Nursing Homes - Cost model, September 1995 | Features

Nursing, residential and long-stay hospital care of elderly, chronically ill and physically disabled people, places by sector, UK 1970-1994
Residential* home places				Nursing** home places		Long-stay geriatric places	Long-stay psycho-geriatric places	Long-stay young disabled person places	Total places
Local Authority		Private	Voluntary	Private	Voluntary	NHS	NHS	NHS
1987	135,500	114,600	42,200	52,000	8,300	43,000
1988	133,500	127,900	43,000	68,700	9,600	51,400†	29,300	2,500	465,800
1989	129,800	143,200	39,900	88,600	10,400	49,500‡	28,200	2,500	492,100
1990	125,600	155,600	40,000	112,600	10,500	47,200‡	27,000	2,500	521,000
1991	117,400	161,200	41,900	135,200	12,100	44,400‡	24,500	2,400	539,100
1992	105,200	162,400	46,900	152,800	13,700	40,200‡	23,500	2,300	547,000
1993	95,000	165,400	51,000	168,200	15,000	37,800‡	22,300	2,200	556,900
1994	86,400	167,500	50,700	178,800	16,000	34,700‡	20,100	2,100	556,300
Source: Care of Elderly People. Market survey 1995. Eighth edition. Laing & Buisson
*Includes residential places in dual registration homes.
** Includes nursing places in dual registration homes.
† The increase in 1988 is caused by reclassification of hospital types when Komer aggregates were introduced.
‡ NHS long stay geriatric beds estimated since 1988 on the assumption that acute/rehabilitation geriatric beds in England have remained constant and all the decline in beds in the speciality of geriatrics overall is attributable to loss of long stay beds.

Typical minimum design provisions for a nursing home
Bedrooms:
Single	10-11.2 m2, one patient per rooms, doors must be lockable
Double	8-9m2 per person is the current standard, no more than 30% of patients should be accommodated in shared rooms
Ceiling height	2.3 m minimum
Layout	Preferably in grouped suites of 10-12 rooms each with their own day rooms/ living and nursing facilities
Corridor widths	Minimum width 1.5 m between handrails at convenient heights
Day space	2.3 m2 per bed, plus dining space. At least two day rooms are required for homes with more than 30 beds
Washing	A minimum of one washbasin in each patient's room with elbow-action taps
Bathrooms	Minimum 8.5 m2, based on one bath for every eight patients and including provision for grab-rail, etc
Toilets	Minimum 4 m2, one for every six patients if combined with a bathroom, one for every eight elsewhere and including grab-rail provision, etc
Sluice rooms	Minimum 3.7 m2, at least one for each floor, preferably one per unit
Water services	Cold water should be kept and distributed at below 20°C. Hot water should be stored at 60°C. Mixer valves should ensure baths run at a fixed temperature of 43°C
Heating (general recommended levels)
Bathrooms, toilets and undressing rooms, etc	21°C
Bedrooms, day rooms, etc	18°C
Corridors, staircases, etc	16°C
	All radiators should be below surface temperature radiators in line with Department of Health guidelines
Ventilation	Natural ventilation is preferred throughout to maintain a fresh atmosphere, but any internal services rooms, toilets, kitchens, sluice and drug rooms will require mechanical ventilation
Lighting	Natural light is preferred. Window areas should be equal to a minimum of 10% of the floor area. A light fitting should be placed over each bedhead, as well as centrally at ceiling level, and both should be controlled by dimmer switches
Nurse call	Nurse-call facilities should be available by each bed and in bathrooms, toilets
Telephone/TV	A telephone point and TV aerial system should be available in all rooms, and points should be similar to hotel standards

Net to gross areas for the model nursing home
Bedroom wings			Administration / hotel services
	m2	%		m2	%
EFD bedrooms x 24	270	15.52	Reception	70	4.02
En-suite WC x 24	44	2.53	Concourse	85	4.89
Dementia bedroom x 24	266	15.29	Staff rooms, toilets, etc	54	3.1
Assisted baths/sluices, etc	118	6.78	Administration areas	40	2.3
Kitchen (local)	22	1.26	Kitchen (central)	30	1.73
Drugs	9	0.52	Laundry	27	1.55
Circulation areas	260	14.94	Circulation areas	70	4.02
Living areas	225	12.93	Conference areas	32	1.84
Stores, plant rooms, etc	11	0.63	Stores, plant rooms, etc	40	2.3
Internal walls	45	2.59	Internal walls	22	1.26
TOTAL (1740 m2 - 100%)	1270	72.99		470	27.01

Costs and the cost model
	Element cost (£)	Cost /m2 gfa (£)	% of total cost
Substructure	76 000	43.68	6.15
125 mm reinforced concrete power-floated slab on damp-proof membrane, sand and 150 mm hardcore		1740 m2 @	£25
450 x 700 mm concrete foundations to external walls with brick/block up to dpc level		450 m @	£65
300 x 700 mm concrete foundations to internal loadbearing walls with block up to dpc level		100 m @	£32.50
Frame	-	-	-
Timber frame structure included within other elements
Roof	182 340	104.79	14.75
Redland Richmond concrete tiles on battens, sarking felt and timber roof trusses @ 600 mm spacings		-	-
100 mm mineral wool insulation between ceiling joists (2100 m2 plan area; 2470 m2 slope tile area)		2100 m2 @	£70
Eaves detail comprising 22 x 144 mm softwood facia, 38 x 75 mm softwood framing, 25 x 100 mm softwood tongue-and groove softwood boarding to soffit 450 mm wide and 100 x 88 mm aluminium gutter with downpipes		444 m @	£60
Gablette ends comprising 50 x 50 mm and 75 x 50 mm softwood framing, 44 x 69 mm and 94 x 69 mm softwood surround, 9.5 mm plywood sheathing and 25 x 100 mm softwood tongue-and-groove diagonal softwood boarding including lead flashings		30 m2 @	£170
Velux roof windows; mainly electronic opening		8 m2 @	£450
External walls	77 660	44.63	6.29
Timber frame and brick clad (facings Freshfield First Quality multi-facints, provisional cost £195 per 1000, with bands and sills of Redland Haunchwood blue engineering bricks, all in colourd mortar) as composite cavity wall with inner skin of 38 x 89 mm softwood framing with breather membrane facing cavity, 9.5 mm plywood sheathing, 90 mm mineral wool insulation betwen studs, 500 gauge polythene vapour check and 12.7 mm Gyproc moisture-resistant wall board to inner face with one coat of Drywall Topcoat		680 m2 @	£92.50
Timber framing and composite beams over window heads with 9.5 mm plywood sheathing, 500 gauge polythene vapour check and 12.7 mm Gyproc moisture-resistant wall board to inner face with one coat of Dywall Topcoat		130 m2 @	£65
Bay window detial 450 mm deep comprising 50 x 100 mm and 38 x 75 mm softwood framing, 50 x 50 mm noggings, 25 x 125 TG&V jointed softwood boarding and insulation, etc. Rate per m2 based on window face excluding window returns		34 m2 @	£125
Special brick oranmental chimney to concourse area		-	£2,060
External windows and doors	52 250	30	34.23
Wrought softwood windows with double-glazed units and 25 x 130 mm softwood sills		214 m2 @	£175
Pair of softwood fully glazed entrance doors in softwood frame including ironmongery and elctro-magnetic closers		1 @	£1,200
Softwood half-glazed doors in softwood frame inlcuding ironmongery and electro-magnetic closers		Single 16 @	£600
		Pair 3 @	£800
Pair of softwood horizontal ouvred doors in softwood frame including ironmongery		2 @	£800
Internal walls	58 760	33.77	4.76
Timber-frame parition of 38 x 89 mm softwood framing covered on both sides with one layer of 12.7 mm Gyproc wall board and one coat of Drywall Topcoat		1540 m2 @	£37
Half-hour fire-resistant timber-frame partition of 38 x 89 mm softwood framing covered on both sides wiht one layer of 12.7 mm Gyproc fireline and one coat of Drywall Topcoat		10 m2 @	£40
33 x 115 mm softwood framing to fully glazed borrowed lights/screens		4 m2 @	£300
100 mm Lignacite 7 N/m2 block as masonry connection walls to drug stores		10 m2 @	£18
Internal doors	53 450	30.72	4.33
35 mm veneered flush single doors in softwood frame including ironmongery		20 @	£200
44 mm veneered 30/30 fireshield single door with in softwood frames including ironmongery		100 @	£280
44 mm veneered 30/30 fireshield doors with vision panels in softwood frames including ironmongery		Single 10 @	£350
		Pair 4 @	£600
Pair of softwood fully glazed lobby doors in softwood frame inlcuding inronmongery		1 @	£1,450
Polyester powder-coated galvanised steel server shutter		3 m2 @	£520
Timber self-coiling rolling grille with 25 mm oak laths		19 m2 @	£510
Beta Naco aluminium louvre with 6 mm glass louvres		4 m2 @	£300
Insulated trap doors complete with frames		15 @	£110
Wall finishes	13 000	7.47	1.05
Plasterboard to walls included with associated structural elements 12.7 mm Gyproc wallbaord dry lining fixed to blockwork on dabs including one coat of Drywall Topcoat		40 m2 @	£10
105 x 105 x 5 mm coloured glazed wall tiles		360 m2 @	£35
Ceiling finishes	11 220	6.45	0.91
One layer of 12.7 mm Gyproc plasterboard and one coat of Drywall Topcoat		1650 m2 @	£6.80
Floor finishes	42 000	24.14	3.4
No screed as floor power-floated		-	-
Baraflor carpets to bedrooms, circulation areas, etc		1087 m2 @	£20
Polyflor XL vinyl sheeting to stores, laundry and sewing areas, etc		74 m2 @	£16
2 mm Polysafe slip-resistant vinyl sheeting to wet areas		206 m2 @	£21
Polytread acoustic vinyl sheeting bedrooms		293 m2 @	£18.50
Gradus S1100 mm high vinyl skirtings		763 m @	£5.50
Matwell and matting to entrance lobby		5 m2 @	£400
Sundries		-	£3,132
Decorations	33 200	19.08	2.69
External		-	£3,200
Internal		-	£30 000
Furniture and fittings	38 200	21.95	3.09
Kitchen fittings (30 m2 of kitchen area)		-	£7,000
Laminated worktops		7 m2 @	£300
Lamiated vanity units 800 x 600 mm on legs		30 @	£275
45 mm diameter softwood mopstick corridor handrails on core rails and brackets		113 m @	£16
44 x 19 mm softwood corner protection fillets screwed and pellated		114 m @	£4.75
Grab towel rails, etc for en-suite WCs		20 @	£105
Assisted bathrooms		12 @	£325
Mirrors		20 @	£22.50
Signs		-	£1,800
WC cubicles, pinboards, other sundries etc		-	£10 250
Sanitary appliances	30 000	17.24	2.43
79 wash-hand basins, 36 WCs, 11 steel sinks, 4 cleaners' sinks, 3 assisted baths and 6 showers		-	£16 500
Special Parker baths		3 @	£4,500
Services equipment	60 000	34.48	4.86
Kitchen equipment (30 m2 of kitchen area)		-	£27 000
Laundry equipment (20 m2 of laundry area)		-	£15 000
Sluice equipment (18 m2 in 4 rooms)		-	£18 000
Disposal installations	6 960	4	0.56
Soil and vent pipework in grey PVCu waste pipework in white ABS		1740 m2 @	£4
Water installations	69 600	40	5.63
Hot and cold water installtion in copper with cold water storage tanks		1740 m2 @	£40
Space heating and air treatment	115 350	66.3	9.34
Radiator low surface temperature hot water heating to reception, circulation, bedrooms, etc and heat source		1740 m2 @	£52.50
Ventilation systems to specific rooms		200 m2 @	£120
Gas installations	4 500	2.59	0.36
Internal gas supplies		-	£4,500
Electrical installations	93 200	53.56	7.54
Main switchgear and distribution (standby generator provision only)		1740 m2 @	£7
Small power installation		1740 m2 @	£10
Lighting and emergency lighting installation including dimmer switches and bedhead and other light fittings		1740 m2 @	£36.15
Computer trunking/ducting installation		-	£720
Protective installations	9 000	5.17	0.73
Lightining protection		-	£9,000
Communications installations	44 190	25.39	3.58
Fire alarm smoke detector system with 22 fire alarm call points		1740 m2 @	£13
Telephone system of 62 telephone points		1740 m2 @	£3.50
Nurse-call system with two pagers, 22 door alarms and 70 call units		1740 m2 @	£6.90
Television aerial system		1740 m2 @	£2
Builders' work in connection with services	8 520	4.9	0.69
Associated holes, sleeves, plant bases		-	£8,520
Sub-total	1 079 400	620.34	87.37
Preliminaries
Contractor's management and staff, site accommodation and other prelminary items, say 9%	97 000	55.75	7.85
Design fees, say 5%	59 000	33.91	4.78
BUILDING TOTAL	1 235 400	710	100
External works	174 000	100	14.09
General sight clearance, excavation, levelling, removal, etc		-	£26 000
Tarmacadam road surfacing on hardcore including kerbs, etc		936 m2 @	£20
Tarmacadam surfacing to timber-edged winding paths		100 m2 @	£21
Precast concrete paving on lean concrete mix		328 m2 @	£20
Grassed areas		2017 m2 @	£4.70
1.2 m polyester-coated galvanised metal roll-top fencing and gates		72 m @	£70
Planted areas		207 m2 @	£4.70
Concrete edgings as mowing margins		389 m @	£3.65
Building drainage		1740 m2 @	£30
Surface water drainage		3840 m2 @	£25
External services runs, connections and building work in connection with external works		-	£25 000
Construction cost	1 409 400	810	114.09
Client's furnishing cost	235 600	135.4	16.71
Furniture, etc		-	£130 000
Soft furnishings		-	£52 000
Medical equipment		-	£30 000
Linen		-	£6,500
Additional kitchen equipment		-	£30 000
Utensils		-	£6,600
Office equipment		-	£5,000

Client's furnishing cost	1 645 000	945.4	133.16
(Excluding external consulants, planning and building fees etc)

Regional Factors
All the costs are based on a scheme in the South-east. Data should therefore be adjusted by the following location factors for schemes in other regions
Region	Factors
Inner London	1.07-1.08
Outer London	1.01
East Anglia	0.95
East Midlands	0.92
Northern	0.94
Northern Ireland	0.8
North-west	0.93
Scotland	1.01
South-east	1
South-west	0.92
Wales	0.93
West Midlands	0.92
Yorkshire and Humberside	0.93