KEYNOTE: An Update From the CQC
- Chris Dzikiti Director of Mental Health - CQC
This presentation will involve: input from those with lived experience; a CAMHS Consultant Psychiatrist; a senior operational leader; and Medical Architecture.
The theme will be the journey of developing the case for and the design of a CAMHS PICU in Poole, Dorset. The presenters will bring together the patient experience, the clinical need, the operational drivers, and the design piece.
The recognised shortage of CAMHS PICU beds nationally, makes this a live issue. The proposed new-build PICU will have a number of state-of-the art therapeutic spaces. The focus of the sessions will be about relating design, to the PICU clinical model and patient experience.
Join us for this exciting immersive workshop and experience first-hand examples of different environments and some of the challenges that neurodiverse people encounter, either as users or employees, as we help to build the template for truly accessible environments for everyone.
Designed by Caudwell Children in collaboration with experts by experience, during this group workshop you will spend time in spaces carefully re-created to highlight some of the challenges people face in the built environment.
Flickering lights, noisy air conditioning, overwhelming communication or overpowering smells can all be common pitfalls of designers, estates or employers who fail to consider a neurodiverse population.
We will explore the potential causes of bad practice (e.g budget constraints, product innovation gaps, outdated guidelines, lack of awareness) and identify practical solutions by listening to a wide range of stakeholders including designers, architects, facility managers and experts by experience.
As employers and service providers across the world begin to recognise neurodiversity within their workforce and service users, many environments still struggle to meet the needs of many neurodiverse people. In this immersive workshop we will re-create some typical spaces, identify the potential pitfalls and aim to create an inclusive, accessible alternative.
This interactive experience will feature some examples of poor practice and participants will be invited to experience potentially heightened sensory stimuli.
Light, sound, smell, furniture, communication, colour, management practices and other environmental influences will all be examined as groups work towards creating a template of best practice by recognising how different people may experience stereotypical spaces.
Attendees will have the option to not participate in the immersive elements of the workshop, but can still take part and contribute to the evidence gathering and discussion.
The results of the workshop and a ‘Accessible Template’ based on the discussion will be posted as a blog on the DIMHN website within 6 weeks of the conference.
This workshop is delivered by national charity, Caudwell Children.
Keith and Andy will talk through the roots and core messages of Towards Safer Services 2022. Towards Safer Services is cross sector strategic guidance to reduce restraint. This will include some reference to some other frameworks and points of good practice. Sharing information, patient involvement, primary and secondary interventions, and collaboration from all parties are of central importance. What should you have completed, top tips, what is likely to be covered in version 2 of TSS?
1 in 4 people experience a mental health problem of some kind each year, and the biggest current concern for these people is the problem with accessing support. Shortage of providers is now critical and staff burnout prevention has become a major concern. The workshop shall aim to look at means of making mental health support more accessible. The primary focus being to improve the social connection through MH cafes & creating healthy wellbeing spaces for patients and staff. Ensuring easy access with free wifi and levelling up home access to those in need. Exploring where the journey begins, and what means can be reviewed and enhanced to create better education and prevention. Investigating ways on how we can destigmatise Mental Health so that it is easily accessible to all.
From a set-off in the evidential background behind recovery centered designs, we explore social sustainability in award-winning Skejby Psychiatric Centre (Project of the Year – New build International) and other projects of current interest. The aim is to take the patient’s perspective and add environmental aspects to comprehend the interdependency between the two. Social sustainability in psychiatric facilities is the sum of several design solutions, which together demonstrate consideration to users. Social sustainability arrives when both physical, mental, and social needs are met, long term. Mental health care patients can be sensitive to stimuli from all three parameters and often spend longer time in facilities compared to somatic patients. Health care personnel spend a lot of time in the facilities too, so the spaces need to function both as a temporary home and a working environment. We will shed light on how we approach to maintain a social balance in our welfare projects, while we search for innovative sustainable paths. The construction sector and psychiatric profession are rapidly changing. Adaptability to new scenarios is a key driver to align social and environmental sustainability. We will show examples on actions to make the architecture last longer. UN Sustainable Development Goals and LCA Design are used as a lever for social and environmental qualities in mental health care designs. Through these it becomes easier to estimate and communicate the complex dynamics of environmental and social impact and support the choices made. You get to see how we in Arkitema follow the carbon footprint and other environmental impact closely, so that we can help to avoid the building sectors contribution to undermining the capacity of ecosystems in the future. This is an opportunity for a stepping-stone to mental health care designs that increasingly meet the needs of the future.
We are all the experts on ourselves. Ideally, we need to stay within our homes and communities. However, if a facility is needed it needs to feel comfortable and the person needs the space and opportunity to learn who they are. Let’s be open to the idea that western psychiatry is not necessarily the right answer for some and maybe multi-cultural approaches can be beneficial.
An audit of mental health patients carried out by Lewisham & Greenwich NHS Trust in August 2019 found that more than half of the people who went to emergency departments (EDs) for help because of their mental health waited more than four hours to get the right care. One in seven spent more than 12 hours in ED, exposing patients, NHS staff and visitors to additional stress. This figure is probably far greater now.
The project involves collaborative working between the Queen Elizabeth Hospital (QEH) and Oxleas NHS Foundation Trust, to improve the collaboration and partnership between mental health departments and ED teams. The new area will allow mental health patients to receive higher quality care by providing them with a specialised area for their specific needs, staffed by specialist nurses from Oxleas.
The new Mental Health Assessment Area (MHAA) at QEH will offer the local population a suitable and safe environment for patients who present in crisis, in which to be assessed and treated whilst awaiting next steps in their care pathway or whilst awaiting transfer into a clinically appropriate environment. This will give a better patient experience by removing patients from the overly stimulating ED environment and by allowing patients to access therapeutic intervention.
The presentation will focus on the collaboration and partnership of the MH and EDs teams and in specific on two of the biggest challenges which were:
• To find and agree on a location within the existing and busy hospital to host the new MHAA, considering the importance of the relationship with the EDs and mental health teams, and
• The consultation with all the different groups of stakeholders to build strong ERs and to deliver a mental health friendly and functional environment which can work for all the stakeholders.
The National Forensic Mental Health Hospital in County Dublin, represents a once-in-a-generation step-change in the design of facilities for mental health services in Ireland. The building was designed by Scott Tallon Walker Architects in association with Medical Architecture. Located on a 10-hectare woodland site, the 25,000m² campus replaces the existing Central Mental Hospital in Dundrum, and accommodates 170 high, medium, and low secure mental health beds. The accommodation is laid out as a series of single storey pavilion buildings around a pedestrianised ‘village green’ which contains peaceful gardens for patient amenity and therapeutic activities. Intuitive wayfinding is achieved through a site-wide narrative of colour, art, and landscaping. The project brief and subsequent design have been heavily focused around providing a safe, secure and healing environment that contributes to a patient`s recovery. The presentation will look at how this has been realised including: • Strategic masterplanning and arrangement of accommodation to optimise the existing topology, mature woodland setting and long coastal views. • Adopting a set of very clear planning principles to manage safety and security, while providing freedom of movement for patients • Addressing the competing requirements of observation with the quality of space, daylight and views • Creating high quality internal environments that will endure • High quality landscaping and space for activity to create community, and a meaningful day for patients • Accommodating differing services and future adaptability through standardisation of design. This new facility sets a new standard in mental health facility design in Ireland and provides an international benchmark from which other nations, including the UK, can use to inform future developments. The presentation will look at lessons learnt from design, delivery and the initial evaluation of performance. Additional Presenter: First Name: Karl Last Name: Burton Job Title: Associate Organisation: Scott Tallon Walker Architects Address: 19/20 Merrion Square, Dublin, Ireland, D02 VR80 Phone: +353 (0)1 6693000 Email: Karl.Burton@stwarchitects.com
We are all different. What makes each of us tick and feel able and well to tackle the challenges of the world is different. How to we find comfort and wellbeing away from home?
We know that personalised and flexible spaces are the result of choice and create the opportunity for individualised care and recovery. Having choice is a fundamental requirement of freedom that is often reduced or removed in In-patient environments. But mental health inpatient settings are regularly designed around a set of core spaces and standardised repeatable rooms, with limited resources focused on how we enable truly individualised care through the building itself.
The workshop will explore key components of a typical mental health ward, striving to define what makes good design appropriate for each of us, and how this can be achieved using innovative products and technologies.
Ideal attendees will include People with Lived Experience, Clinical Staff, Estates and Facilities Teams, and Designers, and will help inform a new best practice for in-patient care environments.
Outcomes will be summarised in a paper within 6 weeks of the workshop.
This presentation will focus on the important role played by good landscape design in the creation of therapeutic mental health facilities. Our approach to landscape design in mental health, and a focus on good such design can enhance mental healthcare settings. We all recognise how green outdoor spaces and access to nature benefits our health and wellbeing. Most important is the provision of patient and service user accessible outdoor space. Spending time in nature has been proven to reduce stress, improve our memories, and make us kinder and more creative. Providing accessible sensory and healing garden spaces enhances the sense of wellbeing and helps to reduce stay times in mental health facilities. It is the vital role of the landscape that is the theme of this presentation. Our presentation will cover a number of key criteria as part of this placemaking process as well as covering the important clinical requirements of providing therapeutic and sensory spaces that encompass safety and security in a much more creative way to avoid places feeling institutional.
In 2020, The NHS declared its journey to net zero vision. This ambitious vision includes mile-stone targets for an 80% reduction in the carbon footprint by 2028-2032 and a 100% reduction in the carbon footprint by 2040 (net zero carbon performance). Achieving these targets demands that we collaborate, acting now, acting decisively, and acting correctly.
This is a great ambition, and it must be delivered whilst maintaining a patient first approach to health care. Based on feedback from service users given in the 2021 Designing in Mental Health Conference, the environmental condition within rooms has a pronounced effect on patient well-being, health and recovery.
Following the successful response to our presentation at last year's conference we would like to come back and present further findings over the year and how current net zero carbon thinking is affecting service user experience.
Having worked for the Trust in IT for four years I'm a person with lived experience and I also have A physical disability, I'm at the centre of the programme's day to day running. I have real responsibilities and I am involved in making key decisions. I have attended all the design engagements and design meetings across the programme. I feel listened to and able to offer feedback and advice. I've been a vessel for service users and carers across our services to be involved, giving feedback on how they'd like the buildings to look and feel.
Sussex Partnership is a mental health and learning disability NHS Foundation Trust in South East England. In 2020, a project was proposed to work with hospital staff to create 'Autism Friendly' environments on acute mental health wards, by primarily looking at the Environment; the Ward Processes; Staff Training and increasing Confidence. This was due to recognising the high number of autistic service users who had reported that the environmental and sensory aspects of their admissions had negatively impacted their wellbeing and inpatient experience.
Two pilot wards were selected: an 18-bed female acute mental health ward and a 19-bed mixed sex acute ward in Sussex. Both wards support adults aged 18-65 with mental health needs, who require inpatient care and treatment.
A sensory audit of the ward environment was completed by two Occupational Therapists (OTs) and a group of Experts by Experiences (EbEs). The EbEs all had experience of admission. Photos were also shared with another OT and further EbEs and The 'Checklist for: Autism & Mental Health-Friendly Environments' was used to help facilitate discussions around the senses and experience of each area of the wards.
The team worked to develop environmental recommendations considering the senses (visual; olfactory; auditory; proprioception/body awareness; tactile; gustatory and vestibular). These were shared with management and estates teams to implement these recommendations safely and efficiently to achieve our goal of creating 'autism friendly' environments. The project coincided with ward refurbishment projects and therefore the recommendations were able to be incorporated as part of the general refurbishments.
By collaboratively working with the group of EbEs, this kept the service user experience in the centre of the project, and challenged all involved to think differently. It is felt that the recommendations are meaningful and already having a positive impact for service users within the mental health wards.
Architecture is a discipline that helps organise environments to suit the user's requirements and needs. This is fundamental to our design philosophy, none more so than when we work on mental health projects. We believe that creating autism friendly environments is central to any scheme and that, no more, should people with autism have to fight for their rights.
In many cases we see that surrounding environments contribute to a person's disablement. The same person set in the right environment could then be seen as an able person.
The main design principles, which we apply to all our projects, have evolved through consultation and engagement with trustees, clinical staff, facility managers and, more importantly, in talking with and respecting people with autism and other learning difficulties and their families.
The presentation will focus on
• How to engage with people with Autism at the design stage
• Autism friendly colour palette research with Hilary Dalke at Kingston University
• Proxemics and sensory space perception
• Specific challenges: finding the right balance between a building that will resist challenging behaviour and the need of sensory stimulation to avoid self harming