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DESIGN FOR HEALTH & SOCIAL CARE04.18

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Design for health and social caresupplement

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Industry news

COMMENT: Taking care with refurbishments

COMMENT: Fire safety in hospitals

SHOW PREVIEW: Design in Mental Health

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Great white hopeA new cancer treatment unit at Chesterfield Hospital balances rigorousdesign for operational efficiency with a concern for patients’ holistic needsto create a highly supportive environment. Sébastien Reed reports

Opening the book on ageingIn redeveloping a retirement housing scheme to provide a distinctly hotel-style alternative for residents, Ashford Borough Council also decided to apply an open book approach to encourage collaboration. Jack Wooler reports

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Freeing up mental health restrictions, electronicallyMartin Lees of Safehinge Primera discusses what the moves to reduce“restrictive practices” in mental health wards mean for door hardware, andhow electronic locksets form a key part of the solution

Modern glazing for mental healthADF reports on some of the drivers which are leading to innovation inglazing mental health units, to address a particular range of challenges

Navigation made easy, with dementia-friendly flooringAs age-related impairments make it more difficult for people to navigate a building, Mark Jackson of Forbo Flooring Systems examines howinnovative flooring approaches can make life easier for those suffering with dementia

How reducing water usage can mean fewer germsPaul Musgrove from CONTI+ considers the benefits of automated systemsfor water management, and how improved management of water flow canreduce infection risks as well as reducing water usage 27

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PROJECTS

FEATURES

CONTENTS

04.18

ADF04_Health Supp 03-13_ADF Flatplan 28/03/2018 11:23

4 NEWS

WWW.ARCHITECTSDATAFILE.CO.UK ADF APRIL 2018

FROMTHE EDITORDesigning buildings for the healthcare sector has to be one of the most demanding and yet

satisfying disciplines for an architect to tackle. With the often conflicting demands of cash-strapped NHS management, skewed local politics and clinical specialties to balance, it’s no

wonder that buildings for healthcare have often tended to appear more functional than caring.

However over the past couple of decades healthcare architects have continued to develop theirparticular and refined set of specialist skills to provide more and more patient-focused, as well asclinically efficient facilities. Just because a building needs to house hi-tech (and often heavy-duty)equipment, it doesn’t mean that it can’t offer people-centred, and even uplifting characteristics, withcopious natural light and health-supporting elements.

Funding for specialties such as cancer care has seen a boost in recent years, acknowledging both thechallenges facing the UK population generally, and its ageing tendencies. No doubt this has helpedprojects such as the NGS Macmillan cancer care unit at Chesterfield Royal Hospital get off theground, which received £2.5m of its £10m build cost through fundraising by Macmillan, including£1.5m from the National Garden Scheme whose name is also over the door.

The core issue is that as the NHS becomes ever more strapped for cash (and it is estimated to have a£12bn funding gap between now and 2020), we are likely see more innovative partnerships of thistype entered into, in order to initiate future projects. Hikes in income tax are vote-losers (as, often,are building large NHS centres of excellence which mean closing local, less-efficient hospitals), sofunding has to be sought where it can be found.

That said, some of the results of such partnerships can include highly tailored design which putspatients first, and the new NGS Macmillan unit in Chesterfield, which is presented on page 14, is agood example, helping to alleviate the challenges of chemotherapy.

We also report in this special supplement on an interesting open-book contract approach which hasdelivered a facility sensitive to increased numbers of residents with dementia in Ashford.

We hope you enjoy the read, and this snapshot of good practice in design and product specificationfor the healthcare sector.

James ParkerEditor

ON THE COVER...

The new NGS Macmillan unit at Chesterfield Hospitalcombines cutting-edge cancer care with a sensitively-designed environment for patients.For the full report on this project, go to page 15

Cover Image © Mark Hadden

DESIGN FOR HEALTH & SOCIAL CARE04.18

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p u b l i s h i n g – v e r t i c a l s e a r c h


Construction of a research campus atLancaster University which will studydisease prevention, designed by JohnMcAslan + Partners, has started on site.

The 8,000 m2 Health Innovation Campus(HIC) forms Phase 1 of the development,and construction completion is scheduledfor Autumn 2019.

Designed with a target of BREEAMOutstanding, this is the latest of fourprojects to emerge from the practice’s long-standing relationship with LancasterUniversity which has also delivered thePostgraduate Statistics Centre, the CharlesCarter Building and the EngineeringBuilding, as well as a multi-project master-plan for the university campus.

Hannah Lawson, director at JohnMcAslan + Partners, said that the keydesign aim for the new facility was to“maximise flexibility, promote inter-disciplinary working and collaboration,and provide exceptional working andlearning environments.”

Paul Morris, director of facilities atLancaster University, said that: “Thecampus masterplan is an excitingdevelopment for the university which has the potential to bring togetherbusinesses, the NHS, students and academics from a broad range of disciplinary backgrounds.”

The scheme will deliver an internationalcentre focused on tackling “the biggestchallenge in healthcare today – helpingpeople to live as long and as healthily

as possible,” said the architects. While themajority of university health researchcentres are dedicated to finding new curesfor diseases, HIC will concentrate onresearch which will prevent people frombecoming ill in the first instance.

It is hoped the facility will create newjobs by supporting 300 Lancashire-basedsmall and medium enterprises to developnew and innovative digital and technologi-cal solutions, and will have a wider impactby engaging regionally, nationally and inter-nationally with hundreds of companies.HIC will place particular emphasis oninnovations targeted at the “broader deter-minants of health,” the prevention and early

diagnosis of illness, and access to care. Alongside the focus on digital

innovation, this will include the design,development and evaluation of healthyplaces to live and work, improving qualityand value in health innovation systems, andthe development of new materials toimprove health.

Professor Neil Johnson, Dean ofLancaster University’s Faculty of Healthand Medicine, comments: “This facility isan ambitious and exciting development forthe University, for the city and the widerregion. It will deliver significant economicbenefits as well as solutions to help us alllive longer and healthier lives.”

5NEWS

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One Hatfield Hospital in Hertfordshirehas been recognised for its commitment tosustainable design; the new £40m

construction has now been certified as aBREEAM Excellent building following arigorous assessment of design, construc-tion and post-construction stages.

Architects Manning Elliot provided thedesign for the project. Theaccommodation provides a suite ofconsulting rooms, treatment andoperating rooms, endoscopy suite, 30single patient ensuite bedrooms,ambulatory care services and imagingsuite with MRI.

This is the second One Healthcarehospital to be constructed that meetsBREEAM Excellent. The rating system“sets the bar for sustainable, productiveand healthy environments that enhancethe wellbeing of the patients, visitors,nurses and consultants”.

CEO of One Healthcare, AdrianStevensen commented: “An importantaspiration for One Healthcare has been toachieve BREEAM Excellent at both OneAshford and One Hatfield hospitals.”

BREEAM Excellent for Hatfield unit

SUSTAINABILITY

John McAslan + Partners’ Lancaster uniHealth Innovation Campus starts on site

RESEARCH


6 NEWS


What is thought to be the world’s first‘design school’ specialising in environ-ments for people with dementia, andfeaturing experts in dementia design, tookplace in Birmingham’s Crowne Plaza Hotelon 13 March.Hosted by the Dementia Centre,

HammondCare, the event saw people withdementia and a supporter work togetherwith design experts, to learn the skillsneeded to become more involved in theprocess of designing dementia-inclusive environments.The event is the first in a series of design

schools, which it is hoped will result in a“rich bank of knowledge about dementia-inclusive design” that can be used byarchitects, planners, developers and serviceproviders to create better buildings andspaces for people living with dementia.Dementia-friendly design can

significantly improve the quality of life forpeople living with the condition, improv-ing decision making, reducing accidents,

lessening anxiety and helping them livemore independent lives.The design school was co-hosted by

associate professor Colm Cunningham,director of the Dementia Centre, andAgnes Houston MBE, who has been livingwith dementia since 2006 and hascampaigned for the cause.Director of the Dementia Centre,

HammondCare, associate professor Colm Cunningham commented: “I feltthere was a real need to increase theinvolvement of people with dementia indesign. People living with dementia have inmany cases learned to live with environ-mental barriers and have developedpersonal solutions to these challenges thatpeople who do not have dementia couldlearn from.”He continued: “Our design school

will give people living with dementia the unique opportunity to work togetherwith design experts and contribute theirideas and knowledge to the creation

of dementia-friendly environments. This school places the person living with dementia at the centre of design,whether that be a home, a hospital, ashopping centre, a public space or a product.”

‘Design school’ expands knowledge on designing for dementia

EDUCATION

Our design school willgive people living withdementia the uniqueopportunity to worktogether with designexperts and contributetheir ideas and knowledge to the creation of dementia-friendly environmentsColm Cunningham

IBI Group has announced its continuedinvolvement in the Healthy New Townsprogramme working with the King’sFund, who have been appointed by NHSEngland to help produce an official NHSguidance publication, which will bereleased in spring 2019.IBI will be contributing to the Estates

and Digital workstreams aspect of theHealthy New Towns guidance documentand will be supporting The King’s Fund(an independent charity “working toimprove health and healthcare inEngland”), and the Town and CountryPlanning Association (TCPA).The NHS England Healthy New

Towns scheme was set up to “rethink how

we live, and how healthcare services canbe delivered”, and looks at ways toimprove health through the built environ-ment. The new publication will provideevidence-based guidance on how to createhealthy neighbourhoods, towns and cities,particularly in places of populationgrowth and new development.IBI director Mario Bozzo, added:

“At IBI, we are bridging the gap betweendesign and technology, especially inhealthcare. This is a great opportunityto work alongside the NHS, as itcontinues to explore how digitalsolutions can support a more effectivedelivery of healthcare.”In other healthcare news for IBI, the

practice has appointed Maarit Heinonen-Smith from PRP Architects, as the firm’sUK retirement living and senior care lead.Heinonen-Smith has built what IBI said

is an “impressive portfolio designing anddelivering innovative housing and caresolutions for people over 55, havingworked as the lead architect on many oftheir flagship projects”.Heinonen-Smith expressed her happi-

ness about joining the firm, commenting:“I am passionate about designing anddelivering inspiring residential architec-ture which allows for flexibility, individ-uality and changing needs, as well aspromoting the health and wellbeing ofthe residents.”

IBI Group reappointed to NHS Healthy New TownsHEALTHY NEW TOWNS


We have undertaken many contracts within the healthcare sector; predominantly design and buildprojects to create new GP surgeries and medical centres.

In addition, we have carried out major refurbishments and extensions to existing medical premises, procured on a traditionalbasis, with our early involvement greatly assisting the efficiency ofproject delivery. I have worked for Jenner for several years, realising a varied

project portfolio in this time. In 2017 I was awarded the title of‘LABC Non-Residential Site Agent of the Year’ for the HayesbankSurgery project in Ashford, Kent. This £1.1m NHS schemecomprised major refurbishment works and an extension to anexisting GP surgery with 17,000 patients on its register.

The surgery and adjacent pharmacy remained open throughoutthe project. There are many specific challenges on healthcare refurbishment

projects, with the overarching requirement being to carry out thework safely and considerately around the staff and patients at thecentre, and to meet the client’s objectives. Early collaborationwith architects, and close working relationships throughout, aresignificant in the achievement of any refurbishment project.With all projects, it is essential to undertake comprehensive,

pre-construction work to ensure an uncomplicated constructionphase. To achieve this, architects should meet regularly with theclient and end users at the tender stage to ensure the accuracy ofinformation within the pre-construction services pack. The

AWARD-WINNERHayesbank Surgery in Ashford – the surgery and adjacent pharmacy remained open throughout the major refurbishment project

Rod Wooldridge of building firm Jenner gives his view on the success factors fordelivering refurbishments that work for contractor, architect and client, with aparticular focus on GP surgeries and medical centres

COMMENT

Taking care with refurbishments

7VIEWS



provision of detailed surveys and accurate, in-depth projectinformation is fundamental to ensure a seamless construction.Likewise, it’s always important to understand the level of ‘out-of-hours’ working that will be required so that we can make adequateprovision in our pricing.

Good quality surveysM&E and structural surveys are integral to the smooth delivery of aproject from the tender stage onwards. For some projects it is usefulto undertake intrusive ‘opening up’ surveys to provide as-built infor-mation in certain areas of the building. This level of detail also helpsus determine suitable subcontractors to appoint to the project,capable of carrying out the work. We request that R&D asbestossurveys are undertaken as soon as possible so that we canprogramme in the specialist removal of any asbestos,avoiding delays when on site. Full drawing sets (design and workingdrawings) and specifications, are a necessity.

MaterialsIt is critical that architects consider buildability and availability ofmaterials, particularly specialist furnishings. One key example of thison healthcare projects is specialist door sets, which have long lead-intimes. Furniture layouts are very important, and room data sheetmeetings, held with the client and end-users, confirm room layoutsare delivered exactly as agreed.

Phasing Careful phasing of the work is imperative. This should beconsidered well in advance of site works commencing, and withconsultation from the design team and premises staff. It isimportant to hold a pre-start meeting with the end-users to discussthe programme and the main issues. Construction programmesshould allow for lead-in and sub-phase handovers, and phasing plansshould show where temporary partitions are to be sited.

Communication & collaborationRegular meetings with staff, end-users, employer’s agents, the clientand architects, from the pre-construction phase and throughout theproject, are crucial. We hold initial meetings on site with all projectstakeholders to introduce our team, discuss the work and addressany issues. Flexibility is key when working in live environments and Ialways aim to meet at least weekly with practice managers through-out the project to ensure they are satisfied with how the work isprogressing, and to provide an outline of the work planned for thefollowing week.

Preparatory workIt is vital to undertake as much preparation as possible beforeworking in staff and patient areas. This includes meeting end-users,architects and the client’s team to discuss health and safety, security,access and schedules of work. Due to the invasive nature of somework, we often need to arrange for out-of-hours working. Ideally,this will have been identified and included in our tender sums. We always put the needs of the patients and staff first and

co-ordinate our activity to minimise the impact on their dailyroutines. In live environments we have to maintain services(including electricity, fire alarm, security systems, telephones, heating,hot water and air conditioning), and often duplicate some. Thisrequires close co-ordination and communication.

Robust health & safety planning This is essential to ensure the safety of staff, patients and ourconstruction teams. Plans will have been approved well inadvance, and I am responsible for ensuring that the controls areimplemented correctly and that the procedures are followed. I makesure all site personnel are fully inducted and attend toolbox talks,monitoring their performance and adherence to health and safetycontrols throughout the project, and taking action if needed.Meticulous organisation is key to ensure this approach is effective.

Ideally our site compound will be adequate in size with sufficientspace for all plant and materials (including spares), easily accessiblebut stored securely. Our compound is segregated from our areas ofwork and inaccessible to staff and patients. As with all ourrefurbishment works, we implement systems to control dust, fumes,noise and vibration. We use portable partitions that are fire proof,sound deadening and secure. Despite extensive planning and efficient contract management

processes, every project requires a high level of flexibility andco-ordination, especially in occupied premises, such as healthcareschemes. Post-contract review meetings allow us to examine ourperformance at every stage of the works, identifying successes andwhere improvements can be made. Lessons learned are shared andincorporated into future contract management processes, ensuringwe continually improve the service we provide to our clients andsupply chain partners.

Rod Wooldridge is site manager at Jenner Contractors

Architects should meet regularly with theclient and end users at the tender stageto ensure the accuracy of informationwithin the pre-construction services packRod Wooldridge, Jenner Contractors

8 VIEWS



In summer 2017, the Government ordered more than 17,000care homes, private hospitals and hospices to carry out checkson the fire safety of their buildings. A number of hospital trusts

were found to have serious breaches, whilst some had failings inbasic fire standards and others were warned that a failure toproperly compartmentalise areas was putting patients at intolerablerisk if fire broke out (source: Health Service Journal).Fire safety continues to be a concern, particularly in hospitals

that have had refurbishment work carried out, with managers nowstarting to question whether the buildings are as safe as theyshould be.Government guidance on the issue of fire safety risk in healthcare

states: “Where the building has recently been constructed orsignificantly altered, the fire detection and warning arrangements,escape routes and facilities for the fire and rescue service shouldhave been designed, constructed and installed in line with currentBuilding Regulations, by following Health Technical Memorandum05-02. In such cases, it is likely that these measures will besatisfactory as long as they are being properly maintained and nosignificant increase in risk has been introduced.”Health Technical Memorandum 05-02: refers the building

designer to Part B of Schedule 1 of the Building Regulations, whichdetails the requirements to provide for fire safety.

Fire compartmentationBuilding Regulations’ Approved Document B requires that thebuilding be sub-divided into a number of discreet compartments orcells. As the dividing walls are filled with specialist materials, thisprevents the passage of fire from one cell to another for a givenperiod of time. This compartmentation offers essential protection,especially in larger buildings, such as hospitals or care homes,which rely on it to ensure the safety of occupants.It is essential that fire compartmentation is installed correctly

and regularly inspected to ensure it has not been breached. This isbest done as part of a fire risk assessment, which is required underthe Regulatory Reform (Fire Safety) Order 2005.The fire risk assessment must be carried out by a Responsible

person and must be detailed and rigorous, covering many aspects,one of which is ensuring the integrity of fire compartmentation,including fire doors.Compartmentation – when it has not been breached and has

been properly installed – should be able to contain large fires andlimit the amount of damage to a building and its contents.As hospitals are occupied by many vulnerable and immobile

people who may find it very hard (if not impossible) to be

evacuated quickly in the event of a fire, special consideration needsto be given to fire prevention – and fire compartmentation, toensure it is meeting patients’ needs.

PROTECTIONCompartmentation offers essential protection, especially in largerbuildings such as hospitals or care homes

Richard Sutton of Horbury Property Services looks at fire safety in healthcareenvironments, and why it is of critical importance that fire compartmentationis properly inspected

COMMENT

Compartmentation streets

It is essential that fire compartmentationis installed correctly and regularlyinspected in order to ensure that thishas not been breached

9VIEWS


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Identifying breachesFire risk assessment, in the majority of cases, does not extend toinspecting the integrity of the fire compartments. Firecompartmentation can be easily ignored as high risk areas areoften hidden above false ceilings, ducts and risers. Even the mostcompetent person may not have the skills and expertise to ensurethe integrity of the compartmentation, meaning the risk of firespreading can go unknown for months, if not years, often until it istoo late.Inspections of fire compartmentation should include checking

whether any damage has been caused by services that have beenadded since the building was completed, such as cabling or ITsystems, or other building work to the walls, floors or ceilings. Thiscould compromise the integrity of the fire compartment.Fire doors are an important part of ensuring fire

compartmentation is maintained too, but they are often not subjectto sufficiently rigorous or regular inspections. Again, this could leadto a breach of fire compartmentation, for example, if the fire sealsare broken, the door closers are not working properly or theironmongery has become worn or the glazing detached. Theyshould be inspected every six months.

Stay-put policy In many hospitals and multi-occupancy buildings, there is a StayPut policy in place, as these buildings are designed to retain a firewithin a compartment. The greatest risk of death is, obviously, tothose in the room in which the fire starts. In a healthcare environment there is a very clear need for a

person-centred approach, which is tailor-made for each patientwho is vulnerable. The most significant influences on fire risk inhealthcare are advanced age, disability, dementia and mentalhealth problems. 30 minutes’ fire protection, for example,which is offered by a standard fire door, would, in most cases, be

insufficient in a healthcare environment.Research shows that in general, compartmentation and fire

protection of escape routes are successful in containing fire. In thelast 10 years there have been very few cases where residents of ahospital have died as a result of a fire in another room. However,since the tragic events at Grenfell Tower, many healthcare providersare looking into increasing fire detection methods and evenintroducing sprinklers within a building in order to keep the firerisk to a minimum.

Assessing the risksFirecode: HTM 05-02 provides specific guidance on fire safety inthe design of new healthcare premises and major new extensions toexisting healthcare premises. The standards on which it is basedrecognise that fire safety in healthcare is dependent on theinteraction between physical fire precautions, the dependency of thepatient, fire hazards and the availability of trained staff to evacuatepatients safely in a fire emergency. While getting this right atspecification stage is essential, as outlined, ongoing inspection andmaintenance of fire compartmentation is vital.What is widely accepted is that when fire compartmentation is

regularly inspected and well maintained, there is no better form offire protection.

Richard Sutton is the general manager at Horbury Property Services

Research shows that in general,compartmentation and fire protection ofescape routes are successful in termsof containing fire

10 VIEWS



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Design in Mental Health is the onlyUK event to focus on the design ofmental health facilities with a

clear focus on creating calm therapeuticenvironments for patients and staff.Both conference and exhibition are

well attended by NHS trusts and privatehealthcare providers alongside architectsand contractors who design and build thefacilities that they manage every day. The 2018 conference features over 40

speakers, with specialist content. It’s theprofessional gathering for all concerned withthe built environment in mental health.Conference sessions include the following:

Post-Implementation ReviewThe building has been delivered, but is itdelivering the benefits? Post-implementationreviews can allow the stakeholders to reflecton the actual benefits realised by serviceusers, staff and visitors. Has the projectdelivered all of the expected benefits? Haveany additional benefits been identified?Where has it failed to achieve the expectedbenefits? What lessons have been learned?

Personal SpaceResearch suggests that perceiving a sense ofenvironmental control can contributepositively to a sense of well-being. However,opportunities for service users to exertcontrol over their everyday environmentswithin mental health settings are limited.

Sonic SpaceFurther research is required to examine theeffects of noise within mental healthcaresettings. Existing research shows that noiselevels can impact on the health andbehaviour of service users and staff, which inturn highlights the importance of appropriateacoustic design.

Aesthetic SpaceAlthough research to evaluate the impact ofart interventions specifically within mentalhealthcare settings is limited, the findings ofexisting studies suggest that environmentalenhancements can positively impact the

health and well-being of users and staff.

Therapeutic SpaceWhilst spatial tensions exist between themitigation of risk and the creation ofde-institutionalised environments, theliterature suggests that facilitating a balancebetween achieving the required levels ofsafety and creating homely non-sterilespaces should be a key consideration inmental healthcare design.

The exhibition is a unique marketplacewhere manufacturers and providers can meetdecision-makers and specifiers, make newcontacts, generate leads and new productideas, and identify current and emergingopportunities in the mental health sector.The annual Design in Mental Health

Awards Dinner takes place on the 15 May2018, the first night of Design in MentalHealth in the Imperial Suite at the NationalConference Centre. The Awards Dinner willcelebrate the best projects, products andpersonnel in the industry while providing theopportunity for guests to network andcontinue the discussions of the day.

The Design in Mental HealthNetworkGood design can help to heal, buttransforming mental-health facilities needscollaboration and teamwork. That’s ournetwork’s purpose. Back in 2005, healthprofessionals and designers started to worktogether. We encouraged service user involve-ment and soon our network began to grow.Now we’re a positive force for change withmembership open to anyone with an interestin our work – from architects to nursingstaff, from building contractors to service-users. We offer access to shared ideas and aforum for discussion. We provide access tocutting-edge research and education andencourage stakeholders to become active increating better healthcare environments.For more information about the Design in

Mental Health Network please go towww.dimhn.org

Previewing the leading UK event focusing on the design of mental health facilities

Design in Mental Health

For more information and to register for the eventgo to www.designinmentalhealth.com

12 DESIGN IN MENTAL HEALTH SHOW PREVIEW



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Looking out across the Derbyshirelandscape, a uniformly-white unit forcancer patients glows like a glacier,

contrasting with the brick structures of theChesterfield Royal Hospital. The new £10mNGS Macmillan unit combines a variety oftreatment, testing and care services spreadover 2,140 m2 and two floors, with thegeneral aim of providing first-class, cutting-edge cancer care to individuals in the widerChesterfield area. The building’s conjoined name is

derived from its highest contributingfinancial stakeholders: Macmillan CancerSupport contributed a third of total fundingfor the project; and the National GardenScheme who were a significant contributor,following an overwhelmingly successfulappeal for funding.Design lead on the project was Guy

Barlow, director of architects The ManserPractice. He says the facility’s design put theinterests of patients and staff first, via acombined approach of honing operationalefficiency and maximising patient comfortand freedom. The architects were chosen to design the

unit following a competitive tender, havingdesigned and executed a new ward for thehospital in 2010 which was a “usefulprecursor” to winning this project, saysBarlow. He explains that the hospital “hadalready seen our understanding of the area,and of what they really wanted.”At the project’s inception, a number

of potential locations around thehospital site were contemplated, includingrefurbishments and extensions. However,the chosen plot’s ability to accommodatefour crucial elements determined the final

decision – its adjacencies to appropriatehospital buildings; the scope for creating adrop-off area; proximity to patient andstaff car parks; and the attractive views oflocal countryside.

ConsolidationIn addition to a growing need for space,the central problem with the cancer careprovision at Royal Chesterfield Hospitalstemmed from the fragmentation of itsservices. As Barlow explains: “The mainpart of the hospital housed the oncologyunit, then at the other end of the hospital,haematology was mixed in with other uses.You also had what you could call aMacmillan Centre (more like a ‘Macmillanroom’) and palliative care, which were indifferent locations as well.”The pharmacy and phlebotomy were

also scattered across disparate parts of theexisting hospital buildings, meaningpatients had to navigate their way acrossthe site in order to get to the appropriatefacility. From a functional perspective, thekey part of the outline brief was to unify allof these services to form an effective andexpanded cancer care unit.Professionals from the hospital’s

oncology, haematology, and palliativedepartments, plus representatives fromMacmillan, formed a consultation groupwith the architects. Collective dialogue, asopposed to individual consultation, wasvital to writing a new operational policy forthe unit. The rationale behind this approachwas not only to get the most out of theclient, but also to identify any adversespillover from one workstream to the other,as well as providing transparency through

NGS MACMILLAN UNITCHESTERFIELD

BUILDINGPROJECTS

A new cancer treatment unit at Chesterfield Hospitalbalances rigorous design for operational efficiency with aconcern for patients’ holistic needs, to create a highlysupportive environment. Sébastien Reed reports

Great white hope

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16 NGS MACMILLAN UNIT, CHESTERFIELD



checks and balances, and resolving anydifferences in opinion. The consensusformed here would go on to define the finallayout of the unit.

The architects also played a guiding rolethroughout these talks, as Guy Barlowexplains: “The participants were a ‘lay’part of the client – they might do one ortwo projects like this in their lifetime, soit’s also important to explain exactly whatto expect at each stage, and how best towork with us.”

Pathways & timetablesA new approach was developed incollaboration with Macmillan to translatebespoke health planning into physicallayout for the new unit. In the existinghospital, care “timetables weren’tstreamlined,” says Barlow. The new unitwas the key to close this gap in efficiency.

“They were all working in their ownsilos, so bringing them together wasintrinsically difficult”. To remedy this, headds, “a key thing to start off with is what’stermed the patient pathway.”

Through further consultation, the activityof patients and staff was logged andanalysed, and journeys were mapped outdiagrammatically to give a clear picture ofwhat was required from the building, and inturn the architects.

Care pathways were defined andmodelled for outpatient consultations andtreatments, Macmillan support, outpatienttreatment check-in, inpatient treatmentcheck-in, and treatment itself. Usingtimetables and flowcharts, the designteam was able to deduce a schedule ofaccommodation and footfall channels – allthe while maximising the use of the space.Each pathway, says Barlow, “is designed tobe a really simple journey.”

“By precisely working out how patientsmoved through their departments, andgoing through their timetables together, wecould get that number from 22 exam roomsdown to 15; 30 per cent less. And so that’sactually what we built”, Barlow says.

A welcoming arrangementOutpatients use the main entrance at thefront of the building while there is aconnection to the main hospital buildingvia a glazed footbridge on the first floor atthe back of the unit. “The building is basedon an L-shaped plan, but curved to theaccommodation so you get these sort of‘hands’ opening to welcome people into theentrance,” Barlow explains. A patientgarden and frontal greenery decorate the

unit and make it more welcoming, whileproviding a dialogue with the neighbouringfields, and giving patients exterior space.

Upon entering at the main entrancethrough automated sliding glass doors,the user is greeted by the new andenlarged Macmillan Information andSupport Centre, combining rooms forcomplementary and alternative therapiesand quiet rooms for reflection. TheMacmillan Support ‘pathway’ ends here.

To the right, a spacious waiting andreception area separates the user from 15consultation rooms and further quietrooms stacked along the spine of thebuilding’s floor plan. In the centre of thecirculation area is one of several ‘note pods,’similar to nurses’ stations with head-heightglazing and views into each consultationroom. These allow staff to discussconfidential matters and take phone callswhile supervising patients.

To the left, a corridor leads from thewaiting area to a lift and stairwell up to thefirst floor for treatment. Leaving the lift orstairwell at the first floor as an outpatient,or arriving through the aforementionedfootbridge as an inpatient, patients cancheck in at the treatment reception, locatedin a central lobby.

From here, patients can either join othersin a bright and airy, open-plan treatmentarea or, alternatively, a separate suite oftreatment rooms for more private care,along with staff accommodation andamenities located at the western end of thebuilding’s upper floor.

“The feeling of a hotel”Patients were enabled to provide a keyguiding voice when it came to the overallfeel of the building, in the consultationprocess. Early on, it was clear what thegroup wanted. Contrary to the architects’preconceptions that patients would want a“home away from home,” it transpired thatpatients wanted a facility that felt more likea hotel – somewhere “uplifting”.

Much of Barlow and team’s work was aneffort to respond to this challenge ofbalancing “non-clinical” design with the

VIEWSThe building’s design optimises views over surroundingcountryside for patients

A new approach wasdeveloped in collaborationwith Macmillan to translatebespoke health planninginto physical layout for thenew unit

17NGS MACMILLAN UNIT, CHESTERFIELD



functional requirements of NHS HealthBuilding Notes (HBNs) and HealthTechnical Memoranda (HTMs). A numberof strategies were employed throughout thebuilding to help achieve this.This intended feeling is evoked almost

immediately in the users’ journey. For theoutpatient, the unit’s sleek and functionaldrop-off area, curved main reception deskand waiting area resemble a hotel entranceand lobby. For the inpatient entering theunit, the glazed footbridge enhances thefeeling of arrival, giving the impression ofpassing an airport gate down the walkwaytowards the aircraft. Floor-to-ceiling metre-wide windows across both levels allow theinterior to be saturated with natural lightwhile linking to its green surroundings.“Artwork is integrated into the fabric of

the building both internally and externallyto make it feel less clinical,” explainsBarlow. Artist Rebecca Salter wasresponsible for steering the artistic directionof the project. The exaggerated use ofyellows and greens were avoided in decid-ing on the building’s colour scheme, due topatients’ concerns that the reflected lightcolour would make patients look more ill.The architects worked with “a limited,

simple palette of colours and materials.”Ash veneer, glass, and concrete appearthroughout the interior, while the exteriorof the building is clad in a simple whiteCorian, referencing the off-white ceramicgranite used to segment the facade of theoriginal hospital building.Colour printing on glass and timber

screens, along with the incorporation ofdecorative motifs into the wayfindingschedule for the building, all contribute toenhancing the building’s ambience.

ControlOperational control features throughout theunit further contribute to the wellbeing andcomfort of the patient, while ensuring theirsafety. In HTM guidance, because of therisk of user ‘defenestration,’ it’s normal tohave to put a restriction on windowsmeaning they can only be opened to 100mm, restricting airflow considerably.

The architects used a fritted pattern –inspired by Rebecca Salter’s artwork – onparts of the ventilated facade, laser cut intothe Corian. The resulting grill obstructs thewindows, therefore meeting guidance, whileallowing fresh air to flow freely into thebuilding. This also filters sunlight, as doSalter’s coloured glazing vinyls, creating adynamic lighting effect which moves acrossthe interior over the course of the day.The natural ventilation also gives staff

maximum control over airflow andtemperature, while brise-soleil fins on thebuilding’s exterior regulate sunlight byproviding shading, and frame views forthose undergoing treatment. “You cancontrol the environment and let light in,”Barlow summarises.Again, following the advice from the

patient consultancy group gathered over avariety of physical mock-ups, communaltreatment pods each consisting of fourinward-facing chairs were purpose-designedto foster a greater sense of intimacybetween patients. Partnering this, the abilityto turn the treatment chairs to see theviews, or enter private rooms to undergocare more discreetly, lend further optionsfor tailoring the experience to support oftenvery unwell users.Sustainability also takes precedent in

The Manser Practice’s design, which hassecured a BREEAM Very Good rating.Sensors in each room automate the use ofLED lighting for optimum efficiency, full-height windows maximise natural light, andflow restrictors reduce water consumption,all meeting the scrupulous parameters ofthe HTM guidance. With the unit now fully functional – it

opened in June 2017 – feedback from bothpatients and staff has been overwhelminglypositive. A former patient said after visitingthe unit: “I am speechless and blownaway; this building has far outreached allof my expectations.” The architectural community has also

shown its appreciation for the unit’s design,as The Manser Practice went on to behighly commended for their work at the2017 Building Better Healthcare Awards, aswell as receiving mentions at a number ofother events.Bringing the unit’s design assets into

alignment with its health support, aMacmillan nurse gave a clinician’s point ofview, and a strong endorsement. “The build-ing encompasses the concepts of FlorenceNightingale’s Environmental Theory: Light,Air, Warmth...Clean...and an environmentthat offers Hope and Advice.”�

Using timetables andflowcharts, the designteam was able to deduce a schedule ofaccommodation andfootfall channels

WELCOMINGThe building has a curved L-shaped plan whichresembles ‘hands opening’ at the entranceAll images © Mark Hadden

18 NGS MACMILLAN UNIT, CHESTERFIELD



OPEN TO CHANGEFarrow Court was designed to be open and modern, incontrast to the reality of many care homes

Farrow Court, now completed to thesouth of Ashford, is a £17m socialhousing project that caters for a range

of elderly residents. The scheme is at theforefront of current Government policy tointegrate housing, health and adult servicesinto communities. Designed by architecture practice PRP,

the development has been constructedaround an existing, smaller supportedhousing scheme for older people, building104 new homes. The fully dementia-friendly new build is council owned, councilrun, and council built via contractorsBouygues UK. It has been conducted using a

collaborative ‘open book’ approach,whereby Ashford Borough Council,consultancy firm Pellings, and Bouyguesworked collectively as partners to reachdecisions at each stage of the build.The project is now a flagship scheme in

the borough. Hoping to engender a non-clinical feel, in contrast to many dilapidatedcare homes or lifeless hospitals, FarrowCourt is an open, modern apartmentdevelopment with extensive accessibilityfeatures, more akin to a hotel than itsinstitutional counterparts.

The schemeIn June 2013, planning permission wasgranted, with a ‘meet the buyer’ event heldshortly after to offer local tradesmen andbusinesses the opportunity to be involved inthe construction of the scheme.The planning process was reportedly

stress-free. Previous residents of the oldflats on the site were excited about theirnew home, and locals were keen to see theold building replaced with a modern

structure, as well as impressed with thenumerous community aspects integratedinto the build.Work began on site in September, and

during the programme £3.6m of fundingwas formally added to the contract sothat 12 homes for people with learningdisabilities could be built as the last of theproject’s three phases. In addition, andtimed to take place during dementia aware-ness week, members of council staffattended training sessions to become‘dementia friends’.On completion of the first phase, the

residents moved across from the old,subsequently demolished, building to thenew units, allowing the commencement ofphase two. This has been built on thesite of the old building and forms aseparate part of the new unit, with aconnecting walkway.The existing scheme’s residents moved

into their new homes by November 2015,with work on phase two beginning at thestart of 2016. Work completed inNovember 2017, with the new residentsmoved in.Daniel Scarsbrook, planning and

development surveyor at Ashford BoroughCouncil, details the demographic shifts thatform the backdrop to the scheme: “In 2025,40 per cent of Ashford’s population will beaged over 50. Eight existing outdatedcouncil-owned sheltered schemes had beenearmarked for development over 15 years,to address the challenge of providing homesthat meet the needs and aspirations of theageing population.”Farrow Court was selected as the first

scheme to be redeveloped as the largesite offered the opportunity to build at a

In redeveloping a retirement housing scheme to provide a distinctly hotel-style alternativefor residents, Ashford Borough Council also decided to apply an open book approach toencourage collaboration. Jack Wooler reports.

Opening the book on ageing

FARROW COURTASHFORD

BUILDINGPROJECTS

19



PHASINGThe phasing and demolition was carefully planned toenable residents to move to the new building, andsubsequent phases to be built

significantly higher density developmentthan previously existed, meaningresidents could then be decanted fromanother scheme, thus freeing that upfor redevelopment. In addition, the development could be

phased, enabling the existing Farrow Courtresidents to stay in their homes while thefirst new apartments were built.

High quality environmentOf the 104 new homes, 33 were built aspart of phase one for the original tenants,then 71 as part of phase two. These include12 learning disability units and sevenrecuperative care units named‘Homebridge’, meaning that people canleave hospital and stay in Farrow Courtwhile a care package is arranged oradaptations put in place to enable them toreturn to their own home. There is also oneguest room within Homebridge.Thought has been put into every detail of

the rooms, with large light switches,assisted front doors, wheelchair accessibilitythroughout, and wetroom ensuites with

doors from both the bedroom and hall forquick entry across the apartment. Ovens areset above waist height for ease of access,and both thick and light blinds are installed,providing flexibility and privacy with thelight either kept in or out. Balconies areincluded on every room above ground, withpatios on each ground floor apartment.All the apartments are priced for

affordable rent at £110.24 a week for aone-bed apartment, and £153.17 for two bed. The homes are of the highestquality for this price range, not just interms of care standards, but as modern,healthy accommodation.Along with the new homes, a wealth of

communal features have been added tothe development. These promote socialinteraction and a sense of belonging, and anavoidance of isolation, to whatever extentresidents require. Among the entertainmentson offer are movie nights, game nights andtrips out.There is a large communal lounge with a

fitted kitchen in the centre of the facility,with a fitted kitchen and doors leading out

20 FARROW COURT, ASHFORD



Farrow Court has beensensitively designedthroughout to supportresidents with dementia

to one of the courtyards. Landscaped gardens are found through-

out the site, with individually namedcourtyards dotted through the development,each with its own unique style and function,and securely designed to enable residents toenjoy them in safety. One such courtyardholds a community garden for growingvegetables, offering familiar outdoor activityto those moving from properties with land.Age UK has opened a day centre in the

building, allowing residents to meet up withfriends and make new ones. A range ofactivities are held in the centre, whereresidents are encouraged to join in andbuild a sense of community, and the charityalso sells cooked meals. The centre providesan additional, lively hub to the scheme, fullof life and happy residents.Farrow Court has its own hair salon, run

by an external hair and beauty firm, andopen six days a week. It’s not only forresidents, but also friends, family and thelocal community. A therapy room is used bya regular chiropodist, as well as for beautytreatments. For basic amenities, a groceryshop is to open soon, for the use of allresidents and the public, and laundryfacilities are available on a pay per use basis.

Design for dementiaThe scheme is the first fully dementia-friendly housing scheme in the borough of

Ashford. The Alzheimer’s Society states thatthere 850,000 people with dementia in theUK, and that by 2025 there will be onemillion people, and two million by 2051.80 per cent of people living in care homesare reported to have a form of dementia orsevere memory problems, with over one insix people aged 80 and over suffering fromsuch neurological disorders. To combat this incipient issue, Farrow

Court has been sensitively designedthroughout to support residents withdementia. The corridors on each floor aredecorated in individual tones for increasedcontrast, and the graphics used in thesignage enable easy recognition. ‘Memoryshelves’ have been installed in front of eachapartment, with residents encouraged toplace an item that represents themselves insome way. These range from cuddly toys, toflowers and pictures, helping to bring notjust a sense of individuality to the homes,but to provide residents with tangiblereminders of where they are.The design combines complimentary

building typologies, including the variousrecreational areas such as the Age UKresource centre. During the design stage,careful consideration was given to Housingour Ageing Population – Panel forInnovation (HAPPI) and the Housing ourAgeing Population – Plan forImplementation (HAPPI2) reports, which

21FARROW COURT, ASHFORD



highlighted a number of standards thathousing for the older populationshould meet. These standards have beenincorporated in the design of FarrowCourt, ensuring residents are offered amixture of property sizes and designs, andincorporating communal facilities. Small breakout areas are spread through-

out the scheme in addition to a mainlounge, adding to the scheme’s open feel.Residents have a say in what these areused for, with a pool table in one, a minilibrary in another, and another still withcomfortable seating and a stereo system(Classic FM is a popular choice).The well-judged design ensures the

development is both roomy and welcoming,while providing the sense of security thatresidents require. This allows them to liveindependently, with access to support asand when required.Daylighting has been employed expertly

across the build, with large windows onevery corridor and room. The entirebuilding is airy and light, the antithesis ofthe stereotypical dark, dank and oftennightmarish care homes of old. “Plentiful natural light is very important

in sheltered housing,” says PRP associatedirector Andrew Robson. “It positivelyimpacts on residents’ moods, reducessolar gain, and illuminates importantareas such as circulation routes, stairs andlift landings.”

Installing windows in the right place canalso ensure that residents are able to see theoutside world from their seat or wheelchairby utilising “carefully positioned mid-rails(in line with Lifetime Homes guidelines)across floor to ceiling glazing to avoidblocking the line of sight.”Anne-Marie Nicholson, partner at

PRP, echoed this sentiment, stressing itsparticular importance for those withdementia: “If the corridors are endless,relentless, artificially lit, then you don’tknow what floor you’re on, what time ofday it is, what the weather’s like.“If you get out of bed in the middle of

the night, you don’t know if it’s dark orlight outside.” On the balconies, frameless glazing has

been used to maximise daylight into theapartments. The balconies are semi-recessedwith surround to provide privacy, butreduced to maximise daylight. On thesurrounds of the other windows, timberpanels provide a break in the brick facade.This timber theme is continued to theground floor, across both the patio doorsand around the windows.Ashford Borough Council’s chief

executive, Tracey Kerly, is extremely proudof what she says is an “innovativedevelopment.” She adds: “The design isexceptional, delivering a significantdifference in quality. The careful attentionto detail to exploit the use of natural light

COURTYARDSThe unit contains a variety of internal coutyards, including one with a communal vegetable garden

22 FARROW COURT, ASHFORD



A wealth of communalfeatures have been addedto the development topromote social interaction

and space has created a building that isfunctional, appropriate for its use, and hasa real sense of place.”

CollaborationAn ‘open book’ process was utilised inthe build, with all parties assisting inputting together a successful funding bidsubmission, and collectively guiding researchon this specialised project. Each party wasalso involved in the consultation process,with all available expertise employed toinform what was a robust brief. As part of the collaboration, greater cost

certainty could be achieved from the outset,buildability could be scrutinised, and fullbuy-in to the design could be achieved. Thismade realising the required design qualitymore achievable.James Green, partner at Pellings, explains

how the open-book idea was initiated:“Ashford Borough Council had previouslyworked with local contractor Denne(now BYUK), including on a large PFIproject, and had developed an establishedrelationship at high level.“Accordingly, there was a willingness to

work together on both sides to deliver thishigh-profile scheme. To appoint Dennedirectly, the council had to use an OJEU-compliant framework. In turn, todemonstrate value for money for a directappointment, Denne suggested an openbook relationship whereby the prelimsand overhead and profit would be fixed andthe individual work packages tendered tothe market.”He continues: “In this way the council

could demonstrate value for money. Thisapproach is fairly rare, especially with localauthorities,” he concludes. The samearrangement has been carried forward tothe next project, which is currently on siteat Danemore, Tenterden.Green reveals what the transparency

means in practice for a consultant: “For anormal contract you are often kept at arm’slength and not aware of the deeper issues.“The nature of the relationship – open

book plus the historical element – broughtgreater transparency.” He added: “This wasamplified by the duration of the project.”He believes the process fostered a greater

understanding of the challenges faced bythe contractor and how they impacted bothcosts and programme.Green continued: “We were able to see

the costs for each package and be involvedin the selection of each sub contractor.”Daniel Scarsbrook of Ashford Borough

Council explains some of the extra benefits

this system produced: “A risk register wasproduced by Pellings, and risks wereallocated accordingly at the start of theproject. We were working together toovercome the challenges of the project.“Generally the approach was more

collaborative. With the contractorproactively keeping costs down, theyhad a vested interest as it could affect theprofit share.”James Green adds: “There were cost

pressures from the sub-contractor tendersdue to the rising market at the time.Accordingly, each package was reviewed indetail by the team, including to considerany cost savings before proceeding.“It meant we could all work together to

make sure the design pre-planning satwithin the budget before being submittedfor approval.”He says that despite the open-book

contract being a novel approach, it was“notparticularly challenging,” adding that “itwas refreshing to work in an open environ-ment without the usual confrontation.”

Setting a precedentThe project is notable for a run ofsuccess, with simple, speedy planning, astraightforward and successful build,smooth tenant changeover, and both criticaland communal acclaim. The scheme,which also appears to be an exemplar ofopen-book collaboration, was named ajoint winner of the Residential-Majorcategory of the 2016 Kent Design andDevelopment Awards.Providing a hub for the local community

and sheltered care facilities, from bingonights to a public salon and restaurant, thescheme is a thoughtfully-designed gift fornot only its residents, but also the local area.It could even be part of a new paradigm ofwhat supported housing can be, far from thedepressing care homes of the past, andinstead offering a hopeful future.�

23FARROW COURT, ASHFORD



The demand for mental health care andsupport continues to rise, and thepressure on resources is increasing.

Service users now spend 341 days, onaverage, in high dependency rehabilitationwards. Going forward, it’s clear that action isrequired to reduce the time service users arespending in facilities.

The Care Quality Commission report onthe State of Care in Mental Health Services2014-2017 highlighted concerns that carefor some patients is overly restrictive, settingan expectation for mental health services tocommit to reducing restrictive interventions.

For Paul Jenkins, chief executive ofRethink Mental Illness, “the system hasbecome too focused on managing risk” and“needlessly detaining service users in veryexpensive settings”.

As a result, more and more trusts are nowlooking for best practice options to minimiserestrictive practices, promote effectiverecovery and consequently reduce the timeusers are spending in their facilities.

Projects we’ve worked on recently haveinstalled electronic locksets to offer thisgreater service user independence, bygranting them complete control over theirown living space. Unlike mechanicallocksets, they enable them to lock andunlock their own door by themselves.Can you imagine staying in a hotel whereyou had to ask reception to do this foryou? If you had an unpleasant neighbour,you may not even feel comfortable leavingyour room.

And while the perceived risk of grantingthis independence has long been consideredtoo great – largely due to self-harm riskswith keys and the potential of disruptive anddangerous behaviour, the CQC report foundexamples where coupling service userindependence with appropriate staff trainingto deal with potentially dangerous behaviour

led to a reduction in incidents. Through balancing good clinical practice

with modern technology, trusts cancreate safe and normalised environmentswhere service users have the necessaryindependence to help them recover, and staffhave the ability and support to deliver high-quality care in a therapeutic environment.

Looking for best practice in safety,recovery and practicality, electronic locksetshave enabled trusts such as SussexPartnership NHS Foundation Trust andHumber NHS Foundation Trust to offerharmless wristbands or key fobs to serviceusers – emulating the home environment andhelping to restore dignity and aid recovery.They have the added benefit of being an easyretrofit – operated via a wireless network,the discreet system uses minimal cabling.

Like all improvements in mentalhealth care, electronic locksets alone are notthe solution. But together with otherimprovements – like creating a therapeuticenvironment and providing appropriate stafftraining – service users can recover quickerand return to their communities.

Sussex Partnership NHS Foundation Trustapproached Safehinge Primera as part of amajor refurbishment of the Brunswick wardin 2017 – offering in-patient care for serviceusers with dementia.

Because familiarity is key to aidingrecovery, they required locksets that wouldhelp to normalise the environment and aidservice user recovery. That’s why they choseto install our electronic lockset, Passport,throughout the facility – providing acomfort to service users by offering controlof their own living space as well as meetingthe CQC’s expectations of reducingrestrictive practices.

Martin Lees is access control manager atSafehinge Primera

The CQC report foundexamples where couplingservice user independencewith appropriate stafftraining led to a reductionin incidents

Martin Lees of Safehinge Primera discusses what the moves to reduce “restrictivepractices” in mental health wards mean for door hardware, and how electronic locksetsform a key part of the solution

Freeing up mental healthrestrictions, electronically

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http://www.safehinge.com/

The design of environments employedin the care of mentally ill peopleprovides a number of challenges,

not least in terms of the windows. An article in the publication Psychiatric

Times goes as far as to say that hospitalsaccommodating mentally ill patients mustbe “devoid of means to commit suicide”.

It states: “The most common type ofhazard was ligature anchor points, that is,protrusions capable of supporting theweight of a person more than 100 lbs. In the United Kingdom, hanging was themethod used in 77 per cent of inpatientsuicides between 1999 and 2007. The mostcommon ligature points were doors, hooksor handles, and windows.”

The specification of fenestration formental health establishments, however, begs some important questions, which needcomprehensive answers from specifiers.Jason Davidson, technical sales director at Crittall Fendor explains: “Depending onthe type of building and the specificrequirements each patient group mighthave, natural daylight, ventilation, security,anti-ligature, supervision, window operation and control are all considered.”

Unobstructed views onto the exteriorspaces are known to aid recovery in someinstances and the ability to clean thewindows effectively has to be balancedagainst the need for adequate security.What is key to the optimal specification ofa window is accurate knowledge of theprecise type of patient group that a hospital– or specific wing of a hospital – serves.

For instance, the potential of escapethrough a window is not always a main issue as some patients within thehospital can leave at any time. For otherpatient demographics, escape might be ofgreater concern.

“For years ventilation had been aproblem in hospitals and secure units,” says Davidson. “Any openable windows

ADF reports on some of the drivers which are leading to innovation in glazingmental health units, in order to address a range of particular challenges

Modern glazing for mental health

25



had to be restrained to stop people either falling out or escaping. Windowswere restrained to only allow a 100 mmgap. This obviously restricted the ventilation drastically.”

Various options currently exist on themarket that have been designed to satisfythese various requirements.

Specifiers should consider an externalsliding window system. With regard tomaintenance, sliding windows can becleaned from the inside and outside allowing maintenance to be carried outwith more ease than some other models and without disrupting patients.

It is also paramount that the windowoffers no points at which a ligature – acord, wire or belt – could be attached by apatient contemplating suicide. The flushframe should offer no such points and thewindow should be openable for ventilationby means of a slipper clutch – a dial-shapedoperating mechanism that similarlyprovides no protrusions for attaching aligature. The fixture is so-called because it is engineered to ‘slip’ repeatedly no matterhow often it is turned and therefore

cannot be forced to open the window wider than intended.

At a time when budgets are tight, facilities managers responsible for mentalhealth institutions are nevertheless keen to see to what extent their buildings can be future-proofed to meet ongoing requirements for patient care.

“If future proofing is considered thenfuture risks and forward costs can bereduced,” argues Davidson. “Manual andelectric blinds are being used more andmore. This is because they are now safe ifused within the double glazed units of awindow, there is very little maintenanceneeded and it gives both patients and staff alot more control over their environment.”

Most important is for building managersto discuss fully with window manufacturersall their requirements at an early stage.“There are advancements being made all ofthe time which give clients more options,”says Davidson. “Getting a full size windowdemonstration is also very important.Seeing a workable sample of a window typeallows for an examination into each benefitand risk a window holds.”

26



Impairments such as sensory, mobility orcognitive (or sometimes a combinationof all three) can have a serious impact

on older people and those with dementia.Functioning, behaviour, independence and,ultimately, quality of life can all becompromised, but appropriately designedenvironments can help keep vulnerablepeople safe from dangers, such as falls.By understanding the impact of suchimpairments, designers, specifiers andcarers can create interiors that can helppeople feel much safer and more confidentin their surroundings.

Contrast is key, and can be used to helppeople with sight loss and dementia to

identify key features and rooms. Good useof contrast can also facilitate independentliving, for example, by supporting people tofind their way around a space and to usecertain fixtures.

One of the key ways to incorporatecontrast within a building is through theflooring specification. As with everybuilding, when we walk through an area wewill subconsciously notice the flooring. Infact, thoughtfully designed flooring canplay a huge role in supporting way findingaround unfamiliar premises, and can alsobe used to define various areas and spaces.

It is recommended that a difference of 30degrees of Light Reflectance Values (LRV) is

As age-related impairments make it more difficult for people to navigate a building,Mark Jackson of Forbo Flooring Systems examines how innovative flooring approachescan make life easier for those suffering with dementia

Navigation made easy, with dementia-friendly �ooring

DEMENTIA-FRIENDLYMany sites are now starting to explore flooring designthat better supports users with dementia

27



achieved between the floors and walls, andbetween doors and walls. However, if thisisn’t possible, it is essential that optimumcontrast is achieved between the two criticalplanes, such as the floor and wall. The adjoining flooring must be tonallysimilar in order to reduce the risk of falls,which means the flooring LRVs should bewithin eight degrees of each other (althoughless is better). The transition strips shouldalso match the tones of both flooringsurfaces, with an ideal difference of nomore than three degrees of LRV. If thecontrast between the floor coverings is toogreat and the transition strip contrasts toomuch – or if it is a highly reflective trim –then this could be perceived as a step andresult in ‘high-stepping’ and potential falls,or even deter people from passing through. When it comes to the actual design of thefloor coverings, it is vital that a glossy orsparkly floor is avoided, as it could beperceived as a wet surface. Flecked flooringcould also convey spots, while logos etchedinto the floor could be observed as anobstacle. As such, a matt finish with asimple, plain design is preferred. With this in mind, the design of abuilding becomes as vital as the bricks andmortar that it’s built with. Because of this,Forbo Flooring Systems has partnered withThe University of Stirling’s DementiaServices Development Centre (DSDC) toreview over 1000 floor finishes; assessingtheir suitability for use in dementia-friendlyenvironments. This includes assessing andrating them in accordance with theirdementia design principles. Many healthcare facilities and sites arenow starting to explore dementia-inclusivedesign – and one example where theflooring has played a large part is ErskinePark, a care home in Bishopston. Spanningthree storeys, floor coverings were used in avariety of colours to easily distinguish eachfloor of the building for the residents, andto help them identify their own floorand apartment. Colours were used todistinguish the floor levels: green tones onthe ground floor to represent leafy grass;a shade of orange on the first floor torepresent earth; and a blue shade torepresent the sky, and help residentsrecognise that they were on the top floor. The key is that flooring for these types ofenvironments needs to be simple, as well asbeing practical and hygienic.

Mark Jackson is key account manager, CareSector, at Forbo Flooring Systems

28



http://www.forbo-flooring.co.uk/

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Surprisingly very few sites in the UK,whether in healthcare, education orleisure, have a fully controlled water

management system. Usually, sites aremanaged through a unique mix ofprocedures, many of which rely uponsignificant levels of human recording andmanual interventions.These include weekly, monthly and

quarterly procedures to safeguard thesystem, possibly including manual flushingto keep water from stagnating, but at lesseffective low temperatures in order to avoidscalding patients.The goal for any water management

system is to ensure the water is clean andsafe with no or little biofilm present.Remove biofilm and you can provide awater environment without harmful germsand bacteria, which is what we are allaiming for. A big concern for buildingmanagers currently is relying on people todeliver part of the maintenance routine,such as medical staff running taps andshowers in a medical area, instead of estatesteams – putting added pressure on analready demanding daily routine.Manual systems can be refined using

consultants to audit procedures and makerecommendations applicable to specificenvironments. Alternatively buildingmanagement systems can integrate shower,tap and urinal products with an automatedsystem. A complete solution is also availableas a Water Management System, for examplethe CNX system from CONTI+, specificallydesigned for complex environments. Such systems connect all taps, showers,

and urinals into one system automating theprocess of a regular hygienic flush whilstrecording all actions in a simple report.Thermostatic flushing at high temperaturescan even be run with peace of mind that theinbuilt failsafe security will eliminate anyscalding incidents. Human error is removed

from the situation along with timeconsuming manual intervention, all ofwhich has a high cost. Facilities managerscan access systems remotely across multiplesites, giving them a complete overview andcomprehensive reporting.Naturally, developing a solution for a new

build is much easier than retrofitting inan existing building, however nothing isimpossible if the benefits are of real value.The situation needs to be explored byclients/designers and installers to be sureof the solution before proceeding. Theclient must be sure to understand what theadvantages really are, and what reportsand functions they will receive. Only byengaging an expert supplier early in theprocess is this possible.Key questions for clients are – what do

you really need to achieve, do you have acomplete and realistic view of how thesystem is currently operating, how does thecurrent system impact employees’ time, andwhat reporting is required? A current project we are involved with

includes around 10 different people in theclient’s organisation, working together withus to develop the system. There is acommon goal to reduce the spread of germswhilst running a reliable and efficientsystem which eliminates staff intervention.In addition to the intensive planning

process for implementation, there are alsothe daily operational considerations toconsider. Hospital management needs todecide who should have access, what levelof access they need, and needs to ensure thatan approved leader is assigned. Althoughmany water management activities are ledby compliance needs, many are just simplecaretaking processes that an automatedsystem can manage reliably and with ease.

Paul Musgrove is the UK developmentmanager at CONTI+

Paul Musgrove from CONTI+ considers the benefits of automated systems for watermanagement, and how improved management of water flow can reduce infection risks aswell as reducing water usage

How reducing water usage canmean fewer germs

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care

shower panel

tel : +44 (0)1505 321 455web: www.horne.co.uk

The Horne shower panels are ideal for hospitals, dementia care, extra care and home care adaptions

Safe, accurate thermostatic control

Visual contrast between components aids sight

Specialised levers - easy to turn and helpfully marked

Minimal effort required to adjust riser handset holder

Robust riser bar doubles as supportive grab bar

Very quick and easy to install, clean and maintain

Safe, comfortable, inclusive showering from Horne


www.horne.co.uk

www.recorduk.co.uk

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CS Acrovyn wall protection Construction Specialties provided a compre-hensive wall protection package for therenovation of the King Edward Building, partof the redevelopment at the Bristol RoyalInfirmary. The scheme included: impactresistant Acrovyn Sheet and Acrovyn corner

protectors in all circulation areas, Acrovyn Doors, bed head protectorsin the wards and a custom printed Acrovyn by Design wall mural atthe entrance area to a multi-faith sanctuary space. Acrovyn productswill protect the facility from impact damage and wear & tear, ensuring the interior is easy to clean and maintain for years to come.

www.c-sgroup.co.uk

Altro brings feel-good factor to centreAn integrated package of Altro floors, walls and ceilings has been installed in a brand newflagship Spinal Injury Centre in Dorset, run bydisability charity Livability, creating a homely,design-led unit with a high level of aestheticappeal. The products used: Altro Wood™ Safety,Altro RelianceTM 25, Altro Pisces™, AltroWhiterock Satins™, Altro Whiterock hygienicceilings, Altro Stronghold™ 30 and AltroFortis™ Titanium. For more information on all

products please contact Altro by calling or visit the website.

01462 489 516 www.altro.co.uk

Wardray provides quality and reliabilityWardray Premise Ltd is a 4th generation,family run, British manufacturer which has been trading for more than 100 years.They are accredited to ISO9001:2008 and ISO13485:2012, with an establishedreputation for quality and reliability.

Wardray are based in the UK with two manufacturing facilities. TheCompany’s portfolio includes: Structural radiation shielding productsfor medical diagnostic and radiotherapy applications; Accessoryproducts and solutions for X-ray and MRI environments; andIndustrial shielding for non-destructive testing (NDT) facilities.

[email protected]

Polyflor flooring brings style and safety A variety of Polysafe safety flooring andExpona luxury vinyl tiles from commercialvinyl flooring specialist Polyflor wererecently used to complete the construction ofNeedham House in Devizes, Wiltshire.Needham House is a housing development

of extra care apartments which allow older people to live independ-ently in their own homes with on-site care and support. Over 2000m²of Polyflor vinyl flooring was installed in the 47 self-contained apart-ments and communal areas. The Polysafe Wood fx and PolysafeVerona safety flooring ranges are fully HSE Compliant.

0161 767 1111 www.polyflor.com


www.wardray-premise.com

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Automatic choice for CLEAN Environmentsrecord’s CLEAN hermetically sealingsliding doors prevent the transmission ofbacteria via air flow whilst controllingtemperature and humidity to provide thehighest levels of hygiene required, inhealthcare environments. Finished in ahigh-pressure laminate, which is durable,

easy to clean and available in a variety of finishes, CLEAN door leavescan also be customised for a contrasting design or to help definespecific areas within a building. Complete with a range of options toprotect from electrons, x-rays, fire and smoke.

www.recorduk.co.uk

Nortech parking systems improve hospitalAccess control system specialists Nortechhave recently seen Gloucestershire CareServices NHS Trust update and improveTewkesbury Community Hospital’s car parkusing Nortech’s Feemaster system. Nortech’sFeeMaster Smart parking management

system is a flexible, simple and cost-effective way of managing carparking access and controlling validity periods using Mifare smartcards. This avoids the need for expensive cabling between componentsand minimises disruption. The FeeMaster entry station is designed tobe used to record the date and time that a vehicle enters a car park.

[email protected]

Bostik’s subfloor preparation products pave the way at Stratford HospitalBostik has been selected by commercial flooring contractor, Pinnacle Flooring, to supply a range of subfloorpreparation products to the new, £22 million Stratford Hospital development. The project, built in the centreof Stratford upon Avon for South Warwickshire NHS Foundation Trust, includes 5,300m2 of space, spreadacross three floors. This is approximately twice the size of the current hospital. The new building will housespecialist cancer and eye units, making state of the art treatment much more accessible to those living inStratford and surrounding communities. Working with Pinnacle Flooring, Bostik supplied a subfloor prepara-tion package to cover approximately 4,000m2 of the new development. Products used included the BostikScreedmaster One Coat Membrane, Screedmaster Universal Primer and Screedmaster Ultimate levellingcompound. Scott Myers, Managing Director from Pinnacle Flooring, commented: “Bostik has a fantastic rangeof high quality products that covered all aspects of our flooring installation needs for Stratford Hospital. Thetechnical expertise and insight that the Bostik team has offered proved invaluable to the project.”

01785 272625 www.bostik-profloor.co.uk

ARCHITECTS DATAFILEIS INDEPENDENTLY

VERIFIED BY ABC

Healthier door closingPowermatic concealed door closers from Samuel Heath are becomingincreasingly popular with specifiers, estates managers and cliniciansthroughout the healthcare sector thanks to the many health, safetyand hygiene benefits that they deliver. Powermatic door closers aretotally concealed when the door is closed and offer few surfaces on which dust and potentially harmful detritus can accumulate. Their low mounting height also simplifies inspection and cleaningprocedures. British designed and manufactured, Powermatic doorclosers are ideal for anti-ligature and anti-barricade applications inmental health facilities. Their concealment also helps to create the lessinstitutionalised, more therapeutic environment valued by clinicians.Finally, the door closers are less likely to be vandalised, significantlyenhancing reliability of the closer and fire door, and reducing repairand maintenance costs.

0121 766 4200 www.concealeddoorclosers.com


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As part of the continuing refurbishmentof The Heritage Building (the oldoriginal hospital) at The Queen

Elizabeth Hospital, Birmingham, new rainwater hoppers and pipes are beinginstalled in stages.Supplied and manufactured in GRP

material by Yeoman Rainguard at their headoffice facilities in Leeds, the Hoppers andDownpipes have been chosen in a design andcolour to be in keeping with the art deco styleof the Heritage Building which was erected inthe early 1930s.Replacing the aging system are Yeoman

Rainguard’s GRP 100mm dia. Standard ClipDownpipes and large Highland RainwaterHoppers in an Agate Grey colour. GRP is a durable and impact resistant

construction material which being light-weight can assist the installation on very highrise or multi storey buildings such as theHeritage Building.Once installed this tough rainwater system

will not require maintenance, other than the occasional clear out, and as a throughcolour material the UV stable hoppers and downpipes will not be pervious to colour bleaching thus eliminating the need for repainting.Offering 30 plus years of care-free service

Yeoman Rainguard GRP rainwater systemsare an economical choice adding to thesustainability of the building and reducingfuture maintenance costs.

“We have dealt with Yeoman Rainguardfor many years and as always we are verypleased with the quality of service andrainwater goods supplied for the refurbishment programme of The HeritageBuilding.” Commented Mick Townsend,Project Manager, Estates & Planning,University Hospitals Birmingham NHSFoundation Trust.

0113 279 5854 www.rainguard.co.uk

Yeoman Rainguard helps Heritage Buildingkeep with Tradition

Allgood completes thoughtful designMaggie’s Centre in Oldham hasincorporated Allgood’s Holt ironmongeryto complete its thoughtful and hopefuldesign. Handcrafted from European oak,the Holt range seamlessly blends with thehardwood cross-laminated timber (CLT)building and reduces the impact of

neuropathy for the centre’s patients. A calm and inviting building, theinnovative use of hardwood CLT and glass means that visitors aremet with a light, open space and views down to the garden below –the inverse of what is expected from a traditional healthcare facility.

0207 387 9951 www.allgood.co.uk

Lifting paediatric servicesNHS Property Services has converted a former schoolinto a state of the art Child Development Centre –Snapdragons Centre. Part of the £3m project hasbeen the installation of six ceiling track hoists intreatment rooms and care facilities, plus a mobilechanging bench and height adjustable basin in toiletfacilities, all supplied by Britain’s leading deliverer ofintimate independence, Closomat. The hoists mean

that children and young people who are not mobile can be movedeasily, safely, and with dignity, without exposing their families, carerand Centre staff to risk of injury through manual handling.

0161 969 1199 www.clos-o-mat.com

The therapeutic benefits of carpet Carpet offers many therapeutic benefits to ahealthcare environment. They are naturallysound absorbent and can reduce the conduc-tion of sound impact by 29 dB, which helpsto create an acoustically sound environment.Carpets also improve indoor air quality, by

trapping airborne particles, which can cause respiratory distress in thecarpet fibre. By choosing a carpet from danfloor’s healthcare collec-tion, which includes an anti-microbial coating, any harmful bacteriawhich comes into the carpet fibre is killed with a four log reductionrate of 99.99 per cent, thus helping with infection control.

0333 014 3132 www.danfloor.co.uk

NHS awards Innova hoisting contractsInnova Care Concepts has been awardedtwo contracts to provide and install patienthoist systems for two sites in the OrkneyIslands. With an accumulative value of£177,000, Innova will work throughout2018 to fix over 45 ceiling hoist systems inbariatric suites, operating theatres, and

above a Changing Place facility. Innova’s unique products and abilityto create flexible systems were a key factor in both decisions. TheWetherby-based company will be working with Keppie and Young &Gault Architects on these projects.

0345 034 1450 www.innovacareconcepts.com


Clarke’s Safety MirrorsUNBREAKABLE LIGATURE RESISTANT

POLYCARBONATE MIRRORS

www.csmirrors.co.uk

01952 [email protected]

Framed Unframed

Quarter – 90 Deg

Leading UK Manufacturer & Distributor – Established 1997Impact Resistant Glass Mirrors – Safety Backed Glass Mirrors BS6206

Unbreakable Shelving – Security Glazing – Convex Mirrors

LIGATURE RESISTANT POLYCARBONATE OBSERVATION MIRRORS

Full – 360 DegHalf – 180 Deg


www.csmirrors.co.uk

ADF04 Health Supp Covers Layout 1 26/03/2018 …...projects such as the NGS Macmillan cancer care...

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Transcript of ADF04 Health Supp Covers Layout 1 26/03/2018 …...projects such as the NGS Macmillan cancer care...