Making it home sweet home

Australian Unity adopts a singular philosophy to the design of its aged care facilities. “It has to be a home. It’s not a facility or a hospital or a clinical setting. It is always a home,” Brett Lafranchi – Australian Unity’s national general manager residential aged care – tells Australian Ageing Agenda.

The aged care and retirement living provider’s old Walmsley site in the eastern Melbourne suburb of Kilsyth was anything but homely. It was, explains Lafranchi, more of a hospital than a home. “Rooms were four-bed shares.” Corridors were as long as a “racecourse”.

For a while, the provider and the architect – Riordan Gough – discussed various options to try and renovate the 40-year-old building. “But at the end of the day it was like a daggy old 1960s’ hotel with low ceilings and no height to put surfaces in the ceiling space. Bathrooms were tiny and pokey, and not compliant,” says Gough – director at Foreground Architecture.

“It was past it’s useful life,” adds Lafranchi, “so the time came to bulldoze it, decamp the home and rehouse residents elsewhere.” After much deliberation, the provider eventually signed off on a final design. “All design decisions were person-centred and evidence-driven to make sure we get the best outcomes for our ageing Australians – our residents – and the general community as well,” says Lafranchi.

Gough tells AAA the aim was to deinstitutionalise the setting. It’s an ideology that underpins much of the architecture firm’s work. “The idea of the philosophy is that we make the experience less corporate or less institutional,” explains Gough. “We’re trying to humanise spaces.”

The new building is as far removed from an institutionalised setting as you can get. There are no room shares and the long corridors are long gone. “We make sure that it’s a short distance from sleeping to living,” says Lafranchi.

As per the brief, Walmsley Aged Care is a non-clinical environment. “You won’t see a nurses’ station with medical equipment and medications and computers and so forth,” says Lafranchi. “We don’t have staff spaces within the households. All the facilities such as kitchen and laundry etcetera are all back of house. The residents would never see them at all.”

Australian Unity has 12 aged care facilities – seven in Victoria, four in New South Wales and one in Queensland. Walmsley – one of nine that have been built and designed from scratch – is based on the small-house model of care. It incorporates the four new National Aged Care Design Principles and Guidelines:

• enable the person
• cultivate a home
• access to outdoors
• connect with community.

Resident feedback was also a critical element of the overall design process, explains Lafranchi. “We needed to make sure that we knew what we were doing there,” he says. “Otherwise, we would have designed and built something that didn’t necessarily meet those expectations.”

Residents wanted a design that increased and improved socialisation, says Lafranchi, “conversing with their neighbours, relaxing and so forth. All of that participation, which helps them maintain a level of independence, was critical – they certainly emphasised that.”

Easy mobility was also emphasised. “So they could get around the facility and out through the courtyards and the gardens – that was an important one,” he says.

After two years under construction, Walmsley Aged Care opened its doors to residents late last year. The site sits on its original footprint – which is co-located with an Australian Unity retirement community.

Interest in Walmsley has been strong since the start, says Lafranchi. “We had 19 admissions in that first week – more than half of those came from residents located next door who were waiting for us to finish building so that they could move in.”

The 120-bed facility consists of seven households in all, with 17 residents in each household. “Each household has its own kitchen, living space, and dining room,” says Lafranchi. “The kitchen is the centre of the house – that’s where people like to be drawn.”

“The idea is to replicate – to a degree – the idea of home,” adds Gough.

It’s the subtlest details that can help create a homelike environment, says Lafranchi. “We make sure that [residents] enter the household coming through a front door and enter a living space.”

We’re trying to humanise spaces.

Riordan Gough

As well, the design of residents’ private rooms considers the wishes of both singles and couples. Couples “have often slept in a double bed for 60 or 70 years,” says Lafranchi. “Most of the traditional designs would have had single beds and a robe,” he adds.

Arranged in fingers and sitting independently from one another, each household has its own botanical theme, explains Gough. “The layouts were fairly uniform, but it was more in the finishes and the colours that we used that helped give each of the households their own character.”

When it comes to lighting, the design incorporates a courtyard model. “Each resident room has direct access to natural light,” says Gough. “They’ve all got good views from their rooms but, also, the common areas have good views out and beyond into the bush or the Dandenong Ranges.”

One of the households at Walmsley serves as a memory support unit, housing residents with various levels of cognitive impairments. Lafranchi tells AAA the household has been carefully designed to enable the person.

“We’ll always make sure that the design of that part of the home will have elements that optimises helpful stimulation or help reduce unhelpful stimulations – which is over-stimulation,” he says.

The memory support household has also been designed to minimise anxiety and confusion. “The design approach creates a path for people to wander along so we don’t have people wandering down corridors with locked doors at the end,” says Gough. “There’s also a circular pathway out and around through the garden and back in again.”

“You want to support movement within and throughout that memory support unit, encourage engagement, and create familiar spaces,” adds Lafranchi.

That’s three design principles and guidelines ticked: cultivate the home, access the outdoors, enable the person. The fourth – connect with community – is achieved in many ways, explains Lafranchi.

“I’ve got the community within – the 120 residents that live in Walmsley Aged Care. I’ve also got the wider Walmsley community – which [includes] our 250 residents that live independently in the retirement community. Then I’ve got the even wider community – the Kilsyth community – the eastern suburbs of Melbourne, which we want to connect with.”

Connection is forged through open days and outings, such as bus trips to the nearby national park and picnics. “That community connectiveness is vital,” says Lafranchi. There are also regular on-site events – such as the celebration above – and activities such as carpet bowls and gardening.

“A high proportion of our residents are green thumbs,” says Lafranchi. Green-thumbed residents can create and cultivate herb gardens or grow and pick homegrown fruit and vegetables. “Residents love to engage in those types of things.”

AAA spoke to Lafranchi a couple of days after Walmsley commemorated an important milestone. “We had our one-year celebration this week, so we were out in the barbecue area. We had morning tea and cut the cake and all of that,” he says. No doubt it will be the first of many happy returns.

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