Every potential site for this client group has its disadvantages. The two issues for the Chesham Community Hospital site of some concern were, the levels of the site which run in all directions and presented a significant challenge to the architects, and the hospital site being located at the top of a hill, which could present problems to people with reduced mobility. The first issue has been overcome by some very skilled and experienced architects whose efforts have been long and hard to ensure that the proposed building works with the existing land levels, rather than attempting to level large areas, with every effort also being made to ensure the building nestles unobtrusively into the site with maximum tree screening.
The challenge of the hospital being located on a hill will be overcome by a number of innovative operational policies. These will include the use of power assisted wheelchairs for use within the community, and appropriate disabled transport available to facilitate community access for patients.
In designing Cestreham House there were a number of criteria which had to be met. Firstly the physical requirements of the building set out as minimum standards by the National Care Standards. We will meet these requirements as a minimum and in much of the design we will exceed these requirements. Patient’s dignity and privacy was a further important consideration, single rooms each with full disabled toilet and bathing/shower facilities is essential. Further regard to dignity has been considered in the design of the units.
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Units of a maximum of 16 beds have been designed in such a way that there are 8 bedrooms, communal areas centrally and a further 8 bedrooms located on a separate corridor. This is to ensure that although units may, in some cases be mixed sex, there will also be a choice of single sex bedroom wings. Single sex female bedroom wings will also have a separate sitting room for women who do not want to use the mixed sex facilities. We need to also ensure adequate offices, meeting spaces and therapy/activity rooms.
A major and possibly controversial consideration was around the overall size of Cestreham House. Placement fees will be determined by the costs of running the service. With a development of this nature significant savings can be made with economy of scale. An example of this is that you would require 1 physio if you only had 3 residents, however the same physio could look after 16 residents, the same concept applies to many areas of care delivery including vehicles, staffing, food laundry etc.
In order to ensure the individual placement costs are within a range affordable to local authorities and PCT’s, it would need to be comparable with public and not for profit sector provision. Such fee levels would also ensure that the service is accessible to a range of people, irrespective of personal wealth. In view of this Chesham Care set the minimum number of beds to ensure viability at acceptable feel levels at circa. 120. The current proposal stands at 128 beds arranged as 8 X 16 bed units. |
