Understanding infrastructure needs for social care

Our research with those living with life-limiting conditions highlighted the need for people to be able to look after their wellbeing, and we explored the role technology plays in keeping people connected. But we found internet infrastructure is poor and this not only impacts on those living with life-limiting conditions but on innovators developing solutions that could help.

What is the impact of being connected?

A number of studies have looked into this area.

In 2010, the Social Care Institute for Excellence (SCIE) commissioned a study into the impact of the Get Connected Investment Project which provided IT services to care homes. It noted:

Residents reported being able to look at websites to do with their interests and hobbies, use internet shopping sites and communicate with family members, often overseas. Some had already noted beneficial impact on their carer’s ability to help manage their condition. Users of domiciliary care services found that they now had improved access to carers and services as well as being able to use the technology to find advice and support groups.

Staff also reported benefits, including access to online training modules, ability to research conditions and drugs, access to nutritional information and better organisation.

There were also indications that families became more engaged, for example using Skype to become more involved in their loved ones’ daily lives and they felt more at ease with their relatives’ care as they had regular, visible, communication and information.

Separate research by the International Longevity Centre UK and Nominet Trust (PDF) has shown that those who reported not using the internet were more likely to say that they 'often' felt isolated from others.

And Age UK has collected some people’s experiences of getting online:

The main thing I wanted to do was to learn how to use the internet to converse with them [her family overseas]. That’s the one reason I was eager to learn.

- Female, 55-64

I’ve always wanted to know about my mum’s background and there’s nobody around to ask, why don’t you ask while you’re young, this is the trouble, but you don’t. That was one of the main reasons I wanted to get on the internet, but also to know I wasn’t on a different planet.

- Female, 75+

Mainly to give myself more confidence that I can still do [things], self-esteem, and feel that I’m achieving something in my life sort of get to the stage where you think I can’t do these things and I’m going to be left well-behind. I didn’t want to get to that stage where I thought well I’m not going to be bothered to do it, because I think once you get that into your head then you’re just letting yourself go, so mainly for moral support and to bring my confidence back.

- Female, 55-64

I can go on the internet and I can search, I can go on Google Earth which I’d never seen or heard of before and I think that’s fantastic, I’ve got relations in South Africa, I’ve been there on Google Earth, I’ve walked up the path and I’ve looked straight at the house.

- Male, 75+

Who has access to the internet?

Today, around 417,000 people live in care homes and most are over 85 years old.

We have estimated that 70.5% of care homes with 'old age' provision do not offer residents internet access - an estimated 283,000 residents.

Care homes are mostly privately run, with 14% voluntary or charity-led, and 5% being operated by local authorities or the NHS. Internet access is available in 31% of privately-run care homes offering 'old age' care, 29% of voluntary or charity led care homes, and there is almost no internet provision in local authority and NHS care homes.

Homes with over 50 beds are most likely to have internet access, but they represent only 22% of all care homes providing 'old age' care.

Our research is based on exploring information available on, assuming a bed occupancy rate of 88.3%.

What can the market offer?

Care homes have needs that are very different to those of a conventional small business, or of a typical family home. Even a ‘superfast’ line of up to 76 Mbps will struggle to cope with more than 20 users making video call simultaneously at peak times (a likely occurrence if residents are calling family members in the evenings and weekends), and the routers provided are often not powerful enough for that number of connections across a care home.

Some organisations already deliver bespoke broadband and wifi packages to care homes, but smaller care homes are less likely to be able to afford both the time and the cost of managing wifi provision.

Some smaller care homes (0-10 beds), might be able to take advantage of conventional home or small business broadband subscriptions, however these may also not always be suitable.

The real problem lies in the middle ground between the small and large care homes. There are 6,291 care homes offering 'old age' provision in the UK that have between 11 and 50 beds, and a further 1,572 with between 51 and 100 beds, that currently lack residential internet access.

Care homes would benefit from the ability to manage the internet including individual log-ins for residents, the ability to block content where appropriate, and troubleshoot issues. Bespoke wifi installation would mean appropriate signals planning and use of multiple lines to offer additional bandwith more cheaply than dedicated leased lines.

While exploring the barriers to wifi provision in care homes, we matched the postcodes of UK care homes to Ofcom data on fixed-line broadband speed and availability and found that care homes are as likely to be able or unable to receive broadband as a residential home; they are not disproportionately located in areas with poor broadband access. However, 15.8% are located in areas with no superfast broadband, which would provide speeds over 30 MBits/s and enable high-bandwidth activities such as Skype and video streaming. Almost 1000 care homes are unable to receive speeds up to 10 MBits/s. And although homes with over 50 beds are most likely to have internet access, we found that 9.31% of homes with 51-75 beds are those receiving only 10 MBits/s.

How does this affect innovators?

We also looked at the number of initiatives which have sprung up aimed at connecting socially-excluded people. These range from people sharing the homes of people who are feeling isolated, to running groups which visit the elderly and cooking clubs to share meals with neighbours.

This is not a complete list but gives a sense how innovation has been stimulated and funded across ageing well and social isolation.

Products and initiatives like these have generated all kinds of ideas and solutions but very few have scaled in their use across social care: