Outdoor space

pandemic could have been the trigger to reappraise the value of using the outdoors more effectively and thus result in new habits, norms and routines to increase engagement levels for residents and staff. They may have experimented with new ways to provide outdoor spaces for different sized groups, and discovered just how stimulating and energising time spent outdoors can be for resident and staff wellbeing. The overall culture change journey

that the pandemic heralded for these settings can therefore be interpreted as an opportunity to be embraced instead of a threat to be tolerated and will likely be resulting in innovative and confidence- building approaches to new practices and habits relating to the outdoors, as well as other areas of the care environment. Then there is another group of care settings towards the task-oriented end of the care culture spectrum for whom the outside space remains a place that is largely off-limits, or difficult to use, for the majority of residents and staff. The health crisis is likely not to have resulted in any changes in habits and routines that would engage more with the outside space. It may have even been used to reinforce further resistances and reasons for not going out more.

Sustaining positive changes to outdoor activity levels It is important to understand the pandemic and the responses made as an urgent and enforced culture change activity. For those managers who had quailed at the idea of undertaking such an energy-intensive and skilled management activity as culture change before the pandemic, you just have! What is important to do now is to review the impact this has had on your overall care culture. How much more do you know about

your garden now? Who likes going out there, staff or residents? How will you ensure the positive benefits of going outside are recorded, shared and can be maintained through the post-pandemic phase? Does your open door policy, for

example, now align more closely with your new routines and practices? Have you simplified ways to go outdoors and to respond to spontaneous requests to visit the garden? As culture change is delivered by the people in your organisation by

greater or lesser degree over the past 12 months, resulting in a new appreciation of, and engagement with, the outside space as there are undeniably positive benefits for the whole care setting in engaging more actively and meaningfully in the outdoors. There is so much evidence out there

over decades to show that it is undeniably a good thing to step outside for all our health and wellbeing.3 As culture change agents, we are

their behaviours, values and attitudes, how is morale? Who has shown most resilience, flexibility and innovation? How do you celebrate and embed these essential qualities into the culture of your organisation? How well do you capture and communicate all the positive gains for the organisation as a whole and for residents as individuals? How well have you encouraged a learning environment in which setbacks and failures are appraised positively as an opportunity to try something else or the same thing differently, particularly in relation to engagement with the outdoor space?

Conclusion We hope that a green wave has indeed washed across the care sector to a

here to help care settings understand the culture change journey they have been on, and to assist in embedding new habits and values towards their outside spaces. They can then take full advantage of all that nature has to give in aiding the overall care provided across their care setting, both indoors and outdoors, long after the pandemic is over.

Footnotes 1. For example, Royal Horticultural Society director general Sue Biggs reported a huge rise in visits to its website in the June 2020 edition of The Garden magazine.

2. Step Change Design, Our Research https://

3. See, for example, Clark P., Mapes, N., Lark P., Burt J., Preston S., Greening Dementia - a literature review of the benefits and barriers facing individuals living with dementia in accessing the natural environment and local greenspace published by Natural England in 2013.

Debbie Carroll and Mark Rendell


Debbie Carroll and Mark Rendell are garden design consultants at Step Change Design. Their approach is called relationship-centred design, which focuses on identifying the care culture in operation at the care setting along a spectrum of care,

June 2021 •

using their care culture map tool, and then matching appropriate design interventions to their current practices. For Mark and Debbie, the recent health crisis can be understood in terms of an enforced culture change process.


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