Electronic Call Monitoring – What is the Best Option For Me

Electronic Call Monitoring (ECM) refers to a range of systems which all essentially do the same job. They enable home care agencies to verify that care workers have attended the correct location, and the time that they arrived and left that location (therein recording the duration of the care visit too).

Often this information feeds directly into a scheduling or rostering system. Sometimes, but not always, the ECM method or solution comes as a part of that rostering system.

For many years the only ECM option available to care providers was the traditional landline telephone based method. While these systems are still in use, it is now becoming much more common for care agencies to use alternative methods to record ‘time and attendance’, typically using an app on a mobile phone.

For full confidence it is best to check or discuss with your the local authorities you provide or wish to provide care for, to confirm if they mandate specific systems or types of systems, or what level of flexibility there is in the systems you can use.

Electronic call monitoring systems can be used by home care, community care and domiciliary care to provide services across multiple sites and manage employees. This is especially helpful for facilities that offer home care. Using a scheduling app or telephony system will create a definitive record of a completed visit which offers reassurance to management that the job is being carried out correctly. The other key benefits of ECM include:

• Improved administrative processes and reduced costs
• Removes the need for many manual timesheets and confirmation
• Monitors care workers in real-time
• Records evidence of a visit taking place
• Enables accurate pay and invoicing
• Improves care management with alerts for any late or missed visits
• Easy and simple to use and record information
• Maintain compliance with Care Quality Commission (CQC) and Local Authority Requirements
• Highlights areas where care quality needs improving or where to increase time provision
• Assure relatives that the service has been delivered and meets specific standards

Landline System

The landline call monitoring system is simple and easy to use but has decreased in popularity over time.

Many local authorities used to mandate all home care providers delivering services for them used the same landline-based system, but this has changed in recent years with local authorities becoming increasingly flexible about the type of ECM system used.

With landline based ECM, once a care worker arrives at their destination, they will need to make a short (around 5 second) call from the service user’s landline to a specific number. This call will automatically be picked up by a system which will allow the administrator to see what jobs have been ‘started’ or ‘completed.’

Pros – simple, affordable, accurate, reach long distances, when connected by traditional phones lines they can still operate during network outages. Unlike some newer methods below, it is not reliant upon placing additional equipment in a service user’s home.

Similarly unlike some other methods like an OTP device, its far less likely that a landline phone will be lost or misplaced.

Cons – portability, not always the best quality, landlines are becoming a thing of the past and service users don’t like their landlines being used. Some service users with cognitive impairments or dementia may not understand why the care worker is making the call and this could be distressing or cause conflict. Do not allow scaling up or down easily as providers have to come out to install new lines.

Compared to more modern methods, landline based ECM is typically more time consuming for the care worker and is more likely to break up an interaction when compared with simply tapping a mobile against an NFC tag for example.

OTP Devices/Mobile App

OTP (One Time Password) devices look similar to pagers and are small and robust. They can be kept in the care plan folder at the service user’s property or in a key safe.  

When required, the OTP device will show a number which will be unique to the service user and time of day. This number should be entered into the mobile app. Due to the unique code that is presented, the system can verify that a care worker has completed the call at a specific location, time and date.

Pros – location is accurate, simple and easy to use, can be used without internet as the code can be written down and uploaded once signal returns

Cons – signal/internet is required for real-time updates, smartphone is required to use app, OTP device will need to be readily available and easy to find, it could be mislaid or lost. The portability of the OTP device does open up the possibility of or questions over whether care workers could abuse the system.  

NFC Using Mobile App

Similar to OTP devices, NFC (Near-Field Communication) electronic call monitoring involves leaving a coin-sized tag at the service user’s property. These tags can are digitally assigned to a specific service user/service location. They can then be ‘read’ by care workers using a smartphone to record the visit start and end time in their app.

Pros – easy to use and quick as it just requires a mobile phone swipe over the NFC tag and arguably less disruptive to the provision of care and contact with service users. A more secure method than QR codes, which are more vulnerable to foul play, for example by photocopying, or photographing a QR code.

The NFC tags themselves are relatively cheap, at around £0.20-£1.00 per tag (or per service user) depending on quantities ordered. And if lost for any reason, it is easy to assign a service user to a new NFC tag and put that tag in their home.

Cons – NFC based Electronic Call Monitoring Solutions offered by the Access Group, are ‘offline enabled’ for NFC, meaning a signal is not required to record time and location with NFC. However some NFC based systems may require an internet connection to work properly.

Smartphones are required in order to read the NFC tag and use the app,  those smartphones will need to be NFC-enabled. NFC tags will also need to be kept safe between visits and will need to be set up again if lost.

QR Codes Using Mobile App

Using a mobile app to scan QR codes was popular during the early adoption of new methods of ECM using mobile phones. However, many providers and local authorities have encountered problems with using QR codes for visit verification.

In the QR code method, every service user will have a unique QR code generated from their profile in the software being used to track visit information. This can be printed out and left in the home. When the caregiver arrives, all they will need to do is scan the QR code to register their presence.

One especially damaging flaw is the vulnerability of the QR code method to unscrupulous care workers, who may photocopy or photograph the QR code to falsely record their attendance to, or time spent at a person’s home.

In practice this means care workers can falsely record they have visited a service user’s home, for whatever period of time, without actually having visited at all. Unfortunately such instances have been reported by care providers, service users, families of service users and local authorities.

While a few bad apples may be to blame, the vulnerabilities that this minority of care workers have exposed means the method as a whole is brought into question. Some local authorities now actively refuse to accept QR codes as a method for visit verification, or electronic call monitoring.

Pros – location setting and mobile signal isn’t required to check-in. It’s cheap, quick and easy to use.

Cons – Is much more vulnerable to abuse and misuse than alternatives such as NFC tags. Majority of local authorities will not accept it, or accept it alone as a visit verification method.

Print outs of QR codes can easily be damaged or lost if not properly protected (laminated) and stored.

NFC or QR Code Plus GPS

Also known as Geo check-in, using NFC or QR codes plus GPS uses the location of caregivers’ mobile phone used to scan a QR code or NFC tag. This is used  to determine if they’re in the right location at the right time. A carer’s location can only be tracked once they’re checked in and out of their visit using the NFC or QR code.

Once a care giver has checked in, the app will make a comparison between the GPS location on the phone and the service user’s address. If the carer’s location is within a certain distance from the home, the check in and out will be successful. If they’re too far from the location, an alert will be generated.

Pros – accurate, it can be turned off for clients who are cared for in several locations or live in rural areas, check-in radius can be extended to reduce anomalies. Addresses the question of care workers ‘abusing’ the system using GPS to confirm that the OTP device/QR code/NFC tag was used in the right location, the service user’s home.

Cons – no good for clients who live in rural areas with no or low signal, location settings can’t be disabled, GPS signal can get obstructed leading to an inaccurate result, smartphones are required

You should now have a much better idea of the main Electronic Call Monitoring systems used in home care in the UK, how each works and which might work best for you.

While landline based systems are still in use, they are fading away in favour of more modern, less intrusive methods. Those modern methods all have their quirks and which one is best for you may be a personal choice, or dependent on some specific aspects of how your care agency operates already.

QR codes, while initially popular have more recently been exposed as lacking the necessary robustness against abuse and misuse from a minority of care workers who want to make it seem as if care has been delivered without doing the job required.

Now, QR codes are increasingly unacceptable as a method of electronic call monitoring /visit verification for most local authority care, and care providers themselves are seeking something more secure and reliable. Which is where NFC comes in as a more secure method you and care funders can have confidence in.

With both NFC and QR code options, GPS offers a second level of verification to make your monitoring of care visits more reliable and trusted, both in your business and with external stakeholders.

You may find your local authority has specific requirements that dictate which system/s you can use, so check and factor this into your choice.

If you want to find out more about the right ECM option for you we can help. At the Access Group we’ve got years of experience advising care agencies on the best ECM option for them. We provide all types of ECM system, integrated with our home care rostering software, so we can work together to find the perfect option for you. Get in touch and we can start the conversation together.