Care and craftsmanship in a home for the elderly


In her monthly column for FX, Brief Encounters, Veronica Simpson is moved by the care and craftsmanship devoted to a new building for some of society’s most frail and vulnerable members.


fx

Words by Veronica Simpson

All Images - Nicky Hirst

One of the most impressive buildings I've recently had the pleasure of visiting - for the form of the building, the quality of the layout, materials and spaces, the vistas and access out into nature, the care taken over colours and textures and art - is a mental-health facility.

Not the kind of phrase one gets to tap into the keyboard every week as a design writer. But Kingfisher Court is quite a special kind of facility, created as part of its governing NHS Trust's mission to be more people focused.

It is part of the 'recovery model' that Hertfordshire NHS Trust is seeking to promote in all its new buildings, emphasising the normal over the institutional. The design process is as unusual as its end goal: requiring 'inclusion and discussion at all levels, involving the whole community - staff and clients - in building, design and usage decisions'. So says Dr Barry Trindall, leader of the programme for Hertfordshire Partnership University NHS Foundation Trust. Following the appointment of P+HS Architects, which won the project at competition, some 2,000 man hours were spent on consultations; the Trust has around 11,000 organisations and individuals on its mailing list, who were invited to participate. The resulting priorities have led to a reinvention of standard operations, as well as design.

A scattering of pebbles sit on a wide window seat
A scattering of pebbles sit on a wide window seat

The buildings are mostly one storey, and lying low within the gently hilly landscape so as to eliminate any imposing, institutional facades. They are clad in timber on the north side, in shingle on the south, with undulating roofscapes that echo the contours of the landscape. Set in 11.5 acres of woodland and greenery, there are vistas from either large or full-height windows throughout, and each of the two wings features landscaped garden/courtyard spaces, enclosed only by buildings. There is barely a fence or high security railing in sight. All client bedrooms have opening windows - a fine-mesh, unimposing security grille behind the glazing keeps the occupants safe, and every bedroom looks out over greenery. All doors are operated by swipe cards, so that as clients improve they can get access privileges to other spaces, including a cafe in the lobby, shared with staff and visitors.

A palette of colour combinations - all designed to complement or coordinate with the landscape - has been selected by service-user groups. Furniture is almost entirely non-institutional. There is high-quality, wood-effect lino and real wood doors and door frames. There is no institutional signage anywhere on the campus - not even at the entrance. Instead of 'consultant offices', there are 51 bookable rooms available to therapists, consultants, staff and service users for meetings.

Says P+HS associate, architect Wendy de Silva: 'The idea of the recovery model of care is that you are helping people to have a meaningful life in their community. It's not that there is just illness and wellness. There's a continuum.

Images of familiar sights decorate the walls
Images of familiar sights decorate the walls

Therefore it's important to have things that feel normal. One thing was very important - places for chance meetings and contemplation. As you come out of a bedroom there are window seats. As you get better you might be able to go into the day spaces or the therapeutic courtyards. As you get better still there are "streets" where you might gather, places where you might meet your partner and children.'

Equally strategic in this humane scheme was the provision of high-quality artworks that directly addressed the community and the site. The Contemporary Arts Society acted as consultant, suggesting 10 artists initially, then whittled down to two by the stakeholder groups, which selected Nicky Hirst and James Ireland. Ireland has peopled the corridors with monumental pieces, large and small - a series of small concrete slabs march along a wall, their rough lower edges inviting touch and exploration, as they have been cast from trees in the surroundings; and bronze pillars that serve no structural purpose but also contain a strip of textured bark cast from local trees. Most thrilling, however, is a glowing window at one corridor's end, whose stained-glass-like film overlay evokes a tropical sunset or sunrise.

Greenery goes right up to the walls
Greenery goes right up to the walls

Hirst has taken her conversations with the user groups and responded with three intimate and evocative strands of work: a series of naturalistic still-life photographs of mantelpieces and shelves, taken across a range of real homes, filled with both personal and universal objects - candlesticks, vases, keys, photographs. They bring an uplifting reminder of quiet domesticity that could only work in a scheme as devoid of the usual institutional materials and colour palettes as Kingsley Green. The second is a collection of everyday objects from nature, cast in bronze and patinated so that they look just like the real keepsakes that everyone will have collected at one time: seaside pebbles, conkers, pinecones, shells. Non-removable clusters of them are casually arranged along window seats or on wooden plinths in the gardens. The impulse is to touch them - which Hirst particularly likes. The third is a small book of photographs of ordinary people's keepsakes and talismen, along with self-penned poems and stories; service users are given one of these on arrival. Says Hirst: 'They are about...attending to the ordinariness of our lives and the things we hold dear.'

Who knows which aspect of these inspiring elements will have the biggest impact - or whether the power is in the accumulation of so many thoughtful and humane details - but it is already working. With phase one operational for three months when I visit, Trindall was able to share the tangible outcomes so far. There has been a 'big reduction' in aggressive incidents, plus a huge drop in tribunal appeals. This latter is massive - some 75 per cent of Kingsley Green's 'clients' are detained here by law. The reduction in tribunals means that, when they arrive, clients perceive that this space is more about healing than incarceration. Reduced tribunals will mean a huge saving to the legal system and the mental health service. What it means in terms for patients and staff, however, is priceless.








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