Architects Douglas Jack and Matt Heaney from Holmes Miller look at how care home design has evolved in recent years to help to create a better environment for both residents and carers. 

It is a sad but inevitable fact that old age will come for us all. If you are lucky enough to make it to the ripe old age of 85, more than one in every six people reading this article will be a care home resident by then. It’s therefore in everyone’s interest that as a society we treat the elderly and most vulnerable with privacy, dignity and respect. 

The world turned upside down

As the world came to a standstill in 2020, nearly half a million people were living in care homes throughout the UK. Everyone connected with the industry had their life turned upside down. Staff were faced with the monumental task of facilitating care in the worst pandemic in a century, and residents, many of whom were active and enjoying life pre-pandemic, saw their daily lives grind to a halt.

But despite the challenges the pandemic has presented, it also allowed designers, architects and providers to reimagine the future of care. In Scotland, the Care Inspectorate is leading the way with its soon to be published guidance for applicants or existing providers of care home services, covering a range of areas, including planning and building standards requirements and infection control design. In England and Wales, similar guidance is under consultation and is expected to be published soon.

Against this backdrop of change, what role do architects play in helping residents continue living a healthy and active life, as well as empowering staff to provide the best care possible?

Designing for care

First and foremost, a care home is not a place to facilitate end-of-life care. It is a community of residents, carers and support workers, all working and living together in a close-knit environment. Care home staff are hugely passionate and dedicated people and as architects, everything we do has to be centred around the individual and improving care and wellbeing.

Many residents will spend the majority of their time inside, meaning that the visual interest in the interiors of care homes needs to be carefully designed to the highest standards possible. Care homes must have a homely and domestic feel, rather than being filled with dull and bland pastel colours. Colour is a powerful communication tool, triggering emotions and memories for care home residents. Rich colours and different materials can help stimulate the senses, especially as many residents with visual impairments cannot easily distinguish subtle colour changes. Not only is visual contrasting of colour, shapes and contrasts useful to make the interior more appealing to staff and occupants alike, but visual contrasting of colours is also proven to reduce agitated behaviour and can help those with dementia.

Creating multipurpose and communal rooms, where everything from cooking groups to movie nights and weekly quizzes can take place, are also great ways to help inspire staff and get them to connect with residents.

Other services and facilities that can be open to visitors, residents and the wider community can include everything from cinema rooms to champagne bars, and hairdressing salons to celebration rooms. Best-in-class care homes should have a range of activities and multipurpose rooms that residents and their loved ones can enjoy when spending time connecting in different settings.

Of course, no one can ignore the huge issues care homes experienced for large parts of the pandemic in managing visits. We were working with a care home provider in Scotland during 2020, and we had to quickly pivot our designs to build an accessible space that had two separate entrances – one accessible to residents and the other accessible to guests to facilitate visits during lockdown. Areas like this will have to be considered and included in new and future designs.

Connecting residents with the outside and community 

Providing access to the outdoors for exercise, fresh air and stimulation is a key tenant in modern care home design. The benefits of these are well documented and easy to understand.

Roselea Court Care Home (pictured below), for example, has landscaped gardens and even has a putting green where residents can enjoy non-strenuous exercise to remain active and let families connect in an outdoor setting, something which the pandemic has proven is much needed.

It may sound counter-intuitive but when outside space is limited – such is the case for many care homes in urban settings – interior design is a fundamental way of helping people connect with the external environment. By making fully thought through choices within spatial design, materials and lighting, you can create bright, open spaces that are pleasant to be in – both for residents and staff, as well as visitors.

Morrison Community Care’s development in Dalgety Bay (artist impression below) represents a state-of-the-art care home suitable for the post-COVID era. The day-to-day activities of residents have been uppermost in consideration. From the creation of small, self-contained, community groups within the wider home, and generous and attractive communal areas with access to external balcony space for each community group – something the Care Inspectorate included in its recent guidance, this project has it all. 

Designing for Net Zero

Creating more sustainable architecture is becoming an increasingly attractive prospect, particularly for funders, investors and local councils who are keen to promote green initiatives across their portfolios and estates. Not only is this the right thing to do for the environment, but with every business required to be net-zero by 2045 in Scotland (2050 in the rest of the UK), it makes commercial sense to design and build with these targets in mind to help future proof the building and reduce the need for work further down the line.  

Passivhaus design may not be a widely understood term in the care sector, but it will almost certainly become an industry standard for best-in-class buildings in the future. Essentially, Passivhaus is a voluntary standard for energy efficiency in a building, which reduces the building’s ecological footprint, resulting in ultra-low energy buildings that require little resources for space heating or cooling.

Being fully insulated drives down long-term operational running costs and the environmental impact of the building. In addition, designing ventilation systems to automatically transfer heat between the air being pumped out of the building and fresh air coming in can keep the atmosphere fresh and dry. This ensures good ventilation and a healthy environment all year round – a key issue for care home providers. It also includes the provision of triple glazed windows that can help eliminate draughts and keep heat in – a key concern for any building housing elderly residents.

Empowering care through design is one-way architects can help providers and councils improve the lives of residents, whilst reducing costs and cutting emissions. Good design is a win for all involved and there’s nothing stopping care providers from using design to create warm and welcoming spaces to provide residents with the dignity and quality of life they deserve.