INPATIENT FACILITY DESIGN
pattern of stars, while a large circular LED light panel is mounted centrally in the ceiling. Here Mark Childs showed me a control panel for the bedroom’s LED lighting, which enables the service- user both to change the colour of the lighting in the bedroom and en-suite bathroom, and to adjust its brightness to suit their mood or the time of day, for instance dimming it at night as bedtime approaches. The three of us felt that if all we did in the bedroom conformed to set industry standards, we would not be challenging the norm. Instead, we focused on providing a good place for sleep and rest, as well as considering reduced ligature. We thus had the lighting developed ourselves.” Another feature designed to ensure a restful sleep are a series of acoustic panels incorporated in the wall in the recess to the side of the bed. Service-users and experts by
experience also emphasised the need for different ‘zones’. Mark Childs elaborated: “We had a couple of young people who said: ‘I want a place to hide, that only I know about – my safe space.’ You obviously can’t have that in a mental health ward, but if you – (he gestured to me to sit in the recessed semi-circular alcove to the opposite side of the room to the bed) – sit here, and I go out the door, I can still see your feet, so the staff member can still have a line of sight, and yet the service-user feels calm and relaxed, and very much in their own space.” The alcove feature was created by Hygenius Healthcare. Service-user feedback had also
highlighted the desire to be able to undertake activity, and, sometimes, the ability to make a mess. Mark Childs said: “There is a nice window seat area – featuring a Safevent window with integral blinds, by Britplas, for use by the service- user, a staff member, or family coming in, to encourage interaction, and it’s nice and comfortable and – again – changes the dynamic. Importantly,” he continued, “and especially for a neurodivergent audience, they need spaces to put stuff away so they can play and be messy, but also tidy. For this we have incorporated a series of small ‘cubbies’ and other storage space in units by Hygenius, as well as space for the user to make the bedroom their own – for example with photos of their family and friends.”
Allowing natural ventilation in The Britplas Safevent window half-opens at the base, to allow in natural ventilation, and has a control to operate the internal blinds. “If you have a really bright sunny day,” Mark Childs said, “sunlight is a great healer, but at times the bedroom’s user may want to feel a bit more relaxed, so they have control over the blinds.” Looking next at the en-suite bathroom,
he pointed out that the room layout means the inpatient can be safely stood, unseen, in the shower, maintaining their privacy,
THE NETWORK | NOVEMBER 2024
Altro produced a single-piece IPS unit for the basin (from Wallgate) formed from its Whiterock cladding PVC material, while the reduced ligature shower is also from Wallgate.
explained: “We are keen for the CAMHS bedroom to have a wardrobe – particularly as mess, and the inability to put things away, can potentially cause distress to neurodivergent people. We are working with Gilling Dod and Hygenius to work out how to make a suitable one.”
A sense of pride He added: “One of the questions that has come up several times is: ‘If you make the bedroom too nice, how will you get young people out of it?’ Our premise, however, is that if you walked in here as a young patient you’d immediately feel cared about and proud of the space. Studies across Europe, in both custodial and healthcare settings, show that, where you improve the environment, vandalism and abuse levels reduce.
but still easily talk to a staff member, and vice-versa. The en-suite incorporates Kingsway’s new anti-ligature Shower door, which my host pointed out is so strong that it will withstand considerable force – indeed somebody putting their shoulder into it – without breaking or shattering. He said: “We did a live demonstration yesterday showing that if the door does need replacing or maintenance, it takes just minutes – simply by unscrewing two fixings at the top and bottom, you can take that off.”
A service-user led modification Altro, he explained, produced a single- piece IPS unit for the basin (from Wallgate) formed from its Whiterock cladding PVC material, while the reduced ligature shower is also from Wallgate. Originally, Mark Childs explained, the Altro-supplied wall above the basin and by the mirror surround had a grey tiled effect, but when the design was shown to children at Caudwell, they emphasised that the pattern could agitate and upset service- users with autism. It was thus changed to a single-coloured finish. Back in the bedroom is a Pineapple
Ryno Rocker chair which – although it can be heavily weighted to 65 kg – allows gentle rocking motion, and provides comfort and calm. It has sloped arms and a low back, is designed to minimise ligature risk, and has a ‘hygienic, wipe-clean surface’. Pineapple also supplied a colourful Boden Rocker beanbag, with its ‘donut shape’ providing ‘a reassuring feeling of wraparound contact’, and its raised back offering head and neck support, while another furniture specialist, Hygenius, fitted out the recessed bed space, supplied the bed, and a separate desk space and seat. Wardrobes for such settings must clearly minimise ligature risk. Mark Childs
The CAMHS co-production bedroom is oversized, simply to make the features as visible as possible to visitors, but – as Robin Graham explained at yesterday’s open day – it could easily be scaled down to the average NHS mental health bedroom size and still work.” My host re-emphasised how much the
team behind the bedroom had wanted to challenge established approaches. “One of the debates from a health and safety perspective was whether a three-sided bed would obscure lines of sight,” he told me. “Speaking to experts by experience, one recalled going into an inpatient bedroom and finding their bed right in the centre. ‘Due to their background’, they need walls around them, and with the bed thus positioned, they felt ‘on high alert’, and couldn’t sleep fully for months. The bed position here is about providing a place of safety and having the surround. If the service-user is asleep, of course, staff have the opportunity for a clear line of sight to check on them. The acoustic paneling behind the bed, developed by a third party, also felt really key in insulating the inpatient from noise.” Mark Childs further explained: “Some of the clinical teams that have visited have said the design would be great for low and medium secure settings, but for high secure, you would need to change the design, because, for example, to access a highly psychotic patient, staff would need access to both sides of the bed. So, there’s been really useful feedback on many aspects of the bedroom’s design. The whole exercise has been about designing and building a co-produced CAMHS bedroom that we feel will stimulate discussion, and can be developed and enhanced the more we learn. We are very proud of what has been achieved so far, but really this is just the start.”
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