Environmental controls

What are environmental controls?

Within the home environment there are many devices that are operated using a handheld remote, or small buttons mounted in sometimes difficult to access locations. For some people with complex physical disabilities, it means they may face difficulties, or be unable to operate these devices. This may include light switches, TV remotes, and telephones. Losing access to these devices means losing a large amount of independence, which may be highly important to the person.

Environmental control systems are set up to allow the user to control their home devices using an accessible switch. Depending on the user's ability, this switch can be operated by their hand, foot, head, voice etc. The system can control home devices such as a telephone, mobile phone, pager or helpcall, TV (smart TV or satellite), music system, hospital-style bed, reclining static chair, lamps, fans or door opener.

Who are they suitable for?

Environmental controls are best suited for users with limited mobility (particularly in the hands) who cannot operate appliances, remotes, help call buttons, telephones, doors etc but still want to retain or even regain some degree of independence. Previous users who have benefitted from these systems have had complex motor disabilities from diagnoses of (but not limited to) multiple sclerosis, stroke, motor neuron disease, and high spinal cord injury. Simple systems can be provided for patients with cognitive impairment or those with few needs.

What can this do for me?

People usually install an environmental control to solve the following problems:

• cannot easily operate appliances and equipment around the home
• cannot open the door to let carers in, or to get out in a wheelchair
• cannot use ordinary remote control handsets
• spend some time on their own and may need to make an emergency call to a carer
• want to remain independent in their own home
• carer needs to be able to pop out to the shops or work in the garden without fear of person getting into trouble and being unable to call for help

Environmental controls vs smart speakers

Many features provided by environmental control systems are also available via consumer-purchased smart speakers such as Alexa, Siri and Google Home. The main difference is that smart speakers rely on mains power, internet and strong speech, which may not be always available. Retaining the ability to call for help if one of these fails is highly important for the user's safety, especially for users without 24/7 care.

What does the NHS Highland Environmental Controls service provide?

The NHS Highland Environmental Controls service offers assessments, issues equipment and provides maintenance and repair services free of charge for patients deemed eligible.

The NHS operate to strict guidelines for provision, so you may find that the NHS will not be able to pay for everything you ask for.

The Environmental Controls service may enable connection to other devices not supplied by the service.

It is the Adult Social Care service's responsibility to fund and supply modifications to the home required to accommodate the environmental control equipment, including:

• provision of an electrician and joiner to assist the contractor
• arranging for a telephone landline
• funding of door openers, curtain/blind openers and page-turners (these are provided at the discretion of social services)

What happens at my appointments?

Initial assessment

Once your referral has been sent to the Environmental Controls service and has been accepted, the team will call you to arrange an appointment. You will be visited at home by one or more clinical scientists who will talk to you about your physical and cognitive abilities, needs, lifestyle and goals. Your referee may be invited to join this appointment to provide additional insight. The scientist will assess you and your environment and determine if environmental controls are suitable for you and answer any questions you may have.

Case conference appointment

If you are eligible and are motivated to use the system, the Environmental Controls service will arrange another appointment to determine which equipment is best suited. Some equipment is provided by a contractor, so the clinical scientist may attend with an engineer from an outside company. In this appointment, details of your home and connected devices are recorded, such as brand of TV, model of reclining bed, location of wall outlets etc. In some cases, this appointment can be combined with the initial assessment.

Issuing and training

Once the equipment has been ordered and arrived, an engineer or scientist will arrange to come to your house. They will install the equipment and teach you how to use it. It is helpful if your main carers and/or family are there with you so they can understand how it works as well.

Maintenance, repairs and adjustments

Some equipment needs annual maintenance, so we will contact you to arrange a time to visit. If there are any issues, you will be given contact details to arrange for repairs or adjustments.