COVID-19: The future of design and infection control.

Better is possible with the right design and environment. 

The impact of COVID-19 on the care sector across the world has been devastating. In some countries, 50% of deaths due to coronavirus have occurred in care homes. In the UK, many – often privately operated – care homes are not equipped or financially resourced to deal with such diseases, supporting those whose care is funded through local authorities.

Existing care homes face the reality that physical distancing is, in many cases, simply not possible. Buildings have not been designed with infection control in mind, leading to all those living in the premises being put at great risk during a pandemic.

Almost 30,000 more care home residents in England and Wales died during the coronavirus outbreak than during the same period in 2019 (ONS), in which two-thirds were directly attributable to Covid-19. With insufficient staff to care for residents, a lack of appropriate testing kits, combined with limited access PPE for staff – the odds, this time, were stacked against the traditional care home model.

“What the pandemic has done is to make us think even harder about making sure these spaces are amazing. If there were another pandemic and people can’t get out, they need to know that they’re in an environment where they can flourish,” explains Stewart Dean, Guild Living’s architectural consultant.

But what if – with the right design – we could minimise the risks and control infection across later living communities?  

Important design considerations include:

  • Care floor design – To enable social distancing by breaking down large overall communities into separate ‘households’ of groups of apartments within the buildings. There will be separate lobby access, separate lifts, and carers stationed to service each household

Stewart continues, “Being able to isolate is key. Having separate access to care and separate access to apartments as well as a small number of units in different areas means you can separate these if required. The traditional style of a care home is hopefully gone, and COVID-19 will really push for the new way of thinking.”

  • Separate facilities – Each household has its own kitchen, dining, and lounge area with their own access to facilities. In the event that an area needs to be in lockdown, residents can then comfortably live and access outside areas but in safe environments.

“With Epsom and Uxbridge, we have a big podium area, which can be cordoned off away from the public. If we did have another scenario where there was restricted movement, people could still go outside and use that space without fear of any sort of contamination, ” Stewart explains.

  • Controlling risk and infection – A second floor drop-off area, providing a separate controlled access point to care floors, and a separate specified entrance for external services results in no cross-contamination, enabling dirty storage to get out and clean storage in without crossing paths or passing the other residents.

Whilst controlling risk is vital during a pandemic, person-centric care is essential with a strong focus on preventing the isolation and loneliness often experienced by older people. It is about providing a choice for people as they age.

Stewart adds, “If they have an amazing space, but cannot communicate with their relatives, and they can only communicate over the phone, or FaceTime. How does that affect them? Are there smart ways that we can bring in relatives to see that without exposing them such as using screens?”

With the right design, we can create environments where people feel safe but enable active, fluid movement within a space. Guild Living will focus on having a mix of amenity spaces, outside areas and a strong sense of community – whilst at the same time creating a space for dignity, privacy and respect if one day you don’t feel like going through the front entrance.