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Royal Preston Hospital use of city care home hailed a success

Posted on - 5th May, 2023 - 7:00am | Author - | Posted in - Deepdale, Fulwood, Health, Preston News, Sharoe Green
One of the rooms at Finney House

More than 500 patients have been admitted to a former care home in Preston since it was converted into a new facility designed to look after people who would otherwise be stuck in hospital – even though they no longer needed to be there.

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As first revealed by the Local Democracy Reporting Service (LDRS), the trust that runs the Royal Preston and Chorley and South Ribble hospitals took over the Finney House site in Deepdale in November last year.

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While the top floor of the three-storey building remains reserved for pre-existing, fee-paying residents, the other 64 beds are available for use by patients who are medically fit to leave hospital, but whose discharge has been delayed. At Lancashire Teaching Hospitals NHS Foundation Trust (LTH), that tally often topped 100 on any given day last year, with hold-ups likely to have been as a result of patients waiting for care packages to be set up so that they could return home safely, or because they needed a place in a residential or nursing home.

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The LDRS understands that by the third week of April, there had been 550 admissions to the largely repurposed Finney House building, on Flintoff Way – with 490 people having been discharged after a short stay.

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Initially, 32 beds were turned over for use by the hospital during the height of the pressure caused by what was widely regarded as an unprecedented winter of demand for NHS services. That number then doubled when more of the site was overhauled in March.

A cinema room at Finney House

Speaking to the LDRS before the latest admission figures were revealed, Faith Button, LTH chief operating officer, said that the Finney House facility proved invaluable for both patients and hospital bosses when space was at a premium in the first few months after it was opened.

“[It] was brilliant and it really helped [with] the winter pressures. We had an average length of stay of just under four days, which [means] it is not getting clogged up.

“We wrap a team around [the patients in Finney House] of social workers, our discharge team and the community teams to really make sure we get patients out into the right placement [in] an appropriate setting.

“The standard of care is good, the patient experience feedback is really good – and it’s a nice facility.

“The whole [health and care] system [benefits] – the ambulance [service] will win, social services will win and it’s a really good [example] of working together,” said Ms. Button, who has been encouraged by how few people who have passed through the new unit’s doors have needed to be readmitted to hospital. Out of the 147 patients to have been sent to Finney House by early January, only 11 subsequently found themselves back in a hospital bed.

Inside Finney House in Deepdale

The trust says that caring for a patient in Finney House costs half as much as it does to look after someone residing in hospital – that is in spite of the more luxurious setting of the former, which still boasts the en-suite bedrooms around which the care home was originally designed, as well as facilities like a small cinema and communal sitting areas. It was described as being akin to a “boutique hotel” when it opened in its original incarnation in 2016.

It is hoped that the arrangement will also help to make permanent improvements to the flow of patients through hospital – from their arrival at the ‘front door’, via Accident and Emergency, to the ‘back door’ and the point at which they are discharged from the wards if they have ended up being admitted.

The recent pressure on hospitals like the Royal Preston stems from the delays often experienced in the final stage of that process – when patients are unable to return home as soon as they are physically fit – and the knock-on effect that bottleneck causes at every point in the patient journey.

If wards are at full capacity, they cannot accommodate people admitted from A&E, which often leaves the emergency department itself overflowing – and so unable to accept patients from ambulances within the national standard of 15 minutes from when they arrive.

One of the sofa and eating areas in Finney House

At LTH, ambulance handover times exceeded an hour on 350 occasions in December, but that figure more than halved to 156 in January and halved again to 71 by February.

However, papers from the trust’s board meeting last month also noted that patients waiting over 12 hours on trolleys in A&E increased slightly in February to 134, while the overall bed occupancy levels in the hospital remained “high” at 94.3 percent – an improvement on the 95.8 percent figure for January, but still some way short of the 85 percent level commonly regarded as the ideal maximum proportion of a hospital’s beds that should be filled at any one time.

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Faith Button says that the plan is for the already innovative initiative that has been created at Finney House to evolve into an even more transformational community healthcare hub, base around a “control room” that provides not just a quicker route out of hospital, but a service that means some people are never admitted in the first place.

“We know that once [some elderly people] are admitted, they’re then in [hospital] for a long time and they decondition – home is the best place [for them].

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“Instead of it just being about [extra] beds…we really want to flip Finney House [into a facility that] works with our community teams, some of our doctors and senior nurses and North West Ambulance Service (NWAS) [on] admission avoidance, call handling and sending out an appropriate person [to people in need of help].

“We really want to…work with NWAS so they don’t potentially have to convey frailty patients [to hospital] – the paramedic on the scene could talk to a medic [in the control room]…and [conclude that the person is] okay and they don’t need to come into hospital – but we [might] send out [someone from the] community team, just to check and wrap some [additional support] around them,” Ms Button explained.

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She added that the hoped-for success of the new set-up will lie in bringing representatives from the the many different strands of the health and social care system into one room, where they will not only be better able to work as one to get the best outcome for patients, but also provide a single point of contact for health practitioners operating in the community.

To that end, GPs could have direct access to Finney House to send patients for a brief stay, rather than referring them to A&E and then possibly ending up spending a prolonged spell on a ward.

Ms. Button says that the Finney House operation would also be primed to make use of so-called ‘virtual wards’, which allow patients to be monitored remotely from their own homes via use of digital technology – enabling medics to keep an eye on vital indicators like blood pressure.

“These are the future models that are going to stop this constant admission into hospital and the blocks [that it creates], whilst we do try and work through some of the workforce challenges in social care. In one way, these challenges are pushing us to think differently.

“Three to four admissions a day that we can prevent [would have] filled up [a ward] very quickly – [especially] with the average length of stay.. It’s really exciting, because if we get this [work] right, I really do think it will make a difference.”

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