Junction 17 Andrew Arnold, Gilling Dod

1. 25TH June 2014, Manchester
Andrew Arnold - Director

2. - Over 135 years in Practice
- Two offices, 58 qualified staff, including
in-house Interior designers
- Over 45 years in the Healthcare sector
- 2 Offices in Chorley and Liverpool
- Member of 5 supply chains under P21+
- Over £760m of live or completed work
Healthcare building spread over 60+
Projects nationwide.
- Over £450 million of live/completed
Specialist healthcare/Mental Health work
undertook in the last 6 years.
Who are we?

3. Current Projects
• North Staffordshire NHS Trust Major redevelopment
• Project Arizona, Walton Centre, Liverpool
• Whole site Redevelopment of Blackpool Victoria Hospital
• Warrington and Halton Hospitals NHS Foundation Trust redevelopment
• The Harbour, LancashireCare NHS Foundation Trust
• Broadmoor Hospital Redevelopment, West London Mental Health NHS Trust

4. Mental Health experience
Specialisms;
- Adult Acute inpatient units
- Rehabilitation Services
- Dementia
- CAMHS (Child and Adolescents Mental Health Services)
- Personality Disorder
- Learning Disabilities
- Psychiatric Intensive Care (PICUs)
- Assessment and Treatment
- Community Mental Health Services
- Low/medium/High Secure Services
- Forensic Services
- DEAF Services
- Step Down Services
- Drug and Alcohol Services
- Assisted Living
- Eating Disorders
- Challenging behaviours

5. CAMHS
• Tier 4 CAMHS services work to help young
people with significant mental health needs
and who may pose a high risk to themselves
and others.
• Patient group - young people with serious
mental illness including psychosis, bipolar
disorders, eating disorders, dual diagnosis
and emerging personality difficulties.
• Other issues – anti-ligature, self-harming
behaviour, mood disorders, safeguarding
issues, psychosis and poor coping skills such
as misusing substances.
• Support in daily living skills such as cooking,
budgeting and shopping as well as more
formal psychological therapies such as
cognitive-behavioural therapy, family therapy
and art and music therapy.
• Age range 13-17

6. Client
• GMW provides district mental health services in
Bolton, Salford and Trafford, both inpatient and
community-based means.
• The Trust also provides inpatient alcohol and drug
recovery services in Prestwich as well as community
services in Trafford, Salford, Cumbria, Wigan and
Leigh, Blackburn with Darwin and Central
Lancashire.
• GMW also provides secure services for adults across
the wider North which include a range of care
pathways.
• Standardised components, Continuous PPE,
shared r+d/testing
• Long term relationship with GDA

7. The McGuinness Unit
Key issues;
• Significant Ligature risks
• Privacy and dignity issues
• Absconding issues
• Lack of therapy space/activity areas
• High levels of serious incidents/flash points
• Stigma
• High re-admittance levels
• Poor staff morale/retention
• Insufficient beds so out of area placements
• Overheating/cold/dark/stuffy
• Acoustics problems/ fire risks
‘Don’t call me crazy’ tv programme.

8. Existing Site / Unit / Context.
Site of the proposed new buildExtg McGuinness unit to be demolished
Site

9. Site Constraints plan
Site topography

10. Design Approach
• Service User engagement key
• Tailor to the audience
• Role plays / games / workshops
• Interactive and fun
• On their patch
• Win their confidence
• Don’t patronise
• The Arts as an outlet
……bribery works!

11. Key outcomes / debates - brief development
• What is an institutional design?
• How do YP use their environment?
• Activity driven spaces
• Respect / dignity / transparency
• Sensible approach to risk
• Mixed gender living
• Stigma in particular Eating Disorder sufferers
• Choice, interaction and retreat
• Ownership
Who
What
WhenWhy
How
Develop the brief

12. Typologies – form, flow and scale

13. Site plan

14. Upper Ground floor plan

15. Lower Ground floor plan

16. Key Design tools
Building as enclosure
Fluid circulation, flowing lounge spaces
Curved form masks scale / views out
Multiple circulation options
Curved corridors mask scale
Extra- care areas not PICU.
Immediacy of garden
spaces
Clustered activity spaces
Boundaries and thresholds

17. Key areas
Bedroom and En-suites
Dining areas
Sight lines
Discrete observation
Access
Access
boundaries
Sight lines and observation.
Snugs and break
out spaces
Views out
Access

18. Aesthetics/imagery
Look of the building, dynamic, movement, boat/sails?, distinctive, interest, layers, stimulation
3d printing to show form/context

19. Aesthetics/imagery

20. Role of interior design
Rebranding the service, welcoming
reception, first impressions, Arts
projects, naming competitions, poetry,
Signage and motifs, photography,
Ownership and sense of place.

21. Structural challenges

22. Construction
Site works begin March 2012

23. Finished building
Phase One H/O June 2013. Phase 2 Oct 2012

24. Finished building

25. Finished building

26. Finished building

27. Finished building

28. Official openingDecember 2013
Olympic champion - Dame Kelly Holmes

29. Post project evaluation – June 2014
Improved Quality of Clinical Care ;
• Reduction in recorded incidents incl safeguarding incidents
• Improved therapeutic milieu
• Reduced lengths of stay
• Improved education engagement
• Reduced acute escalations (ie via new time out areas/observation)
• Improved Privacy and dignity incl gender issues
• Better intensive nursing outcomes
• More dignified/controlled admissions facilities
• Closer/more efficient clinical adjacencies
Improved Patient environment ;
• Appropriate colour schemes / interior design
• Activity led spaces
• Immediacy/accessible garden spaces
• Choice and variety of activity/therapy spaces
• Light and airy spaces
• No fences/invisible security
• Improved meet and greet/visitor facilities

30. Post project evaluation – June 2014
Safety and Security ;
• Built in robustness
• Reduced incidents of absconding in the last 12 months (previously a huge issue)*
• Reduced incidents of self harming in the last 12 months
• Reduced instances of Fire Alarm triggering
Miscellaneous;
• Reduced use of out of area placements
• Reduced incidents of YP in Adult MH facilities
• Better overlap with Tier 3 CAMHS
• Improved staff facilities
• Improved staff morale, pride, retention/recruitment
• Improved Service reputation, Identity, perception
• YP ownership in environment eg Personalised gardens
• *change in staff focus (ie less keeping YP in, now helping YP recover)
• Reduced Revenue costs (Cost per bed per day etc)
• 40% reduction in energy costs
• Reduced maintenance costs

31. Legacy…
New Low Secure Unit – due on site in November 2014
New Recovery Academy – currently out to tender.
Design Project of the Year – DMHN conference 2014
Next phase of development - Future
replacement Gardner Unit. 2015

32. Design evolution…….
Above – CAMHS unit for Lancashire Care NHS Trust, Preston
Below – CAMHS unit for Lincolnshire Partnerships NHS Foundation Trust
Right - Evolved bedroom/en-suite design
Above - CAMHS unit for Black Country Partnership NHS Trust. Dudley
Plus CAMHS Projects for Nottinghamshire Healthcare NHS Trust and
Cheshire and Wirral Partnership NHS Foundation Trust.

33. Reflections/critical success factors
• Importance of design Champions
• Sensible risk debate
• Repeatable design data
• Continuity
• Empathy
• Brave client / Experienced Design team
• Enlightened Contractors
• Meaningful End user engagement
• Ownership by the End users

34. Thank you
www.gillingdod.com