Intermediate care services help people to recover, regain independence, and remain at home.

Intermediate care may help people:

  • Remain at home when things start to get challenging or difficult
  • Recover after a fall, accident, acute illness or operation
  • Avoid going into hospital unnecessarily
  • Return home more quickly after a hospital stay

Intermediate care services are usually provided by a mix of health and social care professionals with a range of different skills. The team might include nurses, social workers, doctors, and a range of therapists.

Intermediate care is a free, short-term service, where intensive support if offered to support people to retain their independence, in their own home, as much as possible. Services can be either community-based, including support at home, or bed-based. We currently have two bed-based intermediate care facilities in Warrington – Brampton Lodge and Padgate House.

To find out more information about intermediate care, please see ’Understanding Intermediate care, Including Reablement: A quick guide for people using intermediate care services’ on the Social Care Institute for Excellence website.

We are looking for your views on the proposed new model for intermediate care, including rapid community response and reablement (more information can be viewed in the consultation documents) and the future of Padgate House.

Options for Padgate House

Option 1: Maintain the current provision

  • We do not consider it financially viable for bed-based services to remain at Padgate House long term as the physical constraints of the building prohibit renovations to meet standards for the future

Option 2: Build a new intermediate care facility

  • A new facility would enable the development of a building that is fit for purpose with the potential to co-locate services on one site
  • A potential site has been identified – Bewsey Old School – which is in proximity to Warrington Hospital
  • Any proposal would require a full technical and financial feasibility study

Option 3: Re-provide beds through existing provision

  • Re-provide the beds from Padgate House into capacity within existing service provision
  • Only facilities that can provide fit for purpose building space would be considered
  • Any proposal would require a feasibility assessment on any potential existing sites that could be utilised, and would require negotiation with the relevant provider(s)

How can you get involved?

The consultation process

We are undertaking a 12-week public consultation. The consultation is open to the public for feedback between these dates:

From Monday 7 December 2020 September to Sunday 28 February 2021.

After the consultation period, we will consider the responses and let you know the outcome.

Consultation responses

Please respond to this consultation by 5pm on Sunday 28 February, either:

Alternatively, if you have any queries about this consultation, would like more information about the modelling work undertaken, or if you would like to request a paper copy of the survey, please email the intermediate care consultation team.

We will also be holding digital where you can hear more about the consultation from the organisations and staff involved in the project (more information to follow).

Frequently Asked Questions (FAQs)

General questions

What is intermediate care?

Intermediate care is a term used to describe a range of services that provide support for a short time to help you recover if you’ve been unwell to increase your independence. Intermediate care services work differently in different parts of the country. In Warrington, we have a range of services that make up our intermediate care provision including:

  • Rapid community response (our crisis service)
  • Reablement and therapy (which helps people learn/re-learn skills necessary for daily living)
  • Intermediate care at home (which provides care at home)

To find out more information about intermediate care, please see ’Understanding Intermediate care, Including Reablement: A quick guide for people using intermediate care services’ on the Social Care Institute for Excellence website.

Will there be any reduction in service availability as a result of these proposed changes?

No. The redesign work is driven by our aims to ensure that services are fit for the future and offer the best possible care, treatment and support to a growing number of people.

Will the redesign result in any changes to the care I currently receive?

Your care is provided based on your individually assessed needs. Any changes to your care will be in response to your needs.

Finance

Is this about cutting costs?

No. The Warrington system, supported by NHS England, has invested additional resources into intermediate care services this year.

How do you know you can afford to re-provide beds from Padgate House somewhere else?

We have not made any decisions about the re-provision of beds at Padgate House. We are seeking your views on this matter as part of this consultation. Any proposals for re-providing beds will be subject to a feasibility analysis, which will include an assessment of costs and affordability.

Workforce

Will there be enough nurses, therapists, social workers, care workers and support staff to support future services?

There is a national shortage of qualified staff across a number of health and social care professions. Many areas nationally experience challenges recruiting staff. We are seeking to develop a more integrated model of delivery that can focus on sharing skills and co-locating services (where appropriate) to reduce unnecessary travel time and enable staff to work more closely together.

We will produce a workforce plan once we have developed our model further.

Will this mean a change to the way staff are employed or managed?

It’s too soon to say. There will be a robust HR consultation process once the staffing for the new service model is understood and agreed. Staff engagement sessions are taking place throughout this consultation process to gather staff views about the future model.

Estates

How do you know that Padgate House is not fit for purpose?

Padgate House has an assessment of ‘Good’ from CQC and a recent survey of patients at Padgate House identified that patients were pleased with an excellent quality of care and support.

We have compared Padgate House, the building, against CQC Regulation 15: Premises and Equipment. The assessment identified over 20 aspects to the building which would benefit from some improvement e.g. the lack of en-suite bathrooms for patients, the lack of parking for staff and visitors, narrow corridors and doorways, no visiting rooms etc.

Can Padgate House be renovated?

We have not made any decisions about the re-provision of beds at Padgate House. We are seeking your views on this matter as part of this consultation.

However, preliminary assessments suggest that renovating Padgate House to the standards required to deliver fit for purpose bed-based care for the future will not be cost effective. The building has a number of constraints e.g. its proximity to a housing estate (which, for example, would prohibit an increase in parking spaces) the footprint of the site (which would not allow for the current number of bedrooms to be extended to accommodate en-suite bathrooms) etc.

If the beds at Padgate House need to be provided somewhere else where will that be?

No decision has been made as yet as we would like to hear your views as part of this consultation.

How will I know if I/my family will be able to travel easily to any new location?

Any proposals for re-providing beds in a new location(s) will be subject to a feasibility analysis which will include an assessment of transport links and travel implications.

Have existing sites been considered?

No decision has been made as yet as we would like to hear your views as part of this consultation.

What are the potential sites for a new building?

Bewsey Old School is currently the only site in scope for this type of use. The location and proximity to the hospital are favourable.

There are a number of other sites but these are reserved for housing development or partnership commercial schemes.

Would you consider using other buildings in Warrington (e.g. an existing care home or empty unit?)

We are open to considering any suitable options at this stage.

How long would it take to build a new facility to replace Padgate House?

It’s too soon to say. If a new building on a new site is considered to be the best option, after a feasibility study, then the scheme will be subject to planning and development processes.

When would Padgate House potentially close?

We don’t know about the future of Padgate House yet. The closure of Padgate House would only happen once any relevant plans were agreed.

Would Padgate House close before an alternative unit was available for use?

We would aim to ensure that Padgate House did not close before an alternative unit was available for use.

If Padgate House were to close in the future what would happen to the building and the land?

It’s too soon to say. We will go through our estates planning processes to come to a decision.

Data

Have you looked at the use of intermediate care services to make sure that there will be enough intermediate care beds for the future?

Yes. We are working with NHS Warrington Clinical Commissioning Group, who commissioned Venn Group to do modelling work to predict the number of beds likely to be required in Warrington, based on expected population need and forecast changes to services. A summary of the modelling work can be viewed below.

IT

Will the new model of intermediate care services ensure that IT systems are able to talk to each other so that we have more connected care?

We are working with Warrington and Halton Hospitals NHS Foundation Trust, Bridgewater Community Healthcare NHS Foundation Trust, and Primary Care to align SystmOne, Lorenzo, EMIS and Mosaic systems as much as we possibly can in the new way of working, so that we can join up information sharing to benefit patients.

Have you completed a Data Protection Impact Assessment (DPIA)?

Yes, we completed a first stage of the DPIA which will be reviewed as the project proceeds.

Assurance

Have you looked at any equality impacts arising from the plans to change some aspects of services?

Yes, we have completed a first stage Equality Impact Assessment (EIA) which will be reviewed as the project progresses.

Have you considered whether any proposed changes impact the quality or safety of service delivery?

Yes. We have completed a first stage Quality Impact Assessment (QIA) which will be reviewed as the project progresses.

Engagement

Have you engaged with patients and carers to understand their views before developing its model for the future?

Yes. A summary of the engagement work we have conducted, in partnership with NHS Warrington Clinical Commissioning Group, is provided in our pre-consultation engagement report, which can be viewed below. There is also a ‘You said, we did’ summary detailing what we have achieved to date.