Tuesday 09 March 2021 @ 10:00am – 11:00am GMT
The past few years have seen enormous changes to the operation and running of care environments across the UK. Pandemic aside, the design of care environments requires updating so that they can respond to the changing socio–economic profile of the country, as well as the demand for better quality individual–led solutions.
In the Latest Re:Think debate, we will explore what can be done by real estate professionals within the sector to not only improve the standard or care, but by doing so, encourage further investment.
As always with our Re:Think sessions, we opened the debate floor first to our colleagues, before inviting discussion to a wider audience. These were the main trends emerging from our internal workshop:
Developing in an Urban Environment
In recent years, there has been much emphasis and research on the need to create biophilic environments within care settings. This coupled with the need, not want, for long–term care residents to benefit from physical access to outdoor space is undisputed. The positive effects of being able to touch plants, feel the wind on your skin and breath fresh air help alight the senses even when others may fade.
Projections show that urbanization, along with the world population growth could see an estimated 2.6 billion people living in urban, densely populated sites by 2050. This will be 68% of the world population. When you compare this with the projected forecast for over-65’s, which will double from 11%, to 22% by 2050, it is clear that adapting our urban environments to be more age–friendly will only ever become more important.
Many elderly people are said to associate urban environments with a lack of public toilets, busy traffic and street crime; suggesting that cityscapes are unfriendly and inaccessible zones for the over 65’s. It is important that this stigma changes so that urban environments are seen as neighbourhoods with a focus on easy accessibility, the very best amenities and are buzzing with social activity and opportunities for the elderly. Ultimately these neighbourhoods create attractive destinations that people want to live in.
Of course, the care requirements for those living in long term care settings will be vastly different to retirement living and those who are physically and cognitively able to access their environment autonomously. The topic becomes interesting when we consider how these urban environments can become the best option for everyone, regardless of care need requirement or age. Whether an individual is on end–of–life support, has late stage dementia or is enjoying retirement, there should be care models which respond and tap into the very best opportunities that an urban neighbourhood can provide.
Staff shortages are quoted as being the primary problem for care home operators. Currently the demand for qualified nurses and carers is at its highest. Care homes are often having to pay agency fees to attract suitably skilled staff members, whilst many more providers find themselves becoming adversely affected by the social care funding crisis.
Job prospects and career progression are low with pay grades usually at statutory minimum. This coupled with the emotional and physical drain of the job requirements result in many staff feeling underpaid and overworked.
High quality staff facilities and amenities are fundamental in order to maintain job satisfaction and staff retention. Care homes in rural locations are often hit the hardest, with minimal public transport links and opportunities to get to work for those without a private car. Therefore, an already shrinking pool of available staff, gets smaller. As such, care providers are having to offer different incentives to promote staff wellbeing and attract the best individuals for the job.
This begs the question whether care environments located within urban environments are able to provide a more encompassing level of care? Easy public transport options, accessible amenities pre- and post-work shifts no doubt result in a better working lifestyle, and surely happy staff = better care?
A Community Focus
Leading international examples show us the benefits of intergenerational living, and co-habitation.
Humanitas Nursing Home in the Netherlands effectively allows students to live rent free when they spend 30 hours per month “acting as good neighbours” to residents of the adjoining nursing home. This not only breaks down the stigmas associated with care environments but eradicates social isolation and feelings of loneliness often experienced by residents.
A mixed tenure solution for the UK could similarly provide affordable housing options for students, whilst a mix of uses on the ground floor would promote an active public realm and opportunities for social interaction between the elderly. A true mixed–use development would further generate a better yield for the project to ensure its financial viability.
The issue of security and maintaining a safe inclusive environment for residents would have to become the highest priority. However, creating ‘buffer zones’ on the ground floor would enable residents to feel part of a wider community, whilst still staying safe within the boundaries of a dedicated plot. After all, the importance of maintaining a sense of community for residents to feel and remain part of something bigger has been proven in many other exemplar projects.
There is a lot to be gained from sharing expertise and knowledge and we wonder how this model can become the future of co-habitation in the UK.
Design Response Following Covid19
The impact that the pandemic has had on the care industry has been devastating. For years, outbreaks of cold and flu viruses within facilities often go unrecognised and Covid19 has emphasised this catastrophe ten–fold.
In many ways, care establishments provide ideal situations for the acquisition and spread of infection; the constant flow of new visitors, staff and residents, coupled with crowded environments of residents sharing sources of air, food, water and health care.
COVID19 may have just given the industry the wake up call it needed to reboot the design of care environments to become much more adaptable and flexible in its layout to support and minimise any future outbreaks. For example, omitting dead end wings, and offering a loop layout instead. Introducing semi–private ‘buffer zones’ outside resident bedrooms to enable safe, unobstructed visitation from loved ones, and creating smaller cluster groups of residents in smaller households.
These solutions need to be developer, as well as design lead in order for the industry to adapt in response to the crisis. The changes also need to be possible to achieve for both privately funded operators, as well as Local Authority care homes. Given the funding crisis many providers are experiencing, is this easier said than done?
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