Designing Housing for People who have Autism 11 th November 2010

Nick Haake NAS Cymru Helen Leigh NAS Cymru Andrew Hole Pentan Partnership

Objectives Develop an understanding of the key success factors when designing housing for people who have autism Explore the experience of developing purpose built accommodation

Christopher Julie and Phil

P.S. Thinking about the old place makes me very emotional- it was horrendous and I do – on a daily basis thank God that we now have a safe environment for Chris. If I live to be a 100 I dont think that I will ever take it for granted.

The Autism Spectrum Extreme ability in some areas Average I.Q. Above average I.Q Mild learning disability Moderate learning disability Severe learning disability

The Triad of Impairments Wing and Gould 1979 SOCIAL BEHAVIOUR Sensory processing problems Anxiety Rituals and compulsions Rituals and compulsions COMMUNICATION IMAGINATION Personality Learning disability

Sensory Sensitivity in any form can make it difficult to concentrate, to trust, at attending to things other than the source of hypersensitivity to join in or to relax. If the discomfort or distraction is extreme enough, they can distract from the abilities to learn. Donna Williams

Sensory Hypersensitivity Distress with Sound Sensitivity to light Discomfort with textures Insecurity with heights Insecurity with Movement / proximity Clutter Temperature issues

Sensory differences Under-sensitive (hypo-sensitive) Over-sensitive (hyper-sensitive) Sensation seekingSensation avoiding These perceptions may vary during the course of a day/week

Reality to an Autistic person is a confusing, interacting mass of events, people, places, sounds and sights. There seems to be no clear boundaries, order or meaning to anything. A large part of my life is spent just trying to work out the pattern behind everything. Set routines, times, particular routes and rituals all help to get order into an unbearable chaotic life.

Key considerations – right from the start Vision and Values Clear brief and person centred Autism Expertise Choose Architect – values and expertise Team work (project management, partnering)

Designing the Right Environment Reduce anxiety Enhance motivation, confidence and self esteem Reduce behaviours which inhibit progress or impair quality of life Enhance concentration/ remove distraction play to strengths/ likes Keep people safe

Planning Features Compulsions and obsessions Known Likes/Dislikes Known Likes/Dislikes Challenging Behaviour & Risks Hypersensitivity Phobias Living Space Living Space

LOW AROUSAL Space – to move around freely Rooms – layout and structure of rooms Clutter Noise Light Durability - solid construction Temperature control

INDEPENDENT LIVING Safe access to kitchens etc. Entrances and exists Security Individual living areas En-suite Individually tailored equipment

CHALLENGING BEHAVIOUR Corridor space Assistive technology Outside space Sight lines Exits and entrances Movement Stairs Fixtures and fittings Materials (walls floorings)

Service Review Themes 2004 Ty Mynydd Ty Nant

TY NANT, RINGLAND CIRCLE, NEWPORT 6no. Self Contained individual design flats with communal accommodation including lounge, dining room, kitchen, quiet rooms, utility room, two staircases and lift. Total Floor Area 750m²and total build cost £993,128. Wide corridors and open circulation areas with curved walls, thus omitting all 90º corners. Accommodation to DDA Standards, fully compliant with current Building Regulation requirements. Building fabric insulation above current building regulation standards from sustainable natural resources. Building plan developed in consultation with Newport City Building Control Department. The gardens are fully landscaped and contain features that are appropriate for the client group. These features include a secure boundary, flower beds and areas to stimulate the clients senses External finishes assist access awareness providing a fully accessible building Fully secure scheme to South Wales Police Secured by Design Standards.

TY NANT, RINGLAND CIRCLE, NEWPORT Self Contained individual design flats with their own lounge/bed area, kitchen with dining area and bath/shower room. Floor area of 51m², which permits flexible usage and high internal space for standards with potential for conversion to Welsh Assembly Government flat units. Bath/Shower room fully concealed pipe work and services with fully tiled walls. Level access shower tray where indicated. Internal colour scheme to NAS recommendations. Colours and tonal contrast with lighting to assist sensory impairment Purpose built robust and durable kitchen units and fitted wardrobes. Robust electrical switches and sockets with secure screw fixing with domestic appearance with low energy domestic light fittings. External and flat entrance door alarm system with sounder in staff accommodation flat. Provision of personal alarms. An internal call system and movement sensors/flood sensors were also included. Typical flat layout

TY NANT, RINGLAND CIRCLE, NEWPORT Extensive provision of natural light with windows triple glazed. Hard wearing floor finishes. Paintwork with satin finish. Integrated fire alarm/emergency lighting installations where fitting appearance matches normal domestic appearance. Substantial levels of sound reduction built into proposals from sustainable natural resources. Energy management under floor heating installations. Efficient boilers heating source with weather compensated controls. Whole building ventilation system. Internal Photograph of Lounge

Internal passages 2.5m wide, curved partitions provide clear sight lines, internal space and clean lines. Staircase with half landing. Thermal and acoustic laminated triple glazed performance windows, which also reduce glare. Glazing to suit special light transmissions and reflectance. Internal sandwiched solar control glazing blinds which also provide privacy. Internal building environment with air comfort cooling installation. Provides continuous background air movement throughout the whole scheme and a coolant effect during high temperature periods. Service areas provided to contain all boiler plant, hot water cylinders anti-scald valves, drainage, service pipework and cut off points. Installation of a Telecare system to aid many challenges facing those living independently. Telecare system aids those especially if they begin to suffer from cognitive, physical, hearing & visual impairments. Enables these challenges to be managed and the risks minimised through use of sensors, detectors and triggers strategically located in the home. TY NANT, RINGLAND CIRCLE, NEWPORT

LONGFORD COURT, NEATH 2 new building dwellings of 5no. Apartments with shared accommodation and communal accommodation including lounge, dining room, kitchen, activity room, utility room and W.C. Floor areas of 420m² and 325m² with a total build cost of £1,356,725. Covered verandah to front and rear of buildings. Accommodation to DDA Standard, fully compliant with current Building Regulation requirements. Heavy duty doors and linings. Building fabric insulation above current Building Regulation standards from sustainable natural resources. Extensive provision of natural light with double glazing with internal blinds. Solar water heating panels. The gardens are fully landscaped and contain features that are appropriate for the client group. These features include a secure boundary, flower beds and areas to stimulate the clients senses External finishes assist access awareness providing a fully accessible building Fully secure scheme to South Wales Police Secured by Design Standards.

LONGFORD COURT, NEATH Flat floor area of 44.6m² and Bedroom floor area of 23m² which permits flexible usage and provides high internal space and volume standards. Bathrooms with fully concealed pipe work and services with fully tiled walls. Internal colour scheme to NAS recommendations, colours and tonal contrast with lighting to assist sensory impairment. Critical surfaces and fixings are designed to stand out and be easily identified. Such as: -Architraves and skirting boards, -cupboard handles and doors, -Matt kitchen surfaces, -Matt tiles around shower and wash hand basin areas, -Colour grab rails. Purpose built robust and durable kitchen units and fitted wardrobes. Robust electrical switches and sockets with domestic appearance with low energy domestic light fittings with circuit control. Internal entrance door alarm system with sounder in staff accommodation flat. Provision of personal alarms. An internal call system and movement sensors/flood sensors also included. Installation of shut off controls to individual flats. Staff accommodation with en-suite shower room facilities. First Floor Plan (Plot 2) Ground Floor Plan (Plot 2)

Thermal and acoustic laminated double glazed performance windows, which also reduce glare. Glazing to suit special light transmissions and reflectance. Internal sandwiched solar control glazing blinds which also provide privacy. Solar hot water systems installation incorporating roof collection panels with combined cylinder storage. Installation in accordance with Best Practice Programme. Integrated fire alarm/emergency lighting installations where fitting appearance matches normal domestic appearance. Substantial levels of sound reduction built into proposals from sustainable natural resource Energy management under floor heating installations. Efficient boilers heating source with weather compensated controls. Internal building environment with continuous background air movement throughout the whole scheme. LONGFORD COURT, NEATH

Service areas provided to receive all boiler plant, hot water cylinders anti-scald valves, drainage, service pipework and cut off points. Installation of a assisted technology to aid many challenges facing those living independently, especially if they begin to suffer from cognitive, physical, hearing & visual impairment. This enables these challenges to be managed and the risks minimised through use of sensors, detectors and triggers strategically located in the home. This photograph shows the pictorial daily planner which offers a structure of the person's day, reducing anxiety and communicates activities and opportunities the person can expect from their day. The activities are all chosen by each individual and photographs of their staff team show who will be supporting the person to undertake the activities. LONGFORD COURT, NEATH

Service Review Themes 2004 CSSIW outlined a Service not fit for purpose Unhomely, overall required updating for building, furniture and equipment Low community presence and participation Lack of domestic hygiene due to component finishes and flooring Lack of activities and access into the community Inadequate security within perimeter areas encountering poor visibility High risk incidences due to challenging behaviour resulting from heightened levels of anxiety Increase in staff injuries a significant factor due to poor layout of homes Poor staff morale low due to inappropriate accommodation and management

Our intervention was: Better environments for people who have autism Culture change – training - Management - Autism - Person centred approach - Staff restructure Assessment and transition Work

2010 Homely environments More space Low arousal settings Active Support interventions Structured opportunities in peoples lives Person Centred Culture

2010 Greater activity levels for individuals Increased communication systems Low levels of anxiety Ritualistic behaviours reduced Lower incidents of challenging behaviour (as you can see)

Challenging behaviour incidents

Quote from CSSIW: I would honestly like to say that it has been a real pleasure working with managers and a provider who really want to make a difference for the people that they support. Some improvements have taken a long time to achieve but I have always felt that you have all been totally motivated to make the changes. I am confident that the service users who you support will continue to receive your absolute best.

SUMMARY An autism centre approach to buildings development A team approach towards an agreed vision A person centred approach

Living and working with people with autistic disorders is not like living or working with anyone else with or without disabilities. Past experiences of social interaction and a desire to help are not sufficient guides. It is essential to understand the nature of autistic conditions. People with these disorders, because of their social impairments cannot meet you half way. You have to make an imaginative leap into their world and try to see things from their point of view. (Wing 1995)