Designing better mental healthcare facilities

A ‘sheltered retreat’ for Dorset’s new specialist eating disorder unit

Sited in a protected wooded glade, Kimmeridge Court at St Ann’s Hospital in Poole has – say its architects, Medical Architecture – been carefully crafted to preserve the quality of its natural setting and ‘create a uniquely private and therapeutic environment for the treatment of patients with eating disorders’.

Built by Kier for Dorset HealthCare University NHS Foundation Trust, the new £8 m inpatient unit provides specialist accommodation to meet a growing demand. Eating disorders are responsible for more loss of life than any other mental health condition, and are becoming increasingly common both in the UK and worldwide. In England, hospital admissions for eating disorders reached over 24,000 in 2020-2021, while in Dorset, the All Age Eating Disorders Service saw a 53% year-on-year increase in admissions rom 2020/2021 to 2021/2022.

Medical Architecture said: “While nationally there is a shortfall in beds for eating disorders, the completion of Kimmeridge Court will increase the Trust’s capacity for specialist care from six to 10, ensuring patients can receive treatment closer to home and their support network. Treatment for eating disorders can be difficult, with some patients exhibiting covert interference behaviours to ‘sabotage’ treatment, such as overactivity, self-induced vomiting, and weight falsification. Staff observation is thus critical to treatment, but can be challenging to achieve while protecting patient privacy and dignity. The new building addresses these challenges, with expanded and improved facilities including inpatient bedrooms, clinical and therapy spaces, and sensitively designed living spaces.

The building is located within the grounds of the Grade II* Listed St Ann’s Hospital on the Dorset coast, near Sandbanks, with its size and positioning ‘carefully crafted’ to have a low impact on the mature coastal trees that occupy the site and respect the surrounding area’s character. The larger two-storey volume is set back from the site boundary and adjoining road, reducing in scale to single-storey as it approaches the street frontage. An irrigated root-protecting foundation design lifts the building above the roots of the large mature Category A trees, which enabled their retention remarkably close to the new building.

Bedroom accommodation and patient day spaces are co-located on the ground floor, with eight inpatient beds and two high-dependency beds. The transparent day spaces have views out to an accessible landscaped garden and the surrounding woodland. Staff and therapy rooms occupy the first floor, with a large multi-functional activity space providing spectacular views out across the tree canopy.

Spaces that support the treatment of eating disorders

Through close consultation with clinical staff, the facilities have been designed to enable patients to re-establish a positive relationship with food and exercise. An Activities of Daily Living (ADL) kitchen area allows patients to practice meal preparation and cooking in an environment that mirrors everyday life, while group therapy spaces are immediately accessible from the dining space. Sliding doors allow these key shared spaces to be opened up to promote social connection, or separated for more private, focused activity.  A private outdoor garden provided as a therapeutic space has been designed to limit opportunities for excessive exercise, a common treatment interference behaviour. If a patient’s treatment requires access to the outside space to be restricted, large areas of glazing provide expansive views to the garden from the lounge and the activity room.

Patients are encouraged to spend time in their bedrooms, which have been designed to be a comfortable space for relaxation and reflection. Bay windows provide a place to sit and enjoy the trees of the wooded glade while allowing light deep in. The bedroom layout, and the ward plan with central staff base, allow observation to be maintained with efficient staffing levels, without compromising patient privacy. The generous corridors are designed as an additional room, providing informal places to sit, rest, and chat, with other patients and the clinical team. This is enhanced by careful location of rooflights to assist placemaking along circulation routes and within the staff base. Anti-ligature measures have been ‘thoughtfully and discreetly integrated to create a calming environment resembling a domestic setting’, while natural materials and neutral colours throughout the interior complement the views to nature. Large areas of glazing and rooflights provide natural light to reinforce circadian rhythms and reduce the need 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 for the treatment and care of vulnerable patients’.  The external landscaping is permeable and designed to reduce surface run-off, retaining as much rainwater on the site as possible, to irrigate the existing and newly planted trees and shrubs, while mitigating local flood risk at times of extremely high rainfall. The extensive canopies of the retained mature trees provide good shade and shelter from extreme future climate effects.

Jess Griffiths, Eating Disorders Therapist, and a former eating disorders service-user at St. Ann’s Hospital, said: “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.”

 

 

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