Q: Cranleigh already has two excellent Nursing Homes (Knowle Park and Cedar Court) both of which have expanded in recent years. Can we be confident that this 64-bed care home will operate at full capacity as it will need to?
A: The demand analysis, previously completed, would indicate there is a sufficient demand for this care home in coming years. There remains evidence of older families and couples moving to Surrey to be nearer to the grandchildren, and then as they age, they then require residential or nursing care. (Giles Mahoney, Director of the Integrated Care Partnership)
HC-One has carried out a market research exercise, which shows much higher levels of demand than are being satisfied. The commercial risk of demand falling is HC-One’s alone. The arrangements with regard to the Community Beds are contained in a Block Contract with the ICP. This is a stand-alone arrangement and will be subject to the standard procurement requirements of the ICP. (CVHT)
Q: If HC-One is sold to a new owner or bought by another company, can CVHT guarantee that the existing arrangements will continue in perpetuity?
A: The arrangements between CVHT and HC-One will be secured by covenants in a lease which is registered against the land title. If HC-One is sold, then the purchaser has to abide by the terms of the lease. CVHT retains the freehold of the land and no purchaser will want to breach the covenants in the lease and thus face the possibility of having the lease terminated and the Care Home handed over to CVHT. Lastly, the obligations are also secured in a Section 106 agreement between CVHT, Waverley Borough Council and HC-One and these obligations specifically operate in perpetuity.
Q: Will CVHT be involved in the decision making process when it comes to allocating the beds to local patients?
Surrey County Council (SCC) are keen to have the option to place those they need to fund in a good quality care home setting, which the CVHT/HC-One community beds would provide, so this will be funded by SCC. The Integrated Care Partnership – the ICP (Made up SCC, CCG, RSCH and other local partners) will lead the process of directing patients to the community beds. We do not envisage CVHT having the capability, capacity or interest in being involved in this process. As now with the RSCH, proximity to a patient’s locality is encouraged to help connect people with their local community, family and friends. (Giles Mahoney, Director of the ICP)
Q: Will the community beds be free at the point of delivery or means tested?
A: After initial assessment, some patients will need to self-pay, and therefore may then move to a more permanent setting of their choice, which could include receiving a package of care in their own home. (Giles Mahoney, Director of the Integrated Care Partnership)
Q: For how long into the future will the 16 community beds be available to local residents?
A: Modelling by Surrey County Council (SCC) has indicated an increasing demand for care homes in the coming years, given the rapidly ageing population, especially in Waverley. (Giles Mahoney, Director of the Integrated Care Partnership)
Q: Can a private care home truly provide the exact model of care, as the Village Hospital did up until 2006?
A: The model of care, which has developed even further since Covid-19, will enable patients to be discharged to the community, to be assessed in their own home or a care home. This will enable people who are medically fit for discharge, to leave the acute hospital setting quickly, and assessments to be made in a more community-based setting, rather than in an acute setting. Patients in the community beds will not require significant medical input. (Giles Mahoney, Director of the Integrated Care Partnership)
Q: Which GPs will provide services to the new care home and its community beds?
A: Before tendering, GPs from local and private practices will need to see full details of clinical governance arrangements and required medical input in the Care Home, which will be provided by the Integrated Care Partnership. This process will take place once planning consent is granted. What is expected of GPs working in private care homes was set out by NHS England in the document ‘Securing excellence in commissioning primary care’.
Q: What are Community Beds and who will get to use them?
Community Beds are beds in community hospitals and care homes that were previously administered by the NHS through the local Clinical Commissioning Group (CCG) but are now to be administered by the Integrated Care Partnership (the new umbrella organisation for the NHS and Adult Social Services).
They provide a variety of care, including step down from RSCH, continuing care, social care nursing, end of life and dementia care.
Giles Mahoney, Director of Guildford and Waverley Integrated Care Partnership (ICP), has emphasised that the Community Beds in Cranleigh will be prioritised for those patients living in Cranleigh and the surrounding villages as this is the most logical use of the Beds, to ensure patients are close to loved ones and their support network which is critical in recovery from illness.
This was the same approach applied to the old Village Hospital in-patient beds where local Doctors allocated the beds at that time.
There were no restrictions on who could enter those beds and, occasionally, patients were admitted from out of the area if there was a vacant bed and no immediate demand from the village or local area.
Admission to the Community Beds will be administered by the ICP under a legal agreement, which the ICP will only enter into once Planning Consent has been given and a date for completion of the building is known.
Q: How will the healthcare worker accommodation be funded?
A: HC-One will pay CVHT £1m for the lease of their part of the site and this, together with pledged donations from local benefactors, will cover the building costs, with the result that no additional capital funding will be required. The envisaged rental income from the block, in the region of £95,000 per annum, will be used to subsidise the beds, support services in the Village Hospital, support the Community Nursing Team and the Cranleigh Medical Practice.
Q: Who will pay for the servicing of the community beds?
A: The beds will be paid for by G&W CCG and SCC, according to use, in a combined block contract arrangement with HC-One.
Q: Who will pay for building the 16 bed community bed wing?
Q: What is the cost of the project?
A: The project cost is approximately £14m.
Q: Who will own the Knowle Lane site?
A: CVHT will continue to own the site in perpetuity.
Q: Are there financial risks for CVHT in partnering with HC-One?
A: The Heads of Terms agreement has addressed any anticipated risk factors.
Q: Why does CVHT need a private partner to provide a 16-bed unit?
A: The opportunity to partner with HC-One makes the return of community beds a reality.
Q: Why is the proposal not a ‘hospital’?
A: The 16 Community Beds will be used in the same way as the original 14 Cranleigh Hospital beds save that they will be delivered as part of a Care Home because the NHS will not agree to a small “stand-alone” unit for clinical governance and financial reasons. The provision of the beds as part of a Care Home allows for the efficient and well-managed treatment of patients in excellent surroundings.