Cressida Toon of Sonnemann Toon on the challenges, and solutions, to flooring in healthcare.
Words by David Tarpey
Sitting in her car in a hospital car park in Birmingham, Cressida Toon speaks to me on the phone, upbeat about the sunny day and happy to talk about what others might see as the prosaic world of healthcare flooring.
Having studied at Cambridge and The Bartlett, her first job 20 years ago was with a company that specialised in architecture for the healthcare sector. She admits that coming in to that area was 'a bit random' but that her family has also produced a lot of doctors and nurses.
Fast forward to 2002, when she set up Sonnemann Toon with a colleague and her husband. Their portfolio now spans healthcare (about 60 per cent) as well as retail, commercial and residential, which she believes allows a healthy cross-fertilisation of ideas across sectors. And always, she and her colleagues live by their guiding maxim of trying to 'elevate the concept of design' within the healthcare sector, where budget considerations always elbow their way to the top of the priority list.
But today, she's talking flooring within the mental healthcare sector. She says simply: 'It's especially important to focus on the patient experience, and that includes reducing anxiety levels. Mental-health patients are so sensitised to their environments that a lot of factors can make their condition worse. With in-patient mental healthcare one of the big drivers is to eliminate risk, so the danger is that the setting can end up looking institutionalised and clinical. But, as the patient's needs are emotional rather than medical, a domestic feel makes them feel more secure and relaxed.
In the Spire Cambridge Lea health facility reception, the carpet in the seating area is bespoke from EGE carpets
'In the past, units often had shiny, speckled, vinyl flooring that was constantly buffed-up. The effect can be to make the floor seem wet and that causes real problems with dementia patients. So we avoid that option and go for wood/timber-effect vinyl, which still meets the requirements of being easily cleaned et cetera. There is also an issue around using colours that calm, such as greens or blues, and avoiding ones that can antagonise, such as reds or orange. It's also important to avoid abrupt changes in tones on the floors as those with dementia can see darker shades as some kind of barrier.'
Other detailed considerations around the issue of human bodily splashes and spillages are also central in the choice between, for instance, a stone or a ceramic tile option. As Toon explains: 'The porcelain can look like stone but isn't porous, so that if blood or vomit hit the ground it won't absorb it in the way stone will."
In this theatre at the Royal London Hospital the flooring is Pastell Conductive, from Armstrong Floor Products
One of her clients is the East London NHS Foundation Trust and this includes several secure units. Patients are considered to be at the forensic end of the spectrum, which means they are disturbed or potentially dangerous.
Such units feature en suite de-escalation and seclusion rooms in which patients are kept under locked supervision. But as Toon explains, being on their own means the patients can take their frustrations out on the decor. She says: 'The flooring here gives us a huge problem. The specification used to be for cushioned vinyl on the floors and walls as the patients often hurl themselves against both. But some were breaking the seams and ripping floors and walls to bits. So now we've gone for a seamless resin with a hard finish and a smooth surface.'
Toon says that another of the challenges of working in the healthcare sector is negotiating with clinicians who are highly aware of the Equality Act issues such as slip resistance, abrasion and challenges around visual impairment. She explains: 'They are, understandably, so nervous of any incident or accident occuring that safety must always come first and aesthetics second.'
Artificial turf by Desso features in this sports physiotherapy centre in Harley Street
A lot of Sonneman Toon's work is also in the private sector and that takes it to the delightful mix of Georgian, Victorian and Edwardian buildings of Harley Street housing the very many medical consulting and treatment rooms.
Of these, Toon says: 'It's great to get in and strip back the carpets, and you can discover the most amazing treats such as the beautiful black and white Edwardian tiles. Often the buildings are listed so one has to be careful, but with a bit of care one can restore the original timber or parquet flooring. That's satisfying, and rediscovering materials from the past has an element of archaeology!'
One of her favourite projects in Harley Street was working for a high-end Italian company developing a sports physiotherapy centre aimed at professional footballers. Toon recalls: "We knocked through a mews house and it was a very deep building. We installed a hydro pool 4m down and then a large area of fake grass so the players could practise on something that felt real beneath their feet/boots!'