Abstract

Background The English Government introduced a target for 80% of Care Quality Commission registered adult social care providers to be using electronic care planning solutions by March 2024 (extended to March 2025) and made available funding to support the transition from paper to digital social care records. Objective The study aimed to generate timely evidence to support care providers to implement digital social care records and maximise the benefit from their introduction. Design and methods A co-created rapid evaluation, involving two data collection phases and feedback to study sites. We interviewed 30 senior leaders, 30 care staff, and 23 people who draw on care services and their relatives from 30 care providers (19 care homes, 11 home care agencies) in 4 sites across England and senior leaders of 3 digital social care record suppliers to understand experiences of adoption and implementation, and financial and economic implications. Results Policy attention and availability of funding have driven adoption of digital social care records, saving time and delivering other benefits, although experiences varied and there was evidence of suboptimal choice of digital social care record system, alongside buyer regret and abandonment. Providers were concerned about ongoing affordability in the context of continued austerity. Implementation is time- and resource-intensive with providers experiencing similar and predictable challenges. Planning, leading, managing and resourcing implementation, including investing in training and involving all users or people affected by digital social care records, were important for mitigating and overcoming challenges. A responsive supplier able to resolve technical problems and reasonable requests for flexibility was also important. Care providers in a franchise or group were at an advantage as they could draw on additional support and the experiences of others. While some features were not used or a matter of preference, a reliable offline working feature was critical for functionality due to patchy internet access. The ability to easily upload images and conduct simple analysis improved functionality; as did the client/relative portal, although this was rarely used and clients/relatives had limited knowledge of digital social care records and their rights. Systems with greater interoperability maximised the benefit from digital social care records. Unfamiliarity with technology was a barrier to using digital social care records, but training and gradual implementation allowed time for adaptation and increased acceptance. People with poor eyesight, dexterity or English had difficulty using digital social care records. We did not find evidence of providers capturing data to assess return on investment from digital social care record introduction. Limitations Assessing care providers’ capacity to estimate their return on investment was difficult as interviewees often lacked knowledge of the financial aspects of the business. Conclusions Where implementation is successful digital social care records, over time, deliver benefits to care providers. However, implementation was too often suboptimal due to poor choice of digital social care record supplier, inadequate planning, management and resourcing of change, an unresponsive supplier and limited accessibility features. Ongoing affordability and continuation with digital social care records are a concern for the future, especially for small providers. Future work Research investigating the abandonment process and impact of digital social care record adoption on the structure and stability of the care market would be valuable. Study registration Phase one ethical approval: the Health Research Authority (23/HRA/4966, IRAS Project ID: 3347698) and phase two from the NHS Research Ethics Committee (24/LO/0204, IRAS Project ID: 335300). Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR163639) as part of the Social Care Rapid Evaluation Team (NIHR153673) and is published in full in Health and Social Care Delivery Research ; Vol. 14, No. 16. See the NIHR Funding and Awards website for further award information.