Outside space Care setting ‘hidden dangers’
For the care setting specifically, the following ‘hidden dangers’ are closely aligned with whether it is truly person-centred and can occur if the skills or practices that reflect this type of care culture are not embedded across the whole team.
1. Have you moved on from risk assessing things? Care setting cannot leap ahead from risk assessing the things, or activity, to risk assessing residents’ individual abilities to engage safely with them if they have not
knows best,’ when they are the experts in understanding their residents’ and their own current abilities and needs.
The designer and care setting’s fearful attitudes match Possibly the most difficult ‘hidden danger’ to identify, and the one that results in no change to current engagement levels (and arguably a faster timeframe towards becoming a neglected garden). Here both parties concur with each other’s attitudes towards health and safety and risk assessment and create a bland and unengaging garden space that may simply be ‘pretty’ to look at but curiously uninviting to visit (or actively discouraged through permission procedures and locked doors). Myths around health and safety remain unaddressed to the detriment of staff members who want to experiment and residents who like to spend time outdoors and engage with garden activities such as hanging out washing or mowing lawns.
How can the designer and care setting create an actively used outside space? It’s crucial that the designer and care setting are honest in their collaboration so that the client brief matches as closely as possible where the care setting currently lies on their journey towards person-centred care and beyond. It is also important that the designer can
interpret what they are told by the care setting effectively, and check the reality on the ground where reasons for lack of use are discussed, so they understand the care culture practices that may be hindering engagement and lie in wait to ultimately scupper their design efforts further down the line.
yet embedded the skills and knowledge about their residents to become truly person-centred.
2. Insufficient knowledge can put residents at risk. Encouraging residents past ‘no,’ when invited to go outdoors can be beneficial to get a shy or reluctant resident to go outside. But, where there is insufficient knowledge about a resident’s current abilities or wishes, or staff lack the skills and experience to interpret if they actually
We created our award winning ‘Why don’t
we go into the garden?’ books and tools to support care settings on a culture change journey to more person-centred engagement with outside spaces, and to be more articulate clients when working with designers to create new gardens. For designers, these resources help them to interpret and apply their design skills within the context of the current care practices, creating the space for care culture improvement and effective collaboration to ensure gardens are used long after they have left.
What success looks like Successful gardens can and should be measured by how easily residents and staff are able to engage with them all year round, doing what matters to them as and when they choose. Creating gardens and, where necessary, supporting an organisational culture shift that will mean it is used requires a joined-up way of working we call ‘relationship-centred design.’ It literally ‘takes two’ to create a
successful garden; care homes to address organisational practices that may hinder full and meaningful engagement with their
mean ‘no,’ particularly where there may be communication difficulties, can easily risk becoming coercive or bullying.
3. The new garden is expected to do the culture change work In this ‘hidden danger’ the care setting believes that a new garden alone will create active engagement outside ignoring their own responsibility to address the care practices that resulted in an under-used space before the designer was invited in.
outside space; and designers to work with an understanding that this must happen before, or alongside, their design work if it is to be used over the long term. Designers that visit their new garden over
a longer period following installation may also spot where further aspects need to be addressed to ensure investment in gardens brings the greatest benefit to residents, staff, and the environment long term. n
Debbie Carroll & Mark Rendell
SCAN HERE More details on our research can be
accessed here: https://stepchange-design.
co.uk/care-home-garden-design/
26
www.thecarehomeenvironment.com May 2026
Debbie Carroll and Mark Rendell are both garden designers with over 20 years’ experience who are both passionate about gardens being well used and well loved. Having designed for a range of care setting gardens they joined forces in 2013 to unlocked what it takes to create actively used care and dementia gardens. Step Change Design, was formed to share the findings of this study and they published the ‘Why Don’t We Go Into the Garden?’ series of books and tools to support improving garden engagement in care settings. This work recently won NAPA ‘Research & Evaluation’ award for their work with Hallmark Luxury Care Homes.
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