Patient care, rehabilitation and recovery

Project Value: £65K
Build Time: Consultation, design and planning: 8 months; build time: 5 months.

Size of Project: 272 sq m
Awards (nominations, shortlists and wins):

Gold Medal for Best Public Building Gardens

Received national press coverage as one of the UK’s latest leading therapy gardens

The Brief

The Royal Free Charity & NHS Trust’s brief was for us to create a specialist garden tailored to the needs of patients as they underwent treatment and recovery. 

The Challenges

One of the key challenges we faced during this project was the logistics of working in the middle of a hospital environment - the gardens are situated within internal courtyards with wards leading directly onto them.  Our only access in and out of the gardens was through a main walkway into the hospital; we were therefore required to satisfy all the relevant health and safety requirements, provide method statements and risk assessments as well as ensuring sound pollution and patient privacy was maintained at all times.

Under these conditions, we did not have the ability to use a mini-digger. That meant that all existing planting and paving had to be manually removed by hand from the gardens. Funding continued to be raised throughout the duration of the build and much of the unskilled labour force was from staff kindly donating their time from companies including Tesco, Sainsbury’s, Metaswitch, Santander and the Masonic Charitable Foundation.

Over 120 working drawings were produced to ensure the correct placement of electrics, paving, resin, pond, planting beds, Japanese Tea House and bridge and working around a dozen existing manholes that served the hospital site within the courtyard garden created many challenges.

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How the garden enhances neuro-rehabilitation and stroke recovery

Neuro rehabilitation patients are at high risk of depression due to prolonged hospital stays.

Stroke is not just a condition of the elderly; the ward also cares for younger stroke patients. Having a safe, engaging outside space allows patients more freedom during their stay, especially for family visits.

We designed the garden to help patients build muscle strength and balance, enjoy their therapy sessions in the fresh air and take part in horticultural activities.  A dedicated patient gardening area was created to assist residents with regaining their motor functions, by using their hands to pot on plants, pruning and watering.

Our creation is based on a Japanese design and provides a tranquil haven for patients for whom the noise of a busy ward can be overwhelming, as well as a quiet place for family and friends to visit.  It also incorporates a gardening project with raised beds to enable patients to participate in gardening activities, all designed to support recovery.

Various materials were used to assist the patients re-learning how to traverse a variety of different floor finishes. These included Marshalls Woodstone Sleepers laid on an arc and in-filled with white cobble stones; resin laid in a curved shape providing a clean stable walkway for patients; and a timber-decked Japanese bridge spanning a blue slate area.

We created a garden that is quiet and peaceful and designed to provide a sanctuary away from the ward.

Tracy Goodman, urgent care matron, said: "When it comes to recovering from a brain injury this can mean many weeks of prolonged hospital stay for our stroke patients. Patients now have a safe and welcoming space for them to continue their therapy in the fresh air. It’s also a great place to simply come and think."

Stroke Recovery – Our Design Philiosophy

This garden utilizes an organic free flowing feel, symbolising the gentle but steady progression of recovery for the hosiptal’s stroke and rehabilitation patients.

An existing day room, already utilised by patients for therapy, was extended outside for the continuation of the patient’s gardening and horticultural activities.  A green house and raised planters provide easy access for wheelchair users and a seating area for group discussions and meetings.

As one progresses from the more organised therapy space into the centre of the garden, there is a free flowing shift into a more calming, Japanese-style garden.  As part of our requirement for creating an `exercise area’ in this space we used different flooring materials from paving, stone, stepping stones and white cobbles as well as the archetypal Japanese Red Bridge.

The use of a fish pond with trickling water within the garden adds an element of gentle sound and calmness.

At the other end of the courtyard is a modern timber representation of a `Japanese Tea Room’, where patients comfortably sit enveloped in a semi-closed structure which focuses their attention inwards towards the garden rather than feeling overlooked by the upper level and walkway.

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Photo Credits: All Photos by Tectonic & David Bishop, UCL Health Creatives

Publications

https://www.theguardian.com/healthcare-network/gallery/2017/sep/12/seven-uks-healing-hospital-gardens-pictures

http://thhb.co.uk/2017/10/05/chase-farm-garden/

http://doctoryak.com/blog/the-restorative-power-of-hospital-gardens/

The gardens were funded thanks to an appeal launched by the Chase Farm Charity, part of the Royal Free Charity. The support was overwhelming and donations came from over 200 individuals, community groups, businesses and hospital staff. Supporters skydived, trekked, climbed Snowdon and put on events.  Over 120 individuals volunteered giving up 865 hours of their time, many returning more than once.