A fresh approach to palliative care

Revolutionary inpatient wing is handed over to staff and patients at St Michael’s Hospice

Image courtesy of Dennis Gilbert/VIEW

The first phase of the redevelopment of St Michael’s Hospice has been completed.

Following an intensive five-year design and construction process, £9.6m has been spent enhancing facilities at the unit in Herefordshire.

A new inpatient building offers accommodation for up to 20 patients in a 21st-century building that has reassessed the requirements and desires of palliative care.

Designed by locally-based architects, Architype, the new wing is a revolutionary step in hospice care, delivering honed solutions which are born from mindful collaboration with this complex and sensitive client and user group.

St Michael’s Hospice has touched the lives of so many people in Herefordshire and it has been a privilege to deliver this fantastic new facility

As the first hospice building for the practice, the design team was open-minded and unassuming in its approach. The highly-ambitious bespoke arrangement and finishing of the building is the result of indepth consultation with patients, staff, infection control teams, and intensive research; culminating in a unique layout that offers a variety of internal spaces designed to be flexible to suit the spectrum of user needs, alongside a optimised floor plan that allows staff to provide care effectively and efficiently.

The building has a simple and robust environmental strategy focusing on high levels of insulation and airtightness, mechanical ventilation, and heat recovery, breathing wall technology, optimised daylighting, and solar gain to deliver a low-energy, comfortable and healthy building.

The building has been designed to maximise the connection to external spaces and uses a natural material palette where appropriate, creating a variety of supportive, calming and uplifting environments.

Developing a scheme that would deliver a non-clinical atmosphere while abiding to healthcare regulations and best practice guidance, challenged the design team to deliver a truly-alternative response.

On entering the building, a light and welcoming reception area, with reception desk located to one side, immediately engages the building user with the beautiful Herefordshire countryside through a fully-glazed wall. Beyond the reception area are integrated services such as therapy suites, physiotherapy, and guest accommodation with the inpatient wing beyond.

A central focus of the inpatient wing is the multifunctional ‘street’ - a central double-height circulation space, flooded by light from the continuous roof glazing. It offers a variety of spaces from discreet seating areas, break-out areas, and conveniently-positioned nursing stations.

The private inpatient accommodation is accessed from the street in the form of five modular ‘clusters’, comprising of four en-suite bedrooms that all open directly onto a communal living room.

The redevelopment will enable the hospice to continue with the highest-possible healthcare standards in an uplifting, comfortable and relaxing environment while benefiting from significantly-reduced running costs

Moving through the building to the more private accommodation, the ceiling height gradually descends, creating a feeling of comfort, security and sense of a familiar, domestic environment. Every entrance and connective space has been fluidly designed providing easy access and large glazed double doors are fitted with integral blinds between the bedrooms, with social spaces allowing for either varying levels of social inclusion or total privacy. From the centre point of the lounge, each bedhead is visible to a nurse, allowing for better communication and transparency.

The clusters are orientated, not only to maximise daylight, but to offer every patient their own outdoor terrace. The strong connection to the beautiful surrounding Herefordshire landscape, is proven to aid physical wellbeing, with each of the clusters having a carefully-chosen colour palette that has developed from the designers research into healing colours.

The design of the bedrooms has also been carefully developed to provide a functional, but non-clinical feel. Features such as hoists have been included so patients can move safely into the specially-fitted bathrooms. Despite the necessity for potentially-imposing equipment, a simple, high-quality feel is maintained, with all machinery stowed in the custom-made integral cupboards specified in every bedroom. Containing a drugs locker and preparation space, hoist storage and motor, wardrobe, fridge, clinical wash basin and ventilation, this cleverly-designed unit is a piece of equipment in itself, providing a one-stop station for nurses and patients.

Providing a non-clinical feel to the building has been a challenge in the healthcare environment, tackling the usual specifications of clinical plastics in exchange for natural materials. Although not possible in every instance when complying with hygiene regulations, natural materials such as timbers and textiles have been used with unusual generosity for a hospice building. Where the direct use of natural materials has not been appropriate for infection control and hygiene standards in key locations, they have at least been made visible, as seen in the timber slat ceilings, the terrace canopies or the timber skirting, producing a visually-softer environment with vastly-improved acoustics.

Both the client and designers were ambitious to make this a building that was extremely functional but supportive, flexible and uplifting for the users, at times feeling more like a spa hotel than a hospice caring for patients with life-limiting conditions.

Striking the right balance with a building that felt highly professional, whilse maintaining comfort and a sustainable living space has called upon skills from almost every member of staff at Architype over the five years. The relationship forged between the practice and the hospice team has been one of shared vision, mutual respect and commitment, with both parties taking a responsible, sensitive and human approach to creating this new pioneering facility for Herefordshire.

Project architect, Paul Neep, said: “St Michael’s Hospice has touched the lives of so many people in Herefordshire and it has been a privilege to deliver this fantastic new facility that will enable them to continue with the highest-possible healthcare standards in an uplifting, comfortable and relaxing environment while benefiting from significantly-reduced running costs."

As patients begin to move into the new building this month, work is set to start with immediate effect on Phase Two; the refurbishment of the existing building. The complete strip-out and refit will aim to offer more services and opportunities to daycare patients and their families, modernising, rationalizing, and improving the sustainable infrastructure of the 1980s building. Facilities will include respite care, holistic treatment, training facilities, community and recreational spaces, all in an improved environment that will support the hospice’s activities and outreach services, complementing the inpatient building.

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