Finding the right balance

How a Hertfordshire dementia care unit is setting a new standard for design

Designers of dementia care units must aim to strike a balance between creating a home-from-home environment and ensuring facilities are robust and safe.

This is the advice from John Plum, project manager for the P21+ development, Lambourn Grove, currently being refurbished for Hertfordshire Partnership University NHS Foundation Trust. The scheme is the second of five older people’s dementia care facilities being developed by the trust, following the opening, earlier this year, of Seward Lodge in Hertford.

I think you can still have a building that offers that home-from-home feel. You just have to think past the opening day and how the service will be delivered

A complete strip out and refurbishment project, the work sees the complete renovation of an existing unit in Hixbury Lane, St Albans, using dementia design principles from the University of Stirling’s Dementia Services Development Centre and clinical leadership from Annette King, service line leader for older people's inpatient and community services. In addition, the team used learning from expert feedback in previous schemes undertaken by the P21+ team led by architect PM Devereux and construction partner, Interserve.

Speaking to BBH, Plum said: “The 24-bed continuing healthcare unit we are currently developing will deliver a specialist care facility for those people with dementia who have the most-complex and severe levels of healthcare need.

“These individuals frequently need specialist care for extended periods. Because of this we have designed and constructed the unit so that it has a much more homely feel.”

But, he warned, that while home-from-home décor was vital to the design ethos; it was still important to make buildings robust.

“The safety of the service users is paramount,” he said. “We need to ensure the clinical interventions can be easily provided at the same time as creating a therapeutic environment where service users feel relaxed, comfortable and safe.”

He added: “In one of our previous units we had small articles of memorabilia laid out. We tended to find that things got picked up and dropped or relocated. My advice, therefore, is to make sure attention is paid to detail and wherever possible consider how rooms can be made to feel like home. People with dementia can easily become distressed and disorientated in new environments.

“At Lambourn Grove we have paid special attention to creating interactive art work with additional wayfinding points, adjustable lighting which guides, and walking routes for people to roam if that is what they wish to do.”

Part single, part two storey, Lambourn Grove is a brick-built building with a tiled roof and is located on the site of a former hospital that was redeveloped and the land used for housing. The dementia care unit was constructed as part of the development, but after more than 25 years of use a radical makeover was required.

We need to ensure the clinical interventions can be easily provided at the same time as creating a therapeutic environment where service users feel relaxed, comfortable and safe

Plum said: “The existing unit was tired and many parts including the service user bedrooms and day spaces didn’t function or flow as a modern service should. So, although this was a refurbishment project, we needed to make a big impact.

“Downstairs the building is divided into three wings - one for women, one for men, and one mixed - but with separate en-suite bathing facilities to allow for gender compliance. Two of the wings also have assisted wet rooms which are large enough to allow for either a bath or shower depending on the service users choice. The refurbished unit has separate male and female lounges as well as communal day space and dining space. A sensory room facility provides a distinct environment in which people can receive one-to-one interaction with a practitioner, either as a relaxation or stimulation intervention. The room has been designed so that even a person who is confined to their bed can access the facility.”

The second floor is back-of-house functions and allows for staff rest including a shower room, hot desk office and a multi-purpose training room.

Surrounding the building are extensive mature gardens, which can be seen from all the bedrooms. These are being redesigned to be level so as to reduce slips, trips and falls. Also, additional raised planters for therapy and seating areas for social interaction.

“I think you can still have a building that offers that home-from-home feel,” said Plum.

“You just have to think past the opening day and how the service will be delivered.

“You have to think about the practicalities of day-to-day life in a dementia unit because, once construction is completed and the design team leave site, staff have to keep on delivering the service in a building that works for both them and yet feels familiar to our service users .”

Construction work on Lambourn Grove is due to be completed in March, and will open to service users in April.

Companies