Outside Space


Top 10 points for garden designers and other outside specialists


1 It’s not about the budget. It’s about the imagination and engagement of the carer to use what they already have, weeds and all. Some of the most active engagement by residents with the outdoors occurred in care settings that did not have the most money available, nor the prettiest gardens. Help the care setting to value what it already has.


2 They may not need your design skills. Don’t default to the design aspect of your work. You may not be required to be a designer, at least initially. It could be that they need your support and guidance about using what they already have. Help show them the merits of what they already have and how to use it to its best. If you have other skillsets (for example from other careers or jobs in management, training, coaching etc.), bring these to the fore. You will be able to see the care culture at work very clearly, and can offer insights to the care staff about the ways they are doing things.


3 Who are your clients? Get to know them. This may take more than one visit to get beneath the marketing ‘spin’. Root around, check (especially on nice days) that doors to the garden are open. If they are not, ask why. If you don’t understand the culture of the care setting, and the attitudes to the outside space that staff and residents already have, how will you know that what you create for them will be used?


4 Don’t design back in the fear. Your client may be further along the health and safety journey than you are – check first so that you don’t take them backwards on their culture change journey. Shocked by open entrance gates? An uncovered pond? Ask the care setting about this before you assume that they are dangerous, or that the outside space is unsecured, as they may be operating within ‘safely imaginative’ practices.


5 Gaps are good. There’s no need to design to the last square metre. Allow possibility and ownership by the resident and the care setting. One thing we need to take on board is that the garden is,


17 in our sample to record diary sheets of interactions the staff made with residents with dementia in the outside space (or indirectly through the windows and doors) over a one- month summer period. They documented and returned 600 completed diary sheets in total. We learned about a curious and positive unintended outcome of doing this journal activity from one home; it had resulted in improved morale among staff. By capturing what they did with their residents, they became aware of just what their roles entailed, and the range of skills they deployed in the course of their work.


Alongside the data-gathering activities of the carers, we decided to carry out our own site visits and observations to provide an outsider perspective. We selected a representative sample of seven care homes and visited them


and should be, a flexible and adaptable space, with gaps and areas that can be personalised and used spontaneously.


6 Avoid gimmicks. Things should be what they are meant to be in the outside space, and things that you expect to see in a garden. If your garden feature is not at least purposeful and realistic, then it will probably be little more than a gimmick in the longer term, and of little meaning and benefit to the residents.


7 Don’t be conceptual or contemporary. A modest treatment using domestic-scale, generationally familiar items will be of greater benefit than contemporary materials and modern and fashionable planting schemes. The simplest and most bland gardens in our research project were the most used.


8 Create familiarity. Generationally familiar plants will delight and engage. Bringing residents’ cherished garden items into the care setting can aid transition into their new home environment.


9 Can residents access the garden easily? What relationship does the resident have with the garden from indoors? Are the chairs facing the outside? Are there obstacles interrupting the view, and getting in the way of entrance doors and natural routes to the outdoors? Are there net curtains and clutter on window sills that obscure a better interaction with the garden? Is the Open Door policy easy to follow, or burdened with too many conditions and procedures?


10 Encourage relationship-centred design. Be prepared to collaborate on smaller commissions with the care setting (rather than one-off approaches) in order to facilitate and support their journey towards relationship-centred care and greater use of the outside space. It will be more rewarding, and allow you to thoroughly understand your client over a longer timeframe, and to fully grasp the issues around dementia and older age.


* The new Care Culture Map and Handbook is now available. For details, visit www.stepchange-design.co.uk


20 times (three visits to all but one of the care homes, where we made two visits before our key contact left his job). In total, we gathered a further 874 separate observations during these visits. Added to the data gathered by the care home staff themselves, we gathered, in total, almost 1,500 pieces of data-capturing interactions between residents and staff with their outdoor spaces.


The Care Culture Map – based on the designers’ findings and the care culture spectrum plotted.


24 THE NETWORK Ap r i l 2 0 16


A GROUND-BREAKING EXPERIENCE It was during our first site visit that our carefully planned research and deeply-held assumptions about our design work began to fall away around us. We were in a small garden attached to an Elderly Mentally Infirm (EMI) Unit, positioning ourselves to make observations of the interactions between carers and residents with dementia in their outside space that afternoon. The garden was a little unkempt, with patches of dandelions and buttercups, and lots of bare patches in the raised beds – not a very impressive or well-looked after space, we thought through our designer eyes. Debbie had mentioned the weeds to the activities manager earlier, and thought that the reply was little more than an excuse. The home liked to keep the weeds, as they found them useful with some residents. What took place in that garden on that June afternoon,


however, was quite literally a ‘ground-breaking’ moment for us. It was a significant shift in perception and understanding that was nothing short of earth-shattering. We saw a magical interaction take place between the activities manager and a resident living with dementia, using what this modest garden already had (weeds and all) to create an authentic, engaged, and warm interaction that visibly lifted the mood of the resident, involved her in a purposeful activity, and helped her remember being a parent and engaging with her own children.


HUMBLED AND A LITTLE ASHAMED We felt humbled and a little ashamed about the critical and arrogant attitudes we had adopted beforehand. What we couldn’t deny was that this interaction took place in a garden that had not been designed by a garden designer. In fact, if either of us had been invited in to redesign this garden, we would have eradicated the very things that had helped facilitate this remarkable and successful act of care.


When we debriefed later that evening, we realised it wasn’t the garden design or the quality of the physical space that had made this interaction meaningful and transformative for the resident. It was about the skills deployed by the person the resident was with in the garden. The garden simply provided a ‘palette of opportunities’ that this skilled, aware, and loving facilitator could draw from to engage sensitively with the resident. There were no wind chimes or water features in this garden;


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