Residential or Nursing Home Closure

This is an official Northern Trust policy and should not be edited in any way Residential or Nursing Home Closure Reference Number: NHSCT/11/428 Target audience: This procedure is applicable to professional staff such as Social Workers, Community Psychiatric Nurses and General/District Nurses within the Acute Hospital Services, Mental Health and Disability and Primary and Community Care for Older People s Services Directorates. It also applies to staff within the Corporate Communications Department, Planning, Performance Management and Finance Directorates. Sources of advice in relation to this document: Patrick Graham, Assistant Director Primary Care & Community Care Zara McIlmoyle, Head of Social Work Replaces (if appropriate): N/A Type of Document: Trust Wide Approved by: Policy Committee Date Approved: 27 July 2011 Date Issued by Policy Unit: 11 August 2011 NHSCT Mission Statement To provide for all, the quality of service we expect for our families, and ourselves. 1

Residential or Nursing Home Closure 2

PROCEDURE TO BE FOLLOWED ON NOTIFICATION OF RESIDENTIAL OR NURSING HOME CLOSURE Target Audience This procedure is applicable to professional staff such as Social Workers, Community Psychiatric Nurses and General/District Nurses within the Acute Hospital Services, Mental Health and Disability and Primary and Community Care for Older People s Services Directorates. It also applies to staff within the Corporate Communications Department, Planning, Performance Management and Finance Directorates. Introduction The Northern Health & Social Care Trust contracts with over 200 residential and nursing homes across Northern Ireland. In order to be in a position to react swiftly to an actual or threatened home closure this procedure has been developed. It outlines the actions needed and by whom and will require an inter-agency, inter-directorate and inter-trust response. Residential and nursing homes may cease to operate for a variety of reasons including: Voluntary closure De-registration Sudden event ( eg fire, or structural damage) Irrespective of the reason for threatened or actual ceasing of operations the immediate response should be aimed at ensuring the health and safety of the residents and patients. The procedure for response to any of the events listed above is supported by proformas in the appendices and these will be referred to throughout the procedure. In producing this procedure the University of Birmingham/Association of Directors of Adult Social Services publication Achieving Closure Good Practice in Supporting Older People During Residential Care Closures was used as a benchmark for good practice. 3

Notification of a Closure/Threatened Closure of a Nursing or Residential Home As the majority of placements in independent sector homes are monitored by the Permanent Placement Team, the Assistant Director with responsibility for that team will undertake a co-ordinating role to ensure this procedure is implemented. This Assistant Director will liaise with other directorates to instigate the following procedure and, if necessary, ensure other Trusts with individuals placed in the home are involved. The Assistant Director will also inform all other relevant directorates in the Trust of the proposed closure. When the NHSCT is informed of a threatened or proposed home closure immediate contact should be made with RQIA (if RQIA not the source of the notification) by the nominated Assistant Director to clarify the reasons for and proposed timescale. Although the Regional Contract for Nursing & Residential Home care requires registered providers to inform the Trust of such circumstances this may not always happen. At this stage consideration should be given to whether or not this constitutes a Serious Adverse Incident (SAI) or merit reporting to the RHSCB under the early alert process. Implementation of the Procedure The Assistant Director with responsibility for the Permanent Placement Team will convene a Project Team including representatives from: All relevant care directorates within the Trust Representatives from Contracts & Commissioning Central Bed Procurement Unit Financial Assessments & Client Contracts Dept Corporate Communications RQIA Manager/Proprietor of home in question Trusts with clients/patients placed in the home in question Although those identified are key stakeholders, other Trust services, for example Transport and Catering, many need to be involved depending upon the circumstances of the closure. Legal advice may also be sought from Trust legal advisors. Consideration will also be given for the need to involve advocacy groups. Appendix 1 summarises the roles and responsibilities of each of those identified as part of the implementation team. 4

Initial Project Team Meeting The responsibilities of those agencies/individuals outlined in Appendix 1 will form the basis of the initial Project Team meeting. The Project Team will develop a detailed action plan outlining responsibilities, actions and timescales. A key action will be to ensure that all parties, and primarily residents/patients and their relatives, are kept informed. A sample agenda is attached as Appendix 2. For this meeting to progress matters a significant amount of preparatory work will be required by all parties. Patient/Resident Transfer Arrangements Appendix 3 identifies the key actions that will be required by staff arranging the transfer of patients and residents. These responsibilities will lie with Named Workers/Care Managers/Permanent Placement Team. Agreement will be required at the Project Team initial meeting regarding responsibility for self-funding clients. A key aspect of the transfer process will be the need for a follow-up review within 4 weeks to ensure patients and residents transferred to other homes have settled in their new environment. Aids for Staff Arranging Transfers to Alternative Accommodation Appendices 4 to 8 are included as aids for staff effecting the transfer of patients and relatives to alternative accommodation. Appendix 4 proforma to record meetings with residents/patients/relatives regarding the transfer process. Appendix 5 - checklist for transfer of patients/residents to their new home. Appendix 6 key contact details. Post Transfer Review Approximately 6 weeks after the closure of the affected home the Project Team will reconvene to consider: Outcome of transfers Lessons to be learned Any further actions 5

Equality, Human Rights and DDA This policy has been drawn up and reviewed in the light of Section 75 of the Northern Ireland Act (1998) which requires the Trust to have due regard to the need to promote equality of opportunity. It has been screened to identify any adverse impact on the 9 equality categories and no significant differential impacts were identified, therefore, an Equality Impact Assessment is not required. Alternative formats This document can be made available on request on disc, larger font, Braille, audio-cassette and in other minority languages to meet the needs of those who are not fluent in English. Sources of Advice in relation to this document The Policy Author, responsible Assistant Director or Director as detailed on the policy title page should be contacted with regard to any queries on the content of this policy. 6

LIST OF APPENDICES Appendix 1 Roles and Responsibilities of Implementation Team Appendix 2 Sample Agenda for Initial Project Team Meeting Appendix 3 Actions to Facilitate Patient/Resident Transfer Appendix 4 Record of Relative Meeting Appendix 5 Checklist for Transfer of Patients/Residents to a New Home Appendix 6 Stakeholder Contact Details 7

Appendix 1 Individual/Directorate/Agency Assistant Director - Permanent Placement Team Roles and Responsibilities of Implementation Team Community General Managers/ Heads of Service within programmes of care with clients/patients placed in affected home Responsibility Convene implementation Act as point of liaison between all involved Keep Director/SMT informed of progress Information regarding clients/patients placed in affected home, including next of kin details Liaise with Central Bed Procurement Unit regarding possible vacancies Contracts & Commissioning Establish contact with registered provider/manager to clarify provider intent/timescale Hold provider to account in respect of contractual agreement Central Bed Procurement Unit Advise of vacancies in other homes appropriate to the affected client group/groups Financial Assessment & Client Contracts Dept Provide details of Trust funded placements, with financial arrangements, of clients/patients in affected home Advise of any third party arrangements/above tariff placements Corporate Communications Advisee of need for communication with media/ public representatives/relatives/others RQIA Advise the NHSCT of all individuals placed in the affected home Maintain close contact with the NHSCT in respect of any concerns encountered during the closure phase Manager/Proprietor of affected home Provide information including care plans/records of client/patient care to ensure smooth transfer of clients/patients Keep trust updated with plans for closure Other Trusts To maintain contact with the NHSCT co-ordinating Asst Director in respect of their intent/progress. The above list of stakeholders and responsibilities is not exhaustive as the implementation of actions to affect a home closure will require further detailed processes. These will be further explored at the initial strategy meeting. 8

Appendix 2 Version: 4 Strategy Meeting of Home Closure Project Team A G E N D A Attended by 1. Introductions/roles 2. Clarify details of potential home closure RQIA/Proprietor Consider if SAI/Early Alert Communication with RHSCB/RQIA/DHSSPS 3. Number of residents/patients affected: NHSCT Other Trusts Self-Funders Respite Day Care FACCD Operational Managers 4. Alternative accommodation options CBPU: Financial Implications/Above Tariff/Top Ups By Locality 5. Preparatory actions to effect resident/patient transfer 6. Information for residents/patients/relatives 7. Advocacy support 8. Media considerations Corporate Communications/RQIA 9. Action plan with responsibilities and timescales 10. Date of next meeting 9

Appendix 3 ACTIONS TO FACILITATE PATIENT/ RESIDENT TRANSFER Version: 4 1. Ensure monitoring of residents in a care home from present date to decant process is completed. 2. Establish a communication plan to meet with families and residents Identify key staff to complete monitoring visits over 7 days a week. Draw up a rota/ plan Draw up check list for monitoring visits Identify key staff to meet with family members Agree date/ times and venues Agree time scale Agree what information will be shared at this time Provide information regarding alternative placements Provide information regarding any financial implications (top ups) 3. Establish communication/ planning with care home Agree communication and management of decant process management and staff 4. Locate and secure alternative placements Liaise with Bed Procurement Team regarding available placements. Review of residents care needs o Identify appropriate placements in suitable localities to meet individual needs. o Agree review process for all former residents 5. Establish a communication strategy with GP s and other professionals Liaise with corporate communications Identify practices that need to be contacted Agree with GPs visits to residents re: medical conditions prior to move Liaise with SMT Liaise with political representatives 10

6. Transport arrangements Agree with family transport of relative o Agree use of taxi s or ambulances as appropriate 7. Finance Agree with finance transfer of payments Liaise with finance re: implications of terminating contract Agree internally the implications of additional top ups 8. Transfer of residents Secure notes and care plans List of current medication and dosage/ application Previous medical history Arrange for Managers of new homes to visit and meet clients Residents to be accompanied to new home and reassured (relative) Preferences for care identified Months supply of medication 9. Post transfer arrangements Review of transferred residents/patients within 4 weeks of transfer 11

Appendix 4 Version: 4 Record of meeting with relatives Nursing/ Residential Home Re-settlement Process Name of Patient/Resident: Venue: Date and time: Present at meeting: Advise of Trust position: Issues/ comments: Advising patient of situation: Locations family would consider for alternative home: Additional Top Ups: Any other discussion: 12

Appendix 5 Checklist for transfer of patients/residents to a new home Version: 4 Name of Patient/Resident: Name of Home: DOB: Date of Transfer: Areas to be Addressed Nursing Care plans Medication Synopsis of patients condition and significant events in past 6 months Comments Copy of Medicine Kardex One months supply of medication Care home to provide. (Ensure adequate notice given for home to complete) Sign and date when arranged Equipment Paperwork Trust equipment for return or transfer with patient CBPU Escalation forms Copy of last review to new home Personal Belongings Packed by: Home of Family Transport GP Monitoring of new placement Family or Trust Chairbound or bed bound Inform of transfer to new home Change of GP if necessary Phone call in 2 3 days to home and family Review in 2 3 weeks 13

Appendix 6 Stakeholder Contact Details Version: 4 NAME JOB TITLE P.O.C ADDRESS TEL: EMAIL Ms Elaine Way Chief Executive Western Health and Social Care Trust Mrs Mairead McAlinden Chief Executive Southern Health and Social Care Trust Mr Colm Donaghy Chief Executive Belfast Health and Social Care Trust Mr Hugh McCaughey Chief Executive South Eastern Health and Social Care Trust Mr Sean Donaghy Chief Executive Northern Health and Social Care Trust Trust Headquarters, Altnagelvin Area Hospital Site, Glenshane Road, Londonderry, BT47 6SB Trust Headquarters, College of Nursing, Craigavon Area Hospital, 68 Lurgan Road, Portadown, BT63 5QQ Trust Headquarters, Roe Villa, Knockbracken Healthcare Park, Saintfield Road, Belfast, BT8 8 BH Ulster Hospital, Upper Newtownards Road, Dundonald, Belfast, BT16 1RH The Cottage, 5 Mr Larry O Neill Director Finance The Cottage, 5 Dr Peter Flannagan Director Medical & Governance The Cottage, 5 Mrs Una Cunning Director (Acting) Primary Care & Community Care for Older Peoples Services The Cottage, 5 Valerie Jackson Director Acute Hospital Services The Cottage, 5 028 Elaine.way@westerntrust.hsc ni.net 028 Mairead.mcalinden@southern trust.hscni.net 028 Colm.donaghy@belfasttrust.h scni.net 02890553100 Hugh.mccaughey@southeast erntrust.hscni.net 02825633701 Sean.donaghy@northerntrust. hscni.net 02825633748 Larry.oneill@northerntrust.hsc ni.net 02825633757 02825633763 Una.cunning@northerntrust.h scni.net 02825633729 Valerie.jackson@northerntrus t.hscni.net 14

Jacinta Melaugh Director Human Resources The Cottage, 5 Martin Sloan Director Planning Performance Management & Support services The Cottage, 5 Cecil Worthington Director Children s Servcies The Cottage, 5 Oscar Donnelly Director Health & Disability Services The Cottage, 5 Beverley Mitchell Manager CBPU Finance Spruce House, Braid Valley Hospital Site, Cushendall Road, Ballymena, BT43 6HL Isobel Selwood Financial Assessment Manager Finance Spruce House, Braid Valley Hospital Site, Cushendall Road, Ballymena, BT43 6HL Noelle Barton Assistant Director Mental Health Holywell Hospital, 60 Steeple Road, Antrim, BT41 2RJ 02825633772 Jacinta.melaugh@northerntru st.hscni.net 02825633718 Martin.sloan@northerntrust.h scni.net 02825633703 Cecil.worthington@northerntr ust.hscni.net 02825633714 Oscar.donnelly@northerntrust.hscni.net 02825635789 Beverley.mitchell@northerntr ust.hscni.net 02825635557 Isobel.selwood@northerntrust.hscni.net 02894413314 x3314 Noelle.barton@northerntrust. hscni.net Mr Nigel Stratton Mrs Anne Orr Interim Assistant Director Assistant Director (Acting) Learning Disability Team Physical Health and Disability Spruce House, Braid Valley Hospital Site, Cushendall Road, Ballymena, BT43 6HL Spruce House, Braid Valley Hospital Site, Cushendall Road, Ballymena, BT43 6HL 02825635591 nigel.stratton@northerntrust.h scni.net 02825635464 Anne.orr@northerntrust.hscni. net 15

Mr Patrick Graham Assistant Director PCCOP S Spruce House, Braid Valley Hospital Site, Cushendall Road, Ballymena, BT43 6HL Mr Roy Hamill Interim Assistant Director PCCOP S Spruce House, Braid Valley Hospital Site, Cushendall Road, Ballymena, BT43 6HL Mrs Pamela Craig Deputy Director PCCOP S Route Site, 8E Coleraine Road, Ballymoney, BT53 6BP Margaret Mulholland Head of Communications Corporate Communications Muriel Dickson Head of Nursing Homes and Pharmacy R.Q.I.A Mr John Black Head of Residential/ R.Q.I.A Day Care Mr Kevin Keenan Assistant Director Older People and Adults Regional Health and Social Care Board Breige Donaghy Assistant Director Strategic Planning and Modernisation The Cottage 5 Ballymena, BT43 6DA 9 th Floor, Riverside Tower, 5 Lanyon Place, Belfast 9 th Floor, Riverside Tower, 5 Lanyon Place, Belfast Health and Social Care Board, Northern Office, County Hall, 182 Galgorm Road, Ballymena, BT42 1QB Bush House, 23 Bush Road, Antrim, BT41 2QB PSNI, PPU Staff Under Review Home Management Under Review Age NI 3 Lower Crescent, Belfast BT7 1NR Patient Client Council Belfast Area and South Eastern Area 1 st Floor, Lesley House, 25-27 Wellington Place, Belfast, BT1 6G 02825635511 Patrick.graham@northerntrust.hscni.net 02825635574 Roy.hamill@northerntrust.hsc ni.net 02827661451 x3451 Pamela.craig@northerntrust.h scni.net 02825633726 Margaret.mulholland@norther ntrust.hscni.net 02890517500 Muriel.dickson@rqia.org.uk 02890517500 John.black@rqia.org.uk 02825311211 Kevin.keenan@hscni.net 0289442 4628 Breige.donaghy@northerntrus t.hscni.net 02890245729 08009170222 INFO.PCC@HSCNI.NET 16

Patient Client Council Northern Area Patient Client Council Southern Area Patient Client Council Western Area Houston s Mill Site, 10a Buckna Road, Broughshane, BT42 4NJ Quaker Buildings, High Street, Lurgan, BT66 8BB Hilltop, Tyrone and Fermanagh Hospital, Omagh, BT79 ONS 08009170222 INFO.PCC@HSCNI.NET 08009170222 INFO.PCC@HSCNI.NET 08009170222 INFO.PCC@HSCNI.NET 17