The Limes Nursing Home, St. Helier: Closure

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A decision made 14 January 2016:

Decision Reference: MD-HSS-2016-0005
Decision Summary Title :	Closure of The Limes nursing home		Date of Decision Summary:	12 January 2016
Decision Summary Author:	Director of Service for Older Adults		Decision Summary: Public or Exempt? (State clauses from Code of Practice booklet)	Public
Type of Report: Oral or Written?	Written		Person Giving Oral Report:
Written Report Title :	Closure of The Limes nursing home		Date of Written Report:	11 January 2016
Written Report Author:	Director of Service for Older Adult		Written Report : Public or Exempt? (State clauses from Code of Practice booklet)	Public
Subject: Closure of The Limes nursing home.
Decision(s): ~~That t~~The Minister ~~agrees~~ decided to close The Limes as a nursing home facility by the end of April 2016.
Reason(s) for Decision: The Limes was originally opened in its current design during the early 1990’s as a residential care home. Over recent years the need for residential care has decreased and gradually the medical dependency level of the patients at The Limes has increased so now all residents have significant nursing needs and are immobile, requiring the use of wheelchairs. The original design of the building was for people who were independently mobile. The risks in evacuating an immobile population in an emergency are greater than evacuating a mobile population and as such the current design of The Limes is not fit for nursing care. The cost of improving the environment to tackle these issues is prohibitive.
Resource Implications: The costs associated with the initial closure process will be funded from the current revenue budget. Once the building is closed there will be estimated savings of £300k in 2016 and £700k from 2017. Patients and their families will be supported in re-locating to alternative appropriate nursing care. Assistance will be offered to staff to find other work in HSSD.
Action required: For ~~the Minister to approve the closure of~~ The Limes Nursing Home to be closed and for the building to be vacated from April 2016.
Signature:		Position: Minister for Health and Social Services
Date Signed:		Date of Decision (If different from Date Signed):

The Limes Nursing Home, St. Helier: Closure - April 2016

Health and Social Services

Closure of The Limes Nursing Home

Background

The decision to close The Limes was announced by HSSD in December 2015. This decision was made due to the risks associated with providing nursing care within the current building that was originally designed for residential care. One of the key differences between residential care and nursing care is the assessed needs of the individuals. People with nursing needs often require assistance with their mobility, including the use of wheelchairs and hoists, to transfer them from one place to another. Currently, none of the patients at The Limes is independently mobile.

The design of nursing home accommodation is such that corridors and doors are wider to allow people in wheelchairs to pass and to allow hoists to be manoeuvred. This is most important during emergency situations when evacuation is required. However, safe handling issues at The Limes are also a cause of concern due to the lack of space. The building is no longer fit for purpose and would not meet new registration standards.

To make the necessary changes to The Limes to bring it up to nursing care standards would require widening corridors, widening bedroom doors and installing a fire sprinkler system. These changes could not be achieved with the patients in situ and they would have to be moved elsewhere, returning when the work was complete. However, upgrading the building is not cost-effective when the independent care sector is offering such high-quality nursing homes.

The planned increase in nursing beds within the independent sector offers the capacity to facilitate the safe closure of The Limes. A new nursing home is due to open during February 2016, which is likely to create vacancies across the sector. HSSD staff are working with the current residents and their families in supporting them to identify good quality nursing care within alternative environments.

The staff at The Limes have been providing good quality care for the residents for many years and HSSD will work with them to identify appropriate alternative employment. It is not envisaged that there will be any redundancies associated with this closure, as there are a number of vacancies throughout HSSD.

Key Issues

The Limes currently provides 25 beds for older people with complex physical care needs. It was originally built in 1993 as a residential home, but over recent years the complexity of patients’ needs has increased, with all service users now receiving full nursing care. The key problems with the current environment are:

• The layout is unsafe for the provision of high quality care to people with complex physical needs due to the corridors, bedroom doors and access to ensuite bathrooms being too narrow. This lack of space results in increased risks of injury to the staff and residents due to the reduced turning space as staff have to lift chairs taking a high proportion of the weight of the resident whilst manoeuvring them.

• Fire control risks have been identified; there is no fire sprinkler system and the absence of self-closing bedroom doors results in total reliance on fire doors in corridors to prevent the spread of smoke and fire. This is of great significance when one considers that all clients are highly dependent and none can walk unaided. Any emergency evacuation would be significantly hampered due to the inability to quickly exit bedrooms and corridors.

• Essential infection and prevention control audit standards cannot be achieved because of fundamental environmental failings. These include poor flooring, frequently blocked drains and wheelchair damage to walls and doors that can lead to higher levels of hospital-acquired infection.

• Often the type of bed used by patients requires changing to meet the needs of the patients. The narrow doorways prevent the changing of beds in a timely manner and engineers have to be called to dismantle the beds to move them. This is also true for bed maintenance – beds need to be dismantled and rebuilt in the bedrooms due to the lack of space in the corridors and doorways.

Conclusion

The Limes nursing home will close by the end of April 2016. The building is the responsibility of Jersey Property Holdings and will be transferred to them upon closure. The current patients and their families will be supported by HSSD staff to identify suitable alternative nursing provision. Staff currently employed within The Limes will be supported to take up alternative posts within HSSD.

11 January 2016