Improving the patient experience Sharing success in mental health and learning disabilities The King’s Fund’s Enhancing the Healing Environment programme

The passion, energy, drive and “commitment of the teams who have led these projects have been inspirational. They have set an example and shown what can be done to improve care environments in both mental health and learning disabilities services. Their achievements show what is possible and should encourage many more to follow in their footsteps.” Niall Dickson Chief Executive, The King’s Fund Improving the patient experience Sharing success in mental health and learning disabilities The King’s Fund’s Enhancing the Healing Environment programme 2004–2008 ‘Improving the Patient Experience’ is a series of publications designed to stimulate and inspire all those involved in designing, procuring, developing and maintaining healthcare buildings to look for new and inventive ways to improve the environments for patients and staff alike. They contain best practice case studies, advice and guidance on how best to implement and manage programmes for change in both new buildings and areas for refurbishment.

Other titles in the series include: • Celebrating Achievement – Enhancing the Healing Environment • Evaluation of The King’s Fund Enhancing the Healing Environment Programme • A Matron’s Charter: An action plan for cleaner hospitals • A place to die with dignity – Creating a supportive environment • Contracting for cleaning • Exploring the patient environment • Friendly healthcare environments for children and young people • The art of good health – A practical handbook • The art of good health – Using visual arts in healthcare • Welcoming entrances and reception areas

This publication celebrates the completion of 47 Enhancing the Healing Environment projects in mental health and learning disabilities trusts outside London.

This phase of the national extension of the King’s Fund’s Enhancing the Healing Environment programme was funded by the Department of Health. Improving the patient experience Sharing success in mental health and learning disabilities The King’s Fund’s Enhancing the Healing Environment programme 2004–2008

Isle of Wight NHS Primary Care Trust: Halberry Unit entrance Sharing success in mental health and learning disabilities

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Cover photographs: Front: Statuary in Fant Oast’s garden, Maidstone, Kent and (inset) a corridor installation at Park House, Manchester. Back: The Enhancing the Healing Environment Programme team at Calderstones, Lancashire.

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iv Foreword

I am delighted to have the opportunity of providing a foreword to ‘Sharing Success’, which marks the completion of 47 projects to improve the environment of care in mental health and learning disabilities as part of The King’s Fund’s Enhancing the Healing Environment (EHE) programme in England. Service users and carers have been an integral part of the trust teams that have created the extraordinary range of schemes described in this publication. I have visited a number of the project sites and I know that their views have not only helped shape the schemes but have also led staff to implement improvements in care delivery. Safety and risk management have rightly been key determinants of the schemes but, working together, the multidisciplinary teams have managed to be both imaginative and innovative in their designs. One of the most striking outcomes of the programme, illustrated so well by many of the projects, is the potential for improved therapeutic environments to have a major impact on safety by, for example, reducing challenging behaviours or slips, trips and falls. This not only improves service users’ wellbeing but does much to improve staff morale, recruitment and retention. It is probably no surprise that many of the projects have focused on improving or creating outside spaces as the therapeutic nature of gardens is well known. I have been delighted to see the range of designs chosen for secure environments, acute wards, elderly care and adolescent units which reflect the particular needs of each group. Many of the spaces have been designed to encourage outdoor activities and are already being well used and much enjoyed. The EHE programme highlights how, with new partnership approaches to consultation and capital planning, and relatively small amounts of money, mental health and learning disabilities environments can be radically improved. I am delighted that so many trusts have embraced this ethos and are now using the principles of the programme to inform the design of future environments. I hope that ‘Sharing Success’ will inspire you to think about what you can do to develop a shared vision and commitment to continue to improve the care environment. Professor Louis Appleby, CBE National Director for Mental Health November 2008

Professor Louis Appleby, National Director for Mental Health, at the opening of “The Elements”, Manchester Mental Health and Social Care Trust

v Acknowledgements

Our President, HRH The Prince of Wales, played a key role in the launch of the Enhancing the Healing Environment (EHE) programme in 2000. Since then his continued support and interest has been greatly appreciated by all those involved in the programme. We are also indebted to our partners at the Department of Health who funded this phase of the programme, and made this publication possible. Professor Louis Appleby, National Director for Mental Health and Dame Christine Beasley, Chief Nursing Officer, have both championed the programme and their ongoing support has been invaluable. We are grateful too, to all those who by their support have ensured its success. In particular we would like to thank those who have contributed to the development work including colleagues at ICI paints (now part of AkzoNobel), Nightingale Associates, Philips Lighting and Tate Modern; and to the EHE team at The King’s Fund who continue to guide and support with a deft touch. My thanks also go to Sarah Waller and Hedley Finn who have provided the material for this publication. This publication marks the completion of one of the most far-reaching programmes to improve the environment of care in mental health and learning disabilities settings in England. Our role at The King’s Fund is to equip teams with the knowledge and skills both to understand the importance of the care environment and to bring about improvements that will make a difference to both patients and staff. The passion and enthusiasm of EHE teams is infectious but behind this lies a great deal of hard work and effort. The programme would not have been such a great success were it not for the commitment and dedication of the people who use these services, nurses, estates staff, and arts coordinators, as well as managers, administrative staff and carers, all of whom have contributed so much. Many trust boards, Leagues of Friends, and local organisations have also made the projects possible. Finally, thanks go to everybody who has supported their local scheme, from those who have made cakes, supplied cuttings for gardens, purchased special furniture or collected pennies, to those who have been up half the night fixing pictures for opening events! This programme changes lives. Thank you all for playing your part in enhancing the healing environment. Niall Dickson Chief Executive, The King’s Fund November 2008

Niall Dickson, Chief Executive, The King’s Fund, presents a plaque to the trust team to commemorate the opening of the EHE scheme at Cornwall Partnership NHS Trust

vi Contents

Foreword v Acknowledgements vi

About ‘Enhancing the Healing Environment’ 1

The mental health and learning disabilities projects 7 The Projects 11 Project Directory 104

Annexes 117 List of participating organisations 117 References 121 Useful addresses 122

Barnsley Primary Care Trust: The Haven window Milton Keynes Primary Care Trust: Campbell Centre Garden About “Enhancing the Healing Environment” About “Enhancing the Healing Environment”

‘Sharing success in mental health and learning disabilities’ celebrates the successes of 46 NHS trusts in England who took part in The King's Fund’s “Enhancing the Heal­ ing Environment” programme. This innovative grants and development programme enabled them to improve the environment and effect positive changes in the delivery of care in mental health and learning disabilities services. This publication celebrates the achievements of the hundreds of people – staff, service users, carers and sup­ porters – who have contributed to these schemes and who have demonstrated their determination and imagination in improving the care environment for some of the most vulnerable people in our society.

The programme to date primary care trusts (PCTs). In all, 48 of the capital’s trusts participated in this The ‘Enhancing the Healing phase of the programme. The King’s Environment’ (EHE) programme was Fund’s investment in the programme is launched in 2000 by HRH The Prince of the largest single investment it has Wales, President of The King’s Fund, as made in London’s hospitals. part of The King’s Fund’s activities to mark the millennium. In 2003 NHS Estates and the Department of Health commissioned The aim of the programme is to The King’s Fund to extend the encourage and enable local trust teams programme to one trust, capable of to work in partnership with service users acting as an exemplar, in each of the to improve the environment in which then 23 Strategic Health Authorities they deliver care. It consists of two main (SHAs) outside London. This national elements: extension was funded by NHS Estates • a development programme for a and charitable foundation monies. nurse-led, multidisciplinary trust team; The King’s Fund • a grant for them to undertake a project to improve their patient The King’s Fund is an independent environment. charitable foundation working for better health. It focuses on By 2008 150 trust teams and over developing informed policy, by 1500 staff and service users with undertaking original research and support from their local communities will providing objective analysis; effective have been involved in improving their services, by fostering innovation healthcare environments. and helping put ideas into action; The EHE programme initially focused and skilled people, by building on improving the acute hospital understanding, capacity and environment in London. The success of leadership. It also acts as a major the programme then led to its extension resource to people working in health. to mental health trusts and a number of

1 Sharing success in mental health and learning disabilities

In 2004 the programme was extended Working in partnership to an additional 23 mental health trusts in England. This phase of the Since 2003 the EHE programme has programme was funded by NHS Estates been funded by the Department of and the Department of Health. In 2005 Health and NHS Estates. The Chief the programme was further extended to Nursing Officer sponsors the mental health trusts, PCTs who provide programme in support of work to mental health services and learning improve the patient experience. The disabilities trusts. This phase of the National Director for Mental Health, programme was funded by the the National Cancer Director, together Department of Health and sponsored by with the Director of Estates and the Chief Nursing Officer and National Facilities, Department of Health, have Director for Mental Health in support of co-sponsored phases of the work to improve the patient experience. extension of the EHE programme. Many NHS special trustees, Leagues In 2006, in partnership with six NHS of Friends, charities, local business trusts and charities and two Marie Curie and community groups have also Cancer Care hospices, The King’s Fund generously supported their local launched a pilot programme focusing on projects. improving environments for care at end of life (ECEL). In 2008 the Department of Health In 2007 The King’s Fund, in partnership commissioned The King’s Fund to with the National Offender Management extend the Environments for Care at Service (NOMS) and Offender Health, End of Life programme to 20 healthcare Department of Health, extended the organisations in England. This EHE programme to a pilot group of programme commenced in April 2008 five HM Prisons and Young Offenders and included 15 acute trusts, two Institutions (HMP/YOI) in London who mental health trusts, two primary care are improving healthcare environments trusts and one HM Prison. in prisons. For a full list of the organisations that have taken part in the EHE programme to date, please turn to page 117.

I have been on a short journey from one mental health ward “ to another – from residing in one to redesigning the second. A short step, but by a long, interesting, challenging and rewarding route.” Service user

2000 2001 2002 2003 2004 2005 2006 2007 2008 January June October May July November November December January July April Programme Cohort 1 Cohort 2 Cohort 3 Cohort 4 Cohort 5 Phase 1 Phase 2 Phase 3 Environments HM Prisons ECEL launched London London London London London National National National for Care at Pilot National Acute Acute Acute Mental Health PCTs Extension Extension Extension End of Life 5 HMP/YOI Extension North West/ North East/ North Central 11 trusts 5 trusts 23 trusts Mental Health Mental Health (ECEL) 19 trusts South West South East 13 trusts 23 trusts and Learning Pilot 1 HMP 8 trusts 11 trusts Disabilities 6 trusts 23 trusts 2 hospices Figure 1 EHE programme timeline

2 About “Enhancing the Healing Environment”

How the trust teams work The trust team attends a development programme which is run by The King’s When they join the programme each Fund. This is designed to equip teams trust is asked to nominate a multi­ with the knowledge and skills they will disciplinary project team, led by a nurse, need to undertake their projects, and including estates and facilities staff, particularly in fostering co-operation and service users and arts coordinators, to engagement with service users, carers plan and manage their project. and the public. Team members have the Team members come from a wide opportunity to explore practical ways in variety of backgrounds and include which the healthcare environment can architects, capital planners, clinical be improved by the use of colour, light, psychologists, consultant medical staff, art and design. Visits to exemplar trusts faith leaders, healthcare assistants, and Tate Modern also form part of this hospital archivists, occupational programme. therapists, patients’ forum members All trust teams are required to gain and PALS staff, physiotherapists, service approval for their projects by making a users, relatives and carers, consultant formal presentation to their board and to nurses, modern matrons, staff nurses a Department of Health/King’s Fund and ward sisters. Trust chief executives project approval panel. are asked to identify internal project sponsors from their board, who will support the project team by acting as internal champions and as a sounding board. Sarah Waller and Hedley Finn at South Essex Partnership NHS Foundation Trust

2000 2001 2002 2003 2004 2005 2006 2007 2008 January June October May July November November December January July April Programme Cohort 1 Cohort 2 Cohort 3 Cohort 4 Cohort 5 Phase 1 Phase 2 Phase 3 Environments HM Prisons ECEL launched London London London London London National National National for Care at Pilot National Acute Acute Acute Mental Health PCTs Extension Extension Extension End of Life 5 HMP/YOI Extension North West/ North East/ North Central 11 trusts 5 trusts 23 trusts Mental Health Mental Health (ECEL) 19 trusts South West South East 13 trusts 23 trusts and Learning Pilot 1 HMP 8 trusts 11 trusts Disabilities 6 trusts 23 trusts 2 hospices

3 Sharing success in mental health and learning disabilities

Defining the projects Evaluation and outcomes Each trust is able to choose the area in Three independent evaluations of the which it wishes to undertake its project, programme have been published to provided that: date. Each of these has shown the • the project aims to achieve a significant benefits for patients, staff and physical improvement which brings organisations in investing in the EHE demonstrable benefit in an area used model of team-based projects, led by by service users; clinical staff in partnership with service users. Without exception, the impact of • the team can demonstrate user the EHE programme in the participating involvement throughout the project; trusts has been greater than the • the scheme is of high quality and individual projects. The programme has represents good value for money. supported the individual development of team members, innovative new Most trusts have undertaken one project approaches to patient involvement and with their grant, although some have the formation of closer links with local chosen to undertake two or more communities, as well as having a major projects. impact on the development of PFI The underlying ethos is that any schemes. changes to existing accommodation The Medical Architecture Research must be conceived to promote patient Unit’s evaluation (Department of Health: wellbeing and to foster a healing 2003), whilst emphasising the personal environment. development of team members and the Many schemes have been successfully success of the individual schemes, completed using the available grant; highlighted the importance that had some have attracted additional funding been placed on humanising the hospital from charitable or trust sources and environment and the need to provide some have received substantial greater privacy and dignity for patients. additional capital funding. The evaluation undertaken by the York Health Economics Consortium in partnership with RKW Healthcare So often in the past, Strategists (Department of Health: 2006) “ changes to the looked in particular at personal environment within the development, improvement to the ward have been done environment, and therapeutic and economic benefit. Their environmental without consultation with review was undertaken using two the staff and patients, nationally recognised environmental resulting in inadequate measures and each of the nine case and inappropriate studies demonstrated significant facilities.” environmental improvements following Senior staff nurse completion of their schemes.

Coventry and Warwickshire Partnership NHS Trust: the WOW garden

4 About “Enhancing the Healing Environment”

A publication entitled Improving and evaluation. The publication also Environments for Care at End of Life identifies environments that are unique (King’s Fund: 2008) draws lessons from to end of life care and makes the pilot ECEL programme and recommendations for the future, highlights how engagement in the including the development of national programme has led to the review of standards and for increased investment trust-wide bereavement policies and in these care environments. end of life care strategies. The Further information about the programme’s emphasis on involvement programme together with a directory in project planning and delivery has of completed projects can be found at informed new ways of engaging service www.kingsfund.org.uk. users in service development, delivery

The Right Honourable Alan Johnson, MP, Secretary of State for Health, visits the team at South Essex Partnership NHS Foundation Trust

The visit to Tate Modern was also particularly helpful in that it “ encouraged a different perspective on art, a different way of thinking about what art is and what it engenders.” Service manager

5 Northumberland, Tyne and Wear: Bothal Unit The mental health and learning disabilities projects

Forty-seven schemes have been completed by the 46 trust teams taking part in the national extension of the EHE programme in England. All focus on improving environ­ ments for care in mental health and learning disabilities services. Through the pro­ gramme, the Department of Health and The King’s Fund hoped to raise awareness and understanding among NHS staff about how to bring about practical, value-for- money environmental improvements.

EHE in mental health and Funding learning disabilities Each team received a grant of £35,000 All London’s mental health trusts took to undertake their project, of which up the opportunity offered by The King’s £30,000 was provided by the Fund to join the programme in 2002, Department of Health via The King’s and two London-based PCTs providing Fund and £5,000 by their trust or SHA. services to those with learning Many teams have used their EHE grant disabilities took part during 2003. as a catalyst to draw in other funding for their project from their trust capital The first phase of the national extension programme, local charities and other of the programme outside London in organisations. Some outstanding and November 2003 included five mental innovative fundraising activities took health trusts. place, including an ‘Every Penny In 2004 each of the then 23 Strategic Counts’ appeal to raise 1,000,000 Health Authorities (SHAs) in England pennies towards a garden scheme (excluding London) were asked to (see p.32). nominate a trust that provided mental With the help of estates colleagues, health services to take part in the many projects have incorporated other second phase of the EHE programme planned works into their schemes. outside the capital. Similarly in 2005 Successful examples include the they were asked to nominate one further replacement of flooring or making areas trust, with the group being extended to Disability Discrimination Act (DDA) include those that provided learning compliant or – by using special central disabilities as well as mental health allocations for improvements, including services. Department of Health funding – the improvement of psychiatric intensive care units (PICUs). This has resulted in some much larger schemes than might The project changes you “ have been expected at the start of the in many ways without you programme. realising. It gives you confidence, it makes you Eight of the trusts completed their look around you, and it project within their £35,000 grant excluding VAT and a further 17 within makes you accept a budget of £70,000 excluding VAT. challenges you would Fifteen of the schemes attracted or were never have considered linked to major capital investments and before.” had a total value of over £100,000. Independent visitor

7 Sharing success in mental health and learning disabilities

33

North East 32 45

North West

Yorkshire & The Humber

31 6 5 23 42 18 22 26 1 16 37 27 39 8 36 12 East Midlands

30 34 25 41 West of England 24 38 11 7 46 4 10 East of England

2 28

35 29 South Central 17 40 3 London 43 21 South East Coast 20 South West 44 13 15 14 19

9

Figure 2 Map showing the location of the 46 trusts taking part in the mental health and learning disabilities Enhancing the Healing Environment programme Key: 1 Barnsley Primary Care Trust 24 Leicestershire Partnership NHS Trust 2 Bedfordshire and Luton Mental Health and 25 Lincolnshire Partnership NHS Foundation Trust Social Care Partnership NHS Trust 26 Manchester Mental Health and Social Care Trust 3 Berkshire Healthcare NHS Foundation Trust 27 Mersey Care NHS Trust 4 Birmingham and Solihull Mental Health NHS 28 Milton Keynes Primary Care Trust Foundation Trust 29 North Essex Partnership NHS Foundation Trust 5 Bradford District Care Trust 30 North Staffordshire Combined Healthcare NHS 6 Calderstones NHS Trust Trust 7 Cambridgeshire and Peterborough NHS 31 North Yorkshire and York Primary Care Trust Foundation Trust 32 Northumberland, Tyne and Wear NHS Trust 8 Cheshire and Wirral Partnership NHS Foundation Trust 33 Northumberland, Tyne and Wear NHS Trust 9 Cornwall Partnership NHS Trust 34 Nottinghamshire Healthcare NHS Trust 10 Coventry and Warwickshire Partnership NHS 35 Oxfordshire and Buckinghamshire Mental Health Trust Partnership NHS Foundation Trust 11 Coventry and Warwickshire Partnership NHS 36 Pennine Care NHS Foundation Trust Trust 37 Rotherham, Doncaster and South Humber 12 Derbyshire Mental Health Services NHS Trust Mental Health NHS Foundation Trust 13 Devon Partnership NHS Trust 38 Sandwell Mental Health NHS and Social Care Trust 14 Dorset HealthCare NHS Foundation Trust 39 Sheffield Health and Social Care NHS 15 Dorset Primary Care Trust Foundation Trust 16 Greater Manchester West Mental Health NHS 40 South Essex Partnership NHS Foundation Trust Foundation Trust 41 South Staffordshire and Shropshire Healthcare 17 Hertfordshire Partnership NHS Foundation Trust NHS Foundation Trust 18 Humber Mental Health Teaching NHS Trust 42 South West Yorkshire Mental Health NHS Trust 19 Isle of Wight NHS Primary Care Trust 43 Surrey and Borders Partnership NHS Foundation 20 Kent and Medway NHS and Social Care Trust Partnership Trust 44 Sussex Partnership NHS Trust 21 Kent and Medway NHS and Social Care 45 Tees, Esk and Wear Valleys NHS Foundation Partnership Trust Trust 22 Lancashire Care NHS Foundation Trust 46 Worcestershire Mental Health Partnership NHS 23 Leeds Partnerships NHS Foundation Trust Trust 8 The mental health and learning disabilities projects

Consultation and engagement so much from their involvement with Integral to the EHE programme is the the programme and the project team consultation with all service users, – increasing their self-confidence and carers and staff in project planning. learning new skills – that they have been Each team includes a service user or able to re-enter the workforce or return service user representative and is to further education. required to provide evidence on how Innovative ways of involving hard- they have consulted and involved wider to-reach patients and clients have groups before their project plans are been developed including the use of approved. “easy word” literature, consultation Service user involvement has been a key workshops, the creation of mood component and a critical determinant in boards and video presentations. the success of the schemes in mental The way in which service users have health and learning disabilities. It is a contributed to schemes has led to matter of great pride that some of the changes in policy in many trusts, service user representatives have gained including the further involvement of

MH perinatal LD adolescent MH adolescent LD adult MH PICU/secure MH working age MH older age

Figure 3 Projects by service user group (MH = mental health; LD = learning disabilities)

spiritual spaces

visitors’ rooms

general social spaces

entrances

outside spaces and gardens

ward or clinical areas (including social spaces)

Figure 4 Projects by location

9 Sharing success in mental health and learning disabilities

service users as foundation trust or as individuals; taken on wider governors. Their wishes, and those environmental responsibilities or of the other users, staff and carers gained promotion as a result of their consulted, have shaped the projects. involvement. The programme also acts Service users are also continuing their as a wider catalyst, by enabling staff to contribution in helping to maintain many think practically and often quite radically of the schemes. about changes in the delivery of care. New partnerships have also been This experience helps them to create formed across the country with local both interior and exterior spaces that groups, firms and charities. Many artists support the healing process and and arts organisations involved in the improved care delivery. projects will continue to support their The completed projects show what local trust’s ongoing work in improving can be achieved with vision, wide the environment. engagement and relatively small amounts of money. Despite working in Projects environments where health and safety Each trust was able to choose the area and risk considerations are paramount, in which it undertook its project, innovative and imaginative solutions provided it met the programme criteria. have been found. The schemes, Many trusts held competitions or invited although relatively small scale, departments to apply for the project have acted as a catalyst to further whilst others linked it to planned improvements, with many trusts now developments. incorporating EHE principles in future Only one trust decided to undertake two capital projects. projects at two different locations with their grant. However, due to trust The longer-term benefits of the EHE mergers during the lifetime of the programme include: programme, an additional three trusts • increased evidence of the were running two EHE projects at therapeutic impact of good design different locations within the trust by the • increased ownership of the end of the programme. hospital environment and a greater awareness of its impact on service Impact users, staff and the public The EHE programme continues to • the potential for improved demonstrate the capacity of frontline environments to reduce aggressive staff working in partnership with service behaviour and improve staff users to be extremely creative in recruitment and retention. bringing about high-quality improvements to the environment in The need for healing environments that which they deliver care. encourage patients to feel welcomed, looked after and cared for, and staff to The programme not only results in feel valued, continues. visible and measurable improvements in healthcare buildings and outside It is hoped that the longer-term benefits spaces, but also develops individual that have already emerged from the EHE team members’ skills, knowledge and programme will continue to influence personal confidence. Many have those charged with care delivery and received awards, either collectively future healthcare design.

10 The Projects

I want to congratulate all of you who are “ celebrating your work in mental health hospitals and learning disabilities services across England. You have not only transformed your care environments with innovative projects but, importantly, have also added to the growing evidence of the impact of the environment on supporting and helping recovery.”

HRH The Prince of Wales, President of The King’s Fund Video message to the Sharing Success Conference November 2007 Sharing success in mental health and learning disabilities

Barnsley Primary Care Trust The Oakwell Centre, Kendray Hospital, Barnsley The Haven: a newly created multifaith room offers space to relax, pray, rest and focus

Plans for a new mental health unit The curved main wall, designed not only for those of working age at Kendray to add interest but also as an aid to Hospital were already well advanced managing the acoustics, has been when the team joined the programme. designed to provide storage space for The Oakwell Centre was to be a mix of religious artefacts. It is lit by a line of redesign and refurbishment of some LEDs that enable the room to be lit in a existing facilities and a partial new build. range of colours. An integral sound The team started their project planning system has been installed so that those by consulting current service users, faith using the room can choose from a range leaders and the local art college. Their of music. aim was to create a safe, secure and The room has been named ‘The Haven’ peaceful place that would foster a following a service user competition and feeling of ‘time for me’, where people has been designed to be used by clients could spend some time alone no matter and their relatives. It has already led to what the time of day. The room where an increased awareness of service people could relax, think and pray users’ spiritual needs within the Centre. was designed to be used for religious observance by all faiths as well as a non-denominational quiet space. I am really pleased with the “ outcome of the room and it A central location was identified for the room in the part of the building that was meets our goals and aims in to be refurbished, with the added bonus every way and much more.” of access into a small garden. Project officer A naturalistic theme was agreed and this We have received a informed the main focus of the room: “considerable amount of a large, triple-glazed, stained glass positive feedback from those window commissioned from a local who have visited, with some artist. commenting that it is the A specially made curved steel and best room in the unit. bamboo screen sited in one corner of ” Team leader the room swings out to reveal a small ablution area with basin and foot bath – and pushes back to rest against the wall when the area is not required.

12 Creation of a multifaith room

13 Sharing success in mental health and learning disabilities

Bedfordshire and Luton Mental Health and Social Care Partnership NHS Trust Wellar Wing, Bedford The Billabong: a cluttered dining room is turned into a vibrant hub with access to the garden

Following wide consultation with service occupational therapy department. The users and an audit of the space, the programme had a history of aboriginal team chose as their project the dining mark making and it was decided to room of the Wellar Wing, a non-purpose incorporate this theme in the built acute mental health unit situated to refurbishment. This decision then led to the rear of Bedford General Hospital. the choice of colours used for the walls, The room was only used for meal-times, fittings and furniture in the redesigned when people usually sat on their own. room. It was also extremely cluttered, as it The process of creating the aboriginal doubled up as the domestic office, and artworks, created by over 110 service felt unwelcoming and uncomfortable. users and staff, proved a very positive The team undertook to create a more way to engage large numbers of sociable area that could be used for a people from the unit and surrounding number of activities, with direct access community services directly in the to the garden for everybody in the Wing. project. The chosen design has maximised the space available and transformed a little used area into a vibrant and welcoming “ Simple changes can make space. The meeting room has been all the difference – using incorporated into the main dining room occupational therapy art as a quiet area. Folding doors from the rather than purchasing a main dining area now allow direct print is just one example. access to the garden. The ceiling has ” Head of capital projects been lowered and a new lighting system installed. Different types of flooring help The transformation of a to delineate the areas as well as creating “drab, dated and altogether an area adjacent to the garden which unwelcoming space, into can be used as a performance space. a light, bright and modern Supported by the trust’s charitable dining and activity room can funds, new crockery, tables and chairs be seen in the eyes of our have been purchased. A video projector clients; their words are not and roll-down screen have been necessary. For me this is installed, and the area is already being complete job satisfaction. used for musical performances, film ” screenings and family events. Facilities coordinator The unit has an active service user arts programme supported by its

14 Refurbishment of a dining room and adjoining meeting room

15 Sharing success in mental health and learning disabilities

Berkshire Healthcare NHS Foundation Trust Charles Ward, St Mark’s Hospital, Maidenhead A redesigned and refurbished day room brings calm and order to dementia sufferers

Charles Ward cares for an older age already reducing the incidents of slips, group of up to 23 people. Many of the trips and falls. service users have dementia and the The furniture was carefully selected, team involved the local Alzheimer’s based on visits to manufacturers before Group at a very early stage in their deciding what to purchase, and the project planning. commissioned artwork chosen to appeal The large day room is the hub of the to the patients. Innovative pictures near ward and was in use constantly for a the dining tables depict various items of great number of social and group food that can be changed depending on activities. However, the room had an the menu and then used to discuss institutional feel, engendered by a large, patients’ choices. Families and staff enclosed nurse station, poor lighting and collected a range of memorabilia which drab furniture. To those with impaired have been placed in glass-fronted vision the polished flooring gave the shelves in the quiet area. impression that it was wet and the The room is now used by more patients whole area could be very noisy at times. simultaneously for longer periods during A key element of the team’s chosen the day. The more flexible room design design was to provide space for has helped staff to manage challenging one-to-one time with staff or visitors. behaviour and one-to-one interaction They also wanted to create a dedicated between patients and staff has area that could be used for watching increased. television, or simply as a quiet space, and to maximise the views on to the adjoining courtyard garden area. Taking part in the “ programme has been the The redesign, by creating a number of discrete areas, has reduced noise levels highlight of my 30-plus years and the colour palate chosen has made in the NHS. The training the room feel calmer and welcoming. events were superb. I The new lighting system allows staff to learned so much about alter the level of lighting in different areas design.” of the room. The flooring has been Senior nurse replaced by a non shiny surface that is

16 Redesign and refurbishment of a day room

17 Sharing success in mental health and learning disabilities

Birmingham and Solihull Mental Health NHS Foundation Trust Reaside Clinic Birmingham A new room enhances family visits

Built in the 1980s, Reaside Clinic The harsh strip lighting has been provides part of the forensic services replaced with a softer and adaptable within the trust and has 92 in-patient lighting scheme, which blends well beds. Prior to the trust joining the with the warm colours chosen for the programme, ongoing discussions with furnishings. the service user strategy forum had A range of leather and other furniture already highlighted the need for has been chosen with care and has a appropriate visiting facilities: the modern feel. There is space to store high-security main entrance was children’s toys when these are not in somewhat forbidding, and the only use, and a bookcase provides reading place where service users could receive materials for visitors and service users visitors was the main reception area. alike. It is hoped that the area can The large, open and busy space offered double up as a quiet room when not no privacy as it served as the waiting in use by visitors. area for all visitors to the clinic. The EHE team therefore decided that the creation Following consultation with service of a family visiting room should be the users, the decision was made not to focus of the project. put a television in the room. Artwork commissioned from a service user now Following a period of consultation about adorns the walls. a possible site for the room, the on-call doctor’s flat was made available. This It is hoped that the room will provide a was well located within the unit, being therapeutic environment conducive to close to the main entrance and next to the building and maintenance of family a courtyard. relationships. The chosen design has made the space as non-institutional as possible. The We have designed the room main room has been enlarged and the “ to be a ‘living room’ so that kitchen area refurbished so that visitors visitors, in particular children, can make drinks. A new door has been are not intimidated by the created to the outside, and part of the surroundings. courtyard sectioned off to provide a ” private garden for the room. Service manager

18 Creation of a family visiting room

19 Sharing success in mental health and learning disabilities

Bradford District Care Trust Lynfield Mount Hospital, Bradford A little-used, dull garden is transformed into an inspiring, sensory space

The centrally located and well-used Service users and relatives were very visitor’s centre was already a vibrant involved throughout the project and part of Lynfield Mount Hospital but the ward managers were extremely the adjoining garden was little used. supportive, each donating half their Following consultation with service users ward environment budget for the year it was felt that this area offered the most towards costs. opportunities for the trust’s EHE project as it would enhance current usage of the centre and encourage new activities. I have been proud to have “ been involved in the process The area consisted of a large sloping space, laid to lawn with a single silver of creating this scheme from birch tree. The team started by visiting start to finish. It gave me an a local garden show to identify the insight into other areas of features they wished to see in the our trust, particularly the redesign. These included private fantastic work that the contemplative spaces, planting that clinical staff do for our would appeal to the senses, water for service users. relaxation, areas for socialisation and ” Project and corporate services space for activities including tai chi, manager creative writing and group work. Involvement in the project Service users were invited to a coffee “ morning to discuss the project and of our service user has their involvement was integral to the increased her self- development of the designs. They confidence and self-esteem helped to choose the garden designer, significantly; it has given her and were actively involved in workshops the courage to return to full facilitated by local artists. employment.” The chosen design has transformed a Modern matron dull and uninspiring space into a lovely garden full of interest. The silver birch has been kept, giving height and focus to the newly planted garden. A stepped rill has been created and flows over pebbles down from the top of the garden to the bottom. This unique water feature also doubles up as a favourite seating spot as well as screening the out-patient clinics beyond. The space has a natural feel engendered by the use of organic shapes, and the planting incorporates banks, rather than flat borders, to echo the curves in the hard landscaping. Fragrant herbs have been planted between the paving stones, and a range of seating options has been provided, including some unusual volcanic rock seats.

20 Creation of a therapeutic garden

21 Sharing success in mental health and learning disabilities

Calderstones NHS Trust Bank End Barn, Calderstones, Lancashire A restored barn provides an activities centre for adults with learning disabilities

Bank End Barn has stood in a In another joint initiative, small fry will commanding position overlooking a grow in tanks on the river bank and then bend in the River Calder for over 300 be released to improve fish stocks. From years. Inaccessible, unused and derelict, the outset many organisations and the but situated on the perimeter of the local community have been involved trust’s 55-acre estate, it was one of the in the scheme with significant support four possible sites considered by the and a financial contribution given by team for their EHE project. Each Lancashire County Council. Local presented challenges but the team schools and the wider community will be decided that they would choose the able to use the barn and surrounding most ambitious – to turn the barn into area when not in use by the trust. an outdoor activities, field study and arts centre for their adult service users who have learning disabilities. I can’t recall any other “ project or scheme that has The main aim of the project was to restore the barn and redesign the driven me so much, given interior, but the team also planned to me so much, and meant so open up access to the river bank and much to me to be part of the surrounding woodland within the trust’s team that delivered the grounds. This would reduce the number Barn.” of off-site activities for service users – Estates manager who would benefit from the fresh air and stunning scenery on their doorstep – “ Being part of the whole EHE and open the area for community use. experience has regenerated skills, creativity, dialogue, Apart from gaining planning permission, the first major hurdle the team had to humour, determination, face was creating vehicular access empathy and confidence.” to the barn. A track was laid across Maintenance craftsman fields on top of a rediscovered access I have been inspired by route but until the barn structure was “ stabilised the team had to gain access the EHE programme, the to the interior through an old window experiences it has given me opening via ladders! and the competencies I have gained. This has enabled me The barn has now been sympathetically to develop my job, take on restored and essential services connected. An eco friendly approach more responsibility and has been taken with a system of ground move into a more senior heat pumps providing the under-floor management position in the heating and the halogen up-lighters trust.” recycled from an earlier project. A small Patient and public involvement kitchen, accessible toilet and sinks for manager art activities have been installed. A special feature is the climbing wall “ Not many employees in the requested by clients. NHS will be able to say they have achieved something as A grant from the BBC ‘Breathing Places’ Big Lottery Fund has improved great as this in their working pathways, and kissing gates have lives. The team should feel replaced stiles so that those in very proud.” wheelchairs can for the first time Trust executive nurse director gain access to the river bank.

22 Creation of an outdoor activity and arts centre

23 Sharing success in mental health and learning disabilities

Cambridgeshire and Peterborough NHS Foundation Trust Edith Cavell Hospital, Peterborough A courtyard garden brings immediate enjoyment to patients and staff

When the team began the programme, the redecoration of the two mental plans were already afoot to move the health wards. They used the skills and two acute adult mental health wards knowledge gained from the programme from their current site within the Edith to improve lighting, colour schemes and Cavell Hospital in Peterborough. to integrate art into this refurbishment. However, the team felt that significant Morale has improved, service users are improvements could be made to taking an interest in maintaining the improve access to outside space until garden and keeping it tidy, and staff the new facilities were available. report a reduction in incidents on the Access to the overgrown, uneven wards. courtyard adjacent to the wards was Throughout the project the team have very limited and the area did not present kept an eye on the future and have the relaxing, therapeutic space that the developed plans and allocated funds for team wished to create for their clients the garden to move to its new site at the and visitors. Lucille Van Geest Rehabilitation Centre, The team’s chosen design has created a which is located on the Peterborough number of distinct areas which maximise General Hospital site. the relatively small space available. New access from the main corridor has been created and trellising used to good “ I am proud of the changes effect. A range of wheelchair-friendly we have made to the benefit surfaces has improved access. of both service users and Benches, tables and chairs have been staff. placed in different areas so that people ” Modern matron are able to sit on their own or in groups. We have made such a The creation of the courtyard garden has “difference to the garden and provided a relaxed outdoor area away from the wards. It has enabled more managed to [also] get capital interaction between clients and staff, money from the trust to and is being used for group therapy improve the ward.” sessions. Facilities & project manager As a result of the courtyard project the team were able to gain trust support for

24 Creation of a courtyard garden

25 Sharing success in mental health and learning disabilities

Cheshire and Wirral Partnership NHS Foundation Trust Springview, Clatterbridge Hospital, Merseyside A new relaxation space and redesigned garden bring the “outside in”

The team initially had three possible user, provide additional colour and a projects to consider at Clatterbridge and stunning focus for the space. held an open day for service users, A mosaic rill runs from the edge of the relatives, staff and the local community corridor through the seating areas and to gather their views. Over 100 people out into the garden echoing the theme attended and engaged in workshops of bringing the outside in. All those during which they were entertained by involved in the project were invited to local musicians. Unexpected guests lay their own piece of the mosaic. The were the local fire brigade after the garden has been redesigned to offer a bread making workshop set off the choice of seating, though the whole area alarm! Feedback clearly pointed to remains observable. redesign of the corridor space adjacent to the out-patient department and The trust now plans to use the garden as the focus for the EHE project. experience from this project to inform There had been plans for some time for future developments and to fund a mini the out-patient services to be relocated EHE project each year. from the area, and this move gave the team the opportunity of creating a social At first, I was astonished space looking on to the garden. “ that my views were taken so In line with the project’s aim to bring the seriously, I was not there as outside in, a large floor-to-ceiling glass the usual ‘token’ service door on to the garden was incorporated. user, I was an equal member Next, and after careful consultation with of the team. We all ended up the trust, the decision was taken to remove the high wooden fence which genuinely caring about each obscured the view of surrounding fields, other.” allowing everyone to enjoy the Service user representative extraordinary vista. Organisationally the hospital Inside, two different seating areas can “ has tapped into the expertise be accessed at any time of day through of the project team in the curved walls from the main hospital planning of the PICU project corridor. The lighting scheme, which can which is well on the way to be adjusted as required, and the wall completion. colours were chosen to enhance the ” artworks in the space. The two central Modern matron photographs, taken by a former service

26 Creation of a relaxation area and garden redesign

27 Sharing success in mental health and learning disabilities

Cornwall Partnership NHS Trust Longreach House, Redruth New family room welcomes visitors to adult mental health services

Longreach House is a 67-bedded PFI within the building and service users development in Redruth, which provides have contributed to artworks for adult mental health services. Although acoustic screens to help dull the the unit had only opened in 2003, the noise in the ward dining area. Further reception area and space for visitors felt developments are planned, including the rather institutional and uninviting. development of a sensory room and To improve the welcome to visitors, the enhancements to the ECT suite. team set about reconfiguring the main reception desk: the counter height It has been a privilege and has been lowered, the partition glass “ an inspiration to work with removed and a welcome sign installed. A glass screen subdivides the reception designers, artists and the space and links it to the adjoining family wider community in room, while providing more privacy. This, developing a vision for together with new flooring, furniture and healthcare buildings for the service user artworks, gives a much future.” more welcoming feel. Occupational therapist A naturalistic, seaside theme has Being part of the EHE been chosen to reflect the local area “ programme has been in the family room. Clever design has integral to my development maximised the space which is now alive with interactive distractions for younger as a practitioner, leader and visitors. Lit glass screens depicting manager over the last two seaside animals subdivide the room so years.” that it can be used by more than one Acting director of nursing family if needed. Cold light has been used to very good effect and the team’s chosen designers have created an imaginative, inviting room, with activities for children of all ages. There is even a small desk for older children to use. A range of seating options and storage facilities has been incorporated within the design so that toys can be tidied away when necessary. The refurbishment of the reception area has been appreciated by both service users and staff. Since completion the visiting room is being actively used by children. The atmosphere is very relaxed and laughter often heard. In addition to the main EHE scheme, a spirituality room has been created

28 Creation of a family visiting room

29 Sharing success in mental health and learning disabilities

Coventry and Warwickshire Partnership NHS Trust Maybury Ward, Avenue Clinic, Nuneaton Colour and light flood Maybury’s psychiatric intensive care unit

Maybury is a ten-bedded psychiatric semi-occluded screen between the two intensive care unit which was built in the areas – allowing staff to unobtrusively mid-1990s. The main corridor of the unit observe clients, and letting clients have and adjoining lounge had been identified a degree of privacy when using the as the top priority for improvement by lounge. service users and staff. The corridor was dark, poorly lit and depressing. It was refreshing to work The clinic is surrounded by older “closely with a clinical team, buildings featuring locally made bricks depicting flowers and it was decided to to see first-hand the issues take these motifs as a theme for the faced on a day-to-day basis artworks for the ward. An artist from the and how improvements in local art college was commissioned to the environment could help develop the scheme with service users. both staff and clients alike.” As part of the refurbishment the walls Estates manager have been painted white to maximise One of my highlights has the effect of the new dimmable lighting “been seeing the finished scheme and the flooring has been project daily and the replaced. difference it has made to A series of seven large light boxes have people’s experience on the been recessed into the corridor walls, ward. each featuring a flower developed from ” the art workshops held with Maybury Ward manager ward clients. The light boxes are linked My time spent on the project by a wave design along the full length of “ has been one of the most the corridor walls, which was chosen to rewarding things I have reflect the recovery model of care used done. As a support worker within the unit. This theme also features the experience has been in the large commissioned artwork in the lounge. The furniture has been replaced inspiring – so much so that with leather armchairs and sofas and a I have started my nurse large plasma TV and DVD player have training this week. Being been purchased. involved in the project gave A unique feature of the refurbishment is me the confidence to pursue the fish tank, which has replaced the my journey to become a wall between the lounge and the main nurse.” corridor. This was specially designed to Support worker/student nurse comply with health and safety rules and provides both visual interest and a

30 Refurbishment of a main corridor and lounge

31 Sharing success in mental health and learning disabilities

Coventry and Warwickshire Partnership NHS Trust Bradbury House, Coventry The WOW garden brings fun and games to children with learning disabilities

Bradbury House was built in 2002 and of challenging behaviour. Some of the provides respite care for children and children have recognised the calming young people from five to19 with effect of the garden, and request to learning disabilities and behavioural go outside when they feel agitated. difficulties. The children usually return to A similar unit in the trust has now started the house for a week every couple of planning its own therapeutic garden. months, going to school during the day During the initial discussions with the and returning in the evenings and for the children, one of the service users, weekends. Charley, showed great interest in the Although the unit was purpose-built, project and became a very valued team there were insufficient funds at the member. He made a video which time for the garden to be developed. described the things he and his friends The EHE project gave the team the wanted to do in the garden, and this opportunity to transform the outside formed a key part of the team’s project space from its dull grassed state into approval presentation. He fundraised for a therapeutic and fun space for the the project and finally, when the project children that could be accessed in all was finished, the honour fell to Charley, weather conditions. suitably suited for the occasion, to cut The children were involved from the the ribbon. outset in helping to develop the design, joining the team on trips to play areas so Ensuring that we got that they could evaluate the equipment “ information and feedback prior to purchase, and attending art and craft workshops – which have continued from all of the children, since the garden was completed. despite their level of learning disability was an exciting Fundraising was a key part of the challenge. project. An ‘Every Penny Counts’ ” campaign was launched, with children Behaviour specialist and parents encouraged to save copper Was it worth it? You only coins in old Smartie tubes. The team “ have to watch the children were amazed at people’s generosity: a playing in the fantastic new practice manager took leave to bake for garden to know that it was the cake sales, directors paid £20 for a all worthwhile. cake and a ham roll, and one of the ” children gave up sweets all year to give Children’s lead the £25 he had saved. In all, over My highs include the thanks £15,000 was raised. “ from Charley’s Dad for how The garden has something for everyone. we had helped him to grow The bright colours chosen for the in skills and confidence after rubberised surface create an inviting his involvement in the project and vibrant feel, even in poor weather. – and the photo of him in his A wide range of robust equipment has new suit looking so proud as been installed and all the planting carefully chosen to be non-toxic. he posed with the Chief Exec. Within a couple of weeks of the garden ” opening, staff began to notice positive Lead nurse for children’s services changes in the children and there has been a significant reduction of incidents

32 Garden redesign

33 Sharing success in mental health and learning disabilities

Derbyshire Mental Health Services NHS Trust Hartington Unit, Chesterfield Royal Hospital Pleasley Ward’s redesign helps elderly mental health patients relax, reflect and recover

The Hartington Unit was built about The scheme has already made a twenty years ago and now provides positive impact on Pleasley Ward and is dedicated mental health care for the seen by the trust as an exemplar. It has elderly. The need for a quiet area on already led to the refurbishment of other the ward was identified from a survey wards in the unit. undertaken with patients, visitors and staff. The main aim of the project was to create a tranquil area for reflection while “I never realised the offering a degree of sensory stimulation transformation of the ward that would help service users relax, would be so dramatic and reflect and recover. In addition the the reaction from patients, team wanted to make better use of the carers and staff has been available central space in the ward and one of amazement. to create a dedicated seating area near ” Acting matron the nurses’ station where patients could sit. “Now I know that there is no The team’s chosen design has end and that completion of transformed first impressions of the the project was only the ward as well as maximising the space beginning. None of us can available for staff and patients. The go back to what or where nurses’ station is now centrally located we were before. and easily found. The new adjustable ” Matron lighting scheme and new flooring, together with the light blue walls, The project went on to win give visitors a sense of welcome. “ our Trust Team of the Year The more visible ward nurses’ station Award, of which I am sure means that staff are now spending we are all immensely more time with patients. Adjacent to the proud.” station are two bright, modern seating Patient support coordinator areas, where glass bricks not only I have witnessed at first provide a feature but are also used to “ bring some borrowed natural light right hand the effect this project into the hub of the ward. has had on the service users and staff; one of the service A quiet room has been created off the main corridor which provides a very users personally thanked me peaceful space. A bespoke lighting for taking the ‘mental health scheme, including LEDs which gently away from the ward’ and change colour, a choice of music providing her with a seat so or video and comfortable furniture she can sit and be part of complete the room. Pictures of different the ward. landscapes, chosen by patients for the ” Estates project manager scheme, have been hung in matching frames along the main corridor. The plan is to change these with the changing of the seasons.

34 Redesign of a ward corridor and creation of a relaxation room

35 Sharing success in mental health and learning disabilities

Devon Partnership NHS Trust The Briars, Exeter Gothic splendour on a homely scale for mental health clients and carers

The Briars, a Grade II listed building, Contact has also been made with a local was originally designed as a holiday history group to research the history of residence for two Victorian sisters where the building, and with an archivist who they created a wonderful botanical holds the records of one of the pioneer garden. About 80 clients a week, creative therapies units in Exeter. with both mental health needs and learning disabilities, visit the creative therapy unit based at The Briars for “I have taken from this a new sessions including art, music, drama view of how change can be and occupational therapy. Most of them achieved.” come accompanied, but before the EHE Health development manager project started there was no dedicated waiting room. Service users and carers “In a context where there is had to sit on the first floor landing to wait a lot of ‘can’t do’ at times, for their appointments or to take people it was energising to be home. working with the possibilities As a starting point, the hall was of ‘can do’ that EHE opened decluttered and the original floor up.” tiles taken as the inspiration for the Lead art psychotherapist redecoration of the hallway, stairs, Both clients and staff feel the corridors and landing. Heritage colours, “ chosen to complement the main tile new look has produced colours, have been used throughout. more relaxed clients who New lighting has been installed and love the waiting room.” flooring laid. Head drama psychotherapist An office has now been converted into manager a very comfortable waiting room: the original fireplace has taken on a new lease of life and the room feels very homely, with large comfortable sofas (in which tired carers can sometimes be found asleep), and soft lighting. A digital screen provides information about surrounding walks through the Devon countryside to offer those waiting inspiration from nature. The main hall window has been transformed into an artwork made of fused glass panels. Over 40 people were involved in the workshops that created the pieces, and some additional glass work has been used for the light box in the corridor. Two large hangings frame the landing window, while a flexible hanging system has been used along the landing and stairway for both commissioned artworks and loans from clients and local artists.

36 Refurbishment of public areas and creation of a waiting room

37 Sharing success in mental health and learning disabilities

Dorset HealthCare NHS Foundation Trust St Ann’s Hospital, Canford Cliffs, Dorset Service users rest and play in Studland and Haven’s PODtastic garden

Studland and Haven wards were built In fact, working on the scheme has about ten years ago and are located in encouraged service users to take pride a building in the grounds of St Ann’s in their environment. Since the garden Hospital. Studland is a 12-bedded low opened there seems to be a downward secure and psychiatric intensive care trend in the number of violent incidents unit on the ground floor and shares a reported in the unit. previously little-used courtyard garden The trust is already building on the with Haven ward on the first floor. This learning from the project and is was the only outside space for those in refurbishing areas in a more Studland ward. contemporary style with less institutional To engage service users and staff from furnishings. The occupational therapy both wards in the courtyard project, service is encouraging service users to the team commissioned a participative contribute works to the new schemes. arts organisation to run a series of workshops. A minimalist, modern design was chosen for the scheme, which also “ The journey through the includes an innovative music and lighting project has been one of system. Risk and safety issues were great personal learning and assessed thoroughly before the scheme development for me as a was approved. clinical leader.” The main planting feature is the shaped Senior clinical nurse small grass areas with silver birch trees, while a large picture of trees gives the illusion of a vista at one end of the courtyard. Specially commissioned white pods, with wooden-deck flooring and bean bags allow service users to sit on their own or in groups, to listen to their favourite music. The pods are made of light panels which give the whole courtyard a magical feel at night. This is emphasised by the imaginative water bubble artwork which provides a real focus to the area and also serves as a reminder of the sea beyond the hospital. The design allows service users to enjoy some privacy whilst staff observation is maintained, and the redesigned space is now used for a wide range of activities, including sports and therapeutic one-to-one sessions. Following the redesign, there have been no attempts to damage the courtyard.

38 Courtyard garden redesign

39 Sharing success in mental health and learning disabilities

Dorset Primary Care Trust Horizon Suite, Forston Clinic, Charminster Patients’ privacy and dignity drive ECT suite redesign

The ECT suite is used two mornings a have already received very positive week, with the majority of service users feedback from patients, who appear attending as out-patients. The entrance much less stressed before treatment. to the suite was difficult to find and When not in use for ECT clinics, the cluttered with filing cabinets and room is now much in demand as a quiet cupboards. A corridor divided the area and for one-to-one discussions. small, cramped waiting room from the treatment room, and the EHE team were determined to create direct access “ I am so proud of what between the two, as part of their project we have achieved – the to improve privacy and dignity for outcome is fantastic.” patients. The treatment room also had Facilities coordinator little storage space, and equipment – which could potentially be disturbing “ The charity I work for has for patients to see – was kept on open been proud to have been shelves and work surfaces. closely associated with such All service users were asked to a useful and grassroots complete a questionnaire about the project.” suite and its development, and the team Service user representative produced a virtual guided tour to elicit The project has enhanced trust board support. “ my interpersonal skills Matching pot plants now help identify and increased my self- the entrance to the suite. The waiting confidence, helping me room has been extended into the on my recovery path. previous entrance corridor, taking over ” the space previously occupied by the Service user representative filing cabinets. A stunning glass wall – reflecting the view of trees from the waiting room and commissioned from a local artist – now forms one wall of the enlarged waiting room, and this, together with the carefully chosen colour scheme and modern furniture, creates a tranquil and welcoming feeling. The local patients’ forum donated artworks for the room. Through a newly created door, patients can now be taken directly to the clinic’s treatment room rather than having to return to the corridor. The treatment room has been extended and redecorated and all equipment is now stored inside new cupboards. The recovery areas have also been repainted and the lighting system enhanced. The team have clearly achieved their aim of improving the patient experience and

40 ECT Suite redesign

41 Sharing success in mental health and learning disabilities

Greater Manchester West Mental Health NHS Foundation Trust Greenway Unit, Trafford General Hospital, Davyhulme The Forget-Me-Not Garden: A sensory project for people with dementia

The Greenway Unit provides mental ‘rooms’, each with a different feel and health services for people aged 65 and purpose. The rooms are delineated by over. It had been refurbished a year curved rendered walls, which add visual before the team joined the EHE interest. Service users and staff chose programme, but there had been the bold colours, while the ‘eyes’ in the insufficient funds at the time for the walls give glimpses of the area beyond. garden to be redesigned, and so it had Integral LED lighting will ensure that remained inaccessible to service users there is always something to look at due to the uneven pathways and broken from the unit’s day-room windows. paving stones. The existing hedge and trees have been Before starting on their project the well integrated into the design. The team researched previous projects water feature is sited in the garden’s and publications that had focused on main social area. The curved wheelchair- providing sensory gardens for people accessible path in the central area with dementia. An additional priority was wends between grass mounds and to provide some quiet spaces, where pretty, fragrant, low-maintenance patients and visitors could sit in relative planting that will gradually soften the privacy to enjoy the space. edge of the pathway. The smallest area Patients and relatives were encouraged of the garden has been designed for to choose the types of planting and quiet contemplation with fixed seating, features they would like in the garden and covered to give shelter. by making a series of ‘mood’ boards. Cottage plants and herbs emerged as This project took us to the overwhelming favourites. The team “ places I’d never been made several visits to garden shows to gain ideas, before commissioning a before. It was a journey local agricultural college to prepare the like no other.” designs. They and many of the relatives Ward sister of those receiving care at Greenway It was fabulous seeing the helped with various aspects of the “ end product and thinking, garden construction and planting. ‘I’ve done that.’ The chosen design has maximised the ” space available, made the garden feel Ward sister bigger and created three very different

42 Garden redesign

43 Sharing success in mental health and learning disabilities

Hertfordshire Partnership NHS Foundation Trust Lambourn Grove, St Albans A stunning reception area welcomes elderly patients

Lambourn Grove was built about set into a wooden panel allows people ten years ago and has a single main to watch a variety of DVDs while waiting. entrance for elderly service users, The ceiling has become part of the whether they are attending an out­ design and echoes the curves of the patient appointment or being admitted reception desk and the floor design. The to one of the three wards on the site. integral LED lighting around the doors to Staff had made every effort to make the the wards, under the seating area and entrance welcoming and homely with on the ceiling throws a sequence of conservatory furniture, but different coloured lights to continually acknowledged that it felt more like a add interest. The scheme is already sitting room than the entrance to the acting as an exemplar for all other trust unit. There was no reception desk and projects and has led to a scheme to people could not see staff. If attending refurbish the wards at Lambourn Grove. an out-patient appointment, patients had to be taken through a locked door to be booked in, then back to sit in a “ Individually, we have grown corridor to await their appointment. in confidence and leadership The team established that a key aim for skills and achieve a sense their scheme would be to provide clear of pride each time positive direction for people as they reached the comments are made about unit. Contact was made with the the project.” University of Hertfordshire, and students Modern matron were encouraged to develop a number of possible designs. The ambience is very “soothing and comfortable Lambourn Grove now boasts a stunning – absolutely wonderful. entrance. Although the space has only Clean, bright and calming. been enlarged by punching out the large ” window at the front, the entrance now Service user feels spacious and very welcoming. A strong, innovative design has been chosen and great care taken with every aspect of the redesign. The entrance to the unit boasts an illuminated handrail to help guide people in and a number of new flower beds. Double glass doors have been installed to aid temperature control. On entering the unit patients and visitors are greeted by a receptionist and then directed either to the wards or to the out-patient department. A waiting area has been created, and bespoke high-backed seating with arms installed to make the area more comfortable and to ease standing for elderly service users. A flat TV screen

44 Redesign of a reception area

45 Sharing success in mental health and learning disabilities

Humber Mental Health Teaching NHS Trust Bartholomew House Changes inside-out bring light and space to mental health service users

Bartholomew House provides mental painted. Service users used to health services for people of working congregate in the ‘crook’ of the ground age, and was chosen by the EHE team floor corridor, and this area has now out of a possible nine projects put been designated as a quiet reading forward by trust staff. Staff and service space, with comfortable seating and users within the ten-bedded building service user artworks. had already identified the lack of light, outside space and artwork and were committed to making positive changes “The comments received to the building both externally and have all been very positive internally. and it has certainly The entrance to the building is at the highlighted to the trust what rear through a small paved area. This can be achieved to enhance has now been fenced in using willow the patient environment with panels, giving a degree of privacy whilst a relatively small amount of allowing those using the garden not to funding and a willingness to feel too enclosed. Curved beds have think differently. been created, including a grassed ” Deputy head of facilities area and herb garden, and a range of textures used for the hard landscaping. It has been good to be part The central water feature, which “ of a national programme provides a gentle sound of running which has raised the profile water, is framed by a mosaic made of this work. by local schoolchildren. The garden is ” Arts and health manager already proving popular and being used for small group work during the summer It has opened my eyes to months. “ different ways of working Internally the team agreed to adopt a and not being afraid to use phased programme of improvements, different groups and starting with moving the nurses’ office professionals including into an under-used sitting room. This artists and designers.” allowed the vacated space to be Charge nurse redesigned to provide a quiet social space, with the added bonus of direct access into the newly redesigned garden. The lounge area has been designed to be light, comfortable and calm and to maximise the view of the garden. A commissioned artist worked with service users and staff to create the main feature artwork for the lounge, and other artworks which now decorate the building. In addition to the lounge and garden areas the lighting throughout the building has been improved and corridors

46 Redesign of communal spaces and garden

47 Sharing success in mental health and learning disabilities

Isle of Wight NHS Primary Care Trust Halberry Unit, Newport Older people with mental health needs benefit from a redesigned garden

Halberry provides care for 16 older The revitalised external space has people with mental health needs. already encouraged more regular use Following consultation with patients, of the garden and has engendered carers and staff, the project team improved communication, interpersonal decided to improve the garden areas. and therapeutic relationships between The team wanted to make much better patients, carers and staff. use of the limited outside space by creating a series of different gardens for the patients to enjoy throughout the “This has been the most year. interesting, stimulating and Five areas have been created including challenging project I have a kitchen garden, “shade” and “flame” ever been involved in.” areas, a social space and entrance. Patient and carer representative Flags now welcome visitors to Halberry, The EHE project has while a specially commissioned Phoenix “ transformed the environment now adorns the external wall. The beds to the side of the main entrance have from tired and institutional been replanted and a “flame” sculpture surroundings to one where introduces the theme for the main the visual artworks, garden garden area to the rear of the unit. The design and horticulture and side entrance has also been screened to carved outdoor furniture provide more privacy to the garden make the environment beyond. conducive to recovery and The “flame” and “shade” areas provide healing.” the largest outdoor space and have Director of arts been planted to add interest throughout the seasons. Spring bulbs will provide early colour, and imaginative wooden seating featuring woodland animals has been placed under the trees. In the summer, the central bed’s flame-shaped artwork will come to life in the yellows and reds of the surrounding plants. Outside the main day room, raised planters have been constructed and the vista opened up by reducing the height of the surrounding planting so that patients can enjoy watching the local wildlife. On the opposite side of the building a kitchen garden has been created not only to provide interest and activities as the fruit and vegetables grow but also to give those in the ward a chance to add exciting items to their diet.

48 Garden redesign

49 Sharing success in mental health and learning disabilities

Kent and Medway NHS and Social Care Partnership Trust Edgehill Ward, William Harvey Hospital, Ashford Social spaces have a calming effect on adult mental health patients

An audit of violent incidents in Edgehill evidence of a reduction in the incidence Ward – which provides acute in-patient of violence. The project is also care for people of working age – influencing the design of new buildings showed that it was the area in greatest within the trust. need of environmental improvement within the trust. Lack of social space on the ward meant that patients were often “ I have learned a great deal bringing chairs to sit in a windowless, about environmental issues hot area by the nurses’ office, while the and its good and bad effect large dining room at the end of the ward on the behaviour of mental – in contrast – remained unused apart health patients. from meal times. ” Mental health act manager and The team, which included the hospital service user representative architect, decided to enlarge the dining It’s been one of the best room by opening it up into the ward “ corridor and adding to it the area projects I’ve ever been previously used as a smoking room. involved in within my lengthy career in the NHS. The chosen naturalistic theme is ” complemented by calming shades of Head occupational therapist lilac and lavender, and the newly created Our project not only area provides a pleasant, light social “ changed the ward space where in-patients and visitors can environment for the better, it sit either alone or in groups. A small tea brought closer involvement bar has been installed, a new dining area created, and a range of flooring with the community it used to delineate the different spaces. serves.” The lighting scheme has been changed Head occupational therapist to include LEDs in the ceiling above the dining tables. The window frames have been painted the same colour as the walls to maximise the views over the surrounding open fields. New modern furniture and crockery have been purchased. Several artists, including former service users, were commissioned to produce a series of textile and painted artworks, with the emphasis on nature and creating a calm environment. Final decisions on the choice of artwork rested with patients, carers and staff. The occupational therapy group took a series of local botanical photographs which now hang along the main entrance corridor. Patients who have been admitted to the refurbished ward comment on the calmer atmosphere, and there is

50 Creation of social spaces

51 Sharing success in mental health and learning disabilities

Kent and Medway NHS and Social Care Partnership Trust Fant Oast, Maidstone, Kent A garden redesign helps to foster community support for young people

Fant Oast provides in-patient services “Pets’ Corner”. Although their arrival for up to ten young people, aged tested the NHS procurement system between 12 and 17, with mental health (there is no category for baby guinea needs. Most of them go to school pigs!), they are already proving a hit during the day, returning to the unit and are providing a real opportunity for for the evenings and weekends during therapeutic interventions with the young their stay. Fant Oast is a Grade II listed Fant Oast residents. building, and although it was undergoing Four part-glazed doors lead from the refurbishment when the team joined lounge to a terraced area for socialising the EHE programme, upgrading the and eating outdoors. Shade is provided surrounding L-shaped garden area was by large parasols and there is further not part of the scheme. The young shade nearby, where a unique wicker people’s wish list included spaces for seat, woven on-site, curves round the family activities, creative pursuits and base of a tree. exercise. The project has led to new partnerships The whole design reflects the circular with the local community, with a shapes of the oasts. Lines of beech volunteer weekend for over 70 people hedging radiate from the intersections being organised to assist with planting. of the oasts, forming green walls to the The sponsorship and support from the major areas of the garden. The hard local Hillreed Foundation has been landscaping, bricks, flagstones and critical in ensuring the high quality of the design of the borders have been chosen garden which is already being well used to blend with the building whilst gaps by the young people and their visitors. have been left in the hedging to allow ease of movement. The more energetic play areas, including “ I have been touched by the football, swings, basketball and a amount of help and support seesaw are located furthest away that we have received from towards the front of the building. Strong the local community . . . The wooden equipment has been provided impact on reducing stigma and the grass reinforced under the play might be small but there are areas to ensure robustness. The school certainly some individuals in has already started to use the space for the community who now its weekly sports group. have a different perception Each area of planting has a focus and of child mental health includes cottage plants and herbs. The problems. central creative area includes a Tipi ” which is already well used for small Team leader group work and a curved wall which will be used as a backdrop for performances. The reverse will provide a canvas for an evolving artwork that the young people will contribute to when they are discharged. Wildlife has been encouraged with a pond and bird bath and two guinea pigs have now taken up residence in the

52 Garden redesign

53 Sharing success in mental health and learning disabilities

Lancashire Care NHS Foundation Trust Scarisbrick Centre, Ormskirk Hospital A clever garden redesign maximises outdoor space

The EHE team focused on the of rubberised material suitable for Scarisbrick Centre at Ormskirk, where wheelchairs. Water features link both work was already under way as part of ends of the garden, and the rail the trust’s concurrent Enhancing Your alongside the path helps those with Environment (EYE) programme. The more limited mobility. Centre cares for adults and those over Comfortable seating areas have been 65 in its two wards. Most service users provided on four of the levels, bounded had limited access to outdoor space, by large rocks. This, together with the as the large garden area was difficult to retained mature trees, provide focus until reach, very steep and lacked interest. the new planting matures. The planting Plans were drawn up to redesign the has been chosen specifically to garden. The brief was to maximise the accommodate the sloping design. space available to service users from At the top of the garden a raised patio both the centre and the adjoining older area with non-slip decking will function age wards, and to make it more as an outdoor social area with views of accessible for individual or group the whole garden. The specially activities. commissioned tables and seating at the To accommodate the very steep top of the garden provided the location gradient, the garden has been divided for a successful opening tea party. into five levels which are linked by a path

Enhancing Your Environment Concurrently with the EHE project, Lancashire Care commissioned The King’s Fund to develop and manage an Enhancing Your Environment (EYE) programme for the trust. Each project also received a capital grant of £35,000 from the trust, so that a further five environmental improvement projects could be undertaken: a reception and waiting room at Fleetwood Hospital; the creation of The Sanctuary at Guild Lodge; the redesign of a complementary therapies room at Bickerstaffe House; a multipurpose room, the Oasis, at Chorley Hospital and a relaxation room at Burnley General Hospital.

People are often seen The visit to Tate Modern was “ walking and talking together “also particularly helpful in in the garden. Groups form that it encouraged a different easily and comfortably within perspective on art, a an atmosphere that is different way of thinking relaxed and natural.” about what art is and what it Senior nurse engenders.” The organisation sees this Team leader “ as an important lesson in The time we spent on how to embed inclusion of “ developing mood boards users of service and carers during the programme in the development and particularly helped people design of services in the with dementia to describe future.” how they would like their Assistant director of estates garden to be.” Service manager

54 Garden redesign

55 Sharing success in mental health and learning disabilities

Leeds Partnerships NHS Foundation Trust The Mount, Hyde Terrace, Leeds New mums find sanctuary at The Mount

Although a recent PFI build, The Mount The new simply and comfortably won the trust’s competition for the site furnished conservatory can be easily of their EHE project. One of only eight accessed from the dining room, and the perinatal units in England, The Mount small garden beyond has been given provides in-patient, out-patient and day new lighter paving and planting. services for mothers and babies, under One of the nurseries has been one roof, but the way the services are transformed into a quiet room for mums provided had changed since the unit only and has its own direct access to was built. The original lounge had the garden. Very beautifully furnished become an out-patient waiting area, with one large L-shaped sofa, the room leaving no private social space for is both intimate and comfortable. In the in-patients during the day, so the chance words of one service user, “It feels like to reshape the rooms on the ground being in a posh friend’s home.” floor was very timely. Project planning started with a period of research with the mothers. A Pre-project naturalistic theme for the redesign The sanctuary of The Mount and refurbishment was agreed and “ saved my life, and by fundraising commenced within the local improving the layout it would community. be more mum-friendly, A key aim was to make the dining area a enhancing healing and more usable space. It was too large for recovery. the current numbers, and felt dark, ” Service user/mum institutional and uninviting. The team agreed that as an integral part of their Post-project project a conservatory should be The most significant lesson erected which would be directly “ has been a reminder: a accessed from the dining room to reminder of the passion and provide greater natural light and a new therapeutic and social space. commitment which nursing staff and patients can bring The dining room now offers two distinct to effecting change through spaces divided by a floor-to-ceiling a specific project. screen: one next to the servery for ” eating, and the other a more relaxed Associate director of nursing seating area with comfortable chairs. The room can be opened up when required by folding back the soundproof room divider.

56 Redesign of social spaces including a conservatory

57 Sharing success in mental health and learning disabilities

Leicestershire Partnership NHS Trust The Willows, Leicester Redesign gives in-patients new Horizons

The Willows is a 40-bedded in-patient users to feel comfortable in the space. unit with four single-storey wards, a The redesigned area and garden are central core area and garden. The core now in constant use by patients, visitors area links the wards and provides the and staff for therapeutic and social main social space for service users, but activities. The area is continually evolving this large, dark space was being mainly and an out-of-hours café service is used as a thoroughfare. Somewhat planned. The learning from the Horizons intimidating due to its size, the wooden project has led to further developments double-height ceiling also made the area using EHE principles in the trust. echo and the space was smoky. The aim of the project was to transform This has been one of the the area into a safe environment which “highlights of my career, would be welcoming, comfortable and of therapeutic benefit. It was also hoped where I have been able that the improvements would aid staff to work very closely with recruitment and morale. patients to empower people and enable them to make The team’s enthusiasm led to a choices. successful bid to Leicester City Council ” for additional funds – which were used Modern matron to extend the scheme to the adjoining The impact of the courtyard garden. “ environment on the healing Low level, curved and undulating process is now a high dividing walls now delineate the priority in any schemes I am comfortable seating area from the main involved in. thoroughfare between the bungalows. ” This curved theme has been followed Estates manager through in the furnishings and garden beds. Large fabric kites have been hung on the wooden ceiling, reducing noise levels, but also making the area feel less intimidating. Planters link the internal and external areas and the courtyard garden space has been maximised. It now provides a peaceful area for enjoying the sound of the central water feature and the range of planting in the surrounding raised beds. Although initially challenging, the involvement of patients in the project has enabled the team to work very closely with the user group during one-to-one sessions, group work and general discussions. The scheme has helped them to take responsibility for and pride in their environment. The newly smoke-free environment has enabled a much wider group of service

58 Reception area and garden redesign

59 Sharing success in mental health and learning disabilities

Lincolnshire Partnership NHS Foundation Trust Pilgrim Hospital, Boston Bold colours enhance mental health unit waiting area

The waiting area for people visiting the tables and a parasol have been mental health unit at Boston for out­ provided, and the new access ensures patient appointments afforded little that the garden is now being well used privacy and there was no access by in-patients and visitors alike. through to the adjoining garden. The aim As a result of the project good links have of the project was therefore to enhance been made with local art groups and the seating area and to increase privacy colleges. A community artist trained to better reflect the services provided in service users and staff in felt-making, the unit. It was also hoped that access and a textile artist then created the to the garden could be improved. Initially colourful artworks displayed in the the team set up a project information reception area. The workshops were board in the reception area which much enjoyed and it is hoped that they immediately increased privacy for those will continue now that the scheme has waiting for appointments. been completed. The local Blackfriars The team wanted to create a modern, Arts Centre advised and supported the airy feel to the reception area. team and has held an exhibition of Encouraged by their visit to Tate Modern service-user artwork at the arts centre. (which is part of the EHE development Those who attended the opening programme), they plumped for a bright ceremony were entertained with a colour scheme and set out to improve keyboard recital by a pupil from nearby the lighting and general decor. Giles School. Screening, in the shape of a glass brick wall, has been introduced to enhance We will be looking at how privacy, while a folding glass door has “ the arts can be incorporated greatly improved access to the garden. into any new projects. As part of the scheme the planting has ” been updated, and better use has been Divisional manager made of the partly sunken area in the middle of the garden. New benches,

60 Reception waiting area and garden redesign

61 Sharing success in mental health and learning disabilities

Manchester Mental Health and Social Care Trust Park House, North Manchester General Hospital An art theme brings focus to Park House’s gardens and corridors

Park House provides over 100 in-patient you walk from one end to the other. beds for those of working and older The steel cladding on the exterior walls age, as well as acting as a base for the of the corridor has also been enhanced community teams. It was chosen as the by the addition of steel and plastic site for the EHE project as it was the artworks. oldest building being used to care for Usage of the gardens has increased by those with mental health needs on the about 60 per cent. They are now used site. Following consultation with service very frequently and the artwork, both users, the under-utilised courtyard areas external and internal, is proving a very on each side of a busy corridor in the popular talking point. middle of the unit were identified as the focus for the scheme. Taking “The Elements” as its overall art “ Working with service users theme, the EHE team recruited a local and staff to create an arts-in-health organisation to help with environment they will enjoy the project and advise on the choice of has been very rewarding. artists to deliver the work. A successful ” Occupational therapist project launch event was held which included the release of arts balloons. “ I am really pleased with the Two artists were selected for the project, results of the project and one of whom worked mainly in plastic so glad I have had the and the other in steel. Both artists opportunity to be involved. undertook a series of workshops with ” Occupational therapist service users, carers and staff to inform their commissions. It was a privilege to have “been part of it. The workshops identified seating, water ” features and sculptural work as the main Carer/non executive director elements of the garden redesign. This I have found the programme led service users to help create “Home”, “ to be one of the most a stainless steel sculpture illustrated valuable learning with their etched words, poems and experiences I have had. drawings and reflecting the journey ” home. The gardens have been planted Ward manager to ensure interest throughout the year and feature a number of small animal sculptures created by service users as their contribution to the scheme. Specially made chairs not only provide comfortable seating but shelter from the sun and rain. The first floor corridor has been repainted and is now hung with a colourful installation made of individual plastic cones, the colours changing as

62 Redesign of gardens and introduction of artworks

63 Sharing success in mental health and learning disabilities

Mersey Care NHS Trust Broadoak Unit, Broadgreen General Hospital Café life comes to Broadoak’s Interlude Garden

The Broadoak unit was built in 1991 and space in which artwork made by service now provides in-patient services for up users can be displayed. From the café, to 90 people of working age. large full-height fold-back glass doors Following an open afternoon held with lead on to a decked area – perfect for service users, improved access to an al fresco lunch or even a spot of outdoor space emerged as the clear entertainment. The official opening of the priority for the EHE project. Two possible Interlude Garden and Lazy Daisy Café sites were identified, and finally it was certainly made full use of the new decided to improve an under-used facilities. internal courtyard. The brief was to make it more inviting, and to relocate the The project was chosen WRVS shop and café, previously sited in “ through consultation, the unit’s reception area, and integrate them into the overall design. open afternoons and questionnaires. One of the early challenges facing the ” team was the removal of the three large Team leader ramps into the courtyard which, together The learning will be carried with an unused shed, dominated the “ forward into the new builds space. The team were then required to planned within the trust. accommodate the uneven surfaces and ” different levels of the courtyard within Modern matron their design, whilst keeping the area wheelchair-accessible. The use of light, colour, water and links to nature were all identified as key design elements, and a Japanese theme was chosen to tie them all in. The theme is echoed in the seating – made in Ashworth hospital’s workshops – the planting, and the silk flags suspended over the courtyard. A main focus of the redesigned space is a large mosaic waterfall, which was created by over 35 service users, while the changes in ground level have been successfully negotiated by using different surface materials and a small bridge over the water feature. The café has been moved and now adjoins the courtyard and provides a

64 Courtyard garden redesign

65 Sharing success in mental health and learning disabilities

Milton Keynes Primary Care Trust Campbell Centre, Hospitals Campus, Milton Keynes The arts-led “Pathway to Recovery” enhances spaces inside and out

The Campbell Centre is an in-patient the rest of the large hospital site but also mental health unit. Built in the early as a work of art in its own right. 1990s, the centre was already The largest external area, “Possibilities undergoing a major refurbishment of are Endless”, has transformed an its in-patient areas when the EHE uninspiring and rarely used space into a project started. The team immediately vibrant activities area. Service users now enhanced the lighting specification for have the opportunity to engage in a the refurbishment and, later on, ensured number of group games or just to sit that improvements were also made to and watch. the out-patient waiting area as part of this general scheme. Supported by the local council and by the Milton Keynes Community They decided to take an arts-led Foundation, this EHE project has already approach to their EHE project and the had a catalytic effect on the Centre and resulting “Pathway to Recovery” was other capital developments across the an ambitious scheme involving five trust. separate artistic commissions in four areas which needed to work as a cohesive whole. To inform the Being involved in the commissions, the team held a sustained “ scheme has increased my period of consultation with all service confidence and given me the users which led to establishing the five skills to complete a project clearly defined commissions. management course this “Restoring Hope” changed a dark and year. claustrophobic waiting space into a ” Support services manager chill-out area that is now used for relaxation sessions, group activities or I would recommend the simply by individuals in need of personal “scheme [EHE] to any arts or space. The “Buddha” bags can be health professional without a moved around as required and the moment’s hesitation. It is a lighting controlled to change the mood. wonderful catalyst … the Artwork has been integrated into the sparks from which will be floor and ceiling. flying around for years to The overgrown courtyard area was come. the focus for “Sense of Trust”, which ” Arts for Health director provides areas for contemplation, relaxation and conversation. Beautiful glass panels also subdivide a small, shaded, more private space within the garden. “Enabling Growth” is already providing service users with herbs and vegetables for cooking sessions – and with gardening opportunities. The “No Barriers” steel fence ties all areas of the garden together, acting as a screen from

66 Arts-led redesign of internal and external spaces

67 Sharing success in mental health and learning disabilities

North Essex Partnership NHS Foundation Trust The Derwent Centre, Princess Alexandra Hospital Therapeutic garden gives patients new skills

The Derwent Centre houses five wards, storage, and the other to a tea-making a 24-hour assessment service, and an area for the summer. Raised borders occupational therapy and psychology have been earmarked for easy planting department. The very large garden, of vegetables. The apple trees have also though actively used for occupational been kept in the more informal area, therapy, had become overgrown and which has been laid to lawn down a little used by the 70 in-patients. gentle slope and is now bordered by a The overall aim of the project was to wooden fence. A small seating area make the garden an integral part of provides a quiet space for reflection. the centre and for it to be perceived Opportunities for training and social as a place of interest for relaxation, enterprise were soon recognised, and a therapeutic activity and socialisation. partnership launched between the trust Patients were involved throughout the and their local Employ-Ability group. design phase, which resulted in four Through this partnership, former distinct areas being developed, each patients helped to plant the garden and clearly delineated by internal fencing and continue to undertake its maintenance trellises. – a type of gardening work that is The team and patients were closely now part of a City & Guilds training involved in the development of the programme. This is an exemplar planting scheme, which includes a partnership, and it is hoped that many variety of colours, textures and smells to more will be forged to enable service encourage positive mental well-being. users to re-enter the workforce. A large seating area has been created near the building with sloped access Our achievement of getting a from the nearby family room, and “ service level agreement with wheelchair-friendly tables and benches purchased. The adjoining “yin and yang” Employ-Ability will ensure garden of pebbles and grass provides a that the garden is maintained real focal point when viewed from the but, more importantly, that wards above. there is long-term service- user involvement. The old greenhouse has been retained ” and a new, larger, partitioned shed Operational services manager installed – one half being allocated to

68 Garden redesign

69 Sharing success in mental health and learning disabilities

North Staffordshire Combined Healthcare NHS Trust Judging by the high number of proposals submitted by trust staff, the prospect of an EHE project was exceptionally well received. The team eventually settled on two projects: the redesign of the garden at Chebsey Bungalows; and the creation of a reflective space at Harplands Hospital.

Chebsey Bungalows, Bucknall Harplands Hospital, Stoke on Trent Park life draws clients out of doors The Oasis offers quiet reflection time Staff at Chebsey look after people with Harplands Hospital was built as a PFI severe learning disabilities. The three hospital five years ago and provides bungalows are built together along one in-patient, out-patient and outreach side of a small cul-de-sac, their services. There was no space for uninspiring rear gardens were each religious services, which had to be held separated by high fences. The aim of in various venues in the building. The the redesign was to make the gardens team secured a small office space in feel less oppressive, and to encourage which to create an “oasis” room for interaction between clients and staff patients, staff and visitors, and set to from the three buildings by removing the design it with the help of a digital fencing. Two clients were identified to photographer. help with the project and all Light boxes now fully cover two of the stakeholders encouraged to help in walls, featuring back-lit pictures of creating the initial designs. skyline and clouds. Seven different The gardens have been opened up and colour sets give the room ever changing designed to give a great variety of colour, though these can be switched off interest for everybody. Quiet areas, and the ceiling lighting used when performance spaces, a gazebo and required. A butterfly within the design activity zones are all included in the new denotes the direction of Mecca, while sensory garden. In fact, the whole area storage has been provided inside the has the appearance and features of a colourful, flower-decked seating. small park. Service users from all three bungalows, some of whom previously refused to leave their dwellings, are now enjoying the garden together. It is hoped that access to the garden will reduce anxiety levels and the need for medication.

I have gained much more “ confidence and transferable skills to everyday life, as well as career-wise, fantastic!” Service user “All in all, an experience not to be missed.” Support services manager

70 Creation of a reflective space and garden redesign

71 Sharing success in mental health and learning disabilities

North Yorkshire and York Primary Care Trust Peppermill Court, York A flight of fancy strikes a chord with elderly male patients

Peppermill Court dates back to the together with images of old York in a 1990s, when it was designed for people “timeline life story”. Participatory with physical disabilities. Since 2005, workshops with patients and carers it has been a designated unit for older helped to inform the vinyl inset artworks men with challenging behaviours, and on many of the unit’s internal windows, the majority of the 18 service users are which reflect the themes of pets and in their 70s. colour. Built round a square central courtyard, The reception area space has been the main reception, bedroom areas, better utilised and is now renamed The social spaces and offices are arranged Old Bull pub. Part of the reception desk in a “race track” along four wide acts as a bar, with optics dispensing corridors. The team decided that they non-alcoholic drinks. The pub sign, could have most impact by focusing on tables, chairs and a realistic picture of a enhancing the reception space; dart-board add to the effect. A specially brightening up the corridors and making adapted fruit machine (no money better use of a few larger open spaces needed!) has become a favourite activity. by providing some meaningful and engaging activities for the service users. I often reflect upon the Following the theme of “Journey into “ happy occasions we had Space”, three of the corridors were revamped to reflect the sun, moon with the team, putting our and stars. Flooring and lighting were project together and sharing changed in all areas, and a colour- our ideas, and as a result I coding system devised to help with am very proud of ‘Journey orientation. into Space’.” The “sun” area closely mirrors a Carer traditional cottage garden, albeit I like it [the pub]. It brings indoors. Cheerful window boxes “ everybody together on the complete the look, while a garden shed same level. houses an array of safe garden ” equipment that the patients can use. Patient A large round central seat surrounds Dementia care mapping a tree and, together with a wooden “ before and after the project bench, now provides somewhere to demonstrates a higher level sit and enjoy the plants and colourful artwork that has been fixed to the walls. of ‘well-being’ for patients now. The “moon” area is a much quieter ” affair, with pictures of the sky at night Unit manager decorating the walls. Lighting can be dimmed to provide a calm, low-stimulus space. Fixed seating now faces an inset television screen which can be used to play DVDs whenever people wish to watch them. In the third corridor, photographs, transferred on to canvas, of the service users and their families now hang

72 Redesign of ward corridors

73 Sharing success in mental health and learning disabilities

Northumberland, Tyne and Wear NHS Trust Hadrian Clinic, Newcastle General Hospital A reception make-over meets visitors’ and staff needs

The Hadrian Clinic was built around ten staff from visitors has been removed, years ago, and provides a range of and staff safety enhanced by use of a in-patient and out-patient services, personal alarm system, CCTV, and a day centre and offices. The clinic’s controlled door entrance. A small reception area therefore sees a lot seating area has been provided so that of “traffic”, but its stark, cold and people can wait for transport. unwelcoming aspect was in need of A large wall-hanging made by the local a redesign. carers group provides focus in the The team conducted an audit of the use comfortably furnished new waiting room. of the reception area, and recorded over Magazines and newspapers are 980 episodes of people entering it on a provided and there is a small area for typical weekday – confirming how very younger visitors. As an additional bonus, busy the reception area was. They then unit volunteers now provide a “meet- held a consultation day with service and-greet” service for patients before users, carers and staff to elicit their their appointments. The whole area is views on the redesign. The outcomes of much more welcoming and has a the day led to the architect’s brief, which professional but friendly feel. pointed to a separate area being created for those waiting for out-patient appointments. I am personally involved in “ PEAT inspections throughout The team drew up plans to create a new, dedicated reception desk. This the trust now and in the would be sited in the central open area, capital investment group.” while the under-utilised reception office User development worker would be transformed into a discrete I am much more aware of out-patient waiting area. “the impact of the physical Architects were appointed and a vibrant environment and can’t go colour scheme of reds, oranges and into a building without yellows chosen. Wayfinding has been assessing its negative and improved by the use of new signs and a positive aspects. floor design which incorporates intuitive ” signage. Better overhead lighting has Lead nurse also brightened up the space. The old glass partition that separated reception

74 Redesign of reception area and out-patient waiting room

75 Sharing success in mental health and learning disabilities

Northumberland, Tyne and Wear NHS Trust Bothal Unit, Northgate Hospital, Morpeth A garden redesign provides instant pleasure for patients with learning disabilities

The Bothal Unit was built in 1939 as one All were delighted to see how their ideas of a number of units on the large had inspired the garden design. The Northgate Hospital site. It currently trust has agreed to “ring fence” a capital provides services for up to 15 women of allocation each year for further schemes working age with complex learning using EHE principles. disabilities. The project team soon focused on the The programme has small tarmacked garden area to the rear “ empowered us to place of the unit. The area was cramped, and hemmed in by a large wooden fence. importance upon the impact More importantly, it lacked direct access of the environment on the from the lounge so that any patient health and well-being of the wishing to go outside had to be people we work with. It has accompanied out of the front door been great to be part of a and round to a side entrance. project which has delivered As the consultation progressed, some of something creative and the patients and staff visited local tangible to service users and gardens and helped to create a number staff at the hospital.” of “mood boards” to illustrate their wish Head art psychotherapist list. They also worked with an artist to develop designs for the unique mosaic “The first residential course balls which decorate the garden, and in was an amazing opportunity making the mosaics for the large plant to meet so many like-minded tubs. people.” The garden has been enlarged and a Lead nurse new lower, lighter, lapped fencing erected. The chosen design has maximised the space, with a winding path and places to stop and sit. The tarmacked area has been retained as an outdoor eating area – which benefits from new furniture and a variety of large potted plants and shrubs. A water feature and a gazebo provide a focus at different ends of the garden, while planting has been carefully chosen to add interest throughout the year. Lighting has been installed so that the view from the lounge area can be enjoyed in the evening. Direct access to the garden has been a huge success, enabling patients to access a safe, secure and beautiful space when they wish. Many former patients attended the opening by the Mayor of Morpeth.

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77 Sharing success in mental health and learning disabilities

Nottinghamshire Healthcare NHS Trust Silver Birch Ward, Highbury Hospital, Nottingham Silver Birch extends a warm welcome to dementia sufferers and their visitors

The EHE team had a very clear vision for silver birch trees and views of nature their project: not only should it be a decorate many of the walls. catalyst for environmental The dining room has lost its institutional improvements, but it should also impact feel, thanks to new furniture and seating. on the culture of care delivery at Access has been improved into the Highbury and throughout the trust. small courtyard patio area, which can be Following a great deal of debate they used year-round thanks to a new decided to focus on Silver Birch Ward, canopy. “Yard Art” pictures of trees and which had been recently completed further light boxes give interest to the under a PFI scheme. While the building outdoor space both day and night. was of very high standard, the overall effect was somewhat clinical and As the team had hoped, they are unwelcoming. The main objective was influencing colleagues to enhance their therefore to create spaces and places environments through a programme of where patients with dementia, their further capital investment across the visitors and staff would feel comfortable trust. They have even contributed a and able to engage with one another. chapter about their EHE project to Mental health services today and The team selected specific areas for tomorrow, published in 2008. improvement including the entrance, visitors’ room, dining area, external courtyard and, as a late addition, a small It has given us a platform to area at the end of the main corridor that “ speak loud and proud not had become a popular alternative only of work within the meeting place for visitors. A series of directorate but also about creative workshops was run to develop achievements within our own a range of artworks, and a silver birch role. theme chosen to link all the ward areas. ” Modern matron As you enter the corridor to the ward, you are now greeted with a series of The leadership development powerful commissioned photographs “ events made a real impact illustrating the personal care given to and provided a much those on the ward. The entrance lobby needed impetus for my own is welcoming, with lighting playing a career development. large part in this transformation, and ” comfortable chairs inviting you to sit. Project manager Opaque film depicting silver birch leaves covers the lower part of the ward corridor windows, affording service users much more privacy. The main ward corridor is now alive with colour and light provided by mosaics and vibrant light boxes. The visitors’ room has a homely feel, and toys have been provided for younger visitors. Comfortable chairs have been placed at the end of the corridor and pictures of

78 Improvements to ward social areas

79 Sharing success in mental health and learning disabilities

Oxfordshire and Buckinghamshire Mental Health Partnership NHS Foundation Trust Mandalay House, Aylesbury Bringing the garden inside for people to enjoy all year round

Mandalay House provides rehabilitation The space created by the retaining wall facilities for 17 resident service users. around the structure has been Although a modern building, there was integrated within the overall design and little social, recreational and therapeutic planted with bamboos and grasses that space, and the little-used garden was will, in time, give additional screening to mostly laid to lawn and lacked interest. the dome. Following consultation it was decided to The design of the internal garden makes purchase a prefabricated building for the the very best of the space available with garden to increase the social space raised planting designed to give interest within the unit. The geodesic structure, a and colour throughout the year. The Solardome®, was supplied and wooden oiled oak seating and trellis constructed by the company on to a uprights were specially commissioned base prepared by the trust. An additional for the space. Terracotta tiles were retaining wall had to be constructed to chosen to blend with the colour ensure a level base, as the garden scheme. The innovative water feature slopes quite markedly. ebbs and flows into a small pool A design brief was then drawn up for the enhancing the relaxing ambience. The interior of the dome, which included space is already being well used by both lighting, seating and low maintenance individuals and for group therapy planting as well as a requirement for sessions. moving water. The work was undertaken by a specialist landscape company. It has been a whole new The dome sits adjacent to the house “learning experience. and is accessed via a small conservatory ” Technical instructor to the rear of the main house. The site was chosen to make the most of the The project has raised views of the surrounding trees and sky, “ awareness of the importance ensuring that the quality of light was and potential to change and maximised during daylight hours. The enhance the environment. integral lighting scheme in the dome ” Team leader ensures that it is used in the evenings as well as during the day.

80 Creation of social and recreational space

81 Sharing success in mental health and learning disabilities

Pennine Care NHS Foundation Trust Mental Health Unit, Stepping Hill Hospital, Stockport A Walk in the Forest: Breathing life into a courtyard garden

The Mental Health Unit at Stepping Hill ongoing arts projects continue to cares for a mixed population including engage people in the space and those of working age, the elderly and promote its therapeutic qualities. The those requiring care in the psychiatric project has also acted as a catalyst and intensive care unit. From the outset of pathfinder for other environmental the project the emphasis has been on improvements at Stepping Hill. working in collaboration with all A group of service users, “Painting with interested parties. During consultation Light”, were encouraged to create a the courtyard garden emerged as the photographic record of the project and favoured scheme. have produced a stunning portfolio to The aim of the redesign was to act as a permanent record of the transform a concrete, weed-ridden area project. into an accessible garden, maximising the space available. The central rowan tree has been retained and is now “ The garden area will act as complemented with silver birch to echo a pathfinder site and will the “Walk in the Forest” theme. These demonstrate that an already give the garden maturity. enhanced healing Patients were invited to enclose a environment incorporating written wish within the leaves that arts, music and design can decorate the acorn seats and also to be provided throughout the contribute to the design of the path rest of the trust’s mosaics, which will add interest in the redevelopment. winter months when the trees have lost ” their leaves. Ward manager A doorway has been made to give direct I am inspired by the number access from the new occupational “ of people who spend time therapy room on to a small deck area in the garden with their where people can enjoy activities in the children. This is a real fresh air. A new social enterprise café success in creating an has opened in the main building and an atmosphere of welcome and area of decking has been provided near safety – exactly what we set the entrance to the garden so people out to achieve. can take their coffees and sit outside in ” the warmer weather. Natural timber and Senior occupational therapist high quality fencing have been used throughout. The narrow space at the back of the building – which could have become an under-used cul-de-sac – has been turned into a quiet but accessible space with an interesting undulating pathway, planting and seating. Since the garden opened it has attracted a variety of new users and the

82 Courtyard garden redesign

83 Sharing success in mental health and learning disabilities

Rotherham, Doncaster and South Humber Mental Health NHS Foundation Trust Sapphire Lodge, St Catherine’s Hospital, Doncaster A new kitchen and conservatory help to promote user independence

Sapphire Lodge is a rehabilitation and maintain or further develop their assessment unit for people with learning independence, and the new disabilities. As the Lodge was due for a environment supports care delivery, major refurbishment, it was agreed that with one-to-one sessions taking place in the EHE project to provide a the conservatory. Specialist computer rehabilitation kitchen and conservatory equipment has been purchased to help would form an integral part of the works. service users become more engaged in The kitchen and extension can be used their own care planning. flexibly to meet both the skills promotion Not only did the project influence the and enhancement agenda. The design, lighting, colours and furnishings conservatory provides a multipurpose of the whole of the Lodge refurbishment space for relaxation, sensory stimulation but it has also influenced the trust’s and individual therapy. modernisation of acute adult mental A very active period of service user and health in-patient services. The EHE carer consultation commenced with the principles are already being applied in drafting of a communication strategy for other trust developments, including a the project. Each team member took psychiatric intensive care unit and a responsibility for the involvement of low-security unit. different stakeholders and a range of leaflets were produced in “easy-read” Be prepared to be format. Links were made with Doncaster “ challenged and be open to Advocacy and the trust’s local self- advocacy group. Over 130 service users change. Be organised and were involved in the 10 consultation enjoy the experience!” sessions and art workshops that were Nurse consultant held. Users were also involved in the selection of the commissioned artist for the project and many helped to make artworks including drawings and paintings for the Lodge. The tiles they made for the kitchen were designed to provide sensory stimulation. In the conservatory the stained glass window adds a feel of the outside and the innovative ceiling installation includes adjustable lighting and a projector for creating different moods. The completed scheme has changed practice, offering more treatment- focused interventions through rehabilitation and skill enhancement. The focus is very much on enabling users to

84 Rehabilitation kitchen and conservatory

85 Sharing success in mental health and learning disabilities

Sandwell Mental Health NHS and Social Care Trust Edward Street Hospital, West Bromwich The Relaxation Garden: A more attractive and accessible garden for elderly service users

The large garden at Edward Street A tree was planted by the Mayor of presented a number of challenges to the Sandwell to celebrate the official EHE team. It was not wheelchair opening of the garden which is already accessible and there were no handrails being very well used. The team are for those with an unsteady gait. There using the knowledge and skills gained was a significant amount of brown-brick during their participation on the EHE hard landscaping and an over-profusion programme to inform other projects in of large shrubs. The central raised the trust. Sandwell Third Age Arts feature was inaccessible to the majority contributed throughout the project and of elderly service users in the unit. will continue to support service user The aim of the redesign was to create a involvement in future art and design garden that was safe and would be projects. accessible to all, that promoted relaxation and provided a calming and Being involved in the project therapeutic experience. Service users “ and the project itself has and staff contributed their ideas for the redesign throughout the project. provided a large amount of positivity to service users, The chosen design makes the garden carers, visitors and feel fresher, open and much more colleagues during such a inviting. The central circular features turbulent time within the have been retained and enhanced. The NHS. brown brick has been rendered in cream ” to produce a lighter finish and a large, Occupational therapist sweeping slope allows easy access up I feel we have achieved more to the highest point where people can “than we thought we could, enjoy a view of the garden and the water feature that marks the central spot. the garden looks fantastic and is now used more than The entire garden is now wheelchair ever, despite the bad accessible and the shaded woodland weather! path at the back of the garden provides ” a number of sheltered, small seating Capital and property manager areas for sunny days. Some of the larger shrubs have been removed and large circular areas of lawn laid. Trellises give structure and height even in the winter. A variety of pots, including some made of mosaic by service users, have been filled with seasonal planting. These will be maintained by the hospital’s horticultural therapy group. Outdoor chairs and tables have been purchased so that an increasing number of service users and visitors can take a cup of tea from the café into the garden.

86 Garden redesign

87 Sharing success in mental health and learning disabilities

Sheffield Health and Social Care NHS Foundation Trust Longley Centre, Sheffield Let There Be Light: Improving ward areas

Work was already underway to enlarge user engagement have increased and refurbish the intensive treatment significantly. An occupational therapist service ward at Sheffield when the team now provides dedicated sessions and a joined the EHE programme. Prior to the student art psychotherapy placement enlargement the unit felt quite dark and has commenced. The scheme has led cramped. The aim of the extensive to the trust incorporating EHE principles refurbishment was to open up the unit to in other schemes, including improving natural light, improve the airflow and the environment for those with extend the available space for service dementia, and to the creation of a users and staff. designated arts lead for the trust. The team asked for windows to be put into the walls of the new office and I think the new ward truly meeting spaces to allow natural light into “ reflects what the group the main corridor. They also reviewed the initial plans for the refurbishment to was trying to achieve. The ensure that all available space was going patients and staff feel that to be maximised during the works. they are valued.” A number of different areas have been Ward manager created within a tight ward template. My particular highlights Lighter shades have been used for the “ include interviewing artists majority of the walls, with stronger (I am a nurse – I interview accent colours to give interest and new nurses!!) and being able flooring installed. A combination of full to provide an exceptional spectrum lighting, “borrowed light” from the corridor windows and an open-plan environment for the service sitting room, spotlights and skylights users who are in extreme have made a great difference to the and acute distress.” general atmosphere. Assistant clinical director/consultant Commissioned artworks have been a nurse key feature, with a series of collages representing the diversity of those using the unit’s services displayed along the “Service users are now main corridor. empowered to make The ward now provides more dignified choices, and have en-suite shower rooms and toilets and a ergonomic spaces that women’s lounge. The dining room, encourage meaningful which was previously too small to seat activity and enable social all the service users at one time, is now interaction.” a sunny and pleasant space with Occupational therapist commissioned service user artwork on the walls. I am totally convinced that if “ we had not been involved The refurbished sun room provides a with this scheme we would tranquil space for clients to sit and enjoy the imaginative roof garden beyond. A not have achieved what we bird sculpture made from recycled have. One of our objectives materials in Zimbabwe provides a focal was to use this scheme as a point within the planting scheme and way to inspire broader has proved a lively conversation piece. change throughout the trust. The project has extended the We have achieved this.” therapeutic options available to patients Area manager in the unit and levels of staff and service

88 Redesign of ward areas

89 Sharing success in mental health and learning disabilities

South Essex Partnership NHS Foundation Trust Keats House, Billericay, Essex Residents help to design and maintain their award-winning garden

The service users at Keats House, a four pieces of weather-proof art made small rehabilitation unit for men with by a local service user group, which learning disabilities, had already said depict the four aims of Valuing People. that they would like to see some The team have been involved in working improvements within their home and with managers across the trust to garden. The garden area, the size of ensure several new developments an average suburban garden, was incorporate light, colour and art and are uninspiring and very under-used. It was comfortable, interesting and healing felt by all at the house that this should environments. It has also changed the form the focus of the EHE project. way service users are consulted and The residents and staff were fully involved in decision making more involved in the development of the generally in the trust. design and an open day was held for The project won the “Award for Best key stakeholders to comment on the Landscape Design” at the 2007 Building outline designs. Although not part of the Better Health Care Awards. core EHE project the team were successful in a capital bid for an extension to the lounge area which, as It was a great pleasure the “summer room”, now means the “ to be involved in such a garden can be enjoyed when the worthwhile project. weather prevents people from going ” outside. Service development manager The garden designer – who also undertook the construction – was chosen because he was keen to engage the patients in clearing the site and in the planting of the new beds. He continues to works with them, weeding and watering, to keep the garden in good shape. The garden has been transformed and now has many distinctive features including curved raised planters, which give height and maturity to the space, a driftwood sculpture surrounded by bamboo, a chequer board with alternate slate tiles and planting, a herb garden and a gazebo made from old Russian oak, which is adorned by beautiful stained glass panels depicting earth, water, air and fire. Lit at night they provide a very special focus, as do the

90 Garden redesign

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South Staffordshire and Shropshire Healthcare NHS Foundation Trust Norbury House, St George’s Hospital, Stafford A refurbished lounge and dining area create a calm environment

Norbury House is a psychiatric intensive Friends and has led to a greater care unit and provides ten in-patient appreciation of the value of all arts to beds. recovery within the trust. There is The focus for the EHE project was the anecdotal and qualitative evidence to main social space and dining area, show a reduction in violent behaviour. which was stark and uninviting with The EHE project team were fully involved plastic tables and chairs. The view out in the independent post-project to the surrounding garden was hidden evaluation undertaken by Staffordshire by heavy curtains and, although the University, which confirmed the very large central skylight did let in some positive impact of the processes used additional light, this was not maximised. during the project and of the completed scheme. The team wanted the area to be a safe, therapeutic environment for both service users and staff and commissioned a The working design studies designer to help them achieve their “ were dog-eared and coffee ambition. Much thought and care was stained by constant use! taken in choosing the final colour ” Senior nurse scheme and accent colours, and all the furniture was tested by service users There is a sense of pride for and staff prior to purchase to ensure it “ both staff and patients and was robust and fit for purpose. a keenness to continue to The new flooring helps delineate the respect the environment dining and more informal seating areas. along with the motivation The whole space feels much lighter, to develop therapeutic brighter and calmer. It is also less activities. cluttered, as adequate storage has been ” Ward manager provided. There has been great attention to detail throughout, as illustrated by an We replaced the plastic innovative magnetic notice board and by “ garden furniture with the use of red plug sockets on the red beautiful bespoke leather wall. sofas and chairs. The result Privacy has been enhanced by the – a comment from a client construction of an internal glass brick – ‘you are doing this for wall, which obscures the view of the us?’ living area from the road. Two layers of ” Designer curtains have been used to dress each of the windows so that the lighter voile can be used on its own during the summer months to allow good views of the garden beyond. The skylight has been turned into an artwork by the installation of light fittings that provide a colour wash of changing colours up the walls to the glass beyond. Paintings and photographs by service users have been hung throughout the building. The art group has continued since the project has been completed. The project was actively supported by Stafford Hospital and Community 92 Refurbishment of lounge and dining areas

93 Sharing success in mental health and learning disabilities

South West Yorkshire Mental Health NHS Trust The Priestly Unit, Dewsbury and District Hospital Water features and clever planting create an attractive courtyard garden

The Priestly Unit was built in the 1990s around four courtyards and the EHE Just under two years ago we team decided to redevelop the one “ knew little if anything about nearest to the main entrance, as it would be seen and enjoyed by most in the unit. The King’s Fund. ‘Wow,’ The courtyard was of reasonable size what a difference two years but lacked both shelter and interest, and can make!” suffered from some off-putting external Ward manager noise courtesy of a poorly sited For the individual who ventilator. “embarks on the project it The team canvassed the views of takes you on a journey of service users and staff by means of a personal and professional survey, to establish what they would like discovery – you develop to see in the new design. Top of the list were private places to sit alone or with new skills, confidence and visitors, and a water feature. This interests.” presented one of the main challenges Ward manager for the team: to balance the need for When you see the effect the social spaces with that for quiet “ completed projects have on reflective time. The team decided to visit Chelsea Flower Show to gain inspiration those who use the enhanced for their design. area it makes you wonder why it has not been done The result has made the very best use of sooner. the space available and created areas of ” real interest for everybody. Access to the SHA portfolio coordinator garden has been improved with a new The residential events door from the adjacent ward. The “engaged me in ways that ventilation issue has been resolved, no other training has. making the area much quieter and ” tranquil. The original paving has been Senior capital projects manager retained wherever possible to blend in with new stone. Each corner of the courtyard now has a different focus. A gazebo provides shelter from rain or sunshine and is large enough for small groups to meet. The introduction of some older trees has already given both height and maturity to the garden. High level planters and hedging have created areas of privacy in which to sit and enjoy the wide variety of special features, including the pink quartz, driftwood, ammonite, water features and etched stones that have been commissioned and purchased for the space. A wooden sculpture featuring the names of the villages served by the unit makes a very special focal point. The redesign has led to other environmental improvements in the trust and to a greater use of the arts as a therapeutic intervention.

94 Courtyard garden redesign

95 Sharing success in mental health and learning disabilities

Surrey and Borders Partnership NHS Foundation Trust Abraham Cowley Unit, Chertsey The Place to Be: Redesigned entrance, dining room and gardens

The Abraham Cowley Unit was opened The adjacent courtyard garden has been in the 1980s and is located at the rear of transformed into a decked open-air a large acute hospital site. It provides café. Tables and chairs are interspaced acute in-patient and out-patient with raised planters and a sandstone services, and a day hospital. water feature has been installed. This The original focus for the project was the area leads on to further gardens for small shop, run by volunteers, situated in-patients and their visitors, developed in a corridor next to the dining room; the as part of this large enhancement dining room itself, which was well cared programme. for but dated; and the adjoining The trust has undertaken a full and courtyard. It was hoped that by positive evaluation of the project, on the integrating the shop into a redesigned three key areas of impact, build quality dining room the area would be used and functionality (using the Department more frequently rather than just for main of Health’s AEDET Evolution toolkit), and meals. The project then expanded to will continue to evaluate the scheme. include the main unit reception area and the gardens adjoining the dining room and ward blocks. To see people using it, “ relaxing and responding as if The team hoped to create a welcoming, harmonious and continuous space they weren’t in hospital at all flowing from the main entrance through …is magic.” reception, into the coffee shop area, Healing arts manager dining room and to the garden beyond. This was a milestone project, Visitors to the unit are now welcomed “ which allowed the trust to with a bright, spacious and light explore design philosophies reception area. The new reception desk that had never been has been cleverly designed to link with considered before. The the secretarial office beyond. Furniture learning will stand the trust has been chosen to complement the commissioned glass work that provides in good stead for future a focus for the whole area. developments.” Easy access is provided to the new café Commissioning manager and shop, which has been relocated to the main dining room and now has commercial fixtures and fittings on which to display its merchandise. Comfortable leather chairs and sofas provide an informal seating area next to the counter. The main dining area is separated from the café by mixed planters. New dining tables and chairs have been purchased and a range of artworks provide interest, including banners that have been hung to soften and lower the wooden double-height ceiling. Glass film depicting butterflies and leaves has been applied to the windows to provide some privacy for those sitting both inside and out.

96 Redesign of reception area, dining room and gardens

97 Sharing success in mental health and learning disabilities

Sussex Partnership NHS Trust St Anne’s Centre, St Leonard’s-on-Sea A new reception and waiting area welcome patients and visitors to the Centre

The team wanted to create a The Hastings League of Friends and the welcoming, reassuring first impression Trust Charitable Funds gave donations for their older age patients and their towards the scheme. The project visitors who come to out-patient engaged the local branch of MIND as appointments, the day centre or the well as a large number of service users in-patient wards at St Anne’s. who together organised and conducted Although redecorated relatively recently the official opening ceremony and also the orientation of the reception desk provided the copy for the trust was confusing so that people magazine. Following the completion of sometimes walked straight past it. The the project the team have been main corridor, though full of light, sloped encouraged to talk about their project at down to the wards whose entrance trust events and nursing conferences. doors were not well lit. This created a somewhat intimidating entrance to the I feel completely transformed in-patient facilities. The large corridor “ both personally and windows, some of which were obscured by bright yellow radiators, looked on to a professionally by the EHE garden, which was dominated by an old project. … I am so grateful bus shelter used as a smoking area. [to The King’s Fund] for this experience, which has been A designer was commissioned to the most inspirational and develop the scheme, taking on board exciting of my career. the results of the team’s extensive ” consultation with a wide range of Practice development lead patients, staff and visitors from St To have one’s eyes opened Anne’s. “ to innovation, singularity The reception desk has been re­ and inspiring design was orientated so that the staff can now see a revelation as well as a people approaching the entrance. New revolution. lighting has been installed throughout, ” with special emphasis placed on lighting Estates service manager the ward entrances, while the flooring chosen for the scheme incorporates age-appropriate signage. The radiators in the corridor have been painted white and no longer distract from the view of the garden. The team created a semi-screened seating area at the top of the corridor, where people can wait close to the entrance. A soft and gentle colour scheme of greens and yellows was chosen, which is reflected in the leaves on the surrounding glass partition and the windows to the adjoining day hospital. Patients who attend the day centre made the tile plaque that commemorates the project and reflects local history and landmarks.

98 Redesign of reception area and main corridor

99 Sharing success in mental health and learning disabilities

Tees, Esk and Wear Valleys NHS Foundation Trust Primrose Lodge, Chester-le-Street A rehabilitation service creates a garden room and improves its communal spaces

Primrose Lodge was built in 1915 and An interior designer helped the team now provides 14 beds for rehabilitation. choose the colours for the internal The unit is well situated within walking refurbishment. Use of the same carpet distance of the shops and community throughout the Lodge gives the whole facilities. The service philosophy is to building cohesion. Particular attention create a homely, friendly atmosphere in has been paid to the redecoration of the which individuals can attain their bedrooms in calm colours to make them personal aims, achieve independence less institutional and more homely. The and build confidence. two main living rooms appear larger and The project focused on the communal much lighter following repainting and the areas on the ground floor of the introduction of new furniture, blinds and two-story building and the garden to curtains. the rear. Working with the residents, The project has already informed further the team developed plans for the schemes within the trust and, as a result refurbishment of the whole building, of a visit made by the team, live music including the construction of a large sessions have been introduced at a garden room. This was felt to be an nearby hospital. essential part of the work, to increase the communal accommodation, provide extra therapeutic space and allow more “The unit is now a much natural light into the building, as well as more conducive environment improving the integration of the garden for rehabilitation and with the main building. recovery.” The garden room is very light and airy Unit manager with comfortable, modern furniture and Many lessons have been good views into the garden from three “ learned by the professional sides. Air conditioning has been provided for use in the summer. A large estates and facilities team veranda looks on to the garden and will engaged in the project and provide residents with a place to enjoy we have already started to the garden in all weathers. apply these across other schemes. The garden has been redesigned and ” provides a number of quiet seating areas Director of estates and facilities as well as a plot for those at Primrose management Lodge to grow vegetables and herbs. The sculpture was made by service users at another trust site and provides an interesting focal point.

100 Creation of a garden room and internal spaces refurbishment

101 Sharing success in mental health and learning disabilities

Worcestershire Mental Health Partnership NHS Trust Witley Ward, D Block, Kidderminster Hospital The colours of nature bring ward entrance to life

The entrance to D2 ward in a 1980s in the corridors and glass shelves full of building was up a flight of stairs and historical items placed in the reception through the out-patients waiting area. area. Once in the ward the reception area was In addition to trust support, the League cramped and staff tended to congregate of Friends helped fund the new furniture in the office beyond. Although the floors and the Arts Council gave a grant were shiny the whole atmosphere was towards the stained glass. The ward dark and depressing. has been renamed Witley Ward rather In an initial survey of patients, visitors than D2 to signify the change in the and staff, 83% described the reception environment and the other wards in the area as dull and drab, 60% felt it was block have also been renamed. unwelcoming and 47% said that sitting in the area made them feel miserable. Lack of natural light, a poor colour “ I have learnt that I have skills, scheme and a clinical atmosphere were experience and ideas that also singled out for comment. Following are useful to a project such the survey a design company was as this. commissioned to work with the team to ” Service user develop outline proposals for the refurbishment on the theme of spring. A “ We started with the objective colour palate of neutrals, browns, of changing an area and we greens and blues was chosen. are now looking at changing The staff office and changing facilities policies, attitudes and have been removed, which has opened working practices.” up the entrance area and created a Service user lighter, brighter space. To enhance patient privacy, the clear glass windows between the day area and reception have been replaced with specially commissioned stained glass. Panels of the glass have also been used at the entrance to the ward and to decorate the other small seating areas. The main lounges have also been refurbished. The lighting scheme has been updated and a coloured back-lit panel has been inserted in the ceiling of the main reception area to add further light. The whole of the ward corridor has been painted and a different flower picture hangs by each bedroom to help patients identify their rooms. To support reminiscence work, black and white historical photographs have been hung

102 Ward entrance area redesign

103 Sharing success in mental health and learning disabilities

Project Directory

This directory covers the 46 NHS trusts in England who took part in the “Enhancing the Healing Environment” (EHE) programme for mental health and learning disabilities. The national extension of the programme, which started in 2004 with trusts outside London providing mental health services, was further extended in 2005 to include trusts that provided learning disabilities as well as mental health services. A comprehensive directory starts on page 106.

Barnsley Primary Care Trust** Bedfordshire and Luton Mental Health and Social Care Partnership NHS Trust* Berkshire Healthcare NHS Foundation Trust** Birmingham and Solihull Mental Health NHS Foundation Trust* Bradford District Care Trust** Calderstones NHS Trust** Cambridgeshire and Peterborough NHS Foundation Trust* Cheshire and Wirral Partnership NHS Foundation Trust** Cornwall Partnership NHS Trust* Coventry and Warwickshire Partnership NHS Trust* Coventry and Warwickshire Partnership NHS Trust** Derbyshire Mental Health Services NHS Trust** Devon Partnership NHS Trust** Dorset HealthCare NHS Foundation Trust* Dorset Primary Care Trust** Greater Manchester West Mental Health NHS Foundation Trust** Hertfordshire Partnership NHS Foundation Trust** Humber Mental Health Teaching NHS Trust* Isle of Wight NHS Primary Care Trust* Kent and Medway NHS and Social Care Partnership Trust* Kent and Medway NHS and Social Care Partnership Trust** Lancashire Care NHS Foundation Trust* Leeds Partnerships NHS Foundation Trust** Leicestershire Partnership NHS Trust* Lincolnshire Partnership NHS Foundation Trust* Manchester Mental Health and Social Care Trust* Mersey Care NHS Trust* Milton Keynes Primary Care Trust** North Essex Partnership NHS Foundation Trust* North Staffordshire Combined Healthcare NHS Trust*

104 Project Directory

North Yorkshire and York Primary Care Trust** Northumberland, Tyne and Wear NHS Trust* Northumberland, Tyne and Wear NHS Trust** Nottinghamshire Healthcare NHS Trust** Oxfordshire and Buckinghamshire Mental Health Partnership NHS Foundation Trust* Pennine Care NHS Foundation Trust** Rotherham, Doncaster and South Humber Mental Health NHS Foundation Trust** Sandwell Mental Health NHS and Social Care Trust** Sheffield Health and Social Care NHS Foundation Trust* South Essex Partnership NHS Foundation Trust** South Staffordshire and Shropshire Healthcare NHS Foundation Trust* South West Yorkshire Mental Health NHS Trust* Surrey and Borders Partnership NHS Foundation Trust* Sussex Partnership NHS Trust** Tees, Esk and Wear Valleys NHS Foundation Trust* Worcestershire Mental Health Partnership NHS Trust*

* Denotes phase 1 of the programme, commenced in 2004 ** Denotes phase 2 of the programme, commenced in 2005

105 Sharing success in mental health and learning disabilities

The 47 mental health and learning disabilities projects This directory has been compiled from information provided by each of the participating trusts. The location for each scheme is given, together with the total project costs. The project costs have been given to the nearest £500 and are inclusive of VAT. The architects, artists and designers who have contributed to each project are also listed.

Trust Barnsley Primary Care Trust Project location The Oakwell Centre Project address Kendray Hospital, Barnsley, S70 3RD Project The Haven: Creation of a multifaith room Costs £50,000 Artists/designers Moorland Court Day Centre: Contribution to design Park Glass Studios: Stained glass Race Cottam Associates: Architects Trust Bedfordshire and Luton Mental Health and Social Care Partnership NHS Trust (formerly Bedfordshire and Luton Community NHS Trust) Project location Wellar Wing Project address Kempston Road, Bedford MK42 9DJ Project The Billabong: Refurbishment of dining room and adjoining meeting room Costs £160,000 Artists/designers Ann Hankins with service users: Artworks Barford Avenue Day Centre (mental health day services): Textile and photographic artworks Michael Ross: Design Stephen Lowe: Photographic artwork Trust Berkshire Healthcare NHS Foundation Trust (formerly Berkshire Healthcare NHS Trust) Project location Charles Ward Project address St Mark’s Hospital, Maidenhead, Berkshire SL6 7DU Project Redesign and refurbishment of day room Costs £65,000 Artists/designers Sarah Otto: Artworks Trust Birmingham and Solihull Mental Health NHS Foundation Trust (formerly Birmingham and Solihull Mental Health NHS Trust) Project location Reaside Clinic Project address Birmingham Great Park, Birmingham B45 9BE Project Creation of a family visiting room Costs £53,500 Artists/designers Pinnegar Hayward Design: Design

106 Project Directory

Trust Bradford District Care Trust Project location Lynfield Mount Hospital Project address Heights Lane, Bradford, West Yorkshire BD9 6DP Project Therapeutic garden Costs £76,500 Artists/designers Anna Clarkson: Design Geoff Reid: Service user workshops Morwenna Catt: Mosaics Trust Calderstones NHS Trust Project location Bank End Barn Project address Calderstones Hospital, Whalley, Clitheroe BB7 9PE Project Restoration of barn to provide outdoor activity/field study and arts centre Costs £184,000 Artists/designers Alan Kinder: Architect Chris Perkins and Alan Kenyon: Photographs and illustrations for tables and story boards Dave Carter, Woodstock Signs: Signs Hexagondraw: Artworks Lesley Fallais, North Light Arts Studio: Arts Coordinator Onward and Outward: Climbing wall Trust Cambridgeshire and Peterborough NHS Foundation Trust (formerly Cambridgeshire and Peterborough Mental Health Partnership NHS Trust) Project location Edith Cavell Hospital Project address Bretton Gate, Peterborough PE3 9GZ Project Creation of courtyard garden Costs £41,000 Artists/designers Simon Wiggins, Excel Landscapes: Design and construction Trust Cheshire and Wirral Partnership NHS Foundation Trust (formerly Cheshire and Wirral Partnership NHS Trust) Project Location Springview, Clatterbridge Hospital Project address Bebington, Clatterbridge, Merseyside CH63 4JY Project Creation of a relaxation area and garden redesign Costs £123,500 Artists/designers 6 Degrees North East, Big Studio Glass Design, Daniel James: Artworks Nightingale Associates: Design Star Design: Wooden seating The Project Group: Mosaic

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Trust Cornwall Partnership NHS Trust Project location Longreach House Project address Barncoose Terrace, Barncoose, Redruth, TR15 3ER Project Creation of a family visiting room and improvements to reception area Costs £91,500 Artists/designers David White, Dena Martin, Rosie Hadden, Yvonne Carter, Arts for Health, Longreach Arts Group: Artworks Sam Boex: Design Trust Coventry and Warwickshire Partnership NHS Trust (formerly North Warwickshire Primary Care Trust) Project location Maybury Ward Project address Avenue Clinic, Nuneaton, Warwickshire CV11 5HX Project Refurbishment of main corridor and lounge Costs £136,500 Artists/designers Alisha Miller, North Warwickshire College: Artworks Hinckley and North Warwickshire College: Arts support Shirley Aquatics: Fish tank Trust Coventry and Warwickshire Partnership NHS Trust (formerly Coventry Teaching Primary Care Trust) Project Location Bradbury House Project address Bredon Avenue, Coventry CV3 2FD Project The WOW garden: Garden redesign Costs £100,500 Artists/designers Design Buro: Design Steve Bentley: Wooden xylophone Trust Derbyshire Mental Health Services NHS Trust Project Location Pleasley Ward Project address Hartington Unit, Royal Hospital, Chesterfield, S44 5BL Project Redesign of ward corridor and creation of relaxation room Costs £106,000 Artists/designers Kevin Aldred: Design Mick Chapman: Photography Trust Devon Partnership NHS Trust Project location The Briars, Creative Therapies Project address Crabb Lane, Exeter EX2 9JD Project Refurbishment of public areas and creation of waiting room Costs £35,000 Artists/designers Barbara Paul, Carol Harvey, Emma Maloney/Double Elephant Print Workshop and service users, Karen Huckvale, Louise Guest, Malcolm Learmonth: Artworks Dawn Chilcott: Design Steven Pettet-Smith, Exeter Healthcare Arts: Arts advice Tati Dennehey: Ceramic sculpture

108 Project Directory

Trust Dorset HealthCare NHS Foundation Trust (formerly Dorset Healthcare NHS Trust) Project Location St Ann’s Hospital Project address 69 Haven Road, Canford Cliffs, Poole, Dorset BH13 7LN Project PODtastic garden: Redesign of courtyard garden Costs £77,500 Artists/designers Dedicated Controls Ltd: Electrical and safety design and installation Lesley Kennedy: Garden design Imageholders: POD design We Garden Like This: Construction Willis Newson: Consultation workshops WOW lighting: Lighting and sound Trust Dorset Primary Care Trust (formerly North Dorset Primary Care Trust) Project location Forston Clinic Project address Charminster, Dorset DT2 9TB Project Horizon Suite: Redesign of ECT suite Costs £38,000 Artists/designers Sasha Ward: Glass Trust Greater Manchester West Mental Health NHS Foundation Trust (formerly Bolton, Salford and Trafford Mental Health NHS Trust) Project location Greenway Unit Project address Trafford General Hospital, Davyhulme, Manchester M41 5SL Project The Forget-Me-Not garden: Garden redesign Costs £55,000 Artists/designers Myerscough College: Design, construction and planting Trust Hertfordshire Partnership NHS Foundation Trust (formerly Hertfordshire Partnership NHS Trust) Project location Lambourn Grove Project address Hixbury Lane, St Albans, Hertfordshire AL4 0TZ Project Redesign of reception area Costs £111,000 Artists/designers Andy Summers, Chris Pellegrine and colleagues from the Graduate Art and Design Department, University of Hertfordshire: Design Briffa Phillips: Architect

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Trust Humber Mental Health Teaching NHS Trust Project Location Bartholomew House Project address Boothferry Road, Goole DN14 6AL Project Redesign of communal spaces and garden Costs £35,000 Artists/designers Darren Simpson, St Joseph’s Primary School: Mosaics Lisa Benton: Mixed media artworks Trust Isle of Wight NHS Primary Care Trust (formerly Isle of Wight Healthcare NHS Trust) Project Location Halberry Unit Project address Halberry Lane, Newport, Isle of Wight PO30 2ER Project Redesign of garden Costs £35,000 Artists/designers Chris Barnes: Landscape design Lucy Wells and service users: Artworks and mosaics Paul Sivell: Tree sculpture Trust Kent and Medway NHS and Social Care Partnership Trust (formerly East Kent NHS & Social Care Partnership Trust) Project location Edgehill Ward Project address The Arundel Unit, William Harvey Hospital, Ashford, Kent TN24 0LZ Project Creation of social spaces Costs £77,500 Artists/designers Cheryl Ives, Louise Jessup, Gusto Gallery: Artworks Occupational Therapy Project: Photographs Shaw Trust: Furniture and mosaics Trust Kent and Medway NHS and Social Care Partnership Trust (formerly West Kent NHS and Social Care Trust) Project location Fant Oast Project address Upper Fant Road, Maidstone, Kent ME16 8DE Project Garden redesign Costs £59,000 Artists/designers Lucy Huntingdon Design Partnership: Design The Hillreed Foundation: Construction and planting Wye College: Planting Trust Lancashire Care NHS Foundation Trust (formerly Lancashire Care NHS Trust) Project location Scarisbrick Centre Project address Ormskirk Hospital, Wigan Road, Ormskirk L39 2AZ Project Redesign of garden Costs £96,000 Artists/designers Henley Salt Landscape and Garden Design Company: Design Karen Carberry: Planting

110 Project Directory

Trust Leeds Partnerships NHS Foundation Trust (formerly Leeds Mental Health Teaching NHS Trust) Project location Perinatal Unit Project address The Mount, 44 Hyde Terrace, Leeds LS2 9LN Project The Mount: Redesign of social spaces including conservatory Costs £106,500 Artists/designers SMC Gower: Architects Trust Leicestershire Partnership NHS Trust Project location The Willows Project address 1 Cordelia Close, Leicester LE5 0LE Project Horizons: redesign of reception area and garden Costs £90,000 Artists/designers Leicester Art College with service users: Artwork Tim Bates, Gordon White & Hood: Design Trust Lincolnshire Partnership NHS Foundation Trust (formerly Lincolnshire Partnership NHS Trust) Project location Department of Psychiatry Project address Pilgrim Hospital, Boston, Lincolnshire PE21 9QS Project Redesign of reception waiting area and adjoining garden Costs £38,000 Artists/designers Lynn Jenkins: Textile artist Kate Hoyles: Felt making Trust Manchester Mental Health and Social Care Trust Project location Park House Project address North Manchester General Hospital, Manchester M8 5RB Project The Elements: Redesign of gardens and introduction of artworks to corridors Costs £87,000 Artists/designers Adam Reynolds, Stella Corrall: Artworks and furniture Neil Copeland: Landscape design Rob Vale, Lime Arts: Arts advice Trust Mersey Care NHS Trust Project location Broadoak Unit Project address Broadgreen General Hospital, Liverpool L14 3PJ Project The Interlude Garden: Redesign of courtyard garden Costs £68,500 Artists/designers Brian Dawes and Judy Mazonowicz: Mosaic DAC Architects: Architects Tony Conroy and service users, Ashworth Hospital: Furniture

111 Sharing success in mental health and learning disabilities

Trust Milton Keynes Primary Care Trust Project location Campbell Centre Project address Hospitals Campus, Milton Keynes MK6 5NG Project Pathway to Recovery: Arts-led redesign of internal and external spaces Costs £157,000 Artists/designers Bex Simon, Kiran Chalal, Natasha Carsberg, Vanessa Dell: Artists Trust North Essex Partnership NHS Foundation Trust (formerly North Essex Mental Health Partnership NHS Trust) Project location The Derwent Centre Project address Princess Alexandra Hospital, Harlow, Essex CM20 1QX Project Redesign of garden Costs £100,000 Artists/designers Employ-Ability: Planting and maintenance Henley Salt Landscape and Garden Design Company: Design, construction and planting Trust North Staffordshire Combined Healthcare NHS Trust 1st Project Harplands Hospital location Project address Hilton Road, Stoke-on-Trent, Staffordshire ST4 6RR Project The Oasis Room: Creation of a reflective space Costs £20,000 Artists/designers Emily Campbell: Large-scale digital photography 2nd Project Chebsey Bungalows location Project address Chebsey Close, Cambrian Way, Bucknell, Stoke-on-Trent ST2 8PQ Project Redesign of garden Costs £45,000 Artists/designers Andy Cooper: Design Jackson’s Nurseries: Landscaping Kniveden Project: Pagoda and planting Trust North Yorkshire and York Primary Care Trust (formerly Selby and York Primary Care Trust) Project location Peppermill Court Project address Ramsey Close, Huntington Road, York YO31 8SS Project Journey into Space: Redesign and redecoration of ward corridors Costs £71,500 Artists/designers Assistive Technology, University of York: Virtual window screens and fruit machine Ben Hughes: Artworks Hunter Design Associates: Design Katrina Bray: Photographs Rachel Gretton, Kate North: Vinyl window displays

112 Project Directory

Trust Northumberland, Tyne and Wear NHS Trust (formerly Newcastle, North Tyneside and Northumberland Mental Health NHS Trust) Project location Hadrian Clinic Project address Newcastle General Hospital, Westgate Road, Newcastle NE4 6BE Project Redesign of reception and out-patient waiting room Costs £112,500 Artists/designers Laing O’Rourke: Construction MAAP Architects: Design Newcastle Carer Centre: Textile artwork and table mosaic Trust Northumberland, Tyne and Wear NHS Trust (formerly Northgate and Prudhoe NHS Trust) Project location Bothal Unit Project address Northgate Hospital, Morpeth, Northumberland NE61 3BP Project Redesign of garden Costs £85,000 Artists/designers Brambledown Landscape Gardeners, Azure Garden Centre: Planting Jane Akhurst: Arts advice Laing O’Rourke: Construction Simon Terry and service users: Mosaics Waterman Landscape Artists: Design Trust Nottinghamshire Healthcare NHS Trust Project location Silver Birch Ward Project address Highbury Hospital, Bulwell, Nottingham NG6 9DR Project Silver Birch Project: Improvements to ward social areas Costs £55,500 Artists/designers Imogen Gray: Photographs Penny Coulson, Theresa Jones, Anne Pollard: Artworks Raphael Daden: Light boxes Trust Oxfordshire and Buckinghamshire Mental Health Partnership NHS Foundation Trust (formerly Buckinghamshire Mental Health NHS Trust) Project location Mandalay House Project Address Stocklake Road, Aylesbury, Buckinghamshire HP20 1AT Project Erection of Solardome® to provide additional social and recreational space Costs £35,500 Artists/designers Ebb & Flow: Landscape design

113 Sharing success in mental health and learning disabilities

Trust Pennine Care NHS Foundation Trust (formerly Pennine Care NHS Trust) Project location Mental Health Unit Project address Stepping Hill Hospital, Stockport, Cheshire SK2 7JE Project A Walk in the Forest: Redesign of courtyard garden Costs £90,000 Artists/designers Jacqui Simmons: Artwork project leader Joanna Kessel, Adam Reynolds: Artists Louise Watson: Glass artworks Painting with Light: Photography Robin Templar Williams: Landscape design Trust Rotherham, Doncaster and South Humber Mental Health NHS Foundation Trust (formerly Doncaster and South Humber Healthcare NHS Trust) Project location Sapphire Lodge Project address St Catherine’s Hospital, Doncaster DN4 8QN Project Rehabilitation kitchen and conservatory Costs £35,000 Artists/designers David Mayne: Artworks Trust Sandwell Mental Health NHS and Social Care Trust Project location Edward Street Hospital Project address West Bromwich, West Midlands B70 8NY Project The Relaxation Garden: Redesign of garden Costs £76,500 Artists/designers David Robinson: Design, construction and planting Trust Sheffield Health and Social Care NHS Foundation Trust (formerly Sheffield Care Trust) Project location Longley Centre Project address Norwood Grange Drive, Sheffield S5 7JT Project Let There Be Light: Redesign of ward areas (ITS) Costs £385,500 Artists/designers Cheryl Ridge: Arts advice HLM Architects: Architecture, interior and garden design Sarah Wakeford and Sam Whiteley, Longley Centre service users and Laura Richardson: Artworks Trust South Essex Partnership NHS Foundation Trust (formerly South Essex Partnership Trust) Project location Keats House Project address 2 Heath Close, Billericay, Essex CM12 9NW Project Redesign of garden Costs £54,000 Artists/designers Lani Shepherd: Stained glass Pat Muller, service users at Coombewood Resource Centre, Queensway House: Valuing People mosaic Roger Simpson: Design

114 Project Directory

Trust South Staffordshire and Shropshire Healthcare NHS Foundation Trust (formerly South Staffordshire Healthcare NHS Trust) Project Location Norbury House Project address St George’s Hospital, Stafford ST16 3AG Project Refurbishment of main lounge/dining area Costs £52,500 Artists/designers Emma Yorke: Arts advice Mark Uttley and service users: Artworks Nightingales Associates: Design Park House Art Group service users: Plaque Trust South West Yorkshire Mental Health NHS Trust Project location The Priestly Unit Project address Dewsbury and District Hospital, Dewsbury WF13 4HS Project Redesign of courtyard garden Costs £63,000 Artists/designers Andrew Howes: Wooden sculpture Celia Kilner: Stone design Parkers Landscape Gardeners: Construction and planting Robert Dutton: Design Trust Surrey and Borders Partnership NHS Foundation Trust (formerly North West Surrey Mental Health Partnership NHS Trust) Project Location Abraham Cowley Unit Project address Chertsey, Surrey KT16 0AE Project The Place to Be: Redesign of reception and dining room Costs £449,000 Artists/designers ARTSCAPE: Video art Jim and Simon Smythe: Oak coffee tables Jo Pearl: Textile banners Peter Fisher: Carvings Stoney Parsons: Glass artworks Trust Sussex Partnership NHS Trust (formerly East Sussex County Healthcare NHS Trust) Project location St Anne’s Centre Project address 729 The Ridge, St Leonard’s-on-Sea, Sussex TN37 7PT Project Redesign of reception area and main corridor Costs £64,000 Artists/designers Elise Liversedge: Design Service Users: Mosaic plaque

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Trust Tees, Esk and Wear Valleys NHS Foundation Trust (formerly County Durham and Darlington Priority Services NHS Trust) Project location Primrose Lodge Project address Durham Street, Chester-le-Street, Durham DH3 3JX Project Creation of a garden room and redesign of internal spaces and garden Costs £272,500 Artists/designers PHS Architects: Interior design Trust Worcestershire Mental Health Partnership NHS Trust Project location Witley Ward, D Block Project address Kidderminster Hospital, Worcestershire DY11 6RJ Project Redesign of ward entrance area and general refurbishments Costs £188,000 Artists/designers Chloe Blount: Artwork Design Buro: Concept designs Peter and Diane Hill: Stained glass and flower pictures Ray Harris: Sign writer

116 Annexes

List of participating organisations The “Enhancing the Healing Environment” programme (EHE) was launched in 2000 by HRH The Prince of Wales, President of The King’s Fund, as part of The King’s Fund’s activities to mark the millennium. To date, the programme has enabled improvements to the healthcare environment in England, in acute, community, mental health and learning disabilities settings; at end of life; and in prisons. By 2008 150 trust teams and over 1,500 staff and service users with support from their local communities will have been involved in improving their healthcare environments. The following lists all the organisations that have participated in Enhancing the Healing Environment. Two stars (**) indicate the trust has two EHE projects.

NHS Trusts

Barking, Havering and Redbridge Hospitals NHS Trust Barnet and Chase Farm Hospitals NHS Trust** Barnet, Enfield and Haringey Mental Health NHS Trust Barnsley Primary Care Trust Barts and The London Hospitals NHS Trust Bedfordshire and Luton Mental Health and Social Care Partnership NHS Trust Berkshire Healthcare NHS Foundation Trust Birmingham and Solihull Mental Health NHS Foundation Trust Birmingham Children’s Hospital NHS Foundation Trust** Bradford District Care Trust Bromley Hospitals NHS Trust Calderstones NHS Trust Cambridge University Hospitals NHS Foundation Trust Cambridgeshire and Peterborough NHS Foundation Trust Camden and Islington Mental Health and Social Care Trust Central and North West London Mental Health NHS Foundation Trust Chelsea and Westminster Hospital NHS Foundation Trust Cheshire and Wirral Partnership NHS Foundation Trust Christie Hospital NHS Foundation Trust Cornwall Partnership NHS Trust Coventry and Warwickshire Partnership NHS Trust** Derbyshire Mental Health Services NHS Trust Devon Partnership NHS Trust Dorset HealthCare NHS Foundation Trust Dorset Primary Care Trust

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Ealing Hospital NHS Trust East and North Hertfordshire NHS Trust East Kent Hospitals NHS Trust East London and The City University Mental Health NHS Trust Epsom and St Helier University Hospitals NHS Trust Frimley Park Hospital NHS Foundation Trust Great Ormond Street Hospital for Children NHS Trust Greater Manchester West Mental Health NHS Foundation Trust Guy’s and St. Thomas’ Hospital NHS Foundation Trust** Haringey Teaching Primary Care Trust Hertfordshire Partnership NHS Foundation Trust Hillingdon Hospital NHS Trust (The) Hillingdon Primary Care Trust Homerton University Hospital NHS Foundation Trust Humber Mental Health Teaching NHS Trust Imperial College Healthcare NHS Trust** Isle of Wight NHS Primary Care Trust Kensington and Chelsea Primary Care Trust Kent and Medway NHS and Social Care Partnership Trust** King’s College Hospital NHS Foundation Trust** Kingston Hospital NHS Trust Lambeth Primary Care Trust Lancashire Care NHS Foundation Trust** Leeds Partnerships NHS Foundation Trust Leicestershire Partnership NHS Trust Lewisham Hospital NHS Trust (The) Lincolnshire Partnership NHS Foundation Trust Liverpool Women’s Hospital NHS Foundation Trust Luton and Dunstable Hospital NHS Foundation Trust Maidstone and Tunbridge Wells NHS Trust Manchester Mental Health and Social Care Trust Mayday Healthcare NHS Trust Mersey Care NHS Trust Mid Essex Primary Care Trust Mid Yorkshire Hospitals NHS Trust Milton Keynes Primary Care Trust Moorfields Eye Hospital NHS Foundation Trust Newham University Hospital NHS Trust** North Bristol NHS Trust North Cumbria University Hospitals NHS Trust North East London Mental Health NHS Trust North Essex Partnership NHS Foundation Trust

118 List of participating organisations

North Middlesex University Hospital NHS Trust North Staffordshire Combined Healthcare NHS Trust North West London Hospitals NHS Trust North Yorkshire and York Primary Care Trust Northampton General Hospital NHS Trust Northamptonshire Healthcare NHS Trust Northumberland, Tyne and Wear NHS Trust** Northumbria Healthcare NHS Foundation Trust Nottingham University Hospitals NHS Trust Nottinghamshire Healthcare NHS Trust Oxfordshire and Buckinghamshire Mental Health Partnership NHS Foundation Trust** Oxleas NHS Foundation Trust Pennine Care NHS Foundation Trust Plymouth Teaching Primary Care Trust Portsmouth City Teaching Primary Care Trust Queen Elizabeth Hospital NHS Trust Queen Mary’s Sidcup NHS Trust Robert Jones and Agnes Hunt Orthopaedic and District Hospital NHS Trust (The) Rotherham Doncaster and South Humber Mental Health NHS Foundation Trust Rotherham Primary Care Trust Royal Brompton and Harefield NHS Trust** Royal Free Hampstead NHS Trust Royal Marsden Hospital NHS Foundation Trust Royal National Orthopaedic Hospital NHS Trust (The) Salisbury NHS Foundation Trust Sandwell Mental Health NHS and Social Care Trust Sheffield Health and Social Care NHS Foundation Trust Sherwood Forest Hospitals NHS Foundation Trust Shropshire County Primary Care Trust South Essex Partnership NHS Foundation Trust South London and Maudsley NHS Foundation Trust South Staffordshire and Shropshire Healthcare NHS Foundation Trust** South Tees Hospitals NHS Trust South Tyneside NHS Foundation Trust South West London and St George’s Mental Health NHS Trust South West Yorkshire Mental Health NHS Trust Southampton University Hospitals NHS Trust Southend University Hospital NHS Foundation Trust St George’s Healthcare NHS Trust St Helens and Knowsley Hospital NHS Trust Suffolk Primary Care Trust

119 Sharing success in mental health and learning disabilities

Surrey and Borders Partnership NHS Foundation Trust Sussex Partnership NHS Trust** Sutton and Merton Primary Care Trust Tavistock and Portman NHS Foundation Trust Tees, Esk and Wear Valleys NHS Foundation Trust** Tower Hamlets Primary Care Trust United Bristol Healthcare NHS Trust University College London Hospitals NHS Foundation Trust University Hospital Coventry and Warwickshire NHS Trust University Hospital of South Manchester NHS Foundation Trust West London Mental Health NHS Trust West Middlesex University Hospital NHS Trust Whipps Cross University Hospital NHS Trust Whittington Hospital NHS Trust (The) Worcestershire Mental Health Partnership NHS Trust Yeovil District Hospital NHS Foundation Trust York Hospitals NHS Foundation Trust** 2gether NHS Foundation Trust for Gloucestershire

Hospices Marie Curie Cancer Care – Glasgow Marie Curie Cancer Care – Hampstead

HM Prisons HMP − Albany HMP − Belmarsh HMP − Brixton HMP/YOI − Feltham HMP/YOI − Holloway HMP − Pentonville

120 References

References Improving the patient experience Celebrating achievement: Enhancing the Healing Environment Department of Health: 2006 Improving the patient experience Evaluation of The King’s Fund’s Enhancing the Healing Environment programme Department of Health: 2003 Improving environments for care at end of life Lessons from eight UK pilot sites King’s Fund: 2008 Mental health services today and tomorrow Part 1: Experiences of providing and receiving care Radcliffe Publishing Ltd: 2008 AEDET Evolution toolkit This toolkit has been designed to assist Trusts and the NHS in determining and managing their design requirements, from initial proposals through to post-project evaluation. www.dh.gov.uk/en/publicationsandstatistics/publications/publicationspolicy andguidance/dh_082089

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Useful addresses

Arts Council England London Arts in Health Forum 14 Great Peter Street Floor 1 London SW1P 3NQ Menier Chocolate Factory Tel: 0845 300 6200 51 Southwark Street Web: www.artscouncil.org.uk London SE1 1RU Commission for Architecture and the Tel: 0845 602 0825 Built Environment (CABE) Web: www.lahf.org.uk 1 Kemble Street Music in Hospitals England London WC2B 4AN Case House Tel: 020 7070 6700 85–89 High Street Web: www.cabe.org.uk Walton on Thames DH Estates and Facilities Surrey KT12 1DZ Department of Health Tel: 01932 260 810 Quarry House Web: www.music-in-hospitals.org.uk Quarry Hill Paintings in Hospitals Leeds LS2 7UE Floor 1 Tel: 0113 254 7386 Menier Chocolate Factory Web: www.dh.gov.uk 51 Southwark Street King’s Fund London SE1 1RU 11–13 Cavendish Square Tel: 020 7407 3222 London W1G 0AN Web: www.paintingsinhospitals.org.uk Tel: 020 7307 2400 The Prince’s Foundation for the Built Web: www.kingsfund.org.uk Environment (Prince’s Foundation) Lime 19–22 Charlotte Road St Mary’s Hospital London EC2A 3SG Hathersage Road Tel: 020 7613 8500 Manchester M13 0JH Web: www.princes-foundation.org Tel: 0161 256 4389 Web: www.limeart.org

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