Strategic Improvements Project
...making better places to live step by step
Background Aged care providers have a dilemma. In conversation, many outline a desire to maximise the independence of residents, but recognise that much of their building stock fails to achieve this aim. The provider cannot justify replacing buildings, which are profitable due to high occupancy resulting from good management or lack of competition. Thus upgrading of facilities does not proceed, often on the basis that a building will be replaced in the future and investment in substantial renovations cannot be justified. The buildings are kept. Few changes are made. The home and lives of residents are not improved. Buildings can stay in this limbo for decades.
The research exists The problems with the buildings are known. A substantial body of research has existed for over thirty years addressing how buildings can support people affected by dementia, sensory impairment and other personal constraints common with ageing (for example see Fleming and Calkins). Providers express a wish to support residents being connected to the wider community, gain opportunities for access to outdoor areas and maintain a domestic life to the extent they are able. However, the research remains unapplied, environments fail to support these aims and buildings remain institutional.
Addressing systemic barriers to improving aged care facilities is about many small actions Systematic barriers to the improvement of aged care facilities clearly exist: the gap between research processes and service provision; the perception that facility improvement is an "all or nothing" proposition; the exclusion of operational staff from property decisions; and a range of other impediments to action.
We believe that the first step is to establish a process for sequential upgrades to an existing site with the funds (even small amounts) available at any point in time.
Survey/fix approach The survey/fix approach, developed by Paul Pholeros and Housing for Health, aims to only survey buildings (to identify detailed issues) once initial funds are designated and available for immediate action. Smaller projects can be set up as a sequence of works and to the extent that will be affordable. It avoids one of the systemic barriers to improving buildings: time, cost and emotional energy otherwise wasted on large scale master planning exercises. The focus is kept on work that affects resident's quality of life.
Retaining the building-wide perspective of traditional masterplanning Over the past 15 years we have seen (and been involved in) numerous materplans that were rigorous and detailed, but never applied. The process outlined below maintains a focus on action, while retaining the building-wide perspective of a masterplan. Each issue relevant to the upgrade is addressed on a range of scales (building, room and fixture/detail) and documentation reflects each level of scale. However, the energy and funds are focused on the point of action (the upgrade or refurbishment work). The process can be distilled into the following steps.
• STEP 1 (Consultation and Fund Designation): Consult with a project team of senior management and centre-specific staff (property, operations and ideally resident representatives) to establish key property-related objectives and design principles (building-related issues that impact on resident quality of life and staff support). Examples of a set of design principles are shown below. At this time we develop benchmarks for a successful outcome and gain direction from organisational executive on the funds available for work on each facility and prepare a business case for the work.
• STEP 2 (Survey): Meet with centre management to discuss general concerns, adjust the design principles developed in Step 1 and audit the facility to test the extent to which each design principle is being achieved (and identify other general problems). The outcome is a list of works required for the design principle to be met that is then prioritised by the project team.
• STEP 3 (Fix): Carry out the designated work and document the process for review and further application on other sites.
• STEP 4 (Evaluate): Test the impact over a 6-12 month period against the benchmarks and reconsider the design principles with the project team for the next stage of work on each site.
Moving forward This process allows an organisation to develop an a alternative, flexible form of Masterplan for the site and an organisation-wide Building Design Guide based on real life experiences within their organisation. This can become a repository of knowledge within an organisation, enabling lessons to be taken from one project to the next. We use a methodology of documenting design issues as Design Ideas in the form shown below and elaborated further with the Past Projects shown on this website.
Many of the 185,000 Australians in residential aged care live in poor conditions. A substantial body of research has established the design requirements to best support people with dementia, sensory impairment and other personal constraints common to aged care residents. Yet, few facilities effectively support the basic needs, of residents let alone the more sophisticated social programs offered by innovative providers. The Strategic Improvements Project provides a four step building renovation program. It ensure that even small amounts of funding can be directed to incrementally upgrade existing facilities, thereby improving the lives of residents.
Constructive Dialogue Architects
Constructive Dialogue is an architecture firm focused on supporting aged care and other social programs with architectural, strategic planning and project management services. READ MORE