Designed by Medical Architecture and built by Kier for Dorset HealthCare University NHS Foundation Trust, the £8m inpatient unit at St Ann’s Hospital in Poole, provides specialist accommodation to meet a growing demand for the service and to prevent vulnerable patients being moved away from their loved ones. Laura Delgado, lead architect, said: “Eating disorders are mental health conditions which require specialist treatment and it was very important that we engaged with the trust and service users from the very beginning of the design process to find out their specific requirements. “Ultimately, we wanted to create a building which was focused on encouraging a positive relationship with food, so all the spaces needed to be very carefully designed.”

A FRESH APPROACH

The site for the new building was in a wooded area with several large, protected trees and a Grade II-listed building. And the design team carefully worked around these site constraints, creating an environment which is helping to change the way mental health support for people with eating disorders is provided. Built over two storeys, the ground floor houses eight inpatient bedrooms and two high dependency bedrooms, each with its own ensuite, as well as communal spaces, therapy areas, and dining spaces. And it is these dining areas which were central to the design approach. Delgado explains: “The dining spaces are key as they are one of the more-challenging spaces in treatment, and where patients experience the most distress. “We wanted the main dining area to be peaceful, with lots of daylight, but we also wanted patients to feel safe and not like they were being very closely observed.

HELP AT HAND

“The food preparation and dining spaces have been designed so that patients are able to receive as much help as they need from staff at the beginning, but as they move on in their recovery, they can become more self-sufficient and can prepare food themselves. “There is also a therapeutic kitchen, where occupational therapists work with patients to create a more-positive relationship with food. “This space has been designed to look much more like a typical kitchen you would find in your home and there are therapy and activity areas where patients can talk about their feelings.” Group therapy spaces are immediately accessible from the dining space to enable workshops to take place, in which feelings about eating are shared and explored. And sliding doors allow these key shared spaces to be opened up to promote social connection, or separated for more-private, focused activity. Bedroom spaces, too, have been carefully designed to encourage patients to spend time there and to prevent common interference behaviour which can be used by patients to ‘sabotage’ treatment. Delgado said: “All bedrooms have views out into the gardens and each has its own ensuite.

PERSONAL AND PEACEFUL

“These are designed to protect the privacy of patients while still allowing staff to passively monitor behaviour. “The clinical team wanted to encourage patients to take rest in their bedrooms as much as possible to avoid overactivity, so we have designed a comfortable space with tree-view window seats to create a feeling that bedrooms are personal, peaceful spaces.” The layout of the bedrooms, and the ward plan with a central staff base, allows observation to be maintained with efficient staffing levels, without patients feeling their privacy has been compromised. Delgado said: “Corridors are not just corridors, there are informal seating spaces built in. “These areas provide opportunities for informal chat with staff, making the corridors a functional space. “The shape of the building, taking in the protected trees, lends itself well to this approach, enabling us to create spaces of refuge outside of the clinical areas, punctuated with good daylight and meaningful views.”

A FINE BALANCE

Bob Wills, director at Medical Architecture, adds: “This project was about creating a fine balance between necessary observation and privacy and dignity, and that is one of the biggest challenges we face as designers of mental healthcare facilities. “We wanted to create private, relaxing spaces where patients can fully focus on their recovery journey, but also where staff are able to provide effective care. “The ADL kitchen, dining area, living spaces, and courtyard garden are one linear space, so the dining room is not the be all and end all. “Patients may be in the dining room, but visually they can move out and beyond that. You need to create that long view to something beyond themselves and beyond the confines of the physical space. “Working closely with the trust we have designed a place where patients can find sanctuary in an environment conducive to recovery-focused and high-quality care. “And, by integrating the building so closely with its natural setting, we have been able to fully harness the therapeutic quality of this fantastic site.”

NATURAL MATERIALS

While most of the patient facilities are located on the ground floor, the larger two-storey volume of the building is set

back from the site boundary and adjoining road, reducing in scale to single storey as it approaches the street frontage. The first floor houses therapy rooms, office spaces, and staff areas, with views into the tree canopy, including a large multi-purpose room with a spectacular framed view. To ensure safety and security, this upper floor can only be accessed by patients when accompanied by a member of staff. Throughout the building, natural materials and neutral colours have been used to complement the ever-present views to nature, with large areas of glazing and rooflights providing natural light to reinforce circadian rhythms and reduce the requirement for internal lighting. Externally, the design uses traditional materials found on the hospital site, such as brick and clay roof tiles, but details them in a contemporary manner, providing a modern and attractive setting. And the external landscaping around the building is permeable and designed to reduce surface runoff, retaining as much rainwater on the site as possible. This is to irrigate the existing and newly-planted trees and shrubs, while mitigating any local flood risk at times of extremely high rainfall.

CLOSER TO HOME

The extensive canopies of the retained mature trees also provide shade and shelter from extreme future climate effects. Commenting on the development, which recently opened to patients, Dr Carla Figueiredo, consultant psychiatrist at Dorset HealthCare University NHS Foundation Trust, said: “We’ve been long awaiting a modern, fit-for-purpose building, and now we have it — it’s beautiful. “With the expanded capacity, fewer of our patients will need to receive care away from their support systems, their family, and their community teams, and this will have such a positive impact on recovery. “I’ve looked at other units around the country and what we have created here makes me very proud.” Jess Griffiths, an eating disorders therapist and former service user at St Ann’s Hospital, added: “As soon as I walked into the new building, I actually welled up. I was so emotional because it is so beautiful, and it’s going to help so many people in their treatment. “I think the environment will facilitate so many more therapeutic activities, like supported eating and all the things you need to increase your chances of recovery.”

Project Team

Client: Dorset HealthCare University

NHS Foundation Trust

Architect: Medical Architecture

Contractor: Kier

Services engineer: TNG Consulting

Engineers

Structure and civil engineer: Godsell

Arnold Partnership

Arboriculture and landscape design:

Hellis Solutions

Ecological consultant: Darwin Ecology

Quantity surveyor: Gleeds