Independent Living and Design for our Ageing Population. Residential Healthcare. An overview of public practice in Ireland

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1 Independent Living and Design for our Ageing Population Residential Healthcare An overview of public practice in Ireland RIAI Healthcare Design Committee

2 The Healthcare Environment Historically Workhouse buildings re-used Nightingale wards Limited access to lower floors due to lack of lifts Inadequate sanitary facilities Poor heating, ventilation and insulation

3 Recent Past within the last 10 years Existing building stock extended and refurbished Multi-occupancy rooms (6 beds not uncommon) Limited en-suite facilities Large communal day and dining spaces model of care Large nurses stations ward type of arrangement Long un-interrupted circulation routes

4 Recent Past within the last 6 years New residential units are briefed and constructed Multi-occupancy rooms maximum now 4 beds Increased en-suite facilities Large communal day and dining spaces still common Large central nurses stations Catering from production kitchens delivered to ward pantries for serving Introduction of ceiling track hoists in some bedrooms & assisted bathrooms Increasing use of passive heating, ventilation, heat pumps etc Overall sense of a more healthcare rather than domestic environment HR

5 Recent Past within the last 4 years In 2006 a joint HSE and Prospectus Task Force report on the Assessment of Need for Residential Care for Older People identified the area of greatest deficiency in the provision of long stay, dementia and respite beds nationally In response to this a Programme was undertaken to tackle this deficit The new units marked a significant change in standards There were now 70% single rooms all with en suite facilities Single rooms allow for residents to bring some of their belongings with them

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7 Recent Past within the last 4 years An increased variety of day spaces available for residents Introduction of ceiling track hoists & other infrastructural supports in bedrooms, bathrooms etc The inclusion of a variety of Therapy Spaces Better access to outdoor space due to better vertical circulation and garden types

8 Recent Past within the last 2 to 3 years Introduction of a new Modal of Care Teaghlach Model was introduced A change from institutional to a person centred model; to encourage and allow for autonomy, privacy and choice The Household Model or small scale living was adopted Units are now grouped into households with increased numbers of single rooms, smaller day and dining rooms, individual front doors A choice of types of spaces; a sun room, a study, activity room, quiet room

9 Recent Past within the last 2 to 3 years Breaking down of circulation space to create incidental seating areas for a quiet moment or conversation Household kitchens serve as both focal points within the household and as therapy spaces Journeys within the unit to encourage normal everyday activities a trip to the hairdresser, the Physio gym, prayer room, multi-purpose room, snoozelan etc Increased number of single rooms with a less clinical feel and larger size HIQA National Quality Standards for Residential Care Settings for Older People in Ireland 2009

10 Recent Past within the last 2 to 3 years Breaking down of circulation space to create incidental seating areas for a quiet moment or conversation Household kitchens serve as both focal points within the household and as therapy spaces Journeys within the unit to encourage normal everyday activities a trip to the hairdresser, the Physio gym, prayer room, multi-purpose room, snoozelan etc Increased number of single rooms with a less clinical feel and larger size HIQA National Quality Standards for Residential Care Settings for Older People in Ireland 2009