The Harmonia Village in Dover represents a new concept in care based upon a social approach that encourages those living with dementia to lead as normal life as possible, engaging with a familiar environment whilst having access to 24 hours care.
The project remodels 12 redundant semi-detached houses to provide accommodation for 30 residents. A new hub building has communal facilities for the Harmonia Village residents and use by the local community and volunteers together with six bed respite care accommodation.
What were the key challenges?
Funding
As an NHS Trust there is little or no direct funding to develop innovative solutions. The client engaged with European partners and secured 60% funding for the project and then went on to secure the match funding. To do this requires an enormous amount of energy and enthusiasm for the concept along with the need to meet with the various criteria of funders such as regular reporting, meetings etc. This is all in addition to the day job.
Stakeholders
A project of this nature requires the engagement and agreement of many stakeholders from funders, local authorities, Care Quality Commission to people living with dementia and the local community.
Condition of Buildings
The houses had been left empty for several years and were in various states of disrepair due to vandalism, and in one case arson.
Design
A project of this unique nature will be under scrutiny and therefore its design will need to follow best practice and latest research to support people living with dementia.
Care Quality Commission (CQC)
There is no existing model or guidance for this type of project and so there is always a risk that it will not be accepted by the CQC who will inspect after completion of the building works and appointment of staff.
Technology
The integration of new technology in healthcare currently used in other sectors to assist staff and reduce costs comparable with current care models to create a sustainable solution.
What was the brief?
The project, led by Henry Quinn the Strategic Intelligence Director at East Kent Hospitals University NHS Foundation Trust (EKHUFT) and Dr. Philip Brighton at Dementia Centre of Excellence Clinical Lead, saw the opportunity of using the redundant housing and site in Dover as a means of realising this new concept of care. Having visited the famous Hogeweyk Dementia Village in the Netherlands in 2015, they developed their concept for care and applied for an EU grant to part fund the project and were successful in securing Interreg 2 Seas EU Fund covering 60% of the project costs. They then went about securing the remaining 40% from the Trust and other project partners. Design work commenced in March 2018, started on site in October 2018 and the handover was October 2019. The facility will be operational early 2020.
From the outset the client had a clear consistent brief backed up with research and visits. The European model they had viewed was unsustainable for the UK in respect of capital and revenue costs. The Trust developed a model which did not require a minimum 60+ bed care spaces (standard UK model) to be financially sustainable and set a budget of only £2.6M for the construction costs. One of the drivers for the Trust was to get people with dementia out of hospital which is unsuitable and unsafe for them and into a more appropriate environment. This has obvious benefits for the Trust to free up bed space in acute care.
The project remodels 12 redundant semi-detached houses to provide accommodation for 30 residents. A new hub building has communal facilities for the Harmonia Village residents, use by the local community and for volunteers, together with a six-bed guest house offering respite care.
Given the aim of maximising the benefits for the local community, it was important to the client that local companies were involved in the design and construction and that they bought into the project ethos. The project is now live and will create new employment opportunities for the healthcare sector, for both nursing and management staff from the local area. Over 30 staff are already employed at the Harmonia Village, and this will increase as the residents take occupancy.
A key focus of the project is urban regeneration and so the Harmonia Village at Dover has been developed with the aim of maximising benefits for the local area and community. The housing on the site was redundant for several years and the project has brought it back to life, vastly improving standards to regenerate and improve the immediate area aesthetically whilst actively engaging socially with the surrounding residents. It is also aiming to de-stigmatise dementia and normalise the presence of people living with dementia in communities
What were the solutions?
The design team researched the latest thinking in dementia friendly environments and adapted these for this context. This included adapting existing housing stock to be fully accessible and to create a new community. Externally the site had to be designed to ensure residents were able to move freely yet safely but at the same time be approachable to the local community. The new Hub building is the transition point between public, semi-public and private space. The Hub also provides a unique ‘guest house with care’ facility enabling visitors to stay over or carers to take a short break with their partners in a safe supportive environment.
This project addresses the population in the UK who are living with dementia by giving them appropriate supportive facilities whilst reducing the demand on NHS acute hospital resources. Their families know they are being well cared for in an environment that allows the resident to be active, which medically has shown to improve a person’s wellbeing.
The new hub building is already being used to proactively engage with a wide array of user groups from local charities to age-related community groups. It is becoming a focal point with a vibrancy to create a true sense of inclusion and community spirit.
Key products used:
Innovare insulated panel system
Kingspan insulation
The Bespoke Brick Company
Apex Facades - timber cladding
Regal Balustrades - external metalwork
Sika Sarnafil roof system
Fermacell Dry Lining
Ecophon Ceilings
Prima Windows
Premdor internal doors
Becker sliding partitions
EmB Ironmongery
Polyflor vinyl floors
Altro vinyl floors
Howdens Joinery – kitchens
Venesta IPS duct panels
Sanitaryware Armitage Shanks/Ideal Standard
Orona Lifts
How is the project unique?
The Harmonia Village in Dover is an exemplar project with the intention the model can be rolled out across the country and indeed Europe.
The design demonstrates how standard housing stock can be retrofitted and adapted to meet the changing needs of the population and in particular those living with dementia. The designs included the integration of new technology.
Funding
The Harmonia Village at Dover is part of a European funded project called Community Areas of Sustainable Care and Dementia Excellence in Europe (CASCADE).
CASCADE is deploying two telemedicine systems in the project guesthouses. The aim here is to test cutting-edge technology in a controlled setting before it is installed in a person’s own home. A residential monitoring system helps people living with dementia to keep living independently while supporting care staff in their decision making. A video communications system allows a person to interact with their care providers, thereby avoiding unnecessary trips to hospital. The project team believes this is the first time that consumer and medical technology have been combined to benefit people with dementia. The ability to access professional services quickly ensures patient safety and reduces frontline staffing costs. Multi-lingual learning packs provide training to everyone who has contact with people with dementia.
What are the sustainability features?
The Harmonia Village in Dover sustainability objectives were to demonstrate the model of design and care could be used throughout the country to adapt redundant homes to be suitable for people living with dementia. The project has retrofitted 12 redundant semi-detached houses, one having been subject to an arson attack, thereby achieving the carbon savings that can be made over demolition and rebuilding. The timber frame houses had a fabric first approach to energy reduction with higher levels of insulation. By bringing these former houses back to life a neglected and vandalised part of the area has been reinvigorated and improved the quality of the local environment for residents.
The project is built on ecologically low grade land and some remedial contamination work was required. This enabled the established surrounding woodland to be maintained and the ecological diversity to be enhanced during the ongoing and future landscaping works by the residents, staff and volunteers.
What building methods were used?
The new Hub building utilised modern methods of construction. The Structural Insulated Panel System provides high levels of insulation and airtightness constructed off site minimising waste. It features a precast concrete floor which efficiently provides acoustic separation to the first-floor bedrooms and added thermal mass.
The existing houses are of timber frame construction and proved to be adaptable to their new use and to improve their thermal performance.
