Extra Care / Residential / Assisted Living
Our approach to extra care and assisted living is centred on ability, social interaction supported through design and sensory based orientation. Many designers stipulate wide corridors - we advocate for a zero corridor environment and work to achieve this wherever possible. Corridoors create an adversarial and un-natural living environment for human beings, as well as being a waste of light and heat.
We work with clients to create socially active domestic scale open plan room / maisonette arrangements, giving wherever possible direct access to the outdoors and indoors.
We create intermediary personalised zones at the entryways between grades of private and public space. This means that when you have left your home within the wider care environment, you still remain in a place of your own, safe, outside that room or flat. You have time to take in your surroundings and the sensory cues that tell you the opportunities for activity or journey. You are never cut off in a single door close from the things that support your identity, therefore it is easy to build your confidence, and enjoy taking an active, outgoing role in life. Your independence is naturally retained and maximised.
Recent surveys have demonstrated that people living in extra care appreciate most the chance to be more sociable and less private, yet design standards continue to focus on privacy. We at Architectonicus focus on wellbeing and the arrangement of space to best enhance positive psychosocial development.
The above image shows an example arrangement for flexible use extra care / assisted living communities. Arranged so that each clusters' use could be changed to move with the locality needs, moving clusters between stages of dementia or varying levels of independence and extra care.
This allows you to minimise staff requirements and focus specialist staff only on individuals requiring those higher skill levels. The Corridor free method allows for domestic scale multi activity day rooms and either secure or open gardens.
Ancillary facilities are easily introduceable once you have identified what will be successful for your project, and for that locality. It is important to research which extra facilities will be viable before committing investment.
Points raised at the event held at Univeristy of Bristol: Extra Care Housing: Connecting Research, Policy and Practice.
One key issue which was raised at the conference, that could be quite heavily design related, is that integrated housing and care is supposed to increase service quality, enable and maximize independent living, reduce costs of services and crisis admissions. However the fact is that there is little or no evidence to support these claims. This makes sense, when one considers that there is no, or very little link between the people, the issues they are living with, the care being provided and the environment in which it all happens... you can't make economies out of a mess...
There was a study presented regarding what people liked most about living in ECH. Most residents liked the friendliness of people, then 24hr care came second, independence came third and security came last. Discussion at the seminar revolved around the fact that so much emphasis is put on privacy, in the running and design of these buildings, but that people are coming there for the opposite, to be more social, to be more open, a lady running a successful ECH said that people at her community liked to leave their studio flat / room doors open, so that a social feeling was maximized.
It is reported that less than half of people living in ECH receive as much social contact as they would like.
Maintaining control over nominations to join an ECH scheme allows managers to preserve the balance of care needs.
Miss allocated residents do not stay long.
It was highlighted that there is tension and lack of integration between ECH and residential care providers.
Pressure is being increasingly put on ECH to take on residents with more complex needs, this is seen as a threat to activity budgets and cost effective care provision across the ECH.
It was raised that long term success, at the cost of lower short term profits, was achieved by developing a sense of co-ownership / co-creation of the Extra Care concept, with the local community as involved as possible in deciding on shared facilities, activities in and out of the community and community involvement with the ECH itself. Residents taking a maximum role in running the ECH themselves wherever possible optimises long term success.
High short term profit, at the cost of potential long term failure, was seen to be the general outcome for many schemes that were 'dropped' into a community without any meaningful engagement.
In terms of on site facilities for ECH and facilities shared with local communities, good judgement has to be put into their selection and the way they are designed into the ECH, as there are cases where these receive high levels of use, and cases where they receive no use or too little use to remain viable.
We are passionate about design as a tool to support good mental health. Even where residents are living with complex syndromes, old age, dementia, or other special needs, challenging behaviours can most usually be generated or exacerbated simply through mental health challenges created by the conditions in which they are living. These are meant to be caring conditions... As specialist architects for wellbeing and care we believe in non institutional, non adversarial design that expresses an opening up to life - ecologically, socially and visually.
Nature, social interaction, light space and scale, sensory journeys - all this can be designed in. Architecture can encourage or inhibit wellbeing... there is no space for corporate or ego based architecture in care. Our designs celebrate the residents and support the work of your care team - it's win win - and because what we do is based on space arrangement rather than materials and finishes, we can match most budgets, that's what is most exciting, special doesn't have to mean expensive. Good design further reduces minimum staff levels and ongoing utility / maintenance costs. Our design and structural strategies can further future proof your investment; allowing easy replacement of external rain screens, flexibility of use designed in, and easy extension / alterations when using modular lightweight frame.