Edwardian value

A modest Edwardian house in a leafy Bedfordshire suburb has been restored and extended as a sub-acute mental health unit. Not a 'glamorous' concept, but, as Peter Scher reports, a sensible demonstration of architectural care as well as health care in the community.

What is a suitable and positively helpful environment to someone whose mental health is impaired? The answer, obviously, depends on the kind of mental problem, its severity and the personality and circumstances of each individual, and so must vary from person to person, from time to time and from place to place. The indiscriminate consignment of the mentally ill to large special institutions in the last century gave way to a sequence of fashions in treatment and the buildings designed for it; well-intended but not always successful.

For those with less severe or `sub-acute' mental illness, good healthcare and social care provided in agreeable settings, not separate from but within the general community, is currently regarded as the most humane. Of course this may not be as inexpensive as treating patients in large healthcare units and, horror of horrors, consultants may have to spend a little more of their precious time in travelling around the community to carry out their tasks in several separate units, but from the point of view of these patients care in the community should be preferable. As for capital costs each development may only be judged on its merits. In the case of the new unit in London Road on the edge of Luton by David Morley Architects, costing around 250 000 for the existing property and 500 000 for its extension, conversion and refurbishment appears to be extremely good value for NHS money.

In reviewing its service and accommodation requirements South Bedfordshire Community Health Care Trust have appointed David Morley Architects to develop options with the service managers for a number of mental health units in the Luton and Dunstable area. As a first result of the strategy adopted this mediumsized Edwardian suburban house, next door to a nursing home run by the trust, was acquired and redeveloped as a 14 person unit. Twenty-four hour supervision is provided for the patients who, though not acutely ill, may need skilled support as they readjust. They are allowed, encouraged and given the independence to use the town's facilities during the day.

ACCOMMODATION& LAYOUT

Originally the two-storey house occupied the middle part of its site, set back from north and south boundaries with adjoining properties, with a generous drive at the front and garden at the rear. It has now been extended on the east into the garden and on the south up to the boundary, giving an additional 50% floor area. The original stair with admirable timber balustrading and landing windows decorated with some coloured glasswork ascends to the first floor and to serve rooms in the roof space.

The fourteen bedrooms are arranged in groups as follows: three on the ground floor in the new extension facing the rear garden, in which the more acute or disabled patients would be placed; eight on the first floor - three occupying the original fabric at the front, and five in the new extension again facing the rear garden; and three tucked into the rearranged and extended roof space. All the bedrooms are furnished in the same way although the configurations and sizes vary and the basic interior colour schemes are different in each group. Each group of rooms shares a bathroom, wc and common (ie lounge, activity, dining) room though these latter are not exclusive to the residents of the same floor but available to all. The trust operates a cook/chill meals service for the unit's main kitchen on the ground floor. On one side of the entrance to the unit is the office and staff changing facility, on the other an interview/treatment room. Overall the layout is very compact; the original house having been transformed into a deep plan block by the extensions.

EXTERIOR

At first sight the main facade is that of the original Edwardian house. However what was once a virtually symmetrical design, with modelled entrance porch, solid wood door and gabled roof dormer on the central axis, is now stretched to the right hand boundary (see illustration, pl9). The symmetrical hipped roof extends over this but by re using original clay roof tiles from the altered rear of the house for the augmented roof no 'join' is evident. Likewise the facade of the extension has been most carefully matched to the original (red brick plinth and dry-dashed roughcast render) and only a discreet vertical movement joint separates old from new.

This front elevation of the extension is provided with a circular window for each floor which looks well but furnishes less daylight than would a more prosaically 'matching' rectangular one. And since the extension has no windows against the southern boundary the ground floor front lounge obtains precious little daylight; the corresponding lounge at the rear has french windows to the garden which admit somewhat more. On the first floor the circular window admits a little daylight to a long living area (see illustration, left) and though this is supplemented with some small rooflights the natural lighting here still seems inadequate.

The rear elevation to the garden is all new-build using the palette of the original building - red brick, dry-dashed roughcast, Redland roof tiles (a good match to the original clay tiles) and white windows, trim and rainwater goods (see illustration above). A novel element here is provided by two fire escape stairs from walkways serving accommodation respectively in the roof space and on the first floor. The steelwork for the spiral stairways and walkways are painted a terracotta colour. The paved patio and garden to which they lead are as yet without ornament or landscaping as the available capital budget could not run to it.

INTERIOR

Inside, the existing rooms and the new have been ingeniously and successfully planned. This was no easy task given the demanding requirements of planning and fire authorities, the latter especially being insistent on strict precautions wherever a building is planned for occupants who are mentally ill. Apart from the various utility rooms with 'wet' areas the floors are carpeted throughout with looped pile for harder wearing in the public areas and the softer tufted pile in the bedrooms and their immediate access corridors.

Understandably the bedrooms have modestly sized windows but, as noted before, the common rooms in the new-build do seem gloomy. On the ground floor the rooms have relatively high ceilings but the french windows have no fan lights and the standard window beside one of them has its head at door height. Behind it the dining room is internal and windowless. Nevertheless the whole facility makes a civilised unit for its users and the community alike. It has been in use since last November and evidence of wear and tear, for this type of accommodation, is minimal. The patients are encouraged to go independently into the town for various activities during the day and on my visit the atmosphere seemed no more institutional than a friendly B&B.

A facility of this quality is surely an invaluable asset for the NHS whatever the fashion in treating the mentally ill may be or become. Of positive value is its non-institutional character in layout, design and detail. As yet this unit at Luton has not acquired a positive richness of its own. One hopes the patients choose pictures and ornaments to display, develop the garden, set humorous or lively objects within the well mannered but neutral interiors. But these cannot arrive to order and are only permissible if they support the care and needs of the patients. The unit take some time to evolve successfully.

Although this community mental health scheme in a converted house with extensions is not `glamorous architecture' it is well worthy of consideration here for it presents one example of the answer to the question I posed at the start. It is clearly both a suitable environment and one with many positive, patient-focused qualities, that should be helpful rather than giving negative experiences to those under mental stress. To achieve this requires architectural judgement and design skill in the direct service of the client/users. This is very hard, if not impossible, to come by where design and build and PFI procurement methods are adopted. What is needed, and what was obtained in this scheme, is judgement in selecting suitable buildings and locations, skill in getting rational, intelligible and pleasant layouts within the severest constraints, and sensitivity to designing within each different context and in focussing on ensuring that the environment embodies qualities that patients, staff and visitors will experience as positive.

Copyright Wilmington Publishing Ltd. Oct 1998
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