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Garden areas

 

The reasons we looked at garden areas were two-fold. First, Commission visitors often hear from people that they find it difficult to spend time off the ward and to get some fresh air, peace and quiet. This is particularly important if someone is detained in hospital and cannot leave the ward when they want to or if they need help from others to get around.Second, garden areas have the potential to be flexible and creative environments which can be used therapeutically to promote the health and wellbeing of individuals. Having access to and using safe and secure outside space has been shown to have beneficial effects on levels of agitation and distress and provides an often welcome opportunity for a break from the ward environment.We believe that spending time outside is essential for maintaining good mental and physical health and that access to outdoor space is therapeutic for individuals and an essential component of an assessment ward environment.

What we would expect to find

The Commission visitors looked to see if there was an easily accessible and safe garden area that was attractive, well maintained and also if there was evidence that the garden was being used in a meaningful way to support rehabilitation and recovery.

What we found

Of the sixty-three wards we visited, nearly one third did not have an attractive and well maintained, easily accessible and safe garden area for people to use.Some of the wards we visited were on upper floors which meant that often patients would need the assistance of a visitor or a member of staff to be able to reach the garden.In other areas the garden was not easily accessible from the ward because it was difficult to get to or out of sight.For example, after visiting one hospital our visitor commented:

The garden area available to people in the ward consists of some wooden benches and shrubbery adjacent to the hospital entrance. It is used by all patients in the hospital and the ground which at first looked like bark and gravel was actually a sea of cigarette butts. It is entirely unsuitable for older people.

On one occasion when there was a safe and attractive garden area the door to this was locked.

One of our visitors commented:

Exceptionally nice and well laid out garden area but door to it was locked, no-one was using it today despite it being very sunny.

One ward we visited had direct access to a large garden area but this was not well maintained and most of it was gravel which is difficult to move across and dangerous for anyone with mobility problems.

Our visitor to Ailsa hospital commented;

Both wards had access to delightful safe gardens and staff try to get anyone who wants to outside in the garden every day.

One gentleman told a visitor that there was nothing he loved more than going outside to "get some fresh air and do a bit of gardening'.  He is physically fit and wanted to go out "and potter" even if it was raining.He felt any member of staff could have facilitated this for him. In practice, it rarely happened.

We found that when there was a good garden area there was evidence that it was being used regularly.

Action needed

  • Hospitals should ensure that there is an easily accessible, safe and secure garden area that provides multi-sensory stimulation.
  • Wards for older people should be at ground level.
  • There should be an inclusive, partnership approach with individuals and carers, voluntary organisations and healthcare professionals to enable individuals to use outdoor environments creatively and flexibly.