Dorset ICB Case Study: Improving Night-Time Safety in Care Homes Using Ally Acoustic Monitoring
Introduction
Under Year 3 of the Digitising Social Care (DiSC) Programme, Dorset Integrated Care System (ICS), working with Dorset Council and Bournemouth, Christchurch & Poole (BCP) Council, delivered a system-level acoustic monitoring initiative aiming to enhance resident safety and improve night-time care in care homes across Dorset Council (DC) and BCP Council areas.
The programme formed part of Dorset’s wider digital transformation agenda, funded through the Digital Transformation Fund, with a specific focus on improving outcomes overnight, when risk is often highest and visibility lowest.
The challenge
Baseline data collected through Dorset’s Expression of Interest process revealed a consistent pattern across participating homes:
- High numbers of unwitnessed bedroom falls
- Regular ambulance call-outs and hospital transfers
- Significant hospitalisation days linked to falls
- Variation in how falls were defined, recorded and escalated
Night-time care was still largely shaped by routine checking, which could disturb residents’ sleep while failing to prevent incidents that occurred between rounds. For the system, this translated into avoidable harm, pressure on emergency services and limited confidence that risk was being managed proportionately overnight.
Dorset ICS sought to understand whether Ally’s AI resident monitoring technology, deployed beyond a small pilot and evaluated robustly, could materially reduce severity, escalation and system impact, not just incident counts.
Outcomes: System-level impact
Six care homes were live and reporting at the point of evaluation. Dorset ICS compared pre-installation baseline data with post-installation outcomes and applied normalisation to account for different reporting periods, ensuring a like-for-like comparison.
Across the programme, Dorset ICS reported:
- 49.2% reduction in total falls
- 58.2% reduction in unwitnessed bedroom falls
- 63.7% reduction in ambulance call-outs
- 79.3% reduction in hospital transfers
- 72.6% reduction in hospitalisation days
- 51.9% reduction in safeguarding notices linked to falls
Five of the six homes improved across most falls-related metrics, with several achieving reductions exceeding 75% in severe outcomes. One site showed an increase in total falls, highlighting the importance of local operational review and practice alignment, rather than treating technology as a standalone solution.
Why unwitnessed falls were a priority
Dorset ICS placed particular emphasis on unwitnessed bedroom falls, recognising that these incidents often carry the greatest risk due to delayed response and escalation.
Following the introduction of Ally acoustic monitoring, unwitnessed bedroom falls reduced by 58.2% overall, representing one of the most consistent improvements across sites. This reduction directly supports safer nights for residents and fewer avoidable escalations for the NHS.
Reducing severity, not just incidents
One of the strongest signals in the evaluation was the scale of reduction in severe outcomes:
- Nearly two-thirds fewer ambulance call-outs
- Almost 80% fewer hospital transfers
- Over 70% fewer hospitalisation days
Even where total fall numbers reduced less dramatically, severity consistently fell, suggesting earlier detection and more proportionate night-time responses enabled by Ally.
Better visibility of risk
The evaluation also showed a 29.6% increase in residents identified as high risk of falls.
Dorset ICS interpreted this as a positive system outcome, reflecting improved identification and documentation of risk, rather than deterioration in safety. Clearer overnight insight supported more proactive care planning and prevention.
Councillor Steve Robinson, Dorset Council Adult Social Care Portfolio member, said:
“The Dorset acoustic monitoring programme provided valuable insight into how technology can support safer, more proportionate night-time care. The reductions seen in unwitnessed falls and severe outcomes are encouraging, while the variation between sites reinforces the importance of digital readiness, local leadership and embedding new ways of working alongside the technology.”
Thomas Tredinnick, CEO & Co-Founder, Ally
“What stands out in the Dorset evaluation is the consistency of reduction in severe outcomes. This wasn’t about replacing care teams or introducing more monitoring, it was about giving teams better visibility at night, so they could respond earlier, reduce harm and protect residents’ rest. The data shows what’s possible when night-time care is shaped around real need, not routine.”
Key takeaways for systems and providers
- Night-time safety improved at scale, not just in isolated pilots
- Severity reduction matters most for residents and the wider system
- Unwitnessed falls fell sharply, reducing risk and escalation
- Improved risk identification supports prevention, not blame
- Technology enables change, but leadership and practice determine outcomes
- Normalised evaluation strengthens commissioning confidence
Why this matters
The Dorset ICS programme demonstrates that when Ally’s AI resident monitoring is deployed as part of a system-led initiative and evaluated rigorously, it can deliver meaningful improvements in night-time safety, reduce pressure on emergency services and support more dignified care.
Just as importantly, the evaluation surfaces learning around readiness, culture and practice, providing a credible blueprint for future digital care programmes.
Read more here.