Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
St Brendan’s Feasibility Study by Technical Services, Comhairle nan Eilean Siar Commissioned by NHS Western Isles and Social and Community Services, Comhairle nan Eilean Siar Background The feasibility study has been commissioned by the Director of Social and Community Services, Comhairle nan Eilean Siar and the Western Isles Health Board to establish the feasibility of upgrading the existing St Brendan’s Hospital and Care Home in Castlebay to achieve the current standards set out in the National Care Standards ‘Care Homes for Older People’ and the NHS Design Guidance. A number of options are to be investigated including refurbishment and extension of the existing facility and new build options. The options to be investigated include the following: 1 2 3 4 5 6 7 8 9 10 11 12 Refurbishment/Modernisation of current social care only facility Refurbishment/Modernisation of current healthcare only facility Refurbishment/Modernisation of current joint health and social care facility New build social care only facility on current site New build healthcare only facility on current site New build of current joint facility on current site New build health care ‘hub’ on current site New build health and social care ‘hub’ on current site Development of a health care ‘hub’ on alternative site(s) Development of a health and social care ‘hub’ on alternative site(s) Redesign of Healthcare only facility on an alternative site(s) Redesign of joint health and social care facility on an alternative site(s) Client Brief In collaboration with Social and Community Services, Comhairle nan Eilean Siar and the Western Isles Health Board an accommodation schedule was prepared for each option based on NHS design guidance and the National Care Standards ‘Care Homes for Older People’ (Appendix 1). Existing Site and Building •Access from residential estate •Parking provision for 15 vehicles •Existing 3 phase electricity supply •Existing 54mm water supply - would need upgrading to 90mm for fire fighting purposes •Existing septic tank – new connection to foul sewer would be required. •Existing BT connections •Variable ground conditions including areas of rock at depths of between 0 – 800mm. •Helipad access Flood Risk Assessment Existing site is outwith the flood risk area with the exception of the South East corner. Alternative Sites • • • • • • • • • • Consultation with Planning Policy Officers and Local Development Plan Fully accessible by road and within close proximity of a suitable helipad Ideally within the Castlebay area On site parking for up to 32 vehicles including disabled parking, plant access and ambulance drop off bay Pedestrian level access from pavements and from the car park Suitable ground conditions i.e. no significant depths of sand or peat Close proximity to existing services i.e. electricity, BT and water connections Suitable foul and surface water drainage The site must not lie within a flood risk area (planning policy will not accept a hospital development within a low to medium flood risk area LDP Policy 7:Flooding) The site must be suitable to take a maximum building footprint of 1980 sqm (single storey footprint) Initial Options Appraisal New Build 2 Storey Joint Facility •REQUIRES MINIMUM 3 ESCAPE STAIRS •PASSENGER LIFT •SHARED KITCHEN •REQUIRES PURCHASE OF ADJOINING LAND FOR ACCESS AND BUILDABILITY •DEMOLISH EXISTING CARE HOME ON COMPLETION AND LANDSCAPE/CAR PARK SITE GIFA INCLUDING PLANT AND STORES APPROX 1700 SQM Initial Options Appraisal New build 2 storey hospital and single storey care home •REQUIRE PASSENGER LIFT IN HEALTH CENTRE/HOSPITAL •SEPARATE CATERING KITCHENS FOR HOSPITAL/CARE HOME •SEPARATE STAFF WELFARE FOR HOSPITAL/CARE HOME •REQUIRES PURCHASE OF ADJOINING LAND TO ACCOMMODATE FOOTPRINT •DEMOLISH EXISTING CARE HOME ON COMPLETION AND LANDSCAPE/CAR PARK SITE GIFA INCLUDING PLANT AND STORES APPROX 1800 SQM INCREASED COST DUE TO INCREASED BUILDING FOOTPRINT Initial Options Appraisal New build single storey hospital, care home and health centre •SEPARATE STAFF WELFARE AND KITCHENS FOR HOSPITAL/CARE HOME/HEALTH CENTRE •REQUIRE PURCHASE OF ADJOINING LAND TO ACCOMMODATE FOOTPRINT •LANDSCAPING/ CAR PARKING COULD ONLY BE PARTIALLY COMPLETED UNTIL HEALTH CENTRE IS COMPLETE. GIFA INCLUDING PLANT AND STORES APPROX 1980 SQM INCREASED COST DUE TO INCREASED BUILDING FOOTPRINT Options Appraisal Conclusions • There was no viable alternative site that could accommodate a building of this scale and that was identified as suitable for development in the proposed Local Development Plan. • The existing site could accommodate a new build two storey facility whilst the existing care home and hospital remain operational. • Adjoining croft land would have to be purchased to allow the existing site to be developed and allow for sufficient car parking and access. • The existing site offers the advantage of having existing connections to services, an established helipad, existing road access, stable ground conditions and minimal land acquisition costs. It was therefore agreed to pursue the following options in more detail; Option 1 Option 2 Option 3 Option 4 Option 5 Option 6 Option 7 Option 8 Refurbishment/Modernisation of current social care only facility Refurbishment/Modernisation of current healthcare only facility Refurbishment/Modernisation of current joint health and social care facility New build healthcare only facility on current site New build social care and separate healthcare facility on current site New build of joint health and social care facility on current site New build healthcare ‘hub’ on current site New build health and social care ‘hub’ on current site OPTION 1 Refurbish/Modernise Existing Care Home Pros •Makes use of the existing site •Provides a single storey option for the care home living accommodation •Minimises land acquisition costs •Helipad can remain in existing location •Single storey hospital is retained •Retains shared staff accommodation and kitchen Cons •Temporarily closing the care home for a minimum of 12 months. •Restricted plant access for building construction •Additional land would be required to accommodate the car park. •Upgrading the building fabric would be costly. Loss of internal floor area due to additional insulation levels required to meet current energy standards. •Extending out the west elevation would mean the relocation of plant and the new standby generator (installed Feb 2012). This could not be relocated whilst the hospital is occupied. •If the hospital was to be upgraded at a later date, additional land would be required. OPTION 2 Refurbish/Modernise of Existing Healthcare Facility Pros •Makes use of the existing site •Provides a single storey option for the hospital •Minimises land acquisition costs •Helipad can remain in existing location •Care home is retained in existing location •Retains shared staff accommodation and kitchen Cons •Significant remodel of existing facility required. •Construction would not be possible without decanting patients and temporarily closing the hospital for a minimum of 12 months. •The restricted area of the site would mean plant access for building construction would be limited and would present operational difficulties for the existing care home. •Additional croft land would be required to accommodate car park. This would involve significant rock removal and leveling of the site. •Access road would have to be reconfigured to allow access to the care home and hospital. •Upgrading the building fabric would be costly and would mean a loss of internal floor area due to additional insulation levels required to meet current energy standards. •If the care home was to be upgraded at a later date, additional land would be required. OPTION 3 Refurbish/Modernise Existing Care Home and Hospital Pros •Makes use of the existing site •Provides a single storey option for the care home living accommodation and hospital •Helipad can remain in existing location •Retains shared staff accommodation and kitchen Cons •Significant remodel of existing facility required. •Construction would not be possible without decanting patients and temporarily closing the hospital and care home for a minimum of 12 months. •The restricted area of the site would mean plant access for building construction would be limited and would present operational difficulties for the existing care home. •Additional croft land would be required to accommodate car park. This would involve significant rock removal and leveling of the site. •Access road would have to be reconfigured to allow access to the care home and hospital. •Upgrading the building fabric would be costly and would mean a loss of internal floor area due to additional insulation levels required to meet current energy standards. •Land acquisition costs incurred to acquire sufficient croft land for access and parking Option 4: New build health care only facility on current site Pros •New purpose built facility that meets current NHS Design Guidance •Lower revenue costs due to good energy performance of new building •New build can be constructed without the need to decant patients or temporarily close the hospital •Two storey option proposed to minimise footprint and build costs •Helipad can remain in existing location •Existing hospital accommodation could be used to upgrade the existing care home facility Cons •Land acquisition costs for adjoining croft •Significant rock removal and retaining walls required to form building footprint, access and car parking •Two storey building would require the use of a passenger lift to be fully accessible. Operational difficulties could occur should the lift fail. •The development of a new build hospital on the existing site would place limitations on any future or concurrent modernisation of the existing care home as site area would be significantly reduced. •Increased revenue costs for CNES of existing building when hospital moves into new build Option 5: New build social care and separate healthcare facility on current site Pros •New purpose built facilities that meet Standards •Lower revenue costs due to good energy performance of new buildings •Constructed without the need to decant patients or temporarily close the hospital •Two storey options proposed to minimise footprint and build costs •Helipad can remain in existing location •Revenue costs can be easily separated •Lower ground floor proposed in care home option to make use of site gradient and minimise rock excavation Cons •Land acquisition costs for adjoining croft •Significant rock removal and retaining walls required •Additional building footprint required as certain accommodation cannot be shared if two separate buildings are proposed •Additional rock excavation required for increased footprint of two separate facilities •Demolition costs •Restricted site for contractors •Two storey building would require the use of a passenger lift to be fully accessible. •Increased construction period due to larger building footprints. Option 6: New build of joint health and social care facility on current site Pros •New purpose built facility that meets Standards •Lower revenue costs due to good energy performance of new building •New build can be constructed without the need to decant patients or temporarily close the hospital and care home •Two storey option proposed to minimise footprint and build costs •Shared staff and patient facilities can reduce building accommodation •Helipad can remain in existing location •Minimal land acquisition costs and the most cost effective building footprint •Shorter construction period due to efficient building footprint. Cons •Land acquisition costs for adjoining croft •Significant rock removal and retaining walls required to form building footprint, landscaping and fire escape access •Demolition costs •Restricted site for contractors to erect new build; phased build may be required. •Two storey building would require the use of a passenger lift to be fully accessible. •Revenue costs will have to be zoned and divided between the two building occupants e.g. NHSWI and CNES Option 6: New build of joint health and social care facility on current site This option is feasible as it presents an efficient building footprint with adequate area for car parking, access and landscaping. Revenue and capital costs are reduced by sharing facilities between the care home and hospital. Construction time is also reduced due to the efficient footprint and overall area of the building. Option 7: New build healthcare ‘hub’ on current site Pros •New purpose built facility that meets current NHS Design Guidance •Lower revenue costs due to good energy performance of new building •Constructed without the need to decant patients or temporarily close the hospital and care home •Two storey option proposed to minimise footprint and build costs •Helipad can remain in existing location Cons •Land acquisition costs for adjoining croft •Significant rock removal and retaining walls required •Restricted site for contractors to erect new build •Two storey building would require the use of a passenger lift to be fully accessible. Operational difficulties could occur should the lift fail. •Limits the opportunities to modernise the care home either concurrently or at a later date •Limits opportunities to share staff, plant and ancillary accommodation with the care home •Extensive car parking required for the GP surgery which would be difficult to accommodate with the existing building remaining. Option 8: New build health and social care ‘hub’ on current site Pros •New purpose built facility that meets current Standards •Lower revenue costs due to good energy performance of new building •Constructed without the need to decant patients or temporarily close the hospital and care home •Two storey option proposed to minimise footprint and build costs •Shared staff and patient facilities can reduce building accommodation Helipad can remain in existing location •Minimal land acquisition costs and the most cost effective building footprint •Shorter construction period due to efficient building footprint. Cons •Land acquisition costs for adjoining croft •Significant rock removal and retaining walls required • Demolition costs •Restricted site for contractors to erect new build; phased build may be required. •Two storey building would require the use of a passenger lift to be fully accessible. •Revenue costs will have to be zoned and divided between the two building occupants e.g. NHSWI and CNES •Significant increase in parking provision to accommodate GP surgery Option 8: New build health and social care ‘hub’ on current site This option is feasible as it presents an efficient building footprint with adequate area for car parking, access and landscaping. Revenue and capital costs are reduced by sharing facilities between the care home and hospital. Construction time is also reduced due to the efficient footprint and overall area of the building. Options Appraisal Conclusion • • • • • The options appraisal sought to identify the most feasible solutions and the conclusions are noted as follows; Options 1, 2, and 3 were deemed unfeasible as the works could not be carried out in a safe manner whilst the existing care home and hospital was in occupation. No facilities have been identified for decanting residents and both NHSWI and CNES could not permit a temporary closure of either facility at this time. Option 4 and 7 would present a feasible opportunity for a new build of the hospital facilities on the existing site, however in doing so it would present a number of limitations on the existing building and the operation of the site as a whole. Option 5 is deemed unfeasible as it does not present an efficient building footprint and the separation of the two facilities increases capital and revenue costs. It is therefore recommended to proceed with cost analysis for Option 6 and 8 and present the findings in section 10 of the report. Recommended Options Option 6 • Hospital and shared staff areas on ground floor • Care home on upper floor • 3 escape stairs and a passenger lift • Level access escape to residential garden • Living accommodation oriented towards Kismul Castle Option 8 • Similar configuration to Option 6 with the addition of a GP surgery • Additional car parking required Floor plans are indicative at this stage in order to establish an accurate cost plan. Building Services • Biomass boiler recommended • Oil back up • Oxygen generator and piped oxygen • CCTV • Patient and resident call out systems • Departure alert system • Water tank for fire fighting Planning Consultation • Kisimul Castle is a Scheduled Ancient Monument, meaning any proposed development that would have an impact on its setting will require consultation with Historic Scotland. • Due to the coastal location of the site, otters which are a European protected species may be present. An otter survey may be required. • As the site is in a coastal location, flooding could be an issue. The preferred proposal to develop to the north of the existing site would avoid the need to consider flood risk further. • An early submission of a Development Impact Assessment will allow meaningful consultation with Scottish Water with regards capacity for the development (refer to para 4.1.2). Health and Safety • CDM Regs apply in full • Phasing works to ensure health and safety of staff, residents and construction personnel • Asbestos survey of existing premises (demolition survey for refurbishment options) Cost Plan • Cost estimate for Option 6 and 8 is included in report • Costs do not include for revenue costs or loose furniture or specialist fit out items e.g. dental chairs, sterilisation equip. • Cost plan does not include for land acquisition and legal fees or VAT. Conclusions • It is feasible to erect a 2 storey care home and hospital on the existing site with the acquisition of a portion of adjoining croft land. Project Risks • • • • • • Water supply capacity for fire fighting Management of health and safety on site Tendering works located in Barra Risk of inflation and escalating materials costs Impact of revenue cost calculations Land acquisition and legal costs