8 June 2022 Seminars

09:15 - 09:45

Keynote Room A – Design in Mental Health Network – an Update

09:50 - 10:10

Creating a Centre of Excellence for Forensic Services

The £50m redevelopment of Northgate Hospital, Morpeth, brings together all of the Trust's secure services from currently dispersed sites, consolidated into a single integrated secure centre of excellence. It was one of the first projects of the New Hospital Programme to start construction after successfully navigating the complex NHSI business case route.

Designed around the concept of a 'village campus', the new medium secure hospital at the heart of the development, offers a wide variety of indoor and outdoor settings for relaxation and activity, to provide a meaningful day for patients. These settings range from bedrooms to living spaces, and sheltered gardens to open courtyards, with opportunities for both structured and unstructured activity and sports. A key aspect of the design of the environment has been to relieve boredom and lower the risk of challenging behaviours and poor physical health.

Although the project is currently under construction and will be significantly built by the time of the conference, the presentation will focus on the project's complex journey and highlight key aspects of the design:
• balancing the needs of security against the competing demands of a therapeutic environment;
• explaining complex design issues in simple and easy to understand diagrams;
• rethinking the design of key spaces to mitigate boredom and promote activity;
• the importance of a strong concept when budget pressures build;
• making the landscape design work to its full potential and its importance in the daily lives of patients and staff.

Speaker:

09:50 - 10:10

Look at the World of Autistics

Arts & Crafts Center in 'Shimon Village' for Autistic People (ASD), and Communication disorder
I was asked to design Arts & Crafts Center for low functioning autistic adults.
In this e process I faced the following challenges:
The first challenge was the gray building with cold finishing materials as gray floor tiles, an office acoustic ceiling and a gray color palette.
The second challenge was designing for low-functioning autistic people who might throw furniture in a fit of rage.

In order to deal with the challenges I faced, I consulted and talked with the village manager and the village staff, learned and researched about the daily life schedule in the village.

I watched the activities of the villagers, the various workshops, during the day, the dynamics of the work in the various crafts and the relationship between the tenants among themselves and the staff.

The work in the village combines work with ancient crafts, alongside activities of painting, movement and music, which allow for an artistic space of expression.

While looking at the paintings, the tenants open a window to the diverse, rich and unique world.
I discovered people with a unique point of view.

The inspiration for the design of the corridors was in fact the paintings of the tenants, I wanted to empower the tenants by enlarging their paintings. The paintings were the center and from them I drew the colors for the walls and benches along the corridors. I enlarged their works to an entire wall and thus created an exhibition in the common space in which they live,
The desire and need for self-expression that exists in every person and person, regardless of his abilities, can be learned from the world-famous autistic painter Jessica Park. "Painting can be pleasant and liberating for people who want to express themselves... and the paintings may help others look at the world of autistics and understand them a little," she said. The art of autistic people is authentic and pure, free from fashionable shackles, logic or interest. It is a visual language, which mediates between the inside and the outside and is always a free choice and personal expression in a particular moment. This is where a thought is close to birth!

I designed the work spaces in light birch wood pleasant to the touch that connects to nature and evokes feelings that industrialized materials don't give.

Speaker:

10:10 - 10:30

Can Five Minutes Activity Five Minutes Before a Meal Time Impact on the Health and Wellbeing of People Living with Dementia

L&M Healthcare's Whittle Hall in Warrington was shortlisted as a finalist in five awards last year, winning one and coming second in another for a pilot study they conducted to see if just five minutes of activity for just five minutes before a meal improved the health and well-being of its residents.

The study was designed to see if an improvement in weight, nutrition, socialisation & interaction could be achieved. 10 participants were selected from their two dementia plus units. (These were residents who have more complex needs and challenging behaviours and were the people who could potentially get the most benefit from this study.) Two different activities were alternated before lunch and teatime; a music based interactive activity called the Jolly Trolley and light projected interactive table-based activity called the Tovertafel and they then filmed what happened.

10 residents were chosen to take part and the project culminated with a pop-up restaurant experience which some family members attended.

Amazing results were achieved
• All but one participant gained weight, in total the group gained 10 kilos.
• Mealtimes were calmer.
• People who were usually assisted to eat ate by themselves
• People were more sociable.
• Positive behaviours were seen that we had not seen before.

Throughout the evaluation period all the residents were alert, engaged and participating in activities;
• Residents began communicating with each other. Despite aphasic (difficulty in comprehending or formulating) language, interaction was still present, non-verbal exchanges were often positive smiling, laughing and the tone of voice used was playful despite the absence of meaningful language.
• Hand function seemed to improve.
• Motor skills seemed to improve or be regained.
• Consumption of food and drink increased.
• There was an increase in autonomy and independence - people who normally required assistance began eating without support and poured themselves drinks.
• Increase in language/communications between residents and staff and with fellow residents
• Increase in eye contact and engagement.

Speakers:

10:10 - 10:30

The Meanings of Place and Space in Forensic Psychiatric Care – And Their Implications for Interior Design, Patient Wellness and Staff Work Environment

This presentation takes its point of departure in a recent study of patients' experience of the physical environment in a forensic psychiatric hospital. Findings show that the physical environment plays a significant role to meet the patients' basic needs and creating meaning, which this environment struggled with. The learning that could be extracted from the shortcoming of this hospital's interior design (the 1970s) is important to acknowledge and bring into the process of designing new facilities, both for the sake of the patient's wellbeing as well as for the staff's work environment.

Speakers:

  • Franz James Senior lecturer and Designer - University of Gothenburg
  • Sepideh Olausson Senior Lecturer in Critical Care - Sahlgrenska Academy
10:30 - 11:00

Break

11:00 - 11:20

Children’s Mental Health Facility Design in the United States

Speakers:

11:00 - 11:20

Lovely vs Ugly – Where is the Interface Between Beauty and Safety in Mental Health Design?

This talk will explore the historical learning curve of mental health architecture and product design and pose the question of whether safety has become more important than beauty in mental health building design. When creating secure and therapeutic environments there is a balance between creating a therapeutic healing space and reducing risk to create safe 'zero risk' spaces but have we gone too far in reducing the risks and overlooked the therapeutic benefits of beauty? Who are we designing buildings for - is it to heal patients or is it to make it easier to clean and maintain?

Speaker:

  • Karen Flatt Architect – Mental Health Lead - IBI Group
11:20 - 11:40

Examining the Environmental Conditions for Psychological Safety: Insight From a Study on De-escalation and Seclusion

The physical environment of inpatient psychiatric units can impact patients' levels of aggression and agitation and therefore, lead to increases in the use of restrictive interventions and seclusion. Many studies have focussed on the impact of the design of the ward on patients' wellbeing, experiences, and recovery. However, studies investigating the impact of the environment and experiences of seclusion on the experiences of escalation and de-escalation of patients is scarce. In this presentation, we present some preliminary findings relating to how the environment and experiences of restrictive interventions and seclusion impact patient and staff experiences of escalation and de-escalation.
A qualitative study was used. Data was gathered through semi-structured interviews using photo-production and photo-elicitation with staff and patients within an intensive care psychiatric unit within the United Kingdom. We will explore three themes in the presentation, including 'Not All Spaces Are Perceived Equally...' which included 2 subthemes exploring the features of the environment that are conductive to de-escalation and the unhelpful qualities of the environment. The second, 'The Seclusion Room Acts as an Antithesis of Its Purpose' explore a paradox between the need and use of seclusion and the negative impacts and associations of the seclusion room. The third , 'Relating and Alienating' includes two subthemes and explores how the relationship between staff and patients changes after seclusion and the impact of the time of the day on patient and staff relations. Running through this analysis is attention to the master theme of psychological safety and how environments might be designed to simultaneously prioritise both psychological and physical safety.

Speaker:

  • Professor Paula Reavey Professor of Psychology and Mental Health - MSc Mental Health & Clinical Psychology London South Bank University
11:20 - 11:40

Red Kite View – a New Chapter in CAMHS Design

Red Kite View - A New CAMHS Unit for West Yorkshire realised through a pandemic.

Red Kite View is a new in-patient CAMHS unit for West Yorkshire, nestled into little woodland in Leeds for Leeds York Partnership NHS Foundation Trust.

Challenges faced during the project was progressing through COVID, not least including the trust embarking on an extension to the project as a pandemic response during construction.

The project uses elements of biophilic design, with the form of the building meandering through the wooden landscape.

Gilling Dod Architects designed the big elements of the building architecture and the smaller details such as door handles and maps for service user welcome packs.

 

Speaker:

11:40 - 12:00

Improving the Patient Experience With a Standardised Design for Safety Suites

This is a unique case study that examines the value of standardisation. It illustrates how the same environment meets a range of service needs.

At Design in Mental Health 2019, Ian Tearle (HPFT), Alexandru Senciuc (Medical Architecture), and John Plum (Blu Building Consultants) presented 'Assembling a standard design for a multi-purpose seclusion unit'. They described a programme to improve the quality of seclusion units across all mental health services run by Hertfordshire Partnership University NHS Foundation Trust. Existing seclusion facilities were of varying design quality, facilities suffered frequent damage which was disrupting the provision of services, while the time and logistics of repair was proving costly. Adopting a holistic approach, the Trust adopted a new standardised design which was applied to seclusion spaces within a range of mental health services such as learning disabilities, low secure services, medium secure services, and others.

We can now present how this standard design has been realised, with three facilities completed to date. The presentation will illustrate:
• how a standard design can be applied to a variety of site-specific conditions, to create a consistent quality of space and a positive patient experience.
• lessons to be learnt from staff and patient feedback since the facilities have been in use. In particular: the impact that the new facilities have on the different services and the effect they have on patient outcomes.
• a preliminary set of guidelines for future design of seclusion and safety suite facilities.

Speakers:

  • Alexandru Senciuc Senior Architect - Medical Architecture
  • Ian Tearle Senior Service Line Lead Forensic Services - Hertfordshire Partnership University NHS Foundation Trust
  • John Plum Project Director - Blu Building Consultants
11:40 - 12:00

Lessons Learnt Designing CAMHs schemes

Speakers:

12:00 - 14:00

Lunch Break

12:30 - 13:00

Rowan View for Mersey Care by IBI Group and Kier Construction

Speakers:

13:00 - 13:30

L&M Healthcare’s Kitwood House

Speakers:

  • Jo Fogg Operations Director  - L&M Healthcare
  • View full profile for Bryan WalkerBryan Walker Architect and Project Director - Dynamic Building Solutions
  • View full profile for Louise HarderLouise Harder Communications Consultant - L&M Healthcare
14:00 - 14:30

Keynote – Room A: Designing a Mental Health System for Equality #BetterTogether

Speaker:

14:35 - 15:35

Seclusion: Do We Need It? What Should It Look Like?

Join the Design In Mental Health Network (DIMHN) for an open interactive round-table discussion and design workshop with advice and expert insight from a host of special guests including facility designers, managers, clinicians, experts by experience, product specialists and academics.

Each discussion will be carefully facilitated and ideas documented by DIMHN for future reference.

For specific practical design discussions join the ‘Designer In The House’ on the DIMHN stand after the session.

Pre-booking by conference delegates is needed for this session as there are limited places.

Speakers:

14:35 - 14:55

Springfield Village – Mental Health at the Heart of the Community

The regeneration of the Springfield University Hospital site will reduce the stigma of mental health conditions by integrating the organisation within the community. This is achieved by combining the vision of a forward-thinking NHS Trust, a progressive view of mental health provision and the innovative thinking of an architect, Springfield Village will modernise and transform the way that mental health services are delivered for over a million Londoners.
The project creates state-of-the-art Inpatient Forensic and Non-Forensic mental health facilities, including 8 new wards with 134 beds, as well as outpatient consulting rooms, office space, retail areas and plant rooms. The wider project includes over 800 new homes, including 20% affordable housing, alongside community shops and a café, a new care home and land available for a new school, all adjacent to a 32-acre new public park. Major parts of the project were funded by the sale of underused buildings and surplus land to residential developers, enabling new facilities to be built alongside live mental health services.
The guiding principles of the new mental health facilities focus on a variety of environments, both internal and external, to create a homely environment that avoids monotony. Gardens and external spaces are incorporated, for the benefit of service users, staff, and visitors. The design achieves a multi-level hospital on a relatively constrained site that links all areas with the internal circulation space, a hospital concourse leading to public facing functions such as shops, restaurant, and gym. The staff entrances are through daylit atriums that bring everyone together in a pleasant, shared environment.
The new facilities were designed with the clinicians and service users to provide the most supportive environment and innovative facilities for the delivery of mental health care.

Speakers:

14:55 - 15:05

The Co-design of Mental Health Facilities with Service Users and Clinical Staff

Derbyshire is an outlier for the use of dormitory style accommodation with one of the highest levels in England. This has a negative impact on privacy and dignity and patient safety plus it also impacts on A&E and Acute Trust flow in Derbyshire.
Derbyshire Healthcare were issued a Formal CQC requirement under regulation 15(1)c to eradicate the use of dormitories by 2024.
Derbyshire also has no Psychiatric Intensive Care Unit capacity for male of female patients leading to all Derbyshire patients being placed out of area for this level of care. This leads to poor patient journeys and a lack of social, familial and environmental connections which are all known to aid recovery. The NHS 5 Year Forward View and Long Term Plan has a stated aim to end inappropriate out of area placements by March 2021.

The Programme being delivered by the DHcFT Programme Delivery Team includes 6 projects, 4 of which are related to dormitory eradication and 2 related to ending the inappropriate use of out of areas PICUs. The Programme include 3 new builds and 3 major refurbishments.

The Programme Delivery Team includes a Clinical Project Manager (a ward manager from an adult acute background) and a Project Officer who is also a service user with a physical disability. These key individuals attend all design meetings and are the key links to the Clinical and Service User reference groups respectively. The design meetings include a wide range of key individuals from across the Trust including E&F leads, Health and Safety, Fire, Security, Clinical, Medical and Infection Prevention specialists.
The co-design approach is being applied to all 6 projects with key decisions on form, function, look and feel being informed by the Clinical and Service Users Reference Groups.

 

Speakers:

  • Nick Richards Project Officer and Lived Patient Experience Lead - Derbyshire Healthcare NHS Foundation Trust
  • Geoff Neild Programme Director - Derbyshire Healthcare NHS Foundation Trust
  • Andy Donoghue Associate Director of Estates and Facilities - Derbyshire Healthcare NHS Foundation Trust
  • Becki Priest Deputy Director of Practice and Transformation - Derbyshire Healthcare NHS Foundation Trust
15:05 - 16:00

Break

15:05 - 15:25

New Hospital Design: A Person-Centred Approach

Bradford's Lynfield Mount Hospital is a typical example of late 20th century design mental health facility. Supposedly purpose-built to treat people with mental health issues, what we recognise now quite clearly is that the "of it's time" hospital does very little to support patients towards recovery, or support the staff who try their best to provide good care.

With a clear vision from the Trust to create a truly supportive environment for personalised and person-centred care, the design development of this new hospital project included full engagement from the outset. Whilst not yet completed, the design development shows how user experience, past and present, influenced decision making and continues to shape design.

More and more people are becoming time-poor. But engaging in the right way is still key to any successful project, be it a new design or a new way of working. Making the process accessible to everyone has evolved using varied tools to ask the right questions of the right stakeholders, so that everyone's voice is heard.

The presentation will share how engagement with all the Trust's stakeholders was successfully undertaken within the restrictions of the Covid-19 pandemic, using varying strategies and tools throughout the process to ensure everyone had the ability and confidence to make valuable contribution.

The presentation will also share some first-hand key insight shared by Stakeholders, particularly those with Lived Experience during their admission and time spent as inpatients, which directly influenced the overall building strategy and detailed building layouts, landscape and aesthetic.

Speakers:

  • Cath Lake Director - P+HS Architects
  • Nick Smith Former Service User - Missing Peace Wellness and Support
15:30 - 16:00

Exploring Perceptions of Public and Private Space in Secure Mental Healthcare Environments 

Speaker:

15:30 - 16:00

The Sea at the Forensic Ward Lobby

Speaker:

16:00 - 17:00

Clinical and Design Principles for an Eating Disorders Unit

This session will explore the needs of severely ill patients with Anorexia admitted to a specialist Eating Disorder Unit. We will reflect on the current situation and the processes and design considerations that will respond to the Service’s vision for the new build and support recovery.

Speakers:

16:00 - 16:20

The Ligature Risk Assessment App at BDCFT

The purpose of a ligature risk assessment (LRA) is for the Clinical Team, Estates and Health & Safety to work together to develop a shared understanding of ligature risks within clinical areas including how risks are eliminated, managed and/or mitigated. The assessment is comprehensive as the assessment team:
• identify all potential ligature points in all rooms within the ward,
• grade the risk presented from each anchor point as per the four risk factors
• assign mitigating actions (where required) to reduce risk

Traditionally the ward LRA is a lengthy documented MDT exercise involving follow up work to record, report and action the assessment and subsequent actions, which were in an Excel document that was susceptible to errors and mistakes.
The objective of the new way of working was to ensure a technological and sustainable solution to undertake LRA'S incorporating:

• App GUI front-end for review and update of LRA's
• Migration of existing data from current inpatient LRA's into a data warehouse
• Development of data analytical reports from the LRA data
• In-built future proofing for any changes to Policy approach

The LRA App was born from collaboration between the health & safety team, KPO, and informatics after possibility thinking and coaching workshops. The app was purpose built within the Office365 platform (Sharepoint & PowerApps), from the ground up in-house using Kaisen methodologies to improve the LRA process through technological methods. The benefits of the app are:

• Improved patient safety for ease of access to clinical review of environmental ligature risks
• Real time risk assessments and scoring, on site.
• Real time tracking of score.
• Reduced the time spent on risk assessment allows more time for proactive resolution.
• Automatic notification.
• Automatic action assignment.
• Real time tracking of actions and progress.
• Live view of each area's risks.
• Automation of impact
• Built in mistake proofing.
• Built in visual control.
• Removed duplication of work.
• Future proofing for any subsequent changes to assessment approac

Speaker:

  • David Gibson Compliance and Governance Manager - Bradford District Care NHS Foundation Trust
16:20 - 16:40

HBN 03.04 Low and Medium Secure Guidance for Both Adults, and Children and Young People

Speaker:

16:40 - 17:00

Guidance Led Testing of Products in the Mental Health Environment

Drawing on practical experiences, this presentation will explore the process for product testing from our initial conversations through testing to a completed test report and the certification scheme being built off the back of this.  This will include a deep dive into the three main segments of testing from the informed choices guidance – reduced ligature, robustness and anti-barricade, giving you an inside view of our process to assist with preparing samples to achieve a representative result and how this translates to a test report.  Furthermore, it will outline the latest information from the upcoming certification scheme.

Speaker:

17:00 - 19:00

Awards Ceremony

17:00 - 17:30

Exhibition and Close