Aged Care Residential ServicesGeneric Brief

Aged Care Residential ServicesGeneric Brief

AcknowledgementsThe development of this generic brief has been made possible by the participation of many people from theDepartment of Human Services and aged care services in Victoria

Working party members included:Rosemary Calder, Aged, Community and Mental Health, Department of Human ServicesVivien Clark, Planning ConsultantJill Coyne, Aged, Community and Mental Health, Department of Human ServicesRalph Hampson, Aged, Community and Mental Health, Department of Human ServicesMichael Harbour, Consultant Architect to the projectJudy Kelso, Aged, Community and Mental Health, Department of Human ServicesIan Pollerd, Aged, Community and Mental Health, Department of Human ServicesMary Rydberg, Aged, Community and Mental Health, Department of Human ServicesJenny Theisinger, Aged, Community and Mental Health, Department of Human Services

Photographs courtesy of Wintringham, Allen Kong Architect, and Silver Thomas Hanley, Architects

Published by the Aged, Community and Mental Health DivisionVictorian Government Department of Human ServicesMelbourne, Victoria

June 2000

Also published on the Aged, Community and Mental Health Division Website athttp://www.dhs.gov.au/acmh

ISBN 0 7311 6042 8

(0400999)

© Copyright State of Victoria 1999

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1 Introduction 11.1 Generic Brief 11.2 Functional Brief 21.3 Policy and Service Context 2

1.3.1 The Framework for Service Provision 21.3.2 Legislation 31.3.3 Residential Aged Care Program 3

2 Functions and Operations 52.1 Philosophy 52.2 Key Elements 5

2.2.1 Needs-Based Planning 52.2.2 Respite 52.2.3 Aged Care Assessment Service 62.2.4 Resident Classification Scale and Funding Structure 62.2.5 Flexibility and Choice 62.2.6 Accreditation Based Quality Assurance System 62.2.7 Certification of Building and Care Standards 72.2.8 Dementia Care 72.2.9 Ageing in Place 7

2.3 Method of Operation 72.3.1 Specified Care and Services 72.3.2 Service Models 8

2.4 Staffing for Aged Care Residential Services 92.5 Components 10

3 Planning Considerations 133.1 Planning Brief 133.2 The Site 133.3 Site Development 14

3.3.1 Residential Lifestyle Issues 143.3.2 Size 143.3.3 Access 143.3.4 Vehicles, Car Parking and Garage 153.3.5 Signage 163.3.6 Landscaping 16

4 Design 174.1 General Design Criteria 174.2 Building Form and Character 174.3 Implications for People Within the Facility 18

4.3.1 Residents 184.3.2 Visitors, Family and Carers from the Community 194.3.3 Staff 19

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Contents:

4.4 Orientation and Climatic Control 194.5 Designing the Building 20

4.5.1 Design Approach/Clusters 204.5.2 Resident Security 204.5.3 Capacity 204.5.4 Acoustics 214.5.5 Mobility 214.5.6 Sensory Aspects 224.5.7 Building Fabric and Finishes 234.5.8 Furniture 254.5.9 Signs and Graphics 254.5.10 Colours 25

4.6 Building Services 264.6.1 Fire Prevention Services 264.6.2 Hydraulic Services 264.6.3 Lighting and Electrical Services 274.6.4 Communication Systems 274.6.5 Security Systems 284.6.6 Mechanical Services 284.6.7 Waste Disposal and Incineration 28

5 Functional Zones and Relationships 295.1 Functional Zones 295.2 Functional Relationships 305.3 Functional Zone 1: Arrival Area 31

5.3.1 External Entry Canopy 315.3.2 Entry/Lobby 31

5.4 Functional Zone 2A: Living Areas – Private 325.4.1 Bedrooms 325.4.2 Ensuite 365.4.3 Assisted Bathroom 385.4.4 Residents’ Smaller Sitting Areas 39

5.5 Functional Zone 2B: Living Areas – Communal Zone 405.5.1 Lounge Areas 405.5.2 Residents’ Courtyards/Gardens 425.5.3 Dining Areas 435.5.4 Kitchen/Kitchenette 455.5.5 Multi-Use Activity/Therapy Space 465.5.6 Toilets 47

5.6 Functional Zone 3: Clinical and Administrative Areas 485.6.1 Staff Base 485.6.2 Medication/Treatment Area 495.6.3 Quiet/Interview Space 495.6.4 Office 50

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5.7 Functional Zone 4: Service and Support Areas 505.7.1 Service Entry/Canopy 515.7.2 Circulation Space/Passageways 515.7.3 Clean Utility Room 525.7.4 Dirty Utility Room 545.7.5 Laundry (Domestic) 545.7.6 Flower Preparation Space 555.7.7 Stationery and Other Administrative Supplies Store 555.7.8 Food Supplies Store 555.7.9 Clean Linen Store 555.7.10 Soiled Linen Holding Space 555.7.11 Waste Disposal (Infectious and other Waste) Space 565.7.12 Cleaners’ Space 565.7.13 Storage Space for Residents’ Personal Belongings 565.7.14 Wheelchair Parking Space 575.7.15 Medical and Mobility Equipment Store 575.7.16 Workshop 575.7.17 Medical Gases Area 585.7.18 Chemical Store 585.7.19 Plant Room 585.7.20 Holding or Mortuary Room 585.7.21 Viewing Facilities 59

5.8 Functional Zone 5: Staff Amenities 595.8.1 Handwashing Facilities 595.8.2 Staff Toilets 595.8.3 Staff Change/Showers/Lockers 595.8.4 Staff Lounge and Kitchenette 60

6 Other Planning Issues 616.1 Town Planning 616.2 Property Agreement 61

7 Appendices 62Appendix 1: Functional Area Schedule 62Appendix 2: Assessment of Existing Facilities 65Appendix 3: Glossary of Terms 67Appendix 4: References and Bibliography 71

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Figures and TablesFigure 1 Good Site Development 15Figure 2 Functional Relationship Diagram 30Figure 3 Single Bedroom Layout with Single Ensuite (1) 35Figure 4 Single Bedroom Layout with Single Ensuite (2) 35Figure 5 Single Bedroom Layout with Shared Ensuite 36Figure 6 Example Layouts of Sitting Areas 44Figure 7 Example Layouts of Dining/Sitting Areas 44Figure 8 Example Layouts of Kitchenettes 45Figure 9 Example Layouts of Clean and Dirty Utility Rooms 53

Table 1: Components/Spaces 11Table 2: Colour Chart 26

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1.1 Generic BriefA generic brief provides detailed guidelines for theplanning and design of health and aged carefacilities. This generic brief has been developed inresponse to the ‘Commonwealth Aged CareStructural Reform’ and the State Government’sobjective for continual improvement in thedevelopment of aged care residential facilities whichwill further enhance the quality of life for agedpersons.

The aim of this document is to:• Assist aged care residential service facilities meet

the objectives of the ‘Commonwealth Aged CareStructural Reform’.

• Provide general principles for quality designoutcomes for public aged care residential servicefacilities in Victoria.

• Give an overview of the services and activitiesthat an aged care residential service facility willcommonly provide and describe in genericterms, the spaces required to conduct thoseservices and activities.

Each design should be refined to suit the serviceneeds and community circumstances as identified inthe agency’s service plan, which must be approvedby the Department of Human Services (theDepartment). Prior to considering the facilityrequirements for service delivery, it is importantthat each health service provider develops acomprehensive knowledge and understanding oflocal community health and aged care needs.

The Department is committed to providing thehighest quality, most effective and cost efficientaged care services.

These guidelines have been structured around thisprinciple with the main objectives being:• Respect for residents’ rights and dignity and

continuous improvement in their quality of life.

• A residential environment which promotes:– A domestic lifestyle – Self respect – Independence – Social opportunities.

• An environment which meets the objectives of‘Ageing in Place’.

• Flexibility to cater for residents with a range offrailties, disabilities, support needs andconfusional states which may vary over time.

The design influences many elements of theeconomic viability of the facility. These include:• Work practices • Management • Flexibility • Maintenance • Energy efficiency • Operating costs.

This generic brief has been developed throughliterature review and an extensive consultationprocess. Consultation was undertaken withrepresentatives from: • The Department of Human Services.• The Commonwealth Department of Health and

Family Services (now the CommonwealthDepartment of Health and Aged Care).

• Aged care residential service providers(government and non-government).

• Carers.

The processes used to develop the generic briefentailed: • The establishment of a steering committee. • Analysis of existing research data and guidelines

workshops. • Site visits to existing facilities. • Literature search.

Variations in developing each facility may benecessary in order to adjust the design to proposedsites including consideration of refurbishment.Some sections of this document relate to specific

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1 Introduction

legislative requirements such as building codes andsafety specifications. However many aspects of thegeneric brief are indicative or conceptual in natureand therefore provide a framework which can beadapted to meet local needs. The development ofaged care residential services in Victoria will beguided by this generic brief.

1.2 Functional BriefThe information in this generic brief can be takenand adapted by an agency in conjunction with anarchitect to develop a project specific functionalbrief from which a building can be constructed orredeveloped. Development of a project specificfunctional brief that will deliver well-planned agedcare residential service facilities involves extensiveconsultation, investigation and coordination. In theplanning stage consultation for individual facilitieswill involve the Department, aged care residentialservice providers, consumers and carers in thecommunity.

Information on the development of a functionalbrief should be obtained from the Department ofHuman Services Capital Development Guidelines.

Particular note should to be taken of the guidelinesfor: • Policies and procedures for undertaking capital

developments. • The planning and evaluation phase. • Fire risk management.

A project control group is formed to manage andensure that a capital project complies withfunctional requirements, and is within the scope,budgets and time constraints of an individualproject. The project control group gives finalendorsement for the project. Final written approvalfor each phase of a project must be obtained fromthe Department. Representatives from theDepartment at a regional and program level,together with representatives of the agency, will

participate in individual project control groups tocontribute constructively to the design anddevelopment of the service, and to facilitate theapproval processes.

1.3 Policy and Service Context1.3.1 The Framework for Service Provision The demographic profile of the Australianpopulation has changed since 1976 withsubstantially higher annual increases in the numberof people over 65 years of age. This trend towardsan ageing population is expected to continue for atleast the next 20 years. The demographic trendtowards an ageing population can be attributed toadvances in health care and a change in olderpeoples’ lifestyles. These changes include takingpositive actions to keep healthy through physicalactivity, healthy eating and social activity. Changingpatterns of care over the last decade have seen ashift in the balance of care away from the moreintensive types of residential care towards home-based care. Consequently the population profile ofaged care residential facilities in the future willincreasingly be the very frail who have limitedcapacity for ambulation, even with considerableassistance, and people with dementia with majorcognitive deficits and a substantial ambulationdeficit.

The Commonwealth Government has the major rolein the provision of residential aged care services. Itestablishes the policy directions in consultation withState governments, the aged care industry andconsumers and provides the bulk of theadministrative support and funding. TheCommonwealth Government is responsible for anaccreditation based quality assurance systemoverseen by the Aged Care Standards andAccreditation Agency Limited. This system includesconsideration of compliance with prudentialrequirements and certification status in residentialaged care services.

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The State Government has a regulatory role in agedresidential care, such as ensuring compliance withbuilding and fire safety regulations, occupationalhealth and safety requirements and industrialawards. The links between each level of governmentare through formal agreements, joint setting ofstrategic directions and joint planning processes andconsultative mechanisms. Service providers aresubject to legally enforceable conditions of grant.

1.3.2 Legislation The Commonwealth Government in 1997introduced four pieces of principle legislation tofacilitate the aged care structural reform process.These were: • The Aged Care Act 1997 which is the main piece of

legislation to support the structural reforms. Itsets out the broad framework for the entire agedcare program, excluding the ‘Home andCommunity Care Program’.

• The Aged Care Act 1997 Principles to providefurther guidance on the Aged Care Act 1997.

• The Aged Care (Consequential Provisions) Act 1997to facilitate the transition from the old programto the new system.

• The Aged Care (Compensation Amendments) Act1997 which allowed for the recovery of amountsof money the Commonwealth paid to a personfor their care where the person also receivedcompensation payments for this care.

• The Aged Care Income Testing Act 1997 allowed the‘Department of Social Security and Veterans’Affairs’ to commence income testing in advanceof the other ‘Acts’.

1.3.3 Residential Aged Care ProgramUnder the Aged Care Act 1997, the CommonwealthGovernment commenced a major restructuring ofresidential aged care with the introduction of a new‘Residential Aged Care Program’. The ‘ResidentialAged Care Program’ is based on an alignment of theformer hostel and nursing home programs. It builds

on their strengths through development ofimproved funding arrangements and regulationsthat apply to all Commonwealth funded residentialaged care services. A major component of theprogram is the amalgamation of nursing homes andhostels to create aged care residential services withone classification system known as the ‘ResidentialClassification Scale’ (RSC). The change in theclassification process has followed extensiveconsultation and development of the detailedarrangements through working groups comprisedof both industry and consumer representatives.

The ‘Residential Aged Care Program’ is designed toaddress possible pressures, in order to put thesystem on a sustainable footing for the future. It willbring the focus back to individuals by giving serviceproviders the funding and flexibility to meet thechanging needs of consumers in a way thatencourages quality and excellence.

The facilitation of access and care for people whoare financially disadvantaged is built into thesystem.

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2 Functions and Operations

2.1 Philosophy The prime objective of aged care residential facilitiesis to provide a purpose built environment, whichenhances the quality of life for its residents. The‘Residential Aged Care Program’ is underpinned bya set of broad principles, presented in the Aged CareAct, Division 2 (Objects).

In summary these are to:• Promote a high quality of care and

accommodation and protect the health and well-being of residents.

• Help residents enjoy the same rights as all otherpeople in Australia.

• Ensure that care is accessible and affordable forall residents.

• Plan effectively for the delivery of aged careservices.

• Ensure that aged care services and funding aretargeted towards people and areas with thegreatest needs.

• Encourage services that are diverse, flexible andresponsive to individual needs.

• Provide funding that takes account of the quality,type and level of care.

• Provide respite for families, and others, who carefor older people.

• Promote ‘Ageing in Place’ through the linking ofcare and support services to the places whereolder people prefer to live.

The Department of Human Services supports theprinciple that aged care residential environmentsshould meet the objective of ‘Ageing in Place’ and iscommitted to the promotion of an environment thatprovides residents with self respect, socialopportunities and continuous improvement in theirquality of life. A major objective of aged careresidential services is flexibility to cater for residentswith a range of issues relating to frailty, disabilities,support needs and confused states of mind whichmay change as time elapses. The outcome of thefacility development must ensure that residentsregard the building as their own home.

To achieve this the following considerations need tobe incorporated into the design:• Residential scale of facility. • Familiar materials and colours. • Size of rooms. • Privacy. • Communal zones. • Linkages between internal and external spaces. • Integration of staff facilities with overall facility. • Cluster development. • External design compatible with surrounding

environs. • Relationships with the community.

It is essential that the facility be designed for theresidents’ requirements and needs and provide anenvironment which enables staff to assist residentsin maintaining independence and dignity.

2.2 Key Elements 2.2.1 Needs-Based Planning The residential aged care needs based planningsystem will continue to ensure that growth in newresidential care places is in line with populationgrowth and targeted towards the areas of greatestneed. The planning system will also continue toensure that each region has an appropriate balanceof services, including services provided to people intheir own homes, services in residential care forpeople with lower levels of need, as well as servicesfor people with higher levels of need. Funding isstructured to provide for special viability funding toassist small, isolated services in rural and remoteareas.

2.2.2 RespiteThe funding structure of the ‘Residential Aged CareProgram’ also includes unified respitearrangements, designed to improve flexibility andencourage greater provision of respite services.

2.2.3 Aged Care Assessment Service The Aged Care Assessment Service (ACAS) consistsof a multidisciplinary team of health professionalswho are responsible for determining a person’seligibility for entry to a residential care facility. Theteam also ascertains the level of care (high or lowlevel) required for each resident.

2.2.4 Resident Classification Scale and Funding Structure

The ‘Resident Classification Scale’ (RCS) is a keyelement of the aligned funding structure. It is asingle funding and classification system, designedto distribute funding equitably across the residentialaged care sector. This system ensures that funding isproperly matched to the care needs of residents.

Categories of CareDifferent residents will need different levels of care.The RCS has been developed comprising eightcategories of relative care needs of residents incategory one representing the most dependentresidents and category eight the least dependent.

• Categories one to four – represent the ‘highdependency care’ levels (nursing home).

• Categories five to eight – represent the ‘lowdependency care’ levels (hostel).

Each person’s care category is determined by theRCS which covers both nursing homes and hostels.The scale is completed by approved providers. Itcontains questions related to the total care of aresident. These include their clinical, social,emotional and personal care needs, level of abilityto perform activities of daily living and anassessment of their cognitive function. It should benoted that the RCS is not a care plan nor is it anaccreditation document. The RCS presumes therewill be an holistic care plan based on a completeassessment of each resident. Funding structures arebased on the RCS level and category of carerequired by the resident.

2.2.5 Flexibility and ChoiceOperational aspects of the ‘Residential Aged CareProgram’ aim to allow more choice and flexibilityfor older people. This is the concept of integratingresidential care facilities to provide low and highlevel care into a unified aged care system.

2.2.6 Accreditation Based Quality Assurance System

The aim of each aged care residential serviceprovider should be to achieve continuousimprovement in the quality of life for theirresidents. An accreditation system with principlesformulated under the Aged Care Act 1997 has beenintroduced to ensure that all services provide highquality care. The accreditation process involves theGovernment working in partnership withconsumers and providers to provide the bestpossible environment and care. This includes theemployment of appropriately qualified and skilledstaff to meet the needs of residents.

Accreditation is the evaluation process whichresidential aged care facilities must go through to berecognised as approved providers. The Aged CareStandards and Accreditation Agency hasresponsibility for managing accreditation for allCommonwealth funded residential aged careservices.

Accreditation Standards These are one of the key elements of theaccreditation framework. Four accreditationstandards were gazetted in the Quality of CarePrinciples 1997. Services that apply for accreditationwill be assessed against all of the four standards asoutlined below:• Standard 1 – management systems, staffing and

organisational development. • Standard 2 – health and personal care.• Standard 3 – resident lifestyle.• Standard 4 – physical environment and safe

systems.

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Each standard has a range of expected outcomesand ongoing staff development is included in theaccreditation process. More detailed information isin the Accreditation Guide for Residential Aged CareServices, July 1998.

2.2.7 Certification of Building and Care StandardsBuilding and care standards are part of theassessment process undertaken by the Aged CareStandards and Accreditation Agency in accreditingservices. The aim of certification is to provide anopportunity for an income stream to support capitalinvestment in improving buildings. An agency mustobtain certification for a facility in order to chargeresidents an ingoing fee for accommodation and toreceive the Commonwealth concessional rebate forpeople who cannot afford to pay the ingoings. Thecertification process focuses on:• Safety, with an emphasis on fire safety. • Hazards. • Resident privacy. • Occupational health and safety. • Lighting and ventilation. • Heating and cooling. • Continuous improvement.

The physical standard of a facility is measuredagainst a ‘benchmark’ standard. Assessment hastaken into account the traditional differencesbetween hostels and nursing homes in design andpurpose and the system of weightings compensatesfor these differences. This is reflected in the BuildingCode of Australia, individual State regulations andrelevant industry guidelines.

2.2.8 Dementia CareAn improved funding system for dementia careensures better access to quality dementia care andprovides appropriate support to both dementiaspecific units and mainstream facilities.

2.2.9 Ageing in PlaceAged care residential services should reflect ‘Ageingin Place’ by enabling people to access anincreasingly diverse range of services to meet theirindividual needs and to stay in familiarsurroundings with their family and friends as theircare needs change, instead of having to move, oftento new areas, to receive the care they need.

2.3 Method of Operation Service provision should promote a lifestyle andsetting which is as domestic as possible. Resident’sfrailty, disabilities and state of mind should also betaken into consideration. These variables willdetermine the degree of assistance and supportrequired by residents in their normal daily activities.

2.3.1 Specified Care and ServicesSpecified care and services are the basic componentsof care which must be provided to residents in anaged care facility. There is no extra cost for theseservices which are based on residents level of care.Additional charges to residents may only beindicated if a low care resident (category five toeight) requires additional services that are usuallyprovided to high care residents. Extra costs need tobe agreed beforehand with the resident, and anitemised account provided. The three componentsto specified care and services in an aged careresidential service are:• Hotel or accommodation related services. • Personal care services.• Nursing and personal care services.

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Hotel or Accommodation Related ServicesHotel or accommodation related services involveand include:• The general operational requirements of the

residential care service including relevantdocumentation.

• Furnishings. • Furniture. • Bedding. • General laundry. • Toiletry goods. • Cleaning services. • Meals. • Maintenance of buildings and grounds. • The provision of staff continuously on call to

provide emergency assistance as required.

Personal Care ServicesPersonal care services involve and include:• Assistance with the activities of daily living such

as bathing, toileting, eating, dressing, mobility,communication, maintaining continence andmanaging incontinence.

• Rehabilitation support. • Recreational therapy. • Assistance in obtaining health and therapy

services. • Support for people with cognitive impairments. • Emotional support. • Treatments and procedures (under the

instructions and supervision of a healthprofessional, where appropriate).

Nursing and Personal Care ServicesNursing and personal care services and equipmentare to be provided for all high care level residentswho need them. These include:• Equipment to assist with mobility such as

crutches, walkers, walking frames, walking sticksand wheelchairs.

• Mechanical devices for lifting residents.• Stretchers and trolleys.

• Bedding fittings and furnishings appropriate toeach resident’s condition.

• Goods to assist with toileting and incontinencemanagement such as absorbent aids, commodechairs, over toilet chairs and shower chairs.

• Toiletry goods including tissues, teeth/denturecleaning preparations, shampoo, hair conditionerand talcum powder.

• Basic medical and pharmaceutical supplies andequipment including provision of oxygen.

• Administration of medications. • Provision of nursing services and procedures. • Provision and/or maintenance of therapy

services such as recreational therapy, speechtherapy, podiatry, occupational therapy andphysiotherapy services where appropriate.

2.3.2 Service ModelsThere are a variety of service models for aged careservices in Victoria. The service needs of acommunity will determine a facility’s location anddevelopment. Aged care residential services may besituated in or adjacent to an extended care facility orhospital. They may be situated independently or offcampus from an auspicing facility. Service modelsinclude the provision of aged residential care in:• High care (nursing home) facilities for RCS

category levels one to four.• Low care (hostel) facilities for RCS category

levels five to eight.• Collocated aged care facilities which encompass

the concept of ‘Ageing in Place’ to provide bothhigh care and low care in a collocated facility.

Responsible and Accountable Professional CarePracticesThe professional requirements of responsible andaccountable care practices for people who live in anaged residential care facility are documented in theCommonwealth Department of Health and Aged CareDocumentation and Accountability Manual 1998. Thismanual describes the:• Process of care delivery to residents. • Documentation of care. • System of classification of care.

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Responsible and accountable professional carepractices apply to all residents in an aged carefacility. These incorporate a partnership between thecare team, the residents, their families and/orsignificant others. The object of the partnership is to:• Assess the residents’ needs, capabilities and their

expectations. • Plan and implement strategies to meet those

needs and expectations. • Evaluate the resident’s needs, capabilities and

expectations on an ongoing basis.

Residents in a facility providing high care will alsoreceive professional nursing care. High care needresidents in a low care facility will require qualifiednursing care provided by appropriately trained staffin either a direct or supervisory capacity. Effectiveprofessional care delivery involves liaison withothers who may have been previously involved in aperson’s care, such as a medical practitioner, anacute or sub-acute facility or other healthprofessional, to ensure a continuum of care for theresident.

2.4 Staffing for Aged Care Residential Services

The Aged Care Act 1997 subordinate legislationprovides the framework within which providers areable to decide on the staffing mix most appropriateto the care needs of their residents. The Aged CareAct section 54-1(1)(b) requires providers to maintainan adequate number of appropriately skilled staff toensure the care needs of the residents are met. Thisincludes skilled nursing staff where this is indicatedby the needs of the residents. There are specificrequirements relating to the level and qualificationsof staff employed in any approved residential agedcare facility. Minimum levels of staffing are requiredto ensure resident safety and supervision. Theclassification process acknowledges the need fornursing and technical procedures for residentsrequiring high levels of care. All members of thehealth care team are responsible for working inpartnership with the resident to provide the

resident’s care needs and lifestyle choices. Staffproviding holistic care to residents in an agedresidential care facility may include:

Aged Residential Care Manager The manager may be a supervisor in a low carefacility or a director of nursing who is a registered‘Division 1’ nurse in a collocated or high carefacility. A manager may represent or be the personapproved by the Department as the ‘approvedprovider’ to operate the aged care service. Amanager is responsible for the operationalrequirement of the facility including administrativeand clerical services.

Medical Practitioners A general practitioner from the local communityusually provides medical treatment to addressresidents’ medical needs.

Environment and Catering Services PersonnelThe environment and catering services personnelhave the responsibility for linen, laundry, wastedisposal, housekeeping and food supplies.

Maintenance Services PersonnelThe responsibilities of maintenance servicespersonnel include plant and equipment, buildingand maintenance, garden and grounds andoccupational health and safety.

NursesQualified nurses registered by a nurses’ registrationboard in a State or Territory provide nursingservices. State legislation prescribes that particularcategories of qualified nurses perform certainfunctions. For example, ‘Division 2’ registerednurses work under the direction of ‘Division1’registered nurses. Technical and nursing proceduresare carried out by a qualified nurse or otherappropriately trained staff under the direct orindirect supervision of a qualified nurse. Certainmedications and medical functions may only beadministered or performed by a qualified nurse.

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Personal Care AttendantsPersonal care attendants provide assistance forresidents to perform personal activities such asbathing, toileting and dressing.

Other Staff and ResourcesPersonnel may be employed, consulted or accessedon a sessional or private basis as required. These caninclude:• Allied health professionals who provide or direct

therapy services designed to maintain resident’slevels of independence in activities of dailyliving. They may include physiotherapists,occupational therapists, speech pathologists,social workers, dietitians, nutritionists,chiropractors, psychologists, podiatrists,recreational officers and diversional therapists.

• Clinical nurse specialists and consultants whoprovide a range of services such aspsychogeriatric care, continence management,palliative care, pain management, cardiac careand mental health.

• Specialist and general medical practitioners. • Dentists. • Pharmacists. • Members of the Aged Care Assessment Service.

2.5 Components Aged care residential services will vary in size.Components in an aged care residential service willdepend on the location and size of the facility, aswell as the needs of the area in which it is to besituated. The possible components/spaces of anaged care residential service facility listed in thefollowing table are described in detail in the section:‘Functional Zones and Relationships’ (Pages 29–60).

Each component/space has a tick box that defines itin the following categories:

ZoneThe zone classified in an accommodation schedule.

RequiredThe component must be provided.

OptionalSome components of the aged care residentialservice are classified as optional and their inclusionwill depend on the size and location of theindividual facility.

Multi- Zone Use The functional area may be shared by more than onecomponent within the facility.

Shared ExternalSome of the components may be shared withexternal services if an aged care residential service issituated in or adjacent to another facility or hospital.

Example tick box:

Zone Multi-Zone Required Shared External

4 All Yes Yes

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Zone Component/Space Required Optional Multi-Zone Use Shared External

External AreasVehicles/car parking facilities ✓ ✓ ✓Garage for aged care residential service vehicles ✓ ✓Bicycle rack ✓ ✓ ✓Signage ✓External storage areas ✓ ✓ ✓

Zone 1 Arrival AreasExternal entry canopy ✓ ✓Entry/lobby ✓ ✓

Zone 2A Living Areas – PrivateBedrooms ✓Ensuites ✓Assisted bathroom ✓Residents’ smaller sitting areas ✓

Zone 2B Living Areas – CommunalLounge areas ✓ ✓Resident’s courtyards/gardens ✓ ✓Dining areas ✓ ✓Kitchen/kitchenette ✓ ✓Activity/therapy area ✓ ✓Toilets ✓ ✓

Zone 3 Clinical and Administrative AreasStaff base ✓ ✓Medication/treatment area ✓ ✓Quiet interview room ✓Office ✓ ✓

Zone 3 Service and Support AreasService entry/canopy ✓ ✓ ✓Circulation space/passageways ✓ ✓ ✓Clean utility room ✓ ✓Dirty utility room ✓ ✓Domestic laundry ✓Flower preparation space ✓ ✓Storage spaces ✓ ✓Plant room ✓ ✓ ✓Holding or mortuary room ✓ ✓ ✓Viewing facilities ✓ ✓ ✓

Zone 5 Staff AmenitiesHandwashing facilities/toilets/change area ✓ ✓ ✓Shower facilities ✓ ✓ ✓Lockers/staff lounge/kitchenette ✓ ✓ ✓

Table 1: Components/Space

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3 Planning Considerations

3.1 Planning BriefIt is essential that a needs analysis and service planbe undertaken of the agency’s catchment area anddemand on services, current and future, at thecommencement of the project. Such a process willdetermine the aged care residential servicesrequired, the relationship/linkages with otherservices/programs and their economic viability. If anoutcome of the service plan is to provide aged careresidential services (either enhancing an existingservice or introducing a new service) then a facilityplanning brief is required to proceed with thefacility analysis. The planning brief has to beendorsed by the Department prior to commencingthe facility development strategy process. Thepurpose of a planning brief is to establish aframework in which a facility development strategyknown as a ‘Master Plan’ can be undertaken.

The planning brief should provide the followinginformation:• Role statement. • Services to be provided. • Number of beds. • Types of residents. • Functional/departmental relationships. • Siting requirements. • Operational objectives. • Facility requirements. • Area schedules. • Engineering services requirements.

Although the development of facilities should bebased on the design guidelines set out in thisdocument it is equally important that the individualneeds of each community are incorporated into thebuilt environment. This is particularly relevantwhere the aged care residential service is acomponent of a number of services provided fromthe same site, for example, Multi Purpose Services(MPS) and Healthstreams.

3.2 The Site Capital works projects for aged care residentialfacilities are generally initiated from a serviceplanning process or a low Commonwealthcertification assessment score. In many instances anexisting site may already be owned by an agencyThis should not preclude each agency investigatingif other sites are available or more suitable. Theseother sites should be critically analysed against theexisting site to determine the advantages anddisadvantages in relocating and developing newfacilities.

When evaluating the existing site or selecting a newsite the following key objectives should beconsidered: • The site should be large enough to accommodate

all the required components including a site ofsufficient size to facilitate access to a coveredentry.

• The shape of the site and the potential for futureexpansion needs to be evaluated.

• The site itself should be easy to move around forall users. This includes ensuring that there islevel ground in resident areas.

• Costs to purchase and develop the site should beevaluated. Existing topography will greatlyinfluence development costs.

• Geotechnical aspects should be assessed todetermine if there is any soil contamination, asthis may impact on capital costs and safety tooccupants.

• Availability of site engineering services such asgas, water and electricity to the particularlocation should be assessed.

• Selection of a site that reflects the generalcharacter of the local community and inparticular the type of environment in whichresidents are likely to feel comfortable may beadvantageous.

• The quality of the views from the selected sitecan add or detract from the character andeffectiveness of the building.

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• Ensure that a location within a residentialenvironment includes appropriate zoning.

• Select a site in close proximity to shops, publictransport, community services such as seniorcitizens clubs, day centres and libraries.

• Choose a site that has a defined street address.• Adjoining developments should reflect

community expectations and familiarity withresidents’ lifestyle.

3.3 Site DevelopmentThe provision and use of external spaces and theirrelationship to the building is an important aspectof site development. Consideration of the total siteis essential as it influences the planning and designoutcomes, and in addition has a significant impacton the development costs of a project. Issues includewhether there are:• Other health services to be provided on the same

site and what their possible functional relationshipwith the aged care residential service would be.

• Any planning opportunities such as sharingresources with adjoining properties, communitysupport, optimising use of existing buildingsand/or vegetation.

• Any planning constraints such as buildingsetbacks, height restrictions, historicalrestrictions, cultural implications or flora andfauna of significance.

3.3.1 Residential Lifestyle IssuesAlthough the building is an essential element in theprovision of aged care residential services, the sitedevelopment will be critical in providing a ‘total’environment to enhance the quality of living foraged persons. Prime consideration in thedevelopment of the site should be given to:• Safe access to and movement around outdoor

areas accessed by residents. These areas shouldbe fenced so that there is no exit from the facilityexcept in an emergency.

• Landscaping.• External spaces which provide social and

therapeutic opportunities. • Strong interaction between indoor and outdoor

spaces.

• Rest points.• Therapy. • Divisional entries back into the building. • Privacy.

3.3.2 SizeThe site should be of such a size that it caters for allbuildings, including future expansion, residentexternal spaces, car parking and servicedeliveries/pick ups. It will need to allow vehicles(ambulance, taxis, bus, cars) to manoeuvre and shouldpromote a free traffic flow for multiple vehicles.

Taking into consideration the building, externalspaces and planning requirements, the site area for a30 bed aged care residential facility would beapproximately 3100–3300 square metres.

The size of the facility may vary depending on siteavailability, adjoining compatible developments andlocal government planning conditions. For example,available inner suburban land might only be 2500square metres resulting in a reduction of externalspaces. However if the residents have lived most oftheir lives in the inner suburbs they would beaccustomed to limited external spaces and haveadjusted their lifestyles accordingly.

3.3.3 AccessConsideration needs to be given to access and exitpoints to the road for vehicles. A loading bay awayfrom the main entry point will facilitate access forservice vehicles. The aged care residential service ispreferably situated on ground floor level with anentrance providing easy access for disabled peopleand for those using wheelchairs, electric scootersand other mobility equipment. Sensor doors/automatically opening doors will facilitate access.The entrance should be covered to provide dryaccess to the building and be well lit at night. Thedesign of the entrance and resident drop off areashould also allow sufficient dry space for staff toassist residents into and out of vehicles. It isessential that there is easy access to the facility at alltimes for fire fighting equipment and otheremergency and service vehicles.

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Figure 1: Good Site Development

3.3.4 Vehicles, Car Parking and GarageCar parking and vehicle traffic flow on site shouldbe taken into consideration to ensure easy accessand a safe environment for residents, visitors andstaff. An adequate number of vehicle parking spacesfor all users of the facility are required. Under mostplanning conditions aged care residential facilitieswill require one on site car parking space for everytwo beds. Considerations include:• Locating car parking spaces to ensure easy level

access to the facility.• Location of service vehicle parking and turning

areas must be situated away from residentsbedroom areas to avoid unnecessary noise.

• The circulation patterns of vehicles accessing carparking spaces as well as delivery and pick uppoints are important. Large service vehiclestraversing through car parks should be avoided.Turning spaces and parking bays for servicevehicles need be simple and practical to facilitateaccess.

• A bicycle rack for staff members should beadjacent to the facility and be designed toaccommodate locking devices.

• The safety of night staff and security of theirvehicles is essential.

• A lockable garage may be provided if there is tobe a designated vehicle such as a mini-bus.

• Space may be required inside the building forresidents to park and store motorisedwheelchairs.

Car Park

CLUSTER

CLUSTER

CLUSTER

Service Vehicles

Main

Entry

Slight Fall

Future

Expansion

Prevailing

Cold

WindsStreet

Good Site Development Usage

N

3.3.5 SignageSignage identifying the aged care residential serviceshould be displayed clearly in English and otherrelevant languages. It should be designedappropriately for people with a visual impairment.The size of all signage will be in accordance withthe relevant building code or standard. Well knownsymbols can be used instead of words. Where theaged care residential service is integrated into otherfacilities, signage should be in keeping with thealready existing display.

3.3.6 LandscapingA carefully designed landscape can provide anenvironment that is sensitive, nurturing, andsupportive and be an extension of internal spaces.Consideration needs to be given to adequate lowmaintenance watering systems for outdoor areas.Provision for a shed or other storage for gardentools and equipment may be required.

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4 Design

4.1 General Design CriteriaIn general, the built environment should bedesigned and constructed in a manner whichpromotes a domestic environment which is costeffective in both capital and recurrent terms. Simplestraightforward solutions should be encouraged forflexibility of accommodation, ease of constructionand effective work practices. Wherever possible thedesign and structure should involve the use of localtrades and materials and Australian products.

An aged care residential service may be eithersituated in a new purpose built stand-alone facilityor adjacent to an existing facility. It may be situatedwithin an existing building that will need to berefurbished. The selected design should always takeinto consideration the factors related to integratingnew designs within or adjacent to an existingbuilding. When designing a facility anaccommodation schedule should be developed foreach area of aged care residential service activity.The space and activity requirements will differ fromfacility to facility and will relate to the resident,staffing, and operational aspects of the facility.

A design brief prepared in accordance withDepartment Capital Works Guidelines detailingspecific building requirements including a roomarea and data schedule is required once thepreferred facility development strategy has beendetermined and approved by the Department.Careful consideration should be given to identifyingspaces which could be multipurpose or have sharedfunctions. Development of specific accommodationschedules will also be influenced by whetherbuilding occurs on a greenfield site or an existingbuilding is refurbished. Building shape shouldminimise circulation routes, energy consumptionand dependence on artificial light. It may benecessary to stage the work in accordance withfunding allocations or to minimise disruption toexisting services. The design of the buildings shouldprovide for this in a cost effective and streamlinedmanner. The building is to comply with the BuildingCode of Australia (BCA), relevant Australian

Standards and the Victorian Department regulationsas applicable, especially in relation to legionella andfire services. All relevant authority approvals mustbe obtained.

Professional advice on the layout and design of anaged care residential service facility is critical. Anexperienced architect and builder will ensure allfacilities comply with relevant building and safetyregulations and codes of practice and will act as avaluable resource in creating a quality environmentfor a target group. Gaining input from clinicians,professionals and others who will use the facility isvital to the design and building process. The designof the facility should consider the realities ofrecurrent costs. The design therefore needs toconsider:• Robustness of materials used in the construction

and fitting of the building.• The use of standard readily available fixtures and

fittings preferably of a commercial or heavy-dutyquality.

• The simplicity of ongoing maintenance of thefacility.

4.2 Building Form and CharacterThe design philosophy of the aged care residentialservice should impart a friendly and invitingenvironment. A non-institutional, safe andsupportive environment needs to be promoted.Whilst the aim should be to keep the scale of thebuilding ‘domestic’, care should be taken to ensurepractical considerations are addressed, including theneed for ease of movement and the avoidance ofcongestion. The appropriate use of ‘private’ and‘communal’ spaces also needs to be considered.Building design must be flexible and adaptable toenable the service to cater for varying resident andservice needs and future service delivery changes.The aesthetic outcomes of the design should takeinto consideration the building’s function,surrounding environment and communityconsultation. An energy efficient and passive solardesign will provide an economically andenvironmentally sustainable facility.

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4.3 Implications for People within the Facility

The architectural design should be responsive to thephilosophy of care and management objectives ofthe service provider. These guidelines challenge theprevious institutionalised approach to designingaged care residential facilities and encouragedesigners to be innovative in their approach todeveloping concepts for the built environment. It isimportant to remember that it will be someone’shome and the design outcome should wherepossible reflect the residents’ needs, familiaritiesand the environment they are accustomed to.

The interior of the aged care residential servicefacility will provide an inviting and positiveenvironment for the people within the facility.Residents should feel comfortable and regard thebuilding as their own home. To achieve this thescale of the facility and the rooms in the facilityshould be domestic and familiar materials andcolours should be used. It is essential that thefacility be designed to anticipate the residents’requirements or needs and to provide anenvironment which enables staff to assist residentsin maintaining independence and dignity and toprovide personal and social support in theresidents’ daily activities. Building design shouldmaximise the capacity of staff to observe residentsand ensure their safety in all parts of the facility.Security is an important issue particularly whenconsidering residents with dementia.

4.3.1 ResidentsPrivacy must be considered at all times andresidents must have a sense of personal space/territory. External spaces need to be easily accessiblefor residents. A cluster design may be mostappropriate to achieve these aims. The design willinclude communal zones, linkages between internaland external spaces and staff facilities integratedwith the overall facility. The external design must becompatible with the surrounding environment. Allmain living areas should have a pleasant view

where possible and should take advantage of anysignificant scenic vistas and/or areas of activityvisible from the development. The building shouldfacilitate a choice of options and encouragecontinuation of residents’ lifestyles where possible.

Cultural DiversityAustralia is a cosmopolitan community inhabited bypeople of diverse cultural backgrounds includingthose from indigenous backgrounds. As aconsequence there will be varying customrequirements relating to language, food, family,religion and social interaction.

These requirements need to be taken intoconsideration when designing a facility which willbe providing accommodation for residents ofdiverse cultural backgrounds. This may includecreating areas for smaller sub-groups such assmaller dining and sitting areas. Other culturalconsiderations include:• Decor and interior design. • Orientation of rooms. • Food preparation. • Recreational space. • Gardens/landscaping.

Dependency IssuesThe varying dependency levels of residents shouldalso be considered in the design and should caterfor:• Medical problems. • Physical disabilities. • Dementia. • Sensory impairments. • Mental state. • Social behaviour. • Nutritional requirements.

Psychogeriatric ConsiderationsPsychogeriatric residents will generally requirecloser supervision and a more controlledenvironment. This is for their own safety as well asthe safety of other residents and staff. The key

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design issues which may have to be incorporatedinto a facility accommodating psychogeriatricresidents are:• An open planning model to minimise corridors. • More robust materials, fixtures and furnishings

including the use of recessed light fittings andfire protection services.

• Safety issues including master controlswitches/emergency shut off and the use oflockable doors to restrict access.

• Elimination of all potential for residents to harmthemselves, for example, the ability to hangthemselves from exposed fixtures or pipes.

Integrated Rural Health Services In most rural communities aged care residentialservice are integrated with other health servicessuch as acute beds, emergency and stabilisation,primary care and day centre. To ensure an agencyachieves maximum operational efficiencies theseservices are often in the one building complex. Inthis situation some adjustments will need to beconsidered when designing such facilities. Howeverany design outcomes should not compromise theobjectives of ‘Ageing in Place’. Design adjustmentsinclude the:• Front Entry – this is usually a combined entry.

Care needs to be given to create sub entries tothe clusters so that visitors to other services of anagency do not enter the aged residential carezone.

• Clinical and Administration Areas – there maybe an increase in administration areas andtreatment rooms. Administration areas should beseparated from the aged care zone.

• Day Centre – if there is a day centre provided onsite, residents may be able to access this area foractivity programs.

• Kitchen – if there is a main central kitchen,kitchenettes would only be required in diningareas.

• Service and Staff Amenities Areas – staffamenities and support areas such as storage andbuilding services may also vary.

4.3.2 Visitors, Family and Carers from the Community

Design implications for people visiting the agedcare residential facility include:• Car parking in close proximity. • Welcome and comfortable seating arrangements

for visitors. • Access to toilets a public telephone and if

possible, space and facilities for umbrellas, coatsand hats.

4.3.3 StaffA design which not only enables team members tocarry out their duties effectively but also caters forthe needs of the staff will enhance the quality of theservice. Planning should include:• Short travel routes where possible within the

facility. • Car parking areas that are adequately lit at night. • Adequate staff amenities.

4.4 Orientation and Climatic ControlThe design should provide for effective sun control,light penetration, thermal performance andprotection from prevailing weather. Orientationshould maximise the use of sunlight (solarefficiency) with buildings positioned to provideprotection to external sitting areas from theprevailing winds. Physical comfort is important forboth staff and residents. Issues that can affectclimatic control include orientation of the building,external surface areas and internal ventilation andheating. Elements to be considered include the useof appropriate insulation, types and colours ofmaterials including walls, window coverings androofing.

Buildings should be positioned to provideprotection to external sitting areas from theprevailing winds and should be designed forpassive energy efficiency.

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Specific orientation factors include:• Combining orientation of the building with the

effective use of passive solar controls such asroof overhangs, screens and pergolas to minimiseheat gain in summer and maximise heat gain inwinter.

• Proper implementation of orientation principlescan also significantly reduce dependence onmechanical means of heating and cooling.

• North-facing walls allow the greatest controlover heat gain and loss by using eaves,overhangs and proper landscape planting.

• Southern and eastern facing rooms can be verypleasant. With minimal screening of easternwalls, hot summer sun can be effectively blockedout.

• Western-facing walls are the most difficult tocontrol, therefore if possible avoid windows inthis wall. However if this is unavoidable useverandas, adjustable louvres or other means ofsolar control.

• Airconditioning should be considered for groupareas such as dining, lounge and activity areas.

• Airconditioning should be considered for theentire facility where climatic conditions require it.

4.5 Designing the BuildingIn keeping with the main design philosophy theinterior of the building will provide an inviting andpositive environment whilst being fully functional.This means that though the scale of the buildingmay be ‘domestic’ practical considerations such asthe need for ease of movement and avoidance ofcongestion should be addressed. Building designshould also maximise the capacity of staff toobserve residents and ensure their safety in all partsof the facility. The interior design should beculturally appropriate and allow for economicalredecoration.

4.5.1 Design Approach/ClustersA ‘cluster’ approach may be appropriate to creategreater flexibility in managing residents with adiverse range of care needs, and to help to create adomestic setting. Each cluster should incorporatethe following principles:• Seven to 10 bedrooms which will have direct

access to ensuites. • One lounge and dining and kitchen/kitchenette. • The lounge area should be nearer to the front

door where possible. • A sitting room. • A toilet near the living area. • Minimisation of long straight corridors.

4.5.2 Resident SecuritySecurity within the facility and the surroundingoutdoor area is particularly relevant where residentswith dementia are involved and where after-hoursaccess needs to be controlled. Security should beprovided in a manner which is unobtrusive yetprovides an environment which is easily supervisedby staff. Features for residents who wander shouldbe given special consideration. The facility needs toallow people who wander to move easily betweeninternal and external zones whilst being maintainedwithin a secure perimeter.

4.5.3 CapacityThe space capacity of the aged care residentialservice will reflect local need for services, thereforespace and activity requirements will differ fromfacility to facility, and will relate to the clients,staffing and operational aspects of the service. Thetotal number of residents, staff, and visitors theaged care residential service needs to accommodateshould be considered in designing spaces andactivity areas. Consideration must be given toidentifying spaces which could be multipurpose orhave shared functions. Facilities developed fromthis generic brief will not necessarily include anallocation for every function or space listed in the

accommodation schedules in this document.Development of specific accommodation scheduleswill also be influenced by whether building occurson a greenfield site or an existing building isrefurbished.

4.5.4 AcousticsThoughtful acoustic design can be used to aidhearing and ensure privacy. Excessive unwarrantednoise is a distraction and can reduce both thecomfort and ease of communication for all in thefacility. Considerations include:• Intrusive external noise sources such as traffic. • Noise can be attenuated by carefully choosing

and planning the site. • External noise sources are minimised by

window/door seals, appropriately constructedwalls and roofs. For example, cavity brick ismore effective than weatherboard.

• Internal noises are likely to come frommechanical and electrical equipment such asfans, airconditioners, and other people’sactivities such as conversation.

• Internal noise can be minimised by separatingquiet areas from noisy areas.

• Acoustic insulation in wall and ceiling spaceswill reduce transmission of noise from one roomto another. This can also be achieved by the useof heavy curtains, wall hangings and fabricupholstered furniture.

• Noisy areas such as kitchens should have walland ceiling surface treatment that will absorbrather than reflect sound waves.

• Service areas such as toilets can act as a bufferzone within the building.

Another important consideration is noisy residentswho may be disruptive to other residents at night. Itis recommended that at least one bedroom percluster be acoustically treated.

4.5.5 MobilityBuildings should be designed to cope for residentswith a wide range of possible physical and medicalconditions. The aim is to provide an environmentthat will allow the maximum mobility possible foreach person. The aged care residential servicefacility will include access for the disabled asrequired under the Building Code of Australia andin accordance with the relevant AustralianStandards. An increasing number of residents inaged care facilities because of their frailty anddependence will need assistance from one or morestaff. Two factors critical to design are the residents’way of ambulating and their need for assistance.Resident mobility may be categorised as:• Those who move about without any form of aid. • Those who need a walking aid such as a stick,

four pronged stick, frame or support from a staffmember.

• Those who move about in a wheelchair. • Those who are bedbound.

Circulation

• Circulation space in passageways, bedrooms,ensuites, bathroom, lounge, dining and otherareas must be sufficient to facilitate access andmovement. This will enable residents usingmobility equipment to pass others in corridors,move around furniture and safely sit down. Itwill also facilitate staff in caring for debilitatedand bedbound residents.

• Examples of average circulation space sizesrequired for ambulant people using thefollowing mobility aids are: – One person using a walking stick – 750 mm

width – One person using 2 walking sticks – 800 mm

width – One person using elbow crutches – 900 mm

width – One person using crutches – 950 mm width– One person using a walking frame – 800–900

mm width.

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Storage

• Storage space is required for various types ofwheelchairs, walking frames or other mobilityaids such as lifting machines and showertrolleys.

• Adequate storage will ensure that wheelchairsand other mobility aids are not left inpassageways where they can cause obstruction.

Bedrooms

• Spatial design issues that affect mobility are thelocation of loose furniture and equipment suchas bedside tables, chairs and medical equipment.

• Consideration needs to be given to using beds onwheels which will enable staff to move the bedon the occasions that they need additionalcirculation space. The width and length ofdifferent types of beds can vary.

• Estimated minimum space required around abed for a mobile lifting machine (no larger than1200 mm in length and 700 mm in width) is:– 1100 mm on the side requiring access for the

mobile lifting machine. – 650 mm for staff person on the other side if

access for the mobile lifting machine is fromone side only.

– 1000 mm at the foot of the bed allows formanoeuvring the lifting machine at the postend of the bed to doors located on either sideof the room.

• Estimated minimum space required around abed for a fixed overhead lifting device and awheelchair (maximum size of 700 mm wide and900 mm in length) access is:– 900 mm on the side requiring access for the

wheelchair.– 650 mm for staff person on the other side if

access for the wheelchair is from one side only.– 1000 mm at the foot of the bed.

4.5.6 Sensory AspectsAged care residential facilities should be designedto accommodate residents with sensoryimpairments. The use of cues and orientation is veryimportant for people with sensory impairments. Theuse of colour, material surface changes and detailssuch as varying corridor widths or change indirection all assist in providing a built environmentin which the resident feels comfortable and secure.Sensory considerations are listed below.

Vision

• The use of natural and artificial light can have amajor influence on people with visualimpairments. Glare can adversely affect avisually impaired person by causing distractionand disorientation.

• Long corridors and neutrally coloured surfacesand reflective floor finishes should be avoided.Some types of floor surfaces may causeconfusion and contrast in colour. For example,the appearance of a step can be given where floorsurfaces change. Abrasive wall finishes shouldalso be eliminated.

• Where two surfaces tend to merge with eachother skirtings in contrasting colours can be usedto clearly differentiate between walls and floor.The use of markings in handrails can help createreference points.

• Appropriate lighting, colours and floor surfaceswill facilitate visual identification.

Touch

• Changing the texture of surfaces can be used todefine a change of function particularly withflooring and wall materials.

Smell

• A garden or walkway area can be a rich source ofstimulation with perfumed plants. However thefacility should not be overloaded with ‘smells’.

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Hearing

• People with hearing impairments place a greateremphasis on visual cues and lip reading.Therefore high lighting levels (carefully avoidingglare) can assist hearing impaired people whomay need to rely on visual clues to aid them.

• For those with partial hearing impairment thereduction of background noise is essential. Theuse of sound absorbing materials such as carpetsand window furnishings can assist. Internal brickwalls are not recommended. The use of timberstud walls with acoustic insulation can reduceboth the sound reverberation and noisetransmission between rooms.

• For communal areas the installation of an audioloop induction system should be considered.

4.5.7 Building Fabric and FinishesGeneral Considerations

• It is desirable for domestic material/finishes to beused within the facility. Selection of non-toxicmaterials, fabrics and finishes in keeping withdesign philosophy of an aged care residentialservice should be investigated and evaluated.

• All surfaces should comply with the DepartmentGuidelines for Fire Safety (Series 7, CapitalDevelopment Guidelines).

• Materials require the capability of withstanding‘institutional’ treatment and maintenance,cleaning and replacement costs are importantconsiderations. Materials that are easily damagedshould be avoided.

Internal Walls

• Plasterboard is a generally satisfactory method oflining walls and allows for a wide range ofcolour selection, however it may be appropriateto provide more durable finishes at lower levelswhere potential damage may occur.

• In wet areas cement sheet should be used on thewalls.

• Exposed natural materials such as brick orconcrete block should not be over-used. They canbe rough, dark and if not used appropriately canalso appear cold and alienating, however if usedin small areas only they can provide a visualhighlight. Timber can be appropriate if usedcarefully. Excessive use can also produce darkwalls, but timber with a natural finish can beused effectively on skirting boards andarchitraves.

Ceilings

• Plasterboard is preferable for ceilings. Considerthe use of skylights that can be designed toprovide indirect daylight without increasingglare or affecting climate control.

Paint Finishes

• Flat or low sheen washable acrylic paint isgenerally acceptable for walls and requiresminimal maintenance. Flat acrylic paint issuitable for ceilings.

• Enamel paints (semi-gloss) are more suited totimber trimming pieces such as architraves,doors and skirtings.

• High-gloss paint should be avoided.• Wet areas may have enamel paint, ceramic tiles

or vinyl sheet.

Floors

• When choosing floor coverings avoid aninstitutional appearance where possible. Themain factors to consider when seeking floorcoverings are those of:– Safety. – Water resistance. – Ease of cleaning. – Resistance to retaining unpleasant odours.– Appropriateness within the facility.

• Non-slip vinyls are available and should be usedin toilet areas. Vinyl floor covering with acushioned backing may be considered in areaswhere activities are conducted. Glossy vinylfinishes should be avoided because of glare andsafety.

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• Carpet may be used in the entry area, office,lounge rooms, quiet sitting rooms, passagewaysor other living areas.

• Carpets with short pile and specialised backingare practical and easy to clean.

• The carpet pile should be tight weave and shortpile so as not to affect wheelchairs and peopleusing walking aids.

• Carpet tiles are an alternative that may besuitable in some areas.

Door and Window Hardware

• Simple robust door and windows hardwareshould be installed particularly in areas used byresidents.

• All door hardware should be lever type of aminimum length of 150 mm and with a smallreturn at the end of the handle.

• Cylindrical type levers appear to be easier to use. • Handles should be located 1050 mm above floor

level.• Window hardware should be of a low

maintenance type and needs to be easy tooperate.

• Avoid locating window hardware at high points.

Door Locking Devices

• The use of door locks is acceptable but carefulconsideration needs to be given to their impacton emergency exits, ease of use and who hascontrol. Considerations include:• Emergency exit doors which are lockable must

be connected to the smoke detection and firealarm system.

• The use of a master key system isrecommended so that staff have access to alllocked doors at any time.

• Residents bedroom doors can be lockable toprovide for their own privacy and be adeterrent from people wandering into theroom when it is unoccupied. This lock shouldbe a fire latch type from inside the room andkey operated from the passageway. It shouldalso have an overriding control so that it canbe operated as a non lockable door insituations where the resident is incapable ofusing locks.

Doors and Doorways

• Doorways should provide sufficient clearance tofacilitate access for wheelchairs, beds and liftingdevices.

• Although doors need to be robust and have goodacoustic quality, consideration also needs to begiven to their weight and appearance. Frailerresidents will not be able to open heavy doorsand heavy doors may also inconvenience staffwho are pushing trolleys or other items.

• The door should be domestic in appearance. • To facilitate orientation for residents each door

may have different patterns of panelling. • Consider using automatic sliding entrance doors

as they make access easier for disabled people.Sliding doors may also be appropriate for accessto outside enclosed gardens or walkways.

Windows

• Window design and location has to be carefullyconsidered in relation to glare, climate control,ventilation and lighting. The placement ofwindows and the view they provide will affectthe internal ambience of a space.

• Operable windows to all resident areas should beeither sliding or double hinged. The use ofawning (wind-out) windows should be avoidedparticularly where opening onto a paved area.

• The sill height in resident areas, such asbedrooms and living rooms should not be above600 mm. It is preferable that where feasible, theyshould be to the floor and if possible incorporateexternal doors.

• The use of aluminium windows is oftenpreferred due to their low maintenance costs.They should be domestic in appearance andcolour coordinated with the building.

• For all glazed doors and windows below 900 mmand those adjoining doors, the glass has to besafety glass.

Other Surfaces

• Joinery should be as domestic as possible both indesign and materials.

• Built in joinery items such cupboards and otherfurniture items will normally have a laminex ortimber veneer finish.

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• Careful consideration has to be given to thepeople who will be using the cupboards, benchesor other fittings with regards to height, frailtyand disabilities.

4.5.8 Furniture Function

• The furniture must be flexible enough to meetthe needs related to a person’s physicalcapability and be selected for specific purposesrather than for multiple purposes.

• Consideration may need to be given tospecialised styles for specialised uses such asstackable furniture for multi-use areas.

Safety

• Tables and chairs must have stability. • Rounded corners of tables, benches and

cupboards will reduce the possibility of injury.The use of sharp edges must be avoided.

• Colours should be used that contrast with wallsand floor covers.

• Avoid glass or clear plastic furniture.

Comfort

• Furniture that will provide maximum comfortfor the specific needs of the residents should beselected.

Appearance

• Appearance should be as domestic as possibleand appropriate to the use of the room.

Durability

• Furniture should be strong and covered in fabricsthat will withstand spillage and will not easilyshow stains. This can be facilitated by the use ofremovable washable covers.

Mobility • Chairs need to have appropriate arm rests and be

of an appropriate height for a disabled or frailperson.

• Toilet pans should be of a suitable height fordisabled access.

4.5.9 Signs and Graphics• Signs must be visible and consistent throughout

the building. To aid visibility they can be in acontrasting colour to the walls.

• Signs are best situated at around 1500 mm abovefloor or ground level. Typeface should be aminimum of 30 mm and raised or indented.

• The use of signs and graphics should be kept to aminimum and where used they should beappropriate international symbols. Careful use ofcolours, materials and design features canprovide a sense of direction and therebyminimise the need for written signage.

• Entrances and exits should be illuminated.

4.5.10 Colours• Carefully chosen colours can help create an

environment which will have a positive effect,for example, reds are generally regarded asstimulating colours that can produce tension orexcitement while blues are considered restfulcolours or even depressants in some shades.

• Colour selection should ignore current fashions ifthese fashions are inappropriate.

• As a general guide larger surface areas should bein pastels and softer colours while smallersurface areas can have stronger and brightercolours as accents.

• The use of contrasts in colour can assist inorientation for the residents.

• Specific colour schemes may be used todifferentiate the various functional zones orcoloured areas on a floor may be used to indicatean area such as lounge room, activities room,bathroom or toilet.

• As a general guide to assist in selection ofappropriate colours the following chart may beuseful:

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Table 2: Colour Chart

4.6 Building ServicesAll building services shall conform to relevantbuilding regulations including the Building Code ofAustralia and its incorporated Australian Standards.They should also conform to the requirements of therelevant planning authorities who have jurisdictionover the area in which the facility is to be built orfurbished. The built environment has to be safe forresidents, staff and visitors. This includes exits, fireservices, smoke and fire compartmentation of thebuilding, access to hazardous chemicals andoccupational health and safety. The design will beinfluenced by length of corridors, number ofexternal exits, types of construction, smoke/fire walland architectural and engineering details, such ashandrails, joinery, door locking devices, lightinglevels, fire warning systems, nurse call systems andmaterials.

It is important that the risk assessment beundertaken on such safety issues. This can include:• An asbestos audit. • A fire safety audit and risk assessment. • A building regulatory audit. • Legionella testing.

4.6.1 Fire Prevention ServicesThe facility will be required to comply with theDepartment of Human Services CapitalDevelopment Guideline Series 7 Fire RiskManagement and other statutory requirements. Firedetection, prevention and suppression systems aredetailed in the Building Code of Australia. Human

safety is the first priority at all times and the agedcare residential service facility must includeadequate and readily accessible means of escape.The regulation number of exits and their requiredlocations should be regarded as a minimumstandard. People may require help during anevacuation due to the nature of the facility.

The design and construction of the building and itsfittings should aim to reduce any fire risks.Furniture and fittings should be selected on thebasis that they will not contribute unduly to theproduction of smoke or fumes in the event of a fire.This should be checked with the manufacturer.Floor and wall coverings are required to meet fireindex figures. A ‘mimic’ panel should be providedin the nurses’ station to indicate the location of anyactivated smoke/thermal fire detector. The main firepanel should be located adjacent to the main entry,visible from outside, in a non-resident access area.

4.6.2 Hydraulic ServicesHydraulic services include hot and cold water andsewerage waste management. Where hot wateroutlets are accessible to residents the water must bethermostatically controlled in accordance withDepartment guidelines. To assist the management ofthe low temperature system operational indicatorlights should be provided within the staff base area.Measures need to be undertaken to prevent thelikelihood of the spreading of legionella through thewater (and air) system.

Arrangements need to be made for emergency ‘shutoff’ of hot or cold water supply when there is afailure of water supply. In addition concealed stoptaps should be installed to each wet area formaintenance purposes. Toilet cisterns willpreferably be of a concealed type with heavy dutycover panels and side sewerage outlets should beavoided. Facilities for washing bedpans and urinalswill be required in each dirty utility room.

Bathroom fixtures should be provided with devices,which limit maximum water flow and shower rosesshould be of a flush mounted, safety type. Levertype taps that are easy to use are desirable for

Colour General Psychological ResponseBlue Peaceful, comfortable, contemplative, restful.Black Despondent, ominous, powerful, strong.White Cool, pure, clean.Yellow Cheerful, inspiring, vital.Purple Dignified, mournful.Red Stimulating, hot, active, happy.Orange Lively, energetic, exuberant.Green Calm, serene, quiet, refreshing.Pastels Neutral, non-respondent, soothing

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resident hand basins. Wastes to basins in residentsareas should preferably be concealed. Floor wastesof a ‘gatic-wade’ type should be provided to all wetareas. Most facilities will be connected to the localsewerage system, however in remote areas wherefacilities need to provide their own treatmentsystem, consideration needs to be given to theimpact on the environment and local authorityrequirements.

4.6.3 Lighting and Electrical ServicesAccess to daylight can improve quality of life anddisabled, frail or cognitively impaired residents willbe dependent on others to control both natural andartificial lighting. It is important to carefullyconsider lighting factors that will fulfil the needs ofresidents and staff. Skylights specifically designedand incorporated into ceilings will minimise theneed for artificial lighting. The lighting systemshould conform to the recommended standards. Allelectrical circuits should include overload/emergency safety breakers.

Low power factor type fluorescent luminariesshould be used where possible. Fluorescent lightinghas an initial greater cost but is more economical torun. It is important to ensure that it is not tooinstitutional or civic by using concealed and pelmetlighting. Power outlets should be a minimum of 450mm above floor level. Use of larger type light andpower point switches with on/off indicators isencouraged for resident areas. The use of doubleadaptors and extension leads should be avoided. Toenable control of local areas for maintenancepurposes the use of sub circuit boards in clustersshould be considered.

Carefully choose locations for general-purposeoutlets. Sufficient numbers of outlets will need to beprovided to obviate the use of double adaptors,power boards and cords. Bedroom lighting shouldsimulate a domestic lighting environment with asecure bedside lamp for reading. A night-lightshould be incorporated in all bedrooms andensuites. Use dimmer switches for greater controlover lighting levels and enable high levels of

illumination for specific tasks as required. Thelighting system including emergency and exitlighting throughout should conform to therecommended standards.

4.6.4 Communication SystemsThe number of required incoming and outgoinglines will be determined by the size of the usergroup in the aged care residential service. Planningneeds to provide adequate telephone access pointsand handsets for staff, residents and relatives. Anintercom may be provided between the main entryand the staff station. A nurse call system that iseasily accessible for debilitated residents andcompatible with the facility will need to be installed.The nurse call system must comply with BuildingCode of Australia.

The location of the nurse call buttons is extremelyimportant whichever system is installed. Buttonsshould be strategically placed particularly inresidential areas. (One type of call system that maybe considered is a pocket type radio pager nurse callsystem equipped with its own antenna, amplifier,transmitter, encoder and receivers for localtransmission within the facility. This type of pagingsystem can be interfaced with the fire alarm andexternal door systems).

The provision of television antenna points is a keyelement for residents and families. They should beplaced in all resident areas. Plans need to includethe installation of cabling and outlets suitable fortelevisions and computers in staff and residentareas. Information technology andtelecommunications cabling shall comply with theDepartment’s ‘IT2 and T2’ cabling strategy andspecifications appropriate to the service complexityrequired within the building. Resident bedroomsshould have a telephone outlet. Telephones with‘Hands Free’ or portable facilities would be mostappropriate for debilitated residents. Visitors willrequire access to a public telephone (preferably acard or coin operated public STD phone) in arecessed area (for acoustic purposes).

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4.6.5 Security SystemsSecurity systems are for protecting staff andresidents from intruders, particularly at night, andfor monitoring the movement of confused ordemented residents. Their installation should notcompromise the quality of the residents’ livingenvironment. Although such security systems arenecessary, care should be taken that they do notcompromise emergency evacuation requirements.Entry doors should have electronic locking. Varioustypes of security systems are available includingsensors or keypads on doors to the externalenvironment or between various zones within thebuilding. The security system can also be integratedwith the fire detection system.

Battery backup to the electrical supply system willbe required to ensure locks are operative during aperiod of power failure. An override capacity toelectronic door locks should be controlled from thestaff base. Security lighting is essential, particularlyto outdoor areas.

4.6.6 Mechanical ServicesPhysical comfort is important and residents may beaffected by extremes of heat and cold. Orientationand construction of the building will affect internaltemperatures. To minimise running costs ofmechanical heating and cooling, the use of energyefficient systems is important.

Heating

• Heating systems should be designed to maintainreasonably even comfortable conditionsthroughout the facility with a recommended airtemperature of 20–24°C in winter.

• Ducted central heating systems or hydronicsystems (hot water radiators) are possibly thebest method of obtaining even temperatures,depending on the size of the building spaces tobe heated.

• The advantage of a hydronic system is that it issilent and does not blow air through a room. Italso allows for the most specific control over theareas to be heated. Individual control wall panelsin each room would give residents the ability toachieve a specific internal temperate climate

within their own bedroom.

Airconditioning

• Airconditioning systems are an effective butexpensive way to achieve physical comfort. Theyare both costly to install and maintain.

• A split-packaged system may be moreeconomical to operate.

• An airconditioning system will operate mosteffectively when the whole building is designedfor maximum efficiency.

• If an airconditioning system is installed it shouldbe provided with an override control whichenables the system to run on 100 per cent freshair to assist in expulsion of unwantedodours/smoke as required.

• All systems should be designed to take intoaccount standards and guidelines for: – Fire precaution. – Internal noise levels. – Ventilation. – Building Code of Australia. – Legionella control. – The Department’s Technical Guideline TG6.00.

VentilationNatural ventilation should be maximised andmechanical ventilation minimised. Ceiling-mountedfans can be helpful in improving air circulation.Where possible, rooms should have externalopening windows and cross ventilation. Mechanicalexhaust systems would normally be used in all wetareas such as toilets, kitchens and bathrooms wheresteam and odours are more prevalent and should bereleased into the atmosphere.

4.6.7 Waste Disposal and IncinerationCareful consideration needs to be given to theprovision of facilities for the collection, holding,separation and disposal of waste products.Guidelines will be strictly adhered to at all times fordisposal of infectious waste. Adequately ventilatedenclosed external rooms with good vehicular accessshould be provided. If the facility is situated in anexisting hospital or institution, those incinerationand waste disposal unit facilities may be used.

5.1 Functional Zones This section will provide a description of eachfunctional area and its relationship within thefunctional zone. It includes consideration ofpurpose, capacity, required relationships and otherrelevant issues. During the design phase detailedroom data should be provided. As a generalprinciple the layout of the building should be assimple as possible with clear directions for visitors.This generic brief will include an example of afacility schedule of rooms/spaces within the variouszones for a typical 30 bed aged care residentialservice facility. A facility schedule for eachindividual aged care residential facility will includethe relevant components of each zone together withroom and/or space sizes. These zones are nodifferent to a normal house environment and can bebroken down into following five main zones:• Functional Zone 1: Arrival areas • Functional Zone 2: Living areas – private and

communal • Functional Zone 3: Clinical and administrative

Areas • Functional Zone 4: Service and support areas • Functional Zone 5: Staff amenities.

Aged care residential services will vary in size.Components in an aged care residential service willdepend on the location and size of the facility, aswell as the needs of the area in which it is to besituated. Each room/space listed below has a tickbox that defines each component in the followingcategories:

Zone The zone classified in an accommodation schedule.

Required The component must be provided.

Optional Some components of the aged care residentialservice are classified as optional and their inclusionwill depend on the size and location of theindividual facility.

Multi-Zone Use The functional area may be shared by more thanone component within the facility.

Shared ExternalSome of the components may be shared withexternal services if an aged care residential service issituated in or adjacent to another facility or hospital.

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5 Functional Zones and Relationships

5.2 Functional Relationships

Figure 2: Functional Relationships Diagram

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ArrivalAreas

CarPark

Living Areas –Communal

ExternalRecreational

Areas –Courtyards

Living Areas –Private

Clinicaland

Administrative Areas

Serviceand

SupportAreas

StaffAmenities

ServiceEntry

5.3 Functional Zone 1: Arrival AreasThe arrival zone should be at the front address ofthe building. It should be easily accessible, invitingand ‘user friendly’. This area needs to provideinformation for people entering the facility andshould avoid the ‘no man’s land’ feeling that iscommon in the entry foyers of many institutionalbuildings.

5.3.1 External Entry Canopy

Function The entry canopy is to provide dry and protectedaccess to the building. This includes protection forresidents and visitors using the front entry directlyto and from vehicles.

Considerations

• Although the canopy acts as a focal point for thefront door, care should be taken to incorporate itinto the overall building aesthetics.

• Clear roofing material should be fitted tomaximise natural light inside the building.

• A covered area should be of an adequate size toallow vehicles such as taxis, bus, cars, andemergency vehicles to manoeuvre and facilitatefree concurrent traffic flow for multiple vehicles.

• The following measurements are an example:– Height – a minimum of three metres to allow

for a minibus with an air conditioner on theroof.

– Length – the size of a car plus two metres. – Width – sufficient for a vehicle with both

doors open plus another vehicle to drive through.

Fig 5.3.1. Arrival area

5.3.2 Entry/Lobby

Function To provide a clearly identifiable initial access pointfor the aged care residential service facility. Access isrequired for emergency vehicles at all times.

The Front Entry

• The front entry sets the agenda for the rest of thefacility and is a key link between the communityand the residents.

• Design should aim to provide as domestic anambience as possible that blends into the overallaesthetics.

• The design should be inviting to visitors whilstproviding a sense of security for residents.

• The entry area is also the first point of referencein accessing other areas within the building.

• The design should allow for residents andvisitors to easily orientate themselves bydisplaying clear directions.

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Zone Multi-Zone Required Shared External

1 All Yes Yes

Zone Multi-Zone Required Shared External

1 All Yes Yes

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• Appropriate illumination day and night will be akey aspect of this area.

• The entry should be designed for people withimpairments such as limited mobility and poorvision who may require assistance to and fromvehicles.

• A ramp will provide easier access for disabledpersons. Where steps are unavoidable at theentry, they should be marked with edgestripping to aid vision.

The Front DoorThe front door needs to be compatible with a typicalhouse entry, while taking into consideration accessfor disabled persons. It should:• Have a security locking system that does not

require keys, controlled from the staff base. • Be of sufficient width and weight to facilitate

access for all people with disabilities. A heavydoor with rapid closing movement will impedeaccess for a frail, aged or disabled person.

Inside the Entry

• The internal component of the entry shouldprovide seating for about three or four chairs andcloset or hanging space for coats, umbrellas orother items.

• Access to public toilets is essential. • A public telephone is desirable in this area. • There needs to be easy viewing of the front entry,

particularly after hours, to enable staff tosupervise people accessing and leaving thispoint. This is particularly relevant where afacility accommodates residents with dementia.

• Natural light should be maximised.

Finishes

• Floor coverings – carpet with dirt removingsurface area incorporated at the door to suit thegeneral decor. Vinyl sheet may be used but can

induce an ‘institutional’ feel. • Walls – painted and/or wallpaper. • Ceilings – painted.

Functional RelationshipThe entry/lobby is the main access point to thefacility. It should have direct access to the staff base.

5.4 Functional Zone 2A: Living Areas – Private Zone

The aim of this zone is to provide residents withprivacy and quiet space within the facility. Visitorsmay only enter this zone after receiving a personalinvitation, giving residents total control and sense ofownership. The area should also have views andaccess to the external environment. Wherepracticable, engineering services should beindividually controlled. It will primarily comprise:• Bedrooms.• Ensuites.• An assisted bathroom. • Small sitting areas.

5.4.1 Bedrooms

Function The bedroom is a place for residents to sleep and tohave private space for sitting, reading or watchingtelevision. It may also be used for social interactionwith invited guests who may include family, friendsor other residents. The design emphasis shouldtherefore be based on a bed-sitting arrangementallowing the residents to personalise the space tomeet their own needs. Bedrooms in an aged careresidential facility will generally comprise at leastseventy five percent single rooms and the remainder

Zone Multi-Zone Required Shared External

2A No Yes No

double bedrooms. This facilitates/allows for privacyand enables greater flexibility in caring for residentswith changing dependency levels. In circumstanceswhere partners, close relatives or friends are alsoresidents, they may be accommodated in adjoiningbedrooms with interconnecting doors.

Access, Size and Layout

• Bedroom size should be a minimum of fourteensquare metres.

• The bedroom needs to be large enough toaccommodate a single bed and space for two tothree chairs. Where appropriate some personalfurniture such as a side table may be included inthe bedroom.

• Layout of bedrooms needs careful considerationto achieve the maximum useable space. Thedesign may include flexibility to allow for twoalternative furniture layouts.

• Direct access to an ensuite is required.• It is essential that there is sufficient space within

the bedroom area at all times to provide forunrestricted movement by the resident.

• Access is necessary for staff using lifting devices,bath-trolleys, wheelchairs and other appropriateitems.

• Bedroom doors must be wide enough to allowaccess for beds and wheelchairs to passagewaysand the outside environment.

• Blind spots, narrow corridors and restrictedroom entrances should be avoided as they affordopportunity for self injury or injury to others bypatients.

• Consideration should be given to direct externalaccess from the bedroom.

• A view from the bedroom to the outsideenvironment is necessary.

Fig 5.4.1. Low care bed

Beds

• All beds should be durable and have the capacityto be raised or lowered as required, for example,a ‘Hi-Lo’ bed.

• Beds need to be fitted with a well-covered,layered, fire retardant mattress (one type is a KCImattress).

• Bed linen may be in home like colours, texturesand design.

• All beds must have the ability to accommodatecot sides, monkey bars and over-bed table asrequired.

• Pressure relieving equipment should be fitted asrequired, particularly for frail debilitatedresidents.

• All beds will have the scope to be easily wheeledto other areas within the facility or to the outsideenvironment as required.

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Communication

• A nurse call system should be appropriate forindividual needs and easily operated by adebilitated resident. The system needs to bedesigned to cater for alternate bed locations.

• There should be two nurse call pointsstrategically located near the bed and sittingarea. At least one bedroom layout should allow aresident to view the toilet from the bed.

• Telephone points need to be installed to enablephone access for residents when necessary.

Heating and Cooling

• Ceiling fans should be considered for facilities inaverage temperature zones.

• In hotter/humid regions air conditioning shouldbe considered. Personal temperature control ofthe room is also important where possible.

Power and Lighting

• Sufficient power points are necessary for allresident and staff needs including access outletsfor personal appliances and if applicable, a pointfor rechargeable wheelchair.

• Bedrooms should simulate a domestic lightingenvironment.

• Each bed should have a secure bedside lamp forreading.

• Lights should be two way switched – at the entrydoor as well as the bed.

• Switches should be easily accessible for theresident.

Windows and Ventilation

• Natural ventilation is desirable. A bedside orceiling fan will provide extra movement of air fora breathless patient.

• Windows will be:• Flyscreened, openable and with a view to an

outdoor area. • Have a maximum sill height of 600 mm. • Have a minimum glassed area of two square

metres. • Be covered with washable, flame retardant

materials capable of day time blackout.

Recreation

• A television, preferably hung from a well-positioned high wall bracket with remote access,is highly desirable as well as access to music,tapes and a radio.

Furniture, Furnishings and Fittings

• Each room will need a comfortable chair orrecliner for the patient to sit out of bed. Mobilewater chairs are large and expensive but facilitatecomfort and care in a severely debilitatedresident. Sufficient chairs for visitor seating needto be included (or available) in the bedroom.

• A bedside cabinet, preferably with a lockabledrawer is required.

• The wardrobe should be 1200 mm minimum inlength. It will ideally have hanging and drawerspace. Adequate shelving, storage or displayspace is necessary for flowers and personalpossessions. A suitably designed bench space canallow for a small fridge (if appropriate),wheelchair storage, linen storage and bedsidewalking frames.

• Picture rails will allow for the hanging ofpictures or wall hangings and a pin-board canprovide an area for displaying cards or photos.

• Doors may be fitted with internal locking devicesthat have external release mechanisms.

• The recommended ceiling height is 2700 mm.• Furnishings should be of a commercial quality

with impervious inner lining and removablewashable covers.

Finishes

• Floors – carpet (preferred) or domestic like mattfinish vinyl over an impervious sealed floor.

• Walls – washable paint and wall protection forbed heads must be incorporated.

• Ceiling – painted. • Joinery – paint, melamine, laminate or sealed

natural wood.

Functional RelationshipThe bedrooms are ideally situated adjacent to thecommunal living areas. Direct access is essential toan ensuite.

Figure 3: Single Bedroom Layout with Single Ensuites (1) Figure 4: Single Bedroom Layout with Single Ensuites (2)

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Figure 5: Single Bedroom Layout with Shared Ensuite 5.4.2. Ensuite

Function To provide ensuite facilities for residents. Theensuite will comprise a toilet, shower, hand basinand storage cupboard. The provision of ensuitesshould reduce staff travel time and assist incontinence management programs.

Although the creation of a domestic environment isencouraged, the ease of cleaning and long termmaintenance of the room should be considered.

Ensuite – Bedroom RatiosEach bedroom will have direct access to an ensuite,enabling a resident to maintain their personalhygiene. Bedrooms in an aged care residentialfacility will have the following approximate ratio ofshared and private ensuites:

As the above ratios are approximate they will needto be rounded to fit bed configurations in eachfacility. The physical distribution of the singleversus shared ensuites will be determined by theagency to reflect the proposed future use of thebuilding and the local availability of home basedcare for persons who would otherwise require lowcare accommodation. (This guideline is to bereviewed to reflect the dependency levels ofresidents in January 2000).

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Single Room Single Ensuite Adjoining or Double Room

Single Ensuite Shared Ensuite Shared Ensuite

50 – 60 per cent 25 – 30 per cent 15 – 20 per cent

Zone Multi-Zone Required Shared External

2A No Yes No

Access, Size and Layout

• The ensuite should be designed in accordancewith the guidelines set out in the AustralianStandards – Designs for Access and Mobility tofacilitate usage by residents and staff. Thereshould be sufficient room for two to threepersons to manoeuvre in and allow enoughspace for shower chairs, overtoilet seats, liftingdevices, shower trolleys or other appropriateitems.

• A layout that enables the toilet to be seen directlyfrom the bed is desirable. A nightlight should belocated over the toilet to assist in continencemanagement, particularly at night.

• The door to the ensuite should be:– Located in a position to enable easy access for

the resident from within the bedroom, yet takeinto consideration privacy and dignity.

– Wide enough to allow ease of access for staffassistance and mobility aids.

– Capable of being locked but able to beaccessed by a nurse in an emergency.

• Where ensuites are shared with two singlerooms, the design will include the followingensuring that:– The doors from each room will both have a

locking capability to provide privacy. – They are accessible from outside by the nurse. – There is an appropriate warning system such

as a light fitted to ensure the ensuite is onlyaccessed via one room at a time.

Nurse Call Buttons

• There should be waterproof nurse call buttonsadjacent to both the toilet pan and the shower.

Hot Water

• All hot water must be supplied via athermostatic mixing valve or similar approvedtemperature control device.

Shower

• A walk-in graded shower area without steps ordoors is required. The floor should generally falltowards the shower.

• The shower will be equipped with a detachableshower head. A shower attachment that can beadjusted for a lower or higher height will assist aperson to shower independently.

• Adequate drainage is essential in the showerarea.

Toilet Pans

• Toilet suites including the type of ‘flusher’should not restrict an incapacitated person’saccess. The height of pan and type of cisternmust be taken into consideration.

• Ensure there is sufficient space between the walland the toilet pan to provide for staff assistanceboth sides of the resident when necessary.

• Ensure that there is sufficient room over the panfor an over toilet seat to be wheeled into aposition that will avoid spills andembarrassment.

• A bibcock tap adjoining the toilet to enablerinsing of bed pans and other items should beinstalled.

Grabrails

• Grabrails that are robust and maintenance freeare required to be fitted in an ensuite inaccordance with Departmental regulations.

• Careful consideration has to be given to thechoice and positioning of grabrails adjacent tothe shower and toilet. Refer to the AustralianStandards for details of location and fixing.

• Fold down rails may be appropriate for residentsrequiring assistance from two or more staffmembers.

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Hand Basin

• The hand basin must be designed to enableusage by residents in wheelchairs or usingwalking frames. The height of the basin needs toallow for a person sitting down.

• Tap fittings need to provide ease of use for adisabled or debilitated person, for example,people with arthritis or loss of sight. Fittingssuch as lever type or ‘sensor’ (activated bytouch) taps may be considered.

• A mirror should be installed over the hand basinand possibly to the side of hand basin at a lowerlevel for people in wheelchairs or sitting down.

Light, Ventilation and Heating

• The ensuite should have good lighting. Naturallight from a window or skylight is preferablewhere possible.

• Heating and mechanical ventilation is essential.Mechanical ventilation can be operated on thelighting circuit with a delay timer.

Fittings

• Cupboard space/shelving and bench top space isrequired for a resident’s personal belongings andtoilet rolls. Height for ease of access and sightingis important.

• A shared ensuite will require two separatestorage areas for personal items.

• If a fold down chair is fitted, ensure that it iswide enough to accommodate the residentcomfortably.

• A small storage cupboard for bedpans and aidsmay be incorporated within the ensuite.

• Safely fitted power points will need to beavailable for shavers and/or hair dryers.

Finishes

• Floor – non-slip type (sheet vinyl or tiles).• Walls – impervious walling material to 2100m

high (sheet vinyl, tiles laminate sheets).• Ceiling – painted.

Functional RelationshipThe ensuite will be directly accessed from thebedroom or bedrooms. The shared ensuite shouldbe incorporated into and accessed from onebedroom at a time.

5.4.3 Assisted Bathroom

Function To provide a facility for patient bathing with theassistance of trained staff. The assisted bathroom isimportant in providing residents with a choice ofbathing facilities and can also be used fortherapeutic purposes.

Access, Size and Layout

• One bathroom is provided for every 20 to 30residents, however the number will depend onthe layout of the facility and the need to provideprivacy/dignity for residents being transferred tothe bathroom from their bedroom.

• Access to the bathroom should not be via publicor communal spaces.

• The layout needs to take into considerationlifting equipment, staff assistance and movementin and out of the room. It is important to ensurethere is sufficient space between the bath and thedoor to provide privacy for a resident beinglifted from a lifting machine into the bath.

• Door width will need to enable access forwheelchairs, lifting devices and bath trolleys. Thedoor should be fitted with a lock on the inside,which can be opened by a staff memberexternally when necessary.

Bath

• A peninsula bath of adjustable height such as a‘Parker Bath’, a ‘Kebo Bath’, an ‘ARJO Bath’ orsimilar.

• A lifting device is essential and the bath shouldbe of a style that allows for lifting device access.

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Zone Multi-Zone Required Shared External

2A 2B Yes No

• A hand basin of the cantilevered type will needto be suitably positioned to provide wheelchairaccess.

• If hairdressing facilities are required in theassisted bathroom, an attachment can be easilyfitted to the hand basin as necessary.

Toilet

• A toilet with grab-rails may be provided in theassisted bathroom. Details are as listed inensuites.

Shower

• Installation of shower facilities with grab-railsand an adjustable and detachable shower hosemay be appropriate. Details for showers are asfor ‘ensuites’. A specialised shower trolley maybe used and stored in the assisted bathroom.

Nurse Call Buttons

• There should be waterproof staff call buttonsadjacent to the bath and where applicable thetoilet and shower.

Hot Water

• All hot water is to be thermostatically controlled.

Light, Ventilation and Heating

• The room is to be heated and mechanicallyvented with an operational switch separate to thelight switch.

Fittings and Furnishings

• Shelving and hanging space for personalbelongings.

• A cupboard is required for towels. • Towel rack. • Mirror. • Shower seat.

Finishes

• Floor – vinyl sheet safety floor covering and anextra floor drainage point.

• Walls – impervious paint finish with ceramic tilesin shower and basin area.

• Ceiling – impervious paint finish.

Functional RelationshipThe assisted bathroom should be located adjacent tothe private living areas.

5.4.4 Residents’ Smaller Sitting Areas

Function A small sitting area, simplistic in design is a spacewhere residents can rest or socialise in small groups.It may also be used for entertaining visitors who donot wish to visit the larger communal areas.

Fig 5.4.4. Quiet sitting area

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Zone Multi-Zone Required Shared External

2A No Yes No

Access, Size and Layout

• The space may be in an alcove off a passageway.It does not have to be fully enclosed on the walladjoining the passageways, but a low heightpartition without a door can be provided ifrequired.

• Visibility and accessibility to allow for casual orplanned social interaction by residents. Externalviews are essential and direct external access isdesirable.

Communication

• Nurse call availability is essential.

Heating and Cooling

• Heating and cooling facilities are required in thesmaller sitting areas.

Furniture, Furnishings and Fittings

• Shelving for books may be incorporated into thisarea.

• Comfortable seating is desirable for four to sixpeople with domestic style fittings with furniturein colours that are soft and suggest tranquillity.

• A full height external window/door of at leastthree square metres and ceiling height of 2550mm minimum is recommended.

Finishes

• Floors – carpet. • Walls and ceilings – paint.

Functional RelationshipThe residents’ smaller sitting areas need to belocated in the private living area adjacent to thebedrooms and toilet. It is desirable that they alsohave direct access to the external environment.

5.5 Functional Zone 2B: Living Areas – Communal Zone

The communal living zone should encourage socialinteraction between residents and the community. Itshould be easily accessible without traversing theprivate zone. Living areas should be located nearthe front entry with direct access to external spacesand views of community activities such as passingtraffic and people in the street are important. Thecommunal living areas comprise:• Lounge areas.• Residents’ courtyards/gardens.• Dining areas.• Kitchen/kitchenette.• Multi-use activity spaces.• Toilets.

5.5.1 Lounge Areas

Function The lounge room together with the dining room isseen as the main hub of daily activity within anaged care residential facility, providing forrecreational, social interaction and therapeuticprograms. Lounge rooms are seen as communalareas for all residents, family, friends andcommunity.

Access, Size and Layout

• It is recommended that one lounge roomproviding a net floor area of three square metresper resident is situated in each 10 bedroomcluster.

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Zone Multi-Zone Required Shared External

2A All Yes No

• As in a house the lounge area needs to be formalto some extent, but must also have a flexiblelayout to cater for various group sizes andactivities in which residents and staff arecontinually moving around.

• Layout must include space for one or morewheelchairs.

• The use of verandahs/covered areas will extendthe capacity and flexibility of these living spaces.

• An operable wall between the lounge and diningroom will provide flexibility in utilising the areato create extra floor space for larger groupactivities.

• Visual contact is required from the passagewayto the lounge area.

• Views and visual contact with external activitiesare desirable and direct external access via doors(preferably swinging) to a veranda is to beincorporated into the design.

Acoustics

• Good acoustics within the room are enhanced bythe use of a combination of carpet, curtains andupholstered furniture.

Power and Lighting

• Sufficient power points should be located forconvenient access.

• Natural light should be maximised and lightfittings are to be domestic in style.

Communication

• Nurse call buttons should be provided.

Heating and Cooling

• Heating in winter and cooling for summer use isrecommended.

• Hot water heating radiators should havethermostat valves.

Furniture, Furnishings and Fittings

• All furniture and furnishings need to bewashable and hardwearing. A chair rail or wallprotection will prevent damage from chairs.

• Furniture and fittings should not be obstructiveto residents with sensory impairments orphysical disabilities nor should they inhibit theuse of the room. There needs to be sufficientseating in comfortable chairs with armrests(arranged in more than one configuration) for thesize of the cluster.

• A lockable cupboard will provide security foraudio-visual equipment. Shelving provides forbooks, magazines and other recreationalmaterial. Inclusion of picture rails will allow forwall hangings and pictures.

• A television may be located in the lounge areas,however staff must ensure that it does notdominate the use of the room. Residents shouldhave the option of having a television in theirown bedroom.

• Portable screens may need to be used for privacyat certain times, for example, when transferring aperson from a wheelchair to a lounge chair.

• Windows should be full height and if feasible,maximise the length of an external wall tooptimise views and conceptually create thefeeling of a larger space.

• Ceiling height should be no lower than 2700 mm.Variation of ceiling height will help to create avarying spacial environment.

Finishes

• Floors – carpet. • Walls and ceiling – paint. • Joinery –- painted or natural finish.

Functional RelationshipLounge rooms need to have direct access to theexternal environment and be adjacent to toiletfacilities.

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Figure 6: Example Layouts of Sitting Areas 5.5.2 Residents’ Courtyards/Gardens

Function To provide the residents with an external space,which is useable and enhances the homeenvironment including areas for socialisation,privacy and therapeutic activities. Features withincourtyards and gardens should provide orientationand focal points for residents, staff and visitors.

Access, Size and Layout

• The area required for residents’ courtyards/gardens is five to eight square metres perresident.

• It is recommended that pathways are 1500 mmto 1800 mm wide.

• Pathways should be clear, simple and shouldlead to a destination.

• Alternative access points back into the buildingare desirable, particularly for residents sufferingfrom dementia.

• The front garden and back garden principle ofa typical suburban residence should be the samefor aged care residential facilities. For example,the front yard is more formal and public whilstthe back yard is informal and private.

• The layout needs to consider accommodation foranimals and/or birds such as a dog kennel andbird aviary.

• A clothesline should be situated close to thedomestic laundry area.

• To assist in providing a discrete secureenvironment the installation of a ‘pool’ fenceis encouraged.

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Zone Multi-Zone Required Shared External

2B All Yes No

Seating and Rest Points

• Fixed seating should be provided every 20 to 30metres.

• Some seating may need to be placed under coveror semi-cover.

• Rest points should be provided in a variety ofpublic and private locations. They should notrestrict pedestrian movement.

Landscaping and Socialisation

• The use of a rotunda, verandas and a barbecuecan assist in providing informal points ofgathering and socialisation.

• Sections of the outdoor space may be allocated asa smoking area.

• The use of raised garden beds to enable residentsto participate in gardening activities, such asvegetable plots, should also be incorporated intothe landscape design.

• Plants and trees need to be carefully chosen. • The following issues in plant or tree selection

need to be considered:– Shade. – Familiarity.– Colour.– Practicality.

It is also important to consider:– Plants that are poisonous or cause allergies. – Maintenance, including watering of the area. – A timed controlled water sprinkler system is

advisable.

Functional RelationshipThe residents’ outdoor areas such as courtyards andgardens should be adjacent to the residents’ livingareas.

5.5.3 Dining Areas

Function The dining areas together with the lounge areas areseen as the main hub of daily activity within anaged care residential facility. The dining area iswhere residents can sit down and have meals, meet,play games and generally socialise.

Access, Size and Layout

• The size of the dining room should be based ontwo square metres per resident.

• It is recommended that there is one dining roomfor each bedroom cluster of 10 beds.

• External access and view is essential.• Variety in seating arrangements and choice of

options for the resident is important. • The design will include space for small private

occasions, such as birthdays. This can beachieved by using an alcove within the diningroom or a small separate room.

• Direct access to the kitchen/kitchenette isessential for hydration and nutrition.

Furniture, Furnishings and Fittings

• Individual tables with seating for two to fourpeople are required.

• Tables need to have the capacity to be joined toseat up to 10 people.

• Domestic style furnishings may includesideboards and audio equipment.

• A dado rail or other wall protection will avoidwall damage from chairs.

• Ceiling heights should be 2700 mm and the useof bulkhead/dropped ceilings to create varyingspacial volume can add to providing intimateareas.

• The use of acoustic materials to control noise isrecommended for floors, walls and ceilings.

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Zone Multi-Zone Required Shared External

2B All Yes No

Finishes

• Floor – carpet or vinyl. • Walls and ceiling – painted.

Functional RelationshipDining areas need to be adjacent to the loungeareas. Access is required to toilets.

Figure 5.5.3: Lounge and Dining Room

Figure 7: Example Layouts of Dining/Sitting Areas

44

45

5.5.4 Kitchen/Kitchenette

Function Kitchen – is used for the storage, preparation andcooking of food. The function of the kitchen willvary depending if there is a main central kitchen onsite. This is often the case for rural agencies, thathave integrated health services. Agencies without acentral kitchen require a greater emphasis onproviding for meal preparation within each 10 bedcluster. Therefore, a full domestic kitchen should beprovided in each cluster. Even when there is acentral kitchen each cluster should have a smallkitchenette.

Kitchenette – is used to provide a refreshment areato prepare beverages and light snacks for residentsand visitors. This space is separate from the centralkitchen where main meals may be prepared. Thekitchenette should be open and incorporated intothe living space.

Access, Size and Layout

• The floor area of a full domestic kitchen shouldbe approximately twelve square metres for up to10 residents and six square metres for akitchenette.

• The kitchen design should allow for a mealpreparation area by staff.

• Access to 24 hour nutrition and hydration, andthe smell and sight of food preparation are veryimportant elements for residents. Sufficient spaceand access to the kitchen for residents is alsorequired to maintain living skills, social skillsand independence.

• An external window is preferable but may varydepending on the total layout of the livingspaces.

• Easy access from the passageway or externalenvironment for the delivery of goods anddisposal of waste should be considered.

• Space may be required for food trolley parking iffood to be transported from a central kitchen.

Safety Issues

• The kitchen layout should be functionallyefficient and safe.

• It is essential that there are master controls in alocked cupboard for each major equipment itemor service which only staff operate.

• Temperature control on hot water supply is alsoimportant for residents’ safety.

• Consideration needs to be given to the safestorage of other loose equipment such as atoaster, mixer and a microwave.

Furniture, Furnishings and Fittings

• Joinery should be as domestic in style as possiblewhile supporting heavy usage. Robust andsimple hinges and handles are particularlyimportant.

Figure 8: Example Layouts of Kitchenettes

Zone Multi-Zone Required Shared External

2B All Yes No

• An island bench between the kitchen and livingspace is desirable to enable residents toparticipate in relevant activities.

• Benches should be fitted with a sink to providespace for the preparation and serving of food.

• Cupboards and drawers for storage of crockery,cutlery and other kitchen utensils are desirable.Storage should be predominantly below benchesto minimise the use of overhead cupboards.Under bench or cupboard space is required for akitchen waste disposal bin.

• A large lockable pantry cupboard should beprovided and appropriately designed for foodstorage.

• Equipment may include a boiling hot water unit,microwave oven, tea/coffee making facilities, atoaster or toaster oven, stove, range hood,domestic refrigerator/freezer and a dishwasher.

• Handwashing facilities are necessary in thekitchen area.

Finishes

• Floor – vinyl sheet floor covering. • Walls and ceiling – plaster covering with

impervious paint surface.

Functional RelationshipThe kitchen/kitchenette is to be incorporated intothe communal living area.

5.5.5 Multi-Use Activity/Therapy Spaces

FunctionActivity spaces – these are primarily for activeprograms such as exercise classes or drama,community participation and large group meetings.

Therapy spaces – these provide for therapyactivities such as physiotherapy, hairdressing andpodiatry.

Multi-use activity space is not only for therapeuticpurposes, but should encourage socialisationbetween residents and visitors. It should be notedthat visitors to an aged care residential service willoften include children. Space may be allocated in asitting room or multi-use activity space as a playarea for children. This space may be equipped witha large box of children’s toys or books.

Access, Size and Layout

• Activity space requires about 30 square metresper 30 residents. This area is based on theassumption that not all residents will access theactivity room at the same time.

• Therapy space needs to be approximatelyfourteen square metres. This area needs to havethe flexibility to be used for a range of differingundertakings.

• To give the opportunity to create a larger space,consideration should be given to locating theactivity room next to a lounge/dining room areawith an operable wall between. This would thenenable the facility to create a useable space of 80square metres, which would cater for allresidents at any one time.

• The shape of room (rectangular or square) isimportant. Open floor space may be required foractivities, therefore the layout needs to be flexibleto enable movement of furniture and equipment.

• A quiet area in the activity space may beconsidered for residents who need a break inactivities.

Power and Lighting

• Computer activities will necessitate theinstallation of computer cabling.

• Television or video entertainment will need atelevision antenna and sufficient power outlets.

Furniture, Furnishings and Fittings These will vary depending upon the type ofactivities proposed and may include the following: • Tables, benches and chairs. Chairs may need to

cater for table activities as well as relaxation.

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Zone Multi-Zone Required Shared External

2B All Yes Yes

• Cupboard storage for equipment. Some lockablecupboard storage may be required.

• A wash basin is required if hairdressing is to beperformed in this space.

• Wall fittings may include a whiteboard, pin-upsurface and space for a projection screen.

• Large full height windows with low sills(approximately 300 mm above floor level) aredesirable. An external wall may have doorsincorporated into the window.

• The ceiling height should be no lower than 2700 mm minimum.

Finishes

• Floor – carpet or domestic like matt finish vinylover an impervious sealed floor.

• Walls – paint/paper or washable and soundattenuating.

• Ceiling – acoustically treated and painted.

Functional RelationshipTo enhance social interaction, the activities/therapyspace should be easily accessed from the communalliving areas as well as the front entry and havedirect external access, preferably to a paved area.Access through resident’s private living areas mustbe avoided.

5.5.6 Toilets

Function Toilets need to be built to allow easy and quickaccess for residents. This will assist with continencemanagement programs. Visitors may also use them.A toilet for disabled persons will be provided ineach cluster and should be located in closeproximity to the lounge/dining area. They shall bedesigned in accordance with the relevant standardsfor a disabled person.

Access, Size and Layout

• Layout will include a toilet pan and a handbasin. Fittings need to be accessible from bothsitting and standing height.

• Toilet doors should open outwards to ensure thatpeople cannot be trapped if they collapse againstthe door. Locks on toilet doors must permit staffaccess in an emergency.

Toilet Pans

• The cistern flushers should be easy to use withlevers or large raised buttons instead of recessedbuttons.

Light, Ventilation, Communication and Heating

• Mechanical ventilation may be activated by thelight switch. No heating is required.

• For safety reasons an electronic communicationsystem should be installed.

Fittings

• Hand basins should be of cantilever type. Tapswhich are of a lever type will be easier to use. Allhot water needs to be thermostatically controlled.

• Handrails should be provided to each toilet – onefixed and one fold down. These rails are requiredto be fixed to the building structure.

• Fittings including toilet paper holders and toweldispensers should be provided. An overtoilettoilet seat may be used to provide both extraheight and support for a resident.

Finishes

• Floors – special non-slip safety vinyl floorcovering should be used in all toilet areas.

• Walls – impervious paint finish with tile splashbacks behind basins.

• Ceilings – painted.

Functional RelationshipToilets are located in each cluster in close proximityto the lounge/dining area.

47

Zone Multi-Zone Required Shared External

2B All Yes No

5.6 Functional Zone 3: Clinical and Administrative Areas

The clinical and administrative areas are seen as afunctional zone which needs to be accessible to, andcontrolled by staff only. This area needs to berelatively central to the overall facility to minimisestaff travel time. It also needs to provide quick andeasy access to resident services and supportfacilities such as the clean and dirty utility rooms.

5.6.1 Staff Base

Function To provide area for staff to carry out report writing,storing residents records, photocopying andmeetings.

Considerations

• The room should not be seen as a reception pointbut rather a large room or space which staff useas a resource area and visitors and residents useas a reference point. It should blend in to theresidential feel of the facility but may haveinternal windows to assist staff with discreetsupervision of residents.

• Consideration needs to be given to the locationof the staff base in facilities, particularly thosethat accommodate dementia patients and/orblended services such as rural health, acutehealth, rehabilitation and aged care. This will beinfluenced by functional relationships, afterhours access and the need for supervision of thefacility’s main access.

• A photocopier will need to be situated in aseparately ventilated space within or adjacent tothis area.

• The space may also be equipped to housestationery supplies, a printer and fax machine ifthese are to be incorporated with the staff station.

• It should have sound attenuation to ensureconfidentiality when appropriate.

Access, Size and Layout• The floor area of the staff base will vary

depending on the number of residents and staffnumbers. Generally it will be 15 to 20 squaremetres.

• The staff base needs to be situated, wherepossible, to provide access and visibility for staff,residents and visitors. It should be accessible tothe front entry and central to the clusters.

• The staff base will also have or adjoin the drugstorage cupboard, which has to be designed inaccordance with the Drugs and Poisons Act andPharmacy Board guidelines.

Heating, Power, Ventilation and Lighting

• Adequate heating and ventilation are essential. • Both high and low lighting levels will be

required.• Equipping the staff station with sufficient double

power points will eliminate the need for doubleadaptors and extension cords. A photocopier, ifsituated in or adjacent to this area, will require adiscrete power outlet.

Communication

• This area requires appropriate facilities forcommunication systems including telephones,computers and the staff assistance call system.

Furniture and Fittings

• Chairs and report writing bench tops or desks. • Bench space surrounding the walls should be at

a height to allow for the possibility of fittingcupboards underneath, for example, two drawerfiling cabinets or mobile drawer units and a safefor valuables.

• Shelving and cupboard space for stationerysupplies, reference material and manuals.

• Handwashing facilities need to be located in oradjacent to the staff station

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Zone Multi-Zone Required Shared External

3 All Yes Yes

Finishes

• Floor – carpet or vinyl. • Walls – paint/wallpaper. • Joinery – laminate or timber. • Ceiling – painted and acoustically treated.

Functional RelationshipThe staff base needs to be situated where possible,to provide access and visibility for staff, residentsand visitors. It should be accessible to the frontentry and central to the clusters. The staff base willbe adjacent to the medication/treatment area.

5.6.2 Medication/Treatment Area

Function The medication room is for the preparation ofmedications and secure storage of pharmaceuticalsupplies. Treatment space provides an area in whichresidents can seek medical examination andtreatment. Acoustic control should be incorporatedinto the design to ensure privacy in this area.

Access, Size and Layout

• The size of this area should be no more than 10square metres.

• The medication/treatment area is locatedadjoining the staff base.

• This area must have restricted access and besecured with a lockable door. Designated staff ora medical practitioner must accompany residentsrequiring medical examination and treatment.

• Careful use of colours will assist in ensuring thatthis clinical space is seen as part of the overallresidential facility.

Furniture, Furnishings and Fittings

• Lockable cupboards for medical andpharmaceutical supplies including a drug safefor drugs of addiction.

• Refrigerated storage facilities.• A bench approximately two metres in length. • A sink with elbow taps.• Overhead cupboards may be fitted but

consideration needs to be given to height andtypes of goods to be stored.

• Space for temporary parking of a drug trolley ifappropriate.

• An examination table may also be incorporatedin this area.

Finishes

• Floors – impervious and easily cleaned, forexample, vinyl.

• Walls and ceiling – painted.

Functional RelationshipThe medication/treatment area needs to be locatedadjacent to the staff base.

5.6.3 Quiet/Interview Space

FunctionTo provide an unobtrusive and private space wheresmall meetings, interviews and counselling can takeplace, for up to six people. Acoustic control isnecessary to minimise internal and external noise inthis area.

Access, Size and Layout

• Space can be from 12 to 14 square metres for aquiet/interview area.

• This room will have external windows and belocated in a discreet area near the front entry.

Furniture, Furnishings and Fittings

• Table and chairs and solid sealed doors.• Pin-up boards and whiteboards may be

appropriate where the room is used for smallmeetings.

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Zone Multi-Zone Required Shared External

3 All Yes Yes

Zone Multi-Zone Required Shared External

3 All Yes Yes

Finishes

• Floors – carpet. • Walls – paint/paper with good sound

attenuation. • Ceiling – paint.

Functional RelationshipQuiet/interview space should have easy access fromthe front entry. It will require access to toilet andrefreshment facilities.

5.6.4 Office

Function The office is for the manager to meet with staff,residents, visitors, doctors and sales representatives.The office may have an adjoining bed/sitting roomwith ensuite facilities that may be used forovernight stays by staff or relatives.

Considerations

• The office needs to be very residential inappearance and likened to a small study in ahouse.

• This area needs to have the capacity to bevisually and acoustically private wherenecessary.

Access, Size and Layout

• This area needs to be approximately twelvesquare metres.

• There needs to be sufficient space toaccommodate meetings of up to four personsplus the manager’s administrative needs.

• It is preferably accessible by the front entry andadjacent to the staff base.

Communication and Power

• Facilities including power outlets, telephoneconnection and computer cabling are necessaryto accommodate office equipment such as acomputer, printer, telephone and facsimilemachine.

Lighting, Ventilation and Heating

• High lighting levels, heating and ventilation arenecessary.

Furniture, Furnishings and Fittings

• A small built in safe for resident’s personalvaluables may be installed in this area if theseare not accommodated in the staff base.

• Desk, chairs, filing cabinets and storagecupboards.

Finishes

• Floors – carpet. • Walls and ceiling – paint. • Joinery – laminate or timber.

Functional RelationshipThe manager’s office is ideally located close to thefront entry and adjacent to the staff base.

5.7 Functional Zone 4: Service and Support Areas

The service and support area comprises the:• Service entry and canopy.• Circulation space/passageways.• Clean and dirty utility rooms.• Domestic laundry and flower preparation space.• Storage spaces. • Plant room.• Mortuary/viewing facilities.

General Considerations:

• The design of the building should include lowmaintenance finishes wherever possible.

• Adequate cleaning services will be essential if theoperation of the facility is to be a success.

• General stores will be obtained as required.• Food services, where appropriate, may be

supplied from the a main kitchen or externalcaterers.

• Provision for transfer and receipt of meals will berequired.

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Zone Multi-Zone Required Shared External

3 All Yes Yes

• The maintenance staff will undertakeresponsibility for building maintenanceotherwise there will be externally contractedagents to provide ongoing maintenance.

• Storage spaces need to be carefully planned toprovide adequate internal and external storagefacilities for a variety of usages. The amount andtype of storage space to be provided will varydepending on the needs and size of each facility.

Storage Considerations

• Careful analysis of storage requirements andgood management in organising the store isessential. This includes maximising availablefloor space.

• Select stackable furniture and equipment for thefacility where possible.

• Shelving should be ergonomically designed. Thisincludes ensuring that shelving is at anappropriate depth, width and height.

5.7.1 Service Entry/Canopy

Function The service entry allows deliveries to the facilitywithout having to pass through the main entranceof the building. The service canopy is to provideshelter at the service entry and under cover accessfor service deliveries.

Considerations

• The service canopy should be designed to ensureit is large enough to provide shelter frominclement weather.

• The space should be large enough, withsufficient blank wall length to allow fortemporary storage of items such as linen or foodtrolleys, items of furniture or items of equipmentfor repair.

• Soiled linen should be removed from thebuilding only through the service entry.

• Ongoing compliance needs to occur withadequate infection control measures.

Functional RelationshipThe service entry and canopy will be adjacent to theservice and support areas.

5.7.2 Circulation Space/Passageways

Function The passageways operate as links between andwithin the various functional zones. They are oftenused to accommodate storage cupboards forequipment and other items such as linen,wheelchairs, fire fighting equipment or other items.

Size, Access and Layout

• The passageways used by the residents musthave a clear width of 1500 mm (betweenhandrails). The width can be extended at any keypoints in the length of a particular passageway.

• The circulation length of passageways should notexceed 28 metres in length in a cluster of 10 beds.

• Although passageways need to be as simple anddirect as possible so as not to create confusion forresidents, they should not be designed as onelong straight corridor without reference points.Alcoves to create rest points at not more thanfourteen metres apart, will encouragesocialisation and aesthetically break down theperceived length of the passageways.

Lighting

• Natural light can be maximised in thepassageways by the use of skylights, highlightwindows, and small sections of external wallswith windows.

• Lighting at night is also important.

51

Zone Multi-Zone Required Shared External

4 All Yes Yes

Zone Multi-Zone Required Shared External

4 All Yes Yes

Figure 5.7.2: Passageway

Handrails and Doorways

• Handrails should be along both sides of everycommon passageway. They will be approximately40 mm in diameter top, 50 mm clear of the walland the top, 900 mm above floor level.

• Handrails need to be simple and easy to grip.Handrails that are flattened not rounded indesign are preferred as residents are able to resttheir arms along the rail. Handrails may bestained in a contrast colour. The use of colour forthe visually impaired residents is also important.Fixing brackets are equally important and shouldnot impede hand movements.

• Doorways should be offset, so as to always havea handrail on least one side of the passageway.

Finishes

• Floor – carpet or vinyl. • Walls – painted.

Functional RelationshipThe passageways are links between and within thevarious functional zones.

5.7.3 Clean Utility Room

Function A clean utility room is for the storage of sterilesupplies, dressings and minor medical equipmentand provides preparation space for dressings andother clinical activities. It may also function as analternative storage area for the medication trolley.Although clean utility rooms are used for a more‘institutional’ type activity they can still be designedto be residential in appearance.

Access, Size and Layout

• The clean utility area should be eight to 10square metres.

• Depending on the total design, one clean utilityroom may be required per 20 to 30 residents.They should be centrally located to the clusters.Staff should not have to walk more than 28metres to access the utility room from thefurthest bedroom. Two strategically placed smallrooms are better than one large clean utilityroom.

• The doors to a clean utility room should belockable and access is restricted to authorisedpersons.

Lighting, Power and Ventilation

• Ventilation of the room is important and the useof vented skylights should be considered forinternal rooms.

• Good natural and artificial lighting is essential.• Sufficient power points should be provided

throughout the room.

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Zone Multi-Zone Required Shared External

4 All Yes Yes

Fittings

• A sink, with elbow taps is required with easyaccess to hand drying facilities.

• Lockable bench high cupboards with bench topsin stainless steel, approximately three metres inlength, and shelving. The use of overheadcupboards should be minimal and ergonomicallydesigned.

• A full height lockable storage cupboard may alsobe included for storage of tall items.

• If a lockable medication refrigerator is notprovided in a medication room it may beaccommodated in this area.

Finishes

• Floor – vinyl sheet floor covering. • Walls and ceiling – plaster with impervious paint

surface.

Functional RelationshipThe clean utility room should be adjacent or near tothe staff base.

Figure 9: Example Layouts of Clean and Dirty UtilityRooms

53

5.7.4 Dirty Utility Room

Function This room is for the hygienic cleaning of bed pansand medical equipment and for disposal of waste.It is also for storage of materials and equipment forsample analysis. It may also function as a cleaners’room or the cleaners’ room can be independent ofthe dirty utility room. Although dirty utility roomsare used for a more ‘institutional’ type activity theycan still be designed to be residential in appearance.

Access, Size and Layout

• The room should be eight to 10 square metreswith one per 20 to 30 residents, depending ontotal facility layout.

• They should be centrally located to the clusters.Staff should not have to walk more than 28metres to access them from the furthest bedroom.It would be better to incorporate two strategicallyplaced small rooms rather than one larger roomin the facility.

• Space is required for temporary storage of soiledlinen and other items before removal to disposalarea.

Lighting, Heating and Ventilation

• Mechanical ventilation and good lighting isessential.

• The use of vented skylights should be consideredfor internal dirty utility room.

• No heating is required.

Fittings

• Acoustic treatment to control noise beingtransmitted into other rooms is essential.

• Doors and cupboards should be lockable.• Bench high lockable cupboards with stainless

steel bench tops approximately three metres inlength.

• A laundry trough, with elbow taps, a slophopper and a pan sanitiser (this should also beeasily accessible for both staff usage andservicing).

• Bedpan/urinal rack. • If room is to be utilised for cleaners’ storage there

needs to be cupboard space for brooms, mops,buckets and cleaning solvents.

Finishes

• Floor – non-slip vinyl sheet. • Walls and ceilings – plaster with impervious

paint finishes.

Functional RelationshipDirty utility rooms should be centrally located toeach cluster of 10 beds.

5.7.5 Laundry (Domestic)

Function To provide a domestic laundry for resident’spersonal belongings. It will be available for use bystaff, family and able residents and be residential instyle.

Access, Size and Layout

• A domestic laundry of eight to twelve squaremetres is to be provided per 30 residents.

• Layout should facilitate ease of access for staffand residents.

Ventilation and Hot Water

• There needs to be both natural and mechanicalventilation in a laundry.

• Hot water will have thermostatic temperaturecontrol.

Furniture and Fittings

• A front-end loader washing machine for easyoperation by persons with disabilities.

• A tumble dryer which is vented to the outsideenvironment.

• Laundry trough and lockable cupboards forstorage of laundry detergents and other laundryitems.

• Ironing facilities and benches for folding clothesand space to accommodate clothes baskets.

54

Zone Multi-Zone Required Shared

4 All Yes External

Zone Multi-Zone Required Shared External

4 All Yes Yes

Finishes

• Floor – non-slip vinyl sheet. • Walls – painted, water resistant. Ceramic tile

splashbacks to all benching. • Ceiling – painted.

Functional RelationshipThe laundry should be located within closeproximity to bedrooms with direct access to anexternal clothesline.

5.7.6 Flower Preparation Space

Function The flower preparation space is for arranging anddisposing of residents’ flowers. Flower preparationspace may be located in the kitchen, laundry,cleaner’s room or an alcove.

Considerations

• Access is required to a sink, bench and wastedisposal bin.

Functional RelationshipThe flower preparation space or alcove shouldideally be situated in the living areas.

5.7.7 Stationery and Other Administrative Supplies Store

Stationery and other such items may be stored inthe staff base or offices in the clinical andadministrative area.

5.7.8 Food Supplies Store

Space will be required for storage of food supplies.The areas needed will depend on a number of

factors including food service arrangements. Anagency may have a main dry food store and a coolroom. Kitchens will generally have food storagefacilities for residents within each cluster of 10 beds.

5.7.9 Clean Linen Store

Function The clean linen store is to house all linen supplied tothe facility. Items to be stored include pillowcases,sheets, blankets, towels, face washers, tea towelsand other items. Linen may be supplied from withinthe facility or from an externally contracted agent.Linen may be stored in each bedroom or instrategically located linen cupboards with adjustableshelving and an appropriate finish in each cluster tominimise staff movement.

Finishes

• Floor – non-slip vinyl sheet. • Walls and ceiling – painted and water-resistant.

Functional RelationshipClean linen should be stored within close proximityto the area where it will be used.

5.7.10 Soiled Linen Holding Space

Function The soiled linen holding space is for storage ofsoiled linen awaiting removal from the site.

Considerations Mechanical ventilation and a floor waste outlet witha tap over it.

Finishes

• Floor – safety non-slip vinyl. • Walls – impervious to 2100 mm and washable. • Ceiling – painted.

55

Zone Multi-Zone Required Shared External

4 All Yes Yes

Zone Multi-Zone Required Shared External

4 All Yes Yes

Zone Multi-Zone Required Shared External

4 All Yes Yes

Zone Multi-Zone Required Shared External

4 All Yes Yes

Zone Multi-Zone Required Shared External

4 All Yes Yes

Functional RelationshipThe soiled linen storage space should be situatedwithin close proximity to a covered external serviceentry.

5.7.11 Waste Disposal (Infectious and Other Waste) Space

Function Waste disposal space is for storage of wastematerials awaiting removal from the site.

Considerations

• A floor waste outlet with a tap over it andmechanical ventilation.

Finishes

• Floor – safety non-slip vinyl. • Walls – impervious to 2100 mm and washable. • Ceiling – painted.

Functional RelationshipThe waste disposal area should be situated withinclose proximity to a covered external service entry.

5.7.12 Cleaners’ Space

Function To store cleaning equipment, cleaning agents orother items and for disposal of liquid waste. Thisroom may also be used as a flower room. Thecleaners’ space may be in a separate area or in adirty utility room.

Fittings and Considerations

• A stainless steel cleaners’ sink and drainer isrequired. The sink will be fitted with water tapsand a bucket rack.

• Laminated benches with ceramic tile splashbacksare desirable for all benching and the cleaners’trough.

• Waste disposal bins of adequate size aredesirable.

• A lockable cupboard for cleaning equipment anddetergents and a tall cupboard which is able tocontain a mop, brush, and other cleaningequipment.

• Adequate mechanical ventilation is essential.

Finishes

• Floor – non-slip vinyl sheet. • Walls and ceiling – painted.

Functional RelationshipThe cleaners’ space should be central to the area itserves and have easy access to handwashingfacilities.

5.7.13 Storage Space for Resident’s Personal Belongings

FunctionTo provide storage for residents’ clothing andluggage.

Considerations

• Residents’ personal storage such as clothesshould be in a wardrobe in their own room.

• Additional luggage can be stored in a centralstoreroom. The space provided can beapproximately eight square metres per 30residents.

Functional RelationshipSpace for smaller items including clothing should bestored in the resident’s bedroom. Larger itemsincluding suitcases may be stored in a centralstoreroom.

56

Zone Multi-Zone Required Shared External

4 All Yes Yes

Zone Multi-Zone Required Shared External

4 All Yes Yes

Zone Multi-Zone Required Shared External

4 All Yes Yes

5.7.14 Wheelchair Parking Space

Function To provide a space or spaces for parking or storageof wheelchairs.

ConsiderationsWheelchairs often create the biggest problem andcareful consideration needs to be given to theirstorage. The options are to:• Provide strategically located recessed bays in the

bedroom passageways, which are discrete. Thiscan be achieved by incorporating a bench orcupboard above the wheelchair handles.

• Incorporate storage space in each room. • Electric wheelchairs may be recharged overnight

in the resident’s bedroom.

Functional RelationshipWheelchairs are ideally stored close to the residentsliving areas.

5.7.15 Medical and Mobility Equipment Store

Function To provide storage for the different types ofequipment necessary for the function of the agedresidential facility.

Considerations and Fittings

• Specifically designed storerooms are required forstorage of medical and mobility equipment andsupplies. Planning for this storage space willdepend of the size, number of residents and thelayout of the facility. There may be one largestorage room or a number of smaller storeroomswith one designated for each cluster of 10 beds.

• These storerooms should be rectangular in shapeand large open unusable spaces should beavoided.

• Select furniture and equipment that can bestacked to make storage easier.

• Storage cupboards should contain sufficientshelving that may be fixed or adjustable, largepigeon holes and perforated ply walls withhooks are also required.

• Mechanical ventilation in the equipment store isdesirable.

• Lighting needs to be ceiling mounted.

Functional RelationshipThe medical and mobility equipment storage spacewill need to be in a convenient location to the areain which it is required.

5.7.16 Workshop

FunctionA workshop is to provide space for items requiredfor general and other maintenance requirements.These may include plumbing, electrical, paint orgardening equipment. Some or all of these servicesmay be provided on a contract basis from anexternal source.

Fittings

• Benches and cupboards including secure storageare desirable.

• Flexible shelving and a shadowboard for toolsand other items are necessary.

• Access to a telephone/intercom, cleaning andhandwashing facilities are necessary.

Finishes

• Floor – concrete. • Walls and ceiling – painted.

Functional RelationshipThe workshop should be situated in close proximityto the service area.

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Zone Multi-Zone Required Shared External

4 All Yes Yes

Zone Multi-Zone Required Shared External

4 All Yes Yes

Zone Multi-Zone Required Shared External

4 All Yes Yes

5.7.17 Medical Gases Area

Function:To provide a safe and secure environment for thestorage of various gas cylinders where these areutilised in an aged care residential service.

Fittings

• Benches.

Finishes

• Floor – concrete. • Walls and ceiling – painted.

Functional RelationshipMedical gases storage space should be situatedwithin close proximity to a covered external serviceentry.

5.7.18 Chemical Store

Function A chemical store is for the storage of chemicals andinflammable liquids. This storage will be in a secureand safe environment in accordance with standards.

Fittings

• Benches and shelving.

Finishes

• Floor – concrete. • Walls and ceiling – painted.

Functional RelationshipThe chemical and inflammable liquids store needsto be in close proximity to the area in which thechemicals are to be used.

5.7.19 Plant Room

FunctionA plant room is to accommodate boilers, pumps, hotwater service units, heat exchangers (if required)and electrical mains distribution board.

Finishes

• Floor – concrete. • Walls and ceiling – painted.

Functional RelationshipThe plant room should be situated within closeproximity to a covered external service entry.

5.7.20 Holding or Mortuary Room

Function A holding or mortuary room is to provide for bodystorage of a deceased person. Some facilities mayrequire mortuary or holding room facilities withrefrigeration. This room may only be requiredwhere undertaking facilities are not in closeproximity to the facility. A holding room ormortuary needs to have service entry access forundertakers.

Considerations

• Trolleys for body storage and refrigeration.

Finishes

• Floor – safety non-slip vinyl. • Walls – impervious to 2100 mm and washable. • Ceiling – painted.

Functional RelationshipThe holding room or mortuary should be situatedwithin close proximity to a covered external serviceentry.

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Zone Multi-Zone Required Shared External

4 All Yes Yes

Zone Multi-Zone Required Shared External

4 All Yes Yes

Zone Multi-Zone Required Shared External

4 All Yes Yes

Zone Multi-Zone Required Shared External

4 All Yes Yes

5.7.21 Viewing Facilities

Function Viewing facilities are to provide viewing of adeceased person for relatives or friends whenbedrooms are not available or appropriate. Thespace should be large enough to accommodatefamily members as well as a bed or mortuary trolleythat can be specifically placed for religiouspurposes.

Finishes

• Floor – carpet or vinyl. • Walls – paint/paper with good sound attenuation

and solid sealed doors. • Ceiling – painted and acoustically treated.

Functional RelationshipThe viewing room should be located within easyaccess of the service entry.

5.8 Functional Zone 5: Staff AmenitiesStaff amenities are to provide areas for staff to storepersonal belongings, relax and attend to personalhygiene.

The facilities to be provided include:• Handwashing facilities. • Staff toilets. • Staff change area, lockers and shower. • Staff lounge with small kitchenette.

Consideration needs to be given to balancing theneed for staff privacy between staff privacy and thefacility being seen as part of the home.

5.8.1 Handwashing Facilities

• Hand basins will need to be provided inaccordance with the building regulations.

• These should be strategically located anddiscretely designed in passageways to minimisethe ‘institutional’ impact.

• Hand basins should have elbow taps orelectronic sensors.

Functional RelationshipHandwashing facilities should be provided at aconvenient locations throughout the facility.

5.8.2 Staff Toilets

• Toilets need to be provided in accordance withthe building regulations. They may be ofconventional design or for disabled use.

• Staff toilets may either be unisex or male/female. • Toilets are described in detail in ‘Functional Zone

2B’.

Functional RelationshipStaff toilets should be provided at a convenientlocation.

5.8.3 Staff Change/Shower/Lockers

It is recommended that a staff shower (inaccordance with building regulations) be provided,which will also be large enough for a person tochange clothes.

Fittings and Finishes

• A lockable cupboard for staff personalbelongings can either be purpose built joinery orproprietary type lockers.

• Floor – safety non-slip vinyl. • Walls – impervious to 2100 mm and washable. • Ceiling – painted.

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Zone Multi-Zone Required Shared External

4 All Yes Yes

Zone Multi-Zone Required Shared External

5 All Yes Yes

Zone Multi-Zone Required Shared External

5 All Yes Yes

Zone Multi-Zone Required Shared External

5 All Yes Yes

Functional RelationshipStaff shower, change area and lockers should beprovided at a convenient location within the facility.

5.8.4 Staff Lounge and Kitchenette

• Staff should be encouraged to share dining andsocial spaces with residents. However, they alsorequire a place to retreat, relax and rejuvenatethemselves. A small staff lounge/entry area witha kitchenette is recommended.

Furniture , Finishes and Fittings

• Kitchen cupboards, a small sink and bench space. • Table, chairs, microwave oven and refrigerator. • Floors – carpet or vinyl. • Walls and ceiling – paint. • Joinery – laminate or timber.

Functional RelationshipThe staff lounge and kitchenette should be providedat a convenient location and ideally have externalaccess yet not be too distant from the mainresidents’ area.

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Zone Multi-Zone Required Shared External

5 All Yes Yes

6.1 Town PlanningGovernment regulations may require that theproposed facility be submitted for town planningapproval. Should the local council receiveobjections, the approval process can be extremelylengthy (several months). The attitude of therelevant council to the project should be ascertainedearly in the planning process and any particularcouncil requirements taken into account. Thecouncil will have policies as to:• Car parking provisions. • Building heights. • Plot ratios. • Landscaping requirements. • External appearance in some cases.

6.2 Property AgreementWhere the proposed facility is to be built onfreehold land owned by anyone other than theDepartment it will be necessary to have in place aproperty agreement guaranteeing ongoing access tothe facility for the purposes of an aged careresidential service. The structure of such agreementswill give overall control of the site to theDepartment for the useful life of the building with asub-lease back to the service provider for the termof the service provider agreement.

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6 Other Planning Issues

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7 Appendices

Appendix 1: Functional Area Schedule30 Bed Aged Care Residential Facility

Zones Space m2 No Total Comments

Zone 1: Entry 15 1 15 Allow seating for up to four people.Arrival

Bedrooms 14 24 336Zone 2A: Bedrooms – shared 27 3 81Living – Ensuites – single 5 14 70 Toilet visible from the bed.Private Ensuites – shared 6 8 48 Toilet visible from beds.

Bathroom 12 1 12 Island bath, shower, toilet and hand basin. Sitting areas 12 3 36 Provide one sitting room per cluster.

Zone 2B: Lounge 30 3 90 Three square metres per resident Lounge mayLiving – adjoin dining room.Communal Dining 20 3 60 Two square metres per resident. Kitchen and dining

to be collocated.Kitchen/ette 12 3 36 One point two square metres per resident Garden/courtyard 200 3 – Each cluster to have its own secure backyard.Activity space 30 1 30 May adjoin lounge with operable walls between.Therapy area 14 1 14Toilets 4 3 12 One per each cluster near the lounge/dining areas.

Zone 3: Staff base 18 1 18 Report writing area, file storage, photocopying.Clinical Treat/medication 12 1 12 Storage for medication and examination table.and Quiet/interview 14 1 14 Up to six people.Administrative Office 14 1 14 For manager.

Zone 4: Passageways One point five metres minimum clear betweenService handrails.And Clean utility room 5 2 10 May be two smaller rooms or one larger room. Support Dirty utility room 5 2 10 May be two smaller rooms or one larger room.

Laundry 10 1 10 Washing machine, dryer, trough and small bench.Clean linen store 6 1 6Residents store 12 1 12Equipment store 16 1 16Cleaners store 6 1 6Soiled linen/waste 10 1 10

Zone 5: Staff amenities 26 1 26 Includes staff lounge, toilets, shower and lockerspace.

Total nett area 1004Circulation/plant 35 per cent 352

Total gross floor area 1356

The following ratios indicate the number of shared/single facilities in a 30 bed facility:

Single Room – Ensuite Single Room – Shared Ensuite Adjoining/ Double Room – Shared Ensuite

50 – 60 per cent 25 – 30 per cent 15 – 20 per cent

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Site Area Requirements for a 30 bed facility with three clusters

Space Comments m2

Residence Gross floor area 1356

Backyards Assumes one secure area of 200 square metres for each cluster 600

Front yard 200

Car parking Fifteen cars 375

Storage Sheds Garden and maintenance materials/tools 20

Service Bay Delivery vehicles including turning circle 100

Front Canopy Allows for two vehicles 60

Total nett site area: 2711 m2

Allow 20 per cent for circulation, boundary setbacks and shape of block: 543 m2

Total site area required for a 30 bed facility: 3254 m2

Site area may be rounded at: 3300 m2

Building Area ScheduleBased on the requirements for each functional area,the total gross floor area (GFA) for a 30 bed standalone facility is 1356 square metres. This includescirculation and assumes three clusters of 10 bedseach.

Some key elements in developing the facility areaschedule include the following:

• Bedrooms shall not be less than 14 square metresper bed.

• Each bedroom shall have direct access to anensuite of not less than 5 square metres.

• Lounge and dining/kitchen(ette) shall be a totalof 6.2 square metres per resident.

• Small sitting rooms are to be 12 square metreseach.

• Assisted bathroom 12 square metres.• Storage total of 50 square metres.• Quiet interview 14 square metres.• Dirty and clean utility rooms total 20 square

metres per 30 residents.• Residents laundry 10 square metres.• Circulation space 35 per cent of nett floor area.

Appendix 2: Assessment of ExistingFacilities Assessment and Evaluation Assessment and evaluation of existing facilities anddesign proposals for new facilities need to reflectthe principles and objectives of the ‘CommonwealthResidential Aged Care Program’ and the Department.The aim of assessment is to ascertain a facility’s:• Community service demand. • Viability. • Ability to meet Commonwealth certification and

accreditation. • Fabric and infrastructure condition.

Assessment examines the facility’s design andcapacity of the design to achieve the best standardsof care and outcomes for residents and staff. Itprovides a broad evaluation of the building fabricand it’s functionality to assist the Department toundertake comparative analysis between facilitiesand prepare regional and State priorities for thecapital works program.

Assessment findings may be classified into thefollowing three categories:• Major Costs

Consideration needs to be given to one of thefollowing:– A ‘Greenfield proposal’.– A major redevelopment of existing facilities.Costs for this category may be $1,000,000 and over.

• Significant CostsThis category indicates that significant buildingworks are required to meet the ‘Regulations andGuidelines’. It usually entails redevelopment ofexisting facilities with possible minor extensions.Costs for these may be from $250,000 – $1,000,000.

• Minor CostsThis category involves upgrading and minorbuilding alterations and/or refurbishment.Costs may be up to $250,000.Funding for minor works may be:– Undertaken by the agency for amounts up to

$50,000. – By application for ‘Annual Provision Funds’

up to $250,000.

New Works Versus RefurbishmentThe advantages and disadvantages of eitherconstructing new facilities or refurbishing andextending existing buildings need to be fullyevaluated when determining the preferreddevelopment strategy.

The outcome will be influenced by:• Service plan/need analysis. • Site suitability. • Capital costs. • Resources. • Ongoing maintenance costs (asset management

policy).• Staging of works. • Inconvenience to residents when redeveloping. • Community perception of facilities. • Operational efficiencies. • Integration with older health and community

services. • Outcome standards – accreditation. • Certification. • Relationship with other services. • Net present value (return on capital investment).

This evaluation process is to be carried out inaccordance with the Capital Works Guidelines andwill incorporate the following:• Service plan/needs analysis. • Master plan. • Feasibility study. • Investment evaluation study.

In undertaking this evaluation process one shouldbe innovative yet pragmatic and take into account:• The residents’ needs. • Staff requirements. • On going maintenance costs.

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Capital Costs The indicative costs listed below are a guide to thedevelopment of new aged care residential facilities.They are based upon ‘normal’ conditions andshould be used only to determine initial budgets.

For more accurate costings on a specific project theservices of a quantity surveyor should be engaged.

Capital costs to be considered for residentialservices include:• Building Costs (cost per square metre)

Includes allowance for site works, externalservices, building services, fittings and designcontingencies. Cost may be $1,500 to $1,700.

• Construction Contingency(Percentage of building costs only).New works 2.5 per cent.Refurbishment works 5.0 per cent.

• Loose Furniture and EquipmentThis includes beds, chairs, tables, cabinets,window furnishings and so on.Costs may be 8 per cent of building costs.

• Fees (including all Consultants)Fees are a percentage of building costs plus loosefurniture and equipment where a consultant isinvolved in the selection. These fees may be from 9 – 12 per cent of costs.

For new developments the total building cost perbed is approximately $80,000 to $100,000 (excludingland purchase costs).

Notes: • Special conditions such as locality, sub soil,

topography and asbestos removal will result in avariation to the cost per square metre.

• Refurbishment or alteration works will be aproportion of new costs.

• If such costs are in excess of 60 per cent of newcosts then serious consideration has to be givento the long term benefits of refurbishment worksagainst new works.

Capital Works GuidelinesThe implementation of an aged care residentialfacility project needs to meet the requirements of theDepartment’s capital project.

For further information regarding the capital worksrequirements, reference should be made to thepublished series of Department of Human ServicesCapital Development Guidelines. They are:

Series 1 General Management Guidelines

1.1 Policy and Procedures Manual

1.2 Project Management Overview

Series 2 Organisation

2.1 Project Control Groups

2.2 Consultant Engagement

2.3 Cost Plans and Reports

Series 3 Investment Evaluation Phase

3.1 Service Planning

3.2 Business Planning

3.3 Planning Briefs

3.4 Master Plan Studies

3.5 Functional Briefs

3.6 Feasibility Studies

3.7 Schematic Design

3.8 Investment Evaluation Reports

3.9 Value Management Studies

Series 4 Documentation Phase

4.1 Design Development

4.2 Contract Documentation

Series 5 Implementation Phase

5.1 Tendering, Evaluation and Acceptance

5.2 Construction Insurance

5.3 Contract Administration

5.4 Commissioning of Facilities

5.5 Decommissioning of Facilities

5.6 Post Occupancy Evaluation

Series 6 Technical Guidelines

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Appendix 3: Glossary of Terms• Accommodation services – these include the

basic ‘hotel’ or accommodation related servicesto be provided to all care recipients who needthem.

• Accreditation – the formal recognition providedto a residential care service by the Aged CareStandards and Accreditation Agency where thatservice is considered to be operating inaccordance with the legislative requirements ofthe Aged Care Act, and providing high qualitycare within a framework of continuousimprovement.

• Accreditation standards – standards againstwhich facilities apply for accreditation. There arefour accreditation standards focusing onmanagement systems, staffing and organisationaldevelopment; health and personal care; residentlifestyle; and physical environment and safesystems.

• Aged Care Act 1997 – the principle legislationthat regulates the residential aged care programfrom 1 October 1997. The Act covers residentialaged care (including former nursing homes andhostels), flexible care (including former MultiPurpose Services (MPS) and nursing homeoptions), and community aged care packages.The Act does not cover ‘Home and CommunityCare’ services, ‘Domiciliary Nursing CareBenefit’ and aged care services that areadministered under State or Territory legislationsuch as ‘Retirement Villages’. The Act supersedesthe National Health Act 1953, which regulatedthe nursing home industry and the Aged orDisabled Persons Care Act 1954 which regulatedthe provision of hostel care, community agedcare packages and capital funding for nursinghomes and hostels for most purposes.

• Aged Care Assessment Team (ACAT) –multidisciplinary team of health professionalsresponsible for determining eligibility for entryto a residential care facility.

• Allied health – the term used to describe healthprofessionals providing a range of therapiesother than medicine and nursing; for example,

physiotherapists, occupational therapists, speechpathologists, social workers, dietitians,psychologists, podiatrists and diversionaltherapists.

• Asbestos audit – an audit carried out by aqualified assessor on existing buildings todetermine if there is any asbestos and identify itas a risk factor.

• AS – Australian Standard – documents preparedby the Australian Standards Association whichthe construction and operation of facilitiesshould comply.

• Capital Funding – financial assistance providedby the Commonwealth to approved providers tobuy land and buildings, build, demolish orupgrade premises and purchase equipment.

• Certification – a specified standard of buildingand care that facilities must meet to enable themto charge accommodation bonds and be eligibleto receive Commonwealth subsidies forconcessional and assisted residents. Facilities thatapply for certification are assessed independentlyof the Department through the application of anationally consistent assessment instrument.

• Classification level – care recipients approved forresidential care or for some kinds of flexible care,are classified according to the level of care theyneed. The classifications may affect the amountsof residential care subsidy or flexible caresubsidy payable to approved providers forproviding care.

• Community visitor – a volunteer who befriends acare recipient who has been identified by thefacility as being at risk of isolation.

• Clinical care – specialised or therapeutic care thatrequires ongoing assessment, planning,intervention and evaluation by health careprofessionals.

• Continence management – the practice ofpromoting and maintaining continence and theassessment, evaluation and action taken tosupport this.

• Continuous improvement – continuous reviewby managers, staff and residents of policies,practices and service outcomes to identify andimplement improvements for better outcomes.

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• Director of Nursing – a registered nurse who hasoverall responsibility for the nursing careprovided in a residential care facility.

• Enrolled nurse – a person who is enrolled by anurses’ registration board in a State or Territory.

• Facility area schedule – a schedule of rooms andtheir floor area to be provided in a development.

• Fire Safety and Risk Assessment – an auditcarried out by a fire engineer to determine thefire safety risks of existing buildings andundertake a risk assessment of existingconditions for the proposed development.

• Functional – a mode of activity that fulfils itspurpose.

• Legionella testing – the testing of equipment andservice supplies to determine the existence oflegionnaire’s disease.

• Gross Floor Area (GFA) – the total floor area of abuilding including individual rooms, circulationand equipment.

• Healthstreams – is a rural funding and servicemodel that aims to consolidate numerousexisting funding programs from a variety of Stategovernment sources into a single more flexiblesystem.

• High care resident – a care recipient who isassigned to classification levels one to four usingthe resident classification scale. The level of carerequired is broadly equivalent to the nursinghome care provided under the previousarrangements.

• Hospitality services – hotel-type services thatsupport basic, everyday living needs.

• Isolated facility – a facility that has beenapproved as being isolated due to it being in aremote location.

• Low care resident – a care recipient who isassigned to classification levels five to eightusing the Resident Classification scale. The levelof care required is broadly equivalent to thehostel level of care provided under the previousarrangements.

• Medical treatment – any action carried out ordelegated by a medical practitioner to addressthe care recipient’s health needs.

• Multi Purpose Services (MPS) – a jointCommonwealth and State Program whichglobally funds the single management ofintegrated rural health services including acuteaged care, primary and community care.

• Nursing and personal care – care which a carerecipient requires for a medically relatedcondition and/or assistance with personal taskssuch as washing and dressing.

• Nursing and personal care staff – staff inresidential care facilities responsible forproviding nursing and personal care to carerecipients.

• OH and S – occupational health and safety.• Outcome standards – the minimum

Commonwealth objectives required in providingaged care residential services.

• Policies – documented statements of intent inrelation to an activity.

• Practices – the actions carried out by staff with aresponsibility for that activity.

• Principle – a statement reflecting the philosophyof a standard and which is supported by theexpected outcomes for the standard.

• Quality system – the organisational structure,responsibilities, procedures, processes andresources for implementing quality management.

• Personal care – assistance provided to carerecipient to perform personal activities such asbathing, toileting and dressing.

• Psychogeriatric – refers to the psychological andpsychiatric problems of some aged persons.

• Qualified nurse – a person who is enrolled orregistered by a nurses’ registration board in aState or Territory.

• Registered nurse – a person who is registered bya nurses’ registration board in a State orTerritory.

• Remote facility – a facility located in a remotearea - this will depend on how the StatisticalLocal Area where the service is located isclassified in the ‘Rural, Remote and MetropolitanAreas Classification’ published by the‘Australian Bureau of Statistics’.

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• Resident – the term generally used to describethe recipients of care in a residential aged carefacility as distinct from the term ‘care recipient’used within the regulatory framework. Aresident has been assessed by an ‘Aged CareAssessment Team’ as requiring residential careand resides in a Commonwealth-fundedresidential facility.

• Residential care – personal and/or nursing carethat is provided to a person in a residential carefacility in which the person is also provided withaccommodation that includes appropriatestaffing, meals, cleaning services, andfurnishings, furniture and equipment, for theprovision of that care and accommodation.

• Residential care facility –a facility consists of anumber of approved places at a specific location.In the Aged Care Act a facility is called a‘service’.

• Residential care standards – standards forresidential care facilities to ensure care recipientsare receiving appropriate care. Residential carefacilities cannot charge accommodation bondsunless they achieve certification. One of therequirements of certification being that the‘Residential Care Standards’ are met.

• Resident classification – process of assigning acare recipient to one of eight care levels based ontheir assessed relative care needs. Relative careneeds are determined according to a ratingagainst 22 questions on the ‘ResidentClassification Scale’.

• Resident classification scale – a nationallyconsistent instrument which assesses a carerecipient’s care needs. This scale has eightclassification levels ranging from low to highcare, with each level having a specified subsidylevel which is paid to the provider for providingthe required care to the care recipient.

• Respite care – care given as an alternate carearrangement with the primary purpose of givingthe carer or a care recipient a short-term breakfrom their usual care arrangement.

• Small facility – a facility with less than 30 places.

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Appendix 4: References andBibliography• Aged Care Services Division 1993, Everyone’s

Future Directions for Aged Care Services in the1990s, Department of Health and CommunityServices, Melbourne.

• Aged Care Division August 1996, Residential Carefor Older Victorians – Redeveloping the Public Sector,Department of Human Services, Melbourne.

• Aged and Community Care Division 1997(revised 1998), Residential Care Manual, 3rdedition, Department of Health and Aged Care,Australia.

• Aranyi, L. and Goldman, L.L. 1980, Design ofLong-term Facilities, Van Nostrand ReinholdCompany Inc, New York.

• Australian Building Codes Board 1999, BuildingCode of Australia 1996 Position Paper, Aged CareFacilities.

• Australian Bureau of Statistics 1990, Disability andHandicap, Commonwealth of Australia CatalogueNo. 4120.0.

• Australian Institute of Health and Welfare 1993,Australia’s Welfare Services and Assistance,Australian Government Publishing Service,Canberra.

• Australian Pharmaceutical Advisory Council1997, Integrated Best Practice Model for MedicationManagement in Residential Aged Care Facilities.

• Australian Standards Association publications(AS).

• Boetticher Raschko, B. 1982, Housing Interiors forthe Disabled Elderly, Van Nostrand ReinholdCompany Inc, New York.

• Brawley, E.C. 1997, Designing for Alzheimer’sDisease: Strategies for Creating Better CareEnvironments, John Wiley and Sons, New York.

• Brenner, P.R. 1997, ‘Issues of Access in a DiverseSociety’, Hospital Journal, 12(2): pp9-16.

• Carter, D.V. and Toon, R. January/February 1999,‘Aged Care – Living or Dying’, Aged Care andHousing Architect, Victoria.

• Clark, R. January/February 1999, ‘Rocks andHard Places – The Architectural Dilemma ofAgeing and Disability’, Aged Care and HousingArchitect, Victoria.

• Code of Practice for Building and ConstructionIndustry, 1994.

• Commonwealth of Australia July 1997,Accreditation Guide for Residential Care Services.

• Commonwealth of Australia, The Aged Care Act1997.

• Corbett, L. January/February 1999, ‘SunshineHospital – New Aged/Mental Health Facilities’,Aged Care and Housing Architect, Victoria.

• Department of Community Services 1989, AHome by Design – Nursing Home Design Principles,Australian Government Publishing Service,Canberra.

• Department of Health and Aged Care April 1999,Aged Care Certification Guidelines, Commonwealthof Australia.

• Department of Health and Aged Care 1998,Documentation and Accountability Manual,Commonwealth of Australia.

• Department of Health and Community Services,1995, Design Guidelines for Residential CareFacilities, Melbourne.

• Department of Planning and DevelopmentNovember 1992, Buildings, Interiors and OutdoorAreas for Home and Community Services – A DesignGuide, Victoria.

• Hiatt, L.G. 1991, Nursing Home Renovation:Designing for Reform, Butterworth Architecture,Boston.

• KLCK Architects January/February 1999, AgedCare, Aged Care and Housing Architect, Victoria.

• Klein, B.R. and Platt, A.J. 1989, Architecture forNew Facilities, Van Nostrand Reinhold CompanyInc, New York.

• Klein, Burton R. and Platt, Albert J. 1989, HealthCare Facility Planning and Construction, VanNostrand Reinhold, New York.

• Kong, A. January/February 1999, ‘Housing withCare’, Aged Care and Housing Architect, Victoria.

• Lydall-Smith, S. and Tenni, C., Facilitating aPsychologically Supportive Environment forResidents, Centre for Applied Gerontology, BECC,Bundoora.

• Mahuhe, Frank H. 1996, Colour, Environment andHuman Response, Van Nostram Reinhold, NewYork.

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• Manning, S. 1998, New Ways of Delivery – Ageingin Place – Can it be Delivered?, Conference Paperfor Hospital and Health Facilities.

• Manning, S. 1998, Riding the Roller Coaster: TheFuture of Nursing Homes in Australia, ConferencePaper for Hospital and Health Facilities.

• Oates, R. April 1997, ‘The Dawn of a New Era inResidential Aged Care’, Australian Health andAged Care Journal.

• Ohno, R. December 1998, A Hypothetical Model ofEnvironmental Perception: Ambient Vision andLayout of Surfaces in the Environment, Presentationat Conference.

• Regnier, V., Hamilton, J. and Yatabe, S. 1995,Assisted Living for the Aged and Frail: Innovations inDesign, Management and Financing, ColumbiaUniversity Press, New York.

• Sixth Symposium on Healthcare Design:Presentations, ‘Long-term Care Design: Researchyou can use in designing for older people’,Journal for Health Care Design, V1.

• So, A.T.P. and Leung, L.M., ‘Indoor LightingDesign Incorporating Human Psychology’.Architectural Science Reviews, Vol 41, pp 113-124.

• The Aged Care Standards Agency July 1998,Accreditation Guide for Residential Aged CareServices, Paramatta NSW.

• Victorian Workcover Authority April 1999,Designing Workplaces for Safer Handling ofPatients/Residents – Guidelines for the Design ofHealth and Aged Care Facilities.

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Web SitesThe Department of Human Services – http://www.dhs.vic.gov.au/hs.html

Department of Health and Aged Care – http://www.health.gov.au

Age Care Act 1997 – www.health.gov.au/acc/legislat/aca1997/acaindex.htm

New Certification Standards Background Paper, Instrument and Guidelines, Position Paper on the BuildingCode of Australia – http://www.health.gov.au/acc/certification/index.htm

National Health and Medical Research Council – http://www.health.gov.au/nhmrc/

The Accreditation Standards Agency – http://accreditation.aus.com

Australian Institute of Health and Family Services – http://www.aihw.gov.au

The Centre for Health Design – http://www.healthdesign.org/links_to_sites.html

Aged Care Residential ServicesGeneric Brief