A guide to help healthcare, mental health and dementia facilities choose floor coverings that are comfortable, inspiring, sustainable and practical 10 | 2024 Key development areas within the healthcare estates and facilities sector INSIGHT In association with
3 INSIGHT | Welcome to INSIGHT, the healthcare design and management special report. The healthcare sector encompasses a range of buildings and spaces, each serving a variety of functions. With this in mind, it’s important that the floor coverings specified stand up to the requirements of the individual space and are designed to best serve the needs of patients, staff and visitors. This can include being able to withstand the day-to-day footfall and traffic; be easy to clean and maintain; comply with the related safety regulations; support net-zero healthcare design; and contribute to the overall design aesthetic, creating a calm and welcoming environment. At Forbo, we understand that choosing floor coverings that tick all of these boxes isn’t a straightforward task. That is why, throughout this issue, we provide you with everything you need to know. INTRODUCTION INSIGHT Editor: Helen Adkins Design: Gemma England Sales: [email protected] Donna Hannaway Head of Marketing UK and Ireland at Forbo Flooring Systems from healthcare design & management magazine (hdm) and mental health and dementia facilities magazine (mhdf) Stable Publishing Limited SBC House, Restmor Way, Wallington SM6 7AH T. 020 8288 1080 www.stable-media.co.uk In association with
There is no one-size-fits-all solution when it comes to flooring for healthcare. There are so many different spaces within hospitals and care homes, all of which will have specific requirements. For example, for hospital treatment spaces, hygiene and ease of cleaning may be the priority, while in corridors it is flooring with excellent durability that is required. There are also areas where a specialist solution may be needed to ensure the safety of patients or staff. Conversely, in care homes, the focus will be on creating a homely, welcoming, but above all, safe environment for residents to live. Entrance flooring We should start at the point where people will enter and exit the building. While often overlooked, entrance flooring has an important role to play in easing cleaning and maintenance schedules, extending the life of other flooring throughout the building and improving occupant safety. In fact, high-quality entrance flooring has been shown to prevent as much as 95% of walked-in moisture and dirt. This significantly reduces the time spent cleaning the flooring inside the building and minimises the risk of slips caused by wet surfaces. Recognising the value and impact an entrance flooring system delivers, Forbo When it comes to flooring for healthcare settings, a one-size-fits-all approach simply won’t suffice. Hospitals and care homes feature a diverse range of spaces, each with its own unique demands. Here are the essential factors to consider in making the right choice How to get the right flooring recently introduced a new 50% extended guarantee for any of its interior flooring products, when installed alongside its Coral or Nuway entrance matting. Corridors Moving through the building, another area that should be considered is the corridors. These are among the highest traffic areas in any hospital or care environment, meaning the flooring must be able to withstand the continual movement of people, beds, wheelchairs and equipment. There are several different floor covering types that may be suitable here, including vinyl flooring, being hardwearing, easy to for healthcare settings 5 INSIGHT | | INSIGHT 4
clean and available in a wide array of colour and patterns. This includes products that replicate the look of natural materials, such as wood and stone. However, linoleum continues to be the most popular choice for these areas. It not only delivers the durability required for the busiest areas of a building but is manufactured from natural materials and has excellent hygiene properties. For example, Marmoleum, Forbo’s own brand of linoleum, is certified climate positive (carbon negative) without offsetting and is made from up to 98% natural raw materials, including linseed oil, jute, pine rosin, wood flour and limestone. Given the countdown to 2050 and the net zero deadline, materials such as linoleum can be invaluable for NHS healthcare design. It is also easy to clean, with the innovative Topshield pro layer, and inherently bacteriostatic, proven to inhibit the growth and spread of infections such as Methicillinresistant Staphylococcus aureus (MRSA), Norovirus and C Difficile. The versatility of linoleum means it can also be used in patient rooms and treatment spaces. Textile comfort This isn’t to say, however, that hard and resilient flooring is always the most suitable specification. There can be spaces where creating a welcoming and comfortable environment is the priority, such as care home residents’ bedrooms or children’s play spaces in paediatric units. In these areas, flocked flooring, such as Forbo’s Flotex collection, can provide the ideal solution, combining the durability of a resilient floor with the warmth and comfort of a carpet. With excellent sound absorbency of up to 20dB, perfect for keeping spaces quiet and creating healing environments, it is also completely waterproof, making it the only truly washable textile floor. Thanks to high-definition digital printing techniques, flocked flooring can be found available in a wide range of colourways and patterns to suit many different design schemes, from bright and energetic to calm and relaxing. For dementia care facilities, there are options available that are accredited by the Dementia Services Development Centre (DSDC) at the University of Stirling. The products rated 1a or 1b have plain and semi-plain designs respectively and are designed to minimise the visual and cognitive issues that bolder, high contrast patterns can cause for those with dementia. Consider looking for flocked flooring that carries the Allergy UK Seal of Approval. Achieved because of the dense fibres that can trap allergens, allowing them to be safely removed during vacuuming, it can help to create a healthier indoor environment. Safety flooring In areas of a building with a higher slip risk, such as for bathrooms, wet rooms and areas where there is an increased risk of spills and splashes, it is necessary to have a specially designed safety flooring. To be classified as safety flooring, rather than slip resistant flooring, it must achieve a Pendulum Test Value (PTV) of 36 or above. For spaces such as wet rooms where people will likely be barefoot, it is necessary to choose a flooring that has been designed and tested to the DIN 51097 standard, which classifies flooring as A, B or C, with C being the highest level of slip resistance. It is also important to note that there is a different pendulum test for barefoot applications, so flooring for these spaces must have a PTV assessed to this standard. Similarly, for employee areas where contamination of the floor surface is likely, such as in commercial laundry areas and kitchens, it is essential to have the right level of slip resistance, as outlined in The Workplace (Health, Safety and Welfare) ‘There are so many different spaces within hospitals and care homes, all of which will have specific requirements' Regulations 1992. Here, a flooring with a PTV of 40 or more and a Ramp Test (R value) of R11 or higher is recommended. Fast fit installation Another important factor to consider for all areas of a healthcare building is how the flooring will be laid. The very nature of healthcare facilities means that they must operate seven days a week, all year round. With this in mind, the installation of new flooring must be carried out as quickly as possible with minimal disruption to patients, residents and their families. Here, adhesivefree flooring solutions can be ideal. By removing the need for adhesives, the flooring can not only be installed quicker but also walked on immediately after installation, as there is no curing time required. This means spaces are out of use for the shortest time possible. It also eliminates the presence of any odours that can be associated with the use of adhesive and makes the flooring easier to reuse or recycle at the end of its life. There are a variety of different adhesivefree installation methods. For example, Forbo’s Fast Flooring range includes products from across its portfolio, from entrance flooring to specialist applications, and offers single-sided and double-sided tape, dovetail connections and an innovative magnetic tabs solution. Selecting the right flooring for healthcare environments is important but with each facility and different areas within each building having specific requirements, a range of complementary products are often required. • To find out more about designing for healthcare environments, download Forbo’s whitepaper here. 7 INSIGHT | | INSIGHT 6
When it comes to interior design for care homes, a balance must always be struck between safety, functionality and comfort. Residents need to be made to feel at home in a comfortable and welcoming environment. However, care home residents may have complex and varied needs due to a range of possible agerelated conditions, making it particularly important to consider the effects of dementia when designing interior spaces and ensure residents can navigate these spaces safely and easily. A recent study by Alzheimer’s Society found that currently around one million people in the UK have a form of dementia, a figure that is projected to rise to 1.4 million by How flooring can help improve dementia care Dementia care presents a range of complex and nuanced needs, making the choice of flooring a critical factor in enhancing patient wellbeing. Here’s how thoughtful flooring selection plays a vital role in creating supportive and therapeutic environments 20401. Across the UK’s nearly 17,000 care homes, it is estimated that there are over 300,000 people living with some form of dementia or severe memory problems2. However, it is important to remember that dementia is an umbrella term that covers several different types, each of which has a different set of symptoms and effects. There are resources available that provide detailed guidance on creating inclusive spaces for neurodiverse people, which includes people with dementia. Among these is the new British Standards Institution (BSI) Publicly Available Specification (PAS): Design for the mind – Neurodiversity and the built environment – Guide, which Forbo contributed to the development of. In fact, we have over 1,000 Dementia Services Development Centre (DSDC) products accredited, online product selector tools and a specialised DSDC brochure to aid in specification decisions. The role of flooring in creating a dementia-inclusive environment As one of the biggest surfaces in any building, the flooring specified can have a significant impact on the experiences of residents. The first factor to consider is the tonal contrast of the flooring to other elements of the interior. A greater contrast should be achieved between critical surfaces, such as floors to walls and doors to walls, to allow those with dementia or visual impairments to see the area three-dimensionally and move more easily through the space. Tonal contrast is determined by the Light Reflectance Value (LRV), which is the measure of the percentage of visible and useable light reflected from a surface when illuminated by a light source. It is recommended that a difference of 30 degrees of LRV is achieved between critical surfaces. When it comes to adjacent areas of flooring, the contrast should be as small as possible. This is because high levels of contrast can create the perception of a change in level that is not there, resulting in trips and falls. LRVs of adjoining flooring should be within eight degrees of each other, although less is better. Similarly, if the transition strips contrast strongly with the flooring it can create a false perception of a ‘As one of the biggest surfaces in any building, the flooring specified can have a significant impact on the experiences of residents’ step, meaning it is important to match these to the tones of both flooring surfaces, with an ideal LRV difference of no more than three degrees. Even a 15mm transitional strip with the wrong tonal contrast can present a trip hazard for an elderly person. The pattern and texture of the flooring should also be considered carefully. For dementia-inclusive environments, it is recommended that flecked, striped and patterned flooring is avoided, as these can create the perception that the floor is not flat or that there are loose materials on the ground. To assist with this, the DSDC at the University of Stirling has developed an accreditation scheme that assesses products in accordance with its dementia design principles. The suitability of a product is classified by a number based on the tonal contrast and pattern. Products classified 1a have a plain aesthetic while 1b has a semiplain design, both of which are suitable for general use within a dementia-inclusive care environment. Floor coverings that are classified as 2 have a patterned surface and should therefore be used more carefully. For example, Forbo’s new Surestep Balance collection of safety vinyl has been designed specially with dementia-friendly environments in mind and features a subtle minimalist design and a matte finish, achieving a DSDC rating of 1b. The design of the spaces within care facilities can make a significant difference to the wellbeing, comfort and safety of those residents living with dementia. In selecting the correct flooring product, a wide range of factors need to be taken into account. The performance of the flooring in terms of slip resistance is just as important as its design, in preventing slips, trips and falls. • 1 https://www.alzheimers.org.uk/about-us/news-and-media/facts-media 2 https://www.carehome.co.uk/advice/care-home-stats-number-of-settings-population-workforce 9 INSIGHT | | INSIGHT 8
Hammersmith Hospital is a major teaching hospital located in Acton, West London. With renowned clinical research facilities and specialised care services, the Trust expanded its oncology service with a £2.9 million investment into a new outpatient department for cancer patients. This involved the complete refurbishment of the former vaccination centre and medical records store. Denise Cloutt, project architect from Ansell and Bailey said: 'We were keen to maximise the amount of natural light coming into the space, helping to brighten the area and have a positive impact on the wellbeing of visitors. We also wanted to use colour and natural imagery to stimulate those within the space and aid with wayfinding. 'To match this, it was important that we incorporated natural imagery, tones and textures, with the use of plants and corresponding colourways for the different areas around the department. The flooring, furniture and other interior finishes needed to reflect the continuation of these pathways.' In looking for this natural product, Denise realised that the Marmoleum collection, Forbo’s natural product range is key to Hammersmith new hospital oncology department. Here, we discover why Forbo’s own brand of linoleum and one of the most sustainable and natural floor coverings on the market, would be ideally suited. The range provided an array of options which work together in terms of Light Reflectance Values and the Dementia Services Development Centre (DSDC) ratings, making it a great fit for healthcare design. Denise continued: 'Marmoleum was perfect for this project as it is an inherently natural product, manufactured from up to 98% natural raw materials and 43% recycled content. It worked well in conjunction with the wider imagery we utilised to bring nature into the space, and we really liked the fact that Marmoleum incorporates ecologically friendly pigments. 'We specified Marmoleum across the build, including in the offices, consultation and exam rooms and all circulation areas. This was in the Rocky Ice, Bluemoon, Leaf, Sage, Blue Heaven, Moonstone, Orbit and Calico colourways from across the Striato, Fresco, Concrete and Splash ranges.' Forbo’s Eternal was also specified on the project, a heterogeneous sheet vinyl floor covering from the Wood collection. Denise commented: 'For the waiting areas and quiet spaces we wanted a vinyl floor covering that could be easily laid, featured natural elements and would stand up to the needs of a busy hospital department. Eternal was perfect for this, with the Elegant Oak colourway bringing a timber look with a Hammersmith Case Study - Oncology warmth feeling into the space. Eternal is also phthalate free, low in emissions, contains at least 60% recycled content in its backing and is easy to clean, beneficial for these busy corridor areas.' Completed in June 2024, the department is already helping to free up capacity in neighbouring departments and has been well received by staff for its fresh design scheme. • Find out more about Forbo’s offering for the healthcare sector, here. 11 INSIGHT | | INSIGHT 10
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