Can you sleep at night if the people in your care can’t?
As a care provider, how would you feel if you came into work in the morning and found someone in your care had fallen and spent two hours lying in pain on the floor, knowing you could have done something about it?
That was Leanne Scrogham’s experience – and her reason to find the money to extend a trial of Nobi lights to all the rooms in Hartland House. She’s confident she made the right decision, noting a reduction in falls, Husain Bolt-level response times, and feedback from families who are grateful for the peace of mind – Innovators in Healthcare April 2025.
And what if you saw your residents walking of their own accord from an area with static lighting into a part of the building that had been upgraded to a circadian lighting system, with families explaining that their loved ones seemed calmer there? What if staff noticed that a lady who had been agitated and aggressive started to chat naturally with others and even help with simple tasks around the home? And if those same staff said that they went home proud and happy, ready to relax and recharge?
That was Ed Russell’s experience – and his reason to invest in an Oxford PhD study and Bradford Dementia Mapping to make sure he was on the right track – and include circadian lighting in his budget for both retrofit and new build projects going forward. Listen to Ed talking about his experience here.
The stats are enough to keep anyone awake at night – falls are the leading cause of hospitalisation among the over 65’s, costing the NHS an estimated £2.4 billion (and £2,600 per fall to a care home), exposure to legal liability (a recent falls-related court case awarded a £200,000 charge).
But, to quote Leanne, “it’s that ‘bitter pill’ of knowing you could have done more that’s really hard to swallow.”
No wonder falls are top of the healthtech agenda, with the ‘falls prevention’ systems market estimated at US$447 million – Fall Detection Systems Market.
But very few go to the root of the problem – improving the quality of sleep.
And yet, the evidence is clear – the right light at the right time can improve sleep quality by an estimated 45% – Pilot study of dynamic lighting and sleep consolidation among older adults in a Jordanian senior care facility, and reduce falls by factors ranging from 34% – 0312 Dynamic Lighting in Memory Care Facilities to Improve Sleep and Mood in Older Adults with Dementia to – Impact of Upgraded Lighting on Falls in Care Home Residents, with one recent retrospective study of over 49 facilities confirming that circadian lighting is a protective factor against falls – Circadian Lighting Was Associated with a Reduction in the Number of Hospitalized Patients Experiencing Falls: A Retrospective Observational Study.
While there are fewer controlled studies on community-dwelling older adults, a number of papers suggest that the basic principles apply here too – The Relationship Between Light Exposure before Bedtime and Daytime Sleepiness Among People Living With Cognitive Impairment.
Healthcare providers aren’t clinicians, so they don’t commit to the Hippocratic Oath to ‘do no harm’ – Do no harm: the beginning of the age of healthy hospital lighting.
Passionate professionals like Leanne and Ed don’t need any reminders about their personal responsibilities to the people in their care.
But for those who need an incentive, improving sleep will help providers to deliver on CQC criteria for excellence -: – The 5 key questions we ask.
• Safe: protected from abuse and avoidable harm
• Effective: care, treatment and support achieves good outcomes, helps to maintain quality of life and is based on the best available evidence.
Shifting from a ‘good’ to excellent’ CQC rating can command an average of 13% premium pricing – Care homes with Outstanding CQC rating charge 13.4% higher fees than those rated Good, and even reduce insurance premiums too – The Hidden Cost of CQC Ratings: How Your Insurance Premiums Are Affected.
A lightbulb is not enough
It makes sense that a lightbulb isn’t enough to set your body clock – as anyone who has slept in a room that’s too hot (or too cold), stuffy or noisy, or simply feels a bit strange, will know.
One of the brilliant outcomes from selection as a finalist with the National Care Forum Innovation Challenge was the opportunity to test the concept of an integrated approach to circadian entrainment.
I set up the Sleep Strategy Partnership, inviting lighting designer John Bullock, digital buildings specialist Ravi Lakhani, and procurement and healthcare innovation expert Lally Widelska to be part of the project.
Together, we set up a proof of concept in one of the cottages in the St Monica Cote Lane historic site in Bristol. Commercial Lighting and the Baulogic team stepped in with their expertise and products to support.
The original offer was targeted at residential care professionals, but the collaboration with Sean Davey and the St Monica Trust team suggested that independent living providers could benefit too.
A series of workshops with residents and conversations with staff reinforced some things that we knew- and some lightbulb moments.
1️⃣ Sleep is top of everyone’s agenda – although few link light and the body clock.
It’s harder to get out of bed – you’re most likely to feel stiff first thing, and that gets worse with age – says an article by the University of Florida.
Even a premium retirement living unit simply doesn’t deliver the quantity and quality of light we need to rise and shine. A retrofit really could help.
2️⃣ No ‘one size fits all’, especially for couples living with different health conditions.
Zoned lighting and heating, and simple moves like integration with the TV (so he can tune in without her moving out) could help us live happily together for longer.
3️⃣ Controls count – it’s a solid ’no’ to knobs that demand a tight grip
especially close to the floor, switches that light up a whole corridor when just one bulb will do and stay on when someone pops in to feed the cat and forgets to turn them off. And a warm ‘yes’ to presence sensing, night-time dimming, energy-saving remote controls – with a help line and a human being, not a QR code and a pdf – so you don’t have to bother your daughter again.
4️⃣ Beware of big brother – but keep a watchful eye.
Valid concerns over surveillance and privacy, while recognising the need for support. Smart home automation could bridge that gap with ambient sensing and machine learning, noticing unusual patterns of activity and environmental conditions – water or gas leaks, air quality and temperature variations – without the need for cameras, alarms or routine calls – freeing time and resources for real human connection.
5️⃣ My home is my castle – but who owns the walls?
Residents own their flats, but the operator runs the building. So who pays for an upgrade, who’s at fault if it gets hacked, and who reaps the rewards? Where do the Facilities Management, IT and Care teams connect?
Bottom line – Light is a ‘trojan horse’ for so many conversations about how we can harness innovation to live happily together for longer – and we’ve only just begun!
With grateful thanks to Sean Davey, St Monica Trust and National Care Forum for making this pilot possible, John Bullock, Ravi Lakhani, Lally Widelska, the Baulogic team (Guy Adderley Darren Palmer and Nick May) and the Commercial Lighting Systems Ltd team (Guy Madgwick and Don Falstein) and the VisionAid Technologies Ltd for all your support and encouragement so far.
If you would like to learn more about the Sleep Strategy Partnership project, please get in touch!
The website is now up and running too.