Community-facing rehabilitation centre offers a new route to recovery
The award-winning redevelopment and extension of an existing but long unused NHS site located in Wesham, on the Fylde Coast, has created a modern new rehabilitation service for Lancashire and South Cumbria NHS Foundation Trust (LSCFT).
The model of rehabilitation care for this facility focuses on empowering the service user to gain or recover their confidence and skills, promoting independence, autonomy and encouraging hope for the future.
The environment developed is seen as fundamental in ensuring that the model of care can be at its most effective.
Leading architect, design and masterplanning practice FWP Ltd was appointed to deliver the £9.4million centre. Earlier this year that work received the Design in Mental Health award for ‘Project of the Year – Refurbishment’.
Here, Daniel Thompson, partner and healthcare lead, and James Halsall, associate, talk about their approach to 21st century mental health design and the FWP team’s work to deliver the facility.
The existing hospital building in Wesham, a small town sitting inland some eight miles from Blackpool’s famous Golden Mile, had stood empty and derelict for more than eight years when the decision was made to bring it back to life.
The aim was to refurbish the NHS building to create a home for a new community facing rehabilitation service. The repurposed building also includes a modern, timber-clad extension to the front that has created a welcoming and engaging entrance.
The whole facility has been designed to help bridge the gap between acute treatment and re-integrating people back into the community. The service it hosts offers a new mental health pathway that sits between acute care and community living.
The trust hopes that the Wesham centre will pave the way for future mental health rehabilitation services across the region.
The service it offers is having a positive impact on existing service users and will benefit new service users who need a different kind of support.
To that end, from day one the design approach looked to help people with long-term mental health conditions manage their own care and give them back the independence and lifestyle they deserve.
The technology, arrangement of the building, décor, expansive landscaped gardens and kitchen projects, all focused on the service user experience to ensure their rehabilitation can take place within a relaxing and positive environment.
The result is a showcase of how far mental health design has progressed in recent years. The project team worked extremely hard in partnership with LSCFT to create a unit that is both warm and welcoming and has a distinct non-clinical feel throughout.
A new approach to mental health design
At the very beginning of the project, the FWP design team was given several requirements to be incorporated into the new facility, to help the trust deliver this new approach to rehabilitation.
The Wesham Rehabilitation Centre has been created with 28 individual en-suite bedrooms for people who require support to regain skills and confidence with everyday tasks such as cooking, cleaning and looking after their own health and wellbeing.
As they step down from acute care the aim is to give the service users the support needed to gain confidence.
Other requirements from the client included delivering a ground floor facility with easy access to the main street, including entrance ramps, that would be inclusive for all.
There was also a need for open free access and egress for staff and service users visiting the community facilities.
Central to the whole development was the creation of a welcoming, warm and non-clinical feel. Wesham has moved away from the clinical setting and into a residential community space.
The design requirements also called for designated female and male en-suite bedroom areas and quiet lounges with open shared spaces.
Private garden and therapy areas, both grassed and hard pave, were created with input from local charity ‘Grow Your Own’ who will work with service users to utilise the garden areas to grow plants and produce
A key point of the refurbishment has been to ensure that service users are encouraged to leave the building to access services in the community, leading to the initial inclusion but subsequent removal of some typical spaces such as a gymnasium, beauty and hairdressing areas.
That has allowed better use of rooms for on-site therapies and has enhanced the provision of residential spaces such as bedrooms, lounges and kitchen/ dining areas.
The kitchen and dining areas are key spaces in the building. FWP were tasked with creating a spacious kitchen for service users to be able to cook all their own meals with staff support.
That kitchen design progressed from a standard two rooms with perimeter worktops and central tables to a focused, much more open ‘Masterchef’ approach.
A separate rise and fall workstation, fully inclusive of the needs of those using them, have been provided, each with preparation and cooking space and individual food storage.
The design has been supported by the inclusion of a breakfast bar and a separate orangery style dining room with views over and access to the kitchen therapy courtyard, which will in time include herb planting.
In addition, the centre’s new entrance area includes a community space with servery to allow service users to engage with the local community by providing hot drinks and snacks, complemented by the provision of a ‘Changing Places’ room and a separate baby change area and child visiting room.
The overall design encompasses many open access spaces, a reception area that is both warm and welcoming and a central living space that connects the two bedroom wings and which is a truly uplifting space for day-to-day relaxing and engagement.
With access to nature contributing to mental wellbeing, the expansive gardens, that include raised beds, a polytunnel and flagged patio, with ecology bird nesting boxes and bug houses as well as outdoor therapy areas, together all these areas make full use of the site. The central lounge area has doors leading straight out into the gardens making easy access all year round.
Externally, additional car parking spacing was created and EV charging points were installed.
This new high-quality environment is a key part in the programme’s success and the comfort of its users as they work to regain their independence.
Inside the building, thoughtful modern design and the use of colour and light has created a calming and peaceful atmosphere. Vaulted ceilings add to the feeling of space and light.
A fresh and uplifting colour palette was chosen to support both calmness and relaxation.
The colours used were also selected to complement the indoor and outdoor therapy areas, including the therapy garden.
Thoughtful interior design has an impact on mental health, wellbeing and the recovery journey. With that in mind the aim was to provide the centre with an air of tranquillity, to make it an uplifting place of calm.
The creation of quiet lounges and open shared spaces has played its part in creating this tranquil atmosphere.
The design of the extension also incorporates large, high windows to allow in as much daylight as possible into the entrance area.
All the rooms have been designed to be anti-ligature. However, it is important that they don’t look and feel clinical and far removed from people’s traditional view of a hospital unit.
Recent years have brought an amazing array of vinyl fabrics and stylish weighted furniture that all help achieve a well thought out interior space.
The building has a seamless continuity brought together through of the use of colours, furniture, flooring design, lighting, and fabric choice.
Collaboration was key
The project continually developed through the two-year design and construction period, with focus from clinical and design teams on the patient experience and with outside agencies invited into the process to encourage the exploration of new ideas.
User and clinical engagement meetings allowed the design to evolve into the completed unit, a facility that is totally removed from people’s traditional view of a mental health hospital environment.
Fortnightly meetings were held with the client during the design process together with dedicated clinical and service user workshops.
There were weekly meetings with the client during the construction period, which started on site in February 2021, including expenditure reviews, site progress, client progress, site walk rounds and technical meetings to ensure the smooth delivery of the project.
FWP, which has offices in Preston, Lancashire and Manchester and London, appointed a strong team of experienced consultants to help deliver the Wesham unit, including Cheadle Hulme-based TACE, which provided mechanical and electrical design support.
TRP Consulting, based in Manchester and Preston, provided civil engineering and structural design and Manchester-headquartered Urban Green has delivered the impressive ecology and external landscape designs. The construction work on the project was carried out by the Eric Wright Group.
Meeting the challenges
The project team had to overcome several challenges, not least delivering this major refurbishment and extension during the Covid-19 pandemic.
Most of the meetings had to be held on Teams and site visits were restricted to small groups – with the rule of six applying for most of the design and construction periods– to protect the construction workforce and clinical staff.
Covid-19 also created several supply chain and cost issues, with a lack of availability and long lead times for some items. There were also issues created by the need to work within the existing fabric of an old building.
The team also worked hard to engage with neighbours as the site had been derelict for several years. This community engagement highlighted how the new style centre would be used to enhance the lives of people using it.
Eric Wright Construction put together newsletters which were circulated in the community to keep people in the loop about the project and several community engagement events were organised for people to attend and give their valued feedback.
A record of delivery
The Wesham centre is just one of several important refurbishment projects that FWP has worked on in recent times for the trust, which provides a range of mental health services for communities in Lancashire and south Cumbria.
The trust’s specialist provision includes inpatient child and adolescent mental health services, perinatal mental health and forensic services including low and medium secure care. The trust also provides a range of physical health and well-being services in the community.
FWP’s specialist mental health team also redesigned the ‘Skylark’ unit in Preston for the trust. This rehabilitation unit is now helping service users recovering from mental health conditions regain the skills associated with day-to-day living.
Several of its service users were among the first to use Wesham on their pathway back to living in the community.