Interior design

State-of-the-art care home design nation

Park Grove Design director Lori Pinkerton-Rolet shares her insight into how care home providers can get ahead of the pack with interior design of new build and refurbishment properties

The world has changed. Before Covid-19, care and dementia home design had already made great strides forward but the trajectory for change must now be ramped-up to accommodate for shifts in competition, staffing and international economics.

Each of these aspects have or, to be blunt, should have a direct impact on the way interiors are designed for these important facilities. There are many ways in which these changes can be interpreted in new builds and refurbishments, but I am going to focus on three key areas: staffing ratios, aesthetics and storage.

While one might expect advances in technology to be the focus of a piece on state-of-the-art care home design, it is my opinion that these developments, and our expectations of them, change so quickly that they can only be as current as the time period of implementation. Technology is therefore not my focus, but rather the more conceptual aspects of design. Let us begin with a quick review of how we got to our current design offering as it provides context to the path forward.

How we got here

Most aspects of society evolve. Let us use television as an example. When TV began the model for widely-broadcast entertainment was radio. As a result, early television was, by and large, radio programmes with pictures. The format then evolved to a unique part-time entertainment which began each day with a little girl and a chalk board and ended with God Save the Queen. That was thought to suit the lifestyle of the populace as it was understood at the time. In 2020 entertainment is largely

tailored to individual preferences with competing services offering whatever we want to watch, whenever we want to watch it. Today the emphasis is on the choices available to the end-user rather a dogmatic approach by those producing the offer.

The development of what we today refer to as residential care homes follows a similar trajectory. Until the 1850s the sick and aged were cared for by relatives in most circumstances. Charities set up voluntary hospitals for people of means, and workhouses with medical officers expanded throughout the nineteenth century to assist those in poverty. In the Roaring Twenties, Public Assistance Institutions took over this roll until the Second World War changed everything including a move toward smaller, more residential-style care facilities. In fact, many large domestic homes were extended and utilised for this purpose in the years that followed.

We must design care homes for the future in which the need for occasional isolation is considered from project inception


My first care home refurbishment designs were for The Hendon Old People’s Housing Association, a home set within a large and extended Victorian vicarage. It was certainly intimate, not fit for purpose, as indeed this was not the purpose for which it was built. And please do not get me started on the laundry facilities!

Even in these intimate settings the model for care was based on a hospital- like offer, based in part on staffing levels. We also find this in larger new build properties where economies of scale result in 70-plus resident rooms. Both the Care Quality Commission and the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 state only that providers must provide sufficient staff for the needs of the people using the service - neither states a ratio. The Royal College of Nursing offers guidelines for staffing levels for hospital wards catering to older people of approximately one member of staff to every ten patients.

While my company Park Grove Design has designed properties for operators with similar levels of staffing, we have also had the good fortune to work with groups like the award-winning Royal Star & Garter homes where the ratio is a more intimate 1:3.

The result of the ‘hospital’ staffing model can still be seen in care homes across the country, where lounges have been set up with chairs in a large circle around the room and a television in one corner. This layout allows a member of staff to see many charges at a single glance. In some homes people also have their meals in these same chairs. The day begins and ends with getting into a chair in which limited neck mobility and built-in winged head supports prohibit speaking to the adjacent person, and distance prevents the resident from speaking to those opposite or from seeing the television properly.

I do not care how many ‘spa-style’ • July 2020

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