AUTISM FACILITIES


Left: A view into service-user private day space. Each apartment includes a defined neutral colour on the front door, windows, and furniture. Below: Views of a service-user bedroom corridor, with seating and views into the therapy courtyard.


in facilities out of the area, making it harder to maintain links with family, local services, communities, and – importantly – clinical/social work professionals who are able to help monitor the quality of care and progress timely discharge into the community.1


Wide-ranging transformation programme The Trust’s wide-ranging transformation programme had already identified the critical need for investment in buildings to create new and improved environments for both patients and staff, alongside other complementary programmes of work to support prevention in mental ill health, increases in digital service provision, and increased care within the community. The approaches were well aligned with the national (NHS England) Transforming Care programme. This is aimed at enabling more people with autism to stay and live in their locality and community through the delivery of a range of projects and services which help people access care at home and in the community, and generally improve the health, quality of care, and quality of life, of those with learning disabilities. The Onyx Unit was one of two key


capital investments within the Trust’s programme which would not only significantly improve the physical quality of facilities at Brooklands, but also enable the creation of more integrated, local pathways of care, and enable proactive interventions to facilitate more timely transitions through services, reducing the length of inpatient stays and readmissions.


THE NETWORK | FEBRUARY 2024


From early in the design process, CWPT


worked closely with service-users, staff, and families from the autistic community, to ensure that the new facilities at the Onyx Unit would be tailored to the specific needs of individuals with autism. Effective patient care was placed at the heart of the design proposals, with key principles centred around the maximisation of dignity, therapy, and safety. The new facility was designed carefully


in order to provide a comfortable and calming environment. Individual en- suite flats also have their own private garden space, so that patients are able to spend periods of time in a quiet, private environment, while an assortment of day spaces and therapy rooms of varying sizes are connected to a communal external garden, preventing prolonged periods of detrimental isolation. Large, glazed windows bring light into internal spaces, while a loop of circulation helps improve the efficiency of the building’s internal operations, and encourages individuals to move, while high-quality welfare spaces for staff help support the Trust’s recruitment and retention strategy. Many autistic patients experience sensory processing difficulties, which can be exacerbated by traditional hospital environments that are often bright, noisy, crowded spaces. The National Autistic Society notes that ‘Wards can be noisy, bright and unpredictable. Without reasonable adjustments to the environment, and support from a professional who understands autism and how to adapt care, it can be completely overwhelming and increase someone’s


level of distress. This can lead to further restrictions, and make it even harder to move to support in the community.’2 In response to patient feedback, a


specific colour palette runs throughout the unit, and – suited to the end-user and their challenges – colours were selected for their shade/tone, appearance, and texture, and how they integrate with each other. Each studio is defined as the ‘front door to their house’ through the use of contrasting front doors. Sensory overstimulation is addressed by providing service-users with a high level of control over their individual space, with lighting and temperature controls in each of the flats allowing residents to adjust to suit their own needs.


Safety and security Safety and security for patients, staff, and visitors, was also recognised as an integral enabler for the provision of high-quality clinical care. Importantly, design decisions regarding security were considered based on three interdependent and intersectional domains: l Relational: the understanding and use of knowledge about individual patients, the environment. and population dynamic;


l Procedural: the timely, correct, and consistent application of effective policies and procedures, and


l Physical: the internal and external perimeters, security mechanisms and technologies (e.g. manual/electronic lock systems, CCTV), and other physical barriers (e.g. airlocks), that exist in the unit and the service as a whole.


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