Focus: Healthcare


Where hygiene is a top priority, flooring has to endure some of the toughest cleaning regimes. We investigate some options


By Kay Hill

Flooring in an office or small shop probably won’t have to cope with a cleaning regime any tougher than a quick vacuum every evening. But when you are specifying flooring for hospitals, laboratories or even care homes, primary schools and nurseries, the floor will need to be not only resistant to staining but also capable of withstanding various degrees of cleaning.

The toughest areas to specify flooring are going to be laboratories, suggests David Broderick, operations director for healthcare and laboratories at fit-out and construction company ISG. Recent projects by the company include the Cell and Gene Therapy Catapult, a new research lab for Guy’s and St Thomas’ Hospital, and a £3m project to create a new Institute of Immunity, Infection and Transplantation at the Royal Free London NHS Foundation Trust.

Brain surgery demands ultra-clean facilities, so Gerflor’s Tarasafe Ultra vinyl flooring was ideal for the new neurosurgery suite at the Canberra Hospital. Tarasafe has a surface treatment for extreme resistance to soiling and staining and has a antibacterial and fungicidal treatment. In addition, it comes with a 12-year warranty and is 100 per cent recyclable. Brain surgery demands ultra-clean facilities, so Gerflor’s Tarasafe Ultra vinyl flooring was ideal for the new neurosurgery suite at the Canberra Hospital. Tarasafe has a surface treatment for extreme resistance to soiling and staining and has an anti-bacterial and fungicidal treatment. In addition, it comes with a 12-year warranty and is 100 per cent recyclable

‘In a high-grade medical research laboratory or infectious diseases lab, the cleaning regime might include vaporised hydrogen peroxide or formaldehyde,’ he warns, while in operating theatres and treatment areas flooring is likely to be subjected to chemical disinfectants as well as hot water. ‘Vinyl can survive all of this,’ he says, making it a popular choice for medical-area uses. ‘You can also use tiling in labs and healthcare settings, but it is more expensive and takes longer to lay. Poured, self-levelling or trowelled resin products like Flowcrete are also suitable.’

Justin Crafty, firm-wide practice area leader for sciences at architectural consultancy Gensler, advises: ‘It’s important to understand any chemicals that might used in the space, for example chemical cleaning products, so that the flooring company can confirm the use will be suitable.

Most people don’t worry about spills on the garage floor – but when the garage is full of vintage motors it’s a different story. Here, Addazing resin flooring in Galaxy Blue, by Addagrip, has been used to give an easy-to-clean finish and attractive pearlised shine.Most people don’t worry about spills on the garage floor – but when the garage is full of vintage motors it’s a different story. Here, Addazing resin flooring in Galaxy Blue, by Addagrip, has been used to give an easy-to-clean finish and attractive pearlised shine

Many flooring materials can resist chemicals adequately in standard tests, but we have found that obtaining a sample of the material that we intend to use and then letting the end-users test it is a great way to discover whether any discolouration, staining, or other visual damage occurs.

‘Additionally, because floor systems respond to wear and heavy loads differently, compromises depending on a user’s need are often necessary. A sheet-rubber floor with good ergonomic properties may not necessarily be good in an environment where a lot of heavy carts are moved, whereas a monolithic epoxy coating on a concrete floor may be a little harsh for an operating room where the surgical team will be standing for extended periods throughout the day.’

Milliken’s Luxury Vinyl Tiles have a transparent wear layer that makes them both easy to clean and resistant to scuffs and scrapes. Here they have been used at the refit of the Credit Suisse gym run by Nuffield, another kind of location where hygiene is taken seriously.Milliken’s Luxury Vinyl Tiles have a transparent wear layer that makes them both easy to clean and resistant to scuffs and scrapes. Here they have been used at the refit of the Credit Suisse gym run by Nuffield, another kind of location where hygiene is taken seriously

Temperature extremes found in some medical environments can also be a challenge. Crafty warns: ‘A pass-through cart washer or autoclave will often experience flooring failures where the flooring system transitions into the machine. The flooring is otherwise perfectly acceptable in terms of wear and moisture resistance, but the introduction of heat in excess of 180°F combined with those factors results in failure for many products. On the other side of the equation, for facilities that use cryogenic liquids, careful choices have to be made because spills can literally shatter sections of floor.’

Danfloor’s Equinox carpet was chosen for the Bedale Centre in Bognor, a centre for people with mental-health issues. It has a 10-year wear guarantee, a strong resistance to stains, a moisture-impervious backing and an anti-bacterial yarn treatment to keep germs at bay.Danfloor’s Equinox carpet was chosen for the Bedale Centre in Bognor, a centre for people with mental-health issues. It has a 10-year wear guarantee, a strong resistance to stains, a moisture-impervious backing and an anti-bacterial yarn treatment to keep germs at bay

One of the most obvious factors for flooring in healthcare settings is that there should be no cracks, splits or seams which could become a breeding ground for germs. ‘Linoleum used to be everywhere in the NHS,’ says Broderick. ‘It was a good product, very hard-wearing and easy to clean, but it’s quite hard to lay and it cracks as it gets old. Vinyl and rubber flooring is now tending to replace linoleum – rubber is less hard-wearing than vinyl, but it comes in more colours and is easy to work with.’

Flooring from Forbo was chosen for Naomi House Children’s Hospice. In the bathrooms footsteps, bubbles and a dolphin design – imagery that is recognised and enjoyed even by children with profound disabilities – were created using Surestep Laguna, which has excellent slip resistance as well as being easy to clean.Flooring from Forbo was chosen for Naomi House Children’s Hospice. In the bathrooms footsteps, bubbles and a dolphin design – imagery that is recognised and enjoyed even by children with profound disabilities – were created using Surestep Laguna, which has excellent slip resistance as well as being easy to clean

Special attention also needs to be paid to where the floor meets the wall – traditional skirting boards are not suitable for healthcare environments. ‘You can’t have ledges or areas where dust and dirt and bacteria can collect,’ warns Broderick. The best solution is to overlap the flooring and wall cladding so you have a double seal, a process known as ‘cap and cove’. This also gives a rounded finish to the edges and corners of the room, which is something that Justin Crafty deems essential.

‘For hygienic environments, it’s crucial to consider the broad spectrum of cleanliness requirements from “moppable” to having to meet operating room levels of cleanability,’ he says. ‘The basic principles that we apply include ensuring that all corners are rounded so that a sponge can contact all surfaces, specifying seamless or homogenous materials, and ensuring that there are smooth or sloped transitions so that there are no surfaces that dust can accumulate on.’

Rubber floorcovering from Nora is seamless and can be rigorously disinfected without sustaining damage, making it suitable for Germany’s tough legal requirements for hospitals. Shown is the Marien-Hospital in Marl, Germany.Rubber floorcovering from Nora is seamless and can be rigorously disinfected without sustaining damage, making it suitable for Germany’s tough legal requirements for hospitals. Shown is the Marien-Hospital in Marl, Germany

International architecture and design practice BDP designed the new Alder Hey children’s hospital in Liverpool and won a string of awards from the RIBA for the project, including the 2016 RIBA National Award. Katharine Blankley, BDP interior design associate, explains how the bright, colourful flooring was selected: ‘We used vinyl flooring by Tarkett as it creates a seamless finish and is easy to clean, so that infection control standards can be met.’

The Alder Hey flooring may be clean, but it is certainly not clinical, which reflects a recent change in attitude towards healthcare floorings. Instead of a plain finish, the design uses a palette of vibrant and bold accent colours, designed to appeal to children as well as to break up the spaces and help with waymarking. ‘People used to think that laboratories and hospitals should be white and boring,’ explains David Broderick, ‘but now we know that people are more productive in their workspaces if there is more colour and more glass; and patients get better quicker in warmer, more colourful environments.’

New flooring technology means it is now possible to create visually interesting floors without compromising on cleanliness, explains Kevin Clinch, technical manager at flooring manufacturer IVC Group that makes sheet and tile vinyl. Vinyl designs can be cut out and fitted closely together on-site before being either heat-welded or permanently joined using the cold Invisiweld technique, in which a special liquid melts and seals the two joins together.

‘It allows considerable freedom in design,’ he says. For people in long-term care facilities such as nursing homes and retirement complexes, as well as for young children in primary schools and nurseries, it is even more important that the flooring doesn’t look too clinical while still being able to cope with significant cleaning. In this field, nylon carpets and carpet tiles that can cope with a diluted bleach solution are a good choice and also allow for a wide range of designs, including bespoke finishes.

Vinyl is also frequently specified, especially if there is also a need for sound reduction. ‘I have been involved in pre-schools that have specified acoustic vinyl not only for its sound-reducing properties, but because it is soft and cushioning if children fall over,’ says Clinch. Vinyl can also come in a variety of non-slip and anti-bacterially treated options for sensitive environments.

According to Shaw Contract Carpeting’s Carpet for Healthcare report, the design of flooring can have a huge impact on quality of life, especially of care-home residents: ‘Colour adds visual warmth while influencing emotions, sleep and wakefulness, creating more than just aesthetic value,’ it says. ‘Certain patients view colour differently – bright, playful colours work well for paediatric applications, while more subtle hues may be more appropriate in senior living environments. High-contrast colours combined with strong graphic patterns may be visually disorienting to some patients, creating feelings of confusion, unsteadiness or instability.

Free-flowing, organic patterns contribute to feelings of well-being and reduce uneasiness, and as leaders in design for the ageing will attest, a carpeted path helps create a setting where patients feel free to explore and interact. It lends itself to a warmer, more residential quality that’s inviting for residents, family and friends.’





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