those in greatest need, a smaller proportion of the adult population is in receipt of social care support than was before austerity, with the result that the needs of a number of people are probably not being met and for others they are being met in a crisis response rather than to anticipate or avoid such interventions.

Good practice guidelines • Independent Review Adult Social Care
• Health and Social Care Standards (2018)
• Health and Social Care Integration (2016)
• Guidance framework on the national health and wellbeing outcomes and indicator measures (February and April 2015)
• Digital health and social care strategy (2018)
• Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 9 – Person Centred Care
• The Digital and Smart City Strategy (CEC)

Examples of the kind of improvements that people are trying to make include:

  • Reducing use of institutional/residential care – increased opportunity for support at home
  • Making better use of adaptations and technology
  • Involving people and their families more in decisions
  • Including wider community supports in care
  • Professionals working together better across traditional boundaries of health, social care support and other services such as housing.

There is wider relevance potentially for the dynamic scheduling tool within district nursing, hospital at home and a potentially for visibility of scheduling across groups and to support teams to reduce their inefficiencies, collate more real time data and spot opportunities for joint supportive working.

  • Fair Work principles to improve workers’ working conditions; peer support and supervision; and a more consistent approach to providing high quality training for staff

Adequate smartphones and e-mail access will enable social care workers and assistants to have access to the information they need for online training and development and for equality of access for internal opportunities. It is also necessary for lone working to improve working conditions.

Health and Social Care Integration and Standards

As part of the integration of health and social care we have a requirement and duty of care to work with our local communities and providers of care to ensure care is responsive to people’s needs and that we follow the guidance for the national health and wellbeing outcomes to ensure;

  • people who use health and social care services have positive experiences of those services, and have their dignity respected
  • people, including those with disabilities or long-term conditions, or who are frail, can live, as far as reasonably practicable, independently and at home or in a homely setting in their community.

In addition, the health and social care standards, considered by the Care Inspectorate, Healthcare Improvement Scotland and other scrutiny bodies in relation to regulation and inspection of health and social care services, cover the following areas that are directly relevant to our consultation and outline the standard of care a person can expect;

  1. I experience high quality care and support that is right for me.
  2. I am fully involved in all decisions about my care and support.
  3. I have confidence in the people who support and care for me.
  4. I have confidence in the organisation providing my care and support.

Enabling our workforce with the tools to better communicate and have access to preference and important information pertaining to the individuals they care will enable us to provide greater quality of care and support.

EIJB Strategic Plan identifies the vision:

Where do we want to be?

  • A sustainable, well performing and trusted health and social care system
  • A clearly understood and supported Edinburgh health and social care Offer, which is fair, proportionate and consistent
  • A person-centred, patient first and Home First approach
  • A motivated, skilled and representative workforce
  • An optimised partnership with the voluntary and independent sectors care supported by the latest technology
  • A culture of continuous improvement and innovation

How are we going to get there?

  • Roll out the Three Conversations approach across the city over time
  • Work towards shifting the balance of care from acute services to the community through Home First supported by our transformation programme
  • Generate a unity of purpose and build momentum
  • Technology – identification of emerging and proven solutionsimplementing commercial off the shelf and spend to save initiatives
  • Learn from others; across Scotland, the wider UK and internationally

The Digital and Smart City Strategy sets out the City of Edinburgh Council’s approach to the sustainable development and delivery of technology to support the Council and enable Edinburgh to become a Smart City, covering the period 2020- 2023.

  • This Strategy describes how we will embrace innovative technical solutions to meet rapidly evolving and changing business needs, respond to the changing shape of the organisation, provide value for money and enable us to respond to opportunities and demands for joint working with our partners.
  • The principles within this Strategy provide a framework for how our future technology services will be designed, sourced and delivered enabling us to support new, safe and secure collaborative ways of working.
  • The Strategy will support the Council in the delivery of the Council’s Business Plan and the commitments within this and adopts the principles of the Edinburgh 2050 City Vision.

Key principles of the strategy relevant to this validation piece and full business case to build in technology into the heart of home-based care and support services:

  • Re-use, Before Buy, Before Build – We will leverage existing capability where appropriate, seeking to simplify the ICT estate.
  • Focus on citizen and customer centric requirements first;
    • Person centred approach and outcomes for people at the heart – preferences and needs information access, fewer missed care visits, consistency of care.
Carbon emissions generated/reduced data • City Vision 2050 consultation – Policy and Sustainability Committee agreed a ‘Short Window Improvement Plan’ (SWIP) in October 2019.
  • City vision is to be net zero on carbon emissions by 2030. More sustainable routes for our outreach mobile workforce could help to impact on reducing carbon emissions from the 32% of our workforce who are registered car users for delivery of homecare services.
  • The SWIP plan looked across the work of the Council and identified a set of actions which the Council could initiate within a short timeframe, in order to immediately improve the organisation’s approach to sustainability.
    • High Impact Action: (T4) ‘Expand and accelerate measures to reduce pollution and improve air quality’. Increasing optimisation of routes within the 32% of our social care workers who are drivers could impact on emissions and air quality, respecting ‘low emission zones’ and better monitor footprint from our service.
    • Moving toward ‘car free’ society and reducing ‘single car occupancy use’.

We know from staff that they visit the office at least once a week to drop off paperwork for filing, to submit expenses forms and to pick up resources. Having greater access to information digitally would help to reduce the amount of travel that frontline workers must undertake and reducing the environmental impact.

Environmental data • City Vision 2050 consultation – Policy and Sustainability Committee agreed a ‘Short Window Improvement Plan’ (SWIP) in October 2019. Paperless Strategy working group

O30. Deliver an accelerated reduction in the use of paper and scope the sustainability impacts of further shifts towards paperless working

  • The Council has set up a Paperless Strategy Working Group, which is supporting services to reduce print volumes and accelerate the shift to paperless working, for example through increasing the use of digital alternative to physical posting.

With staff currently not on e-mail, information is relayed over the phone, through texts, postal and photocopying activities unless the individual has agreed to use their personal e-mail address. This is costly, time consuming and often information errors occur in the relay and confirmation of receipt. HR related requests for annual leave, mileage expenses and overtime claims are all currently paper based. Staff only receive organisational information if these are printed and posted out to the worker and training materials are all hosted on The Orb. Policies and procedures need to be printed and posted and are often large documents which could be e-mailed more effectively with a read receipt confirmation requested.

In addition, care plans are paper based and printed at cost, care plan printing with 4,500 service users across the city at any one time constitutes a significant environmental impact and cost. In the long term it is envisaged that this could be digitised with individual and carer access to online records and real time updates. This also reduces the potential for information loss or human error in relaying information.

Risk from cumulative impacts • Engagement with workforce focus groups and interviews for this business case
• Information gathering integration and sustainability sessions
Feedback on interviewing frontline workers delivering social care in homebased care highlighted the accumulative impact of not investing in support to our workforce. Systems have not been upgraded or invested in over several years and the scheduling system is currently moving into ‘extended support’.

  • an overarching sense of feeling devalued and unsupported
  • disengaged with the possibility that better ways of working are possible
  • inequality with their allied health professional peers who have now all received devices and are exploring technology in support of their work – examples such as Near Me which could be explored within social care
  • performance is measured on things they cannot influence
  • ‘we have requirements from Care Inspectorate to fulfil – some things not within gift – i.e. mobile technology and the use of’
  • Comparison made to agency staff – ‘they are so far ahead in terms of tech’ – their workers have phones with apps installed – we are paper based
  • Currently achieving grade 4/5 with the Care Inspectorate with no tech (and existing systems/ processes) – Agencies score less and have the tech – imagine the score if we had the technology
  • Existing performance is based on contact time
  • There is a clear appetite to use digital, but a limit to what they can do with what we have (even for patient care)
  • Mindful that the workforce is ageing too (has an impact)
  • Many staff don’t have emails (that’s not equitable when organisational wide messaging goes out)
  • HCR have basic Nokia’s often with poor reception/battery life
  • Text Essendex costs £1000 p month. No CEC email address/ no smart phone.  Have to use own computers at home to receive information
  • A huge amount of communications but homebased care staff don’t get them – they get texts and phone calls – not a great experience – message gets relayed differently and information is fragmented.
Other (please specify) Edinburgh Joint Strategic Needs Assessment (JSNA)
• Independent Adult Social Care Review (IASCR) 2021
Skills for Care – Supporting staff that regularly work alone 


  • The workforce: the health sector is a major source of labour demand and the sector is expected to grow faster than any other sector. However, there are skill shortages and unfilled vacancies, even at present.
  • Testimonials from staff regarding the need to have the necessary tools to do their job as social care workers and assistants who are in most cases lone working.


  • ‘foundation that needs nurturing and strengthening is the social care workforce. For us to achieve the improvements we seek, they need to feel engaged, valued and rewarded for the vitally important work that they do’.

Skills for Care:

  • Caseload management tools that help to match people to the workers with the right skills, knowledge and similar interests
  • Include time for travel, handovers and record keeping
  • Accessibility and location of where people live
  • Sharing rotas early – provide workers with easy ways to access the rota and keep up to date with any changes
  • Develop a contingency plan to maintain safe staffing levels, for example:
    • work with other local services whose workers could cover shifts
    • have a team of bank lone workers
    • use agency staff to cover emergencies

“We have a rota app – it works well – if the rota is updated, I get a notification.”

“The app (that the agency utilised) used geo-tagging which enabled the service to monitor that the care worker had arrived safely at the property and their time of arrival. The application monitored when the care worker left and enabled the service to monitor the time that had been spent with the person.”

CQC inspection report, homecare agency rated ‘outstanding’ for ‘safe’

In the research, lone workers said that there were some key challenges or risks in relation to their personal safety, including:

  • travelling to different locations alone, especially at night
  • poor mobile phone signals in some areas, meaning that lone workers may be unable to contact managers or colleagues in the event of an emergency or when they need prompt advice or assistance
  • not having colleagues on hand to assist should they be exposed to unexpected or unpredictable behaviour or situations.

Supporting personal safety tips:

  • issuing mobile phones including, where required, a function that provides access to specialist support in case of an emergency
  • having a process and system for lone workers to regularly clock in and out, for example, of each home or service visit – this could be, for example, via an app
  • using GPS tracking devices so employers know the location of lone workers
  • offering a help/advice line for lone workers during working hours, including out of hours

Staff have reported that our existing handsets have poor battery, often experience poor signal and cannot link to their car for handsfree/navigation – some workers are using their personal phones.

Additional evidence required Health and Safety Executive (HSE) “It is the employer’s duty to take every reasonable precaution to ensure the safety of lone workers and to carefully consider and deal with any health and safety risks for people working alone.”

Equality, Health and Wellbeing and Human Rights


Individuals and carers receiving care and support

  • Care plans could be impacted and digitised in the long term with access for individuals and carers, but not through this solution
  • Greater opportunity for wellbeing activity engagement with local community and activity for health and wellbeing, diet nutrition and exercises from three conversations approach
  • Carers sharing with staff teams’ apps that support different conditions and impairments
  • Translation apps available to support those who don’t speak English as their first language
  • Background and preferences note, and key safety information shared more efficiently with social care worker to enable the best quality of support possible and ensure safe provision
  • Greater opportunity for technology enabled care solutions with a well-equipped workforce able to showcase opportunity
  • Ease of handover, progress notes visible to allocated partner care workers.


  • Improved information share methods and accuracy, enabling real time updates and communication on the move and to hand
  • Improved health and safety support for lone workers through
    • wider software potential enabled by the smartphones including SHE health and safety app (Assure)
    • Near Field Communication (NFC) tag use to give actual real time data on safe arrival at the visit
  • Remove inequality and equity of access that exists within team including:
    • equipping the workforce with the tools required to do the job in comparison to AHP colleagues already equipped with devices. Ability to act on a three conversations approach with technology as the enabler
    • material deprivation who do not have a device of their own for work or personal use or ability to support these needs
    • learning and development opportunities such as SVQ which could be managed through Teams/Zoom
    • e-mail and log in for online resources having an e-mail ensures visibility of individuals and ability to access hot desk resources. Ability to ensure secure transit and evidence read receipt of information shared
  • Empowering and connecting staff to the organisation to ensure they are valued, with equal access for information, employment opportunities (secondment/internal only), news, wellbeing information and support, learning and development, the Intranet (TheOrb – MyHR, MyICT) and benefits, forums and workplace peer support groups.
  • Ensuring work life balance for workers


  • Increase ability for managers to support their teams through annual conversations, virtual team meetings and in the event of an emergency
  • Ability to evidence support delivered and circumstances should complaints or concerns be received.


  • Accessibility of the solution:
    • Dyslexia friendly – check accessibility of solution
    • Accessible for those with learning disability
    • Accessible for those with hearing impairments
  • Staff will need to charge the devices overnight – no difference to existing set up as having to charge Nokia or Alcatel handsets

Affected populations

  • Homecare and Reablement Workforce
  • Individuals, carers and families receiving care and support

Environment and Sustainability


  • Reducing paper-based practices and where possible remove need for paper-based and time-consuming activity
  • Reduce need to travel into the office for training purposes if some activity can be done through handheld device (may not be practical and may require laptop for this activity)
  • Reduce widespread travel through optimised and safe routes make best time efficiency and visibility of teams
  • Reduce need for archiving and storage, if a more digital approach was adopted then less paper use and storage would be needed
  • Could explore the potential of using CEC vehicles to further reduce emissions – fleet of electric cars with charge points being introduced. 233 out of 725 social care workers are car drivers – 32%.
  • Optimised and local routes support toward 2030 carbon neutral target
  • Noise pollution currently in locality offices, using telephone calls to transfer information (better ability to share information and tech quality will reduce noise pollution)
  • Security and data protection risk due to the use of paper at the moment
  • Support for lone workers in an emergency
    • Does the device link to emergency services / or co-ordinators quicker?
    • Tracking ability and recording (visual and audio) is enabled
    • NFC tags are being scoped– enabling clocking in and out of visits and real time support – flag if a worker has not arrived at a property to trigger a follow up call
    • Mobilise App enables visit status tracking – accept visit, arrived, left
    • Phones will have better reception and better access to 4G.
  • Fire risks
    • Due to less printing be needed as a result of information share through the application and e-mail, expect to reduce amount of paper storage in office required for archiving, reducing overall fire risk
    • Noted: Reduction in fire wardens and co-ordinators across sites (no replacements have been put in place following office and resource moves) and lack of training underway. Fire drills are not completed regularly.
  • Recording and reporting incidents (RIDDOR) – health and safety have explored potential for SHE app to support real time reporting of incidents to the SHE portal
  • Sustainable travel
    • Majority of our social care workers are walkers
    • Routes will be able to be planned better to ensure efficiency
    • Route optimisation could encourage staff to walk / cycle routes in place of car due to more efficient planning
  • Referring to related support
    • Housing quality / substandard houses / environments
      • Possibility to share across housing who already use this application within CEC – cross over of individuals we support
      • Possible to enable quicker reporting of issues and ensure that action is taken
      • Dirty house cleans are identified on hospital admission, but could this be done proactively to avoid unnecessary admissions


  • 711 basic handsets in use at the moment that will need disposal including sims and circuit boards
  • Increased carbon footprint through use of smartphones – need a comparison against existing (marginal at best and may be more efficient in their power use)
  • Increased equipment requiring sanitation on devices

Affected populations



  • Time efficiency across business support team currently managing time consuming and paper-based processes for expenses claims for social care workers and assistants
  • Ability to access internet and services for immediate referral and signposting. This would speed up the access process, supporting the 3 conversations approach
  • Create additional capacity within the service and business support through effective management enabling more individuals to access support and care
  • Potential to sign post to local business and external organisations that can offer support
  • Could link to external providers and provide greater visibility across support services, possibility to data share more effectively across care provider organisations, currently done through SharePoint
  • Improved working conditions by offering the correct tools to do the job; connects staff to the wider organisation; greater awareness of job opportunities across the organisation; enables staff to undertake online training via device; raises awareness of training opportunities; staff will be more informed.
  • Equitable by providing staff with the tools to do their job;
    • MS Teams, has the ability to enable subtitles so that the meeting is accessible to all staff (visual and hearing impairments);
    • MS Teams has the ability to dial in through phone line (visual impairments)
    • Digital device could assist workers who have accessibility needs
    • Reduces inequality across the organisation
    • Enables collaboration between home care teams and reduces isolation.


Affected populations

  • Workforce
  • Individuals receiving care and support services
  • External Care Providers
  • Community Organisations

The implementation of the new software will be partly carried out by contractors, both of whom have an existing relationship with the City of Edinburgh Council.


Respect and corporate social responsibility are two of CGI’s core values. Thus, we continue to be committed to unyielding integrity and high standards of business conduct in everything we do. Incidentally, CGI’s ethical commitments align with the United Nations (UN) Global Compact’s 10 principles as described below.

CSR: Corporate social responsibility | CGI UK and CGI’s CSR policy |

Equality: Diversity and inclusion | CGI UK

Total Mobile

“The Totalmobile application is a native client application that makes use of libraries and functions available on each supported platform this has enabled the majority of the accessibility features on the platforms (IOS, Android and Windows). The specifics of these can be supplied on request.

Accessibility will always be a consideration when developing new functionality for existing and new products. A number of our development, testing and product teams have accessibility needs and form part of our input process through the development lifecycle. As an example, vision support for zooming and display accommodations, guided learning access, speech, text and interactions such as assistive touch, keyboard and call auto routing. We evaluate using automated tooling like SiteImprove. The SiteImprove tool scans the website and measures against the WCAG standards and where appropriate we make changes.”

Anti-Slavery brief statement from full policy shared:

“It is Totalmobile’s policy to conduct all its business in an honest, transparent and ethical manner. We take a zero-tolerance approach to modern slavery and human trafficking within Totalmobile and its supply chains and are committed to acting professionally, fairly and with integrity in all our business dealings and relationships wherever we operate”.


“We are committed to understanding, monitoring and managing our social, environmental and economic impact to enable us to contribute to society’s wider goal of sustainable development. This commitment is deeply ingrained in our core values and we aim to demonstrate these responsibilities through our actions and within our corporate policies.”


Our company will:

  • Respect the law
  • Honour its internal policies
  • Ensure that all its business operations are legitimate
  • Keep every partnership and collaboration open and transparent Business ethics We’ll always conduct business with integrity and respect to human rights.
  • We’ll promote: Safety and fair dealing, Respect toward the consumer, Anti-bribery and anti-corruption practices
  • Donations and aid Our company may preserve a budget to make monetary donations.
  • Supporting the community Our company may initiate and support community investment and educational programs.

Totalmobile are an equal opportunities employer. This means that we will make good faith efforts to comply with the spirit and letter of the equality laws.

*Attached full policies:

  • Anti-Slavery and Human Traffic Policy
  • Corporate Social Responsibility Policy
  • Equal Opportunities Policy

If yes, it is likely that a Strategic Environmental Assessment (SEA) will be required and the impacts identified in the IIA should be included in this.

No. Does not meet criteria for SEA.

If further evidence is required, please note how it will be gathered. If appropriate, mark this report as interim and submit updated final report once further evidence has been gathered.

  • Carbon footprint of smartphones offset by reduction in vehicle use with greater optimised and local routes
Specific actions (as a result of the IIA which may include financial implications, mitigating actions and risks of cumulative impacts) Who will take them forward (name and job title) Deadline for progressing Review date
Information requested and gathered from proposed contractor’s: CGI/TM on accessibility, equality, human rights including children’s rights, environmental and sustainability issues and how they will be addressed. Claire Bennett, Project Manager 2/04/21 Complete N/A
The accessibility of devices and new system for those with dyslexia, learning disabilities and hearing impairments will be checked Claire Bennett, Project Manager 2/04/21 N/A
Measures will be put in place to ensure that paper is stored safely before archiving, this change should reduce amount of storage required Deborah Mackle (South West Locality Manager, SRO Homebased Care) 26/04/21 31/05/21 – follow up
Measures will be taken to ensure that sufficient fire wardens and co-ordinators across sites are in place and training and fire drills are completed regularly Deborah Mackle (South West Locality Manager, SRO Homebased Care) 26/04/21 31/05/21 – follow up
Options for recycling basic handsets which are currently in use will be investigated Claire Bennett, Project Manager 26/04/21 enquiry If successful in our bid for smartphones. June end.
  • 711 existing basic handsets require recycling – look to recycle.
  • Potential environmental impact from manufacturing of smartphones.
  • Implementation team will have homecare and reablement representation to ensure the needs of workers and those with protected characteristics are supported in the business change.

D Mackle

Name: Deborah Mackle, Locality Manager, South West Edinburgh (EHSCP)

Date: 11/05/2021