Extra care housing: a paradigm shift

This paper sets out to investigate if and how a spatial typology for extra care housing (ECH) can be defined within the context of housing for older people in the UK. In particular, it focuses on the concept of domesticity in relation to the perception of public, semi-public and private domains. Four sheltered housing schemes that have been remodelled into ECH within the past four years, have been selected as case studies. The spatial distribution of various public, semi-public, and private domains of the pre-remodelled and remodelled schemes have been analyzed quantitatively and interpretively, to determine how their distribution might help bolster or undermine the ethos behind ECH. Likewise, the spatial layouts of the sheltered, as well as the extra care schemes have been analysed syntactically, to determine how different spatial morphologies and their probabilistic functions might begin to help define ECH as a new type of group housing for older people. The findings of the paper suggest that the extent to which the spatial configuration of a scheme affects one’s notions of self-containment and control, has a direct impact on whether the scheme performs as a building or as a settlement. It is furthermore argued that the more a scheme functions as a settlement, the less institutional it may feel. Thus, as a typology, a successful extra care scheme can be defined as a building that works as a settlement

Extra care housing: a paradigm shift

This report sets out to investigate if and how a spatial extra care housing typology can be defined within the context of housing for older people in the UK. In particular, it focuses on the concept of domesticity in relation to the perception of public, semi-public and private domains. Four sheltered housing schemes that have been remodelled into extra care housing within the past four years, have been selected as case studies. The spatial distribution of various public, semi-public, and private domains of the pre-remodelled and remodelled schemes have been analyzed quantitatively and interpretively, to determine how their distribution might help bolster or undermine the ethos behind extra care housing. Likewise, the spatial layouts of the sheltered, as well as extra care schemes have been analysed syntactically, to determine how different spatial morphologies and their probabilistic functions might begin to help define extra care housing as a new type of group housing for older people. The findings of the report suggest that the extent to which the spatial configuration of a scheme affects one’s notions of self-containment and control, has a direct impact on whether the scheme performs as a building or as a settlement. It is furthermore argued that the more a scheme functions as a settlement, the less institutional it feels. Thus, as a typology, a successful extra care scheme can be defined as a building that works as a settlement

Hospital Door Handle Design and Their Contamination with Bacteria: A Real Life Observational Study. Are We Pulling against Closed Doors?

Objective To determine whether microbial contamination of door handles in two busy intensive care units and one high dependency unit was related to their design, location, and usage. Design Observational study of the number of viable bacteria on existing door handles of different design at defined entry/exit points with simultaneous data collection of who used these doors and how often. Setting Two busy specialised intensive care units and one high dependency unit in a tertiary referral NHS neurological hospital. Main outcome measures Surface bacterial density on door handles with reference to design, location, and intensity of use. Results We found a significant correlation between the frequency of movements through a door and the degree to which it was contaminated (p = <0.01). We further found that the door's location, design and mode of use all influenced contamination. When compared to push plate designs, pull handles revealed on average a five fold higher level of contamination; lever handles, however, displayed the highest levels of bacterial contamination when adjusted for frequency of use. We also observed differences in contamination levels at doors between clinical areas, particularly between the operating theatres and one of the ICUs. Conclusions Door handles in busy, “real life” high acuity clinical environments were variably contaminated with bacteria, and the number of bacteria found related to design, location, mode and frequency of operation. Largely ignored issues of handle and environmental design can support or undermine strategies designed to limit avoidable pathogen transmission, especially in locations designed to define “thresholds” and impose physical barriers to pathogen transmission between clinical areas. Developing a multidisciplinary approach beyond traditional boundaries for purposes of infection control may release hitherto unappreciated options and beneficial outcomes for the control of at least some hospital acquired infections