‘MEADOW GREEN’ – A New Type of Dementia Ward – DSA Environment + Design

Nominee Information

The Meadow Ward team at the New Haven Unit, Princess of Wales Hospital in Bromsgrove were experiencing problems common to dementia wards. They found that the inability for dementia patients to get outside was causing considerable frustration, agitation and distress. Because patients were unable to undertake any journey beyond the confines of the building, the indoor ward environment was becoming a significant trigger for patients, and a significant strain on staff morale.

 

The project delivers outdoor facilities in the form of a ‘corner shop’ and ‘pottering shed’ that support purposeful engagement via valuable familiar activities without the need for PRN medication. Staff now have somewhere ‘meaningful’ to escort distressed patients to calm them down.

DSA worked with Mike Taylor (Capital Programme Manager for Herefordshire and Worcestershire Health and Care NHS Trust) and ward staff, spending time with them to develop the initial ideas. Looking beyond just the function of the proposed facilities, DSA closely examined the brief and, inspired by Susan Neville’s knowledge of world-leading practice in the Netherlands, developed the design of a new ‘outdoor ward environment’.

‘Meadow Green’, the name chosen by staff, recreates the ‘everyday environments’ that we readily use and take for granted. The conversations with staff were captured in interviews and summarised in a video produced by DSA, which was used in the successful bid for funding.

The design of the outdoor ward faced numerous challenges. The existing space was tight and sloping which previously discouraged use by patients. Existing services and access presented hurdles, and an existing mature maple tree had to be incorporated into the proposals. DSA submitted a planning application to address the concerns regarding the impact on neighbours, with the proposals for fast-growing bamboo and the incorporation of the maple securing a consent.

The layout and scale of the new buildings dealt with the level changes to create a versatile and safe social space. The ‘corner shop’ may easily be transformed to become a barber shop, hairdressers, cafe, or post office! For the King’s coronation it even became the Charles III pub! Importantly, the pavilion has power and water to make it ‘real’, and not just ‘pretend’.

The ‘pottering’ shed contains ample space and supplies for gardening activities. A metal shed stores furniture and props securely and safely. False building facades are often used in dementia design, however evidence is now suggesting that a ‘functioning’ outdoor ward is crucial in achieving the desired care outcomes. Meadow Green now provides a model for this.

This project is special because it was retrofitted to an existing NHS hospital, installed to a budget and NHS clinical constraints. The project is subject to a continuing longitudinal study by the University of Worcester. DCM (Dementia Care Mapping) shows incidents of challenging behaviour have dropped sharply. This success comes from the leadership that Clare Mcfadyen, Occupational Therapist has shown in integrating Meadow Green into staff working and patients’ treatment plans.