Calling all care providers - the business case for investing in FrailtySIM
For some industries and learning requirements, the business case for the use of immersive, simulation-based training is focused on delivering effective training in a safer and/or lower cost ‘virtual environment’, using ‘virtual’ or replica equipment. Examples include advanced driving for emergency services, military training on advanced weaponry, and surgical procedures.
Caregiver training is different.
It focuses on human-centred rather than process or equipment-centred skills.
A lot of the formal training is concentrated into the induction process, frequently focused on the Care Certifcate and mandatory requirements. It is usually delivered by in house trainers to small groups (sometimes only 2-4 members of staff), in makeshift classrooms. The main investment is time – of both learner and trainer. As such, the business case for investing in new technology to support training is different to those industries and sectors where there is a clear cost saving and practical benefit.
Set out below are what we consider to be the factors that make the case for investing in FrailtySIM and the associated training resources:
- Highly relevant
- More effective learning
- Improved outcomes for clients and staff
- Low marginal cost
- Popular and innovative
- Wider system of care (and societal) benefits
1. Highly relevant
Why?
There are over 10 million people aged 65 and over in England alone. This is projected to grow, with oldest old growing at fastest rate. It is estimated that up to 5 million (50%) may be living with reduced resilience and increased vulnerability associated with frailty and over 1.5 million (15%) will have moderate or severe frailty which necessitates support with the activities of daily living. This support is increasingly provided in the person's home rather than in an institutional setting such as a care home.
Implication for care providers
All clients aged 65 and over of home care or care home providers are likely to be living with at least moderate level of frailty, and many will have severe frailty. A greater understanding and awareness of the condition, and empathy for those living with condition, is essential for high quality person-centred care. This is reinforced through national publications such as “I’m still me” and has been formalised in the Frailty Framework of Core Capabilities published by Skills for Health in September 2018.
2. More effective learning
Why?
Results from User Testing and wider deployment since the initial prototype was developed have consistently shown that 98% of users rate it ‘good’ or ‘excellent’ for developing understanding and empathy with over 66% providing the highest rating (5/5). It has also been consistently rated ‘one of the best things’ about training events where it has been used. More broadly, simulation-based training and particularly the immersive nature of virtual reality has been shown to be more effective than traditional approaches at changing working practices.
Implication for care providers
Time spent on FrailtySIM training will have more impact than traditional approaches. It may also achieve learning goals that are not possible with current training programmes but that are essential for delivering higher quality person-centred care (e.g., empathy, understanding and observational skills, use of assistive technology).
To be most cost effective FrailtySIM would replace or enhance an existing element of training (and hence use time already set aside for training more effectively rather than adding further training time). This may be challenging for care providers where investment in training is limited by the tight margins and frequent staffing shortages and where training may already be pared back to the mandatory requirements only. However, our User Testing partner did find ways to incorporate into induction training and some offices provided additional training opportunities as part of ongoing Caregiver development.
3. Improved outcomes for clients and staff
Why?
Improved understanding, empathy and observational skills should all lead to better person-centred care. This in turn leads to improved quality of life for older people living with frailty and should provide greater job satisfaction for those providing care and support. FrailtySIM can also be used to help employees and employers find out if supporting older people is suited to the employee.
Used as part of the recruitment process, and if issues arise during their employment, FrailtySIM could help to ensure staff most suited to caring roles are supported to develop improved empathy, understanding and observational skills. This would lead to an increase in proportion of staff well suited to Caregiver roles, whilst ensuring that those individuals less suited to the care environment have the opportunity to pursue employment more appropriate to them.
Implication for care providers
There are three potential business benefits for care providers:
- Reduced turnover of staff due to greater satisfaction with work and improved selection of those staff most suited to caring roles. The investment in training may form part of an improved ‘offer’ to existing staff and new recruits which may lead to more suitable applicants successfully completing the recruitment process.
- Ability to charge a premium for higher quality care achieved through better trained staff.
- Less complaints and issues to manage through having a better trained workforce, more suited to caring roles.
However, given the current state of the care market not all of these benefits may be realisable. Whilst a premium for higher quality care may be possible in the private / self-funder market, this may not be the case with current local authority contracts. In addition, greater ‘investment in people’ and job satisfaction may not be enough to offset the issues associated with low pay, zero hours contracts, low esteem etc.
4. Low marginal cost
Why?
The marginal cost of FrailtySIM use once the software, hardware and supporting training resources have been purchased is very low. We want to see it used as much as possible and so offer a one-off purchase of the resources.
There is inevitably some ‘wear and tear’ of the hardware although in around 2,000 uses we have only had to replace one pair of headphones having moved to better (but still relatively low cost) headset. Do please sanitise shared equipment thoroughly after each use to protect from inadvertent transmission of COVID-19 and other infectious conditions,
Implication for care providers
The cost component of the business case is related to the initial purchase of the hardware, although the vast majority of the cost is the Smart Phone which may already be available. As highlighted by the feedback from User Testing, the greater the availability of relevant VR-based learning apps, the stronger the business case for acquiring the equipment. Other empathy-building based VR or 360 video apps are available for autism, blindness and dementia and so there are increasing opportunities to widen the use of the hardware.
5. Popular & innovative
Why?
Feedback from users highlights the popularity of FrailtySIM. For the vast majority of people (95%+) across all ages, gender and educational backgrounds, FrailtySIM provides a fun and engaging way to learn. It is very different compared to the training staff experience most of the time, and in many cases, it is the first time that the user has experienced fully immersive virtual reality. The novelty will undoubtedly reduce over time as use of VR becomes more common, but for now and the immediate future it is rightly seen as innovative.
For the small cohort (2-3%) who do not feel able to complete the experience or are unwilling to try, the video-based walkthrough ensures they also gain from the training.
Implication for care providers
FrailtySIM offers a different way to engage with training. Designed to be learner-led, it provides a more appealing and immersive way to undertake independent learning than standard ‘e-learning’. Individuals with access to the resources may therefore be willing to undertake the training in their own time or in breaks that otherwise would not have been used for learning.
FrailtySIM also provides a shared experience for all those using it. It therefore enables reflective discussions about both the experience gained through the scenarios and how it compares with ‘real life’ experiences. This promotes idea sharing as well as emotional support between peers.
6. Wider system of care (and societal) benefits
Why?
Greater awareness of frailty and its implications for the care and support that is required for those living with the condition should lead to earlier and better identification of frailty. It should also improve awareness of changes in a person and their environment that may be warning signs of deterioration or increased vulnerability.
Understanding the importance of these ‘clues’ and how care staff can act as the ‘eyes and ears’ of the wider system should prompt this information to be passed on to the relevant person or organisation. This in turn should help trigger more proactive and responsive interventions from other agencies (including Local Authority, NHS), mirroring the “See it, say it, sorted”campaign that aims to help build a more vigilant network on railways across the country and raise awareness of the vital role the public can play in keeping themselves and others safe.
This enables a shift from more costly, reactive, institutional-based interventions to supporting older people to live as independently as possible in their own homes. Improved frailty awareness is in line with national guidance such as Fit for Frailty from the British Geriatrics Society which advocates that all health and care staff should be trained to identify frailty. This is reinforced by the Frailty Framework of Core Capabilities.
Implication for care providers
This has the potential to raise the profile and importance of care providers and their staff. It highlights the vital role that they play in promoting & supporting independence of older people which, in the case of home care providers, enables more to live at home longer.
Through highlighting their contribution to ‘the greater good’, it strengthens the case for better contracts which reward quality and multi-disciplinary working. This in turn will hopefully lead to improved pay and conditions, and greater recognition for the hard-working staff within the sector.
* * *
Our experience through both the Ufi VocTech project and wider deployment is that FrailtySIM is highly relevant, popular and innovative; provides more effective learning than traditional approaches at a low marginal cost; has potential to deliver improved outcomes for staff and provides wider benefits to the care system.
Whilst most training of Caregivers is undertaken by the employing care provider, the business case for FrailtySIM is also relevant for training organisations. This includes FE colleges, universities as well as private training providers that deliver training services to the health & care sectors.
The Learning Resources are available as part of FrailtySIM-in-a-box or as a digital download and include:
- Facilitator’s guide (digital and hard copy available)
- Introductory Video
- Walkthrough Video
- Become Victor & Being Jane slides
- Walking through Frailty slides
- Reflections and clues worksheet
- Walking through Frailty workbook