Introduction
Prior to the transformation of an existing, bleak, unfurnished, unplanted courtyard into a new, vibrant, and inclusively multisensory landscape, the Grenville Ward Courtyard at the Royal Cornwall Hospital, in Truro, Cornwall, United Kingdom, was used as an outdoor smoking lounge for the busy and highly stressed staff. The scope of the design entailed the planting, surfacing, and furnishing of the landscape to create vibrant and motivating therapeutic and restorative environments for users, therapists, staff, and other visitors. Working closely with staff rehabilitation specialists, the garden was designed to the specification of site users, clinicians, and care professionals. The resulting design is an inclusive and appealing multisensory landscape, containing environments and elements supporting the rehabilitation goals of the Grenville Ward Hospital clinical program (for post-operative elderly care) and the wider hospital community.
Description
Grenville Ward at the Royal Cornwall Hospital in Truro, Cornwall cares for elderly post-operative patients. The ward is in a two-story temporary building expected to last about ten years. No attention had been paid to the exterior, a harsh, paved courtyard that offered little respite for the staff and nothing at all for patients and visitors. The scope of the design entailed the planting, surfacing, and furnishing of the landscape to create a series of vibrant and motivating therapeutic and restorative environments for users, therapists, staff, and other visitors. Working closely with staff rehabilitation specialists, the garden was designed in collaboration with site users, clinicians, and care professionals. The resulting design is an inclusive landscape, contributing to the rehabilitation goals of the Grenville Ward clinical program and the wider hospital community.
The brief for the project from the hospital ward staff and the Health Arts Coordinator at Royal Grenville Hospital entailed the production of a high quality and restorative multi-sensory therapeutic courtyard garden environment and a venue for future arts projects and commissions. Working closely with the hospital ward staff and a diverse hospital management client team led by the Health Arts Coordinator, Westley Design and the Sensory Trust facilitated an inclusive design consultation process. This documented process secured approval for the detailed design phase. The design aimed to produce a suite of outdoor ‘rooms,’ with varying multi-sensory opportunities for patient interaction, rehabilitation, and recreation appropriate to the elderly users. The hospital staff also required a respite area with a designated degree of separation from the patient area; hence the ‘room concept’ was applied to the overall design.
Photos
Overview 1
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Overview 2
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Patients and Staff
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Initial Plantings
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Garden Details 1
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Garden Details 2
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Garden Details 3
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Design and the User Experience
The patient population in this public health facility is primarily post-operative frail elderly people. Some are wheeled outside by staff or family from the ward to the garden on beds or chairs or some use walking aids. Once in the garden, there are multiple opportunities for patients to partake of the welcoming outdoor environment either as an active treatment venue or as a place of respite and general relaxation. During the garden-making process, staff and patients were involved in planting workshops and watched the blacksmith/artist produce sculptural elements for the garden on–site. The engagement of patients and staff during development of the garden helped to create a sense of ownership.
The staff and patients involved in design development worked to build a design responsive to a mix of physiological, cognitive, social and emotional needs. The garden is an intimate sensory experience for some patients and others can enjoy it only from inside.
Westley Design produced the final master plan, details, and planting design, and undertook construction management of the project. Westley Design worked with furniture designers/makers Tulip Art, metal artist John Christian, hospital Arts Coordinator Sara Norrish and staff physiotherapists and occupational therapists to create a range of furnishings to specifically respond to the specific needs of the Grenville Ward. Westley Design and Jon Christian designed unique pergolas to create areas of shelter and shade. Working with physiotherapists and occupational therapists, the design team created specialized handrails that were installed in the garden for use in balance and mobility therapy programs. Westley Design worked with Tulip Art Studios to design accessible planters and a semi-transparent water wall to provide a degree of separation between the staff amenity area and the patients’ garden space.
Evaluation
The aim of the garden was to create an improved environment to provide the hospital patients with ample opportunity to be out of doors and engaged with nature. The initial goal was successfully met, producing tremendous support from the staff in the process and in caring for the landscape when it was complete. A wide range of donations including materials, plants and time contributed to the success of the garden. In fact, plants are given to the garden on a weekly basis either from staff, patients or family members who are grateful for the care that their relatives have received. This is recognized as a positive measure of the value users place on the garden.
Prior to the installation of the sensory garden, approximately eight staff per day used the space and no patients used it. After completion of the garden twenty or more staff, patients, and visitors per day use the area, which represents an impressive 150% increase in use. Patients, accompanied by staff or family visitors have been observed to spend significant periods of time each day in the garden. Some draw, and some weed and tend to the plants. One patient who repeatedly attempted to leave the ward, was discovered to have been a keen gardener in his day, and was happy to spend hours watering and weeding in the courtyard. Another patient has used his interest in art to become absorbed in drawing and painting the garden.
The positive, energetic spirit of the hospital team leaders ensured that the project was completed and made available to the benefit of both patients and staff. Previously there was no dedicated staff rest area available on Grenville Ward. Subsequent to the transformation of the courtyard, the staff makes good use of the space for therapy, respite, contemplation, and relaxation. Although the garden was designed as a shared space for all to use, the design of the space allows for private corners for confidential conversations and private moments of contemplation and refuge. Clinical staff, patients and their families, and visitors enjoy the courtyard. The garden is even used for growing herbs for cooking.
Because of the overwhelmingly positive response to the garden, the scheme has generated client support for extending this type of design project more widely across the hospital campus. As an indicator of the pride felt for the space, the hospital staff themselves have become informal garden custodians and gardeners!
Universal Design Features
- Universal Design Features
- Raised planters and raised beds are installed throughout the garden.
- Flexible seating options are available in the garden.
- Plantings were chosen to appeal to multiple senses; smell, touch, and sight.
- Pergolas with climbing vines provide unique shade options.
- A shaded area is available in the staff ‘room; of the garden.
- Specially designed handrails were installed for use during therapy sessions, but are also useful at all times for multiple types of users.
- The raised water wall feature that separates the garden into staff and patient spaces can be viewed and listened to by all users.
- There are flush paved walking surfaces throughout the garden.
- There is a flush, zero step entry to garden. The doorway is wide enough to accommodate wheeled mobility devices, beds and anyone walking with assistance.
Environmentally Sustainable Features
- Given that the fact that Grenville Ward is currently housed in a temporary building, the garden has been designed with an expectation that most elements could be salvaged when it is time to move it.
Project Details
* None available
Project Team
Client:
Sara Norrish – Arts Coordinator
Sharon Addinall – Estates Manager
Company: Royal Cornwall Hospital Trust
Contact: Sharon Addinall
Email: Sharon.Addinall@rcht.cornwall.nhs.uk
Project Manager/Landscape Designer:
Michael Westley
Company: Westley Design
Email:mike@westleydesign.co.uk
Telephone: +44 (0)1326 259 817
Contractor
RCHT
Hospital Estates Team Contact
Name: Sharon Addinall
Email:Sharon.Addinall@rcht.cornwall.nhs.uk
Agency, Authority Oversight or Partnership
Name: Royal Cornwall Hospital Trust
Email:Sharon.Addinall@rcht.cornwall.nhs.uk
Metal Artist
Name: John Christian
Company: Boquio Arts Email: www.boquio.com
Additional information
Reference Grenville Ward Landscape Project , Interim Evaluation Report August 2006
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