Agenda-Item-7-Appendix-1-University-of-Stirling-Dementia-Hospital-Design

Observe: Alerting staff but not ringing out to disturb patients/people with dementia Corridors 1.8 E The colour and tone of the floor covering contrast with the colour and tone of the f

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DEMENTIA DESIGN BUILDING AUDIT

Hospital Design

Community Hospitals NHS Dumfires and Galloway

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DEMENTIA SERVICES DEVELOPMENT CENTRE, UNIVERSITY OF STIRLING

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1.0 INTRODUCTION

This Building Review Report has been prepared following observational site visits to the buildings

by members of DSDC’s approved building Auditors and constitutes an evaluation of the existing building in relation to DSDC Dementia Design Principles The evaluation is based on information and advice contained in the under-noted set of designing for dementia guide booklets published by the Dementia Services Development Centre at the University of Stirling:

• Designing Gardens for People with Dementia

• Designing Interiors for People with Dementia

• Light and Lighting design for People with Dementia

• Hearing, sound and the acoustic environment for people with dementia

• Designing balconies, roof terraces and roof gardens for people with dementia

• Designing outdoor spaces for people with dementia

• Dementia Design for General Hospitals and Emergency Departments

The review of the building design also takes into account the Equality Act 2010, the

recommendations and guidance provided by the British Standards BS8300:2009 ‘Design of

buildings and their approaches to meet the needs of disabled people - Code of practice’ and

applicable national building regulations

Comments and recommendations made throughout this review relate principally to matters of design and the appropriateness of the building for people with dementia and do not refer to any general merits or otherwise of the design of the building for older and more frail people or to

service and management issues

It should be noted that a building review report based on an observational site visit is not the same

as a full audit and it will still remain the responsibility of the designers to comply with the detailed requirements of the Dementia Design for General Hospitals and Emergency Departments

Provision of design consultancy services by The Dementia Services Development Centre does not constitute endorsement of the completed building provided by your organisation The name or branding of The Dementia Services Development Centre cannot be used in any format to promote the completed building, unless your organisation has received certification through our design audit service

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2.0 PROJECT PARTICULARS

BUILDING CLASSIFICATION: Hospitals: in-patient, out-patient & day care address:

various as outlined below (8 sites)

Annan, Kirkcudbright, Langholm, & Newton-Stewart

Lesley palmer

Castle Douglas, Lochmaben, Moffat, & Thornhill

This report covers the environmental design assessments undertaken of eight community

hospitals in the area covered by the NHS Dumfries and Galloway These small to-medium sized hospitals are spread out in various locations across the Dumfries and Galloway region

The ages, positions, configurations and general conditions of the buildings was varied, with all possessing a combination of both positive and negative features in terms of supporting the well- being of occupants

Each of the hospitals was visited for a morning or afternoon, by one of the two above named approved dementia design auditors from the Dementia Services Development Centre at University

of Stirling.

Assessments were carried out in a systematic manner using the Dementia Design for General Hospitals and Emergency Departments (Cunningham et al, 2012), a formal tool based on the most reliable research evidence in the field of design for dementia, sight loss and age-related impairment

Please Note:

All audit items marked with a tick

All audit items marked with a 'cross are considered to be a Pass are considered to be a Fail

Please ignore which column these ticks and crosses have been placed.

Crossed Out Items and Sections, and those marked N/A were deemed Not Applicable - Score callcualtions were adjusted accordingly.

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Moffat Community Hospital Built 1927 Annan Community Hospital

Thomas Hope Hospital Built 1898 "B" listing Aug 1971

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As a summary, the following common themes were identified across all 8 hospitals:

1 The flooring throughout the hospitals varies in tonal contrast between adjacent / adjoining floor finishes Evidence suggests that where adjoining floor finishes have less than 10 units of Light Reflectance Value of a difference, there is a reduced likelihood of people with dementia and / or a visual impairment from wrongly perceiving a change in level Often this can result in ‘high-stepping’ which may result

in a trip and fall In addition changes in tonal contrast in flooring have been attributed to reducing the persons confidence in walking where the environment is perceived as confusing This also occurs where visual obstacles are created such as the red ‘wash your hands’ vinyl which is fixed to the floor A person with dementia will avoid walking over this, therefore increasing anxiety, and reducing confidence

in walking through the circulation areas Where there is planned maintenance or proposals to replace flooring, we recommend that flooring is reviewed throughout to ensure there is not greater than 10units

of LRV between each finish This extends to transitional strips, which should also match tonally and not offer glare

2 Walls and floors should contrast The normal ageing of the eye results in lower colour discrimination Where walls and floors contrast, this will improve the persons ability to see the three-dimensional aspects of the room, thus supporting movement and use Walls and floors should contrast by 30

units of Light Reflectance Values difference This information is widely published by paint and flooring manufacturers

3 The assisted bathrooms and toilets are very clinical in their design We acknowledge the need for wipeable surfaces for infection control measures However the colours of the room, use of lighting and materials can make the room more appealing and relaxing This is considered important to reduce anxiety in the patient when being bathed

4 Visual contrast within the assisted bathrooms and toilets was very poor There was very little contrast between grabrails and walls or toilet / paper towel dispensers and the walls on which they are fixed This will make it difficult for patients with normal age related visual impairments from locating these items and using them We recommend that walls are painted to improve contrast at grab rail locations

5 There is significant visual clutter throughout and in particular at entrance doors As such, information can be difficult to decipher; key messages are lost and in one occasion the entrance pad was

concealed We recommend that signage is reviewed throughout and unnecessary notices and signs removed Over stimulation through visual clutter can increase anxiety and distressed behaviour in people with dementia

6 The gardens and day rooms have the potential to be bright, well designed and social spaces In many

of the buildings there were excellent, direct connections between common areas and the gardens We recommend further investment in these areas to encourage more social activity and use of the garden

7 In all hospitals the auditors were impressed by the cleanliness and support from the care staff Good care and good design often serve as a proxy to the other and we would recommend some investment

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The entrance mat offers too much

contrast with the adjacent floor &

can be perceived as a step The

vinyl sign can create confusion for

a person with dementia.

There is very poor contrast tween the toilet, grab rails and wall behind make it difficult to see and make use of the fittings inde- pendently.

be-There is significant visual clutter and over-signing within each of the 8 hospitals This can create confusion and difficulty in using the built ment Recommend that signage is reduced to only those required and notices reduced / dispersed throughout the building

environ-Corridors host a significant amount

of equipment which can increase risk to patients from trips, collision and in some cases confusion

Storing items in the corridors also detracts from the legibility of the space.

Vertical blinds can create shadows and banding on the floor which can

be perceived as a change in level thus increasing risk of fall They can also create visual illusions or where the PWD has hallucinations can create anxiety and distressed behaviour

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Floor finishes should be matt to

reduce glare The ageing eye is

more sensitive to glare and this

can impact on the persons ability

to move freely, perceive and see

the environment correctly and can

increase risk of falls

Good contrast between the toilet seat and the toilet bowl Poor contrast between the grab rails and the walls & flooring

The light creep through the windows and highly reflective ing creates patches of glare and shadow on the floor which can

floor-be perceived as water or wet This can reduce the person with dementia’s confidence in moving across the floor.

The change in flooring at doors offers too great

a contrast and can be perceived as a change

in level thus resulting in increased likelihood of

‘high-stepping’.

In general we do not recommend sliding doors where the patient

is likely to be elderly Sliding doors require greater core strenght, are not always familiar and don’t offer the same level of acoustic privacy as a swing door

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Dementia design for

general hospitals and emergency departments:

Audit tool/checklist

Part 2: Workbook

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This booklet forms part of a suite of materials produced by the Dementia Services Development Centre (DSDC) at the University of Stirling It should only be used to carry out an audit in conjunction with the

accompanying guidance booklets

Carrying out an audit using this tool does not constitute any form of endorsement of the building or

surrounding environment by the Dementia Services Development Centre of the University of Stirling

Endorsements are made only of buildings audited and certified by University of Stirling trained and

registered design auditors Organisations using this tool may state in publicity that they “have referred to and utilised dementia-friendly design materials produced by the University of Stirling” No further assertions may

be made in any publicity or published materials without the express consent of the University of Stirling.The guidance and advice presented in this document is compiled from research evidence, international design literature and observation of implemented best practice It has been produced by the University of Stirling with due diligence and in good faith However the University of Stirling cannot be held liable for design or operational decisions made by users of this material resulting from the contained advice

This tool assesses only the environment in terms of suitability for people with dementia, it does not evaluate quality of care

For further information contact:

Dementia Services Development Centre

Iris Murdoch Building

MobileEmail:

NHS Dumfries and Galloway: Dementia Design Audits Annan Community Hospital

NHS Dumfries & Galloway Annan Hospital

Martin Quirke

13 Feb 2017

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1.1 R The entrance to the unit is clean

1.2 R The entrance to the unit is welcoming

1.3 R The entrance to the unit is tidy

1.4 R The entrance to the unit is well lit

1.5 E There is good access for those with physical or mobility problems including wheelchair users Observe: Handrails; lift; ramp; height and accessibility of door handles; disabled parking spaces near building

1.6 R There is seating to provide opportunities for rest

1.7 R The door entry system is discreet Observe: Alerting staff but not ringing out to disturb patients/people with dementia

Corridors

1.8 E The colour and tone of the floor covering contrast with the colour and tone of the furniture

1.9 E The colour and tone of the floor covering contrast with the colour and tone of the walls

1.10 R The skirting contrasts with both the floor and walls Observe: contrasting skirting or capping strip

1.11 E The flooring is consistent in colour/tone throughout including threshold strips

Fire doors held open in corridors need a strongly contrasting edge if they are not flush with the wall

1: Entrance, corridors, wayfinding and lift

Bell noise appears to be limited to non-patient reception area only

In a majority of areas the main flooring material appears to lack sufficient contrast with adjacent walls However, this is partly offset by contrasting skirtings and architraves

Darker Floor edging strips to corridors provide undesireable contrast to the main flooring materials Tonal continuity would be preferable to reduce the risk of falls

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1.13 R Large-patterned floor coverings have been avoided

1.14 R Strong wallpaper patterns have been avoided

1.15 R The space has good levels of natural lighting

1.16 R Glare from natural lighting can be managed

1.17 R The space has good levels of artificial lighting

1.18 R The lighting can be controlled according to the time of day

1.19 R Ceilings, floors, floor coverings, are sufficiently sound absorbent to support communication

1.20 R All corridors lead to meaningful places Observe: Dead ends have been avoided or made interesting

1.21 R Corridors are wheelchair accessible

1.22 R Corridors are of varying widths

1.23 R Corridors have interesting items on the walls in order to provide focal points of interest

1.24 R There is seating at frequent intervals to provide opportunities for rest

1.25 R There are comfortable handrails to give both physical assistance and a sense of direction/distance

All corridors tend to lead to locked doors, storage rooms, or Staff-Only spaces etc

Some frame images are located on walls, but the number of these could be increased somewhat

Seating is only available within the day room (and in the reception area located outside

of the locked ward area)NHS Dumfries and Galloway: Dementia Design Audits Annan Community Hospital

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1.26 R Corridors are well lit

1.27 R Corridors are evenly lit

1.28 E Notices and leaflet racks are located away from patient areas They should be located where staff, relatives and patients without dementia can see them such as in alcoves or entrance areas

1.29 R Nurse alarm call systems are discreet, alerting staff but not otherwise disturbing patients/people with dementia

1.30 R Edges to steps are clearly delineated for safety Observe: Nosings are clearly contrasted with the treads and riser

Rooms from corridors

1.31 R Doors open easily with minimal physical effort

1.32 E Doors open against the wall to allow a full view of rooms

1.33 E Doors to day rooms are unlocked

1.34 R Doors to bed areas are not directly opposite, facing each other

1.35 R The colour and tone of the door handles contrasts with the colour and tone of the doors

1.36 R Handles are comfortable and easy to use

The corridor appears to have high levels of good quality LED lighting installed recently

No instances of call alarm were heard by the auditor during the survey visit

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1.38 R Staff facilities are located where they do not cause noise for patients Observe: Nurses’ station; staff sitting room

1.39 R Service areas such as machine room are located where they do not cause noise for patients

1.40 R Doors to staff-only facilities are well concealed Observe: Doors are the same colour as the walls; skirting or handrail extends along the door with no or minimum door furniture

Wayfinding and signage

1.41 E There is clear signage to help wayfinding for everybody

1.42 E There is a contrast between the colour and tone of the writing on the sign and the colour and tone of the background of the sign

1.43 E There is a relevant, easy to understand picture or graphic image as well as words on each sign

1.44 E There is a contrast between the colour and tone of the background of the sign and the colour and tone of the door/wall

1.45 R Signs are fixed to the doors they refer to, not to adjacent wall surfaces, except where they are needed for directions

1.46 E The bases of all signs offering wayfinding for patients are around 4 feet/1.2 metres from the ground Measure

1.47 R There is extensive use of glass to show what is behind doors and walls and to increase visibility Observe: Glass is not covered

1.48 R There are landmark objects such as memorabilia and art to aid wayfinding

An image is provided on many Toilet Signs but not signage to other spacesNHS Dumfries and Galloway: Dementia Design Audits Annan Community Hospital

Majority of signs relevant to patients are located too high on the wall or door to which they areattached Staff-only signs should be removed where possible, and placed very high up if not

Glazed elements are provided within main circulation doors, within the walls looking into day spaces and ward bed areas (with blinds for times when these are needed)

Little distinction is made between doors to different kinds of spaces

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1.49 R The interior is calming e.g the lining is pastel coloured, not reflective or shiny

1.50 R The flooring matches that of the adjacent landing

1.51 R The lighting is bright, but glare-free and uniform

1.52 R There are no mirrors or reflecting surfaces

1.53 R A sensor keeps the doors open until people reversing in wheelchairs are safely inside the lift

1.54 R Button controls are large and clear and contrast with the door frame

1.55 R Lift is not in the bed areas

1.56 R Lift is not on the adjoining wall of a bed area

Unit 1

subtotal Essential (out of 13):

Recommended (out of 35)

Are any of the positive design features compromised by the observed use of space e.g inappropriate storage,

signs or windows covered, access obstructed?

NOT APPLICABLEN/A

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2.1 R There is no large nurses’ station for the whole ward

2.2 R There is a small reception desk

2.3 R There is seating by the reception desk

2.4 R There are small desks/tables and seats for staff to undertake written work near the single rooms

2.5 R There are small desks/tables and seats for staff to undertake written work in the bays

2.6 R There is a separate office, not visible to patients

Unit 2

subtotal Essential (out of 0): Recommended (out of 6):

Are any of the positive design features compromised by the observed use of space e.g inappropriate storage,signs or windows covered, access obstructed?

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3.1 R The entrance is clean

3.2 R The entrance is welcoming

3.3 R The entrance is tidy

3.4 R The entrance is well lit

3.5 E There is good access for those with physical or mobility problems including wheelchair users Observe: Handrails; lift; ramp; height and accessibility of door handles; disabled parking spaces near building

3.6 R There is comfortable seating

Corridors

Although some contrast is provided between walls and floor, this appears to be less than the 30% difference in Light Reflectance Values required for good dementia design

The floor boarder strip contrasts too much against the main areas of flooring material

Ok However it should be noted that a large proportion of flooring throughout has a 'speckled' patination across it This is not recommended Solid colours are ideal

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oom 3: Waiting room

3.13 R The space has good levels of natural lighting

3.15 R The space has good levels of artificial lighting

3.19 R Staff facilities are located where they do not cause noise Observe: Nurses’ station; staff sitting room

3.20 R Service areas such as machine room are located where they do not cause noise

Unit 3

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Bed ar

General

4a.1 E The colour and tone of the floor covering contrast with the colour and tone of the furniture

4a.2 E The colour and tone of the floor covering contrast with the colour and tone of the walls

4a.3 R The skirting contrasts with both the floor and walls

4a.4 E The flooring is consistent in colour/tone throughout including threshold strips

4a.5 R Large-patterned floor coverings have been avoided

4a.6 R Strong wallpaper patterns have been avoided

4a.7 R Ceilings, floors, floor coverings, are sufficiently sound absorbent to support communication

4a.8 R The room is made recognisable by easy visibility of the bed

4a.9 E The entrance to the patient’s bed area is differentiated Observe: Doors should have a picture or motif on them to make each room door different

4a.10 E Where possible, there are personal items by the patient’s bed

4a.11 R The door to the bed area is easy to open, the handles comfortable and easy to use

Lighting

4a.12 E The room can be made dark overnight but there is an optional facility for very low-level lighting

4a: Bed area: single room

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Bed ar

4a.13 R There is a soft light in the en suite which can be left on if necessary

4a.14 R There is a mechanism to facilitate night-time checks by staff without disturbing sleep Observe: A discreet dimmer switch by the door; a discreet switch by the door to an ultra low output lamp;

a torch made available in the corridor

4a.15 R The room has good levels of natural lighting

4a.16 R Glare from natural lighting can be managed

4a.17 R The lighting can be controlled according to the time of day

4a.18 R There is good lighting over the bed/chair beside the bed

4a.19 R There is enough space for the visitor to remain while treatment is on-going Observe: Enough space at both sides of the bed

Windows/view

4a.20 R Window sills are low enough to be able to see out to the garden/balcony/roof terrace or street from a sitting position Assess by sitting down Observe: Furniture or foliage does not obscure the view

4a.21 R There are no screens or equipment blocking the window

4a.22 R There are light blinds to control glare

4a.23 R There are blinds or screens to allow dark conditions

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Bed ar

General features

4a.24 R The floors, floor coverings and ceilings minimise noise

4a.25 R Mirrors are well situated

4a.26 R Mirrors are designed to be removable or easily covered

4a.27 R Doors open easily with minimal physical effort

Eating area (in bed, bedside bed, at table)

4a.28 R Table should contrast with bedcover/floor Observe: Strong contrast

4a.29 E Crockery, glassware and cutlery contrast with table Observe: Strong contrast

Toilet wayfinding (en suite or alternative)

4a.30 R The individual has access to private en suite toilet facilities

4a.31 R There is not a sliding door

4a.32 R There is a sign on the door

4a.33 R The toilet can be made visible from the bed for those who need this cue

4a.34 E If there is no en suite toilet, there are toilet facilities nearby Observe: Toilet facilities

4a.35 E There is clear signage to aid wayfinding to the nearest toilet

In most but not all cases

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Bed ar

4a.36 E There is provision for relatives and friends to remain within or near bed areas for 24 hours if necessary Observe: place for folding bed or space for recliner chair

4a.37 E Large, analogue, accurate clocks are visible to all patients Observe Clocks in all bed areas visible to all beds

Unit 4a

The appears to be practicible only in the larger single room at the end of the corridor - this is an exemplary room is many respects

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Bed ar

General

4b.1 E The colour and tone of the floor covering contrasts with the colour and tone of the furniture

4b.2 E The colour and tone of the floor covering contrasts with the colour and tone of the walls

4b.3 R The skirting contrasts with both the floor and walls

4b.4 E The flooring is consistent in colour/tone throughout including threshold strips

4b.5 R Large-patterned floor coverings have been avoided

4b.6 R Strong wallpaper patterns have been avoided

4b.7 R Ceilings, floors, floor coverings, are sufficiently sound absorbent to support communication

4b.8 R The room is made recognisable by easy visibility of the bed

4b.9 E The entrance to the patient’s bedroom is differentiated Observe: Doors should have a picture or motif on them to make each room door different

4b.10 E In addition, for some people, there are personal items by the patient’s bed

4b.11 R The door to the bed area is easy to open, the handles comfortable and easy to use

Lighting

4b.12 E The room can be made dark overnight but there is an optional facility for very low-level lighting

4b: Bed area: bay

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Bed ar

4b.13 R There is a soft light in the en suite which can be left on if necessary

4b.14 R There is a mechanism to facilitate night-time checks by staff without disturbing sleep Observe: A discreet dimmer switch by the door; a discreet switch by the door to an ultra low output lamp;

a torch made available in the corridor

4b.15 R The room has good levels of natural lighting

4b.16 R Glare from natural lighting can be managed

4b.17 R The lighting can be controlled according to the time of day

4b.18 R There is good lighting over the bed/chair beside the bed

4b.19 R There is enough space for the visitor to remain while treatment is on-going Observe: Enough space at both sides of the bed

Windows/view

4b.20 R Window sills are low enough to be able to see out to the garden/balcony/roof terrace or street from a sitting position Assess by sitting down Observe: Furniture or foliage does not obscure the view

4b.21 R There are no screens or equipment blocking the window

4b.22 R There are light blinds to control glare

4b.23 R There are blinds or screens to allow dark conditions

4b: Bed area: bay

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Bed ar

General features

4b.24 R The floors, floor coverings and ceilings minimise noise

4b.25 R Mirrors are well situated

4b.26 R Mirrors are designed to be removable or easily covered

4b.27 R Doors open easily with minimal physical effort

Eating area (in bed, bedside bed, at table)

4b.28 R Table should contrast with bedcover/floor Observe: Strong contrast

4b.29 E Crockery, glassware and cutlery contrast with table Observe: Strong contrast

Toilet wayfinding (en suite or alternative)

4b.30 R The bay has adjacent toilet facilities

4b.31 R There is not a sliding door

4b.32 R There is a sign on the door

4b.33 R At least one bed should have the toilet visible from the bed

4b.34 E If there is no adjacent toilet, there are toilet facilities nearby Observe: Toilet facilities

4b.35 E There is clear signage to aid wayfinding to the nearest toilet

4b: Bed area: bay

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Bed ar

4b.36 E There is provision for relatives and friends to remain within or near bed areas for 24 hours if necessary Observe : Is there provision for an overnight stay?

4b.37 E Large, analogue, accurate clocks are visible to all patients Observe Clocks in all bed areas visible to all beds

Unit 4b

4b: Bed area: bay

Limited, but possible

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En suit

General features

5.1 E The colour and tone of the door contrast clearly with the colour and tone of the adjacent walls

5.2 E The colour and tone of the floor covering contrast with the colour and tone of any furniture

5.6 R Strong patterns on the wall finishes have been avoided

5.7 R Ceilings, floors, floor coverings, are sufficiently sound absorbent to minimise noise and support communication

5.8 E There is a sign on the door to aid wayfinding

5.9 R There are a minimum of two artificial lights in the room

5.10 E Wall colours are warm and light to maximise light levels

5.11 E Ceramic wall tiling or waterproof lining materials are domestic in appearance

5.12 E The colour and tone of the tiling/wall contrast clearly with the colour and tone of sanitary fittings

5: En suite or adjacent toilet provision

OK in many, but not all ensute spaces

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En suit

5.13 E The colour and tone of the tiling/wall contrast clearly with the colour and tone of grab rails

5.14 R Grab rails are comfortable to grip

5.15 R The room is homely

5.16 E The room does not smell unpleasant

5.17 R Extractor fans are quiet

Toilet area

5.18 E The colour and tone of the toilet seat contrast clearly with the colour and tone of the toilet bowl

5.19 E The colour and tone of the toilet seat contrast clearly with the colour and tone of the floor

5.20 R Cisterns are traditional in appearance

5.21 R Lever handles or pull chains contrast in colour/tone and tone with the cistern or background wall

5.22 E There are domestic-style toilet roll holders

5.23 E Toilet roll holders contrast clearly with the background wall (or contain contrasting coloured toilet rolls)

Most soap, towel and toilet roll holders etc are commercial / medical type, so unlikely to be familiar to older people with dementia

Toilet Cisterns generally of the concealed type, making the WC less recognisable to people with dementia

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En suit

5.24 E The toilet roll is within easy reach of the toilet Observe: Location/height Assess by sitting on toilet

5.25 R There is adequate space for transfer to toilet from wheelchair or hoist, especially when two carers are required

Wash hand basin area

5.26 R Wash hand basin taps are recognisable in appearance (e.g cross-head)

5.27 R Wash hand basin taps are simple to operate

5.28 R Wash hand basin taps have clear indications to help people understand which is hot and which is cold

5.29 R The mirrors are well positioned Observe: Location/height (e.g over wash hand basin)

5.30 R The mirrors are designed to be removable or easily covered

Shower/bath area

5.31 R There is convenient shelving close by for toiletries

5.32 E Shower/bath controls are simple to operate

5.33 E Shower/bath controls have clear indications to help people understand which is hot and which is cold

5.34 R There is provision in place to maintain privacy while showering (e.g shower curtain)

Extended lever taps used in many cases

Some taps have more challenging controls (eg Single action for all functions)

Mirrors are generally not easily removed or covered

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Communal facilities

General communal toilet/bathroom features

6.1 E The colour and tone of the door contrast clearly with the colour and tone of adjacent walls

6.2 E There is a sign on the door to aid wayfinding

6.3 E The room is made recognisable through the visibility of bathroom fittings and other items such as shampoo and towels

6.8 R Strong wall finish patterns have been avoided

6.10 R The room has good artificial lighting

6.11 R There are a minimum of two main artificial lights in the room

6.12 R The main light fitting is not placed directly over the bath

6: Communal toilets/bathrooms

Too much contrast exists at thresholds and transitions to other flooring areas

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Communal facilities

6.13 E Wall colours are warm and light to maximise light levels

6.14 E Ceramic wall tiling or waterproof lining materials are domestic in appearance

6.15 E The colour and tone of the tiling/walls contrasts clearly with the colour and tone of sanitary fittings

6.16 E Tiling and wall colours contrast clearly with the grab rails

6.17 R The room is homely

6.18 E The room does not smell unpleasant

6.19 R Grab rails are comfortable to grip

6.20 R There is adequate space for transfer to the toilet from a wheelchair or hoist, especially when two carers are required

Toilet area

6.22 E The colour and tone of the toilet seat contrasts clearly with the colour and tone of the toilet bowl

6.23 E The colour and tone of the toilet seat contrasts clearly with the colour and tone of the floor

6.24 R Cisterns are traditional in appearance

Wall colours appear to be tonally too light relative to the light coloured sanitaryware

Contrast is available in handfull of instances, but not generally

Sufficient contrast provided in some cases, but not always

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Communal facilities

6.25 R Lever handles or pull chains contrast in colour/tone with the cistern or background wall

6.26 R There are domestic-style toilet roll holders

6.27 R These contrast clearly with the background wall (or contain contrasting-colour toilet rolls)

6.28 E The toilet roll is within easy reach of the toilet Observe: Location/height Assess by sitting on toilet

Wash hand basin area

6.29 R Wash hand basin taps are recognisable in appearance (e.g cross-head)

6.30 R Wash hand basin taps are simple to operate

6.31 R Wash hand basin taps have clear indications to help people understand which is hot and which is cold

6.32 R Noisy hand-dryers have been avoided in favour of towels Observe: Listen to the sound of the hand- dryer

6.33 R Mirrors are well situated

6.34 R Mirrors are designed to be removable or easily covered

Shower/bath area

6.35 R There is convenient shelving close by for toiletries

6.36 E Shower/bath controls are simple to operate Try out

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Communal facilities

6.37 E Shower/bath controls have clear indications to help people understand which is hot and which is cold Observe: Are the controls easy to understand with clear colour contrast?

6.38 R There is a shower/bath curtain to provide privacy

6.39 R The floors, floor coverings and ceilings are designed to minimise noise

Unit 6

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ADL k

7: Physiotherapy and occupational therapy room

General examination room features

7.4 E The flooring is consistent in colour/tone and tone throughout including threshold strips

7.7 R The room has good levels of natural lighting

7.9 R The room has good levels of artificial lighting

7.11 R If there is an ADL kitchen area, it has glass fronted cupboards or open shelves

7.12 R Taps and other equipment are easy to understand

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7: Physiotherapy and occupational therapy room

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General lounge features

8.7 R The room has good levels of natural lighting

8.9 R The room has good levels of artificial lighting

8.11 R The room should be recognisable as a place for sitting comfortably, with lounge chairs and coffee tables, pictures on the walls and cupboards

8.12 E The room should be recognisable as a place for eating or activities with tables and chairs

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8.13 E No more than ten people should sit and eat together

8.14 E There are extra/enough seats for staff interacting with patients at mealtimes

8.15 R Table layout is designed to allow patients to eat alone if required

8.16 R Crockery/cutlery are of traditional design

8.17 R Crockery, glassware and cutlery contrast in colour/tone to table and/or background surface Observe: Crockery is not childish or unrecognisable

8.18 R Ceilings, floors and floor coverings should absorb sound as much as possible to support audible communication Observe: is there a lot of reverberation?

8.19 R There are sufficient ‘domestic-style’ light fittings to help promote a recognition of place

8.20 R Décor is age-appropriate and culturally sensitive

8.21 R The room is small and homely

8.22 R There is a range of furniture suitable for the needs of all, including chairs of different heights/depths

8.23 R Furniture design/placement enables, rather than restrains, patients Observe: Depth of seat; position of tables and seating

8.24 R Window sills of the main windows are low enough to be able to see out to the garden or street froma sitting position Assess by sitting down Observe: Furniture or foliage in the garden does not obscure the

view or the natural light

A mixture of crockery appears to be available

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