The re-engineering of healthcare delivery in the UK, with its shift away from institutionalised settings towards the community has resulted in the creation of a ' new' tier of intermediate care. Furthermore, there is increasing interest in extending the provision of care services into the home itself using telecare. However, current telecare technologies often work in isolation and are incapable of supporting the range of services anticipated in an integrated manner. This thesis is concerned with the development of a generic system architecture for (second-generation) telecare services in the home, which promotes the concepts of integration at the systems level and serves to identify the nature of the devices and system intelligence required. A viewpoint analysis of stakeholder needs and requirements is presented and analysed to establish a spectrum of potential telecare services. These are used in conjunction with a domain analysis of the home environment to identify domain properties with significance for telecare, allowing the identification of system-elements within the home. The resulting system analysis (including a consideration of stakeholder conflict and safety) enables a model for a next-generation telecare system to be proposed based on local (and distributed) intelligence in the home. Methods of implementing telecare services are identified and characterised using object-oriented techniques in order to establish a modular, adaptable, component-based architecture. It has been established that many second-generation telecare services possess similar requirements that can be implemented by re-using a relatively small number of class-based components, either in isolation or in a hybrid arrangement. Some of these have been realised in the form of a telecare demonstrator system, consisting of a virtual integrated care environment and a range of prototype sensors. The virtual environment enables the simulation of a virtual client in a virtual domain and has been developed for system testing purposes. The preliminary results of the simulation testing and the extension of this work into several UK field trials are reported.