Exploring the implementation of ‘surveillance’ technologies in care homes

Background: An ageing society and rising prevalence in dementia are associated with rising demand for care home places. 'Surveillance' technologies are increasingly appealing to care homes because of their potential to protect residents, increase resident freedom and autonomy, and reduce staff burden. It is unclear how far use of surveillance technologies can deliver potential benefits and how these technologies are used in practice. This study explored implementation of surveillance technologies in care homes to develop understanding about their use.Methods: An embedded multiple-case study design was employed with 3 care homes in North West England. Data collection included 36 semi-structured interviews with staff, relatives and residents, informed by Normalization Process Theory to focus on individual and organisational factors within implementation; 175 hours' non-participant observation; investigation of care records and technology manufacturer literature. Data were analysed inductively using Framework Analysis.Results: 5 overarching themes emerged: Understanding of surveillance technologies; Business and environmental influences; Reasons for using surveillance technologies; How surveillance technologies were implemented; What happened during use.Mitigation against risk seemed to override other potential benefits as a reason for use. This strength of mitigation against risk seemed to influence understanding of surveillance technologies as being fundamentally different to other interventions, and challenged adherence to person-centred philosophies of care emphasising resident choice.Conclusions: Mitigation against risk seemed to be an overriding justification for the use of surveillance technologies. Care homes may need to consider how staff and relatives understand risk and surveillance technologies in relation to person-centred care