Transcript St Brendan`s Feasibility Study

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:
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2
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5
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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
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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
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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.
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The existing site could accommodate a new build two storey facility whilst
the existing care home and hospital remain operational.
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Adjoining croft land would have to be purchased to allow the existing site to
be developed and allow for sufficient car parking and access.
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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
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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
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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.
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Due to the coastal location of the site, otters which are a European
protected species may be present. An otter survey may be required.
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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.
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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
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CDM Regs apply in full
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Phasing works to ensure health and safety of staff, residents and
construction personnel
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Asbestos survey of existing premises (demolition survey for refurbishment
options)
Cost Plan
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Cost estimate for Option 6 and 8 is included in report
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Costs do not include for revenue costs or loose furniture or specialist fit out
items e.g. dental chairs, sterilisation equip.
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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
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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