TO CARE: a hospice by the clyde by annabellebrading

TO CARE: a hospice by the clyde Annabelle Joy Brading | 201112053

Dedicated to Josephine Steele.

Contents Page To Care: A Hospice by the Clyde

1.0

2.0

3.0

Introduction

4.0

Design Principles

Background

Key Concept Drivers

Additional Information

Statutory and Guidance

Site Details

5.0

Design Process

Site Analysis of Govan

Precedence

7 9

Site History

Context

Site Materials

29 31

Analysis of Potential Sites

Option B

14 17

Development of the Clyde

35 36

Preferred Location of Building

Building Organization

Development of Chosen Option Development of Bedroom

Site Assessment

59 66

Connections

Development of Viewing Room

Opportunities of the Site

Development of Sanctuary

Land-use

69 70 72

Architectural Ambition

Preferred Site

Option A

Building Concept

Development of Social Space

Connection Between Viewing Room and Sanctuary

6.0

7.0

Design Solution 77

Location

78 82

Plans

Interior Inspiration

89 97

Elevations

101

Building Explanation

102

Access

103

Landscape

105 106

Regulations and Guidance

107

Escape

110

Technical Strategy - Structures and Construction

115

Technical Strategy - Energy and Environment

Sections

3D Visualisations

Daylighting

Sketch Appendix 117

Development Through Sketches

1.0 Introduction 1.1 Background

HISTORY OF THE HOSPICE MOVEMENT The hospice movement as we know it today was founded in Britain by Dame Cicely Saunders. In the 1950s Cicely Saunders (who later became Dame Commander of the British Empire because of her pioneering work) began to develop the techniques of pain control which she had first observed when she was a volunteer at Saint Luke’s Hospital. It is little known that Dame Cicely is qualified in three different professions; she first became a registered nurse; then a certified social worker, and finally, she became a qualified doctor when she recognised it was the only way she would be able to realise her ambition to help those in pain in the way she wished. At Saint Luke’s Hospital the practice had been to give tablets regularly to stop pain, rather than wait until the person complained of discomfort. This system operated very well and provided the basis on which Dame Cicely continued her work. She originally conceived her idea of opening a home, especially for those with incurable diseases, in 1947. Her aim was to establish a place dedicated to research and patients. These extra components make the modern hospice movement different from its forerunners and this is why Dame Cicely is acknowledged as the founder of the modern hospice movement. Saint Christopher’s in Sydenham in South East London, which is Dame Cicely’s ‘own’ hospice, opened in 1967 and had largely been inspired by David Tasma, one of her early patients. Through their special relationship, as he lay ill, she gained a valuable insight into how the dying could be helped and cared for, not only physically but also emotionally and spiritually. David left the first £500 she needed to launch Saint Christopher’s. “I’ll be a window in your home”, he had said. Today a vast window at the front of the hospice is called “The David Window”. Since the opening of Saint Christopher’s more than 220 similar units have been set up throughout the United Kingdom. Many of these have specialist palliative care teams which go into patients’ homes working with other community healthcare professionals. Many also have day care facilities. Although hospices have cared primarily for people who have advanced cancer, many are now including people with other life-limiting illnesses, such as Motor Neurone Disease and AIDS. Many people from all around the world visited hospices in Britain and saw what was being done to help those in need. Following Dame Cicely’s example, they returned to their own countries, determined to give similar help to their own people.

The problems faced by the patients and their families was not always easily understood by people who had not experienced it. It was not easy to explain, and even harder to gain the co-operation of doctors and nurses in countries where the concept was unknown. It was also very difficult, sometimes, to gain the agreement of governments to allow the establishment of hospices and to grant funds for development.

PALLIATIVE CARE End of life care is support for people who are in the last months or years of their life. End of life care should help you to live as well as possible until you die, and to die with dignity. The people providing your care should ask you about your wishes and preferences, and take these into account as they work with you to plan your care. They should also support your family, carers or other people who are important to you. You have the right to express your wishes about where you would like to receive care and where you want to die. You can receive end of life care at home or in care homes, hospices or hospitals, depending on your needs and preference. People who are approaching the end of life are entitled to high-quality care, wherever they’re being cared for. End of life care includes palliative care. If you have an illness that can’t be cured, palliative care makes you as comfortable as possible, by managing your pain and other distressing symptoms. It also involves psychological, social and spiritual support for you and your family or carers. This is called a holistic approach, because it deals with you as a “whole” person.

Dame Cicely Saunders with a patient at his bedside

Palliative care isn’t just for the end of life. You may receive palliative care earlier in your illness while you are still receiving other therapies to treat your condition. Supportive care should be fully integrated with diagnosis and treatment. It encompasses: • Self help and support • User involvement • Information giving • Psychological support • Symptom control • Social support • Rehabilitation • Complementary therapies • Spiritual support • End of life and bereavement care Palliative care is the active holistic care of patients with advanced progressive illness. Management of pain and other symptoms and provision of psychological, social and spiritual support is paramount. The goal of palliative care is achievement of the best quality of life for patients and their families.

Information found: http://www.farleighhospice.org, http://www.nhs.uk and http://www.ncpc.org.uk/palliative-care-explained

1.0 Introduction 1.2 Additional Information

BRIEF

THESIS IDEOLOGY

Many children with a life-threatening or life-limiting condition now live into young adulthood due to advances in medical care. The need for respite care to extend beyond children’s services is important to meet the individual needs of these young people. The journey to adulthood itself can be uncertain and because of illness young people and their families can be faced with many challenges. Young adults have their own unique needs that are different to those of children and a children’s hospice no longer meets their individual requirements. Focused support through this period of transition from children’s to adult services is essential. The new facility would provide support for young people with palliative care needs. The facility would provide care centred on privacy, dignity and independence. Young adults are able to come to the new hospice for respite visits. These visits are available throughout the year and can be booked to suit the needs of the young person. Sometimes a visitor may stay for a couple of days, and at other times they may choose to visit for a whole week. Hospices rely on their architecture to do a significant amount of the passive palliative work, setting the scene for people going through a traumatic experience. They are places where people draw on strengths they may not have realised they had, in order to maximise their own capacity to cope. The buildings should provide the chance for people to read themselves differently, as individuals in unusually difficult circumstances, not as patients, let alone terminally ill ones. The building must feel safe and welcoming. They need to be small, and domestic in scale, yet retain a strong sense of dignity. The architecture should exude hope, giving the users a place to turn to which is surprising, thought provoking and even inspiring.

For this hospice I want to create a place where patients feel they can escape to, a place that is almost like a holiday away from their problems, although they will have to face reality in the hospice it is to be more of a respite. Spaces from the socially dynamic to the private nook or cranny will be provided for the patient, visitor or staff members every need.

OUTLINE REQUIREMENTS As well as stitching itself within the selected master-plan, the hospice should be designed to increase the sense of connectedness between people: they are not alone in this situation and people can find ways of moving forward from the crisis of a diagnosis. The architecture should be thinking about the human relationships and assisting those connections, presenting spaces that make people feel better rather than worse (like most hospitals). As an architect, you must be aware of the balance of promoting infection control whilst simultaneously retaining a sense of dignity for the user at all times. You are asked to subject your own thesis ideology as to contemporary hospice design – especially single-occupancy rooms versus ward strategy. Inherent social factors such as culture, religion, sex, relationships and bespoke places of worship should be considered in conjunction with fundamental considerations, such as maximising daylight and the opportunity to be able to look out (and even step out) from inside to outside, should be addressed. This must not however, be to the expense of simultaneously retaining a strong degree of privacy for the more intimate spaces. The hospice should serve as an interface, both physically and metaphysically. The importance of the dichotomies of inside/outside, inclusion/exclusion, life/death - all situated within its given location - is intrinsic in its design. 2

It is important that the hospice have a warm, homely feeling and will not remind users of clinical environments. It is to be a place where anything is possible, that they can do or have whatever an able bodied teenager or young adult would be able to do; have a dog, play guitar, pull up to the hospice jetty on a speedboat. The last thing that I want to create is a stereotypical arrangement of spaces which make a patient feel small, isolated or uninspired. Teenagers, well or ill are going to want to push boundaries, explore and feel independent all whilst feeling safe in the comforts of home. They will need to feel confident that there are people they can rely on and by creating a well working hospice for the staff this will allow them to do they’re job a little more easily and feel strong to help each individual with whatever they need.

BACKGROUND INFORMATION - GOVAN Govan is many things to many people: an ancient settlement; a home to both the Vikings and the earliest Christian settlers and their legacy of exquisite Dark Age carved stones; a seat of Kings during the turbulent Kingdom of Strathclyde; a primitive fording point of the River Clyde; a rural landscape of fertile farming lands, cottage weaving industry and salmon fisheries in the pre-industrial era; the undisputed leader of the 19th century world’s shipbuilding industry, with a workforce of unmatched prowess in the invention and manufacture of great ships to grace the seas; a place of immense wealth and exceptional architecture; the base of ‘Mrs Barbour’s Army’ of women rent strikers, who together defended their homes from the sheriff officers whilst their men fought in the Great War; a close knit tenement community; the scene of the Upper Clyde Shipbuilder’s “work in” that defied a Westminster government and asserted the working man’s inalienable “right to work”; the epicenter of a catastrophic rupture caused by the end of heavy industry on the Clyde; a place and community in a crushing spiral of decline; a poverty statistic; the butt of Rab C jokes; an undesirable stereotype; a resilient and spirited community; a historic place with unique and desirable assets; a place and people with potential to regenerate. Change is cyclical. Places wax and wane in popularity. Indeed, Govan has already experienced two great periods of prosperity in the medieval and shipbuilding eras, which is two more than most places can boast. Hidden under the grime is a place that is at once special and unique, a place and a community that can sparkle again given a little TLC. Information found: Year 4 Handbook and http://www.getintogovan.com/ about-govan/

2.0 Site Details 2.1 Site Analysis of Govan

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2.0 Site Details 2.1 Site Analysis of Govan

Residential Residential

Industrial Industrial

Recreational / Civic Recreational / Civic

Medical

University

Medical

University

Green Space Green Space

Rail Connections Rail Connections

Major Road Networks Major Road Networks

1:10000

2.0 Site Details 2.1 Site Analysis of Govan

1:5000

2.0 Site Details 2.1 Site Analysis of Govan

1:5000

2.0 Site Details 2.2 Site History 650

The church and the ceremonial hill at Govan are part of the kingdom of the Clyde Britons which is ruled from Dumbarton Rock. The king of Dumbarton has just won a great victory over the Scots of Dalriada (now Argyll) and has become one of the most powerful kings in the British Isles.

870

A new power appears in the seas around Britain and Ireland around AD 800 - Viking raiders from Norway and Denmark. In 870 Vikings sail up the Firth of Clyde to plunder the old fortress at Dumbarton. The king of the Britons is captured and killed. But the kingdom manages to survive, and the new king moves up the river to Govan, which becomes the heart of the kingdom. The kingdom itself gets a new name: Strathclyde.

1050

Around this time, the kingdom of Strathclyde is conquered by the Scots and absorbed into the kingdom of Scotland. The Scottish King, David I, establishes a new diocese based at Glasgow Cathedral (founded 1114), which eclipses the old church and power-base at Govan, and its associations with the British kings. The Scottish kings have no use for the court hill at Govan. They have their own ceremonial mound, at Scone. The royal estate lands at Partick are given over to the Bishops of Glasgow.

1888

Construction work on the current Govan Old Church is begun in 1884. It is designed by architect Robert Rowand Anderson in the Gothic style, is a much larger and grander building than its predecessor and features an elaborate cycle of stained glass, conceived by the then minister Rev John Macleod. The new church opens in 1888.

1938

George MacLeod and his Govan congregation found the Iona Community on the island of Iona and in Govan. Unemployed craftspeople from Govan work to restore the monastic quarters of the Abbey of St Columba on the island. Like Govan’s St Constantine, Columba was an early missionary who brought Christianity to Scotland.

AD 500

756

1000

1700s

1900-1930s

1970

Around 500, according to tradition, the Christian missionary St Constantine arrives in Govan and builds a small wooden church next to a sacred well and in the shadow of the ceremonial hill. The people of Govan and the Clyde Valley in these early times are called ‘Britons’. They’re different from their neighbours, the Scots and Picts, and speak their own language. In this language the name Govan means ‘little hill’.

A combined army of Picts and Northumbrians attacks Dumbarton and forces the Clyde Britons to surrender. The invaders are recorded as having forded the River Clyde at Govan, and the actual surrender may have taken place in a ceremony on the ancient hill of Govan.

The kings of Strathclyde are at the height of their power. They rule as far south as the Solway Firth. They and their families worship at the old church of St Constantine at Govan and are buried in the churchyard, their graves being marked by finely carved crossslabs and ‘Hogback’ stones. The royal palace is sited across the river at Partick, and the ancient hill to the east of the church forms the administrative hub of this new power-base, used for important ceremonies, gatherings and pronouncements.

The medieval church is replaced by a new church in 1726. The graveyard contains burial markers spanning over 500 years, the earliest of which are typically flat, carved slabs favoured by prominent, local land-owning families. By the eighteenth century, artisans and craftsmen are also buried in the churchyard. The craftsmen prefer a style of upright headstone carved with designs reflecting their craft, e.g. shears for weavers, the trade most commonly commemorated.

Govan’s second age of greatness is at its height – the burgh is an international centre for shipbuilding. By the 1930’s over 30% of the world’s shipping is ‘Clydebuilt’. Doomster Hill has been levelled to make space for the shipyards – no trace of it remains. In 1912, Belfast shipbuilder Harland and Wolff buys three small shipyards in Govan and constructs giant new sheds and slipways on the site of Doomster Hill. The churchyard at Govan is almost entirely surrounded by shipyards.

In 1971, the Upper Clyde Shipbuilders ‘work in’ at Fairfield and three other yards lasts for more than a year and saves the yards from closure. Following restructuring, Govan Shipbuilders is created in 1972. Today, the yard employs over 2000 workers and is operated by BAE Systems. In 2010, some 800 mourners attend the funeral at Govan Old Church of UCS union leader, Jimmy Reid. The restored A-listed Fairfield Shipyard Offices are due to open in late 2012 as a heritage centre and office spaces.

2.0 Site Details 2.2 Site History

2.0 Site Details 2.3 Site Materials

2.0 Site Details 2.4 Analysis of Potential Sites Site A The Church site provides a small secluded site hidden behind Govan Old Parish Church. The site has Northern views to the river and maximises Eastern and Western sunlight, buildings to the South may block out Southern sunlight. There are two main access routes into the site, one from Govan road which passes through the Church’s main graveyard and a more subtle one to the left of the site which is through a residential estate, this would be more difficult to find and would require good planning. The site is next to an area heavily populated by show people, this would perhaps conflict a hospice design due to noise. However the site is big enough that you would be able to maximise quiet parts of the building to the West of the site. This site is next to the original crossing of Partick and Govan and is right in the heart of the town. Site B Site A

The Dock site provides a large area of land next to the Govan Graving Docks which could be landscaped into a ‘retreat.’ The site has northern views to the river and maximises Eastern,Western and Southern sunlight. There is main access to the site through a small slip road off of Govan road and the large site could then be landscaped into smaller roads. There is a lot of different context around the site creating different building heights allowing a small hospice to fit in quite nicely with is surroundings. The Graving Docks are a very historic part of Glasgow and is an important site in Govan’s shipbuilding history. The basin which splits the site in half could be used as a crossing or moment of solace and allow the river to become an integral part of the hospice design. The Graving Docks are a very run down part of Govan, it is important to think of a future use for the entire site or separating it into two. It is important for the hospice to be in a safe, concealed area of Govan. 10

Site B

2.0 Site Details 2.4 Analysis of Potential Sites

Site A 11

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2.0 Site Details 2.4 Analysis of Potential Sites

Site B 12

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2.0 Site Details 2.4 Analysis of Potential Sites

Strengths

Weaknesses

Opportunities

Threats

Views to the river

Aesthetic of waterfront

Close to good transport links

Waterfront underdeveloped

Opportunity to use building to connect to rest of Glasgow

Danger of flooding - flood control perhaps needed

Close to residential

Lack of good landscape or public areas near river

New public building can be catalyst in development or improvement of Govan

Site may not develop sufficiently

Close to museums and venues

Views to ruinous and commercial buildings

Opportunity for good public outdoor space near the river

2.0 Site Details 2.5 Development of the Clyde

2.0 Site Details 2.6 Preferred Site

Site Location

Govan Graving Docks 17

Site Boundary 1:2500

3.0 Site Assessment 3.1 Connections - Surrounding Context and Site

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3.0 Site Assessment 3.1 Connections - Buildings and the Clyde

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3.0 Site Assessment 3.2 Opportunities of Site

Tourists

Residents

Tourists

Residents

Involve the river Clyde in building design. Most of Govanâ&#x20AC;&#x2122;s Architecture turns its back on the river and there is a gap by the Graving docks for a hospice to create a special interaction. 20

Integrate the river into the city creating a dynamic waterfront.

Restore the historic site and provide scenic views and tranquil areas.

Green space around Govan is insufficient. There is an opportunity on the site to provide urban green spaces for the area.

3.0 Site Assessment 3.3 Land-use

21 22

4.0 Design Principles 4.1 Key Concept Drivers

DIGNITY

CHOICE

Your right to: • be treated with dignity and respect at all times; and enjoy a full range of social relationships.

Your right to: • make informed choices, while recognising the rights of other people to do the same; • know about the range of choices; and • get help to fully understand all the options and choose the one that is right for you.

“A state, quality or manner worthy of esteem or respect; and (by extension) self-respect. Dignity in care, therefore, means the kind of care, in any setting, which supports and promotes, and does not undermine, a person’s self-respect regardless of any difference. Or, as one person receiving care put it more briefly, ‘Being treated like I was somebody” Policy Research Institute on Ageing and Ethnicity/Help the Aged, 2001 Building on a long tradition in medical ethics that encourages critical analysis of key concepts, nursing research has explored and tested the concept of dignity. The kind of ‘concept analysis’ of selected literature from the UK, the rest of the EU, Canada, the USA, Japan and Australia has provided some clear themes about the fundamental meanings of dignity, which are: • respect • autonomy • empowerment • communication Many of the threats to dignity take place at an apparently small-scale, practical level. These can involve, for example: • treating adults ‘like babies’ because of actual or assumed incapacity - giving them mashed food, insisting on early bedtimes, using patronising tones of voice • seeing pain as an unavoidable and therefore tolerable consequence of older age • repeated small slights such as the imposition of leisure activities that imply a low intellectual level • care which treats people as objects, or language which labels them as ‘conditions’ or problems • poor environments and dirt • never stopping for a conversation, or taking time to get to know older patients or residents as real people with personalities and histories • disregarding grief at bereavement among very old people, who see their circle of friends, relatives and companions shrink. The Dignity Therapy developed by a Canadian Research team is based on the principle that recognising patients as people with histories and legacies to leave, promotes their dignity and reduces distress. It consists of a recorded interview, which – transcribed and edited – can be left by the patient to people of their choosing. The therapy has been positively evaluated in use with patients dying of cancer; in 2009, a multi-national team set up a Randomised Controlled Trial of the therapy with elderly people reaching the end of life in care homes in London (Hall et al., 2009). ‘Acknowledging patients as whole persons is one of the most ardent predictors of dignity’ (Chochinov, 2006) 22

“People should have choice, as much as possible within the constraints of their illness, about how they spend their time and with whom. Care should be planned with them and around them...... This applies whether the person is receiving care at home, in a care home, hospital or hospice.” - Patient “The most important choice for people is to be given the time and opportunity to express their choices, as all too often individuals are not included in the decisions regarding their care.” - Patient

choose what the want to do in the building as it allows comfort and stability to become a backbone for their decisions. By feeling safe in their environment patients will feel much more at home as they will relax. Ways of making patients feel safe in their surroundings is by having security systems in place, fire escapes and staff which will take care for them and look out for them.

PRIVACY Your right to: • have your privacy and property respected, and to receive the time, the space and the facilities you need and want • be free from intrusion as long as it is safe for you and everyone else. The best way to deal with the issue of privacy is by giving every patient their own room, this also helps with infection control. By having an individual room patients will have the choice if they wish to socialise with other people or not. All bedroom doors will have vision panels however there is the possibility for these to be closed and accessed by nurses when needed, allowing patients privacy but also giving staff the ability to check on them for health reasons. Privacy is a big issue to everyone but especially for teenagers and young adults who may want to spend time with partners or have a sense of control over when they wish to be seen by others.

EQUALITY Your right to: • live an independent life, rich in purpose, meaning and personal fulfilment; • be valued for your ethnic background, language, culture, and faith; • be treated equally and live in an environment which is free from bullying, harassment and discrimination; and • be able to complain effectively without fear of victimisation. Choice is potentially one of the most important factors when designing a hospice as patients feel all control has been lost, especially the age group of 16-25 where they want to feel independent. Therefore it is an important theme to carry through the design and allow the users of the building the ability to do whatever they want whilst also not feeling lost. Clinical environments are very controlled which is another factor, as I do not want the hospice to resemble this kind of environment but rather a more familiar comfortable setting.

SAFETY Your right to: • feel safe and secure in all aspects of life, including health and well-being; • enjoy safety but not be over-protected; and • be free from exploitation and abuse. Safety is an important part of allowing patients this ability to freely

Hospices should support the principle of equality and diversity. This means they are committed to ensuring that everyone who engages with the Hospice is treated with dignity, fairness and respect. There is a legal and moral responsibility for ensuring that discrimination does not occur and that there is an effective policy in place which we monitor and review regularly. There is a responsibility to provide an environment free from unlawful direct or indirect discrimination, harassment or victimisation. There is also a right to give all patients equal care and treat everyone fairly, this is very important when dealing with someone with a terminal illness and there is no need to make their life anymore stressful. Treating patients with the respect equal to how you would treat a well person, by being sympathetic to their needs but also allowing them the choice and abilities to do for themselves as much as they are able as they will not want to be patronized or made to feel they are any less able than they feel. Information found: http://www.gov.scot/Resource/Doc/1095/0001719. pdf and http://www.scie.org.uk/publications/guides/guide15

4.0 Design Principles 4.2 Statutory and Guidance

DESIGN IMPACT ON PATIENTS WELL-BEING

LOCATION AND SITE

COURTYARDS

Professor Roger Ulrich has conducted several studies on how different aspects of design affect the well-being of patients in the healthcare system. His research has been primarily conducted in hospitals, but several concepts are equally important to hospice care. He notes that traditionally in the design of healthcare facilities, little attention was given to the psychological needs of patients. The emphasis was always on budgets, codes, efficiency etc.

Many existing hospices are located in rural settings, quite isolated from any neighbours. Several reasons exist for selecting such a location, ranging from the availability of land, donated land, and a desire to have the hospice appear an oasis, a place where one can get away from the norm, and have a vacation. Another school of thought is that the hospice, if possible, should be located in town, where teenagers can mix with local teenagers, thus patients in bed can hear normal noises outside - hear the traffic, hear children on their way to school and can feel less isolated. Whether in town or in the country it will be beneficial for the hospice to overlook some natural scene, whether a park, or woods, on at least one side of the building.

The use of courtyards is a valuable tool for hospice design. Courtyards bring natural daylight into the building and provide interest to what would otherwise be internal spaces. They also provide visual connections, making a large building less confusing to a visitor. A courtyard may be large and accessed by users of the hospice or smaller with no access: • Accessed courtyards may be used for sitting in the sun, out of the wind, or for taking a stroll, and they can include a terrace connected to the dining area or other internal spaces. They also allow very ill patients a chance to get outside without having to leave the area. • Enclosed courtyards are usually smaller and can be landscaped with rocks or water features.

Site selection encompasses several aspects, and ideally the selection process should involve the architect. The site should be central to the proposed service area, be easy to find and to access by vehicle, and be close to public transportation if possible. The site should be evaluated if its has the ability to accommodate the requirements a hospice will place on it. These requirements are: • Adequate space for parking and vehicular movement including emergency services • Room on the site to separate public areas from service areas • Ability to locate patients bedrooms with a view and sunlight • Ability to provide privacy to patients rooms • Space enough to allow for future expansion • Suitable topography • If an on-site sewage system is required the site should have appropriate soils and the space required (taking into account future expansion) • Cost • Will local requirements allow planning and zoning permission to be granted for such a project? • Are their noisy activities nearby? • Will residential neighbours object?

Courtyards can be as effective if open on one side as they can if fully enclosed, but with an enclosed courtyard thought must be given to how to access if for maintenance, and what equipment is required. The geographical location is important as it would be unwise to create a small enclosed courtyard in an area which regularly receives a large amount of snow.

However when patients are exposed to good design, especially visual exposure to nature, they show rapid improvements - lower blood pressure, less pain, less anxiety and shorter periods of hospitalisation. The most important design tool to be utilized with this approach is to provide the patients with windows that look out to a natural landscape, or a landscaped area - trees and water seem to have the most positive effect. The design of Evelina Children’s Hospital in London is based on this concept and most (unfortunately not all) of the bedroom’s look out over a park. The bedrooms are on upper levels so their view isn’t blocked by a busy road in front of the park, but look over the road directly to the park. Patients suffering from the conditions which bring them to a hospice must experience a large amount of stress, and by designing areas which provide a calming experience should increase their quality of life. Another factor, along with views of nature, is for the patients to see smiling faces. Creating an efficient and pleasant work environment for the nursing staff will help in this respect. Pet therapy was also seen to have a very positive effect. Professor Ulrich also notes that another factor in helping patients psychological well-being is to give them as great a sense of control as possible in all areas. He also noted a difference in patients well-being based on artwork in the facility, with serene paintings having similar benefits to visual exposure to nature. In one extreme study case, patients actually tore down some abstract paintings. Working in hospice care is one of the most demanding forms of nursing and witnessing death on such a regular bases can be disheartening. Imagine the difference between a nurse working in a maternity ward, bringing life into the world, and one working in hospice care. One of the most important things when designing a hospice is to take great care of the nursing staff. Every opportunity should be taken to ensure that they enjoy a comfortable, efficient and practical work environment. The better the working environment for the nurses, the happier they will be, and surely that will relate to them providing better care and cause a ripple-down effect through the entire facility. Independence is a very important issue especially for this 16-25 year old age group, the amount of independence they require is and individual situation. Generally speaking, young teenagers require the most independence. As teenagers age through their teen years, it is common for their conditions to worsen, and so for them to become more dependant again. 23

BUILDING EXTERIOR Entering the building: the important factor here is making a comfortable transition from the outside to the inside - helped by a covered entry, keeping an intimate sense of scale, and upon entrance having it be obvious where to proceed in the building. A covered porch with a rocking chair provides a place for someone to sit and gather themselves before entry. The object of the approach is to set a comfortable feel before entering the building. Patients themselves also need to be comforted and reassured by the architecture, but if arriving by ambulance they will miss the approach and their first impression will be of the front entrance. Patients require a non-institutional design so they don’t feel as if they are entering a hospital, and need to feel reassured that they are entering a facility which can and will take good care of them.

GARDENS AND LANDSCAPING The grounds surrounding a stand-alone hospice play an important part in the overall hospice experience. Having a pleasant view from the patients rooms and other common areas such as a living room is important to assist in maintaining a calm state of mind. A landscaped garden using either existing trees or plantings or staring from scratch should be part of every projects budget. Even small spaces can be carefully treated to become areas of natural beauty and a joy to the eye. Paths around the gardens are nice but in reality are seldom used by the patients - they are used primarily by family members and visitors if at all. If paths are to be used, they should be hard surfaces to facilitate wheelchairs and to minimize treading-in of gravel. Birds fascinate most patients, and a nicely landscaped area combined with feeders readily attracts them and provides hours of interest. Raised planters at the side of patios allow patients who use wheelchairs to tend a few flowers. These can be located on the patio areas of living room and patient rooms. A small private garden for contemplation is a wonderful addition to a sanctuary or bereavement suite. Gardens can be anything from formal affairs designed on an axis with waterfalls and fountains to a simple, random collection of trees and daffodils and other seasonal flowers. Either one will serve the purpose. Landscaping can also be used to shield the hospice from loud roads or high winds. Patient bedroom gardens should be easily accessed by beds or wheelchairs allowing patients the opportunity to experience outside with their visitors or other patients rather than just a view to look at. Information found: Children’s Hospice Design Manual and Hospice Design Manual written by Timothy Moorhouse

4.0 Design Principles 4.2 Statutory and Guidance

INFECTION CONTROL The control of infectious disease within the hospice is essential for the protection of patients, staff, family members and visitors. Infection can be controlled by preventing cross-contamination, by providing materials and finishes which can easily be cleaned and sterilized, by ensuring contaminated air isn’t returned to the building, and by possibly providing and isolation room. Cross-contamination: Patient bathrooms should be for patient use only. Staff should use staff bathrooms, and visitors and family members should be provided with public bathrooms close by. Hand sterilization should be readily available in all bathrooms. All cutlery and dishes should be sterilized with hot water (to at least 70°C) during the dish washing process. Materials and Finishes: Patient rooms have to be thoroughly cleaned especially between patients, so all surfaces should be easily sanitised. Vinyl flooring in the patient rooms is the easiest to keep clean and is the material of choice for many hospices. However, it can have an institutional feel to it as well as being nosier and more slippery than carpet. New types of flooring which resemble hardwood flooring are the most successful.

USE OF COLOUR The use of colour inside a hospice building is an important tool in creating a desired atmosphere. This includes carpet and other flooring colours, wall colours and colours of accessories and furnishings. Correct use of colour can create more productive work spaces for the staff, and can create more relaxing rooms for the patients and their family members. Colour has the ability to alter peoples moods and affect the way they feel and can lead to feelings of warmth, intimacy and serenity, or colours can excite and stimulate. Most colours cause mixed reactions some good some bad. Blue for example can be calming and can decrease heart rate but can also cause depression - hence ‘the blues’. To avoid strong reactions from any colour their use should be minimized and be subtle. Volumes have been written on the use of colour and detailed references on the subject is recommended. However, colours fall generally into two groups - warm and cool, warm colours are the ones to be used in a hospice - we have all experienced the cold gray or green of hospital walls. Natural wood is very warm and can be used liberally - window sills, furniture, doors etc. In general, warm off whites are a good choice for patient bedroom walls. They are neutral and the colour can be picked up in the curtains and fabrics. Warm green carpeting or natural wood laminate flooring are good choices for flooring. Hints of orange are good for this age group as orange is stimulating and reaction to it is a combination of the physical and the emotional, it is also referred to as a ‘fun colour’. 24

ROBIN HOUSE CHILDREN’S HOSPICE - GARETH HOSKINS ARCHITECTS

5.0 Design Process 5.1 Precedence - Study Trip

Maggieâ&#x20AC;&#x2122;s Centre - Reiach and Hall

5.0 Design Process 5.1 Precedence - Study Trip

Maggieâ&#x20AC;&#x2122;s Centre - OMA

5.0 Design Process 5.1 Precedence

OUTSIDE WORLD

5.0 Design Process 5.1 Precedence

INSIDE WORLD

5.0 Design Process 5.2 Context

Govan New Yard, Glasgow. H.M.S. Northampton, 1876. The Glasgow shipyards were, at this time, the most productive in the world.

Aerial photo of Govan, Glasgow, on 24 March 1950.

5.0 Design Process 5.2 Context

5.0 Design Process 5.3 Option A

By using the surrounding context to create a grid I was able to generate a square block on the site. By separating the private block from the rest of the building, which follows the strong like of the river, I was able to create interesting shapes for the entrance and surrounding landscape.

5.0 Design Process 5.4 Option B

By using the surrounding context to create a grid I was able to generate 3 blocks again creating shapes for the entrance and surrounding landscape. By elevating the private block up a storey bedrooms will have maximum views of the river and will be kept away from noise, this also will create shelter above the entrance.

5.0 Design Process 5.5 Preferred Location of Building

Model at 1:500

5.0 Design Process 5.6 Building Concept

When designing a hospice for 16-25 year old I want to create a place that gives patients and essential kit of parts that makes them feel normal, I want to provide them with things that being in hospital normally takes away from them. I feel that for the age group social involvement is incredibly important in making these patients feel ‘normal’ whilst also designing spaces for privacy and sanctuary. I want this hospice to feel comfortable and warm, I want patients to feel as if ‘anything goes’, so that in the moments of despair or happiness whatever they need and want will be possible. The hospice is not only for the sick patients but for those that will be left behind to grieve, for them I want to make the journey as easy as possible and make this design a haven. Alvar Aalto once said ‘Architecture should defend man at his weakest’ this gave me great inspiration as emotions are orchestrated by good design. There is no tougher time that what the people in this building will have to go through, therefore I think it is imperative to get the design right and make this a happy vibrant space that will also serve its purpose as a clinic and aid in moments of distress.

5.0 Design Process 5.6 Building Concept

Function 1

Function 2

Function 1

Private

Function 2

Social

Function 3 Function 3

The original concept was to split the building into three main functions and treat these with different architectural language to zone the building for its different purposes.

Clinical

Private, Clinical and Social spaces seemed like the three main zones for the 16-25 year olds in a hospice, with social being at the heart of the space as it should be the most dynamic part of a young persons life.

The clinical block however will be a very predominant part of the patients lives and therefore can be easily accessed by any part of the building, from this patients can choose to spend time with others or be in solitude.

5.0 Design Process 5.6 Building Concept

Private block slanted towards basin to get South Western light and a view of the water and a controlled landscape to aid in calming and provide solace.

Clinical and Social blocks rotated due to grid formed by context and create a hinge for entrance and spaces for nice external use which are sheltered by the building. Social Block links both Private and Clinical blocks.

Final building concept shows how blocks interact with one another and create outdoor spaces for patients, staff and visitors to use. The hinge created is a symbolic point of entry as it shows â&#x20AC;&#x2DC;a fork in the roadâ&#x20AC;&#x2122; a choice for anyone entering the building about where they want to move to next.

5.0 Design Process 5.6 Building Concept

External

Social

Private

Clinical

Free flowing landscaping will form in between the two rigid buildings and will be loosely designed spaces allowing users a choice and to move freely around the building. Idea to have to landscape transition inside with line of eposed timber columns to make the move through the front door less formidable as it will be a similair space and feel familiar. 40

5.0 Design Process 5.7 Building Organisation

Adjacency Diagram 41

5.0 Design Process 5.7 Building Organisation

The Needs of the Patient

The Needs of the Visitor

5.0 Design Process 5.7 Building Organisation

The Needs of the Clinical Staff

The Needs of the Management Staff

5.0 Design Process 5.8 Development of Chosen Option

Site Boundary

Context buildings

Grid created by context Building outline Main access

Potential parking zone Potential landscaping

Medical and service access Escape route

New trees

The docks site was chosen for its ability to become a retreat for the hospice, a concept which came from this was crossing the basin to access the entrance of the hospice. This would act as a poetic idea of leaving the world behind and entering somewhere new. Landscaping and roads are being developed to allow access for service, drop off parking, hearse and ambulance. They need to be accessible but also kept separate without becoming confusing. 45

1:1250

5.0 Design Process 5.8 Development of Chosen Option

Model at 1:500

5.0 Design Process 5.8 Development of Chosen Option

STORYBOARD

5.0 Design Process 5.8 Development of Chosen Option

Site Boundary

Context buildings

Grid created by context Building outline Main access

Potential parking zone Potential landscaping

Medical and service access Escape route

New trees

Due to patients need to access the front door through vehicle and quickly crossing water as the only optional route would not be acceptable however it may be possible to incorporate the idea throughout the design. The sanctuary has been designed to come out of the water with a jetty connecting it to the mainland, landscaping and routes are being developed to incorporate public access to this without disturbing the hospice. 49

1:1250

5.0 Design Process 5.8 Development of Chosen Option

Model at 1:500

5.0 Design Process 5.8 Development of Chosen Option

STORYBOARD

5.0 Design Process 5.8 Development of Chosen Option

Site Boundary

Context buildings

Grid created by context Building outline Main access

Potential parking zone Potential landscaoing

Medical and service access Escape route

New trees

Bedroom gardens cantilever over water and design has been developed to incorporate as much external landscaping as possible for views and natural daylighting, which aid in the healing process. Main entrance has been simplified to enter on the hinge and has no walls or gardens complicating it. Rather a shared surface and landscaping will form a drop off zone outside the front door. 53

1:1250

5.0 Design Process 5.8 Development of Chosen Option

Model at 1:200

5.0 Design Process 5.8 Development of Chosen Option

STORYBOARD

5.0 Design Process 5.8 Development of Chosen Option

After developing the concept to a good stage I wanted to take a few steps back and begin to question if this was really the best option for the site and if there were any missed opportunities that I had not explored. By splitting my model in two I could use it as a 3D tool to help this quick experiment. I tested 14 different variations of my design and ultimately realised that there were many other opportunities but they did not fit with my concept or original ideas. However by contorting the model into various different shapes I did find out that I had overcomplicated the geometry and swayed from my original building diagram. The last model is the first 1:500 model I built and by putting it back on the site I wanted to simplify my design back to the original concept.

Model at 1:500

5.0 Design Process 5.9 Development of Bedroom

Model at 1:100

5.0 Design Process 5.9 Development of Bedroom

SNUG/EXTERNAL SPACE

BEDROOM/BATHROOM

CIRCULATION

1:50

5.0 Design Process 5.9 Development of Bedroom

SNUG/EXTERNAL SPACE

BEDROOM/BATHROOM

CIRCULATION

1:50

5.0 Design Process 5.9 Development of Bedroom

Maggieâ&#x20AC;&#x2122;s Centre - OMA

Model at 1:50

5.0 Design Process 5.9 Development of Bedroom

Model at 1:20

5.0 Design Process 5.9 Development of Bedroom

Model at 1:50

5.0 Design Process 5.10 Development of Social Space

Model at 1:100

5.0 Design Process 5.11 Development of Viewing Room

Model at 1:50

5.0 Design Process 5.11 Development of Viewing Room

Model at 1:50

5.0 Design Process 5.12 Development of Sanctuary

Model at 1:50

5.0 Design Process 5.13 Connection between Viewing Room and Sanctuary

Model at 1:100

5.0 Design Process 5.13 Connection between Viewing Room and Sanctuary

Model at 1:50

5.0 Design Process 5.14 Architectural Ambition (Form Studies)

C 72

The form created by the private block was difficult. It is a long linear building and a main priority was getting light into the bedrooms and circulation areas. The elevation was also complicated by the snug/external areas of the bedroom, therefore I spent some time working on the form of the building and how it would tie back to the simple form of the clinical/social block. In the end I decided upon a shape formed by skylights and had the viewing room and multi-disciplinary rooms form double height bookends. These spaces will be very difficult for families to be in and should be treated differently to the rest of the block.

5.0 Design Process 5.14 Architectural Ambition (Elevation Studies)

Grey Brick

Blonde Brick

Red Brick

Timber

Weathered Timber

Corten Steel

5.0 Design Process 5.14 Architectural Ambition (Precedence)

After creating different elevation studies and looking at what sort of materials would not only suit a hospice but root the building into the site of the Govan Graving Docks I found a beautiful harmony with using corten steel and timber. Both materials represent the rusty strength of the ships and their industrial character whilst also providing warm vibrant and welcoming tones for a hospice environment. Both materials will be allowed to weather naturally to provide constant change through their aging as the ships would do. Corten steel also weathers well in highly corrosive environments which may be important located so close to the river and birch timber will weather to a lovely silver colour, change is an important part of hospice design and I think it is important for a building to be able to age elegantly. 74

5.0 Design Process 5.14 Architectural Ambition (Elevation Studies)

Elevation of Entrance Approach

Weathered Elevation

5.0 Design Process 5.14 Architectural Ambition (Historic Connection)

Homage to Shipbuilding

Working the Clyde

Homage to Shipbuilding (2005)

“The sculpture designed by Jimmy Cosgrove and constructed by Hector McGarva was installed in October 2005. It was made from cast iron and corten steel showing the silhouette of a shipyard worker and his dog. On the adjacent table lie the different tools he would have used. The piece has an inscription ‘celebrate those who made the Clyde great’.” From ‘Welcome to Glasgow’

Tribute to the men who worked in ship building on the River Clyde sited in Bellahouston Park. Homage to Shipbuilding (2005) is made up of steel plates that were originally used to build the ships in

Sculpture in the grounds of Bellahouston Park.

6.0 Design Solution 6.1 Location

1:5000

6.0 Design Solution 6.2 Plans

C 25 25 5

25 25 5

1. Entrance 2. Office 3. Cloakroom 4. WC 5. Accessible WC 6. Store 7. Counselling Room 8. Refuse 9. Bin Store 10. Plant Room 11. Hydrotherapy Pool 12. Changing Room 13. Staff Room 14. Kitchen 15. Social Space 16. Relaxation Lounge 17. Staff Changing 18. Consulting Room 19. Therapy Room 20. Multi-Sensory Room 21. Multi-Purpose Room 22. External Courtyard 23. Winter Garden 24. Multi-Disciplinary Room 25. Bedroom 26. Family Suite 27. Viewing Room 28. Sanctuary 29. External Courtyard/Space for Hearse and Ambulance

25 5

25 25 25 28

25 26

A 2 16 15

3 4 5

5 4 17

13 22

5 7

5 19 20

22 7 5 8 10

Plan

6.0 Design Solution 6.2 Plans

SOCIAL SPACE

KITCHEN

Social Space and Kitchen 1:50

6.0 Design Solution 6.2 Plans

JETTY

VIEWING ROOM

SANCTUARY

CIRCULATION

EXTERNAL LANDSCAPE / AMBULANCE / HEARSE STORE

Viewing Room and Sanctuary 1:100

6.0 Design Solution 6.2 Plans

SNUG / EXTERNAL SPACE

BEDROOM / BATHROOM

CIRCULATION

WINDOW SEAT

Bedroom Plan

1:50

6.0 Design Solution 6.3 Sections

CIRCULATION

BEDROOM

SNUG

Bedroom - Section C-C 1:50

6.0 Design Solution 6.3 Sections

Section A-A

Section C-C 83

1:100

6.0 Design Solution 6.3 Sections

Section B-B

1:100

1:100 84

6.0 Design Solution 6.3 Sections

OFFICE

RELAXATION LOUNGE

EXTERNAL COURTYARD

Section A-A 1:50

6.0 Design Solution 6.3 Sections

SOCIAL SPACE

Section B-B

1:50

6.0 Design Solution 6.3 Sections

EXTERNAL COURTYARD

WAITING AREA/WINDOW SEAT

CONSULTING ROOM

Section C-C 1:50

6.0 Design Solution 6.4 Interior Inspiration

6.0 Design Solution 6.5 Elevations

Elevation 01 - South West Facing

1:100

Elevation 03 - South Facing

1:200

6.0 Design Solution 6.5 Elevations

Elevation 02 - North East Facing

1:100

Elevation 04 - West Facing

1:200

6.0 Design Solution 6.5 Elevations

Elevation 01 1:50

6.0 Design Solution 6.5 Elevations

Elevation 02 1:50

6.0 Design Solution 6.5 Elevations

Elevation 03 1:50

6.0 Design Solution 6.5 Elevations

Elevation 04 1:50

6.0 Design Solution 6.5 Elevations

Elevation 04 1:50

6.0 Design Solution 6.5 Elevations

1:500

6.0 Design Solution 6.6 3D Visualisations

Entrance

Approach 97

Circulation

6.0 Design Solution 6.6 3D Visualisations

Bedroom - from the Patientâ&#x20AC;&#x2122;s Eyes 98

6.0 Design Solution 6.6 3D Visualisations

Bedroom ‘Snug’ 99

6.0 Design Solution 6.6 3D Visualisations

External Garden 100

6.0 Design Solution 6.7 Building Explanation

Green Space

Private Clinical Social Public

Service and Deliveries

Drop Off

Parking

Ambulance and Hearse

Building Diagram

101

Access

Internal/External Connections

6.0 Design Solution 6.8 Access

102

Pedestrian Route

Cycle Route

Drop Off Route

Service Route

6.0 Design Solution 6.9 Landscape

103

TIANJIN QIAOYUAN Turenscape Landscape Architecture

6.0 Design Solution 6.9 Landscape

104

6.0 Design Solution 6.10 Regulations and Guidance

ACCESSIBILITY

LIGHTING

NOISE

Buildings should be designed to consider safety and the welfare and convenience of building users. An inclusive environment is one within which everyone, regardless of age, disability or circumstance, can make use of facilities safely, conveniently and without assistance to the best of their ability. Buildings that consider future flexibility of use also contribute to the creation of a more sustainable housing stock, simplifying alterations. This can allow people to remain longer in their home, through changing circumstances, with the minimum of disruption and inconvenience.

Standard 2.10 Every building must be designed and constructed in such a way that in the event of an outbreak of fire within the building, illumination is provided to assist in escape.

Every building must be designed and constructed in such a way that it is provided with aids to assist those with a hearing impairment.

Standard 4.1 Every building must be designed and constructed in such a way that all occupants and visitors are provided with safe, convenient and unassisted means of access to the building. Limitation: There is no requirement to provide access for a wheelchair user to: a. a house, between either the point of access to or from any car parking within the curtilage of a building and an entrance to the house where it is not reasonably practicable to do so, or b. a common entrance of a domestic building not served by a lift, where there are no dwellings entered from a common area on the entrance storey. Whilst the guidance to this standard reflects general good practice, certain issues remain out with the scope of the building regulations. There are numerous publications offering additional guidance on accessibility and inclusive design, including those listed below: • BS 8300: 2009 – ‘Design of buildings and their approaches to meet the needs of disabled people – code of practice’ • Housing for Varying Needs, Parts 1 & 2 - Communities Scotland • ‘Inclusive Mobility’ – Department of Transport, 2002 • ‘Guidance on the Use of Tactile Paving Surfaces’, published jointly by The Scottish Office and the Department for the Environment, Transport and the Regions (DETR). The longer a pedestrian route, the greater difficulty it can present to many people. Therefore, in addition to minimising gradients where possible, as recommended in clause 4.1.3, the length of an accessible route to an accessible entrance of a building should be limited to 45m. Tactile paving - at a location where the footpath is level with a road surface, such as at a dropped kerb, tactile paving should be used to provide warning to a person with a visual impairment of the presence of a vehicular route. This need not apply to a route within the curtilage of a single dwelling. Information on use of tactile paving on footpaths is given in ‘Guidance on the Use of Tactile Paving Surfaces’. The width of a pedestrian route to a building should reflect how it will be used. For example, most public footpaths are at least 1.8m wide, which allows two-way traffic under most circumstances.

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Escape routes should be illuminated to aid the safe evacuation of a building in an emergency. Emergency lighting and exit signage may be necessary under the Fire Safety (Scotland) Regulations 2006 (see clause 2.0.8). Reference should be made to Part 1 of the Cinematography (Safety) (Scotland) Regulations 1955 for buildings such as cinemas where there are specific requirements for lighting. Due to the special fire precautions within residential care buildings, hospitals and enclosed shopping centres, additional guidance is grouped in the annexes. The intention is to help designers and verifiers find the information they require quickly when designing or vetting such buildings. However it is important to remember that the guidance in the annexes is in addition and supplementary to the guidance to Standard 2.1 to 2.15. For additional guidance on: • residential care buildings, see annex 2.A • hospitals, see annex 2.B Emergency lighting is lighting designed to come into, or remain in, operation automatically in the event of a local and general power failure. It should be installed in buildings considered to be at higher risk, such as in high rise buildings, buildings with basements or in rooms where the number of people is likely to exceed 60. Emergency lighting should be installed in: • a room with an occupancy capacity of more than 10 and any protected zone or unprotected zone serving such a room. Standard 3.16 Every building must be designed and constructed in such a way that natural lighting is provided to ensure that the health of the occupants is not threatened. Limitation: This standard applies only to a dwelling. The Average Daylight Factor test is applied to habitable rooms within domestic properties. A kitchen is generally deemed to be a habitable room if it is large enough to accommodate a dining area. If the kitchen is small or if the property has a separate dining area then the accepted practice is to treat the kitchen as a non habitable room. The guide recommends an Average Daylight Factor of 5% or more if there is no supplementary electric lighting, or 2% or more if supplementary lighting is provided. There are additional minimum recommendations for dwellings of 2% for kitchens, 1.5% for living rooms and 1% for bedrooms.

People with hearing loss should be able to access facilities in a building and to participate fully in activities such as conferences, meetings and entertainment. Standard 5.2 Every building, must be designed and constructed in such a way to limit the transmission of source noise from normal domestic type activities, through a wall or floor, between a room and internal space where noise is likely to occur, to a level that will not cause inconvenience to the building occupants. 5.2.2 Internal Walls The design performance levels in clause 5.2.1 can be achieved by using the Generic Internal Constructions available on the BSD website http://www.scotland.gov.uk/topics/ built-environment/building/ building-standards. Alternatively, product manufacturers may have solutions that will achieve the design performance level. 5.2.5 Doors in Internal Walls Rooms intended for sleeping should be separated by a door that will act as a sound barrier and reduce noise transference. Therefore, a door that provides direct access to a room intended to be used for sleeping should have an overall mass per unit area of at least 25 2 kg/m

SAFETY Standard 4.9 Every building must be designed and constructed in such a way that protection is provided for people in, and around, the building from the danger of severe burns or scalds from the discharge of steam or hot water. Guidance is given under this standard on a number of issues relating to hot water safety. Guidance is given to minimise the risk of explosion due to malfunction of an unvented hot water vessel by: • ensuring that such installations are carried out by appropriately qualified personnel, and • requiring a minimum range of safety devices be fitted to any such installation to prevent the temperature of the stored water exceeding 100°C. Standard 4.13 Every building must be designed and constructed in such a way that doors and windows, vulnerable to unlawful entry, can be secured to deter housebreaking and protect the safety and welfare of occupants. Information found: Technical Handbooks 2015 Domestic, Daylight and Sunlight Study (Within Development)

6.0 Design Solution 6.11 Daylighting

21 June

12:00

03:46

08:07

20:17

12:00

Daylighting - Summer Solstice

106

S 15:49

Daylighting - Winter Solstice

21 December

6.0 Design Solution 6.12 Escape

FIRE SAFETY RISK ASSESSMENT 1. Identify fire hazards Identify: sources of ignition, sources of fuel and sources of oxygen. 2. Identify people at risk Identify: People in and around the premises, people especially at risk. 3. Evaluate, remove, reduce and protect from risk Evaluate the risk of a fire occurring, evaluate the risk to people from fire, remove or reduce fire hazards, remove or reduce the risks to people: • Detection and warning • Fire-fighting • Escape routes • Lighting • Signs and notices • Maintenance 4. Record, plan, inform, instruct and train Record significant finding and action taken, prepare an emergency plan, inform and instruct relevant people; cooperate and coordinate with others, provide training. 5. Review Keep assessment under review Revise where necessary 1. Identify fire hazards Fire hazard rooms Certain rooms within patient-access areas of healthcare premises constitute a particular fire hazard. These are known as “fire hazard rooms” and may include: • chemical stores; • cleaners’ rooms; • linen stores; • clothes storage; • dayrooms; • disposal rooms; 2. Identify people at risk The risk assessment should take into account the patient’s medical conditions, sensory awareness and mobility. In complex healthcare premises providing services for patients with very high dependency (such as those in critical care areas, special care baby units, operating theatres or those suffering from mental illness) or disabled people, it may also be necessary to seek expert advice of another competent person (for example clinical staff). 3. Evaluate, remove, reduce and protect from risk The chances of a fire starting will be low if the premises are well-managed and have limited ignition sources that are kept well away from combustible materials. In general, fires start in one of three ways:

107

• accidentally, such as when smoking materials are not properly extinguished or when lighting displays are knocked over; • by defect, act or omission, such as when electrical office equipment is not properly maintained or when waste packaging is allowed to accumulate near a heat source; or • deliberately, such as an arson attack where external waste receptacles placed too close to the building have been set on fire (see Health Technical Memorandum 05-03 Part F – ‘Arson prevention in NHS premises’ for further guidance). For occupants with very high dependency (see Step 2), the provision of additional fire precautions should be considered, such as: • visual observation; • lower travel distance; • increased refuge; • lower height above ground; • higher numbers of staff; • escape bed lifts; and • automatic suppression systems (for example sprinklers).

Sliding doors are acceptable on escape routes in healthcare premises, provided they convert to outward-opening doors when subjected to reasonable pressure from any direction. In the case of powered sliding doors, they should be installed to ensure that they fail-safe to the fully open position in the event of a power failure. For further information on actuation of release mechanisms, see BS 7273-4. Single Direction Escape: The maximum distance to be travelled before there is a choice of escape route or a protected escape route is 15m. The maximum overall distance to be travelled within a sub-compartment is 30m. In healthcare premises (other than those accommodating dependent or very high dependency patients) where the corridors are more than 30m long, the corridors should be subdivided near their centre by fire doors and, where necessary, fire-resisting construction so as to limit the spread of fire and smoke and to protect escape routes if there is a fire. Very often this can be achieved through the use of compartmentalisation.

Any fire detection and alarm systems should comply with Health Technical Memorandum 05-03 Part B – ‘Fire detection and alarm systems’, which provides general principles and technology guidance on the design, specification, installation, commissioning, testing, operation and maintenance of fire-alarm systems in healthcare premises. It should be read in conjunction with BS 5839-1.

For the safety of dependent and very high dependency patients, staff and fire-fighters, • elements of structure (such as a column or otherparts of a structural frame, a load-bearing wall or afloor) should possess the following minimum levels of fire resistance: • single-storey healthcare premises – 30 minutes;

Once a fire has started, has been detected and a warning has been given, occupants should be able to escape safely, either unaided or with assistance, but without the help of the fire-and-rescue service. The escape routes and their evacuation strategy should form part of a fire safety strategy for the premises, which should also include the procedures for operating and maintaining any fire protection measures necessary for the safe operation of the building. Appendix G of Health Technical Memorandum 05-02, and Health Technical Memorandum 05-01, provide further guidance on the development and documentation of fire safety strategies and procedures. A place of reasonable safety can be an adjacent sub-compartment or compartment on the same level. From there, further escape will be possible either to another adjacent compartment or to a protected stairway or direct to final exit.

4. Record, plan, inform, instruct and train An emergency plan for dealing with any fire situation should be in place. The purpose of an emergency plan is to ensure that: • where practicable, all staff know what to do if there is a fire; and • the premises can be safely evacuated. The emergency plan should be based on the fire safety strategy (see ‘Risk assessment in patient- access areas’) (which may be revised based on the outcome of the fire risk assessment) and be available for employees, their representatives (where appointed), patients (if they request it) and the enforcing authority. Clear and relevant information and appropriate instructions should be given to staff and the employers of other people working in the premises, such as contractors, about how to prevent fires and what they should do if there is a fire. In some premises it may also be prudent to give information to patients and regular visitors.

Automatic fire-suppression systems will normally form part of a fire-engineering solution and may mitigate some of the risks associated with: • dependent and very high dependency patients; • lack of fire-resisting construction around fire hazard rooms; • poor levels of observation; • reduced fire protection to elements of structure; or • insufficient external-envelope protection.

5. Review The fire risk assessment should be a dynamic document that is maintained under constant review. The following are typical examples of reasons to review the validity of the current fire risk assessment:

alterations to the premises, changes in use or occupation of the premises.

Information found: https://www.gov.uk.com and Approved Document B from the planning portal.

6.0 Design Solution 6.12 Escape

MARIE CURIE CASE STUDY Marie Curie, the cancer charity dedicated to caring for patients with terminal illness, take pride in providing vibrant, homely, hospice care for patients and their families. Key to Marie Curie’s principle of providing the best possible quality of life is their first class facilities that patients can feel at home in. When designing their latest hospice in Birmingham, key to Marie Curie vision was to give the facility a heart from where all things would resonate. From this central hub, three corridors would lead guests to hospice accommodation, living and leisure facilities. However, the building’s design configuration to meet fire regulations, planners had to provide a means to protect against fire and smoke channelling along the corridors to other areas of the hospice. Whilst non load-bearing fire walls and fire doors would enable the building to meet fire regulations, the physical partitioning of this would impede on the principle of an open plan central hub thus causing the hospice to begin to resemble a hospital. Coopers solution was to install three FireMaster fire curtains at the entrance of each corridor, these fire curtains would deploy from the ceiling and effectively compartmentalise the central hub in the event of a fire to protect the corridors from fire and smoke migration. This option would guarantee that the building’s open plan design is constructed as designed whilst the FireMaster fire curtains would provide 2 hours protection against fire, protecting the occupant from the harmful effects of fire. Coopers fire curtains are developed to be sympathetic to architectural design and can be installed in a building’s ceiling, remaining hidden from view until triggered by a fire alarm. In this instance, smoke seals were also installed into the fire curtain’s side guides to guard against smoke and hot gases leaking through side channels and spreading to other parts of the building. From concept to full commissioning, Coopers worked with main contractor Wilmot Dixon and Marie Curie to guarantee that the hospice met with local building control approval. Coopers FireMaster fire curtain’s also enabled the hospice’s open plan environment design to be achieved, helping Marie Curie to achieve their principle values by distancing the building away from feeling like a hospital environment towards a homely, more vibrant living space. Furthermore, the installation and commissioning were completed in line with The Prince of Wales official opening of the £20m hospice. “Our fire and smoke curtains help the world’s most architecturally famous buildings meet stringent fire regulations without compromising design”

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Like the Marie Curie hospice my design currently has no partitioning as it would ruin the free flowing open plan and concept of ‘glimpses’ which help you decide how to move around the building. It would also make the building feel much more like a hospital which was something I tried to separate from this design. The Glulam structure has a 60 min fire resistance and bedrooms and treatment rooms will be surrounded by 60 min fire walls and glazed screens. However in terms of fire not being able to spread around the whole building fire curtains could be added to compartmentalise the building if necessary in a fire. On the next page I have showed how the building worked without the need for fire curtains or 60 min smoke sealed fire doors but have also given an option for how the building could be changed if necessary to meet all the fire regulations I stated previously found in Part B of the planning portal.

Information found: http://www.coopersfire.com/case-studies/marie -curie-hospice

6.0 Design Solution 6.12 Escape

Current Design

Fire Risk Applicable Design 2 hour fire curtains to be installed in ceilings and will be triggered by a fire alarm. Indicated with red dashed line. Red walls indicated 60 min and blue walls indicate 30 min resistant wall. Black lines show travel distances and direction of escape, none are greater than 30m within a sub-compartment or 15m with single direction escape.

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1:500

6.0 Design Solution 6.13 Technical Strategy - Structures and Construction

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Model at 1:500

6.0 Design Solution 6.13 Technical Strategy - Structures and Construction Post and beam timber was selected as the preferred choice of structural system as I wanted to create a warm homely atmosphere inside the hospice and expose some timber columns to symbolize strength and stability. Spans are small enough for timber construction allowing a much more cost effective and sustainable option. Closed timber panels, including any openings for windows and doors, can be pre-made in the factory and swiftly erected on site. This speeds up weather tightness for further external cladding and internal finishing. Unlike many processed timber composite panels, timber frame is easy to de-construct and reuse. Timber, if used in construction, retains the majority of the carbon that it absorbed in itâ&#x20AC;&#x2122;s lifetime.

Advantages Can have great structural strength, High insulation capacity can be achieved with relatively thin wall construction. Disadvantages Limited storey height, can be carbon intensive when treated with preservative, a lot of carpentry required.

A. Timber Framed Construction

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Disadvantages Size directed by OSB 1200mm panels, used for small spans, glued components unlikely to be recycled.

B. Structurally Insulated Panels (SIP)

Advantages Good thermal mass if left exposed, good sound and fire resistance(up to 1 hr), speedy erection on site, carbon sequestration in wood.

Advantages Hempcrete is a carbon sink, good thermal insulation properties, 1 hr fire resistance, can be recycled to produce more of the same.

Disadvantages Additional insulation required, heavy for transportation on site, unlikely to be recycled due to glued components.

Disadvantages Thick walls to maximise thermal properties, special spray equipment and applicator required, fast monolithic construction.

C. Glue Laminated Timber Panel System

Structural Grid

Advantages Potential for reclaimed and recycled components, whole panels could be reclaimed and reused, speedy erection on site, lightweight: 25kg/m2.

D. Timber Framed Hemp-Lime Surround (Hempcrete)

In the case of spans (shortest being 4m, longest being 9m) Glulam Timber is the best option as it can span longer than natural timber. A Glulam structure is much safer (predictable burn) and can be more cost effective than an unprotected steel structure. When fire encases a Glulam beam, a carbonized layer forms (charring) around the structural core, which restricts the external supply of oxygen and heat and thus significantly impedes the subsequent burn-off. This is very important feature in a building where the occupants move at such a slow rate. It also has good thermal mass if left exposed, can be specified with formaldehyde-free glues and is airtight and vapour permeable.

6.0 Design Solution 6.13 Technical Strategy - Structures and Construction

150mm of soil

12.5mm of plywood 30mm vertical timber - Scottish larch

100mm of gravel

75mm British gypsum 45mm airgap with 45x45 horizontal timber batons at 600mm centres

150mm of drainage layer warm roof waterproof membrane

12.5 mm of plywood

150mm insulation

30mm plywood Glulam timber beam

200mm insulation 30mm plasterboard or vertical timber boards - Scottish larch

1:10 Roof Build-up

100x50mm engineered timber 100mm screed with underfloor heating warm roof waterproof membrane 150mm insulation

Raft foundation

400mm hardcore

1:10 Floor Build-up 112

1:10 External Wall Build-up

1:10 Internal Partition Build-up

6.0 Design Solution 6.13 Technical Strategy - Structures and Construction

Option A - Amphibious Structure

Option B - Concrete Hull Foundation Structural Grid of Sanctuary

Option C - Anchored Floating Foundation Platform

Option D- Stilts

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6.0 Design Solution 6.13 Technical Strategy - Structures and Construction

After researching various ways of water based Architecture I decided to go with the more traditional option of stilts. Due to the reason that the entire design is not on water this is the best option as the floor level will not move and will be accessed by a walkway also on stilts which will also connect to the cantilevering viewing room. A simple concrete structure will become the base of the sanctuary which will connect to foundations in the riverbed, a timber structure will be used for the construction of the sanctuary and will be clad in corten steel panels and use corten steel fins to the south and west facing faรงades for environmental reasons. 114

6.0 Design Solution 6.14 Technical Strategy - Energy and Environment

Solar Shading - Winter Vegetation and Noise

Solar Shading - Summer

Vegetation and Wind Speed

Ground Source Heat Pump

MVHR

Solar Shading

Rain Water Harvesting

SUDS

Orientation

Vegetation

A heat pump extracts heat from one location (the ‘source’), upgrades the heat and then moves it to another location (the ‘sink’). The source of heat can be the ground, water or air. The temperature gained is lower than with other technologies and a heat pump requires electricity (or gas) to convert harvested heat into useful heating. The electrical energy used for the pump can be offset by renewable energy sources such as PV. A gas boiler will be used as a back up to burn gas for personal washing and space heating systems. UK regulations require condensing boilers of at least SEDBUK 88% (seasonal Efficiency of a Domestic Boiler in the UK). Most heat pumps are reversible to provide cooling in the summer and will reduce heating efficiency in winter.

MVHR, is an energy recovery ventilation system using equipment known as a heat recovery ventilator, heat exchanger, air exchanger, or air-to-air heat exchanger which employs a counter-flow heat exchanger between the incoming and outgoing air flow. This system can reduce the ventilation loss by 80%. Natural ventilation will be used when appropriate as the building is designed for every room to have external views and windows. However for kitchens, bathrooms and the hydro-therapy pool mechanical ventilation will be necessary and can be recovered and used to heat the building allowing the ground source heat pump to be used to its full advantage. Simply by extracting stale air and using it to preheat fresh air supply, MVHR can remove smells and CO2.

Solar shading should be designed to allow solar gain during the colder months while reducing summer solar gain. Good solar gain should not reduce daylighting so much that electrical lighting is needed. From 2080 in Scotland, solar shading may also provide ‘future proofing’ with retrofit measures. On east/west façades, external moveable louvred shutters provide the best solar shading, whilst also providing good solar gain during winter. The longest part of this design maxmmaximises East/West orientation and is where bedrooms, viewing room and sanctuary are located. Deciduous trees have also been used in the design for summer solar shading as they can provide around 80% reduction in summer solar gain and have been placed in large clusters to the south of the building.

The 2-3°C temperature rise predicted by 2040/80 will mean that the air will be able to contain approximately 20% more water. This will lead to heavier rain than we are used to. Rainwater can be harvested for toilet flushing, landscape irrigation and washing machines. Harvesting also reduces the strain on storm water or combined sewers. Rainwater tanks are usually sized to store 5% of yearly collected rainwater. Across the UK, winter rainfall is predicted to be 30-50% greater than the proportion of summer rainfall. CO2 reductions may be achieved, depending on which systems are used, how much rainwater can be collected. Rainwater recycling can reduce CO2 emissions by 15-40% in a small building and even up to 100% with a gravity fed system.

Water run off is usually diverted to storm water sewers. SUDS are ideally a hybrid of systems, in this building I have chosen to use a flat green roof where possible which will reduce water runoff by 50-90% as well as being a biodiverse roofing strategy. Excess water falling on pitched roofs, not retained or drained through permeable paving (car park, roads and outdoor spaces) will be harvested and slowly released to ponds/reedbeds or storm sewers. Filter drains and swales will be used around the large landscape. Glasgow has one of the highest rainfalls in the UK and has the potential to store 65% per hectare of rainwater and reuse for grey water systems which as previously mentioned can be used for toilets, landscape irrigation and washing machines.

The building is orientated so that the longest sections of the building maximise East/West directions. This maximises the solar gains and allows the majority of spaces to be orientated towards the sun at some point in the day to benefit the internal environment. Ideally each building should have two orientation aspects maximising solar gain. Many design and local authority guidelines recommend that single aspect units (bedrooms) should face south or west however this can lead to solar heat gain, particularly given in the increasing temperatures due to climate change, solar shading in this direction has been provided as previously mentioned. The vertical sky component is a measure of the daylighting potential, it is expressed as the percentage of daylight falling from an unobstructed sky onto a vertical window. In Scotland this percentage is 22%.

As previously mentioned vegetation has been used to the south of the building for solar shading but is also useful in providing noise reduction from cars and traffic that may occur outside the building to allow a peaceful and calm atmosphere for the hospice. As Deciduous trees lose their leaves in the winter it is recommended to have a mixture of both deciduous and coniferous to provide benefits for both solar shading and noise reduction year round. As there is not a main road outside the building this mix should be enough to reduce noise reduction between 5-10 dB. Distance between building and vegetation will become greater to allow for solar shading. Vegetation will also help protect the entrance and drop off zone from bad weather and high wind speeds, coniferous trees are needed again for winter months.

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6.0 Design Solution 6.14 Technical Strategy - Energy and Environment

Rain Water Harvesting

SUDS (Sustainable Urban Drainage System)

Scottish Larch

Corten Steel Scottish Larch weathered after nine years. There are frequent knots in Scotlarch® boards, which demonstrate the natural origins of the product and give it a characterful look. Scotlarch® is a naturally durable timber and, for external cladding purposes, is classed as “moderately durable” (class 3 according to BS EN 350-2). This is due to the resin and extracts in the wood which create a resistance to decay. With correct detailing (i.e. no sapwood on exposed faces) and appropriate fixings, Scotlarch® cladding should have a lifespan potential of at least 30-50 years (realistically it can be expected to last twice as long as this). Most of Ruswood’s Scotlarch® originates within 100 miles of their Highland sawmill. In addition to the sustainability benefits this affords, Ruswood’s Scotlarch® is FSC®-certified, meaning that it is sourced from well-managed forests. Scotlarch® is their most cost-effective cladding species, with prices starting at £17 per m2 for sawn boards. Summary: Locally sourced product, innate durability, natural look, weathers to a muted grey tone, sustainable.

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Glass Periodic cleaning and inspection should be the only maintenance required when using exposed weathering steel. In addition, scratches and dings are benefited by the oxide structure and will heal through their own natural development without the need for replacement. Long term cost savings are realized by the material’s durability, which can be seen by the various structures and buildings built nearly up to 50 years ago. Reducing the environmental impacts associated with Volatile Organic Compounds (VOC) emissions from paint coatings and cleaning functions required with painting, positions weathering steel as a sustainable building product that provides a range of LEED certifications. Aged weathering steel brings a multi-dimensional aspect to a buildings appearance. The patina can transform multiple times on a daily basis from a state of dry to wet (and back again) and with it brings a sense of depth and wonder. Summary: Low maintenance, long term cost savings and performance, environmental benefits (LEED credits), dynamic appearance and texture.

The glazed elements of the building are all triple-glazed units housed within insulated aluminium frames. The specified windows are from a Swiss company named SkyFrame who have built up their company researching and developing the thermal performance of windows whilst maximising daylight by minimising the frames. Its success lies with the thermally completely separated panels within the frame to reduce cold bridging often found within metal frames and are low maintenance technology. Sky Frame 1 units will be used for sliding glass door technology. The 12 mm thick units are suitable for applications without thermal insulation requirements. The system also incorporates special sliding seals that offer a high level of sound control. Summary: Low maintenance, high levels of sound control, 98% of daylight gets in.