Agenda item

[Report of the Director of Adults and Health. To be introduced by the Cabinet Member for Adults and Health.]

This report seeks approval for consultation with stakeholders for the proposal to close Osborne Grove Nursing Home and relocate residents to alternative nursing home provision that is capable of meeting their care and support needs and promoting their wellbeing. The closure would allow for the development of an expanded 70 bed nursing home provision on site.

The Cabinet Member for Adults and Health introduced this report which sought approval for consultation with stakeholders for the proposal to close Osborne Grove Nursing Home and relocate residents to alternative nursing home provision that was capable of meeting their care and support needs and promoting their wellbeing. The closure would allow for the development of an expanded 70 bed nursing home provision on site.

The Cabinet Member expressed that the July 2019 decision, to build a new 70-bed nursing home on the Osborne Grove site, demonstrated the Council’s commitment to providing high quality nursing care in the borough and represented a major investment in new facilities. As demand for nursing care continued to grow in the borough, the proposed development would assist in increasing the supply of residential nursing care places.

The Cabinet Member highlighted the Feasibility Study determined that the redevelopment of Osborne Grove would have implications for the current residents, in terms of health and personal wellbeing due to the inevitable disruption that would result from the building work and site preparation. Therefore, it was proposed to consult on the proposal to move the remaining residents and to close the Home pending development of the site.

In response to questions from the Leader, Councillors Hearn and Morris, the following information was provided:

• It was confirmed that there were two residents still residing at the Osbourne Grove Nursing Home.
• The Cabinet Member acknowledged Osbourne Grove Caring Home had previous issues which the Council sought to address through rebuilding and redeveloping the site for nursing care. There was an improvement plan in place at the nursing home which had been recognised as helping to improve the difficulties but there was still greater improvement required. 
• The Cabinet Member informed that the impact of the redevelopment on the surrounding area would be taken into consideration when the Council moved forward with the detailed redevelopment plan.
• The Cabinet Member noted the Council was proposing a lengthy consultation process to ensure that the remaining residents at the nursing home, their relatives and carers had the opportunity to be properly consulted and have their preferences or alternative arrangements acknowledged. The Council would then facilitate those wishes, insofar as it was possible to do so, such as relocating them inside or outside the borough.
• The Cabinet Member noted that the policy of the Council was to relocate affected residents to care homes recognised as being either only good or outstanding.

RESOLVED

1)    To approve for consultation with residents, carers and other stakeholders the proposal to close Osborne Grove Nursing Home and relocate residents to alternative nursing home provision that is capable of meeting their care and support needs and promoting their wellbeing. The reason for the proposed closure is to allow for the development of an expanded 70 bed nursing home provision on site to meet current and future care needs in the Haringey.

2)    To agree that a report on the findings of the consultation and the proposed recommendation be brought back to Cabinet for a decision on the proposal.

Reasons for decision

In June 2018 a decision was taken by Cabinet to stop the previously agreed closure of the Home, pending a feasibility study to be undertaken for the future development of the site. Part of this decision was that the existing residents should be allowed to remain in the Home if they choose, pending the outcome of the feasibility study report.

In July 2019 the feasibility report was presented to Cabinet and they agreed to endorse the preferred option: that is, to demolish the current building and rebuild a 70 bed nursing provision including the clinic site, ensuring that the use of the site overall is maximised.

It was further noted in the report that none of the future development Options including the preferred option could be safely commenced with the current residents on site given the levels of disturbance (including noise and dust) that will result from the demolition and construction works and their likely impact on these very vulnerable residents with significant health needs. A further report should be presented to Cabinet in September 2019 on the plans for consultation with residents on the proposals to close the Home and relocate residents for the purpose of the development before a final decision is made.

There must be a period of consultation with residents, family members and other stakeholders to allow them to give their views on the proposals to close the Home which Cabinet will consider before a decision is made.

Alternative options considered

The option to retain the current 32 bed dual registration residential/nursing home on the site was considered but rejected, primarily because it would not increase the registered nursing capacity within the borough and because it would not address a number of fundamental design issues with the current building which prevent it functioning effectively as a nursing home and which could not be fully addressed due to structural limitations.

The existing building has a number of shortcomings which have been confirmed through the Feasibility Study, although the scheme was a new build only completed in 2008. The building was originally designed as a residential care home, but has been used as a nursing home as the acuity of needs of residents has increased. The design of the building is unsuitable to cater for the needs of an increasingly frail resident population. Below is a list of some, though by no means all, of these issues:

• The building only has one lift located some distance away from a large proportion of residents’ bedrooms. The lift is not wide enough for a hospital bed which creates significant problems from a mobility perspective and to ensure bed bound residents have an opportunity to move with some ease around the building or in an emergency.
• Department for Health: Care Homes for older people national minimum standards/care home regulation 3^rd edition’s guidance for the provision of all new build nursing homes that Bedrooms should exceed 12sq metres of usable floor space excluding ensuite facilities. The bedrooms in the current building inclusive of ensuites are 15.5m2 which means the rooms fall short of current standards for new build older peoples care homes. In practical terms, this means that care staff cannot access the beds from both sides, but only from one side.
• There is a lack of en-suite wet rooms in the building which impedes the ability of residents to wash within their own rooms (as opposed to washing in assisted bathrooms) or independently should they be able to.
• The width of the doors in a number of bedrooms is not sufficient for a hospital bed or for residents with mobility issues.
• The layout of the building creates numerous ‘blind-spots’ which necessitate a more intensive staffing structure than that generally associated with schemes of the current size. Each wing comprises 8-beds this compares with most purpose-built nursing homes where there are 12-15 beds per unit.
• There are a number of additional fire safety concerns with the property which the Council has been addressing with the London Fire Brigade relating to the building’s ability to withstand heat for an adequate length of time in the event of a fire.
• The building is not built to withstand progressive collapse. Current building guidance states that only residents who are able to mobilise would be able to reside in these rooms therefore this limits which residents the Council could place in these beds.
• Structural walls limiting design team ability to adjust room composition.

As part of the detailed feasibility study that was conducted, options for being able to accommodate the remaining residents on site were considered but this in itself would require a move to another part of the building and presented considerable risks to wellbeing and quality of life. Therefore this was not deemed appropriate.

The option of not consulting on the proposal to close the home and relocate residents to allow for the preferred development Option was considered and rejected. Fairness demands that residents, carers and other stakeholders are consulted before a final decision is made.