Aged Care Design Principles to help, not hinder, sector

A new era of aged care design is here after the Department of Health and Aged Care released its Final report on the development of the draft National Aged Care Design Principles and Guidelines. 

Set to be officially introduced on July 1, 2024, the Design Principles and Guidelines have been developed in response to Recommendation 45 from the Royal Commission into Aged Care Quality and Safety’s final report, ‘Improving the design of aged care accommodation’.

Four overarching Principles are featured in the document, with an additional 31 Guidelines offering insight into what aged care providers should be looking to incorporate into their residential aged care homes. A series of scenarios, rationales, checklists and outcomes also provide extra context to assist with understanding. The four Principles are:

1. Enable the Person: To support people living in a place that maintains their health, well-being and sense of identity.

“We saw each Principle as a starting point to something that was important. ‘Enable the Person’ is the starting point for the fact that buildings can support orientation, and perception, and limit over-stimulation. It’s about how can we make buildings that help people to function and live a fuller life,” Nick Seemann, Co-lead author, Dementia Training Australia (DTA) Environments Team Lead and Director of Constructive Dialogue Architects explained. 

2. Cultivate a Home: To create a familiar environment in which people have privacy, control and feel they belong.

“‘Cultivate a Home’ is all about how can we reduce the scale (of a building) ideally to small-scale households. There are elements within that which look at smaller groups of people in rooms, smaller scales of space, people having their own bedrooms and bathrooms.”

3. Access the Outdoors: To support people seeing, accessing and spending time outdoors in contact with nature.
4. Connect with Community: To encourage people to connect with family, friends and community, continuing to participate in meaningful activities.

“Getting outdoors and people being disconnected from the community are some of the real challenges in aged care and Principles Three and Four address those issues. Each one says what can we do with buildings to help people enjoy outdoor spaces and how people in aged care homes can maintain connections with the local community on-site.”

A toolkit with solutions, not mandates

Rather than being a mandatory set of instructions for aged care providers and designers, the Principles and Guidelines effectively constitute a toolkit to help providers recognise where improvements can be made in a financially viable way. Mr Seemann said the Guidelines have been designed to align with relevant building and construction codes, and there’s no intention to enforce them.

“The biggest anxiety in the sector is that in the past there was building certification, nobody wants that to be [re]introduced. Nobody wants further regulation. So at this stage, there’s no concept of a mandatory regime for regulating buildings,” Mr Seemann said.

There’s also no need to run through the document and implement each and every suggestion. Instead, Mr Seemann highlighted the fact that each scenario shows you can have a big impact on resident care through small physical changes. 

“Environments need to be central to reform because in many cases the very things which have caused people to move into care, such as challenges due to dementia, are made worse by the environment. Despite their best efforts, staff are working in environments which they’ve received as a legacy so they are often trying to achieve things that are made harder by the buildings,” he explained.

“One of the really important things is to show providers this is what you can do to retrofit or adapt existing spaces to create a more positive environment. The Guidelines are built in a way that supports design principles for new buildings but they are also a good news story about how we can fix problems in existing buildings. It’s not an all-or-nothing approach.”

DTA will launch training programs to support providers in the implementation of Principles and Guidelines in the coming months, and providers are encouraged to contact DTA through [email protected]. 

Meanwhile, aged care stakeholders have until October 20 2023 to provide feedback on the draft Principles and Guidelines.