Sustainable building benefits the bottom line and has synergies with best practice in dementia care, aged care and retirement living organisation HammondCare has found, with operable windows, natural light and timber reflecting what is simple, comforting and familiar for residents.
The organisation cares for around 1100 people in residential aged care facilities across NSW and Victoria, with a further 2600 people assisted across about 20 other locations through community aged care services, in-home palliative care, mental health, dementia support and consultancy, as well as a number of hospital-based rehabilitation services.
It employs approximately 3000 staff including full-time, part-time and casuals, has assets valued at $166 million in FY14 and spent a total of $18 million on capital works in FY14 including new builds and upgrade works. Residential care accounted for 36 per cent of the 2013-14 revenue of $178 million.
Michael Cooney, HammondCare’s facilities and asset manager, says a review of sustainability and energy efficiency was commenced in 2012, when the expected annual electricity bill across all its sites was in the vicinity of $1.9 million. As a not-for-profit, reducing that cost and making its buildings more efficient was a priority.
Solar photovoltaics, LED lighting upgrades and energy management systems were investigated, and an initial step of raising staff awareness about reducing energy use undertaken.
Cooney says the initial goal was a 10 per cent reduction in energy use through changes in staff practices. By 2015, a 20 per cent reduction had been achieved.
Over $1 million was invested in energy efficiency initiatives including solar PV across six sites, totalling over 400kW of generation capacity. Smart Commercial Solar undertook five of these installations, a total of 1280 panels with 320kW.
Cooney says the investment rate of return on energy efficiency initiatives has been almost 19 per cent, with $500,000 in total returns to date. The full ROI will be achieved in 5.5 years.
An analysis of the load profile showed the organisation’s aged care and dementia care facilities have areas of peak demand through the bulk of the day and large parts of the night. Installing energy management systems meant it was possible to pick up on areas of wastage and “pull back on those”, Cooney says.
“We looked at the traditional HVAC program profile, and a lot of the facilities had it operating 24/7 with no timers and no thermostats, and it was switched on in bedrooms when residents were not in room.”
Smart technology was installed including a web-based platform to control all HVAC systems, as well as timers and sensors that interface the HVAC with outdoor air temperatures.
Cooney says this shaved another 10 per cent off power use. It also increased comfort levels for residents.
Opening the windows often a better option
Previously, many residents would be wearing jumpers in summer, as many of the dementia care age group are not used to constant airconditioning in their homes. All the rooms in the facilities have outside air flow from windows and doors, and residents commonly open the windows of bedrooms and doors from dining and living rooms leading to gardens and patios to capture the breeze rather than having the HVAC system on, Cooney says.
Switching to LED
More than a dozen of the organisation’s buildings have been retrofitted with LEDs to replace halogen or fluorescent lighting, predominantly in common areas. Cooney says there was a preliminary stage of research and a trial undertaken in conjunction with a lighting consultant and an electrical consultant to investigate lux levels and how they impacted on residents.
The result of the 12-month retrofit project has been significant savings, good feedback from residents, staff and visitors, and a reduction in maintenance of lighting of at least 50 per cent in the upgraded buildings.
Cooney says the maintenance on the LEDs is non-existent or minimal, and also that the hazardous materials side is reduced, as they do not contain mercury. Halogens or fluoros need special separate storage before being disposed of, according to WorkCover guidelines.
Solar hot water
Other energy initiatives include the installation of gas boosted solar hot water at the last three new facility builds. Cooney says the solar systems both for hot water and those for power have been set out on the buildings in a way that makes them quite obvious to residents and visitors.
He says residents with dementia are able to clearly identify what the panels are and what they are for, and that the feedback from visitors and family members has been very positive.
Saving on water
Water efficiency is another focus. Cooney says there have been numerous recycled water systems installed, and rainwater capture and reuse systems. This is also part of all new-build designs where it is used for toilet flushing and landscape irrigation and at one site also for laundries.
Greener materials that make sense for people
Sustainability is also a feature of the materials selection for new builds, such as the recently opened facility at Miranda. Designs and specifications are informed by the work of the Dementia Centre, a research, training and consulting organisation operated by HammondCare.
“Domestic and familiar” is the approach, Cooney says. This means minimising PVC and other vinyl-type products, and using carpets through all common areas and bedrooms for its acoustic qualities, air quality benefits and comfort appeal. Certified timber is used extensively for doorways, doors, handrails and furnishings.
“Timber has an affiliation for that generation and their homes,” Cooney says.
Individual textures are carved into each door and into panelling, so residents can feel their way down the hallway and find their room if they have low vision.
Cooney says that for outdoor furniture, the organisation specifies it should be made from recycled timber if possible. Plastic chairs simply are not on the agenda.
The entire design principle is to provide a home-like environment, not an institutional one, and this includes acoustics, air quality and reduced official signage.
Home-like with freedom to wander
Facilities are designed as cottages with up to 16 residents that share common areas including a domestic kitchen and laundry residents can use, and outdoor spaces including productive gardens, contemplation areas and room to wander. There are no long corridors, and contrast in paints and finishes is used to draw people’s attention to important areas or items, including in the bathrooms.
Most have herb gardens and some grow vegetables in raised beds if residents are keen on gardening.
No eggs that bounce
Fresh produce, whether grown onsite or purchased offsite, is at the core of how meals are approached. The organisation has abandoned centrally produced institutional food and all meals are now cooked fresh in the kitchens of the cottages by staff. The smell of fresh food draws residents to dining areas, which counteracts the tendency to forget to eat and risk of malnutrition that is one of the common health complications associated with dementia.
Cooney says there are no locked doors or obstacles in the resident areas, and all medical and other facilities such as pan rooms are in a “back of house” area only accessed by staff. The reason, he says, is no one would expect to see a clinical room in their home, so they don’t see them at HammondCare facilities.
“We try to mimic what people have at home.”
This extends to the furnishings, knick-knacks, curtains, blinds, heating and other elements, with items including books and bric-a-brac from the 1930s-1960s placed in common areas. Some of the cottages have a resident cat.
“Good dementia design is about creating a safe environment and a sense of comfort and safety inside and out,” Cooney says.
The organisation currently has a number of facilities under construction at Wahroonga in Sydney, Cardiff near Newcastle, and is scoping a project to develop a new 90-bed dementia-specific home in conjunction with Alfred Health in Melbourne.
Cooney says expansion is on the cards for the next five to 10 years, as there is a growing need for dementia care services, particularly outside the Sydney basin.
“That demand means good providers have an opportunity,” Cooney says.