For several years, the LGIU along with partners in local government and in tech worked to develop a platform and app to support better information sharing in home care to improve the lives of people who needed care, their families and the care workers themselves. It was a great product, but ultimately it failed.
CoCare was designed to be a bridge between service providers, care workers, families, commissioners and service users. With a really simple interface, intuitive responses and simple messaging it could not only track social care outcomes and provide low-impact assessment of user need it could also be a vital communication tool for people whose family might be living far away.
Most importantly, it was designed to support outcomes based commissioning, a more flexible approach to delivering care based on people’s individual needs at the time they needed them and trusting skilled care workers to be able to deliver and report on care needs in a way that made sense to them and didn’t overburden them.
Unfortunately, the pace of business, local government and development didn’t always match up and the needs of different product users to share (and hide) information didn’t always gel. Ultimately, Covid, too hit just as the product was being piloted, and a final product never launched.
One: Services under stress can be hives of innovation
The germ of the idea came from several sources and several people, in councils, in industry and in local government. But we all met through an LGIU research project on the home care workforce. It was clear then that home care was a service under a tremendous amount of stress. With low prices offered for home care and a pressurised, rapidly overturning workforce with no clear ladder of progression there were serious problems. (Problems which remain and continue to be dealt with in a piecemeal manner.)
This coupled with the fact that technology had barely touched the service with poorly accessible paper records sometimes being the only source of communication between family members and care worker teams meant that it should have been absolutely ripe for innovation. Technology could and should be used as a bridge between service providers, commissioners, families and service users.
Best of all there were a lot of people who really care about outcomes in social care for people and who understood the plight of care workers and were desperately looking for new ways of doing things.
Two: Too much stress can be an innovation killer
But as much as people wanted change and had ideas for change, the fact that home care was under so much pressure meant that there was little space or emotional energy for change. Money wasn’t really the problem (although tight financial constraints didn’t help), it was more about finding great staff who could work with us consistently for the period of time needed to really innovate within the service.
When people are under stress, their risk appetites become skewed. They might take on too much risk or not enough. Local government can already be a ‘risk averse’ culture – and yes, when you’re dealing with people’s lives and livelihoods as well as public money, you should be careful. But there is always a certain amount of risk with innovation, but sometimes innovation is seen as riskier than it really is. Just because something is new doesn’t mean it inherently poses more risk than the existing way of doing things or a big complex, but different way of doing something.
Three: The voice of the user in design really matters
There are many things about the development of CoCare that I wish we’d done differently. But one thing that I’m still really proud of was our service design approach to development. The initial idea was developed with care workers by someone with formal design qualifications. We brought people together from different disciplines to design and develop the product using design principles. We tested, iterated, used paper prototypes with people who would be using the product. We listened to service providers, commissioners and to the care community.
In the end we developed something that was simple to use and addressed many of the most painful problems in home care. I will remain proud of that. I think we did the right ‘thing’, I know we designed it in the right way for the right reasons.
Four: The voice of the bureaucracy can be a real innovation killer
Our design was maybe too simple. It wasn’t an all-in-one tool that allowed you to roster and bill and report. It supported light touch monitoring and communication based on care worker and family needs. When we’d take sneaky peaks at competitors at social care shows, ‘similar’ products might have screens and screens of forms. We knew from working with care workers that none of them had the time to do that and some of them didn’t have the inclination.
Our tool provided much better monitoring of services than paper based records, but it didn’t include remote sensors or a lot of box ticking. It had various safeguards built in, but it did rely on trusting care workers to some extent, which displeased some commissioners. What it didn’t allow was fudging of times by local care companies, as information went straight to both the care company and to the commissioning authority, which some care companies didn’t like.
It isn’t that we didn’t think the needs of care providers and commissioners weren’t important, we did. It’s just that we sometimes struggled to balance those needs in a way that truly supported outcomes based commissioning. We could have communicated this much better.
Five: Tech startup has to be nurtured especially in difficult environments and to address complex social problems.
While we were great at getting to the final round of accelerator funding and support, we never quite managed it. This was probably for a variety of reasons including some that might be too uncomfortable for me to explore as they’d start with a thorough self-inventory! Having worked for a number of years on the fringes of tech in social spaces or to achieve public sector outcomes I’ve seen a lot of baffling projects get through funding hoops only to flounder later or come to nothing. Maybe ours would have, too – but good tech mentoring might have made a world of difference. We definitely should have pushed harder in this direction.
There was a lot we could have done differently and some things that could have gone better. If not for Covid, we might have even made it. But by March 2020, we were tired of pushing.
I say this because tech, like many others, is an industry where failures are often swept under the carpet and success is lauded. But it’s worth learning from what didn’t go well when we’re looking at the ways we harness technology to make vulnerable people’s lives easier, safer and more dignified.
It’s hard to hold my hand up and say “I failed”, but I did. Part of continuing with ethos of CoCare is sharing some of those lessons and continuing that conversation.