Around two thirds of the 96 beds in the building are currently vacant – and so will soon be used to accommodate patients who are medically fit to leave hospital, but are waiting for a care package to be put in place
The trust that runs the Royal Preston Hospital is set to take over a care home in the city – and use it to house patients who no longer need a hospital bed, but whose discharge from the wards has been delayed.
Lancashire Teaching Hospitals NHS Foundation Trust (LTH) will acquire the lease of the Finney House facility next month, the Local Democracy Reporting Service (LDRS) can reveal. Under the arrangement, existing residents of the home, on Flintoff Way in Deepdale, can choose to remain there and LTH will assume responsibility for their care from the current operator, L&M Healthcare.
However, around two thirds of the 96 beds in the building are currently vacant – and so will soon be used to accommodate patients who are medically fit to leave hospital, but are waiting for a care package to be put in place to support them back in their own home, or for a space in a care home. As the LDRS reported in June, there are often as many as 100 patients on any given day across both the Royal Preston and Chorley and South Ribble Hospital who no longer meet the criteria for being hospitalised – but have nowhere else that they can immediately go.
That bottleneck at the so-called ‘back door’ of the hospitals lies at the heart of many of the challenges that the NHS faces right through the acute and emergency care system, with social care packages now taking longer to arrange because of staff shortages and additional demand. Faith Button, chief operating officer at LTH, hopes that the plans for Finney House – which the trust will begin operating on 14th November – will lessen the pressure that the Royal Preston is likely to face this winter and have a “transformative” effect in the longer term.
“It will take a huge chunk out of those delays [in discharging people from] our acute wards, which means we can get some flow through A&E. So in terms of patients waiting in A&E [for] a long time, it’s immediately going to take some pressure off of that. Over winter, it’s probably just going to mitigate [additional] winter demand, but [also] it’s the right setting for the patient – they shouldn’t be in an acute bed and it means we can flow the acutely unwell patients from A&E into an acute bed, because they’re freed up.
“For the North West Ambulance Service, it means we won’t be holding ambulance crews because A&E is full [and] because we’ve got 100 patients in the acute beds [who] shouldn’t be there – so it all starts to help that urgent care flow, “ Ms. Button explained. LTH will open up 32 Finney House beds next month for patients ready for hospital discharge, with all of the other rooms not in use by existing residents becoming available to the trust early in the new year.
The temporary ‘Nightingale’ hub that operated in the main car park of the Royal Preston between February and June this year – which was initially intended for Covid patients during the Omicron surge – ended up serving a similar purpose to that which is planned for Finney House. Hospital bosses were so pleased with how it worked that they seized the opportunity to create a more permanent – and, indeed, plush – set-up barely a mile from the Royal Preston’s Sharoe Green Lane site.
Finney House opened in August 2016 and was marketed as being more akin to a boutique hotel than a care home, featuring finely-decorated rooms and facilities such as a library and cinema. At the time of opening, 32 of its 96 bedrooms – spread across three floors – were reserved for residential care, with the remainder available for those with nursing care needs. People with dementia are also looked after at the facility.
However, the home regularly found itself on the wrong side of inspectors from the regulator, the Care Quality Commission (CQC). It was rated as “requires improvement” on several occasions – including after its most recent inspection in June. It did receive a ‘good’ rating, in 2019 – and staff were often praised in the CQC inspection reports – but Finney House has twice found itself in special measures, being deemed “inadequate”.
Lancashire Teaching Hospitals will now become the CQC-registered operator of the facility – both for patients poised for a return home and current residents. The trust will lease the building from L&M Healthcare for five years, in the first instance.
L&M also runs the Hulton House Luxury Care Residence on Lightfoot Green Lane in Preston, which will be unaffected by the Finney House changes. The LDRS understands that the operator recently refurbished the ground floor of the Finney House complex and Faith Button says that the facilities that will be on offer to patients transferred from the Royal Preston can only aid their recovery as they await the care packages they need.
“The facility is going to be so much better for patients waiting for a package of care for three days than staying on a busy ward. We know hospitals have bugs and germs [whereas in Finney House, patients will] be in an ensuite room, with a TV [and] being looked after – and the person who needs that medical bed and medical input by specialist doctors is up on an acute ward and not in A&E.”
Ms. Button told the LDRS that it costs around half as much to care for a patient in a community bed – the like of which will be available at Finney House – as it does to keep them in an acute bed in hospital, meaning that the new set-up will benefit NHS budgets as well as patients.
She said that the trust’s experience of running the Nightingale hub would ensure that the discharge hold-ups experienced on the wards would not simply be transferred to Finney House – and that some of the social workers arranging the required care packages could base themselves at the facility, helping to ensure that it did not become “clogged up”. Therapists will also be on hand to help patients recover during their stay at the so-called “step down” facility.
Health and social care partners will consider potential additional uses for the beds at Finney House in the future, with the possibility of them accommodating people who might otherwise find themselves in hospital – as well as those waiting to leave the wards. Faith Button said that they could be used as a method of “admission avoidance” – for someone who may need a few days’ support, without which, the individual would have to be hospitalised.
For now, however, she says that the focus is on the opening up of the first beds for patients next month – and the benefit that it is hoped they will bring across the wider health and social care system. “All trusts, at the moment, have got patients who don’t need to be in their beds and we’ve then got escalated costs if A&Es are full and overcrowded and [we are] holding ambulances.
“So this really does seem [like] a solution for us [and] is really quite exciting. That is the general direction, we’re trying to get [more integration between] health and social care and the integration of community services with health. I think this is just the start of something for us.”
Lancashire Teaching Hospitals (LTH) is currently recruiting 62 full-time equivalent staff in preparation for the opening of the first 32 community beds at Finney House next month.
The trust is looking to fill nursing, allied health professional and social care roles. Meanwhile, all of the existing staff at Finney House will have the chance to become NHS employees by transferring to LTH under the relevant employment legislation.
Anne Kirkham, head of community services for the hospital trust, said: “This is a really exciting development which secures the future of staff who wish to keep working at Finney House. We are always on the lookout for great people and are looking forward to welcoming Finney House colleagues into the LTH trust family.”
Faith Button, LTH chief operating officer, said that there were exciting opportunities for those moving across to work for the trust.
Because we have such good education set-ups [and] training facilities – and being such a big acute provider – we can certainly offer…quite a lot to these staff. We can start to do some really interesting things with this workforce – and new innovative things with therapies.”
All LTH vaccines can be found on the trust website at lancsteachinghospitals.nhs.uk/join-our-workforce
What about Finney House residents
Faith Button said that existing residents in Finney House – and their families – had all been informed of the planned changes and reassured that there was no question of any of them having to move out.
She told the LDRS all of those currently living at the facility – a mixture of private, fee-paying residents and those whose care is funded by the local authority – were “very happy” with the plans. Asked whether Lancashire Teaching Hospitals would be running the residential side of Finney House as a profit-generating operation, Ms Button said that she did not anticipate that there would be much capacity to raise revenue – but confirmed that it would not be operated at a loss to the trust.
The split in occupants between former hospital patients awaiting a return home and care home residents may change over time with the natural turnover of residents. However, it is anticipated that the ratio will gradually shift towards accommodating more people who have just left hospital.
Paul Fletcher, commercial and business director at L&M Healthcare, said that the deal with Lancashire Teaching Hospitals was “a positive step for all parties involved”. He added: “Residents and staff that choose to can remain in place with no disruption to the service and L&M Healthcare can now focus on the next phase of progression for the L&M Healthcare group.
“We’d like to take this opportunity to thank our residents, their families, and our dedicated and hardworking staff for all their support. We hand over the reins knowing they will be in safe hands with the Lancashire Teaching Hospitals NHS Foundation Trust in what will be a unique-to-the-area hybrid service.”
Pressure points in numbers
Some of the A&E delays that could be eased by an improved flow of patients through the hospital system include:
338 – number of ambulance handover delays of more than an hour at Lancashire Teaching Hospitals in August
169 – number of 12-hour trolley waits at Lancashire Teaching Hospitals in August, up from 74 in June
8.6 percent – proportion of admitted and non-admitted patients waiting over 12 hours in A&E at Lancashire Teaching Hospitals in August, up from 7.6 percent in June
Source: Lancashire Teaching Hospitals
- 10:40, 14 OCT 2022