Orchard Care Homes has demonstrated its commitment to using technology to drive growth in the health and social care sector with its latest investment in a state-of-the-art pain identification tool.

The organisation has introduced the PainChek App into some of its residences across the North of England and the Midlands, becoming the largest care provider in the UK to use the App to identify pain levels in its residents living with dementia.

Recognising that pain is one of the causes of people living with dementia in care homes experiencing distress, Orchard sought alternative approaches to pain identification and started trialling PainChek in January 2021. This is an approved medical device designed to improve pain assessment and identification for people living with dementia or other cognitive impairment who are unable to effectively verbalise when they are experiencing pain.

PainChek is an app that functions on the care record handheld devices used within Orchard. The app is an evolution of a popular paper-based assessment and incorporates AI facial recognition technology. This scans the person’s face in around 3 seconds and identifies 9 micro facial indicators of pain which are difficult to detect by eye. In addition, there are a series of observations recorded – the person’s vocalisations, movement, behaviour, alterations to their activity and physiological features. The assessment notes the presence or lack thereof of 42 signs and eliminates the subjective scoring scale of previous tools. Suitable for use by nurses and care staff alike, the process takes under 2 minutes to complete.

Level of pain is determined by the app and staff use their clinical judgement to determine what analgesia or therapy is to be used to address the person’s pain. Data of the pain burden for each individual and across the entire home is automatically collated and can be reviewed in line with other elements such as levels of distress, medication use and ultimately engagement in meaningful occupation and activities of daily living.

Orchard has to date launched this innovative approach to identifying and managing pain in four of its care homes: Green Park, Ashlea Lodge, Thornton Hall & Lodge and Three Bridges. The assessment is being incorporated into current workflows such as medication rounds. Teams are also being coached on ensuring the assessment is used when they observe a person becoming distressed in order to rule in or out, pain as the cause of the person’s distress. As a result, the company is already seeing an increase in the use of pain relief; pain relief being more frequently reviewed as to its efficacy and prescriptions being modified to ensure the pain is being managed effectively.

While embedding PainChek is still in its infancy, Orchard is able to evidence many positive outcomes for its residents, including 100% increase in pain assessment for those unable to verbalise pain, reduction in distress response behaviours and reduction in the use of benzodiazepines and antipsychotics.

Professor Martin Green OBE, Chief Executive of Care England, commented “Orchard Care Homes is to be commended for its heavy investment in technology that will improve the quality of care to their residents. This investment will see Orchard Care Homes in the forefront of developing new and innovative approaches to supporting people who are living with dementia.”

Hayden Knight, CEO at Orchard Care Homes, acknowledged this important step forward, saying Recognising pain in people living with dementia is challenging, pain can have such a negative impact on quality of life and may lead to distress responses, often described as behaviours that challenge, a term Orchard Care Homes is keen to move away from. By using facial recognition technology, we are able to quickly identify pain in those unable to verbalise this, not only will this enable the right treatment to be sought to help address the reason for pain, but it will also promote engagement and activity participation.”

The care group plans to roll out the system across all its homes this year.