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Architects for Health - Junction 17

Junction 17
Andrew Arnold, Gilling Dod

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Architects for Health - Junction 17

  1. 1. 25TH June 2014, Manchester Andrew Arnold - Director
  2. 2. - Over 135 years in Practice - Two offices, 58 qualified staff, including in-house Interior designers - Over 45 years in the Healthcare sector - 2 Offices in Chorley and Liverpool - Member of 5 supply chains under P21+ - Over £760m of live or completed work Healthcare building spread over 60+ Projects nationwide. - Over £450 million of live/completed Specialist healthcare/Mental Health work undertook in the last 6 years. Who are we?
  3. 3. Current Projects • North Staffordshire NHS Trust Major redevelopment • Project Arizona, Walton Centre, Liverpool • Whole site Redevelopment of Blackpool Victoria Hospital • Warrington and Halton Hospitals NHS Foundation Trust redevelopment • The Harbour, LancashireCare NHS Foundation Trust • Broadmoor Hospital Redevelopment, West London Mental Health NHS Trust
  4. 4. Mental Health experience Specialisms; - Adult Acute inpatient units - Rehabilitation Services - Dementia - CAMHS (Child and Adolescents Mental Health Services) - Personality Disorder - Learning Disabilities - Psychiatric Intensive Care (PICUs) - Assessment and Treatment - Community Mental Health Services - Low/medium/High Secure Services - Forensic Services - DEAF Services - Step Down Services - Drug and Alcohol Services - Assisted Living - Eating Disorders - Challenging behaviours
  5. 5. CAMHS • Tier 4 CAMHS services work to help young people with significant mental health needs and who may pose a high risk to themselves and others. • Patient group - young people with serious mental illness including psychosis, bipolar disorders, eating disorders, dual diagnosis and emerging personality difficulties. • Other issues – anti-ligature, self-harming behaviour, mood disorders, safeguarding issues, psychosis and poor coping skills such as misusing substances. • Support in daily living skills such as cooking, budgeting and shopping as well as more formal psychological therapies such as cognitive-behavioural therapy, family therapy and art and music therapy. • Age range 13-17
  6. 6. Client • GMW provides district mental health services in Bolton, Salford and Trafford, both inpatient and community-based means. • The Trust also provides inpatient alcohol and drug recovery services in Prestwich as well as community services in Trafford, Salford, Cumbria, Wigan and Leigh, Blackburn with Darwin and Central Lancashire. • GMW also provides secure services for adults across the wider North which include a range of care pathways. • Standardised components, Continuous PPE, shared r+d/testing • Long term relationship with GDA
  7. 7. The McGuinness Unit Key issues; • Significant Ligature risks • Privacy and dignity issues • Absconding issues • Lack of therapy space/activity areas • High levels of serious incidents/flash points • Stigma • High re-admittance levels • Poor staff morale/retention • Insufficient beds so out of area placements • Overheating/cold/dark/stuffy • Acoustics problems/ fire risks ‘Don’t call me crazy’ tv programme.
  8. 8. Existing Site / Unit / Context. Site of the proposed new buildExtg McGuinness unit to be demolished Site
  9. 9. Site Constraints plan Site topography
  10. 10. Design Approach • Service User engagement key • Tailor to the audience • Role plays / games / workshops • Interactive and fun • On their patch • Win their confidence • Don’t patronise • The Arts as an outlet ……bribery works!
  11. 11. Key outcomes / debates - brief development • What is an institutional design? • How do YP use their environment? • Activity driven spaces • Respect / dignity / transparency • Sensible approach to risk • Mixed gender living • Stigma in particular Eating Disorder sufferers • Choice, interaction and retreat • Ownership Who What WhenWhy How Develop the brief
  12. 12. Typologies – form, flow and scale
  13. 13. Site plan
  14. 14. Upper Ground floor plan
  15. 15. Lower Ground floor plan
  16. 16. Key Design tools Building as enclosure Fluid circulation, flowing lounge spaces Curved form masks scale / views out Multiple circulation options Curved corridors mask scale Extra- care areas not PICU. Immediacy of garden spaces Clustered activity spaces Boundaries and thresholds
  17. 17. Key areas Bedroom and En-suites Dining areas Sight lines Discrete observation Access Access boundaries Sight lines and observation. Snugs and break out spaces Views out Access
  18. 18. Aesthetics/imagery Look of the building, dynamic, movement, boat/sails?, distinctive, interest, layers, stimulation 3d printing to show form/context
  19. 19. Aesthetics/imagery
  20. 20. Role of interior design Rebranding the service, welcoming reception, first impressions, Arts projects, naming competitions, poetry, Signage and motifs, photography, Ownership and sense of place.
  21. 21. Structural challenges
  22. 22. Construction Site works begin March 2012
  23. 23. Finished building Phase One H/O June 2013. Phase 2 Oct 2012
  24. 24. Finished building
  25. 25. Finished building
  26. 26. Finished building
  27. 27. Finished building
  28. 28. Official openingDecember 2013 Olympic champion - Dame Kelly Holmes
  29. 29. Post project evaluation – June 2014 Improved Quality of Clinical Care ; • Reduction in recorded incidents incl safeguarding incidents • Improved therapeutic milieu • Reduced lengths of stay • Improved education engagement • Reduced acute escalations (ie via new time out areas/observation) • Improved Privacy and dignity incl gender issues • Better intensive nursing outcomes • More dignified/controlled admissions facilities • Closer/more efficient clinical adjacencies Improved Patient environment ; • Appropriate colour schemes / interior design • Activity led spaces • Immediacy/accessible garden spaces • Choice and variety of activity/therapy spaces • Light and airy spaces • No fences/invisible security • Improved meet and greet/visitor facilities
  30. 30. Post project evaluation – June 2014 Safety and Security ; • Built in robustness • Reduced incidents of absconding in the last 12 months (previously a huge issue)* • Reduced incidents of self harming in the last 12 months • Reduced instances of Fire Alarm triggering Miscellaneous; • Reduced use of out of area placements • Reduced incidents of YP in Adult MH facilities • Better overlap with Tier 3 CAMHS • Improved staff facilities • Improved staff morale, pride, retention/recruitment • Improved Service reputation, Identity, perception • YP ownership in environment eg Personalised gardens • *change in staff focus (ie less keeping YP in, now helping YP recover) • Reduced Revenue costs (Cost per bed per day etc) • 40% reduction in energy costs • Reduced maintenance costs
  31. 31. Legacy… New Low Secure Unit – due on site in November 2014 New Recovery Academy – currently out to tender. Design Project of the Year – DMHN conference 2014 Next phase of development - Future replacement Gardner Unit. 2015
  32. 32. Design evolution……. Above – CAMHS unit for Lancashire Care NHS Trust, Preston Below – CAMHS unit for Lincolnshire Partnerships NHS Foundation Trust Right - Evolved bedroom/en-suite design Above - CAMHS unit for Black Country Partnership NHS Trust. Dudley Plus CAMHS Projects for Nottinghamshire Healthcare NHS Trust and Cheshire and Wirral Partnership NHS Foundation Trust.
  33. 33. Reflections/critical success factors • Importance of design Champions • Sensible risk debate • Repeatable design data • Continuity • Empathy • Brave client / Experienced Design team • Enlightened Contractors • Meaningful End user engagement • Ownership by the End users
  34. 34. Thank you