Gillian Bremner, chief executive of Presbyterian Support Otago, shares why she believes consultation and collaboration are the key to getting it right when it comes to new developments.
What will make life more comfortable for residents? How can nursing and caregiving activities be carried more efficiently? What floor area is optimal for the function of each room?
Those were just some of the questions Presbyterian Support Otago (PSO) staff asked each other and residents when it came time to modernising a hospital wing at Iona Home & Hospital in Oamaru.
The Iona project
Once input was gathered it was clear a total rebuild between the original 1954 tile roof and an enlarged concrete base was required.
“Despite upgrades, no matter how you look at it, a 59-year old building is outmoded,” said PSO chief executive Gillian Bremner.
“The 22-bedroomed Kirkness hospital wing had just three bathrooms, a narrow corridor, no storage, small bedrooms, and was a very difficult work environment. On top of that, the wing was one of two that made up the hospital unit, yet they weren’t easily linked.”
Bremner said that working through differing options and listening to the various opinions such as the placement of the nurses’ station and how many sluice rooms were needed, the project did end up with some late design changes, but that wasn’t unusual in a building of this nature.
“What we’ve ended up with is a very modern integrated unit of one rebuilt wing costing $5.2m and one redecorated wing, now linked three ways, with one being a wide glass walkway overlooking two sheltered courtyards. The seating area in this section is a popular meeting point for residents and families,” she added.
Natural daylight floods into the ‘new’ 1278 sqm Kirkness wing, with its wide corridors, multiple seating areas, 27 large bedrooms – each with an ensuite large enough to take a shower trolley – practical storage areas, huge main lounge, dining room, and nurses station. All bedrooms and lounges have easy access to verandahs and decks.
Financial support from the community allowed for a family/whānau room for families to use when spending extended time with residents.
“Residents in the old Kirkness told us windows needed to be lower and without the horizontal frame in the centre so they could easily see outside from their chairs and bed, so we took that into account.
“Bedrooms are nearly 16 sqm and staff no longer have to remove chairs, walkers, hoists, and other equipment from rooms before attending to residents, making for a safer and more efficient working environment,” Gillian said.
Logistically, the build wasn’t an easy one because some residents still needed to be accommodated in the wing throughout the whole process – a challenge that affected everyone at the 90-resident complex – especially as it was undertaken in two distinct stages.
“While it wasn’t easy for us or the contractors, the commitment of staff in making it as painless as possible was extremely pleasing. At most, residents were only moved twice.
“Essential services had to be maintained to all areas of the home so communication between all parties, including laundry and kitchen teams, was of paramount importance.
“The importance of constant consultation and communication with all parties, from the outset to the conclusion, is something we’ll carry forward to our new venture in Wanaka,” Bremner added.
Joint venture with Aspiring Village
The new venture to which Bremner refers is a joint partnership with Aspiring Lifestyle Retirement Village to build a care home on the village grounds.
Although PSO has its own retirement village, Wanaka Retirement Village, as well as Elmslie House Home & Hospital in the town, the organisation felt it would be beneficial to look at ways it could collaborate with another provider rather than be in direct competition.
“That led to initial talks, and ultimately, a joint venture partnership where we share ownership of the facility, but with PSO operating the home and hospital. Elmslie House carries four-year Ministry of Health Certification so it makes sense for us to expand on what we do well.”
Aspiring Village Chief Executive Aaron Armstrong said that with over 60 villas and newly opened lifestyle facilities, the village was now over half-way through its development.
“Our focus is very much on the independent living end of the market but we’re keen to develop a care home on site so residents could have a true continuum of care,” he said.
“We had the land available and the experience to project-manage the build, but not the expertise in residential geriatric care, so this joint venture will bring our dream to fruition.
“We realise that providing great quality rest home, hospital, and dementia care to our residents and others in the community takes a unique set of skills, which is why we chose to form a joint venture with PSO. They have a strong reputation for providing good quality care, both in our local community through Elmslie House, and in the wider Otago region.”
Bremner added that the potential for shared resources and staffing across both facilities would be fully explored, with Elmslie House benefitting as a result.
“We’ve consulted with staff in our existing facilities on the draft plans, looking in particular at the size of the rooms. As we did at the start of the Iona Kirkness re-build, a mock up room has been set up with equipment to ensure space for hoists and shower trolleys is adequate. The number, size, and shape of the lounges, outdoor courtyards, and flow within the facility are all seen as critical, and there are particular design guidelines for dementia units to be utilised.”
Cost-effective heating and cooling is important in a place like Wanaka, and as in Wanaka Retirement Village, certain ‘green star rating’ features could be included.
“By and large the needs of residents determine the features, and the increased use of computer-based assessment tools such as InterRAI means wifi access throughout the facility is essential. It will also help residents communicate with relatives electronically,” Bremner added.
Working drawings by the Aspiring Village architect and resource consent applications are underway for the $5m first stage of the three stage care complex. Construction of the 10 dementia and 18 home and hospital rooms, along with the Upper Clutha Hospice rooms, is expected to start this September.
PSO has demonstrated that a multi-pronged approach, one in which takes into account the lessons learned from previous projects such as the Iona re-build, but also employs the strengths of others as in the Aspiring project and constantly listens to what the market wants, can work well when embarking on new ventures.